INTRODUÇÃO: A doença renal crônica (DRC) é uma patologia progressiva e debilitante, que apresenta alta mortalidade devido a causas cardiovasculares. Pacientes com DRC apresentam alterações metabólicas e musculares que estão associadas com diminuição da capacidade funcional e baixa tolerância ao exercício, porém pouco se sabe sobre o acometimento da musculatura respiratória desses pacientes. Dessa forma, os objetivos primários deste estudo foram avaliar a força muscular respiratória (FMR) de pacientes com DRC e verificar a existência de associação da força da musculatura inspiratória com fatores de risco cardiovasculares já descritos na DRC. MÉTODOS: A amostra foi composta por pacientes com DRC (estádios 3 ao 5) (grupo DRC, n = 30) e por indivíduos saudáveis (grupo controle, C. n =11). Posteriormente, para fins de comparação, os pacientes com DRC foram divididos em dois grupos: pacientes com DRC em fase não dialítica (estádios 3 e 4 - grupo DRC-ND, n=12) e pacientes com DRC em hemodiálise (estádio 5 - grupo DRC-D, n = 18). Todos os indivíduos realizaram os seguintes procedimentos: manovacuometria digital para mensuração da pressão inspiratória máxima (PImax) e pressão expiratória máxima (PEmax); registro da pressão arterial (PA) batimento a batimento e do eletrocardiograma para mensuração das variáveis hemodinâmicas; registro da atividade simpática nervosa muscular (ANSM); avaliação da composição corporal por meio de bioimpedância; avaliação da velocidade de onda de pulso (VOP) carotídea-femoral; avaliação da função endotelial; teste ergoespirométrico para mensuração da capacidade funcional cardiorrespiratória. Para os indivíduos do grupo DRC-D as avaliações foram sempre realizadas no segundo dia interdialítico da semana. Posteriormente as curvas de pressão arterial registradas foram utilizadas para mensurar a variabilidade da frequência cardíaca (VFC) e da PA e para determinar o barorreflexo espontâneo. RESULTADOS: Os pacientes com DRC apresentam redução da FMR quando comparados ao grupo controle (PImax: DRC= 82,51 ± 24,39 vs. C= 115,20 ± 18,71 cmH2O; PEmax: DRC= 99,64 ± 19,86 vs. C= 138,90 ± 27,08 cmH2O). Não houve diferença nas pressões respiratórias entre os grupos DRC-D e DRC-ND. Além disso, os pacientes com DRC apresentam diminuição da VFC [SDNN: DRC = 19,03 (10,95 - 44,28) vs. C= 45,25 (28,45 - 76,86)ms], aumento do balanço simpatovagal (DRC= 3,42 ± 1,99 vs. C= 1,54 ±1,01), aumento da variância da PA sistólica [DRC= 48,60 (13,38 -149,00) vs. C= 29,76 (15,83 - 49,54) mmHg2, prejuízo tanto da ativação (DRC= 0,40 ± 0,15 vs. C= 0,72 ± 0,10) quanto da sensibilidade barorreflexa (DRC= 7,98 ± 4,37 vs. C= 20,87 ± 10,68 ms/mmHg), bem como, aumento da ANSM (DRC= 20,44 ± 3,88 vs. C= 17,75 ± 1,46 bursts/min). Para a maioria dos índices de VFC o grupo DRC-D apresentou maior comprometimento do que o grupo DRC-ND. Contudo, o balanço simpatovagal, a variância da PA sistólica, a ANSM e a ativação do barorreflexo não foi diferente entre os grupos DRC-D e DRC-ND. Além disso, os pacientes com DRC apresentaram menor consumo de oxigênio que os indivíduos saudáveis (DRC= 29,1 ± 7,76 vs. C= 38,5 ± 7,9 ml/kg/min), redução da função endotelial (DRC= 4,90 ± 4,62 vs. C =8,70 ± 2,19%) e aumento da VOP (DRC= 8,30 (6,15 - 12,2) vs. C= 6,55 (5,4 - 7,8) m/s) quando comparado ao grupo controle, sendo que não foram observadas diferenças entre os grupos DRC-D e DRC-ND para estas variáveis. Quanto a composição corporal, os indivíduos com DRC apresentaram menor massa corporal celular, menor massa magra, maior massa gorda, menor água intracelular, e maior porcentagem de água extracelular quando comparados ao grupo controle. Não foram observadas diferenças na composição corporal entre o grupo DRC-D e DRC-ND. Houve associação positiva entre a força muscular inspiratória e o consumo máximo de oxigênio, bem como entre a PImax e níveis séricos de albumina nos indivíduos com DRC. CONCLUSÕES: Pacientes com DRC, mesmo em fase não dialítica, apresentam comprometimento da FMR, principalmente da PImax, bem como redução da capacidade funcional cardiorrespiratória, sendo que, existe uma associação entre a PImax e o consumo máximo de oxigênio. Além disso, os pacientes com DRC apresentam prejuízo da VFC e da sensibilidade barorreflexa, aumento do balanço simpatovagal, da ANSM e alterações vasculares, que embora pareçam ser mais evidentes nos doentes renais em fase dialítica, já podem ser observadas também na fase pré-dialítica da DRC / INTRODUCTION: Chronic kidney disease (CKD) is a progressive and debilitating condition that presents high mortality due to cardiovascular causes. Patients with CKD have metabolic and muscular changes that are associated with decreased functional capacity and low tolerance to exercise, but little is known about the involvement of the respiratory muscles in these population. Thus, the primary objectives of this study were to evaluate the respiratory muscle strength (RMS) of patients with CKD and to verify the existence of an association of inspiratory muscle strength with cardiovascular risk factors already described in CKD. METHODS: The sample consisted of patients with CKD (stages 3 to 5) (CKD group, n = 30) and healthy individuals (control group, C n = 11). For comparison purposes, patients with CKD were divided into two groups: non-dialytic CKD patients (stages 3 and 4 - CKD-ND group, n = 12) and patients with CKD on hemodialysis (stage 5 - group CKD-D, n = 18). All subjects performed the following procedures: digital manovacuometry to measure maximal inspiratory pressure (MIP) and maximal expiratory pressure (MEP); recording of blood pressure (BP) beat-to-beat and electrocardiogram for measurement of hemodynamic variables; register of sympathetic nervous muscle activity (SNMA); assessment of body composition by bioimpedance; assessment of carotid-femoral pulse wave velocity (PWV); evaluation of endothelial function; ergospirometric test for measurement of cardiorespiratory functional capacity. For the subjects in the CKD-D group the evaluations were always performed on the second interdialytic day of the week. Subsequently, the recorded blood pressure curves were used to measure heart rate (HRV) and BP variability and to determine spontaneous baroreflex. RESULTS: Patients with CKD had a reduction in RMS when compared to the control group (MIP: CKD = 82.51 ± 24.39 vs. C = 115.20 ± 18.71 cmH2O; MEP: CKD = 99.64 ± 19, 86 vs. C = 138.90 ± 27.08 cm H2O). There was no difference in respiratory pressures between the CKD-D and the CKD-ND groups. In addition, patients with CKD had a decrease in HRV [SDNN: CKD = 19.03 (10.95 - 44.28) vs. C = 45.25 (28.45 - 76.86) ms], increased sympatovagal balance (CKD = 3.42 ± 1.99 vs. C = 1.54 ± 1.01), increased systolic BP variance [CKD = 48.60 (13.38 -149.00) vs. C = 29.76 (15.83 - 49.54) mmHg2, impairment of both activation (CKD = 0.40 ± 0.15 vs C = 0.72 ± 0.10) and baroreflex sensitivity (CKD = 7.98 ± 4.37 vs. C = 20.87 ± 10.68 ms/mmHg), as well as increased SNMA (CKD = 20.44 ± 3.88 vs. C = 17.75 ± 1.46 bursts/min). For most HRV scores, the CKD-D group presented greater impairment than the CKD-ND group. However, sympathovagal balance, systolic BP variance, SNMA and baroreflex activation were not different between the CKD-D and CKD-ND groups. In addition, patients with CKD had lower oxygen consumption than healthy subjects (CKD = 29.1 ± 7.76 vs. C = 38.5 ± 7.9 ml/kg/min), reduction of endothelial function (CKD = 4.90 ± 4.62 vs. C = 8.70 ± 2.19 %) and increased PWV (CKD = 8.30 (6.15 - 12.2) vs. C = 6.55 (5, 4 - 7.8) m/s) when compared to control group, and no differences were observed between the CKD-D and CKD-ND groups for these variables. Regarding body composition, individuals with CKD had lower cellular body mass, lower lean mass, higher fat mass, lower intracellular water, and higher percentage of extracellular water when compared to control group. No differences were observed in body composition between the CKD-D and CKD-ND groups. There was a positive association between inspiratory muscle strength and maximum oxygen consumption, as well as between MIP and serum albumin levels in individuals with CKD. CONCLUSIONS: Patients with CKD, even in the non-dialytic phase, have FMR impairment, mainly MIP, as well as reduction of cardiorespiratory functional capacity, and there is an association between MIP and maximal oxygen consumption in this population. In addition, patients with CKD have impairment of HRV and baroreflex sensitivity, increased sympatovagal balance, SNMA, and vascular alterations, that although they may appear to be more evident in renal dialysis patients, may also be observed in the predialytic phase of DRC

Chan Wan-Sze. / Thesis (M.Phil.)--Chinese University of Hong Kong, 2001. / Includes bibliographical references (leaves 64-76). / Text in English; abstracts in English and Chinese. / Chan Wan-Sze. / Table of Content --- p.II / List of Table --- p.VI / List of Figure --- p.VII / Abstract --- p.1 / Chapter Chapter 1 --- Introduction --- p.4 / Chapter 1.1 --- Background of study --- p.4 / Chapter 1.1.1 --- Oxygen consumption and heart rate --- p.4 / Chapter 1.1.2 --- V02Rand HRR --- p.7 / Chapter 1.1.3 --- Application of the association between V02 and HR- --- p.8 / Chapter 1.2 --- Purpose and significance --- p.9 / Chapter 1.3 --- Operational Definitions --- p.10 / Chapter 1.4 --- Hypotheses --- p.11 / Chapter Chapter 2 --- Review of Literature --- p.12 / Chapter 2.1 --- Exercise prescription for Cardiorespiratory Fitness --- p.14 / Chapter 2.1.1 --- Mode of exercise --- p.14 / Chapter 2.1.2 --- Frequency --- p.15 / Chapter 2.1.3 --- Duration --- p.16 / Chapter 2.1.4 --- Intensity --- p.17 / Chapter 2.2 --- Measurement of exercise intensity --- p.19 / Chapter 2.2.1 --- Rate of Perceived Exertion (RPE) --- p.21 / Chapter 2.2.2 --- Heart Rate (HR) --- p.23 / Chapter 2.3 --- Children and exercise intensity --- p.29 / Chapter 2.4 --- Summary --- p.30 / Chapter Chapter 3 --- Methodology --- p.32 / Chapter 3.1 --- Participants --- p.32 / Chapter 3.2 --- Procedures --- p.32 / Chapter 3.2.1 --- Resting measures --- p.34 / Chapter 3.2.2 --- Peak oxygen uptake (V02peak) testing --- p.34 / Chapter 3.3 --- Equipment and instrumentation --- p.36 / Chapter 3.3.1 --- Body mass and height --- p.36 / Chapter 3.3.2 --- Expired gases collection --- p.37 / Chapter 3.3.3 --- Heart rate measurement --- p.38 / Chapter 3.3.4 --- Determination of oxygen uptake (V02peak) and heart rate (HR) values --- p.38 / Chapter 3.4 --- Statistical Analysis --- p.39 / Chapter Chapter 4 --- Results --- p.41 / Chapter 4.1 --- Descriptive statistics --- p.41 / Chapter 4.2 --- Resting and maximal measures --- p.43 / Chapter 4.3 --- Submaximal exercise --- p.45 / Chapter 4.3.1 --- Phase I: %HRmax versus %V02peak --- p.47 / Chapter 4.3.2 --- Phase II: %HRR versus %V02peak --- p.48 / Chapter 4.3.3 --- Phase III: %HRR versus %V02R --- p.50 / Chapter 4.4 --- Summary of results --- p.53 / Chapter Chapter 5 --- Discussion and Conclusion --- p.54 / Chapter 5.1 --- Phase I: Preliminary findings from basic measures --- p.54 / Chapter 5.2 --- Phase II: %HRmax versus %V02peak --- p.57 / Chapter 5.3 --- Phase III: %HRR versus %V02peak --- p.58 / Chapter 5.4 --- Phase IV: %HRR versus %V02R --- p.60 / Chapter 5.5 --- Limitations of the study --- p.62 / Chapter 5.6 --- Conclusion and implications --- p.62 / Chapter 5.7 --- Recommendations and further studies --- p.63 / References --- p.64 / Appendix A --- p.77 / Appendix B --- p.79 / Appendix C --- p.80 / Appendix D --- p.81 / Appendix E --- p.82 / Appendix F --- p.83

Choque séptico é caracterizado por desequilíbrio entre o transporte e o consumo de oxigênio, podendo acarretar hipóxia tecidual. A disfunção microcirculatória, característica cardinal da fisiopatologia do choque séptico, causa má distribuição de fluxo sanguíneo microvascular e, consequentemente, shunt de oxigênio, disóxia tissular e, teoricamente, diminuição no consumo de oxigênio (VO2) pela célula. No presente estudo, foi investigada a associação entre alterações microcirculatórias causadas pela sepse e o consumo de oxigênio em pacientes pediátricos. Dezessete crianças com choque séptico ressuscitadas foram estudadas em quatro momentos durante a internação na unidade de terapia intensiva (dentro de 24, 48 e 72 horas após a admissão ou diagnóstico de choque e após a resolução deste, antes da extubação traqueal). A microcirculação sublingual foi avaliada utilizando o método de imagem Sidestream dark field (SDF) e o VO2 foi calculado através da calorimetria indireta. Outras variáveis hemodinâmicas, como transporte de oxigênio, índice cardíaco, pressão arterial invasiva, lactato arterial e saturação venosa central, foram coletadas. Embora as variáveis hemodinâmicas tenham se mantido em níveis satisfatórios, graves alterações na microcirculação foram visualizadas, especialmente na densidade de vasos pequenos perfundidos (DVPP), na proporção de vasos pequenos perfundidos (PVPP) e no índice de fluxo microvascular (MFI). Foram encontradas assosciações significativas entre o VO2 e os parâmetros da microcirculação: dVO2 e dDVPP (&#946; coefficient= 6,875; p<0,001), dVO2 e dPVPP (&#946; coefficient=92,246; p<0,001) e dVO2 e dMFI (&#946; coefficient=21,213; p<0,001). Não foram encontradas correlações entre as alterações microcirculatórias e as outras variáveis. Em conclusão, este estudo mostrou que pacientes pediátricos com choque séptico apresentaram grave disfunção microvascular e que o fluxo microcirculatório alterado estava associado ao VO2, podendo estar implicado na fisiopatologia da disóxia tecidual da sepse. / Septic shock is characterized by the imbalance between oxygen delivery and consumption leading to tissue hypoxia. Microcirculatory dysfunction, a key element of septic shock pathogenesis, elicits maldistribution of microvascular blood flow and consenquently oxygen shunt, tissue oxygenation debt and, theoretically, impaired oxygen consumption (VO2). In this study, it was investigated if there is an association between microcirculatory changes and VO2 in pediatric patients with septic shock. Seventeen resuscitated patients with septic shock were studied in four moments (within 24hr, 48hr and 72hr of the admission or diagnosis of shock and after its resolution, prior to extubation). Sublingual microcirculation was evaluated using Sidestream dark field (SDF) imaging and VO2 was measured directly by indirect calorimetry. Other hemodynamic variables, like cardiac index, oxygen delivery, invasive arterial pressure, arterial lactate and central venous oxygen saturation were also recorded. Although global hemodynamic variables were within satisfactory ranges, microvascular variables were markedly altered, especially microvascular flow index (MFI), proportion of perfused small vessels (PPV) and perfused small vessel density (PVD). Significant associations between oxygen consumption and microcirculatory parameters were found: dVO2 and dPVD (&#946; coefficient= 6.875; p<0.001), dVO2 and dPPV (&#946; coefficient=92.246; p<0.001) and dVO2 and dMFI (&#946; coefficient=21.213; p<0.001). There was no correlation between microcirculatory alterations and other variables in this study. In conclusion, this study showed that pediatric patients with septic shock presented severe microcirculatory dysfunction and abnormal microvascular blood flow could be associated to oxygen consumption.

L’objectif de ce travail était de valider une méthode simple permettant de déterminer la sollicitation des métabolismes aérobie et anaérobie en cours d’activité en prenant l’exemple du tennis. Son principe général est de séquencer l’activité globale composite en sous-activités appelées activités fondamentales AF et de déterminer pour chacune d’entre elles la consigne énergétique DEc(i) afin de modéliser l’adaptation des filières énergétiques grâce au modèle bioénergétique Astrabio©. Des étalonnages permettent d’obtenir les fonctions d’astreinte qui relient DEc(i) à un paramètre mécanique M pertinent, vitesse de déplacement ou cadence de coups, pour les 6 AF sélectionnées au tennis. Une méthode d’analyse vidéo simple utilisant une seule caméra est appliquée lors des matchs de tennis pour déterminer les AF et estimer M. Ces paramètres sont introduits dans le modèle Astrabio© qui détermine la DEc(i) de chaque AF, DE aérobie et DE anaérobie par différence. Les quantités d’énergie aérobie prédites à chaque jeu des matchs ne présentent pas de différence statistique avec celles réellement mesurées par la méthode d’analyse directe de DE (K4b2). Elle met en évidence qu’en dépit d’une DE aérobie moyenne assez faible comprise entre 40% et 60% VO2max, le tennis se caractérise en réalité par des efforts supra-maximaux pouvant atteindre 300% VO2max lors des frappes de balle et le métabolisme anaérobie représente environ 30% de l’énergie totale dépensée sur un match. Cette méthode présente l’intérêt majeur d’être facilement applicable et de décrire l’astreinte réelle d’une activité en fournissant une estimation des DE aérobie et anaérobie à partir de l’analyse vidéo de l’activité / The aim of this study was to present a simple method to access the aerobic and anaerobic components of energy expenditure during activities as tennis. The principle consists in dividing the exercise into several fundamental activities (FA) based on a video recording and to estimate the metabolic power (MP) of each FA, the aerobic energy expenditure (EEO2mod) and the anaerobic energy expenditure thanks to the Astrabio© model. Six FA are selected and each FA is described by a “strain function” connecting MP to the selected pertinent mechanical variable M (speed running V and events frequency ω). The video analysis is used to determine FA, V and ω during tennis match. The parameters V and ω are introduced in the Astrabio© model to calculate MP of each FA. Then, this model calculated the aerobic energy expenditure (EEO2mod) in terms of MP and the anaerobic energy expenditures was calculated by substracting this (EEO2mod). There was no significant difference between calculated and measured oxygen consumptions (p<0.05). This method shows that even when the aerobic EE average is quite low and nearing 50% of VO2max, the total energy expenditure of a point can reach up 2 or 3 times the VO2max of the subjects during points and strokes. In tennis anaerobic metabolism can account for around 30% of the total energy expenditure per game, and almost 70% during points. The interest of this method is to provide a good estimation of aerobic and anaerobic energy expenditures thanks to a simple video analysis. This method presents the advantage that it is easy to apply and requires only simple and inexpensive equipment: a camera, a computer, and a tracking software

Este estudo teve como objetivo analisar a influência de parâmetros morfológicos, funcionais e psicológicos no quadro bioquímico, sanguíneo e imunológico de indivíduos com HIV/aids. Para tanto, a amostra foi constituída por 41 voluntários infectados pelo HIV (25 66 anos de idade [x: 40,75 ± 8,68 anos]) do Ambulatório de Imunodeficiências Secundárias do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo (ADEE 3002-HC-FMUSP). Os voluntários foram divididos em dois grupos de acordo com CD4+ nadir (< 200 cél·mm3 ou > 200 cél·mm3). Foram mensuradas as variáveis composição corporal, parâmetros neuromusculares e cardiorespiratórios, capacidade funcional, qualidade de vida, atividade física, satisfação sexual, sintomas depressivos assim como parâmetros bioquímicos, sanguíneos e imunológicos. Foram observadas diferenças estatisticamente significativas entre os grupos somente para o teste velocidade máxima de caminhada, colesterol total, LDL e CD4+ nadir (p<0,05). Houve tendência de os voluntários localizados no grupo CD4+ nadir < 200 cél·mm3 apresentarem maior associação nas variáveis composição corporal, parâmetros neuromusculares e cardiorespiratórios, capacidade funcional, qualidade de vida, atividade física, satisfação sexual e sintomas depressivos sobre o quadro bioquímico, sanguíneo e imunológico. Os resultados deste estudo permitem concluir que a composição corporal, parâmetros neuromusculares e cardiorespiratórios, capacidade funcional, qualidade de vida, atividade física, satisfação sexual e os sintomas depressivos não se associam fortemente com o quadro bioquímico, sanguíneo e imunológico de indivíduos infectados pelo HIV independente do histórico clínico pregresso. Por outro lado, existe interdependência entre as diferentes características acima descritas nos diferentes grupos para CD4+ nadir (< 200 cél·mm3 e > 200 cél·mm3), sobretudo, para aqueles voluntários localizados no grupo CD4+ nadir < 200 cél·mm3 / The purpose of this study was to analyze the influence of morphological, functional and psychological parameters on biochemistry, blood and immunological status of HIV/aids individuals. Sample was constituted by 41 HIV infected men individuals (25 66 year-old [x: 40.75 ± 8.68 years]) of the Secondary Immunodeficiency Ambulatory from Hospital das Clínicas Faculty of Medicine, USP (ADEE 3002-HC-FMUSP). Volunteers were agrouped into two groups according to the CD4+ nadir (< 200 cell·mm3 or > 200 cell·mm3). The variables measured were body composition, cardiorespiratory and neuromuscular parameters, functional capacity, quality of life, physical activity, sexual satisfaction, depressive symptoms, as well as biochemical, blood and immunological parameters. There were statistically significant differences between the groups only for maximum walking velocity, total cholesterol, LDL and CD4+ nadir (p<0.05). There was tendency of the volunteers in the group CD4+ nadir < 200 cell·mm3 to show more prevalence and higher significant correlation values in the association among body composition, neuromuscular and cardiorespiratory parameters, functional capacity, quality of life, physical activity, sexual satisfaction and depressive symptoms and biochemical, blood and immunological parameters. The data permite to conclude that there was not strongly association among body composition, neuromuscular and cardiorespiratory parameters, functional capacity, quality of life, physical activity, sexual satisfaction and depressive symptoms, and biochemical, blood and immunological parameters regardless of historical clinical status. On the other hand, it was observed the existence of an interdependence phenomenon among the previously described different characteristics in the distint groups to CD4+ nadir (< 200 cell·mm3 and > 200 cell·mm3), specially, for the volunteers of the CD4+ nadir < 200 cell·mm3

No description available.

Les poissons vivant au sein d’une rivière sont soumis à des variations circadiennes de température pouvant influencer la croissance, la digestion et le métabolisme standard. Les modèles bioénergétiques utilisant les fonctions métaboliques pour déterminer la croissance d’un poisson ont souvent été élaborés avec des poissons acclimatés à des températures constantes. Ces modèles pourraient sous-estimer l’énergie dépensée par un poisson soumis à des températures fluctuantes. En utilisant la respirométrie par débit intermittent, les objectifs de ce travail étaient : (1) de quantifier les différences entre les taux métaboliques standards de poissons acclimatés à une température constante (20.2 oC ± 0.5 oC) et à des fluctuations circadiennes de température (19.8 oC ± 2.0 oC; 19.5 oC ± 3.0 oC) et (2) comparer deux méthodologies pour calculer les taux métaboliques standards de poissons sujets aux fluctuations circadiennes de températures : respirométrie (a) en température constante ou (b) en température fluctuante. Les poissons acclimatés à des fluctuations circadiennes de température ont des taux métaboliques standards plus élevés que des poissons acclimatés à une température constante. À 20.2 oC ± 0.5 oC, les taux métabolique standards ont été de 25% à 32% plus bas pour des poissons maintenus à une température constante que pour des poissons gardés sous des fluctuations circadiennes de température. Les méthodologies utilisées pour estimer les taux métaboliques standards de poissons sujets aux fluctuations de température offrent des résultats similaires. / Fish that inhabits river are subjected to circadian fluctuations in water temperature. These fluctuations can influence growth, digestion and metabolic processes. Bioenergetic models are traditionally modeled using data recorded from fish kept at constant water temperatures. These models could underestimate the energy spent by fish subjected to fluctuating temperatures. Thus, with intermittent-flow respirometry, the objectives of this study were to: (1) quantify the differences between standard metabolic rates of fish acclimatized to a constant temperature (20.2 oC ± 0.5 oC) and two circadian fluctuating temperatures (19.8 oC ± 2.0 oC; 19.5 oC ± 3.0 oC) and (2) compare two methodology for calculate standard metabolic rates of fish subjected to circadian fluctuating temperatures: intermittent-flow respirometry with (a) constant temperature or (b) fluctuating temperatures. Fish held at circadian fluctuating temperatures have higher standard metabolic rates than fish acclimatized to a constant temperature. At 20.2 oC ± 0.5 oC, standard metabolic rates was 25% to 32% lower for fish held at constant temperature than for fish held under circadian fluctuations. However, results of the two different strategies used to calculate standard metabolic rates of fish subjected to circadian fluctuating temperatures did not differ.

Die Belastung des Energiestoffwechsels der Hochleistungskuh ist in der peripartalen Phase am größten. Die Regulation der Futteraufnahme und des Energiestoffwechsels durch den Nucleus arcuatus (ARC) des Hypothalamus spielt eine entscheidende Rolle während dieser Phase. Zahlreiche Metabolite und Hormone, wie z.B. das Peptidhormon Ghrelin, beeinflussen die Expression des orexigenen (futteraufnahmesteigernden) Neuropeptids Agouti-related Protein (AgRP) im ARC des Hypothalamus. Das Ziel dieser Arbeit war es, den Zusammenhang zwischen Körperfettmobilisierung und orexigenen Signalen im peripartalen Zeitraum der Hochleistungskuh näher zu untersuchen. Hierfür wurden 20 multipare Hochleistungskühe der Rasse Deutsch-Holstein (2.-4. Laktation) 7 Wochen ante partum (ap) bis 6 Wochen post partum (pp) untersucht. Die Tiere wurden in Anbindehaltung aufgestallt und entsprechend der jeweiligen Produktionsperiode bedarfsgerecht energetisch versorgt. Die ad libitum Futteraufnahme und Milchleistung wurden täglich gemessen und die Milchzusammensetzung wöchentlich analysiert. Das Körpergewicht und die Rückenfettdicke (RFD) wurden ebenfalls wöchentlich bestimmt. Einmal wöchentlich wurden Blutproben genommen, um die Konzentration von nicht-veresterten Fettsäuren (NEFA), Triglyceriden (TG) und Aminosäuren zu bestimmen. Eine Leberbiopsie wurde am 34. Tag ap und am 3., 18. und 30. Tag pp entnommen. In der 5. Woche ap und in der 2. Woche pp wurden die Tiere in eine Respirationskammer eingestallt und darin jeweils am 1. Tag ad libitum versorgt, während ihnen am 2. Tag das Futter für 10 h entzogen wurde. Die Futteraufnahme bzw. die kompensatorische Futteraufnahme nach Futterentzug wurden ebenfalls gemessen. Mit Hilfe der indirekten Kalorimetrie wurden der Sauerstoffverbrauch, die Bildung von Kohlenstoffdioxid und Methan gemessen, und der Respiratorische Quotient (RQ), die Fettoxidation (FOX) und die Kohlenhydratoxidation (KOX) berechnet. An beiden Tagen des Aufenthaltes in der Respirationskammer wurden stündlich Blutproben entnommen und die Konzentration von Acyl- und Gesamtghrelin, NEFA und TG bestimmt. Am 40. Tag pp wurden die Tiere geschlachtet und der ARC entnommen. In Studie 1 wurden 16 Tiere, basierend auf ihren Leberfettgehalt (LFC) am 18. Tag pp in eine Gruppe mit hohem LFC (H, n=8) und eine mit niedrigem LFC (L, n=8) eingeteilt. Für die Studie 2 wurden 18 Kühe entsprechend ihrer NEFA-Blutplasmakonzentration am Schlachttag in eine Gruppe mit hoher NEFA- (H, n=9) und eine mit niedriger NEFA-Plasmakonzentration (L, n=9) eingeteilt. In Studie 1 konnte gezeigt werden, dass die Acyl- und Gesamtghrelin- Plasmakonzentrationen nicht mit der pp Futteraufnahmesteigerung von Hochleistungskühen korrelierten. H-Kühe, die im Vergleich zu L-Kühen einen höheren Leber- und Milchfettgehalt, eine größere RFD und einen geringeren RQ aufwiesen, zeigten während des 10-stündigen Futterentzuges den größeren Anstieg der Acylghrelinkonzentration sowie ein größeres Acyl- und Gesamtghrelin-Verhältnis. Signifikante Korrelationen zwischen dem präprandialen Acyl:Gesamtghrelin- Verhältnis und zahlreichen Parametern des Fettstoffwechsels, wie bspw. LFC, Milchfettgehalt, RQ und RFD, lassen einen Zusammenhang zwischen Ghrelin, dem Fettstoffwechsel und der Fettverteilung erkennen. In Studie 2 konnte nachgewiesen werden, dass die in der Frühlaktation auftretende unterschiedliche Aktivierung hypothalamischer AgRP-Neurone von H- und L-Kühen nicht mit deren Futteraufnahme assoziiert ist. Die höhere NEFA-Plasmakonzentration, die höhere RFD, die höhere FOX und der höhere Sauerstoffverbrauch der H-Kühe waren jeweils signifikant mit der geringeren Aktivierung hypothalamischer AgRP-Neurone korreliert. Diese Korrelationen belegen einen Zusammenhang zwischen dem prozentualen Anteil aktivierter AgRP-Neurone und dem Sauerstoffverbrauch sowie der Substratverstoffwechselung während der Frühlaktation. Zusammenfassend lässt sich schlussfolgern, dass die untersuchten Signale des orexigenen Systems im peripartalen Zeitraum der Hochleistungskuh nicht mit der Futteraufnahme, jedoch mit dem Fett- und Energiestoffwechsel assoziiert waren. Ferner lassen die Resultate den Schluss zu, dass die Futteraufnahme bereits vor der Kalbung durch den Körperfettgehalt determiniert ist, und dass die Fettmobilisierung per se kaum einen Einfluss auf die Futteraufnahmesteigerung in der Frühlaktation besitzt.

Made available in DSpace on 2015-07-22T20:49:54Z (GMT). No. of bitstreams: 0 Previous issue date: 2009-10-28 / Ha evidencias de que o fluxo microvascular de oxigenio (QO2mv) limita a taxa de aumento da captacao de oxigenio ( O2) no inicio do exercicio intenso em pacientes com doenca pulmonar obstrutiva cronica (DPOC). Entretanto, ainda nao esta claro se a suplementacao de O2 poderia acelerar a cinetica do O2 atraves da melhora do QO2mv em pacientes nao-hipoxemicos ou levemente hipoxemicos. Assim, o objetivo do estudo foi investigar se a suplementacao aguda de O2 (HiOX=50%O2) poderia alterar a dinamica entre oferta e O2 microvascular na transicao do exercicio leve para o intenso, alem de avaliar se os possiveis efeitos da HiOX na oxigenacao tecidual tissular teriam efeito modulador na cinetica da utilizacao muscular de O2. Para tal, foram avaliados 19 pacientes do sexo masculino, nao-hipoxemicos ou levemente hipoxemicos (PaO2>60mmHg) portadores de DPOC de gravidade moderada a acentuada (VEF1/CVF < 0,7 e VEF1 entre 30 e 60% do previsto) e estaveis clinicamente, durante exercicio submaximo de alta intensidade (80% da maxima atingida no exercicio incremental em cicloergometro). Neste contexto, foram investigados os efeitos da HiOX em comparacao com normoxia (NOX = 21% O2) na cinetica do O2 mensurado em nivel pulmonar (p) e da extracao fracional de O2 (HHb mensurada pela espectroscopia por raios quase infravermelhos - NIRS) no vasto lateral. A HiOX esteve associada com aumento na tolerancia ao exercicio (p<0,05) alem de reducao da concentracao de lactato, sensacao de dispneia e desconforto muscular corrigidos para o tempo de duracao do exercicio (Tlim) (N=19). Nos 11 individuos com sinais adequados para estudo da cinetica, a extracao fracional de O2 estimada acelerou-se (DHHb: t= 4.8 } 2.4 s vs. 6.7 } 3.0 s; P<0.05) e um subsequente fenomeno de govershoot h foi observado em 7/11 pacientes, sugerindo prejuizo no QO2mv. Entretanto, durante o periodo estado-estavel, houve reducao dos valores de HHb em 9/11 pacientes sugerindo melhora do QO2mv. Como consequencia desse efeito dual da HiOX no QO2mv (i.e, reducao seguida de melhora), a cinetica do O2p foi acelerada em 6 pacientes mas lentificada em outros 5 pacientes. De forma interessante, observamos que pacientes que apresentaram aceleracao da cinetica do O2p com HiOX tambem apresentaram maiores reducoes dos valores de DHHb no estado-estavel comparados aos demais pacientes (HiOX . NOX= -23.4 (-55.5 to -5.8) ƒÊM/cm vs. -0.62 (-22.6 to 10.7) ƒÊM/cm; p<0.05). Adicionalmente, houve correlacao significativa entre reducao dos valores de DHHb no estado-estavel e aceleracao na cinética do O2 com HiOX (R= 0.61; p<0.05). Em conclusão, HiOX melhorou a tolerância ao exercício físico, além de ter resultado em redução significativa da dispnéia, percepção de fadiga periférica e lactato corrigidos pelo tempo de exercício em pacientes com DPOC não-hipoxêmicos ou levemente hipoxêmicos. Entretanto, nosso resultados indicam que houve prejuízo transitório no QO2mv no início do exercício, que foi compensado por melhora subseqüente, justificando assim os efeitos heterogêneos do O2 na cinética do O2p. Portanto, as consequências da HiOX na taxa de aumento do metabolismo oxidativo no início do exercício intenso nessa sub-população de pacientes parece depender de um complexo balanço entre os efeitos negativos iniciais no fluxo sanguíneo microvascular e as posteriores conseqüências positivas nos determinantes difusivos e/ou convectivos do transporte capilar-muscular de O2. / There is convincing evidence that impaired microvascular O2 delivery (Q LO2mv) to the peripheral muscles limits the rate of increase in pulmonary O2 uptake ( O2p) at the onset of supra-gas exchange threshold exercise in patients with chronic obstructive pulmonary disease (COPD). It is currently unclear, however, whether O2 supplementation could actually improve Q LO2mv thereby accelerating O2p kinetics in patients who are not overtly hypoxemic (PaO2 > 60 mmHg). We therefore investigated the effects of hyperoxia (HiOX= 50% O2) and normoxia (NOX) on the kinetics of O2p and fractional O2 extraction in the vastus lateralis ( [deoxy- Hb+Mb] by near-infrared spectroscopy) in 11 non- or mildly-hypoxemic patients. HiOX increased exercise tolerance compared to NOX (P<0.05). At the on-exercise transient, however, HiOX was associated with faster [deoxy-Hb+Mb] kinetics (= 4.8 } 2.4 s vs. 6.7 } 3.0 s; P<0.05) and a response govershoot h in 7/11 patients suggesting impaired Q LO2mv. Subsequently, however, [deoxy-Hb+Mb] decreased to lower steady-state values compared to NOX in 9/11 patients (P<0.05). As a likely consequence of these opposite effects of HiOX on Q LO2mv (i.e., early impairment followed by later improvement), O2p kinetics were accelerated in 6 but slowed in 5 patients. Interestingly, patients in whom HiOX accelerated O2p kinetics showed consistently-larger reductions in gsteady-state h ..[deoxy-Hb+Mb] compared to their counterparts (HiOX . NOX= -23.4 (-55.5 to -5.8) ƒÊM/cm vs. -0.62 (-22.6 to 10.7) ƒÊM/cm; p<0.05). In conclusion, HiOX can transitorily impair the convective flow of O2 to the working peripheral muscles at the onset of heavy intensity exercise in patients with COPD who are not overtly hypoxemic. This effect, however, might be (over)compensated by a subsequent increase in local O2 availability in selected patients. These data seem to provide a mechanistic explanation for the heterogeneous effects of HiOX on O2p kinetics in this patient sub-population. / TEDE / BV UNIFESP: Teses e dissertações

Made available in DSpace on 2016-06-02T20:19:15Z (GMT). No. of bitstreams: 1 3462.pdf: 1115624 bytes, checksum: 922f1de495cfca273a837f049f67e6f2 (MD5) Previous issue date: 2011-02-28 / Financiadora de Estudos e Projetos / Objective: To assess the six-minute step test (6MST) in terms of its ability to evaluate the aerobic functional capacity of COPD patients. In addition to compare, correlate and verify if there is an agreement between the metabolic (oxygen uptake-VO2), ventilatory (minute ventilation-VE) and cardiovascular variables (heart rate-HR), and perceived exertion of the 6MST and the incremental cardiopulmonary exercise test (ICPET). Methods: Metabolic and ventilatory variables, heart rate, dyspnea and lower limb (LL) fatigue were recorded from 18 COPD patients (five had mild COPD, five moderate, six severe and two very severe) performing the 6MST and the submaximal ICPET on cycle ergometer (work rate was increased by 5-10 watts) on different and not consecutive days. Results: There were no significant differences between VO2, HR, VE, dyspnea and LL fatigue mean values at the peak of both tests. Moderate correlations were found between the 6MST performance and ICPET s VO2 (r=0.49;p=0.05) and performance (r=0.63;p=0.005), high correlations were found between both VO2 (L/min and mL/kg/min) (r=0.76 and r=0.77;p=0.001), and moderate correlations were found between HR (r=0.68;p=0.002) and LL fatigue (r=0.59;p=0.011) between the tests. There was no agreement between VO2, HR and LL fatigue values between the tests. Conclusion: The 6MST has the ability to assess aerobic functional capacity and presents cardiorespiratory responses and perceived exertion similar to the ICPET in magnitude, however it cannot replace the ICPET, since the 6MST assesses and demands greater and more localized work from peripheral muscles, thus not reflecting the same ICPET cardiorespiratory capacity. / Objetivo: Verificar se o teste do degrau de seis minutos (TD6) permite avaliar a capacidade funcional aeróbia de pacientes com doença pulmonar obstrutiva crônica (DPOC) além de comparar, correlacionar e verificar se há concordância entre as variáveis metabólica (consumo de oxigênio-VO2), ventilatória (ventilação minuto-VE), cardiovascular (frequência cardíaca- FC) e de percepção de esforço entre o TD6 e o teste de exercício cardiopulmonar incremental (TECPI). Métodos: 18 pacientes com DPOC (cinco com obstrução leve, cinco moderada, seis grave e dois muito grave) executaram o TD6 e o TECPI submáximo em cicloergômetro (incrementos de 5 a 10W) em dias não coincidentes e não consecutivos. O TD6 foi realizado em um degrau cuja altura media 20cm e durante seis minutos os pacientes foram orientados a subir o mais rápido possível em cadência livre. Durante os testes foram avaliados o VO2, a VE, a FC, a sensação de dispneia (SD) e a sensação de fadiga de membros inferiores (SFMMII), por meio da escala de Borg. Resultados: Não houve diferenças significativas entre as médias dos valores de VO2, FC, VE, SD e SFMMII no pico de ambos os testes. Observaram-se correlações moderadas entre o desempenho no TD6 (número total de subidas no degrau) e o VO2 no TECPI (r=0,49;p=0,05) e entre o desempenho no TD6 com o desempenho no TECPI (r=0,63;p=0,005); correlações fortes entre os VO2 (L/min e mL/kg/min) (r=0,76 e r=0,77;p=0,001) e correlações moderadas das FC (r=0,68;p=0,002) e das SFMMII (r=0,59;p=0,011) entre os testes. Não se observou concordância entre os valores de VO2, FC e SFMMII entre os testes. Conclusão: O TD6 pode avaliar a capacidade funcional aeróbia e apresenta respostas cardiorrespiratórias e de percepção de esforço semelhantes ao TECPI em magnitude, porém não substitui o TECPI, uma vez que o TD6 não reflete a mesma capacidade cardiorrespiratória do TECPI por ser um teste que avalia e exige um trabalho maior e mais localizado da musculatura periférica.