Lactato como marcador temprano de hipoxia cerebral en pacientes neurológicos bajo anestesia general: una revisión sistemática / Lactate as an early marker of cerebral hypoxia in neurological patients under general anesthesia: a systematic review

Resumen: Las complicaciones neurológicas perioperatorias secundarias a hipoxia durante procedimientos de sedación y anestesia general son frecuentes en cirugía cardiovascular y en pacientes con comorbilidades. Sin embargo, hasta el momento no existe un consenso para el diagnóstico de estas posibles complicaciones. En pacientes con trauma encefálico severo y/o hemorragia subaracnoidea el lactato cerebral no fue útil para predicción de hipoxia cerebral; pese a ello, la relación de lactato/piruvato podría ser una herramienta para diagnóstico intraoperatorio de hipoxia cerebral aguda. Los estudios sugieren que éste debe asociarse a otros marcadores y/o a monitoreo multimodal. Es necesario realizar estudios que evalúen su valor predictivo para hipoxia cerebral.

Abstract: Perioperative neurological complications secondary to hypoxia during sedation and general anesthesia procedures are frequent in cardiovascular surgery, and in patients with comorbidities. However, so far there is no consensus for the diagnosis of these possible complications. In patients with head trauma severe and/or subarachnoid hemorrhage cerebral lactate was not useful for predicting cerebral hypoxia, however the lactate/pyruvate ratio could be a tool for intraoperative diagnosis of acute cerebral hypoxia. Studies suggest that it must be associated with other markers or multimodal monitoring. Further studies are needed to evaluate lactate predictive value for the diagnosis of cerebral hypoxia.

Soluble interleukin-6 receptor in young adults and its relationship with body composition and autonomic nervous system.

BACKGROUND: The immune system generates inflammatory responses through cytokines like Interleukin 6 (IL-6) and the Tumor Necrosis Factor alpha (TNF α); these cytokines mediate cellular responses aided by the presence of soluble receptors such as: Soluble Interleukin 6 Receptor (sIL6R) and Soluble Tumor Necrosis Factor Receptors Type 1 and 2 (sTNFR1, sTNFR2); the literature is limited about the relationship between this cytokines and the role of its soluble receptors. OBJECTIVES: This study is to determine a possible relationship between specific inflammatory markers and their soluble receptors with the autonomic nervous system's activity and body composition. METHODS: 27 subjects (13 men of 19.3 ± 1.6 years old and 14 women of 19.1 ± 1.7 years old) were evaluated. Body composition, autonomic nervous system activity and plasma concentration of inflammatory markers IL-6, TNF α, sIL6R, sTNFR1 and sTNFR2 were measured using bio-impedance, heart rate variability and ELISA respectively. RESULTS: A positive association between body-fat percentage and the sIL6R (0.47, p = .013) as well as inverse relationship between muscular mass and the sIL6R (-0.45, p = .019) were found. The sIL6R was also positively correlated with sympathetic activity markers: Relation LF/HF (0.52, p = .006), cardiac sympathetic index (0.45, p = .008), and cardiac vagal index (-0.44, p = .022). CONCLUSION: This study suggested that the IL-6 trans-signaling involving both the soluble receptor, sIL6R, and gp130 membrane co-receptor could produce inflammatory responses that generate an impact on the autonomic nervous system, possibly due to its direct action on the hypothalamus, the solitary tract nucleus, or the heart.

Revisión sistemática de "miocinas y regulación metabólica" / A systematic review of "myokines and metabolic regulation"

Malos hábitos como el sedentarismo, obesidad o sobrealimentación, se relacionan a la evolución de estados pro-inflamatorios crónicos, principal factor de riesgo para el desarrollo de enfermedades crónicas no transmisibles (ECNT). Sin embargo, modificar únicamente el peso corporal no reduce el riesgo, es necesario también aumentar la masa muscular, dando a entender que existe una relación benéfica asociada a este tejido que no está totalmente dilucidada. Durante los últimos años, las explicaciones celulares más interesantes se han enfocado en la producción de citokinas musculares denominadas miokinas, dentro de las que se destacan la interleucina 6, el factor inhibidor de la leucemia, entre otras recientemente estudiadas como lo son la mionectina y la musclina. Debido a los múltiples avances, se realiza una revisión que pretende: presentar los hallazgos más recientes y representativos acerca de las miokinas, corregir conceptos y demostrar su aplicabilidad en la prescripción del ejercicio físico para la salud

Bad habits such as sedentary lifestyle, obesity or overfeeding, are related to the production of chronic pro-inflammatory states, the main risk factor for the development of chronic noncommunicable diseases (CNCD). However, modifying only the body weight does not reduce the risk, it is necessary to increase muscle mass, this implies there is a beneficial relationship associated with the muscle tissue that is not fully elucidated. During the last years, the most interesting cellular explanations have focused on the production of muscle cytokines called myokines, among which stand out interleukin 6, the inhibitory factor of leukemia, with others recently studied such as mionectine and muscline. Due to the multiple advances, this intends to present the most recent and representative findings about myokines, correct concepts and demonstrate their applicability in the prescription of physical exercise for health

Efecto de los movimientos explosivos y de impacto aplicados en piscina sobre la composición corporal, la fuerza y la densidad mineral ósea de mujeres mayores de 60 años / Effect of high impact movements on body composition, strength and bone mineral density on women over 60 years

Introducción. La osteoporosis está caracterizada por pérdida de masa ósea y deterioro de la microarquitectura del tejido óseo que genera fragilidad relacionada con el riesgo de fracturas. El objetivo es analizar los efectos de un programa de entrenamiento basado en movimientos explosivos y de impacto aplicados en piscina sobre la composición corporal, la fuerza explosiva y la densidad mineral ósea de mujeres mayores de 60 años de edad. Material y métodos. Treinta y cinco mujeres saludables físicamente activas (60 ± 4,19 años) fueron divididas en un grupo de entrenamiento en piscina con uso de multisaltos (JG) y un grupo control (CG). JG entrenó durante 24 semanas, 3 veces por semana, una hora y media por sesión. Pruebas de composición corporal, fuerza explosiva y densidad mineral ósea fueron aplicadas antes y después del programa. Resultados. Hubo diferencias en la fuerza explosiva (JG vs. CG = p < 0,05-0,001) y la potencia estimada (JG vs. CG = p < 0,05-0,002) entre JG vs. CG, con incrementos significativos en JG. No hubo diferencias significativas en el porcentaje de masa grasa y magra, densidad mineral ósea lumbar y femoral entre los grupos, aunque pudo observarse ligeros incrementos significativos densidad mineral ósea lumbar y femoral en JG después de la aplicación del programa (JG pretest vs. JG postest = p < 0,05). Conclusiones. El programa de entrenamiento con movimientos de impacto y explosivos aplicados en piscina induce ganancias en la expresión de fuerza y potencia muscular con ligeras adaptaciones en la densidad mineral ósea en mujeres mayores de 60 años (AU)

Background. Osteoporosis is characterised by loss of bone mass and deterioration of bone tissue microarchitecture that leads to fragility related to the risk of fractures. The aim of the study is to analyse the effects of a training program based on explosive movements and impact, assessed in a swimming pool, on body composition, explosive strength and bone mineral density in women over 60 years old. Material and methods. A total of 35 healthy physically active women (60 ± 4.19 years) were divided into a training pool group using multi jumps (JG) and a control group (CG). JG trained for 24 weeks, 3 times a week, an hour and a half per session. Body composition testing, explosive strength, and bone mineral density were assessed before and after the program. Results. There were differences in the explosive force (JG vs CG = P < .05 to .001) and the estimated power (JG vs CG = P < .05 to .002) between JG vs CG, with significant increases in JG. There were no significant differences in the percentage of fat and lean mass, bone mineral density lumbar and femoral between groups, although slightly significant increases in bone mineral density lumbar and femoral could be seen in JG after program implementation (JG pre-test vs JG post- test = P < .05). Conclusions. The training program with impact and explosive movements assessed in a pool induces gains in muscle strength and power with slight adaptations in body mass index in women over 60 years (AU)

[Effect of high impact movements on body composition, strength and bone mineral density on women over 60 years]. / Efecto de los movimientos explosivos y de impacto aplicados en piscina sobre la composición corporal, la fuerza y la densidad mineral ósea de mujeres mayores de 60 años.

BACKGROUND: Osteoporosis is characterised by loss of bone mass and deterioration of bone tissue microarchitecture that leads to fragility related to the risk of fractures. The aim of the study is to analyse the effects of a training program based on explosive movements and impact, assessed in a swimming pool, on body composition, explosive strength and bone mineral density in women over 60 years old. MATERIAL AND METHODS: A total of 35 healthy physically active women (60±4.19 years) were divided into a training pool group using multi jumps (JG) and a control group (CG). JG trained for 24 weeks, 3 times a week, an hour and a half per session. Body composition testing, explosive strength, and bone mineral density were assessed before and after the program. RESULTS: There were differences in the explosive force (JG vs CG=P<.05 to .001) and the estimated power (JG vs CG=P<.05 to .002) between JG vs CG, with significant increases in JG. There were no significant differences in the percentage of fat and lean mass, bone mineral density lumbar and femoral between groups, although slightly significant increases in bone mineral density lumbar and femoral could be seen in JG after program implementation (JG pre-test vs JG post- test=P<.05). CONCLUSIONS: The training program with impact and explosive movements assessed in a pool induces gains in muscle strength and power with slight adaptations in body mass index in women over 60 years.

Factores de riesgo cardiovascular y su relación con la composición corporal en estudiantes universitarios / University students’ cardiovascular risk factors and their relationship with body composition

Objetivo Evaluar la prevalencia de factores de riesgo cardiovascular en una población de jóvenes universitarios y su relación con la composición corporal. Materiales y Métodos Se realizó un estudio de prevalencia, con muestreo aleatorio en 193 jóvenes (94 mujeres y 99 hombres) entre 16 y 26 años. Se midió: colesterol total, lipoproteínas de baja y alta densidad (LDL-C y HDL-C), triglicéridos (TG) y glucosa, presión arterial en reposo, perímetro abdominal, talla, peso, porcentaje de grasa y masa muscular, se aplicó una encuesta para evaluar hábitos nutricionales, de vida y estrés. Resultados Los factores de riesgo cardiovascular más relevantes encontrados en hombres fueron: valores de LDL-C ≥100 mg/dl (60,6 %), porcentaje de grasa >20% (50,0 %) y valores de HDL-C <40 mg/dl (39,4 %); en mujeres: porcentaje de grasa >33% (63,0 %), LDL-C ≥100 mg/dl (39,4 %) y HDL-C <50 mg/dl (91,5 %). 12,1 % de los hombres y 21,3 % de las mujeres reunieron criterios de síndrome metabólico, 19,2 % de los hombres y 27,7 % de las mujeres tienen riesgo aterogénico alto. Se encontraron correlaciones significativas con la composición corporal. Conclusión Existe una alta prevalencia de factores de riesgo cardiovascular en jóvenes universitarios, dados por alteraciones del perfil lipídico y cambios antropométricos relacionados, esto sugiere la necesidad de modificaciones en sus hábitos de vida y la composición corporal.(AU)

Objective Assessing the prevalence of major risk factors for cardiovascular disease in a sample population of university students and their relationship with body composition. Methods A prevalence study was carried out on a random sample of 193 16 to 26 year-old university students (94 females and 99 males). Total cholesterol, high density lipoproteins (HDL), low density lipoproteins (LDL), triglycerides (TG) and glucose, resting blood pressure, waist circumference, height, weight and body fat and muscle mass percentages were measured. The participants answered a survey to assess their nutritional habits, lifestyle and stress. Results The major cardiovascular risk factors for males were ≥100 mg/dl (60.6%) LDL-C, >20% (50.0%) body fat percentage (BF%) and <40 mg/dl (39.4%) HDL-C; female risk factors were >33% (63.0%) BF%, ≥100 mg/dl (39.4%) LDL-C and <50 mg/dl (91.5%) HDL-C. Both male (12.1%) and female students (21.3 %) had criteria for metabolic syndrome and males (19.2%) and females (27.7%) had a high atherogenic index of plasma (AIP). Significant correlations with body composition were found. Conclusion Cardiovascular risk factors had high prevalence in this sample of undergraduate students due to alterations in their blood, lipid profile and anthropometric changes, suggesting that modifications must be made regarding their lifestyles and body composition.(AU)

[University students'’ cardiovascular risk factors and their relationship with body composition]. / Factores de riesgo cardiovascular y su relación con la composición corporal en estudiantes universitarios.

OBJECTIVE: Assessing the prevalence of major risk factors for cardiovascular disease in a sample population of university students and their relationship with body composition. METHODS: A prevalence study was carried out on a random sample of 193 16 to 26 year-old university students (94 females and 99 males). Total cholesterol, high density lipoproteins (HDL), low density lipoproteins (LDL), triglycerides (TG) and glucose, resting blood pressure, waist circumference, height, weight and body fat and muscle mass percentages were measured. The participants answered a survey to assess their nutritional habits, lifestyle and stress. RESULTS: The major cardiovascular risk factors for males were ≥100 mg/dl (60.6%) LDL-C, >20% (50.0%) body fat percentage (BF%) and <40 mg/dl (39.4%) HDL-C; female risk factors were >33% (63.0%) BF%, ≥100 mg/dl (39.4%) LDL-C and <50 mg/dl (91.5%) HDL-C. Both male (12.1%) and female students (21.3 %) had criteria for metabolic syndrome and males (19.2%) and females (27.7%) had a high atherogenic index of plasma (AIP). Significant correlations with body composition were found. CONCLUSION: Cardiovascular risk factors had high prevalence in this sample of undergraduate students due to alterations in their blood, lipid profile and anthropometric changes, suggesting that modifications must be made regarding their lifestyles and body composition.