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Biomedical subjects

L Palacios

Publications and source records attributed to L Palacios.

At least 37 records · Page 2Linked to original sources

Improvement in exercise tolerance and spirometric values in stable chronic obstructive pulmonary disease patients after an individualized outpatient rehabilitation programme.

OBJECTIVE: We sought to determine whether patients with stable chronic obstructive pulmonary disease (COPD) whose exercise performance is mainly limited by dyspnoea are able to improve their exercise tolerance after rehabilitation with an individualized programme based on aerobic training at the ventilatory threshold (VT) level. PATIENTS AND EXPERIMENTAL DESIGN: Thirteen stable and moderate to severe COPD patients took part in an outpatient rehabilitation programme lasting 4 months. This individualized programme consisted of exercise training (general training on cycle and upper-limb training by rowing at the heart rate corresponding to VT) together with provision of adequate calorie and protein support. RESULTS: Lung function test after rehabilitation revealed significant increases in FVC (82.9 vs 69.2 % pred) and FEV1 (47.2 vs 39.7 % pred), although FEV1/FVC were unchanged (44.8 vs 46.8%). Incremental exercise test performed on cycle revealed significant increases in time, work rate (82.0 vs 63.2 W), peak VO2 (14.6 vs 10.7 ml.kg-1.min-1), peak VO2 (840 vs 701 ml.min-1), peak VT (1309 vs 980 ml), and O2-pulse (8.3 vs 6.7). However, exercise tests were always symptom-limited by dyspnoea. CONCLUSIONS: We conclude that this individualized outpatient rehabilitation programme is able to improve exercise tolerance in stab le COPD patients affected by dyspnoea during exercise, through an apparent reconditioning of both skeletal and respiratory muscles and improved gas exchange during exercise, thus reducing the ratio of dead space to tidal volume. In consequence, patients whose exercise capacity is so reduced that they cannot develop significant lactic acidosis may reduce the ventilatory cost for exercise through this individualized therapy.

Aged↗

A physical-chemical analysis of the acid-base response to chronic obstructive pulmonary disease.

The metabolic contributions to chronic acid-base changes were examined in the plasma of arterial blood in patients with chronic obstructive pulmonary disease (COPD) and chronic hypercapnia, by a quantitative physical-chemical analysis. Patients were stratified into three groups: group 1 (Paco2 less than 40 mmHg; 1 mmHg = 133.3 Pa), group 2 (Paco2 between 40 and 50 mmHg), and group 3 (Paco2 higher than 50 mmHg). With the development of hypercapnia (Paco2 from 38.2 +/- 1.6 to 53.8 +/- 0.6 mmHg) and hypoxemia (Pao2 from 73.6 +/- 2.5 to 62.1 +/- 2.1 mmHg), blood pH decreased slightly (from 7.405 +/- 0.007 to 7.372 +/- 0.009). The strong ion difference ([SID]) increased in the hypercapnic group (from 39.7 +/- 1.7 to 46.2 +/- 2.9 mequiv.L-1) parallel to the increase in [HCO3-] (from 23.8 +/- 0.5 to 30.8 +/- 0.8 mequiv.L-1). The change in [SID] was quantitatively similar to the [HCO3-] change, thus reflecting a metabolic compensation of chronic respiratory acidosis. [SID] increase was mainly accounted for by changes in the [Na+]/[Cl-] ratio due to a significant decrease in plasma [Cl-]. Other ions measured as well as the weak acid buffers ([ATOT]) remained constant. From the present results, we suggest the usefulness of the physical chemical approach in the characterization of acid-base disturbances due to chronic hypercapnia when water retention or protein depletion are expected further to hypochloremia, as can be the case in severe COPD patients.

Acid-Base Equilibrium↗

[Iron supplementation in Chilean Mapuche infants of the Cautin Province, Chile].

A 1.8 ml iron supplementation of ferrous sulfate is administered for 90 days to 76 Mapuche infants, 12 months of age, male and female, from the rural area of the Cautin province of Chile. The iron nutrition is evaluated before and after the supplementation, through: hemoglobin, haematocrit, transferrin saturation and seric ferritin. Stools test are taken at the infant's home, to confirm the supplement intake and to measure the iron excreted. To study the contained of dietary Fe a Recordatory 24 hour Inquest (RI) is applied moreover a Proximal Chemical Analysis (PCHA) to meal test proceeding from the infant's homes. At 12 months before starting the supplementation, the anemia prevalence was of 28.3%, but it disappear as a result of the intervention. Also 65.3% of the infants showed and increase of 1 g or more on their hemoglobin, which indicates that they were anemic at the beginning of the iron supplementation. By means of this therapeutic test it was find 31% more of anemic infants, indicating more sensibility of this method. The high levels of anemia prevalence are due to the low iron intake, characteristic of the non lactious foods, which according results of the RI reaches an average of 2.8 +/- 1.2 mg of Fe/day, versus 4.8 +/- 4.0 mg of Fe/day according to PCHA. The observed difference between both test showed that there is a process of food environmental contamination, by the use of iron utensils and great soil contact. The high environmental contamination could also be proved by the high iron excretion stools (140 mg of Fe/100 g of stools). This method used to measure the Fe excretion of the supplement, would not be valid in rural population groups with similar characteristics to those of the studied group, because it does not discriminate between the intake and the extremely high environmental contamination. To prevent anemia due to iron absence in infants, it is absolutely necessary to have some iron fortified food starting at 6 months of age, as a complement for breast milk.

Anemia, Iron-Deficiency↗

Factors influencing acid-base status during acute severe hypothermia in unanesthetized rats.

Blood acid-base changes were studied during acute hypothermia (4-6 h) induced by cold exposure in the unanesthetized rat. Stewart's quantitative analysis was applied as a complementary approach to determine the relative contributions of several non-respiratory components to the arterial acid-base response. Acute decrease in body temperature (TB) lowered PaCO2 (32.5 to 14.5 mmHg) and [HCO3-]a(24.20 mEq/L to 17.56 mEq/L), increased pHa (7.481 to 7.608) and diminished the [OH-]/[H+] ratio, but had no significant effect on [SID] or [Atot], although both total phosphorus [PT] and inorganic phosphate [Pi] increased. The acid-base changes found were intermediate between those predicted by alpha-stat and pH-stat hypotheses. Deviation from the regulative alpha-imidazole strategy was more apparent in the plasma than in the intraerythrocyte compartment. We conclude that blood pH changes observed were mainly caused by increased relative ventilation (lung ventilation per unit of CO2 removed) and by resulting changes in PCO2, with a minor metabolic component but without significant contribution from ionic shifts or changes in plasma protein concentration.

Acid-Base Imbalance↗

Hematological, electrolyte, and biochemical alterations after a 100-km run.

Seven well-trained male long-distance runners were studied during a 100-km road race. Hematologic parameters, plasma electrolytes, glucose, lactate, urea, and creatinine content in plasma and the activity of the enzymes gamma-glutamyltransferase and creatinine kinase were determined before and after the race. A slight increase in hematocrit was found after the race, although the red blood cell count and hemoglobin concentration remained unchanged. Further, a significant rise in the number of white blood cells, lymphocytes, and neutrophils was found after the race. Postrun concentrations of plasma sodium and potassium increased significantly from 142 +/- 7 to 161 +/- 7 mmol.L-1, and from 4.22 +/- 0.37 to 5.15 +/- 0.46 mmol.L-1 (p < 0.05), respectively. Plasma concentrations of lactate (1.29 +/- 0.31 vs. 3.57 +/- 1.22 mmol.L-1), urea (6.09 +/- 1.0 vs. 8.35 +/- 1.35 mmol.L-1), creatinine (73.4 +/- 3.5 vs. 117.6 +/- 19.4 mumol.L-1), plasma creatine kinase (91.1 +/- 25.1 vs. 2843 +/- 2341 IU.L-1), and gamma-glutamyltransferase (20.28 +/- 1.88 vs. 24.14 +/- 4.09 IU .L-1) increased significantly (p < 0.05) after the run. It was concluded that during ultralong-distance races, acute renal dysfunction and muscle damage could contribute to the observed hypernatremia and hyperkalemia.

Adult↗

Changes in blood ammonia and lactate levels during a triathlon race.

Blood ammonia and lactate concentrations were analyzed in 7 volunteer male athletes before and immediately after each segment of an endurance triathlon. The purpose of this study was to examine the effects of triathlon on ammonia and lactate blood levels and the possible correlation between both in each different event. Concentrations of blood ammonia were increased after each of the three segments, reaching a peak after the 40 km bicycle ride. Concentrations of blood lactate were also increased over baseline. However, there was a higher increase after the 1.4 km lake swim, than after the 40 km bicycle ride or after the 10 km run. No correlation was found between the levels of ammonia and lactate, suggesting that ammonia and lactate follow different metabolic patterns.

Adolescent↗

Comparison of acid/base status in conscious and anaesthetized rats during acute hypothermia.

Acute hypothermia was surface-induced in unrestrained conscious rats at two different levels, moderate (30 degrees C TB) and severe (20 degrees C TB). Data reflecting the acid/base status were determined. The values obtained for moderate hypothermia were compared with the acid/base pattern observed during hypothermia induced by two different anaesthetics, sodium pentobarbital and urethane, at room temperature. Conscious, hypothermic animals developed an apparent respiratory alkalosis, with an increase in pHa (from 7.476 to 7.546 in moderate hypothermia and from 7.484 to 7.563 in severe hypothermia) correlated with a decrease in arterial bicarbonate levels (from 22.9 to 16.8 mmol l-1 and from 20.7 to 14.9 mmol l-1 respectively). Lactate increased slightly in conscious, severely hypothermic rats (1.02 mmol l-1). This acid/base pattern was clearly different from that seen in sodium pentobarbital (mild respiratory acidosis) and urethane-induced hypothermia (metabolic acidosis). These results suggest that conscious rats follow a pattern closer to that underlying the relative alkalinity shown by many poikilotherms than to that underlying the constant pH shown in hibernating mammals. This latter pattern, nevertheless, approaches that observed during moderate pentobarbital hypothermia and the acid/base pattern during shallow hypothermia in birds. Anaesthesia may interfere with the development of the processes that lead to the acid/base pattern observed in conscious animals.

Acid-Base Equilibrium↗

Erythrocyte osmotic resistance during acute hypothermia in awake unrestrained rats.

Erythrocyte osmotic fragility and plasma ionic composition were studied in rats subjected to acute hypothermia. A decrease in osmotic fragility and a significant increase in plasma magnesium and total phosphorus were observed in blood from hypothermic rats in relation to control. A decrease in erythrocyte osmotic fragility from hypothermic animals was observed when the test was performed at 37 degrees C, whereas osmotic fragility was unaltered if the test was carried out at body temperature. This could be interpreted as an adaptative response to counteract the opposite effect on erythrocyte osmotic fragility observed at low temperature 'in vitro'.

Animals↗

Severe hypoxia decreases oxygen uptake relative to intensity during submaximal graded exercise.

The effect of severe acute hypoxia (fractional concentration of inspired oxygen equalled 0.104) was studied in nine male subjects performing an incremental exercise test. For power outputs over 125 W, all the subjects in a state of hypoxia showed a decrease in oxygen consumption (VO2) relative to exercise intensity compared with normoxia (P < 0.05). This would suggest an increased anaerobic metabolism as an energy source during hypoxic exercise. During submaximal exercise, for a given VO2, higher blood lactate concentrations were found in hypoxia than in normoxia (P < 0.05). In consequence, the onset of blood lactate accumulation (OBLA) was shifted to a lower VO2 (VO2 1.77 l.min-1 in hypoxia vs 3.10 l.min-1 in normoxia). Lactate concentration increases relative to minute ventilation (VE) responses were significantly higher during hypoxia than in normoxia (P < 0.05). At OBLA, VE during hypoxia was 25% lower than in the normoxic test. This study would suggest that in hypoxia subjects are able to use an increased anaerobic metabolism to maintain exercise performance.

Adult↗

Respiratory gas exchange using a triaxial alveolar gas diagram.

A triaxial alveolar gas diagram to depict fractional concentration of oxygen, carbon dioxide and nitrogen is described, in which the R = 1 line is always implicit. Although it is not claimed that this representation leads to new insights into respiratory physiology, a method of plotting on a triaxial coordinate system has been found to be well suited to many applications when a direct display of fractional nitrogen concentration is required.

Carbon Dioxide↗

A method for sampling representative muscular venous blood during exercise in rats.

A technique for chronic cannulation of the muscular branch of the femoral vein in the rat is described. The method was validated by the application of vascular corrosion casts and comparative analysis of lactate concentration with mixed venous blood and arterial samples taken through the cannulas during lower hindlimb muscle contraction in anaesthetized rats.

Animals↗

Plasma and red blood cell magnesium levels and plasma creatinine after a 100 km race.

Magnesium homeostasis is critical for exercise performance. In this report the effect of long distance race on the erythrocyte and plasma magnesium concentration is determined in a group of 7 well-trained male amateur runners. After a 100 km race the plasma Mg2+ levels increased significantly from 0.845 +/- 0.074 to 0.934 +/- 0.099 mmol.l-1 (p < 0.05). However, the intra-erythrocyte Mg2+ concentrations were not modified significantly (2.10 +/- 0.2 mmol.l-1 versus 2.14 +/- 0.12 mmol.l-1). Creatinine plasma levels increased significantly from 73.4 +/- 3.5 mumol.l-1 to 117.6 +/- 19.4 mumol.l-1 (p < 0.01), suggesting impairment of the renal function. A significant positive correlation between plasma magnesium and plasma creatinine, r = +0.65 (p < 0.01) was found. These results suggest that an increase in the magnesium plasma levels could be related to renal failure during long-distance running.

Adult↗

Differential effects of hypothermia upon blood acid-base state and blood gases in sodium pentobarbital and urethane anaesthetised rats.

1. The effects of two anaesthetics, sodium pentobarbital and urethane, and the effects of anaesthesia-associated hypothermia on acid-base status and blood gases were studied in rats without assisted ventilation. 2. Manipulation of conscious rats produces a progressive increase in arterial lactate associated with slight hyperventilation. 3. Sodium pentobarbital anaesthesia produces mild respiratory acidosis accompanied by increase in lactate arterial values. Urethane anaesthesia leads to partially compensated metabolic acidosis. 4. Hypothermia reduces metabolic acidosis and hypercapnia induced by sodium pentobarbital anaesthesia. No difference between hypothermic and normothermic values was observed in urethane anaesthesia.

Acid-Base Equilibrium↗

Role of erythrocyte organic phosphates in blood oxygen transport in anemic quail.

The effects of two different degrees of experimentally induced anemia and the consequent high percentage of circulating immature erythrocytes on oxygen affinity (pH 7.5 and 41 degrees C), erythrocyte organic phosphates, and Hb fractions have been studied in quail. Blood reticulocytes reached percentages of 24 and 69-87% in the first and second experiments, respectively. Variations in the phosphate levels found during the anemic process were related to the amount of circulating reticulocytes. The erythrocyte [ATP] (brackets indicate concentration) and [ATP]/[Hb] molar ratio increased with the release of reticulocytes and returned to control levels as they matured. The erythrocyte [inositol pentakisphosphate (InsP5)] decreased significantly when circulating reticulocytes showed their highest values, whereas there was hardly any effect on the [InsP5]/[Hb] molar ratio, which changed only slightly. Hb-O2 affinity also exhibited no statistical changes associated with acute anemia. These latter findings indicate that InsP5, at physiological concentrations, is the primary modulator of quail Hb function; the observed rise in [ATP] has no additional influence on Hb-O2 affinity. It is suggested that InsP5 tends to maintain the blood oxygen affinity in both mature erythrocytes and reticulocytes. The main compensatory response at blood level is a rapid bulk reticulocyte release from medulla.

Adenosine Triphosphate↗

Therapeutic trial of vigabatrin in refractory infantile spasms.

Infantile spasms usually start during the first year of life and constitute one of the most difficult types of epilepsy to treat. They carry a very poor prognosis for both epilepsy and mental development. Seventy children, including 47 infants, with intractable infantile spasms were entered into an open study with vigabatrin as add-on therapy to the usual anticonvulsant treatment. All were resistant to previous treatments, including corticosteroids (43 patients), carbamazepine, benzodiazepines, and sodium valproate. Two children withdrew from the study because of intolerance to vigabatrin (hypotonia or hypertonia) before evaluation of efficacy could be made. Of the remaining 68 children, 29 (43%) showed complete suppression of spasms. Forty-six children had a greater than 50% reduction in spasms. The best response was observed in those with tuberous sclerosis (12/14 compared with 12/18 with symptomatic infantile spasms of other origin and 22/36 with cryptogenic infantile spasms). Following the initial response to treatment of these patients (n = 68), a long-term response was confirmed in 75% of children with symptomatic infantile spasms and 36% of children with cryptogenic infantile spasms. In eight children, all other anticonvulsant medication could be definitively withdrawn. Tolerability appeared excellent, with 52 of 70 patients reporting no side effects. Somnolence, hypotonia, weight gain, excitation, and insomnia were the most common problems at the beginning of the study and were usually transient. Given the poor prognosis of this type of childhood epilepsy, vigabatrin appears to be a very interesting advance in the management of drug-resistant infantile spasms.

Adolescent↗

Changes in haemoglobin oxygen affinity and erythrocytic 2,3-BPG in ethanol-treated rats.

1. The effects of alcohol on blood oxygen transport properties were studied in rats after a chronic administration of ethanol in drinking water. 2. Ingestion of ethanol provokes an increase in haemoglobin oxygen affinity (at pH 7.4). This is caused by a drop in the MCHC and erythrocyte 2,3-BPG concentration that give rise to a decrease in the 2,3-BPG/Hb ratio. 3. No changes in haemoglobin fractions were observed. 4. The results indicate a depletion in the red blood cell glycolytic pathways. 5. If metabolic acidosis occurs, the expected loss of blood affinity in vivo due to the fall in pH would be compensated by the changes observed in vitro.

2,3-Diphosphoglycerate↗

Morphological changes in neuromuscular junctions during exercise.

Long lasting exercise produces several morphological changes in teleostean neuromuscular junctions (NJs), consisting of progressive synaptic vesicles (SVs) depletion and lamellar branching of the nerve endings. Exercised fishes kept swimming during 1 hr against a 3.5 1/min flow of oxygenated water in spite of the fact that the number of SVs was reduced in about 70% after 10 min of exercise. This observation indicates that the SVs formation fails to restore their original number and consequently, under such circumstances, the transmitter release may occur by a different mechanism.

Animals↗