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Near-infrared spectroscopy combined with vascular occlusion test (NIRS-VOT) is a reactive hyperemia technique for in vivo evaluation of skeletal muscle microvascular reactivity. Previous studies using NIRS-VOT have been shown to be able to detect impairments in microvascular function in high-risk cardiovascular disease populations, such as older individuals. It has been demonstrated that older individuals have slower reactive hyperemia compared with young individuals. Importantly, older individuals also show less desaturation during ischemia compared with young individuals. Based on these findings, it has been suggested that the slower reactive hyperemia observed in older individuals is explained by the lower desaturation during blood flow occlusion (reduced ischemic stimulus). This retrospective analysis compared reactive hyperemia in 36 young and 47 older tissue desaturation-matched individuals that underwent 5-min blood flow occlusion. Overall, we showed that older individuals have impaired reactive hyperemia compared with young when matching for the degree of desaturation and blood flow occlusion time. These findings provide evidence that lower tissue desaturation during ischemia is not a major determinant of impaired reactive hyperemia in older individuals.NEW & NOTEWORTHY Previous findings have suggested that aging-related impairment in skeletal muscle reactive hyperemia is majorly influenced by a lower degree of tissue desaturation during ischemia in older individuals compared with young individuals. In a retrospective analysis including 83 tissue desaturation-matched individuals, we show that the degree of tissue desaturation is not a major determinant of aging-related impairments in reactive hyperemia.
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Envejecimiento , Hiperemia , Microcirculación , Músculo Esquelético , Flujo Sanguíneo Regional , Espectroscopía Infrarroja Corta , Hiperemia/fisiopatología , Músculo Esquelético/irrigación sanguínea , Músculo Esquelético/metabolismo , Músculo Esquelético/fisiopatología , Humanos , Estudios Retrospectivos , Masculino , Envejecimiento/metabolismo , Envejecimiento/fisiología , Anciano , Femenino , Adulto , Adulto Joven , Persona de Mediana Edad , Factores de Edad , Isquemia/fisiopatología , Isquemia/metabolismo , Oxígeno/sangre , Oxígeno/metabolismoRESUMEN
BACKGROUND: Nonalcoholic fatty liver disease (NAFLD) is a leading cause of chronic liver disease and cirrhosis. NAFLD is mediated by changes in lipid metabolism and known risk factors include obesity, metabolic syndrome, and diabetes. The aim of this study was to better understand differences in the lipid composition of individuals with NAFLD compared to controls, by performing direct infusion lipidomics on serum biospecimens from a cohort study of adults in Mexico. METHODS: A nested case-control study was conducted with a sample of 98 NAFLD cases and 100 healthy controls who are participating in an on-going, longitudinal study in Mexico. NAFLD cases were clinically confirmed using elevated liver enzyme tests and liver ultrasound or liver ultrasound elastography, after excluding alcohol abuse, and 100 controls were identified as having at least two consecutive normal alanine aminotransferase (ALT) and aspartate aminotransferase (AST) (< 40 U/L) results in a 6-month period, and a normal liver ultrasound elastography result in January 2018. Samples were analyzed on the Sciex Lipidyzer Platform and quantified with normalization to serum volume. As many as 1100 lipid species can be identified using the Lipidyzer targeted multiple-reaction monitoring list. The association between serum lipids and NAFLD was investigated using analysis of covariance, random forest analysis, and by generating receiver operator characteristic (ROC) curves. RESULTS: NAFLD cases had differences in total amounts of serum cholesterol esters, lysophosphatidylcholines, sphingomyelins, and triacylglycerols (TAGs), however, other lipid subclasses were similar to controls. Analysis of individual TAG species revealed increased incorporation of saturated fatty acyl tails in serum of NAFLD cases. After adjusting for age, sex, body mass index, and PNPLA3 genotype, a combined panel of ten lipids predicted case or control status better than an area under the ROC curve of 0.83. CONCLUSIONS: These preliminary results indicate that the serum lipidome differs in patients with NAFLD, compared to healthy controls, and suggest that assessing the desaturation state of TAGs or a specific lipid panel may be useful clinical tools for the diagnosis of NAFLD.
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Colesterol/sangre , Lisofosfatidilcolinas/sangre , Enfermedad del Hígado Graso no Alcohólico/sangre , Esfingomielinas/sangre , Triglicéridos/sangre , Adulto , Anciano , Biomarcadores/sangre , Estudios de Casos y Controles , Estudios de Cohortes , Femenino , Humanos , Lipidómica , Masculino , México , Persona de Mediana Edad , Curva ROCRESUMEN
The purpose of the study was to assess whether there are differences in cardiorespiratory fitness between children with and without cystic fibrosis (CF). Ten children with CF attended at a referral center for the treatment of CF and 13 children without CF were evaluated. The average age of the children with CF was 10.40 (3.13) years and those without CF was 9.39 (3.25) years. The children performed the three-minute step test with monitoring of hemodynamic parameters and the rating of perceived exertion (RPE) every minute. Oxygen desaturation of 4% during the test occurred in three children with CF and none of the children reached a SatO2 percentage < 75%. After the step test, the findings showed that children with CF presented higher RPE scores during the test (p = 0.002) when compared to children without CF (p < 0.001). The RPE was the only parameter that changed during the test and demonstrated that children with cystic fibrosis tired more during the test when compared to children without CF despite the lack of changes in hemodynamic variables.
RESUMEN
OBJECTIVE: To investigate the features of cardiorespiratory events in infants born preterm during the transitional period, and to evaluate whether different neonatal characteristics may correlate with event type, duration, and severity. STUDY DESIGN: Infants with gestational age (GA) <32 weeks and/or birth weight <1500 g were enrolled in this observational prospective study. Heart rate (HR) and peripheral oxygen saturation (SpO2) were recorded continuously over the first 72 hours. Cardiorespiratory events of ≥10 seconds were clustered into isolated desaturation (SpO2 <85%), isolated bradycardia (HR <100 bpm or <70% of baseline), or combined desaturation/bradycardia and classified as mild, moderate, or severe. The daily incidences of isolated desaturation, isolated bradycardia, and combined desaturation and bradycardia were analyzed. The effects of relevant clinical variables on cardiorespiratory event type and severity were assessed using generalized estimating equations. RESULTS: Among the 1050 events analyzed, isolated desaturations were the most frequent (n = 625) and isolated bradycardias the least common (n = 171). The number of cardiorespiratory events increased significantly from day 1 to day 2 (P = .028). One in 5 events had severe characteristics; event severity was highest for combined desaturation and bradycardia (P < .001). Compared with other event types, the incidence of combined desaturation and bradycardia was inversely correlated with GA (P = .029) and was higher with the use of continuous positive airway pressure (P = .002). The presence of a hemodynamically significant patent ductus arteriosus was associated with the occurrence of isolated desaturations (P = .001) and with a longer duration of cardiorespiratory events (P = .003). CONCLUSIONS: Cardiorespiratory events during transition exhibit distinct types, duration, and severity. Neonatal characteristics are associated with the clinical features of these events, indicating that a tailored clinical approach may reduce the hypoxic burden in preterm infants aged 0-72 hours.
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Bradicardia/epidemiología , Hipoxia/epidemiología , Femenino , Humanos , Recién Nacido , Recien Nacido Prematuro , Masculino , Estudios Prospectivos , Factores de TiempoRESUMEN
BACKGROUND: Left double-lumen endotracheal tubes have been widely used in thoracic, esophageal, vascular, and mediastinal procedures to provide lung separation. Lacking clear objective guidelines, anesthesiologists usually select appropriately sized double-lumen endotracheal tubes based on their experience with 35 and 37Fr double-lumen endotracheal tubes, which are the most commonly used. We hypothesized the patients with a left main bronchus of shorter length (<40mm) had a greater chance of experiencing desaturation during one lung ventilation, due to obstruction in the orifice of the left upper lobe with the bronchial tube. METHODS: We included 360 patients with a left double-lumen intubated between September 2014 and August 2015. The patient's age, sex, height, weight, and underlying disease were recorded along with type of surgical procedure and the desaturation episodes. In addition, the width of the trachea and the width and length of the left bronchus were measured using computed tomography. RESULT: Patients with a left main bronchus length of less than 40mm who underwent intubation with a left double-lumen endotracheal tubes had significantly higher incidence of desaturation (Odds Ratio (OR: 8.087)) during one-lung ventilation. Other related factors of patients identified to be at risk of developing hypoxia were diabetes mellitus (OR: 5.368), right side collapse surgery (OR: 4.933), and BMI (OR: 1.105). CONCLUSIONS: We identified that patients with a left main bronchus length of less than 40mm have a great chance of desaturation, especially if other desaturation risk factors are present.
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Bronquios/anatomía & histología , Hipoxia/epidemiología , Intubación Intratraqueal/métodos , Ventilación Unipulmonar/métodos , Adulto , Anciano , Femenino , Humanos , Complicaciones Intraoperatorias/epidemiología , Masculino , Persona de Mediana Edad , Estudios Retrospectivos , Factores de Riesgo , Tomografía Computarizada por Rayos XRESUMEN
Abstract Background Left double-lumen endotracheal tubes have been widely used in thoracic, esophageal, vascular, and mediastinal procedures to provide lung separation. Lacking clear objective guidelines, anesthesiologists usually select appropriately sized double-lumen endotracheal tubes based on their experience with 35 and 37 Fr double-lumen endotracheal tubes, which are the most commonly used. We hypothesized the patients with a left main bronchus of shorter length (<40 mm) had a greater chance of experiencing desaturation during one lung ventilation, due to obstruction in the orifice of the left upper lobe with the bronchial tube. Methods We included 360 patients with a left double-lumen intubated between September 2014 and August 2015. The patient's age, sex, height, weight, and underlying disease were recorded along with type of surgical procedure and the desaturation episodes. In addition, the width of the trachea and the width and length of the left bronchus were measured using computed tomography. Result Patients with a left main bronchus length of less than 40 mm who underwent intubation with a left double-lumen endotracheal tubes had significantly higher incidence of desaturation (Odds Ratio (OR: 8.087)) during one-lung ventilation. Other related factors of patients identified to be at risk of developing hypoxia were diabetes mellitus (OR: 5.368), right side collapse surgery (OR: 4.933), and BMI (OR: 1.105). Conclusions We identified that patients with a left main bronchus length of less than 40 mm have a great chance of desaturation, especially if other desaturation risk factors are present.
Resumo Justificativa Os tubos endotraqueais de duplo lúmen (Double-lumen tubes - DLTs) para intubação seletiva esquerda têm sido amplamente utilizados em procedimentos torácicos, esofágicos, vasculares e mediastinais para proporcionar a separação dos pulmões. Com a falta de diretrizes claras, os anestesiologistas geralmente selecionam os tubos com base em sua experiência com os tubos endotraqueais de duplo lúmen de 35 e 37 Fr, os mais comumente usados. Nossa hipótese foi que os pacientes com um brônquio principal esquerdo de menor comprimento (< 40 mm) apresentavam uma chance maior de sofrer dessaturação durante a ventilação monopulmonar, devido à obstrução do orifício do lobo superior esquerdo com o tubo brônquico. Métodos No total, 360 pacientes submetidos à intubação seletiva esquerda mediante o uso de tubo de duplo lúmen foram incluídos no estudo entre setembro de 2014 e agosto de 2015. Idade, sexo, altura, peso e doença de base foram registrados, junto do tipo de procedimento cirúrgico e os episódios de dessaturação. Além disso, a largura da traqueia e a largura e comprimento do brônquio esquerdo foram medidos por meio de tomografia computadorizada. Resultados Os pacientes com comprimento do brônquio principal esquerdo inferior a 40 mm, submetidos à intubação seletiva esquerda com tubos endotraqueais de duplo lúmen, tiveram incidência significativamente maior de dessaturação (Odds Ratio - OR: 8,087) durante a ventilação monopulmonar. Outros fatores relacionados aos pacientes e identificados como risco de desenvolver hipoxemia foram diabetes mellitus (OR: 5,368), cirurgia de colapso direito (OR: 4,933) e IMC (OR: 1,105). Conclusões Identificamos que os pacientes com comprimento do brônquio principal esquerdo inferior a 40 mm apresentam grande chance de dessaturação, principalmente se outros fatores de risco para dessaturação estiverem presentes.
Asunto(s)
Humanos , Masculino , Femenino , Adulto , Anciano , Bronquios/anatomía & histología , Ventilación Unipulmonar/métodos , Intubación Intratraqueal/métodos , Hipoxia/epidemiología , Tomografía Computarizada por Rayos X , Estudios Retrospectivos , Factores de Riesgo , Complicaciones Intraoperatorias/epidemiología , Persona de Mediana EdadRESUMEN
OBJETIVO: Avaliar o comportamento da adaptação cardiovascular e da saturação periférica de oxigênio em indivíduos com DPOC submetidos no teste de caminhada dos seis minutos (TC6). MATERIAL E MÉTODOS: Trata-se de um estudo de corte transversal, que foram incluídas pessoas com diagnóstico de DPOC, confirmado pela espirometria e de ambos os sexos. A magnitude de sintomas foi avaliada pela escala de dispneia Medical Research Council (MRC) e questionário COPD Assessment Test (CAT). Aplicou-se o TC6 para avaliar a tolerância ao esforço. Para mensurar a frequência cardíaca máxima (FC máx) prevista para a idade foram utilizadas equações específicas para população brasileira. RESULTADOS: Avaliou-se 34 indivíduos com DPOC, 20 (58,8%) homens; relação VEF1/CVF foi 56,7%± 10,2% pós broncodilatador (BD). Quatorze 14 (41,2%) indivíduos apresentaram impacto clínico moderado; 16 (47,2%) dos avaliados apresentou grau 2 na escala do MRC. As médias das distâncias percorridas no primeiro e segundo TC6 foram 383,5 ± 13,6; 408,6 ± 85,7 metros, correspondendo a 70, 75%; 75,10% em relação ao valor previsto (p=0,001). As médias da FC máx ao final do primeiro e segundo TC6, foram 94,1 ± 21,9; 92,3 ± 17,9 bpm e a FC pós percentual da FC máx prevista pré e pós TC6 foram 61,1% ± 17,7%; 59,7% ± 21,5% e 14 (41,2%) pacientes apresentaram dessaturação de O2 no primeiro TC6; 9 (26,5%) no segundo teste. CONCLUSÕES: Pacientes com DPOC, apresentam aumento da FC identificado pelo esforço submáximo, por meio do percentual da FC max. Indivíduos com maior comprometimento da função pulmonar apresentaram dessaturação de O2. .
OBJECTIVE: To evaluate the behavior of cardiovascular adaptation and peripheral oxygen saturation in individuals with COPD submitted to the six-minute walk test (6MWT). MATERIAL AND METHODS: It was performed a descriptive study with person with a diagnosis of COPD confirmed by spirometry of both sexes. The Medical Research Council (MRC) dyspnea scale and the COPD Assessment Test (CAT) questionnaire were used to assess the magnitude of symptoms. The 6MWT was used to assess effort tolerance. To measure the maximum heart rate (HRmax) predicted for age, specific equations were used for the Brazilian population. RESULTS: 34 individuals with COPD were evaluated, 20 (58.8%) men; FEV1 / FVC ratio was 56.7% ± 10.2% after BD. Fourteen (41.2%) were classified as grade 2 and were classified as grade 2 (MRC scale). The means of the distances covered in the first and second TC6 were 383.5 ± 13.6; 408.6 ± 85.7 meters, corresponding to 70.7%; 75.1% in relation to the predicted value (p = 0.001). The mean maximum heart rate at the end of the first and second 6MWT were 94.1 ± 21.9; 92.3 ± 17.9 bpm and the heart rate post-percentage of the predicted maximum heart rate before and after the 6MWT were 61.1% ± 17.7%; 59.7% ± 21.5% and 14 (41.2%) patients presented O2 desaturation on the 6MWT; 9 (26.5%) in the second test. CONCLUSIONS: Patients with COPD throughout the 6MWT show increased heart rate and O2 desaturation in exercise activity.
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Enfermedad Pulmonar Obstructiva Crónica , Prueba de Paso , Frecuencia CardíacaRESUMEN
Beetroot juice (BJ) consumption has been associated with improved cardiovascular health owing to an increase in NO bioconversion. This study evaluates the effect of BJ consumption on macrovascular endothelial function (flow-mediated dilation (FMD)) and muscle oxygen saturation (StO2) parameters in pregnant women within a randomised, crossover, double-blind design in which twelve pregnant women consumed a single dose (140 ml) of BJ or placebo (PLA). Urinary nitrate was assessed before (T0) and 150 min after BJ/PLA consumption. FMD was used to evaluate macrovascular endothelial function, and near-IR spectroscopy was used to evaluate muscle StO2 parameters during the occlusion and reperfusion phases, which were taken at baseline (PRE) and 120 and 140 min after BJ/PLA consumption, respectively. A significant increase in urinary nitrate was observed at 150 min after BJ consumption when compared with T0 (BJ: 0·20 (sd 0·13) v. T0: 0·02 (sd 0·00), P=0·000) and PLA intervention (PLA: 0·02 (sd 0·00), P=0·001). FMD improved after BJ consumption when compared with PRE (BJ: 11·00 (sd 1·67) v. PRE: 5·53 (sd 1·17), P=0·000) and PLA (5·34 (sd 1·31), P=0·000). No significant difference between PLA and PRE in FMD (P=1·000) was observed. In StO2 parameters, a difference was not observed after BJ consumption compared with PRE and PLA intervention. The data demonstrate that a single dose of 140 ml of BJ consumption improves macrovascular endothelial function, but not StO2 parameters.
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Beta vulgaris/química , Endotelio Vascular/metabolismo , Jugos de Frutas y Vegetales , Músculo Esquelético/metabolismo , Óxido Nítrico/metabolismo , Adulto , Estudios Cruzados , Método Doble Ciego , Femenino , Humanos , Nitratos/orina , Oxígeno/metabolismo , Consumo de Oxígeno , Raíces de Plantas/química , Embarazo , Espectroscopía Infrarroja Corta , Adulto JovenRESUMEN
Fatty acids (FAs) have been postulated to impact adiposity, but few epidemiological studies addressing this hypothesis have been conducted. This study investigated the association between serum phospholipid FAs (S-PLFAs) and indicators of obesity. BMI and waist-to-hip ratio (WHR) were collected from 372 healthy Mexican women included as controls in a case-control study. S-PLFA percentages were determined through gas chromatography. Desaturation indices, SCD-16, SCD-18, FA desaturase (FADS)1, and FADS2, biomarkers of endogenous metabolism, were proxied respectively as 16:1n-7/16:0, 18:1n-9/18:0, 20:4n-6/20:3n-6, and 22:6n-3/20:5n-3. Multiple linear regressions adjusted for relevant confounders and corrected for multiple testing were conducted to determine the association between S-PLFA, desaturation indices, and indicators of adiposity. SCD-16 (ß = 0.034, P = 0.001, q = 0.014), palmitoleic acid (ß = 0.031, P = 0.001, q = 0.014), and dihomo-γ-linolenic acid (ß = 0.043, P = 0.000, q = 0.0002) were positively associated with BMI. Total n-6 PUFAs (ß = 1.497, P = 0.047, q = 0.22) and the ratio of n-6/n-3 PUFAs (ß = 0.034, P = 0.040, q = 0.19) were positively associated with WHR, while odd-chain FAs (pentadecanoic and heptadecanoic acid) showed negative associations with all the adiposity indicators. In conclusion, increased endogenous synthesis of palmitoleic acid and a high n-6/n-3 ratio are associated with increased adiposity, while odd-chain FAs are associated with decreased adiposity. Further studies are needed to determine the potential causality behind these associations.
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Adiposidad , Ácidos Grasos/sangre , Ácidos Grasos/metabolismo , Fosfolípidos/metabolismo , Adiposidad/efectos de los fármacos , Estudios de Casos y Controles , delta-5 Desaturasa de Ácido Graso , Grasas de la Dieta/farmacología , Femenino , Humanos , México/epidemiología , Persona de Mediana Edad , Obesidad/sangre , Obesidad/epidemiología , Obesidad/patologíaRESUMEN
BACKGROUND: The Global Initiative for Chronic Obstructive Lung Disease (GOLD) 2011 update recommends that the management and treatment of COPD be made to combine the impact of disease and future risk of exacerbation. These patients have worsening quality of life and limitation of activities of daily living (ADLs), which can be manifested as a decrease in S(pO2) and progressive dyspnea. The aim of this study was to determine whether the COPD combined classification proposed by GOLD 2011 is able to differentiate patients with ADL limitation, such as oxygen desaturation or dyspnea, and impaired quality of life. METHODS: This was an observational, cross-sectional study. Forty-four subjects were categorized in 4 GOLD groups (A-D). The mean age was 69 ± 8.8 y, with FEV1 of 1.33 ± 0.53 L (49 ± 15.7% of predicted). The Modified Medical Research Council dyspnea and London Chest Activity of Daily Living (LCADL) scales and the St George Respiratory Questionnaire (SGRQ) were applied. The 6-min walk test and ADL simulation in an appropriate laboratory were also conducted. RESULTS: There was no association between the COPD combined evaluation groups and the presence of oxygen desaturation and dyspnea (chi-square test), although a higher prevalence of oxygen desaturation was noticed in group D subjects. With regard to dyspnea, there were subjects with dyspnea in all groups when ADLs were performed. No correlation between dyspnea and oxygen desaturation variation was found. Group B and D subjects showed higher ADL dyspnea (total LCADL scores of 28% and 30%) compared with group A subjects. Group D subjects showed poorer quality of life (total SGRQ score of 49.3%) compared with less symptomatic groups. CONCLUSIONS: The COPD combined classification was not efficient in determining oxygen desaturation and dyspnea while subjects were performing ADLs. The subjects in the symptomatic groups with increased risk of exacerbation showed poorer quality of life and higher dyspnea levels. (ClinicalTrials.gov registration NCT01977469).
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Actividades Cotidianas , Enfermedad Pulmonar Obstructiva Crónica/clasificación , Calidad de Vida , Caminata/fisiología , Anciano , Estudios Transversales , Femenino , Estudios de Seguimiento , Humanos , Masculino , Consumo de Oxígeno , Enfermedad Pulmonar Obstructiva Crónica/fisiopatología , Enfermedad Pulmonar Obstructiva Crónica/psicología , Estudios Retrospectivos , Encuestas y CuestionariosRESUMEN
OBJECTIVE: to evaluate associations between morphometric variables, cervical circumference (CC), and abdominal circumference (AC) with the presence of nocturnal desaturation in children and adolescents with sickle-cell anemia. METHODS: all patients were submitted to baseline polysomnography, oral cavity measurements (maxillary intermolar distance, mandibular intermolar distance, and overjet), and CC and AC measurements. RESULTS: a total of 85 patients were evaluated. A positive correlation was observed between the height/age Z-score and CC measurement (r = 0.233, p = 0.031). The presence of nocturnal desaturation was associated with CC (59.2± 9.3 vs. 67.5 ± 10.7, p = 0.006) and AC measurements (27.0 ± 2.0 vs. 29.0± 2.1, p = 0.028). There was a negative correlation between desaturation and maxillary intermolar distance (r = -0.365, p = 0.001) and mandibular intermolar distance (r = -0.233, p = 0.037). CONCLUSIONS: the morphometric variables of CC and AC may contribute to raise suspicion of nocturnal desaturation in children and adolescents with sickle-cell anemia. .
OBJETIVO: avaliar associações entre variáveis morfométricas e circunferências cervical (CC) e abdominal (CA) com a presença de dessaturação noturna em crianças e adolescentes com anemia falciforme. MÉTODOS: todos os pacientes foram submetidos à polissonografia basal, medidas da cavidade oral (distância intermolar da maxila, distância intermolar da mandíbula e overje), CC e CA. RESULTADOS: foram avaliados 85 pacientes. Foi observada correlação positiva entre o escore Z altura/idade e a medida da circunferência cervical (r = 0,233 p = 0,031). A presença da dessaturação noturna associou-se com as medidas da circunferência cervical (59,2 ± 9,3 vs 67,5 ± 10,7; p = 0,006) e abdominal (27,0 ± 2,0 vs 29,0 ± 2,1; p = 0,028). Houve correlação negativa entre a dessaturação e a distância entre os segundos molares da maxila (r =-0,365, p = 0,001) e da mandíbula (r = -0,233, p = 0,037). CONCLUSÕES: as variáveis morfométricas e circunferências cervical e abdominal podem contribuir para a suspeita da dessaturação noturna em crianças e adolescentes com anemia falciforme. .
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Adolescente , Niño , Preescolar , Femenino , Humanos , Masculino , Anemia de Células Falciformes/complicaciones , Cuello/anatomía & histología , Oxígeno/metabolismo , Diámetro Abdominal Sagital/fisiología , Síndromes de la Apnea del Sueño/diagnóstico , Anemia de Células Falciformes/fisiopatología , Ritmo Circadiano , Estudios de Cohortes , Estudios Transversales , Mandíbula/anatomía & histología , Maxilar/anatomía & histología , Boca/anatomía & histología , Polisomnografía , Síndromes de la Apnea del Sueño/etiología , Síndromes de la Apnea del Sueño/fisiopatologíaRESUMEN
OBJECTIVE: to evaluate associations between morphometric variables, cervical circumference (CC), and abdominal circumference (AC) with the presence of nocturnal desaturation in children and adolescents with sickle-cell anemia. METHODS: all patients were submitted to baseline polysomnography, oral cavity measurements (maxillary intermolar distance, mandibular intermolar distance, and overjet), and CC and AC measurements. RESULTS: a total of 85 patients were evaluated. A positive correlation was observed between the height/age Z-score and CC measurement (r = 0.233, p = 0.031). The presence of nocturnal desaturation was associated with CC (59.2± 9.3 vs. 67.5 ± 10.7, p = 0.006) and AC measurements (27.0 ± 2.0 vs. 29.0± 2.1, p = 0.028). There was a negative correlation between desaturation and maxillary intermolar distance (r = -0.365, p = 0.001) and mandibular intermolar distance (r = -0.233, p = 0.037). CONCLUSIONS: the morphometric variables of CC and AC may contribute to raise suspicion of nocturnal desaturation in children and adolescents with sickle-cell anemia.
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Anemia de Células Falciformes/complicaciones , Cuello/anatomía & histología , Oxígeno/metabolismo , Diámetro Abdominal Sagital/fisiología , Síndromes de la Apnea del Sueño/diagnóstico , Adolescente , Anemia de Células Falciformes/fisiopatología , Niño , Preescolar , Ritmo Circadiano , Estudios de Cohortes , Estudios Transversales , Femenino , Humanos , Masculino , Mandíbula/anatomía & histología , Maxilar/anatomía & histología , Boca/anatomía & histología , Polisomnografía , Síndromes de la Apnea del Sueño/etiología , Síndromes de la Apnea del Sueño/fisiopatologíaRESUMEN
Traditionally, ruminal ciliate protozoa have been studied with respect to the metabolism of dietary nutrients. Their role has focused on their predatory behavior, the paradigm of its retention in the rumen, and its apparent limited flow to the duodenum. On the other hand, Conjugated Linoleic Acid (CLA) and Vaccenic Acid (VA) are important because of their nutritional value. This review aims to characterize the biological alternatives used by rumen ciliate protozoa for the production of CLA, highlighting three aspects: 1) rumen protozoa are involved only in the initial stage of biohydrogenation to produce CLA isomers, 2) desaturation by protozoa has not been reported, while endogen synthesis by desaturation of VA in mammary glands and fatty tissues has been demonstrated as the main route of CLA in ruminants, 3) even though incorporation of VA and cis9, trans11-CLA in protozoa structure is related with CLA production, this is only important when protozoa flow from rumen to duodenum, producing 30 to 43% of CLA and a 40% of VA, respectively. It is concluded that rumen protozoa are fundamental in the lipid metabolism of ruminants.
Tradicionalmente, los protozoos ciliados ruminales han sido estudiados en relación con el metabolismo de nutrientes de la dieta suministrada al rumiante. Particularmente, su papel ha sido cuestionado debido a sus características predadoras, aunado al paradigma de la retención de los protozoos en el rumen y el aparente limitado flujo al duodeno por reciclaje de la proteína microbiana. De otro lado, los ácidos linoleico conjugado (CLA) y vacénico (VA) son dos productos de gran interés nutricional. Estas dos situaciones han generado interés en la investigación de esta representativa población de la microbiota ruminal. El objetivo de este trabajo fue caracterizar, a partir de la literatura científica, las alternativas biológicas utilizadas por los protozoos ciliados del rumen para la producción de CLA. Nosotros encontramos que: 1) los protozoos ruminales sólo participan en la parte inicial de la biohidrogenación, la “isomerización de ácidos grasos insaturados”, generando isómeros de CLA, 2) la desaturación en protozoos, no se demostró en estudios, y queda claro que la síntesis endógena por desaturación de VA, en glándula mamaria y tejidos grasos se establece como el mayor recurso de CLA en el rumiante, 3) aun cuando la incorporación de VA y cis9, trans11-CLA en la estructura de los protozoos está relacionada con la producción de CLA, esta sólo es importante hasta cuando se da el flujo de protozoos del rumen a duodeno donde son responsables del 30 al 43% del CLA y 40% del VA. Se concluye, que los protozoos ruminales son trascendentales en el metabolismo lipídico de rumiantes.
Tradicionalmente, os protozoários ciliados no rúmen têm sido estudados em relação ao metabolismo dos nutrientes na dieta fornecida ao ruminante. Em particular, o seu papel tem sido questionado devido às suas características predatórias, combinado com o paradigma da retenção de protozoários no rúmem e ao aparente fluxo limitado para o duodeno através da reciclagem da proteína microbiana. Por outro lado, o ácido linoléico conjugado (CLA) e o vacenico (VA) são dois produtos de grande interesse nutricional. Estas duas situações têm gerado interesse na investigação dessa representativa população da microbiota ruminal. O objetivo deste estudo foi caracterizar as alternativas biológicas utilizadas pelos protozoários ciliados do rúmem para a produção de CLA a partir da literatura científica. Nós encontramos que: 1) os protozoários ruminais só participam na parte inicial da biohidrogenação: a isomerização “de ácidos graxos insaturados”, gerando isômeros do CLA. 2) até hoje, não tem sido demonstrado a desaturação em protozoários e fica claro que a síntese endógena por desaturação do VA na glândula mamária e tecido adiposo se estabelece como a maior fonte de CLA no ruminante. 3) embora a incorporação de VA e cis9, trans11-CLA na estrutura do protozoário está relacionada com a produção de CLA, ésta só é importante ate quando há fluxo de protozoários do rúmem para o duodeno onde são responsáveis do 30 ate 43% do CLA e 40% do VA. A conclusão é que os protozoários ruminais são transcendentais no metabolismo lipídico dos ruminantes.