Integrated Cardio-Respiratory Control : Insight in Diabetes

Autonomic dysfunction is a frequent and relevant complication of diabetes mellitus, as it is associated with increased morbidity and mortality. In addition, it is today considered as predictive of the most severe diabetic complications, like nephropathy and retinopathy. The classical methods of screening are the cardiovascular reflex tests and were originally interpreted as evidence of nerve damage. A more modern approach, based on the integrated control of cardiovascular and respiratory function, reveals that these abnormalities are to a great extent functional, at least in the early stage of the disease, thus suggesting new potential interventions. Therefore, this review aims to go further investigating how the imbalance of the autonomic nervous system is altered and can be influenced in many chronic pathologies through a global view of cardio-respiratory and metabolic interactions and how the same mechanisms are applicable to diabetes.Peer reviewe

Slow breathing and hypoxic challenge: cardiorespiratory consequences and their central neural substrates

Controlled slow breathing (at 6/min, a rate frequently adopted during yoga practice) can benefit cardiovascular function, including responses to hypoxia. We tested the neural substrates of cardiorespiratory control in humans during volitional controlled breathing and hypoxic challenge using functional magnetic resonance imaging (fMRI). Twenty healthy volunteers were scanned during paced (slow and normal rate) breathing and during spontaneous breathing of normoxic and hypoxic (13% inspired O2) air. Cardiovascular and respiratory measures were acquired concurrently, including beat-to-beat blood pressure from a subset of participants (N = 7). Slow breathing was associated with increased tidal ventilatory volume. Induced hypoxia raised heart rate and suppressed heart rate variability. Within the brain, slow breathing activated dorsal pons, periaqueductal grey matter, cerebellum, hypothalamus, thalamus and lateral and anterior insular cortices. Blocks of hypoxia activated mid pons, bilateral amygdalae, anterior insular and occipitotemporal cortices. Interaction between slow breathing and hypoxia was expressed in ventral striatal and frontal polar activity. Across conditions, within brainstem, dorsal medullary and pontine activity correlated with tidal volume and inversely with heart rate. Activity in rostroventral medulla correlated with beat-to-beat blood pressure and heart rate variability. Widespread insula and striatal activity tracked decreases in heart rate, while subregions of insular cortex correlated with momentary increases in tidal volume. Our findings define slow breathing effects on central and cardiovascular responses to hypoxic challenge. They highlight the recruitment of discrete brainstem nuclei to cardiorespiratory control, and the engagement of corticostriatal circuitry in support of physiological responses that accompany breathing regulation during hypoxic challenge

Spontaneous Group Synchronization of Movements and Respiratory Rhythms

Peer reviewe

Yoga and Rehabilitation: Physical, Psychological, and Social

Non peer reviewe

Oxygen-induced impairment in arterial function is corrected by slow breathing in patients with type 1 diabetes

Hyperoxia and slow breathing acutely improve autonomic function in type-1 diabetes. However, their effects on arterial function may reveal different mechanisms, perhaps potentially useful. To test the effects of oxygen and slow breathing we measured arterial function (augmentation index, pulse wave velocity), baroreflex sensitivity (BRS) and oxygen saturation (SAT), during spontaneous and slow breathing (6 breaths/min), in normoxia and hyperoxia (5 L/min oxygen) in 91 type-1 diabetic and 40 age-matched control participants. During normoxic spontaneous breathing diabetic subjects had lower BRS and SAT, and worse arterial function. Hyperoxia and slow breathing increased BRS and SAT. Hyperoxia increased blood pressure and worsened arterial function. Slow breathing improved arterial function and diastolic blood pressure. Combined administration prevented the hyperoxia-induced arterial pressure and function worsening. Control subjects showed a similar pattern, but with lesser or no statistical significance. Oxygen-driven autonomic improvement could depend on transient arterial stiffening and hypertension (well-known irritative effect of free-radicals on endothelium), inducing reflex increase in BRS. Slow breathing-induced improvement in BRS may result from improved SAT, reduced sympathetic activity and improved vascular function, and/or parasympathetic-driven antioxidant effect. Lower oxidative stress could explain blunted effects in controls. Slow breathing could be a simple beneficial intervention in diabetes.Peer reviewe

Former Foodstuff Products (FFPs) as Circular Feed: Types of Packaging Remnants and Methods for Their Detection

Alternative feed ingredients in farm animal diets are a sustainable option from several perspectives. Former food products (FFPs) provide an interesting case study, as they represent a way of converting food industry losses into ingredients for the feed industry. A key concern regarding FFPs is the possible packaging residues that can become part of the product, leading to potential contamination of the feed. Although the level of contamination has been reported as negligible, to ensure a good risk evaluation and assessment of the presence of packaging remnants in FFPs, several techniques have been proposed or are currently being studied, of which the main ones are summarized in this review. Accordingly visual inspections, computer vision (CV), multivariate image analysis (MIA), and electric nose (e-nose) are discussed. All the proposed methods work mainly by providing qualitative results, while further research is needed to quantify FFP-derived packaging remnants in feed and to evaluate feed safety as required by the food industries

809-1 Different Respiratory Rates Affect the Measurement of Autonomic Tone by Power Spectral Analysis of Heart Rate Variability in Patients with Heart Failure

Power spectral analysis of heart rate variability is frequently used as an easy non invasive method for assessing autonomic tone. However changes in respiratory rate are frequently ignored and these may have an important effect on the measurements of spectral components, especially in heart failure. We have assessed the effect of different respiratory rates (10, 15, 20 min-1 and spontaneous) on low frequency (LF) and high frequency (HF) components of HR variability in 11 heart failure pts (CCF) (EF=40±4%; 9 males) and 9 normal subjects (5 males).ResultsLF & HF spectral power in normalized units (%); S=spontaneous (mean±SEM)LF10HF10LF15HF15LF20HF20LFSHFSSupineCCF19±863±9*18±554±713±447±8*16±649± 8Normal14±668±818±658±1015±670±522±955±10StandCCF15±766±619±746±830±1051±97±531±10Normal28±955±830±942±958±1027±550±1217±5*p<0.05Supine HF power falls with increasing respiratory rate in most CCF pts and this effect is similar to that seen in normals on standing (i.e. at increased sympathetic levels). An improvement in clinical state of CCF pts will lower respiratory rate and this effect alone will increase HF power rather than any therapy

Sleep-disordered breathing and pregnancy outcomes: The impact of maternal oxygen saturation

ObjectiveTo investigate pathological associations between sleep-disordered breathing (SDB) and pregnancy outcomes. MethodsFrom May 2016 to September 2019, obese women during their uncomplicated singleton pregnancies underwent screening sleep questionnaires, oxygen saturation monitoring, and, in proper cases, complete overnight polysomnography. Their medical records were also recorded. ResultsIn all, 112 pregnant women were included in the study cohort; 44 showed an oxygen desaturation index & GE;10, and their newborns had a significantly higher rate of congenital abnormalities and respiratory distress syndrome compared with the women with normal pulse oximetry. Stepwise multivariate regression analysis showed that basal oxygen saturation was independently associated with the occurrence of fetal growth restriction. ConclusionAmong obese pregnant women, the rate of congenital abnormalities is higher in the ones with altered pulse oximetry. Maternal basal oxygen saturation in the first trimester of pregnancy predicts fetal growth restriction independently of maternal age, ethnicity, body mass index, gravidity, and hypertensive disorders of pregnancy

Different intrauterine environments and children motor development in the first 6 months of life : a prospective longitudinal cohort

This prospective cohort longitudinal study examines the risk factors associated with different intrauterine environments and the influence of different intrauterine environments on children’s motor development at 3- and 6-months of life. Participants were 346 mother/newborn dyads enrolled in the first 24 to 48 h after delivery in public hospitals. Four groups with no concurrent condition composed the sample: mothers with a clinical diagnosis of diabetes, mothers with newborns small for gestational age due to idiopathic intrauterine growth restriction (IUGR), mothers who smoked tobacco during gestation, and a control group composed of mothers without clinical condition. Children were assessed at three- and six-months regarding motor development, weight, length, head circumference, and parents completed a socioeconomic questionnaire. The IUGR children had lower supine, sitting, and overall gross motor scores at 6 months than the other children’s groups. Anthropometric and sociodemographic characteristics negatively influenced gross motor development. IUGR and anthropometric and sociodemographic characteristics negatively impact motor development. Intrauterine environment impact child neurodevelopment

Infant processed food consumption and their interaction to breastfeeding and growth in children up to six months old

Background: Evidences suggest that early processed food (PF) consumption may cause harm to infant health. During the first 6 months of life, it is not known whether the timing and quantity of this food group can impact breastfeeding and growth. The aim of the study was to analyze the associations between time of introduction and quantity of infant PF consumption with duration of breastfeeding and infant growth at 6 months of age. Methods: Data were longitudinally collected in six interviews, from birth to 6 months, in a sample of Brazilian newborns with adverse intrauterine environments. PF consumption was calculated by gravity score of processed foods (GSPF) in relation to feeding supply quality and time. For the analysis, the scores were divided into tertiles, making scores severities: Null, Mild, Moderate, and Severe. The interaction between GSPF and breastfeeding (exclusive and non-exclusive) and growth parameters (analyzed in Z-scores, by weight for height, weight for age, and body mass index for age) was tested. Results: A total of 236 infants were included in the study. Greater GSPF were associated with better rates of breastfeeding practices and higher growth indicators scores in the sixth month of infants. These findings were confirmed after adjustment for family income, maternal age, pre-gestational body mass index, and growth z scores at birth. Conclusion: The harms of eating PF in relation to breastfeeding and infant growth are more evident the greater and earlier they are consumed. Future studies should explore interventions to reduce and delay the consumption of these foods to prevent adverse health outcomes in later life