Efeito da suplementação de carboidratos na resposta glicêmica de adolescentes diabéticos tipo 1 durante o exercício

Durante o exercício, indivíduos com diabetes tipo 1 podem necessitar um aporte maior de carboidratos (CHO), do que os contidos nas bebidas esportivas, para manter os níveis de glicose sanguínea. OBJETIVO: Verificar a resposta glicêmica em adolescentes diabéticos tipo 1, durante 60 minutos e após 60 minutos do término de exercício submáximo (55-65% do VO2max) em ciclo ergômetro em 2 situações: (1) com a utilização de bebida carboidratada a 8% (CHO 8%) e (2) com a utilização de bebida carboidratada a 10% (CHO 10%). MÉTODOS: Dezesseis adolescentes (10 meninos e 6 meninas – 16,25 ± 2,65 anos), com diabetes tipo 1 controlada (HbA1c< 7,31%) e sem complicações da doença, pedalaram a 55-65% do VO2max por 60 min em dois dias separados. Os sujeitos ingeriram tanto a bebida com CHO 8% como a CHO 10% (2,62 g e 3,28 g de frutose; e 5,38 g e 6,72 g de glicose em 100 ml, respectivamente) em cada uma das duas sessões de exercício. As duas bebidas eram similares na cor e no sabor. O volume ingerido das bebidas foi de 5 ml·kg-1 15 min antes do exercício, e 2 ml·kg-1 a cada 15 min de exercício, oferecidos de forma randomizada e duplo-cega. RESULTADOS: Após 60 min de bicicleta, houve uma redução não significativa de 20,06 mg·dL-1 (p>0,05) e a manutenção (-0,533 mg·dL- 1)(p>0,05) da glicemia capilar com a ingestão das bebida CHO 8% e CHO 10%, respectivamente. Durante o exercício, a diferença entre os deltas das bebidas também não foi significativa (p=0,056). No período de recuperação, não foram encontradas diferenças significativas na glicemia entre as sessões. Também não foram encontradas diferenças significativas entre as sessões na freqüência cardíaca, taxa de percepção ao esforço, peso pré e pós-exercício e nos sintomas gastrointestinais. CONCLUSÃO: A ingestão de bebida contendo 8% e 10% de CHO preveniu uma redução significativa na glicemia induzida por uma hora de exercício contínuo em adolescentes com diabetes tipo 1.

Efeito da natação e do basquetebol em cadeira de rodas sobre o colesterol HDL: uma investigação em indivíduos com lesão medular

Despite the observation of an increase in life expectancy in individuals with Spinal cord injury (SCI), it is lower than that of the general population. Studies have shown that affected individuals have a sedentary lifestyle that reflects negatively on health and quality of life. Studies have demonstrated that HDL cholesterol (HDL-C) levels, a high-density lipoprotein and important predictor of cardiovascular disease, are lower in this population exposing these people to a greater incidence of heart disease from atherosclerotic process In the general population, exercise increases HDL-C serum levels, but this phenomenon is not very clear in people with spinal cord injury (SCI). The present study examined the effect of both swimming and wheelchair basketball in the lipid profile of eleven men and seven women with SCI. The subjects included in regular exercise programs showed increases in HDL-C levels and decreases in CT/HDL-C and LDL-C/HDL-C ratios. We found better results mainly in men with lower levels of SCI and in those that sustained exercise intensities above 60% of the heart rate reserve. The duration of training sessions can be an essential factor in these results. The results suggest that both the exercise prescription and the personal characteristics of people with SCI influence changes in the lipid profile mediated through exercise. The elaboration of this work is an attempt to clarify uncertainties about health and the longevity of people with SCI generated in discussion of all members of the interdisciplinary rehabilitation team, especially the physiotherapists, nutritionists, nurses and physicians that contributed considerably in all phases of the research

Risco de doença cardiovascular em mulheres com história de distúrbio hipertensivo da gravidez

OBJECTIVE: Preeclampsia is a disease that can lead to a high maternal and infant morbidity. Worldwide, the incidence of this disease is highly variable and there is no data on this disorder in the Brazilian population. This study aimed at determining incidence and risk factors in the hypertensive disorders during pregnancy in a neighborhood of Natal, in addition to observing the evolution of these disorders one year and five years after delivery. METHODS: Prospective cohort study to assess the outcome of pregnancies of 242 women who became pregnant between 2004-2007 in the neighborhood of Bom Pastor in the city of Natal, state of RN, Brazil. Five years after delivery, there was an active search of thirty-nine (39) women who became pregnant and had a hypertensive disorder during pregnancy and/or pré-eclâmpsia, out of the total of 242 participants in the initial study. We administered a structured questionnaire to obtain basic information about the current clinical situation of patients and occurrences of subsequent pregnancy and presence of hypertensive disorders during pregnancy. We also searched for information on the use of hypotensive drugs and contraceptives. The following characteristics were checked and recorded: a) current weight, b) blood pressure c) body mass index - BMI, and we collected biological samples (blood and urine) for measurement of biochemical parameters and evaluation of microalbuminúria. Finally, we monitored the ambulatory blood pressure (ABP), which uses the method of automatic measurement of heart rate, systolic and diastolic blood pressure and an average of the two for the period of 24 hours. RESULTS: Out of 218 women who completed the study, the incidence of hypertensive disorders was of 16.9% (37 out of 218), while the incidence of preeclampsia was 13.8% (30 of 218). Women with preeclampsia had a BMI (body mass index) averaged of 25.3 (± 4.8) while this ratio in normotensive women was of 23.5 (± 3.7), p = 0.02. The risk of preeclampsia rises with age (OR 1084 p = 0.0034) and with a family history of hypertension (OR 2.6 p = 0.01). The follow-up one year after delivery revealed that 50% of women with hypertensive disorders in pregnancy remained hypertensive. High BMI was also observed after 5 years of delivery. CONCLUSIONS: an elevated BMI, age above 35 years and excessive weight gain during pregnancy were associated with hypertension in the long term in patients with prior preeclampsia. History of preeclampsia increases the risk of chronic hypertension

Exercício aeróbico, resistência de artéria carótidae autonomia funcional em mulheres idosas

The aim of this study was to analyze the effects of an aerobic exercise program on the internal right carotid resistive index (IRCRI) and the functional autonomy levels of elderly women. The sample was composed of 25 elderly sedentary women, aged between 60 and 75 years, allocated into two groups: an experimental group consisting of 14 women submitted to aerobic treatment and a control group (n=11). Carotid artery resistance assessment was conducted using Doppler ultrasound and functional autonomy by the following tests: 10m walk (10mW), rising from a sitting position (RSP), rising from a chair and moving about the house (RCMH), rising from the ventral decubitus position (RVDP) and putting on and removing a t-shirt (PRTS). Aerobic training consisted of walking 30 minutes a day, 3 times a week, for 3 months. To control the intensity of the walk, the index of perceived exertion was used, with standardized Borg scale values corresponding to 13-15 points, characterized as slightly tiring exercise with training heart rate (TRH) between 50% and 80% of heart rate reserve (HRR). Repeated measures ANOVA was used for statistical analysis. Compared to the control, the experimental group obtained a statistically significant decrease in right internal carotid resistance (p = 0.021) and a significant increase in the following tests: 10mW (p=0.000), RSP (p=0.035) and RCMH (p=0.016). These results suggest that engaging in aerobic exercises was effective in decreasing IRCRI and improving functional autonomy inelderly women

Parâmetros eletrocardiográficos e valores séricos e urinários de sódio e potássio em cães tratados com furosemida

The serum and urine Na+ and K+ levels and their relationship with electrocardiography characteristics,were studied in 15 male adult mongrel dogs, treated twice-a-day,with 2, 4, 8mg/kg of live weight doses of furosemide and furosemide associated with KCl during 35 days. Urine samples were analyzed weekly in order to determine the Na+ and K+ concentrations and to evaluate the urinary excretion of both cations. Electrocardiography was performed simultaneously, using limb derivations, speed 50mm/sec and calibration of 1 cm corresponding to 1mV. Data showed decreased seric concentrations of Na+ and Ki, increase in Na+ fractional excretion between days 7 and 21 of the treatment, slower heart rate and longer PR, QRS and QT intervals in the ECG. Briefly 2mg/kg furosemide associated with KCl was the most suitable treatment since it induced lesser side effects.

Effects of levomepromazine and different desflurane concentrations upon electrocardiographic variables in dogs

Objectives To investigate the effects of levomepromazine and different desflurane concentrations upon electrocardiographic variables.Animals Twenty adult mongrel dogs of both sexes weighing 6-28 kg.Methods Dogs were divided into two groups of 10 animals. Group I received 1 mg kg(-1) lV of levomepromazine and 15 minutes later anesthesia was induced with propofol (3 mg kg(-1) IV). Desflurane end-tidal concentration was set at 1.6 MAC. After 30 minutes at this concentration, measurements were taken and the end-tidal concentration was reduced to 1.4 MAC. Thereafter, it was reduced to 1.2 and then 1.0 MAC at 1.5-minute intervals. The same procedure was followed for group 2, except that levomepromazine was replaced with 0.2 mL kg(-1) of 0.9% saline solution and more propofol was needed for induction (7 mg kg(-1)). The animals' body temperature was maintained between 38.3 and 39 degreesC using a heating pad. The electrocardiographic tracing was obtained from lead II throughout the experimental period. The measurements were taken immediately before the administration of levomepromazine or placebo (T-1), 15 minutes after pre-medication (T-2) and 30 minutes after the establishment of 1.6 MAC (T-3)The other measurements were made at the concentrations of 1.4, 1.2, and 1.0 MAC, respectively (T4-6). The numerical data were submitted to analysis of variance plus F-test (p < 0.05).Results the dogs that received levomepromazine had a decrease in heart rate. However, in both groups it increased with desflurane administration. Levomepromazine, in association with desflurane, did not induce significant electrocardiographic changes, and all mean values (except P-wave duration) were within the reference range for this species.Conclusions and clinical relevance This study documented that levomepromazine, in association with desflurane, does not induce significant changes in electrocardiographic variables, suggesting that this drug combination has minimal effect on myocardial conduction.

Cardiovascular effects of desflurane following acute hemorrhage in dogs

Objective: To determine the cardiovascular effects of desflurane in dogs following acute hemorrhage.Design: Experimental study.Animals: Eight mix breed dogs.Interventions: Hemorrhage was induced by withdrawal of blood until mean arterial pressure (MAP) dropped to 60 mmHg in conscious dogs. Blood pressure was maintained at 60 mmHg for 1 hour by further removal or replacement of blood. Desflurane was delivered by facemask until endotracheal intubation could be performed and a desflurane expiratory end-tidal concentration of 10.5 V% was maintained.Measurements and main results: Systolic, diastolic, and mean arterial blood pressure (SAP, DAP and MAP), central venous pressure (CVP), cardiac output (CO), stroke volume (SV), cardiac index (0), systemic vascular resistance (SVR), heart rate (HR), respiratory rate (RR), partial pressure of carbon dioxide in arterial blood (PaCO2), and arterial pH were recorded before and 60 minutes after hemorrhage, and 5, 15, 30, 45 and 60 minutes after intubation. Sixty minutes after hemorrhage, SAP, DAP, MAP, CVP, CO, Cl, SV, PaCO2, and arterial pH decreased, and HR and RR increased when compared with baselines values. Immediately after intubation, MAP and arterial pH decreased, and PaCO2 increased. Fifteen minutes after intubation SAP, DAP, MAP, arterial pH, and SVR decreased. At 30 and 45 minutes, MAP and DAP remained decreased and PaCO2 increased, compared with values measured after hemorrhage. Arterial pH increased after 30 minutes of desflurane administration compared with values measured 5 minutes after intubation.Conclusions: Desflurane induced significant changes in blood pressure and arterial pH when administered to dogs following acute hemorrhage.

Continuous infusion of ketamine in hypovolemic dogs anesthetized with desflurane

Objective: To evaluate the cardiorespiratory effects of continuous infusion of ketamine in hypovolemic dogs anesthetized with desflurane.Design: A prospective experimental study.Animals: Twelve mixed breed dogs allocated into 2 groups: saline (n=6) and ketamine (n=6).Interventions: After obtaining baseline measurements (time [T] 0) in awake dogs, hypovolemia was induced by the removal of 40 mL of blood/kg over 30 minutes. Anesthesia was induced and maintained with desflurane (1.5 minimal alveolar concentration) and 30 minutes later (T75) a continuous intravenous (IV) infusion of saline or ketamine (100 mu g/kg/min) was initiated. Cardiorespiratory evaluations were obtained 15 minutes after hemorrhage (T45), 30 minutes after desflurane anesthesia, and immediately before initiating the infusion (T75), and 5 (T80), 15 (T90), 30 (T105) and 45 (T120) minutes after beginning the infusion.Measurements and main results: Hypovolemia (T45) reduced the arterial blood pressures (systolic arterial pressure, diastolic arterial pressure [DAP] and mean arterial pressure [MAP]), cardiac (CI) and systolic (SI) indexes, and mean pulmonary arterial pressure (PAP) in both groups. After 30 minutes of desflurane anesthesia (T75), an additional decrease of MAP in both groups was observed, heart rate was higher than T0 at T75, T80, T90 and T105 in saline-treated dogs only, and the CI was higher in the ketamine group than in the saline group at T75. Five minutes after starting the infusion (T80), respiratory rate (RR) was lower and the end-tidal CO(2) (ETCO(2)) was higher compared with values at T45 in ketamine-treated dogs. Mean values of ETCO(2) were higher in ketamine than in saline dogs between T75 and T120. The systemic vascular resistance index (SVRI) was decreased between T80 and T120 in ketamine when compared with T45.Conclusions: Continuous IV infusion of ketamine in hypovolemic dogs anesthetized with desflurane induced an increase in ETCO(2), but other cardiorespiratory alterations did not differ from those observed when the same concentration of desflurane was used as the sole anesthetic agent. However, this study did not evaluate the effectiveness of ketamine infusion in reducing desflurane dose requirements in hypovolemic dogs or the cardiorespiratory effects of ketamine-desflurane balanced anesthesia.

Avaliação hemodinâmica e metabólica da cetamina e cetamina S(+) após a reposição volêmica com hidroxietilamido 130/0,4 e solução salina hipertônica 7,5%

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

Efeitos comportamental, clínico e analgésico promovidos pela injeção epidural preventiva de morfina, xilazina ou clonidina, em equinos

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

Efeitos cardiorrespiratórios da buprenorfina em cães anestesiados pelo desfluorano

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

Hemogasometria e variáveis cardiopulmonares após administração do butorfanol em cães anestesiados pelo desfluorano sob ventilação espontânea

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

Intraocular pressure evaluation of equines anesthetized with romifidine, tiletamine/zolazepam, halothane and vecuronium

O objetivo deste estudo foi o de avaliar uma associação anestésica com e sem a utilização de relaxante muscular não-despolarizante e seu efeito sobre a pressão intra-ocular de eqüinos. Também objetivou-se uma técnica anestésica sem efeitos adversos que possa ser utilizada em procedimentos e cirurgias oftálmicas nesta espécie animal. Para tanto, dezesseis eqüinos foram divididos aleatoriamente em dois grupos de oito animais cada. Os animais do grupo I foram pré-medicados com romifidina, induzidos com tiletamina/zolazepam e a anestesia foi mantida com halotano e vecurônio. Os animais do grupo II receberam a mesma associação anestésica, com exceção do vecurônio. No decorrer do experimento, a pressão intra-ocular, a pressão arterial e a freqüência cardíaca foram avaliadas em diferentes momentos. A associação anestésica composta pela romifidina, tiletamina/ zolazepam e halotano com e sem vecurônio não promoveu alterações estatisticamente significativas na pressão intra-ocular de eqüinos e o seu uso é exeqüível em procedimentos oftálmicos nesta espécie animal.

Hemodinâmica de diferentes frações inspiradas de oxigênio em cães submetidos à infusão contínua de propofol sob ventilação espontânea

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

Variáveis cardiorrespiratórias, índice biespectral e recuperação anestésica em cães anestesiados pelo isofluorano, tratados ou não com tramadol

Foram avaliadas possíveis alterações cardiorrespiratórias e no índice biespectral em cães anestesiados pelo isofluorano, associado ou não ao tramadol. Utilizaram-se 16 animais, distribuídos em dois grupos denominados GC (grupo-controle) e GT (grupo tramadol). Todos os cães foram induzidos e mantidos sob anestesia com isofluorano. Os animais do GC receberam 0,05ml/kg de solução salina a 0,9% e os do GT 2mg/kg de tramadol, ambos por via intramuscular. Foram avaliados: freqüência cardíaca, pressão arterial sistólica, diastólica e média, eletrocardiografia, freqüência respiratória, saturação de oxiemoglobina, concentração de dióxido de carbono ao final da expiração, índice biespectral e recuperação da anestesia. Concluiu-se que a administração de tramadol em cães anestesiados pelo isofluorano não produz alterações nas variáveis cardiorrespiratórias, no índice biespectral e no tempo de recuperação da anestesia, porém proporciona boa qualidade de recuperação anestésica.