Dynamics of chest wall volume regulation during constant work rate exercise in patients with chronic obstructive pulmonary disease

This study evaluated the dynamic behavior of total and compartmental chest wall volumes [(V CW) = rib cage (V RC) + abdomen (V AB)] as measured breath-by-breath by optoelectronic plethysmography during constant-load exercise in patients with stable chronic obstructive pulmonary disease. Thirty males (GOLD stages II-III) underwent a cardiopulmonary exercise test to the limit of tolerance (Tlim) at 75% of peak work rate on an electronically braked cycle ergometer. Exercise-induced dynamic hyperinflation was considered to be present when end-expiratory (EE) V CW increased in relation to resting values. There was a noticeable heterogeneity in the patterns of V CW regulation as EEV CW increased non-linearly in 17/30 "hyperinflators" and decreased in 13/30 "non-hyperinflators" (P < 0.05). EEV AB decreased slightly in 8 of the "hyperinflators", thereby reducing and slowing the rate of increase in end-inspiratory (EI) V CW (P < 0.05). In contrast, decreases in EEV CW in the "non-hyperinflators" were due to the combination of stable EEV RC with marked reductions in EEV AB. These patients showed lower EIV CW and end-exercise dyspnea scores but longer Tlim than their counterparts (P < 0.05). Dyspnea increased and Tlim decreased non-linearly with a faster rate of increase in EIV CW regardless of the presence or absence of dynamic hyperinflation (P < 0.001). However, no significant between-group differences were observed in metabolic, pulmonary gas exchange and cardiovascular responses to exercise. Chest wall volumes are continuously regulated during exercise in order to postpone (or even avoid) their migration to higher operating volumes in patients with COPD, a dynamic process that is strongly dependent on the behavior of the abdominal compartment.

Roles of estrogen and progesterone in modulating renal nerve function in the rat kidney

The maintenance of extracellular Na+ and Cl- concentrations in mammals depends, at least in part, on renal function. It has been shown that neural and endocrine mechanisms regulate extracellular fluid volume and transport of electrolytes along nephrons. Studies of sex hormones and renal nerves suggested that sex hormones modulate renal function, although this relationship is not well understood in the kidney. To better understand the role of these hormones on the effects that renal nerves have on Na+ and Cl- reabsorption, we studied the effects of renal denervation and oophorectomy in female rats. Oophorectomized (OVX) rats received 17β-estradiol benzoate (OVE, 2.0 mg·kg-1·day-1, sc) and progesterone (OVP, 1.7 mg·kg-1·day-1,sc). We assessed Na+ and Cl-fractional excretion (FENa+ and FECl-, respectively) and renal and plasma catecholamine release concentrations. FENa+, FECl-, water intake, urinary flow, and renal and plasma catecholamine release levels increased in OVX vs control rats. These effects were reversed by 17β-estradiol benzoate but not by progesterone. Renal denervation did not alter FENa+, FECl-, water intake, or urinary flow values vs controls. However, the renal catecholamine release level was decreased in the OVP (236.6±36.1 ng/g) and denervated rat groups (D: 102.1±15.7; ODE: 108.7±23.2; ODP: 101.1±22.1 ng/g). Furthermore, combining OVX + D (OD: 111.9±25.4) decreased renal catecholamine release levels compared to either treatment alone. OVE normalized and OVP reduced renal catecholamine release levels, and the effects on plasma catecholamine release levels were reversed by ODE and ODP replacement in OD. These data suggest that progesterone may influence catecholamine release levels by renal innervation and that there are complex interactions among renal nerves, estrogen, and progesterone in the modulation of renal function.

Cyst infection in hospital-admitted autosomal dominant polycystic kidney disease patients is predominantly multifocal and associated with kidney and liver volume

Positron-emission tomography/computed tomography (PET/CT) has improved cyst infection (CI) management in autosomal dominant polycystic kidney disease (ADPKD). The determinants of kidney and/or liver involvement, however, remain uncertain. In this study, we evaluated clinical and imaging factors associated with CI in kidney (KCI) and liver (LCI) in ADPKD. A retrospective cohort study was performed in hospital-admitted ADPKD patients with suspected CI. Clinical, imaging and surgical data were analyzed. Features of infected cysts were evaluated by PET/CT. Total kidney (TKV) and liver (TLV) volumes were measured by CT-derived multiplanar reconstruction. CI was detected in 18 patients who experienced 24 episodes during an interval of 30 months (LCI in 12, KCI in 10 and concomitant infection in 2). Sensitivities of CT, magnetic resonance imaging and PET/CT were 25.0, 71.4, and 95.0%. Dysuria (P<0.05), positive urine culture (P<0.01), and previous hematuria (P<0.05) were associated with KCI. Weight loss (P<0.01) and increased C-reactive protein levels (P<0.05) were associated with LCI. PET/CT revealed that three or more infected cysts were present in 70% of the episodes. TKV was higher in kidney-affected than in LCI patients (AUC=0.91, P<0.05), with a cut-off of 2502 mL (72.7% sensitivity, 100.0% specificity). TLV was higher in liver-affected than in KCI patients (AUC=0.89, P<0.01) with a cut-off of 2815 mL (80.0% sensitivity, 87.5% specificity). A greater need for invasive procedures was observed in LCI (P<0.01), and the overall mortality was 20.8%. This study supports PET/CT as the most sensitive imaging method for diagnosis of cyst infection, confirms the multifocal nature of most hospital-admitted episodes, and reveals an association of kidney and liver volumes with this complication.

Negative emotions affect postoperative scores for evaluating functional knee recovery and quality of life after total knee replacement

This study aimed to determine whether psychological factors affect health-related quality of life (HRQL) and recovery of knee function in total knee replacement (TKR) patients. A total of 119 TKR patients (male: 38; female: 81) completed the Beck Anxiety Inventory (BAI), Beck Depression Inventory (BDI), State Trait Anxiety Inventory (STAI), Eysenck Personality Questionnaire-revised (EPQR-S), Knee Society Score (KSS), and HRQL (SF-36). At 1 and 6 months after surgery, anxiety, depression, and KSS scores in TKR patients were significantly better compared with those preoperatively (P<0.05). SF-36 scores at the sixth month after surgery were significantly improved compared with preoperative scores (P<0.001). Preoperative Physical Component Summary Scale (PCS) and Mental Component Summary Scale (MCS) scores were negatively associated with extraversion (E score) (B=-0.986 and -0.967, respectively, both P<0.05). Postoperative PCS and State Anxiety Inventory (SAI) scores were negatively associated with neuroticism (N score; B=-0.137 and -0.991, respectively, both P<0.05). Postoperative MCS, SAI, Trait Anxiety Inventory (TAI), and BAI scores were also negatively associated with the N score (B=-0.367, -0.107, -0.281, and -0.851, respectively, all P<0.05). The KSS function score at the sixth month after surgery was negatively associated with TAI and N scores (B=-0.315 and -0.532, respectively, both P<0.05), but positively associated with the E score (B=0.215, P<0.05). The postoperative KSS joint score was positively associated with postoperative PCS (B=0.356, P<0.05). In conclusion, for TKR patients, the scores used for evaluating recovery of knee function and HRQL after 6 months are inversely associated with the presence of negative emotions.

Altered mean platelet volume in patients with polymyositis and its association with disease severity

Polymyositis (PM) is an autoimmune disease characterized by chronic inflammation in skeletal muscle. Mean platelet volume (MPV), a marker in the assessment of systemic inflammation, is easily measured by automatic blood count equipment. However, to our knowledge, there are no data in the literature with respect to MPV levels in PM patients. Therefore, in this study we aimed to investigate MPV levels in patients with PM. This study included 92 newly diagnosed PM patients and 100 healthy individuals. MPV levels were found to be significantly lower compared with healthy controls (10.3±1.23 vs 11.5±0.74 fL, P<0.001). Interestingly, MPV was found to be positively correlated with manual muscle test (MMT) score and negatively correlated with erythrocyte sedimentation rate (ESR) in patients with PM (r=0.239, P=0.022; r=−0.268, P=0.010, respectively). In addition, MPV was significantly lower in active PM patients compared with inactive PM patients (9.9±1.39 vs 10.6±0.92 fL, P=0.010). MPV was independently associated with PM in multivariate regression analyses, when controlling for hemoglobin and ESR (OR=0.312, P=0.031, 95%CI=0.108 to 0.899). The ROC curve analysis for MPV in estimating PM patients resulted in an area under the curve of 0.800, with sensitivity of 75.0% and specificity of 67.4%. Our results suggest that MPV is inversely correlated with disease activity in patients with PM. MPV might be a useful tool for rapid assessment of disease severity in PM patients.

Oat hulls treated with alkaline hydrogen peroxide associated with extrusion as fiber source in cookies

Cookies were prepared with the replacement of 20% of wheat flour by chemically (alkaline hydrogen peroxide) and physically (extrusion) treated oat hulls, with the objective to investigate the possibility of use of this modified material. Cookies elaborated with the untreated hulls were used as control. Cookies were evaluated for their physical (spread ratio, specific volume and color) and sensory characteristics, and no difference was detected (p<0.05) among the cookies in relation to the physical properties. Triangule test, used to verify difference (p<0.05) among treated and untreated cookies, confirmed the efficiency of the treatment in sensory level. The acceptance level of cookies with treated fiber was evaluated by potential consumers of the product, obtaining 91% acceptance. The cookies presented 10.6 g of dietary fiber per 100 g of product.

Replacement of mechanically deboned chicken meat with its protein hydrolysate in mortadella-type sausages

Mortadella-type sausage manufactured using mechanically deboned chicken meat were reformulated replacing MDCM with increasing amounts of MDCM protein hydrolysates (10%, 20%, and 30%), and their physicochemical, microbiological, and sensorial characteristics were evaluated for 60 days of storage at 4 °C. The higher substitutions resulted in sausages more susceptible to lipid oxidation with higher TBARS values during storage; however, these values were lower than the organoleptic perception threshold. The sausages were darker and less red, with lower lightness (L*) and redness (a*) values than those of the control treatment. They had soft texture, which was evidenced by both the instrumental and sensory analysis. Therefore, the formulation containing 10% of MDCM protein hydrolysates proved to be the most suitable for mortadella-type sausage elaboration.

Effects of whole-wheat flour and bordeaux grape pomace (Vitis labrusca L.) on the sensory, physicochemical and functional properties of cookies

Abstract Grape pomace, which is derived from the skin and seeds, is the residue from the production of grape juice and wine. It corresponds to up to 20% of the total volume and it contains a high level of dietary fibers and bioactive compounds. In the Brazilian market, there is no product containing grape pomace as a replacement for conventional wheat flour. Thus, this study aimed to assess the effects of whole-wheat flour and organic Bordeaux grape pomace (Vitis labrusca L.) on the sensory, physicochemical and functional properties of cookies using response surface methodology (RSM). The regression models indicated that the addition of whole-wheat and organic grape pomace decreased (p < 0.0001) the water activity and significantly increased the content of fibers, hardness, brittleness, antioxidant activity and total phenolic content of the cookies. The RSM models presented suitable R2 and R2adj values (> 65% of explained data variability), except for brittleness. The sensory evaluation results revealed that no significant differences (p > 0.05) were observed for the cookie samples, implying that the addition of grape pomace and whole-wheat flour did not negatively affect the preference of cookies.

Efeito do número de sementes e do volume de água na condutividade elétrica de sementes de Dalbergia nigra (Vell.) Fr.All. ex Benth.

O presente trabalho teve como objetivos verificar o efeito do número de sementes e do volume de água utilizada no teste de condutividade elétrica (CE) para avaliar o vigor de três lotes de sementes de Dalbergia nigra (jacarandá-da-bahia) e correlacionar esses resultados com os dados de germinação em laboratório e em viveiro. Os testes de germinação em laboratório e viveiro foram conduzidos com quatro repetições de 25 sementes. O teste de CE foi realizado com 25, 50 e 75 sementes embebidas a 75, 100 e 125ml de água, por diferentes períodos. A porcentagem de germinação e de plântulas normais em laboratório, indicaram o lote III como de qualidade inferior aos lotes I e II. A primeira contagem da germinação e o índice de velocidade de germinação em laboratório e a emergência, índice de velocidade de emergência e porcentagem de plântulas normais em viveiro identificaram o lote II como superior ao lote I e o III como inferior. A CE diminui com o aumento do volume de água e aumentou com o período de embebição. A diferenciação dos lotes foi mais eficiente, quando se utilizou 75ml de água deionizada e amostras de 50 sementes com pelo menos 36 horas de embebição, com valores de CE menores nos lotes I e II do que no lote II. Os coeficientes de correlação simples entre a CE e as demais características avaliadas, em laboratório e viveiro, foram elevados e significativos, evidenciando alta associação entre os mesmos. Assim, pode-se recomendar que o teste de CE seja conduzido a 25ºC, com amostras de 50 sementes embebidas em 75ml de água deionizada, por períodos iguais ou superiores a 36 horas de embebição, para determinar a qualidade fisiológica de lotes de sementes de jacarandá-da-bahia.