A922 Sequential measurement of 1 hour creatinine clearance (1-CRCL) in critically ill patients at risk of acute kidney injury (AKI)

Meeting abstrac

Global patient outcomes after elective surgery: prospective cohort study in 27 low-, middle- and high-income countries.

BACKGROUND: As global initiatives increase patient access to surgical treatments, there remains a need to understand the adverse effects of surgery and define appropriate levels of perioperative care. METHODS: We designed a prospective international 7-day cohort study of outcomes following elective adult inpatient surgery in 27 countries. The primary outcome was in-hospital complications. Secondary outcomes were death following a complication (failure to rescue) and death in hospital. Process measures were admission to critical care immediately after surgery or to treat a complication and duration of hospital stay. A single definition of critical care was used for all countries. RESULTS: A total of 474 hospitals in 19 high-, 7 middle- and 1 low-income country were included in the primary analysis. Data included 44 814 patients with a median hospital stay of 4 (range 2-7) days. A total of 7508 patients (16.8%) developed one or more postoperative complication and 207 died (0.5%). The overall mortality among patients who developed complications was 2.8%. Mortality following complications ranged from 2.4% for pulmonary embolism to 43.9% for cardiac arrest. A total of 4360 (9.7%) patients were admitted to a critical care unit as routine immediately after surgery, of whom 2198 (50.4%) developed a complication, with 105 (2.4%) deaths. A total of 1233 patients (16.4%) were admitted to a critical care unit to treat complications, with 119 (9.7%) deaths. Despite lower baseline risk, outcomes were similar in low- and middle-income compared with high-income countries. CONCLUSIONS: Poor patient outcomes are common after inpatient surgery. Global initiatives to increase access to surgical treatments should also address the need for safe perioperative care. STUDY REGISTRATION: ISRCTN5181700

Guidelines for the use and interpretation of assays for monitoring autophagy (4th edition)1.

In 2008, we published the first set of guidelines for standardizing research in autophagy. Since then, this topic has received increasing attention, and many scientists have entered the field. Our knowledge base and relevant new technologies have also been expanding. Thus, it is important to formulate on a regular basis updated guidelines for monitoring autophagy in different organisms. Despite numerous reviews, there continues to be confusion regarding acceptable methods to evaluate autophagy, especially in multicellular eukaryotes. Here, we present a set of guidelines for investigators to select and interpret methods to examine autophagy and related processes, and for reviewers to provide realistic and reasonable critiques of reports that are focused on these processes. These guidelines are not meant to be a dogmatic set of rules, because the appropriateness of any assay largely depends on the question being asked and the system being used. Moreover, no individual assay is perfect for every situation, calling for the use of multiple techniques to properly monitor autophagy in each experimental setting. Finally, several core components of the autophagy machinery have been implicated in distinct autophagic processes (canonical and noncanonical autophagy), implying that genetic approaches to block autophagy should rely on targeting two or more autophagy-related genes that ideally participate in distinct steps of the pathway. Along similar lines, because multiple proteins involved in autophagy also regulate other cellular pathways including apoptosis, not all of them can be used as a specific marker for bona fide autophagic responses. Here, we critically discuss current methods of assessing autophagy and the information they can, or cannot, provide. Our ultimate goal is to encourage intellectual and technical innovation in the field

Hypotensive response after water-walking and land-walking exercise sessions in healthy trained and untrained women

Daniel Rodriguez1, Valter Silva2, Jonato Prestes3, Roberta Luksevicius Rica4, Andrey Jorge Serra5, Danilo Sales Bocalini6, Francisco Luciano Pontes Junior71São Judas Tadeu University, São Paulo, SP, Brazil; 2College of Physical Education of Sorocaba, Sorocaba, SP, Brazil; 3Graduation Program in Physical Education, Catholic University of Brasilia, Brasilia-DF, Brazil; 4Department of Physical Education, Arbos College, São Bernardo do Campo, SP, Brazil; 5Department of Physical Education and Laboratory of Rehabilitation Science, Nove de Julho University, São Paulo, SP, Brazil; 6Department of Medicine, Federal University of São Paulo – Escola Paulista de Medicina, São Paulo, SP, Brazil; 7School of Arts, Sciences and Humanities, University of São Paulo, São Paulo, SP, BrazilBackground: The aim of this study was to compare post-exercise hypotension after acute sessions of water-walking and land-walking in healthy trained and untrained women.Methods: Twenty-three untrained (n = 12) and trained (n = 11) normotensive women performed two walking sessions in water and on land at 40% of peak VO2 for 45 minutes. Systolic and diastolic blood pressure and mean arterial pressure were measured 15, 30, 45, and 60 minutes after the exercise sessions.Results: No differences were found between the groups for age and anthropometric parameters, but peak VO2 for the trained women (45 ± 8 mL/kg/minute) was higher than for the untrained women (31 ± 3 mL/kg/minute). No differences were found between the groups with regard to systolic and diastolic blood pressure and mean arterial pressure after water immersion. The heart rate in the trained group (62 ± 3 beats per minute [bpm]) was significantly lower (P < 0.05) than in the untrained group (72 ± 4 bpm) on land, and after water immersion, this difference disappeared (58 ± 5 bpm in the trained women and 66 ± 5 bpm in the untrained women). Sixty minutes after water-walking, systolic blood pressure (108 ± 8 mmHg vs 97 ± 3 mmHg), diastolic blood pressure (69 ± 5 mmHg vs 62 ± 5 mmHg), and mean arterial pressure (82 ± 6 mmHg vs 74 ± 4 mmHg) decreased significantly with rest in the untrained group, and no differences were found after land-walking. In the trained group, significant (P < 0.05) differences were found only for systolic blood pressure (110 ± 9 mmHg vs 100 ± 9 mmHg) after 60 minutes of water-walking; decreases in systolic blood pressure were found after 45 minutes (99 ± 7 mmHg) and 60 minutes (99 ± 6 mmHg) compared with rest (107 ± 5 mmHg) after land-walking.Conclusion: Single water-walking and land-walking sessions induced important hypotension following exercise. Additionally, walking performed in chest-deep water has a better effect on exercise-induced hypotension in untrained healthy women than walking at a similar intensity on land.Keywords: water-based exercise, post-exercise hypotension, blood pressure, cardiovascular response, normotensive wome

Effects of exercise intensity on postexercise hypotension after resistance training session in overweight hypertensive patients

Paula Andréa M Cavalcante,1,2 Roberta L Rica,1,2 Alexandre L Evangelista,1,3 Andrey J Serra,3,4 Aylton Figueira Jr,1,2 Francisco Luciano Pontes Jr,5 Lon Kilgore,6 Julien S Baker,6 Danilo S Bocalini1,2 1Translational Physiology Laboratory, 2Postgraduate Program in Physical Education and Aging Science, São Judas Tadeu University (USJT), 3Department of Physical Education, 4Postgraduate Program in Biophotonics Applied to Health Sciences, Nove de Julho University (UNINOVE), 5Department of Gerontology of Arts, Science and Humanities School, São Paulo University, São Paulo, Brazil; 6Institute of Clinical Exercise and Health Science, University of the West of Scotland, Hamilton, Lanarkshire, Scotland Abstract: Among all nonpharmacological treatments, aerobic or resistance training (RT) has been indicated as a significantly important strategy to control hypertension. However, postexercise hypotension responses after intensity alterations in RT are not yet fully understood. The purpose of this study was to compare the outcomes of differing intensities of RT on hypertensive older women. Twenty hypertensive older women participated voluntarily in this study. After a maximum voluntary contraction test (one repetition maximum) and determination of 40% and 80% experimental loads, the protocol (3 sets/90" interset rest) was performed in a single session with the following exercises: leg press, leg extension, leg curl, chest press, elbow flexion, elbow extension, upper back row, and abdominal flexion. Systolic and diastolic blood pressures were evaluated at rest, during exercise peak, and after 5, 10, 15, 30, 45, and 60 minutes of exercise and compared to the control. Both experimental loads were effective (P<0.01) in promoting postexercise systolic hypotension (mmHg) compared to controls, after 30, 45, and 60 minutes, respectively, at 40% (113±2, 112±4, and 110±3 mmHg) and 80% (111±3, 111±4, and 110±4 mmHg). Both procedures promoted hypotension with similar systolic blood pressures (40%: -11%±1.0% and 80%: -13%±0.5%), mean arterial blood pressures (40%: -12%±5.5% and 80%: -12%±3.4%), and rate-pressure products (40%: -15%±2.1% and 80%: -17%±2.4%) compared to control measures (systolic blood pressure: 1%±1%, mean arterial blood pressure: 0.6%±1.5%, rate-pressure product: 0.33%±1.1%). No differences were found in diastolic blood pressure and heart rate measures. In conclusion, hypertensive older women exhibit postexercise hypotension independently of exercise intensity without expressed cardiovascular overload during the session. Keywords: resistive training, postexercise hypotension, aging, hypertensio

Effects of circuit-based exercise programs on the body composition of elderly obese women

Danilo Sales Bocalini,1 Lucas S Lima,3 Socrates de Andrade,4 Angelo Madureira,4 Roberta L Rica,4,5 Rodrigo Nolasco dos Santos,4 Andrey Jorge Serra,1,2 Jose Antonio Silva Jr,2 Daniel Rodriguez,6 Aylton Figueira Jr,6 Francisco Luciano Pontes Jr31Departamenteo de Educação Física e, 2Ciências da Reabilitação da Universidade Nove de Julho (UNINOVE), São Paulo, SP, Brazil; 3Curso de Gerontologia, Escola de Artes, Ciências e Humanidades da Universidade de São Paulo (EACH), São Paulo, SP, Brazil; 4Universidade Gama Filho (UGF), Rio de Janeiro, RJ, Brazil; 5Departamento de Educação Física, Colegio Arbos, São Bernardo do Campo, SP, Brazil; 6Departamento de Educação Física. Universidade São Judas Tadeu (USJT), São Paulo, SP, BrazilAim: The aim of this study was to investigate the impact of circuit-based exercise on the body composition in obese older women by focusing on physical exercise and body weight (BW) gain control in older people.Methods: Seventy older women (>60 years old) voluntarily took part in the study. Participants were randomized into six different groups according to body mass index (BMI): appropriate weight (AW) control (AWC) and trained (AWT) groups, overweight (OW) control (OWC) and trained (OWT) groups, and obesity (O) control (OC) and trained (OT) groups. The exercise program consisted of 50 minutes of exercise three times per week for 12 weeks. The exercises were alternated between upper and lower body using rest between sets for 40 seconds with intensity controlled by heart rate (70% of work). The contraction time established was 5 seconds to eccentric and concentric muscular action phase. The following anthropometric parameters were evaluated: height (m), body weight (BW, kg), body fat (BF, %), fat mass (FM, kg), lean mass (LM, kg), and BMI (kg/m2).Results: The values (mean ± standard deviation [SD]) of relative changes to BW (−8.0% ± 0.8%), BF (−21.4% ± 2.1%), LM (3.0% ± 0.3%), and FM (−31.2% ± 3.0%) to the OT group were higher (P < 0.05) than in the AWT (BW: −2.0% ± 1.1%; BF: −4.6% ± 1.8%; FM: −7.0% ± 2.8%; LM: 0.2% ± 1.1%) and OWT (BW: −4.5% ± 1.0%; BF: −11.0% ± 2.2%; FM: −16.1% ± 3.2%; LM: −0.2% ± 1.0%) groups; additionally, no differences were found for C groups. While reduction (P < 0.03) in BMI according to absolute values was observed for all trained groups (AWT: 22 ± 1 versus 21 ± 1; OWT: 27 ± 1 versus 25 ± 1, OT: 34 ± 1 versus 30 ± 1) after training, no differences were found for C groups.Conclusion: In summary, circuit-based exercise is an effective method for promoting reduction in anthropometrics parameters in obese older women.Keywords: anthropometric parameters, body fat, obesity, older women, physical exercis