Dinâmica ultrassonográfica dos volumes do conteúdo gástrico após a ingestão de água de coco ou sanduíche de carne. Um estudo cruzado controlado e randômico com voluntários saudáveis

Background

Adequate preoperative fasting is critical in preventing pulmonary aspiration of gastric content. We proposed to study the sonographic gastric content dynamics after the ingestion of liquid or solid food in healthy volunteers and confront it with current guidelines for preoperative fasting times.

Enriched Flavonoid Fraction from <Emphasis Type="Italic">Cecropia pachystachya</Emphasis> Trécul Leaves Exerts Antidepressant-like Behavior and Protects Brain Against Oxidative Stress in Rats Subjected to Chronic Mild Stress

The purpose of this study was to assess the effect of an enriched C-glycosyl flavonoids fraction (EFF-Cp) from Cecropia Pachystachya leaves on behavior, mitochondrial chain function, and oxidative balance in the brain of rats subjected to chronic mild stress. Male Wistar rats were divided into experimental groups (saline/no stress, saline/stress, EFF-Cp/no stress, and EFF-Cp/stress). ECM groups were submitted to stress for 40 days. On the 35th ECM day, EFF-Cp (50 mg/kg) or saline was administrated and the treatments lasted until the 42nd day. On the 41st and 42nd days, the animals were submitted to the splash test and the forced swim test. After these behavioral tests, the enzymatic activity of mitochondrial chain complexes and oxidative stress were analyzed. EFF-Cp reversed the depressive-like behavior induced by ECM. It also reversed the increase in thiobarbituric acid reactive species, myeloperoxidase activity, and nitrite/nitrate concentrations in some brain regions. The reduced activities of the antioxidants superoxide dismutase and catalase in some brain regions were also reversed by EFF-Cp. The most pronounced effect of EFF-Cp on mitochondrial complexes was an increase in complex IV activity in all studied regions. Thus, it is can be concluded that EFF-Cp exerts an antidepressant-like effect and that oxidative balance may be an important physiological process underlying these effects.     

Macro- and micro-structural white matter differences correlate with cognitive performance in healthy aging

Studies have shown that white matter (WM) volumetric reductions and overall degradation occur with aging. Nonetheless little is known about the WM alterations that may underlie different cognitive status in older individuals. The main goal of the present work was to identify and characterize possible macro and microstructural WM alterations that could distinguish between older healthy individuals with contrasting cognitive profiles (i.e., “poor” vs “good” cognitive performers). Structural and diffusion magnetic resonance imaging was performed in order to quantify local WM volumes, white matter signal abnormalities (WMSA) volume (a measure of lesion burden) and diffusion tensor imaging scalar maps known to probe WM microstructure. A battery of neurocognitive/psychological tests was administered to assess the cognitive performance. Poor performers showed a higher slope for the positive association between WMSA volume and age compared to good performers. Even when controlling for WMSA volume, poor performers also evidenced lower fractional anisotropy, as well as positive associations with age with higher slopes of regression parameters in radial and axial diffusivity. Altogether results suggest that cognitive performance is related to differences in WM, with poor cognitive performers displaying signs of faster aging in WM.     

“Publish or Perish” Promotes Medical Literature Quantity Over Quality

When it comes to medical research, incentives align to promote “publish or perish.” This results in quantity over quality. A solution is to change the goal of medical scientist and clinician training from bolstering a curriculum vitae to mastering scientific research methods. In addition, the metric for scholarly authorship should be quality, for which validated measurement tools exist, rather than number of publications.     

Big Data: Progress or a Big Headache?

Large administrative database, or “big data” research studies can include an immense number of patients. Strengths of research based on big data include generalizability resulting from diverse patients, diverse providers, and diverse clinical settings. Limitations of research based on large administrative databases may include indeterminate quality and obscure purpose of data entry, lack of information regarding confounding variables, and suboptimal clinical outcome measures. Thus, research conclusions based on big data must be scrutinized in a discerning and critical manner.     

Are cardiovascular and metabolic responses to field walking tests interchangeable and obesity-dependent?

Purpose: To investigate if cardiovascular and metabolic responses to the six-minute walk test (6MWT) and incremental shuttle walking test (ISWT) are in agreement with cardiopulmonary exercise testing (CPX) and determine if both submaximal tests are interchangeable in obese and eutrophic individuals.

Method: Observational and cross-sectional study included 51 obese women (ObG) and 21 controls (CG) (20–45 years old). Subjects underwent clinical evaluation, CPX, the 6MWT and ISWT. We applied Bland–Altman plots to assess agreement between walking tests and CPX. Correlation analysis assessed relationships between key variables.

Results: There was an agreement between CPX and both the 6MWT [oxygen uptake (VO₂ mL?kg^?1?min^?1)?=?6.9 (CI: 5.7–8.1), and heart rate (bpm)?=?37.0 (CI: 33.3–40.7)] and ISWT [VO₂ (mL?kg^?1?min^?1)?=?6.1 (CI: 4.9–7.3), and heart rate (bpm)?=?36.2 (CI: 32.1–40.3)]. We found similar cardiovascular and metabolic responses to both tests in the ObG but not in the CG. Strong correlations were demonstrated between 6MWT and ISWT variables: VO₂ ( r?=?0.70); dyspnoea (r?=?0.80); and leg fatigue (r?=?0.70).

Conclusions: 6MWT and ISWT may both hold interchangeable clinical value when contrasted with CPX in obese women and may be a viable alternative in the clinical setting when resources and staffing are limited.

• Implications for Rehabilitation

• Obesity is a worldwide epidemic, with high prevalence in women, and it is associated to impaired cardiorespiratory fitness and functional capacity as well as high mortality risk.

• Assessing oxygen uptake by means of cardiopulmonary exercise testing is the gold standard method for evaluating and stratifying cardiorespiratory fitness, however it is not ever applied due to costs and staffing.

• Walking field tests may be a cost-effective approach that provides valuable information regarding the functional capacity in agreement to metabolic and cardiovascular responses of cardiopulmonary exercise testing.