Different fasting periods in tiletamine-zolezepam-anethetized cats: Glycemia, recovery, blood-gas and cardiorrespiratory parameters

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Intubação traqueal e o paciente com o estômago cheio

A aspiração pulmonar do conteúdo gástrico, apesar de pouco frequente, exige cuidados especiais para sua prevenção. A depressão da consciência durante a anestesia predispõe os pacientes a esta grave complicação pela diminuição na função do esfíncter esofágico e dos reflexos protetores das vias aéreas. Guias de jejum pré-operatório elaborados recentemente sugerem períodos menores de jejum, principalmente para líquidos, permitindo mais conforto aos pacientes e menor risco de hipoglicemia e desidratação, sem aumentar a incidência de aspiração pulmonar perioperatória. O uso rotineiro de agentes que diminuem a acidez e volume gástrico parece estar indicado apenas para pacientes de risco. A intubação traqueal após indução anestésica por meio da técnica de sequência rápida está indicada naqueles pacientes, com risco de aspiração gástrica, em que não há suspeita de intubação traqueal difícil. A indicação correta da técnica, sua aplicação criteriosa e a utilização racional das drogas disponíveis podem promover condições excelentes de intubação, com curto período de latência, rápido retorno da consciência e da respiração espontânea, caso haja falha na intubação traqueal.O presente artigo tem como objetivo discutir os métodos atualmente utilizados para controlar o volume e o pH do conteúdo gástrico, proteger as vias aéreas durante as manobras de intubação e reduzir o refluxo gastroesofágico.

Correlação de diferentes períodos de jejum com níveis séricos de cortisol, glicemia plasmática, estado clínico e equilíbrio ácido-base em case submetidos à anestesia geral inalatória

This study correlated the solid preoperative fasting periods with plasma glycemia, serum cortisol, condition clinic and acid-base balance in dogs submitted to inhalation of general anaesthesia. Eight adults, animals were distributed into three groups in accordance with solid preoperative fasting: group 1 (12 hours), group 2 (18 hours) and group 3 (24 hours). Gastric emptying was observed and following this animals were submitted to the same anesthetic procedure. Heart and respiratory rate, rectal temperature, capillary refill time, percent hydration and noninvasive arterial pressure determined before and after Acepromazine and every 10 minutes during anaesthesia, included ETCO 2; values blood gas (pH, PaCO 2, PaO 2, HCO 3, TCO 2, SaO 2, BE), glycemic and serum cortisol were analyzed before MPA and each 30 minutes during anaesthesia. In recovery anaesthetic, glycemia and serum cortisol were repeated. During anaesthesia there were little cardiovascular and respiratory alteration not having interference of the preoperative fasting periods. Animals with 12 hours of the preoperative fasting showed a higher rise in glycemia levels than others groups in recovery anaesthetic. Serum cortisol wasn't influenced by fasting. Solid preoperative fasting independent of the duration describe a discreet respiratory alkalosis. All animals showed good clinical condition in all three groups. Solid preoperative fasting of the 18 hours is recommended to ensure a complete absence of the solid food contents in stomach.

Comparação entre diferentes períodos de jejum em cães submetidos à anestesia geral inalatória: aspectos clínicos, bioquímicos e eletrolíticos

Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)

Feeding strategy with alternate fasting and refeeding: effects on farmed pacu production

P>A 36-day trial was conducted to determine the effects of repetitive periods of food restriction and refeeding on growth and energy metabolism in pacu (Piaractus mesopotamicus). A total 264 juvenile fish (36.9 +/- 2.8 g) were fed with the experimental diet for 36 days using three regimes: (i) feeding daily to satiation (FD); (ii) no feed for 3 days, then feeding the same amount offered to the control groups for the next 3 days (NF/R controlled); and (iii) no feed for 3 days, then feeding to apparent satiation for the next 3 days (NF/R at satiation). The treatments were distributed into four tanks each. WG and SGR were higher in FD group. Fish refed showed hyperphagia just up to the second day of refeeding. The worst feed conversion rate and the lowest protein efficiency ratio were found in fish NF/R controlled. The lowest values of visceral fat somatic index were found in both fasted fish groups, particularly in NF/R at satiation. The LL and glycogen concentrations, and the hepatosomatic index were all elevated in both feed restricted fish. Muscle lipid showed a tendency to decrease after the cycle of fasting and refeeding. Plasma free fatty acids and glucose levels were elevated in fish subjected to feeding restrictions while serum triglycerides levels were reduced. Triiodothyronine levels were significantly depressed in fish from the NF/R-controlled group and remained at the same levels as the control fish in fish NF/R at satiation. Results indicated that fish subjected to cyclic periods of 3-day satiation or controlled feeding after 3-days of fasting were unable to achieve the final body weight of fish fed to satiation after 36 days.

Preoperative warming combined with intraoperative skin-surface warming does not avoid hypothermia caused by spinal anesthesia in patients with midazolam premedication

CONTEXTO E OBJETIVO: Hipotermia inadvertida no perioperatório é freqüente durante anestesia subaracnóidea e após a administração de midazolam. O objetivo foi avaliar os efeitos do aquecimento da pele no intra-operatório, associado ou não ao aquecimento da pele durante o período de 45 minutos no pré-operatório, na prevenção de hipotermia intra- e pós-operatória determinada pela anestesia subaracnóidea em pacientes com medicação pré-anestésica com midazolam. TIPO DE ETUDO E LOCAL: Estudo prospectivo e aleatório, realizado no Hospital das Clínicas, Universidade Estadual Paulista (Unesp), Botucatu, SP. MÉTODOS: O estudo foi realizado em 30 pacientes com estado físico ASA (da Sociedade Norte-americana de Anestesiologistas) I e II submetidos à cirurgia eletiva do abdômen. Como medicação pré-anestésica, utilizou-se o midazolam, 7,5 mg via intramuscular (IM) e anestesia subaracnóidea padrão. em 10 pacientes (Gcontrole) utilizou-se isolamento térmico passivo; 10 pacientes (Gpré+intra) foram submetidos a aquecimento ativo no pré- e intra-operatório; e 10 pacientes (Gintra) foram aquecidos ativamente somente no intra-operatório. RESULTADOS: Após 45 minutos de aquecimento no pré-operatório, os pacientes do Gpré+intra apresentaram temperatura central mais elevada em relação aos dos grupos não aquecidos antes da anestesia (p < 0,05) mas não no início da cirurgia (p > 0,05). Os pacientes que receberam aquecimento no intra-operatório apresentaram temperatura central mais elevada no final da cirurgia em relação aos de Gcontrole (p < 0,05). Todos os pacientes estavam hipotérmicos na admissão da sala de recuperação pós-anestésica (temperatura central < 36º C). CONCLUSÕES: 45 minutos de aquecimento no pré-operatório combinado com aquecimento no intra- operatório não evita, mas minimiza a ocorrência de hipotermia determinada pela anestesia subaracnóidea em pacientes que receberam midazolam como medicação pré-anestésica.

Effect of respiratory muscle training on pulmonary function in preoperative preparation of tobacco smokers

OBJETIVO: Avaliar o efeito da utilização de um programa de treinamento específico dos músculos respiratórios sobre a função pulmonar em indivíduos tabagistas. MÉTODOS: Foram estudados 50 indivíduos tabagistas assintomáticos com idade superior a 30 anos, nos seguintes momentos: A0 - avaliação inicial seguida do protocolo de exercícios respiratórios; A1 - reavaliação após 10 minutos da aplicação do protocolo; e A2 -reavaliação final após duas semanas de treinamento utilizando o mesmo protocolo três vezes por semana. A avaliação foi realizada através das medidas de pressões respiratórias máximas (PImax. e PEmax.), picos de fluxo respiratórios (PFI e PFE), ventilação voluntária máxima (VVM), capacidade vital Forçada (CVF) e Volume expiratório forçado no primeiro segundo (VEF1). RESULTADOS: Não houve melhora na CVF e VEF1 da avaliação inicial para a final. Houve aumento significativo das variáveis PFI, PFE, VVM e PImax nas avaliações A1 e A2. A variável PEmax. aumentou somente na avaliação A2. CONCLUSÃO: A aplicação de protocolo de exercícios respiratórios com e sem carga adicional em indivíduos tabagistas produziu melhora imediata na performance dos músculos respiratórios, mas esta melhora foi mais acentuada após duas semanas de exercício.

Preoperative and Postoperative Nutritional Evaluation in Patients with Non-advanced Megaesophagus

Megaesophagus, an affection characterized by aperistalses of the esophageal body and deficient relaxation of lower esophageal sphincter, has disphagia as main symptom. The aim of this study was to evaluate the nutritional status of patients with non advanced megaesophagus in pre and post-operative periods of cardiomyotomy. Ten patients were evaluated at 5 moments (pre-operative - M 1 and post-operative - 1, 3, 6 ant 12 months after surgery). The anthropometric, hematimetric and biochemical parameters were studied in the 5 moments. Conclusions: 1. Most 017 the patients with non-advanced megaesophagus are eutrophic; 2. Surgical treatment determines an improvement in nutritional status and an increase in HDL cholesterol values.

Comparison between 100-g glucose tolerance test and two other screening tests for gestational diabetes: combined fasting glucose with risk factors and 50-g glucose tolerance test

CONTEXTO E OBJETIVO: A falta de consenso sobre os protocolos de rastreamento e diagnóstico do diabetes gestacional, associada às dificuldades na realização do teste oral simplificado do diabete gestacional (o teste de tolerância a 100 g de glicose, considerado padrão-ouro) justificam a comparação com alternativas. O objetivo deste trabalho é comparar o teste padrão-ouro a dois testes de rastreamento: associação de glicemia de jejum e fatores de risco (GJ + FR) e o teste oral simplificado de tolerância a 50 g de glicose (TTG 50 g), com o teste de tolerância a 100 g de glicose (TTG 100 g). TIPO DE ESTUDO E LOCAL: Estudo de coorte longitudinal, prospectivo, realizado no Serviço de Ginecologia e Obstetrícia do Hospital Universitário da Universidade Federal de Mato Grosso do Sul. MÉTODOS: 341 gestantes foram submetidas aos três testes. Calcularam-se os índices de sensibilidade (S), especificidade (E), valores preditivos (VPP e VPN), razões de probabilidade (RPP e RPN) e resultados falsos (FP e FN), positivos e negativos da associação GJ + FR e do TTG 50 g em relação ao TTG 100 g. Compararam-se as médias das glicemias de uma hora pós-sobrecarga (1hPS) com 50 e 100 g. Na análise estatística, empregou-se o teste t de Student, com limite de significância de 5%. RESULTADOS: A associação GJ + FR encaminhou mais gestantes (53,9%) para a confirmação diagnóstica que o TTG 50 g (14,4%). Os dois testes foram equivalentes nos índices de S (86,4 e 76,9%), VPN (98,7 e 98,9%), RPN (0,3 e 0,27) e FN (15,4 e 23,1%). As médias das glicemias 1hPS foram semelhantes, 106,8 mg/dl para o TTG 50 g e 107,5 mg/dl para o TTG 100 g. CONCLUSÕES: Os resultados da eficiência diagnóstica associados à simplicidade, praticabilidade e custo referendaram a associação GJ + FR como o mais adequado para o rastreamento. A equivalência das glicemias de 1hPS permitiram a proposição de um novo protocolo de rastreamento e diagnóstico do diabete gestacional, com menores custo e desconforto.

Effects of fasting and intermittent fasting on rat hepatocarcinogenesis induced by diethylnitrosamine

The influences of fasting on DEN-initiation and of intermittent fasting (IF) on the rat liver chemical carcinogenesis process were evaluated in a 52-week long assay. Three groups of adult male Wistar rats were used: Groups I to 3 were treated with a single i.p. injection of 200 mg/kg of diethylnitrosamine (DEN). Group 2 was submitted to 48 h fasting prior to DEN treatment. After the 4th week, Group 3 was submitted to IF, established as 48 h weekly fasting during 48 weeks, while Groups I and 2 were fed ad libitum until the 52nd week. All animals were submitted to 70% partial hepatectomy and sacrificed at the 3rd and 52nd weeks, respectively. Fasting prior to DEN-initiation did not influence the development of altered foci of hepatocytes (AFHs) and of hepatic nodules (Group 2 vs. Group G1). IF inhibited the development of preneoplastic lesions, since this dietary regimen decreased the number and the size of glutathione S-transferase (GST-P) positive foci and the number and size of liver nodules (Group G3 vs. Group G1), the inhibitory effect of IF was also reflected in the development of clear and basophilic cell foci. These results indicate that long-term IF regimen exerts an anti-promoting effect on rat hepatocarcinogenesis induced by DEN. (C) 2002 Wiley-Liss, Inc.

Morphological changes of the intestinal mucosa of broilers and layers as affected by fasting before sample collection

The present study aimed at evaluating the histo-morphological changes resulting from different fasting periods before the collection of tissue samples in different segments of the small intestine (duodenum, jejunum and ileum) of 7-d-old male chicks of a broiler and a layer strain. A completely randomized experimental design in in a 2x7 factorial arrangement, being two strains with different growth rates (Ross 308 and HyLine® W36) and seven fasting periods (0, 2, 4, 6, 8, 10 and 12 hours ), with six replicates, totaling 84 birds. The comparison of the morphometrics of the duodenum, jejunum and ileum of broiler and layer chicks demonstrated faster digestive tract development in broilers relative to layers. The fasting period caused morphological changes in the liver and small and large intestines in both strains. Therefore, it must be highlighted that in studies involving organ weights and intestinal morphometrics, birds must not be submitted to fasting before tissue collection.

Productive consequences of fasting neonatal chicks of different genetic constitutions for growing

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Chicken meat quality as a function of fasting period and water spray

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Correlations Between Pre- and Post-Fasting Growth in Nile Tilapia

We tested the correlation between growth rate before and after a food deprivation phase in twelve single held Nile tilapias, Oreochromis niloticus. The experiment was divided into three phases: before food deprivation (phase 1: 15 d), food deprivation (phase 2: 12 d) and refeeding (phase 3: 15 d). The specific growth rate - SGR, food conversion efficiency - FCE and feed ingestion increased significantly during phase 3. Positive and significant correlations were found either to SGR or to feed ingestion between Phase 1 and 3 but not for FCE. The SGR on phase 3, moreover, were positively correlated to FCE and feed ingestion, while on phase 1 SGR was positively correlated to FCE only. Thus, high pre-fasting SGR or feed ingestion reflects in likewise high post-fasting SGR or feed ingestion values. Moreover, since SGR and FCE are correlated to each other in both phase 1 and 3, but phase 3 SGR is also correlated to feed ingestion; we could suppose that hyperphagic behaviour could be the main compensatory mechanism. Accordingly, we suggest that a fish with an elevated growth performance shall display a proportionally raised post-fasting growth response in order to normalize its predetermined growth trajectory and resume its normal growth rate.

Metabolic changes in Brycon cephalus (Teleostei, Characidae) during post-feeding and fasting

Metabolic changes during the transition from post-feeding to fasting were studied in Brycon cephalus, an omnivorous teleost from the Amazon Basin in Brazil. Body weight and somatic indices (liver and digestive tract), glycogen and glucose content in liver and muscle, as well as plasma glucose, free fatty acids (FFA), insulin and glucagon levels of B. cephalus, were measured at 0, 12, 24, 48, 72, 120, 168 and 336 h after the last feeding. At time 0 h (the moment of food administration, 09.00 h) plasma levels of insulin and glucagon were already high, and relatively high values were maintained until 24 h post-feeding. Glycemia was 6.42 +/- 0.82 mM immediately after food ingestion and 7.53 +/- 1.12 MM at 12 h. Simultaneously, a postprandial replenishment of liver and muscle glycogen reserves was observed. Subsequently, a sharp decrease of plasma insulin occurred, from 7.19 +/- 0.83 ng/ml at 24 h of fasting to 5.27 +/- 0.58 ng/ml at 48 h. This decrease coincided with the drop in liver glucose and liver glycogen, which reached the lowest value at 72 h of fasting (328.56 +/- 192.13 and 70.33 +/- 14.13 mumol/g, respectively). Liver glucose increased after 120 h and reached a peak 168 h post-feeding, which suggests that hepatic gluconeogenesis is occurring. Plasma FFA levels were low after 120 and 168 h and increased again at 336 h of fasting. During the transition from post-feeding to fast condition in B. cephalus, the balance between circulating insulin and glucagon quickly adjust its metabolism to the ingestion or deprivation of food. (C) 2002 Elsevier B.V. All rights reserved.