Cardiovascular Fitness in Normal Weight and Obese Children and Adolescents - A Systematic Review of Studies Published After 2000s / Condición Cardiovascular en Niños y Adolescentes con Peso Normal y Obesos: Una Revisión Sistemática de Estudios Publicados Después de la Década del 2000

SUMMARY: The primary aim was to gather available data published after the 2000s, on cardiovascular fitness in normal weight and obese children and adolescents. Based on the data, the secondary aims were to identify the most used outcomes and to determine the differences in cardiovascular fitness in the mentioned populations. Following PRISMA recommendations, multiple databases were searched: Google Scholar, PubMed, Cochrane Library, ProQuest, and Research Gate, with additional inclusion criteria: original study published in English, normal weight and obese children and adolescents as participant sample, studies that have assessed cardiovascular fitness parameters, and studies with participant's nutrition state. A total of 19 studies, with a total of 4,988 included participants (both obese and normal weight) were identified, with the most common participants have presented better results in terms of BMI, BF%, VO2max, VO2peak and METs, while the HR values are inconsistently presented. Despite deficiencies the study deficiency in the last two decades, there are differences in the mentioned populations. Further studies should focus on including the technology that reaches teens and families for overweight and obesity prevention and advancements in standard measurements for juvenile overweight and obesity, as well as for the creation, adaption, and validation of measuring instruments. As good framework for future directions, there is a need for more concise and unified measurements of cardiovascular fitness parameters in normally weight and obese children and adolescents.

El objetivo principal fue recopilar datos disponibles publicados después de la década del 2000 sobre la condición cardiovascular en niños y adolescentes con peso normal y obesos. En base a estos datos, los objetivos secundarios fueron identificar los resultados más utilizados y determinar las diferencias en la condición cardiovascular en las poblaciones mencionadas. Siguiendo las recomendaciones de PRISMA, se realizaron búsquedas en múltiples bases de datos: Google Scholar, PubMed, Cochrane Library, ProQuest y Research Gate, con criterios de inclusión adicionales: estudio original publicado en inglés, niños y adolescentes con peso normal y obesidad como muestra participante, estudios que hayan evaluado enfermedades cardiovasculares, parámetros de condición física y estudios con el estado nutricional de los participantes. Se identificaron un total de 19 estudios, con un total de 4.988 participantes incluidos (tanto obesos como con peso normal), siendo las variables más comunes: IMC, %BF, VO2máx, VO2pico, FC, PAD, PAS y MET. Generalmente, los participantes con peso normal han presentado mejores resultados en términos de IMC, %BF, VO2máx, VO2peak y MET, mientras que los valores de FC se presentan de manera inconsistente. Independientemente de la deficiencia de estudios en las últimas dos décadas, existen diferencias en las poblaciones mencionadas. Estudios futuros deberían centrarse en incluir tecnología que llegue a adolescentes y familias para la prevención del sobrepeso y la obesidad y avances en las mediciones estándar del sobrepeso y la obesidad juvenil, así como para la creación, adaptación y validación de instrumentos de medición. Como buen marco para direcciones futuras, se necesitan mediciones más concisas y unificadas de los parámetros de la condición cardiovascular en niños y adolescentes con peso normal y obesos.

Papel del Delta de PCO2 en la evaluación pronóstica de morbimortalidad en una cohorte de pacientes de un hospital latinoamericano / Role of PCO2 Delta in the Prognostic Evaluation of Morbidity and Mortality in a Cohort of Patients from a Latin American Hospital

Introducción. El shock séptico es la manifestación más grave de sepsis con tasas de letalidad que pueden llegar hasta el 80%. En los últimos años, ha cobrado relevancia la diferencia arteriovenosa de dióxido de carbono, por su implicación teórica en el metabolismo anaerobio y su significado respecto del normal funcionamiento celular. Por lo antes mencionado, creemos necesario realizar un estudio que nos permita establecer la utilidad de la diferencia arteriovenosa de dióxido de carbono en el paciente con shock séptico de la unidad de cuidados intensivos, como medida indirecta de la perfusión tisular y de la utilización de oxígeno por los tejidos, que nos permita establecer un diagnóstico precoz y el pronóstico de los pacientes críticamente enfermos. Métodos. Estudio observacional, descriptivo y transversal. Muestra de veintiocho pacientes adultos. Resultados. Como se ha registrado en otras series, la mayor parte de los pacientes afectados por shock séptico, en nuestro estudio, fueron hombres mayores de 65 años, con al menos una comorbilidad, siendo el principal sitio de infección el respiratorio (67,9%), asociado a una alta tasa de mortalidad (67%). Conclusiones. Los pacientes con diferencia arteriovenosa de PCO2 mayor a 6 mmHg tienen un riesgo aumentado de muerte de 3,2 veces. (AU)

Introduction. Septic shock is the most serious manifestation of sepsis with mortality rates that can reach up to 80%. In recent years, the arteriovenous carbon dioxide difference has gained relevance, due to its theoretical implication in anaerobic metabolism and its significance with respect to normal cell function. Due to the aforementioned, we believe it is necessary to carry out a study that allows us to establish the usefulness of the arteriovenous carbon dioxide difference in the patient with septic shock in the intensive care unit as an indirect measure of tissue perfusion and utilization. of oxygen through the tissues, which allows us to establish an early diagnosis and prognosis of critically ill patients. Methods. Observational, descriptive and cross-sectional study. Sample of 28 adult patients. Results. As has been reported in other series, most of the patients affected by septic shock in our study were men over 65 years of age, with at least one comorbidity, the main site of infection being respiratory (67.9%), associated with a high mortality rate (67%) Conclusions. Patients with an arteriovenous PCO2 difference greater than 6 mmHg have a 3.2-fold increased risk of death. (AU)

Diferencia en la expresión del ligando de receptor activador para el factor nuclear K B, en tejido tumoral frente a la infección por diferentes patógenos periodontales / Difference in receptor activator of nuclear factor K B expression in tumoral tissue by different periodontal pathogens

La enfermedad periodontal es una de las principales causas de pérdida dentaria. Clínicamente, esta patología, mediada por la desregulación del sistema inmune producto de una disbiosis ocurrida en el surco gingival, inicia con la inflamación de la encía y evoluciona con el daño irreversible de los tejidos que rodean el diente. El hueso alveolar es uno de los tejidos afectados esta patología, esto debido a la activación de osteoclastos por la sobreexpresión de la proteína RANKL en el huésped. El propósito de este trabajo es determinar el nivel de sobreexpresión de RANKL, en un modelo de células tumorales U2OS, frente a la infección con Porphyromonas gingivalis y Prevotella intermedia. Para identificar el nivel de RANKL, se definieron cuatro grupos: Un grupo control, no tratado; Grupo PG, tratado con P. gingivalis; Grupo PI, tratado con P. Intermedia; y un grupo PG+PI, tratado con ambas bacterias. El nivel relativo de la proteína RANKL fue determinado en el sobrenadante y en los extractos celulares de manera independiente, mediante la técnica Western blot. En sobrenadantes, el grupo PG mostró mayores niveles de RANKL comparados con PI (p < 0,05). En extractos celulares los niveles fueron mayores en el grupo PG+PI (p < 0,05). El grupo PI mostró los niveles más bajos de RANKL. La infección polimicrobiana resulta en una mayor expresión de RANKL en células tumorales U2OS, mientras que frente a la infección P. gingivalis, se observó mayor cantidad de RANKL soluble.

SUMMARY: Periodontal disease is one of the main causes of tooth loss. Clinically, this pathology, mediated by the deregulation of the immune system due to a dysbiosis occurred in the gingival sulcus, begins with the inflammation of the gum and evolves with the irreversible damage of the tissues that surround the tooth. Alveolar bone is one of the most affected tissues by this disease, due to the activation of osteoclasts by the upregulation of RANKL in the host. The aim of this study is to determine the increase of RANKL, in a U2OS tumor cells model, inoculated with Porphyromonas gingivalis and Prevotella intermedia. To identify the level of RANKL, four groups were defined: A control group, not treated; PG group, treated with P.gingivalis; PI group, treated with P. intermedia; and a PG+PI group, treated with both bacteria. The relative level of RANKL was determined in the supernatant and cell extracts independently, using the Western blot technique. In supernatants, the PG group showed higher RANKL levels compared to PI (p < 0.05). In cell extracts the levels were higher in the PG+PI group (p < 0.05.). The PI group showed the lowest levels of RANKL.Polymicrobial infection results in a greater expression of of soluble RANKL was observed.

A resistência do fluxo inspiratório modifica a intensidade de uma sessão de pilates? / Does inspiratory flow resistance modify the intensity of a pilates session?

INTRODUÇÃO: As evidências sobre a melhora da capacidade funcional utilizando o Método Pilates não são contundentes. Uma possibilidade de melhorar o efeito de uma sessão de Pilates sobre a capacidade cardiorrespiratória de seus praticantes é utilizar a resistência de fluxo inspiratório (RFI) de forma concomitante. Esse efeito pode ser visualizado através da determinação do limiar glicêmico (LG), técnica utilizada como marcador de intensidade do exercício. OBJETIVO: Testar a hipótese de que a utilização de RFI em uma sessão de pilates antecipa o LG. MÉTODOS: Estudo crossover de corte transversal. Foram avaliados 26 indivíduos de ambos os sexos, sendo 10 do sexo masculino, sadios e com idade entre 20 e 40 anos. Os voluntários foram randomizados para dois protocolos: Protocolo RFI ­ 11 movimentos do Método Pilates com RFI utilizando 20% da pressão inspiratória máxima; e Protocolo sem RFI (SRFI) ­ 11 movimentos do Método Pilates sem RFI. Os dois protocolos foram realizados no mesmo dia, sendo um pela manhã e outro à tarde, conforme randomização feita por sorteio aleatório simples. No repouso e ao final de cada movimento coletas de sangue capilar foram realizadas para dosagem da glicemia e construção da curva glicêmica. O LG foi determinado no menor ponto da curva. RESULTADOS: O LG foi antecipado no protocolo que utilizou RFI, ou seja, no protocolo com RFI o LG foi visualizado no sexto exercício, enquanto no protocolo SRFI o LG foi visualizado no nono exercício (p<0,05). CONCLUSÃO: A RFI antecipou o LG, o que sugere que a RFI aumenta a intensidade de uma sessão de pilates. Isso aventa a hipótese de que a RFI pode proporcionar a médio e longo prazo benefícios adicionais aos praticantes do Método Pilates.

INTRODUCTION: The evidence on the improvement of functional capacity using the Pilates Method is not conclusive. One possibility to improve the effect of a Pilates session on the cardiorespiratory capacity of its practitioners is to use the inspiratory flow resistance (IFR) concomitantly. This effect can be visualized by determining the glycemic threshold (GT), a technique used as an exercise intensity marker. OBJECTIVE: To test the hypothesis that the use of IFR in a Pilates session anticipates GT. METHODS: Cross-sectional crossover study. A total of 26 individuals of both genders were evaluated, 10 of whom were male, healthy, and aged between 20 and 40 years. The volunteers were randomized to two protocols: Protocol IFR - Eleven movements of the Pilates method with IFR using 20% of the maximum inspiratory pressure, and Protocol no IFR (NIFR) - Eleven movements of the Pilates method without IFR. The two protocols were performed on the same day, one in the morning and the other in the afternoon, according to randomization by simple random draw. At rest and at the end of each movement, capillary blood collections were performed to measure blood glucose and construct the glycemic curve. GT was determined at the smallest point on the curve. RESULTS: The GT was anticipated in the protocol that used IFR; that is, in the protocol with IFR, the GT was visualized in the sixth exercise, while in the NIFR protocol, the GT was visualized in the ninth exercise (p<0.05). CONCLUSION: IFR anticipated GT, which suggests that IFR increases the intensity of a Pilates session. This suggests the hypothesis that IFR can provide additional medium and long-term benefits to Pilates method practitioners.

Modelling anaerobic peak power assessed by the force-velocity test among late adolescents

SUMMARY OBJECTIVES: The aim of this study was to examine the concurrent contributions of body size, estimates of whole-body composition, and appendicular volume in addition to participation in competitive basketball to explain inter-individual variance in anaerobic peak power output during late adolescence. The study also tested non-participation versus participation in basketball as an independent predictor of peak power output. METHODS: The sample of this cross-sectional study was composed of 63 male participants (basketball: n=32, 17.0±0.9 years; school: n=31, 17.4±1.0 years). Anthropometry included stature, body mass, circumferences, lengths, and skinfolds. Fat-free mass was estimated from skinfolds and lower limbs volume predicted from circumferences and lengths. Participants completed the force-velocity test using a cycle ergometer to determine peak power output. RESULTS: For the total sample, optimal peak power was correlated to body size (body mass: r=0.634; fat-free mass: r=0.719, lower limbs volume: r=0.577). The best model was given by fat-free mass and explained 51% of the inter-individual variance in force-velocity test. The preceding was independent of participating in sports (i.e., the dummy variable basketball vs. school did not add significant explained variance). CONCLUSION: Adolescent basketball players were taller and heavier than school boys. The groups also differed in fat-free mass (school: 53.8±4.8 kg; basketball: 60.4±6.7 kg), which was the most prominent predictor of inter-individual variance in peak power output. Briefly, compared to school boys, participation in basketball was not associated with optimal differential braking force. Higher values in peak power output for basketball players were explained by a larger amount of fat-free mass.

Empiema pleural por Parvimonas micra en un paciente inmunocompetente: reporte de un caso / Pleural empyema by Parvimonas micra in an immunocompetent patient: a case report

Se presenta el caso de un paciente joven inmunocompetente, con antecedente de tuberculosis pulmonar, que acude al hospital por un cuadro clínico subagudo de fiebre persistente, baja de peso, disnea y abolición del murmullo vesicular. La tomografía de tórax mostró un extenso empiema en hemitórax izquierdo. Se le toman muestras para detección de gérmenes comunes y se le colocan un tubo de drenaje torácico y se inicia antibioticoterapia. La prueba de MALDI-TOF MS identificó a Parvimonas micra, una bacteria anaerobia, comensal de la flora oral, asociado a periodontitis severa, escasamente reportado en empiema pleural, especialmente, en personas inmunocompetentes. En la evaluación odontológica se realizó el diagnóstico de gingivitis y pericoronaritis de la tercera molar. El paciente evolucionó favorablemente. Se sugiere que, en casos de empiemas pleurales subagudos o crónicos, se debe considerar, además de las micobacterias, como agente etiológico al Parvimonas micra, y optar por exámenes como MALDI-TOF MS o secuenciamiento del 16S rRNA, colocación de tubo de tórax, cobertura antibiótica empírica y evaluación odontológica.

We present the case of a young immunocompetent patient, with a history of pulmonary tuberculosis, who attended the hospital with a subacute clinical picture of persistent fever, weight loss, dyspnea and abolition of vesicular murmur. Chest CT scan showed an extensive empyema in the left hemithorax. Samples were taken for detection of common germs. Then, a chest drainage tube was placed and antibiotic therapy started. The MALDI-TOF MS test identified Parvimonas micra, an anaerobic bacterium, commensal to the oral flora, associated with severe periodontitis, but rarely reported in cases of pleural empyema, especially in immunocompetent patients. Gingivitis and pericoronaritis of the third molar were diagnosed during oral evaluation. The patient progressed favorably. Parvimonas micra should be considered as a possible etiological agent in cases of subacute or chronic pleural empyema, in addition to mycobacteria. Tests such as MALDI-TOF MS or 16S rRNA sequencing, chest tube placement, empirical antibiotic coverage and an adequate oral evaluation should be considered in these cases.

Postoperative infection after anterior cruciate ligament reconstruction caused by Finegoldia magna: a case report / 中华骨科杂志

One case of knee infection after anterior cruciate ligament reconstruction caused by the gram-positive anaerobic bacterium Finegoldia magna was reported. The patient was admitted to hospital due to fever and knee joint swelling and pain after anterior cruciate ligament reconstruction. Through medical history, physical examination, imaging examination and next-generation sequencing, it was confirmed that the infection was caused by Finegoldia magna. Through literature review, 37 literatures on infectious diseases caused by Finegoldia magna was retrieved and analyzed, and the identification points of anaerobic bacteria, the application of second-generation sequencing technology and the treatment status of infection after anterior cruciate ligament reconstruction were reviewed. The incidence of infection after arthroscopic anterior cruciate ligament reconstruction is low, while anaerobic infection is even more rare and difficult to culture. The next-generation sequencing can be used to assist the diagnosis. On the basis of giving priority to the preservation of the reconstructed ligament, the combined use of arthroscopic debridement, irrigation and sensitive antibiotics is the main treatment method.

Enzyme production mechanism of anaerobic fungus Orpinomyces sp. YF3 in yak rumen induced by different carbon source / 生物工程学报

In order to investigate the enzyme production mechanism of yak rumen-derived anaerobic fungus Orpinomyces sp. YF3 under the induction of different carbon sources, anaerobic culture tubes were used for in vitro fermentation. 8 g/L of glucose (Glu), filter paper (Flp) and avicel (Avi) were respectively added to 10 mL of basic culture medium as the sole carbon source. The activity of fiber-degrading enzyme and the concentration of volatile fatty acid in the fermentation liquid were detected, and the enzyme producing mechanism of Orpinomyces sp. YF3 was explored by transcriptomics. It was found that, in glucose-induced fermentation solution, the activities of carboxymethyl cellulase, microcrystalline cellulase, filter paper enzyme, xylanase and the proportion of acetate were significantly increased (P < 0.05), the proportion of propionate, butyrate, isobutyrate were significantly decreased (P < 0.05). The results of transcriptome analysis showed that there were 5 949 differentially expressed genes (DEGs) between the Glu group and the Flp group, 10 970 DEGs between the Glu group and the Avi group, and 6 057 DEGs between the Flp group and the Avi group. It was found that the DEGs associated with fiber degrading enzymes were significantly up-regulated in the Glu group. Gene ontology (GO) function enrichment analysis identified that DEGs were mainly associated with the xylan catabolic process, hemicellulose metabolic process, β-glucan metabolic process, cellulase activity, endo-1,4-β-xylanase activity, cell wall polysaccharide metabolic process, carbohydrate catabolic process, glucan catabolic process and carbohydrate metabolic process. Moreover, the differentially expressed pathways associated with fiber degrading enzymes enriched by Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway analysis were mainly starch and sucrose metabolic pathways and other glycan degradation pathways. In conclusion, Orpinomyces sp. YF3 with glucose as carbon source substrate significantly increased the activity of cellulose degrading enzyme and the proportion of acetate, decreased the proportion of propionate, butyrate and isobutyrate. Furthermore, the degradation ability and energy utilization efficiency of fungus in the presence of glucose were improved by means of regulating the expression of cellulose degrading enzyme gene and participating in starch and sucrose metabolism pathway, and other glycan degradation pathways, which provides a theoretical basis for the application of Orpinomyces sp. YF3 in practical production and facilitates the application of Orpinomyces sp. YF3 in the future.

Recent advances in the structure and function of microbial community in anaerobic granular sludge / 生物工程学报

Anaerobic granular sludge (AnGS), a self-immobilized aggregate containing various functional microorganisms, is considered as a promising green process for wastewater treatment. AnGS has the advantages of high volume loading rate, simple process and low excess sludge generation, thus shows great technological and economical potentials. This review systematically summarizes the recent advances of the microbial community structure and function of anaerobic granular sludge, and discusses the factors affecting the formation and stability of anaerobic granular sludge from the perspective of microbiology. Moreover, future research directions of AnGS are prospected. This review is expected to facilitate the research and engineering application of AnGS.

Regulating anaerobic metabolism and promoting myocardial ischemia-hypoxia injury by diesel particulate matter and its key component benzoapyrene via targeting oxygen sensors / 环境与职业医学

Background The exposure to diesel particulate matter (DPM) and its polycyclic aromatic hydrocarbons (PAH) is closely related to the morbidity and mortality of ischemic heart disease (IHD). However, it is unclear what key components and targets of DPM exposure involve in myocardial ischemia-hypoxia injury and associated mechanisms. Objective To identify key PAH components of DPM that act on myocardial hypoxic injury, andclarify the role of oxygen sensors-regulated anaerobic metabolism in DPM and key components-induced hypoxic injury and the targets of the key PAH components. Methods Human cardiomyocyte cell line AC16 cells were exposed to 0, 1, 5, and 10 μg·mL−1 DPM in a high glucose DMEM medium with 10% fetal bovine serum (FBS) (HGM) or low FBS (0.5%) in high glucose DMEM medium (LFM), for 12 h under 2% O2, and expression of hypoxia-inducible factor-1α (HIF-1α), Bax, and Cleaved-caspase3 was determined by Western blotting. Under normal condition, the cell viability was detected after PAH exposure for 12 h. Under the condition of ischemia-hypoxia model, cells were exposed to 0, 0.005, 0.5, and 5 µg·mL−1 PAH for 12 h, and the protein expression of HIF-1α, Bax, and Cleaved-caspase3 was determined. After exposure to DPM or PAH for 12 h, the contents of pyruvate and lactate in cells were detected. Pretreatment with glycolysis inhibitor GSK2837808A was used to explore the role of glycolysis in DPM and benzo[a]pyrene (BaP)-induced hypoxia injury. A molecular docking technique was used to analyze the binding affinity between PAH and oxygen sensors (prolyl hydroxylase domain-containing protein 2, PHD2, and factor-inhibiting hypoxia-inducible factor 1, FIH1), and the protein levels of PHD2, FIH1, and hydroxyl-HIF-1-alpha (OH-HIF-1α) after the DPM or BaP treatment were further determined. Results Under hypoxia, DPM exposure in the LFM induced the expression of HIF-1α, Bax, and Cleaved-caspase3 (P<0.01). Therefore, hypoxia and LFM were selected as the basic ischemia and hypoxia condition. Except for anthracene (Ant) (P>0.05), other PAH decreased cell viability when the concentration was above 1 μg·mL−1 (P<0.05). All concentrations of BaP induced the expression of HIF-1α protein (P<0.05), and the protein levels of Bax and Cleaved-caspase3 were up-regulated after the 0.5 and 5 µg·mL−1 BaP exposure (P<0.01). After exposure to DPM (1, 5 and 10 μg·mL−1) or BaP (0.5 and 5 μg·mL−1), the intracellular pyruvate and lactate contents increased (P<0.05). The glycolysis inhibitor co-treatment decreased the levels of HIF-1α, Bax, and Cleaved-caspase3 proteins compared with the DPM or BaP exposure group for 12 h (P＜0.05). The binding abilities of the five PAHs to the oxygen sensors PHD2 and FIH1 were strong, and BaP was the strongest. Although the DPM or BaP exposure had no effects on the protein levels of PHD2 and FIH1 in AC16 cells (P＜0.05), the protein level of OH-HIF-1α was decreased (P＜0.01). Conclusion BaP exposure can promote hypoxia and injury of myocardial cells and is the key PAH component of DPM that induces myocardial ischemia and hypoxia injury. BaP exposure inhibits the hydroxylation function of PHD2 on HIF-1α by combining with PHD2, decreases the level of OH-HIF-1α and induces HIF-1α accumulation. And then HIF-1α promotes anaerobic metabolism and accelerates ischemia and hypoxia injury of myocardial cells.

Effects of 6-week Circuit Training on Anaerobic Performance and Simple Reaction Time in Individuals with Intellectual Disability (ID) in Kelantan State (Kesan Latihan Litar Selama 6 Minggu Terhadap Prestasi Anaerobik dan Tindak Balas Masa Ringkas dalam Individu Kurang Daya Intektual (ID) di Negeri Kelantan) / Jurnal Sains Kesihatan Malaysia

@#Participation in exercise benefits health and fitness among Intellectual Disability (ID) individuals. Circuit training is one of the exercise programme that can be tailored by manipulating the intensity, time and types of exercise. The purpose of the present study is to examine the effects of six weeks of circuit training on anaerobic fitness and simple reaction time in ID individuals. Thirty participants with mild to moderate ID were selected from individuals who are registered with the Pusat Pemulihan dalam Komuniti (PDK) and Yayasan Orang Kurang Upaya (YOKUK) in the Kelantan state. Participants were randomly divided into Circuit Training and Control groups. Participants in Circuit Training group followed a circuit training exercise programme, two times per week for six weeks, whereas participants in Control group were not involved in circuit training and carried out their regular activities. The anaerobic peak power was significantly decreased (ƿ < 0.001) in Control group after six weeks. The anaerobic power of post-test was significantly improved (ƿ = 0.042) from the pre-test in Circuit Training group and it was also significantly higher (ƿ = 0.001) than Control group. There were no significant differences for the anaerobic capacity and simple reaction time between and within groups. Circuit training can be conducted to enhance anaerobic power in ID individuals, however longer participation may be needed to improve anaerobic capacity and simple reaction time.

Influence of high-intensity exercise on physical fitness of swimmers / Influência do exercício de alta intensidade sobre a aptidão física dos nadadores / Influencia del ejercicio de alta intensidad en la aptitud física de los nadadores

ABSTRACT Introduction High-intensity swimming requires athletes to have explosive power, endurance, lactic acid resistance, aerobic metabolism, and other qualities. Pre-competition physical training is mainly based on high interval training, promoting ATP-CP synthesis in the body. It can enhance the resistance to lactic acid and promote lactic acid clearance. Objective This article explores the effect of high-intensity pre-competition training on the physical fitness of swimmers. The results can be used as a reference for swimmers to perform high-intensity training before the competition. Methods Eight swimmers were selected by random sampling. The study subjects received eight weeks of high-intensity training before the competition. The athletes' gas metabolism and anaerobic thresholds were detected before and after training. At the same time, the physiological and chemical indicators of the experimental subjects were detected in this paper. Finally, this paper analyzes the experimental results by employing mathematical statistics. Results The metabolism function of the athletes changed significantly in the later period of pre-competition training (P<0.05). Serum lactate concentration had no significant effect on the anaerobic threshold (P>0.05). Conclusion High-intensity exercise has a particular promotion effect on improving the physical quality of swimmers. This exercise can lay a solid foundation for the swimmer's physical fitness. Level of evidence II; Therapeutic studies - investigation of treatment results.

RESUMO Introdução A natação de alta intensidade requer que os atletas tenham uma força explosiva, resistência, tolerância ao ácido láctico, metabolismo aeróbico e outras qualidades. O treinamento físico pré-competição é baseado principalmente no treinamento de alto intervalo, o que pode promover a síntese de ATP-CP no corpo. Ele pode aumentar a resistência ao ácido láctico e promover a sua eliminação. Objetivo Este artigo explora o efeito do treinamento pré-competição de alta intensidade sobre a aptidão física dos nadadores. Os resultados podem ser usados como referência para os nadadores realizarem treinamentos de alta intensidade antes da competição. Métodos Oito nadadores foram selecionados por amostragem aleatória. Os sujeitos do estudo receberam oito semanas de treinamento de alta intensidade antes da competição. O metabolismo dos gases e os limiares anaeróbicos dos atletas foram detectados antes e depois do treinamento. Paralelamente, os indicadores fisiológicos e químicos dos sujeitos experimentais foram detectados neste trabalho. Finalmente, este trabalho analisa os resultados experimentais empregando estatísticas matemáticas. Resultados A função metabólica dos atletas alterou-se significativamente no último período de treinamento pré-competição (P<0,05). A concentração sérica de lactato não teve efeito significativo no limiar anaeróbico (P>0,05). Conclusão O exercício de alta intensidade tem um efeito especial de promoção na melhoria da qualidade física dos nadadores. Este exercício pode estabelecer uma base sólida para a aptidão física do nadador. Nível de evidência II; Estudos terapêuticos - investigação dos resultados do tratamento.

RESUMEN Introducción La natación de alta intensidad requiere que los atletas tengan fuerza explosiva, resistencia, tolerancia al ácido láctico, metabolismo aeróbico y otras cualidades. El entrenamiento físico previo a la competición se basa principalmente en el entrenamiento de alto intervalo, que puede promover la síntesis de ATP-CP en el cuerpo. Puede aumentar la resistencia al ácido láctico y favorecer su eliminación. Objetivo Este trabajo explora el efecto del entrenamiento de alta intensidad previo a la competición en la condición física de los nadadores. Los resultados pueden servir de referencia para que los nadadores realicen un entrenamiento de alta intensidad antes de la competición. Métodos Se seleccionaron ocho nadadores por muestreo aleatorio. Los sujetos del estudio recibieron ocho semanas de entrenamiento de alta intensidad antes de la competición. Se detectó el metabolismo gaseoso y los umbrales anaeróbicos de los atletas antes y después del entrenamiento. Paralelamente, en este trabajo se detectaron los indicadores fisiológicos y químicos de los sujetos experimentales. Por último, este documento analiza los resultados experimentales empleando estadísticas matemáticas. Resultados La función metabólica de los atletas cambió significativamente en el último período de entrenamiento previo a la competición (P<0,05). La concentración de lactato sérico no tuvo un efecto significativo sobre el umbral anaeróbico (P>0,05). Conclusión El ejercicio de alta intensidad tiene un efecto promotor especial en la mejora de la calidad física de los nadadores. Este ejercicio puede establecer una base sólida para la aptitud física del nadador. Nivel de evidencia II; Estudios terapéuticos - investigación de los resultados del tratamiento.

APRIMORAMENTO DA COORDENAÇÃo FÍSICA DOS NADADORES BASEADO NO TREINAMENTO DE RESISTÊNCIA ANAERÓBICA / Improvement of swimmers' physical coordination based on anaerobic endurance training / Perfeccionamiento de la coordinación física de los nadadores basado en el entrenamiento de la resistencia anaeróbica

ABSTRACT Introduction: Anaerobic exercise is a critical factor in swimming training. Coaches who monitor an athlete's anaerobic capacity can use this tool to improve competitive performance. Objective: Analyze the effect of the anaerobic function test on swimmers' training. Methods: We examined the anaerobic exercise capacity of swimmers the relationship between human body composition and anaerobic work capacity. For this purpose, 14 swimmers were selected by random sampling. Individual anaerobic threshold, serum testosterone and serum cortisol of the athletes at different periods were measured. Results: Individual anaerobic thresholds were significantly lower in male and female athletes after training. The difference was statistically significant (P<0.05). The plasma testosterone/cortisol content of female swimmers after six weeks of anaerobic endurance training was significantly lower than the pre-training mean (P<0.05). After six weeks of anaerobic endurance training, the plasma testosterone/cortisol content of the male swimmers was lower than that of the standard group (P<0.05). Conclusion: The swimmers' bodies were impacted after anaerobic endurance training. The importance of attention by the coach to consider the differences between male and female athletes when conducting dedicated anaerobic threshold training is emphasized. Level of evidence II; Therapeutic studies-investigating treatment outcomes .

RESUMO Introdução: O exercício anaeróbico é um fator crítico no treinamento de natação. Os treinadores que monitoram a capacidade anaeróbica de um atleta podem utilizar essa ferramenta para melhorar o desempenho competitivo. Objetivo: Analisar o efeito do teste de função anaeróbica sobre o treinamento dos nadadores. Métodos: Examinou-se a capacidade de exercício anaeróbico dos nadadores, a relação entre a composição do corpo humano e a capacidade de trabalho anaeróbico. Para isso, foram selecionados 14 nadadores por amostragem aleatória. Foram mensurados o limiar anaeróbico individual, testosterona sérica e cortisol sérico dos atletas em diferentes períodos. Resultados: Os limiares anaeróbicos individuais foram significativamente menores em atletas do sexo masculino e feminino após o treinamento. A diferença foi estatisticamente significativa (P<0,05). O conteúdo de testosterona/cortisol plasmático das nadadoras após seis semanas de treinamento anaeróbico de resistência foi significativamente menor do que a média de pré-treinamento (P<0,05). Após seis semanas de treinamento de resistência anaeróbica, o conteúdo de testosterona/cortisol plasmático dos nadadores masculinos era menor do que o do grupo padrão (P<0,05). Conclusão: Os corpos dos nadadores foram impactados após o treinamento de resistência anaeróbica. Ressalta-se a importância da atenção pelo treinador em considerar as diferenças entre os atletas masculinos e femininos quando realizar um treinamento do limiar anaeróbico dedicado. Nível de evidência II; Estudos terapêuticos - investigação dos resultados do tratamento .

RESUMEN Introducción: El ejercicio anaeróbico es un factor crítico en el entrenamiento de la natación. Los entrenadores que controlan la capacidad anaeróbica de un atleta pueden utilizar esta herramienta para mejorar el rendimiento competitivo. Objetivo: Analizar el efecto de la prueba de función anaeróbica en el entrenamiento de los nadadores. Métodos: Examinamos la capacidad de ejercicio anaeróbico de los nadadores, la relación entre la composición corporal humana y la capacidad de trabajo anaeróbico. Para ello, se seleccionaron 14 nadadores por muestreo aleatorio. Se midieron el umbral anaeróbico individual, la testosterona sérica y el cortisol sérico de los atletas en diferentes períodos. Resultados: Resultados: Los umbrales anaeróbicos individuales fueron significativamente más bajos en los atletas masculinos y femeninos después del entrenamiento. La diferencia fue estadísticamente significativa (P<0,05). El contenido de testosterona/cortisol en plasma de las nadadoras después de seis semanas de entrenamiento de resistencia anaeróbica fue significativamente inferior a la media previa al entrenamiento (P<0,05). Después de seis semanas de entrenamiento de resistencia anaeróbica, el contenido de testosterona/cortisol en plasma de los nadadores masculinos fue inferior al del grupo estándar (P<0,05). Conclusión: Los cuerpos de los nadadores sufrieron un impacto después del entrenamiento de resistencia anaeróbica. Se destaca la importancia de que el entrenador tenga en cuenta las diferencias entre los atletas masculinos y femeninos a la hora de realizar un entrenamiento dedicado al umbral anaeróbico. Nivel de evidencia II; Estudios terapéuticos - investigación de los resultados del tratamiento .

Bacterial and C linical P rofile of D iabetic F oot U lcer using O ptimal C ulture T echniques: A Prospective Hospital Based Study

Background: Diabetic foot ulcers (DFU) are the complications of diabetes mellitus. The infection of diabetic foot ulcer is microbes in nature. If they are not recognized and controlled it may lead to many devastating consequences like limb amputation, sepsis, and even mortality. So, the present study was aimed that to determine the bacterial and clinical profile of diabetic foot ulcer using optimal culture techniques. Methods: This prospective study was conducted on Type 2 Diabetic patients with foot ulcer. Around 206 total cases were enrolled on the basis of inclusion and exclusion criteria. The duration of study was over a period of two years. Results: The result of this study revealed that causative agent of DFU were found due to aerobic in n = 170 cases whereas anae robic bacteria in n = 36 cases. Conclusion: This study concludes that that proper care should be offered, causative organisms should be timely identified and antibiotic should be sensibly chosen to cut short the morbidity and mortality of DFU.

Diagnostic and therapeutic approaches in deep neck infections: an analysis of 74 consecutive patients / Abordagens diagnósticas e terapêuticas em infecções cervicais profundas: uma análise de 74 pacientes consecutivos

Abstract Introductıon: Deep neck infections are a group of diseases with serious complications and mortality, which can occur as a result of common diseases in the community and which have surgical and medical treatment options. Objectives: Patients ages, genders, complaints, physical examination findings, hospitalization complaints, history of antibiotic use before the application, additional diseases, radiological tests and analysis of examinations, type of treatment method, antibiotic agents selected in treatment, bacterial culture results, duration of hospitalization, complications, mortality rates were systematically recorded. In the study, anaerobic bacterial factors, which are difficult to produce in routine, were produced by considering special transport conditions and culture media. Methods: A total of 74 patients who were hospitalized in the Department of Otorhinolaryngology, University of Mersin, between 01.07.2016 and 01.07.2017 for deep neck infection were evaluated prospectively. The study included 37 female and 37 male patients. The ages of the patients ranged from 1 to 69 and the mean age was 31 years. Results: According to the analysis of the obtained data, there was a statistically significant relationship between the patients with additional diseases and the treatment modalities of the patients (p = 0.017). The surgical treatment rate was increased in this group of patients. In patients with a history of antibiotic use, it was found that patients in the pediatric group were in hospital longer in terms of length of stay compared to adults (p = 0.036). In adult patients who underwent surgery, the absorptive long axis was found to be longer in mm than in patients receiving isolated medical treatment (p = 0.008). Conclusions: Deep neck infections is a disease group that seriously concerns public health, with significant mortality and morbidity. Ensuring airway safety of patients should be the first intervention. Abscesses located lateral to the tonsil capsule may not drain adequately without concomitant tonsillectomy.

Resumo Introdução: As infecções cervicais profundas constituem um grupo de doenças com graves complicações e mortalidade, que podem ocorrer como resultado de doenças comuns na comunidade e que têm opções de tratamento médico e cirúrgico. Objetivo: Detectar bactérias anaeróbias e comparar a eficácia do tratamento médico-cirúrgico em diferentes faixas etárias. Método: Foram sistematicamente registrados idade dos pacientes, sexo, queixas, achados do exame físico, queixas na hospitalização, histórico de uso de antibióticos, doenças adicionais, exames radiológicos e análise dos exames, tipo de tratamento, agentes antibióticos selecionados no tratamento, resultados de cultura bacteriana, duração da hospitalização, complicações e taxas de mortalidade. No estudo, culturas bacterianas anaeróbias, difíceis de obter rotineiramente, mesmo considerando-se condições especiais de transporte e meios, foram obtidas. Foram avaliados prospectivamente 74 pacientes internados no Departamento de Otorrinolaringologia da Universidade de Mersin, entre 01.07.2016 e 07.07.2017, devido a infecção cervical profunda. O estudo incluiu 37 pacientes do sexo feminino e 37 do masculino. A idade dos pacientes variou de 1 a 69 anos e a média foi de 31. Resultados: De acordo com a análise dos dados obtidos, houve uma relação estatisticamente significante entre os pacientes com doenças adicionais e as modalidades de tratamento dos pacientes (p = 0,017). A taxa de tratamento cirúrgico foi maior nesse grupo de pacientes. Em pacientes com histórico de uso de antibióticos, verificou-se que aqueles do grupo pediátrico permaneceram mais tempo hospitalizados em comparação aos adultos (p = 0,036). Nos pacientes adultos submetidos à cirurgia, verificou-se que o eixo longo absortivo era mais longo em mm do que nos pacientes que receberam tratamento médico isolado (p = 0,008). Conclusão: As infecções cervicais profundas constituem um grupo de doenças que são preocupantes na saúde pública, com sua mortalidade e morbidade. Garantir a segurança das vias aéreas dos pacientes deve ser a primeira intervenção. Os abscessos localizados lateralmente à cápsula tonsilar podem não apresentar drenagem sem a tonsilectomia.

Comparação do efeito de beta alanina, bicarbonato de sódio e limão como agentes tamponantes entre ciclistas em exercício de alta intensidade / Comparison of the effect of beta alanine, sodium bicarbonate and lemon as tamponant agents among high-intensity exercise cyclists

Alguns suplementos exercem atividade tamponante e têm sido reconhecidos por sua contribuição anaeróbica em exercícios de alta intensidade, retardando a fadiga muscular periférica e potencializando assim a performance esportiva. O objetivo deste estudo foi comparar o benefício ergogênico no tamponamento e dano muscular, dos suplementos beta alanina, bicarbonato de sódio e suco de limão por meio da dosagem de lactato sanguíneo e creatinofosfoquinase (CPK) e na performance de ciclistas submetidos a exercício anaeróbico de alta intensidade. Estudo transversal crossover, realizado em quatro etapas, com ciclistas do sexo masculino. A suplementação foi constituída de 6 g de beta alanina, 0,2 g/kg de bicarbonato de sódio e 30 mL de suco de limão. Lactato sanguíneo e enzima CPK foram dosados pelo método teste ultravioleta enzimático e cinético, respectivamente, em cada uma das etapas. A performance correspondeu à rotação máxima por minuto (RPM) da Air Bike. Participaram do estudo sete ciclistas, com média de idade de 31,14 ± 3,71 anos. O lactato e a CPK apresentaram significância entre os momentos em todas as etapas avaliadas, porém as suplementações comparadas entre si não apresentaram diferença estatística. Não houve melhora da performance (p>0,05) com as utilizações de bicarbonato de sódio, beta alanina e suco de limão em ciclistas. Para os parâmetros avaliados, nenhum dos suplementos apresentou superioridade nas variáveis de tamponamento, dano muscular e performance no treinamento.

Some supplements exert buffering activity and have been recognized for their anaerobic contribution to high-intensity exercise, delaying peripheral muscle fatigue and thus enhancing sports performance. The aim of this study was to compare the ergogenic benefit in muscle buffering and damage of beta alanine, sodium bicarbonate and lemon juice supplements through the measurement of blood lactate and creatine phosphokinase (CPK) and on the performance of cyclists submitted to high intensity anaerobic exercise. Cross-sectional study, carried out in 4 stages, with male cyclists. Supplementation was 6 g beta alanine, 0.2 g/kg of sodium bicarbonate and 30 mL of lemon juice. Blood lactate and creatine phosphokinase enzyme were measured by the enzymatic and kinetic ultraviolet test method, respectively, in each of the steps. Performance corresponded to the maximum rotation per minute (RPM) of the Air Bike. Seven cyclists participated in the study, with a mean age of 31.14 ± 3.71 years. Lactate and CPK presented significance between the moments in all the evaluated stages, however the supplements compared to each other showed no statistical difference. There was no performance improvement (p>0.05) with the use of sodium bicarbonate, beta alanine and lemon juice in cyclists. For the parameters evaluated, none of the supplements showed superiority in the variables of buffering, muscle damage and training performance.

Comparação da proporção entre pressão venosa central menos arterial de dióxido de carbono e conteúdo de oxigênio arterial menos venoso central e níveis de lactato como preditores de mortalidade em pacientes críticos: uma revisão sistemática e metanálise / Comparison of central venous minus arterial carbon dioxide pressure to arterial minus central venous oxygen content ratio and lactate levels as predictors of mortality in critically ill patients: a systematic review and meta-analysis

RESUMO Objetivo: A proporção entre pressão venosa central menos arterial de dióxido de carbono e conteúdo de oxigênio arterial menos venoso central (Pcv-aCO2/Ca-cvO2) é frequentemente usada como substituta para a oxigenação tecidual. O objetivo deste estudo foi identificar e sintetizar a literatura e a qualidade das evidências que suportam a Pcv-aCO2/Ca-cvO2 como um preditor de mortalidade em comparação com o lactato em pacientes críticos. Métodos: Pesquisamos vários bancos de dados procurando estudos que tivessem medido a Pcv-aCO2/Ca-cvO2 em pacientes críticos. Pesquisadores independentes realizaram a triagem dos artigos e a extração de dados. Uma metanálise de efeitos aleatórios foi realizada. Diferenças médias padronizadas agrupadas foram usadas para comparar a capacidade prognóstica da Pcv-aCO2/Ca-cvO2 e do lactato. Resultados: Inicialmente, obtivemos 172 estudos; 17 foram incluídos para descrição qualitativa, e dez foram incluídos para síntese quantitativa. A média de Pcv-aCO2/Ca-cvO2 foi maior nos não sobreviventes do que nos sobreviventes (diferença média padronizada agrupada de 0,75; IC95% 0,34 - 1,17; I2 = 83%), assim como os níveis de lactato (diferença média padronizada agrupada = 0,94; IC95% 0,34 - 1,54; I2 = 92%). Ambos os testes foram preditores estatisticamente significativos de mortalidade, embora com sobreposição de IC95% entre eles. Conclusão: Evidências de qualidade moderada mostraram pouca ou nenhuma diferença na capacidade da Pcv-aCO2/Ca-cvO2, em comparação com o lactato, em predizer mortalidade. No entanto, nossas conclusões são limitadas pela considerável heterogeneidade entre os estudos. Registro no PROSPERO:CRD42019130387

ABSTRACT Objective: The central venousarterial carbon dioxide pressure to arterial-central venous oxygen content ratio (Pcv-aCO2/Ca-cvO2) is frequently used as a surrogate for tissue oxygenation. We aimed to identify and synthesize literature and quality of evidence supporting Pcv-aCO2/Ca-cvO2 as a predictor of mortality in critically ill patients compared with lactate. Methods: We searched several databases for studies measuring Pcv-aCO2/Ca-cvO2 in critically ill patients. Independent investigators performed the article screening and data extraction. A random-effects metaanalysis was performed. Pooled standardized mean differences (SMD) were used to compare the prognostic ability of Pcv-aCO2/Ca-cvO2 and lactate. Results: We initially retrieved 172 studies; 17 were included for qualitative description, and 10 were included for quantitative synthesis. The mean Pcv-aCO2/Ca-cvO2 was higher in nonsurvivors than in survivors (pooled SMD = 0.75; 95%CI 0.34 - 1.17; I2 = 83%), as was the case with lactate levels (pooled SMD = 0.94; 95%CI 0.34 - 1.54; I2 = 92%). Both tests were statistically significant predictors of mortality, albeit with overlapping 95%CIs between them. Conclusion: Moderate-quality evidence showed little or no difference in the ability of Pcv-aCO2/Ca-cvO2, compared with lactate, to predict mortality. Nevertheless, our conclusions are limited by the considerable heterogeneity among the studies. PROSPERO registration:CRD42019130387

El efecto del tipo de acondicionamiento físico sobre la insulina y glucosa en las distintas fases del ejercicio

Objetivo: Describir el comportamiento de la glucosa y la insulina durante las etapas del ejercicio en atletas acondicionados en ejercicio aeróbico y anaeróbico. Materiales y métodos: En un estudio cuasiexperimental de corte transversal se compararon la glucosa e insulina de 6 atletas anaeróbicos y 10 aeróbicos durante el reposo, ejercicio de moderada - alta intensidad y la recuperación. Se eligió un valor p de <0.05, se encontró distribución no-normal y se utilizaron pruebas no paramétricas y modelos de regresión linear. Resultados: El ejercicio moderado llevó a hipoinsulinemia, y el intenso a hiperinsulinemia e hiperglicemia. No encontramos diferencias entre los dos tipos de atletas. Conclusiones: El comportamiento del sistema nervioso autónomo afectaría el balance glucoenergético corporal durante el ejercicio aún más que la insulina, con variaciones dependiendo del tipo de entrenamiento, pero es necesario realizar estudios adicionales para evaluar esta relación.

Objective: Describe glucose and insulin behavior at the different phases of exercise in aerobic and anaerobic athletes. Materials and methods: Glucose and insulin from 6 anaerobic and 10 aerobic athletes were compared during rest, moderate-high intensity exercise, and recovery. Statistical analysis was performed to evaluate insulin and glucose behavior, and differences between aerobic aerobic and anaeribic-trained individuals. A p value of <0.05 was set. A non-normal distribution was found, non-parametric tests and multivariate analysis were performed. Results: Moderate exercise led to hypoinsulinemia, whereas intense exercise caused hyper-insulinemia and hyperglycemia. No differences were found between the 2 groups. Conclusions: Autonomic nervous system behavior may play a role in the glucoenergetic balance that could overcome insulin effect, and it could vary depeding on the type of exercise régimen but further evaluation is necessary to confirm these findings

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.

Anaerobic digestion pathways in biochemistry: a teaching practice / 生物工程学报

Anaerobic digestion is another important anaerobic catabolism pathway besides lactic acid and ethanol fermentation, which is of great significance for recycling resources, maintaining the ecological balance, optimizing the energy structure, alleviating the energy crisis, and promoting the implementation of the "Carbon Peaking and Carbon Neutrality" strategy. However, such an important metabolic process has not been involved in the current textbooks and teaching of biochemistry courses, making the teaching system incomplete. The anaerobic digestion process involves many reactions and complex metabolic pathways. In order to improve the students' understanding to this process, we created a full chart of the whole anaerobic digestion process based on systemic literature review and integrated it into the classroom teaching through the BOPPPS teaching mode. It was found that the classroom teaching assisted by this metabolic chart could help students establish the structural framework of the anaerobic digestion process and enrich the knowledge system of metabolism, achieving a good teaching effect. This paper introduces the content of the metabolic pathways of anaerobic digestion and the design of the teaching process, which would facilitate the teaching reforms and perfection of textbooks for related courses, such as Biochemistry, Environmental Engineering Microbiology and New Energy Engineering.