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The Ketone Bridge Between the Heart and the Bladder: How Fast Should We Go?
Gabriel Faria-Costa,João Oliveira,Inês Vilas-Boas,Inês Campelo,Elisa Azeredo Silva,Carmen Brás-Silva,Susana Maria Silva,Tiago Antunes-Lopes,Ana Charrua 대한배뇨장애요실금학회 2024 International Neurourology Journal Vol.28 No.-
Metabolic syndrome (MS) is associated with both cardiovascular and bladder dysfunction. Insulin resistance (IR) and central obesity, in particular, are the main risk factors. In these patients, vicious pathological cycles exacerbate abnormal carbohydrate metabolism and sustain an inflammatory state, with serious implications for both the heart and bladder. Ketone bodies serve as an alternative energy source in this context. They are considered a “super-fuel” because they generate adenosine triphosphate with less oxygen consumption per molecule, thus enhancing metabolic efficiency. Ketone bodies have a positive impact on all components of MS. They aid in weight loss and glycemic control, lower blood pressure, improve lipid profiles, and enhance endothelial function. Additionally, they possess direct anti-inflammatory, antioxidant, and vasodilatory properties. A shared key player in dysfunction of both the heart and bladder dysfunction is the formation of the NLRP3 inflammasome, which ketone bodies inhibit. Interventions that elevate ketone body levels—such as fasting, a ketogenic diet, ketone supplements, and sodium-glucose cotransporter 2 inhibitors—have been shown to directly affect cardiovascular outcomes and improve lower urinary tract symptoms derived from MS. This review explores the pathophysiological basis of the benefits of ketone bodies in cardiac and bladder dysfunction.
Functional assessment of respiratory muscles and lung capacity of CrossFit athletes
Saulo Cesar Vallin Fabrin,Marcelo Palinkas,Evandro Marianetti Fioco,Guilherme Gallo Costa Gomes,Eloisa Maria Gatti Regueiro,Gabriel Pádua da Silva,Selma Siéssere,Edson Donizetti Verri,Simone Cecilio H 한국운동재활학회 2023 JER Vol.19 No.1
CrossFit is a high-intensity training related to physical fitness and respiratory capacity that can promote changes in lung function. This crosssectional study was aimed at evaluating respiratory muscle strength, electromyographic (EMG) activity, and lung capacity in CrossFit athletes. Thirty subjects aged between 25 and 35 years were divided into groups: CrossFit athletes (n= 15) and sedentary individuals without comorbidities (n= 15). Respiratory muscle strength was evaluated using maximal inspiratory and expiratory pressures, lung capacity, and EMG of the sternocleidomastoid, serratus anterior, external intercostal, and diaphragm muscles at respiratory rest, maximal inspiration and expiration, and respiratory cycle. Data were tabulated and subjected to statistical analyses (t-test and Spearman test, P< 0.05). Respiratory muscle strength on EMG of the sternocleidomastoid, serratus, external intercostal, and diaphragm muscles at the respiratory cycle and maximal forced inspiration and expiration were higher in the CrossFit athletes group than in the sedentary group without comorbidities. CrossFit athlete group showed significantly strong positive correlation between maximal inspiratory and expiratory muscle strengths (Spearman rho= 0.903, P= 0.000), with increasing muscle strength during inspiration favoring an increase in strength during expiration. The forced vital capacity (FVC) and forced expiratory volume in 1 sec (FEV1) also showed a significantly high positive correlation (Spearman rho= 0.912, P= 0.000) in the CrossFit athletes group, showing that higher FVC favors higher FEV1. The results of this study suggest that improved fitness is based on increased respiratory muscle strength on EMG in CrossFit athletes.
( Rosiane Maciel Scandiuzzi ),( Caio Antonio De Campos Prado ),( Edward Araujo Junior ),( Geraldo Duarte ),( Silvana Maria Quintana ),( Fabricio Da Silva Costa ),( Gabriele Tonni ),( Ricardo De Carval 대한산부인과학회 2016 Obstetrics & Gynecology Science Vol.59 No.5
Objective To assess the maternal demographic characteristics and uterine artery (UA) Doppler parameters at first and second trimesters of pregnancy as predictors for hypertensive disorders (HDs) and adverse perinatal outcomes. Methods This prospective cohort study comprised 162 singleton low-risk women undergoing routine antenatal care. The left and right UA were assessed by color and pulsed Doppler and the mean pulsatility and resistance indices as well as the presence of a bilateral protodiastolic notch were recorded at 11 to 14 and 20 to 24 weeks’ gestation. Multilevel regression analysis was used to determine the effects of maternal characteristics and abnormal UA Doppler parameters on the incidence of HD, small for gestational age newborn, cesarean section rate, Apgar score <7 at 1st and 5th minute, and admission to the neonatal intensive care unit. Results Fifteen women (9.2%) developed HD. UA mean resistance index (RI), UA mean pulsatility index, and parity were independent predictors of HD. Compared to the pregnancies with a normal UA mean RI at the first and second trimesters, pregnancies with UA mean RI >95th percentile only at the first trimester showed an increased risk for HD (odds ratio, 23.25; 95% confidence interval, 3.47 to 155.73; P<0.01). Similar result was found for UA mean pulsatility index >95th percentile (odds ratio, 9.84; 95% confidence interval, 1.05 to 92.10; P=0.05). The model including maternal age, maternal and paternal ethnicity, occupation, parity and UA mean RI increased the relative risk for HD (area under receiver operating characteristics, 0.81). Conclusion A first-trimester screening combining maternal characteristics and UA Doppler parameters is useful to predict HD in a low-risk population.