Concurrent adaptations in maximal aerobic capacity, heat tolerance, microvascular blood flow and oxygen extraction following heat acclimation and ischemic preconditioning.

We investigated the effects of: 1) Ischemic pre-conditioning (IPC) plus a concurrent five-day heat acclimation + IPC (IPC + HA), 2) five-day HA with sham IPC (HA), or 3) control (CON) on thermoneutral measurements of endurance performance, resting measures of skeletal muscle oxygenation and blood flow. Twenty-nine participants were randomly allocated to three groups, which included: 1) five-days of repeated leg occlusion (4 x 5-min) IPC at limb occlusive pressure, plus fixed-intensity (55% V˙ O2max) cycling HA at ~36 °C/40% humidity; 2) HA plus sham IPC (20 mmHg) or 3) or CON (thermoneutral 55% V˙ O2max plus sham IPC). In IPC + HA and HA, there were increases in maximal oxygen consumption (O2max) (7.8% and 5.4%, respectively; P < 0.05), ventilatory threshold (VT) (5.6% and 2.4%, respectively, P < 0.05), delta efficiency (DE) (2.0% and 1.4%, respectively; P < 0.05) and maximum oxygen pulse (O2pulse-Max) (7.0% and 6.9%, respectively; P < 0.05) during an exhaustive incremental test. There were no changes for CON (P > 0.05). Changes (P < 0.05) in resting core temperature (TC), muscle oxygen consumption (m V˙ O2), and limb blood flow (LBF) were also found pre-to-post intervention among the HA and IPC + HA groups, but not in CON (P > 0.05). Five-days of either HA or IPC + HA can enhance markers of endurance performance in cooler environments, alongside improved muscle oxygen extraction, blood flow, exercising muscle efficiency and O2 pulse at higher intensities, thus suggesting the occurrence of peripheral adaptation. Both HA and IPC + HA enhance the adaptation of endurance capacity, which might partly relate to peripheral changes.

Medical thoracoscopy for the treatment of complicated hepatic hydrothorax.

Hepatic hydrothorax is a complication of liver cirrhosis. Several invasive therapeutic approaches have been performed such as thoracentesis, video-assisted thoracic surgery and repair of the diaphragmatic defects with debatable results. Medical thoracoscopy is a minimally invasive and effective technique with challenging applications that has not been thoroughly used in the treatment of hepatic hydrothorax. We hereby present the case of a hepatic hydrothorax complicated by thoracic empyema in a 38-year-old patient with alcoholic cirrhosis that was treated with medical thoracoscopy and talc pleurodesis.

Industrial scale pilot plant operation by Kefir yeast cells immobilized on delignified cellulosic material for whey treatment.

Kefir yeast cells immobilized on Delignified Cellulosic Materials (DCM) is proposed as a suitable form of biocatalyst for whey treatment. A bioreactor of 11.000L was used in all experiments. 5 repeated batch fermentations were taken place with whey volumes of 3000L and 5000L. Fermentation times achieved were below 15 h and final ethanol concentration was of the level of 2%v/v. Residual sugar was low while conversion rate reached 95%. In a second frame of experiments the immobilized cells bioreactor was operated on a feed-batch process, beginning from 2000L of whey and adding 2000L in every feed. In a third frame of experiments, whey fermentation was performed on a continuous operation for a period of 13 days. The system retained its operational stability, exhibiting relatively high ethanol yield and ethanol productivity. All experiments indicated that the biocatalyst of kefir yeast cells immobilized on delignified cellulosic materials has a carry through property on whey fermentation on industrial scale.