Double Product and Autonomic Function as Predictors of Quality of Life in Heart Transplant Recipients: A Cross-Sectional Study

ABSTRACT Introduction: Heart rate control by the autonomic nervous system (ANS) is impaired in heart transplant (HT) recipients, leading to increased resting heart rate, metabolic demand, and fatigue, which can impair their quality of life (QoL). In this study, we hypothesized the association of hemodynamics and autonomic function as predictors of QoL in HT recipients. Methods: This is a cross-sectional study conducted with HT recipients aged ≥ 18 years at ambulatorial accompaniment. Blood pressure was used for hemodynamics assessment, and heart rate variability (HRV) was used for ANS assessment. QoL was assessed by the 36-item Short Form Health Survey. The significance level was set as P≤0.05. Results: Twenty-two volunteers were included in the study. Systolic blood pressure (SBP) and double product (DP) were significantly negatively associated with the physical functioning domain of QoL. DP, the number of consecutive normal RR interval differences > 50 ms (NN50), and the percentage of normal RR intervals that differed by > 50 ms from the adjacent interval (PNN50) exhibited negative association with the physical role domain. NN50 and PNN50 were significantly associated with bodily pain, social functioning, and emotional role domains. SBP was negatively associated with the vitality domain. Considering general and mental health domains, no variable demonstrated significant association. DP, NN50, and PNN50 were negatively associated with the total score of QoL. Conclusion: This study demonstrated DP and HRV as predictors of QoL in HT recipients. These innovative results can become a relevant therapeutic target for improving QoL in HT recipients prior to its deterioration.

Antibacterial effect of isoeugenol against Pseudomonas aeruginosa

Abatsract Pseudomonas aeruginosa is an important nosocomial pathogen and its clinical importance is mainly related to nosocomial infections. Increased rates of bacterial resistance in recent years has led WHO to publish a global priority list to guide research and discovery of new antibiotics, where P. aeruginosa is among the group of bacteria for which there is a critical level of priority for new drugs to be discovered. In this context, isoeugenol appears as an interesting alternative and the objective of this study was to investigate its action against P. aeruginosa. Isoeugenol presented significant antibacterial activity, with minimum inhibitory concentration (MIC) of 64µg/mL and minimum bactericidal concentration (MBC) of 128µg/mL, and was considered bactericidal against this species. Molecular docking revealed interactions that suggest that isoeugenol may bind to the enzyme Penicillin-Binding Protein 3 and interfere with the bacterial cell wall synthesis process. This study reinforces the antibacterial potential of this compound and emphasizes that more studies are needed in order to better investigate its mechanism of antibacterial action.

4-Carvomenthenol, a monoterpene of essential oils, and its underlying effects on anti-inflammatory activity and immediate hypersensitivity reaction

Abstract The monoterpene 4-carvomenthenol (Carvo) is found in essential oils of plant. Here, we evaluate the Carvo oral pretreatment in acute inflammatory experimental models and in silico molecular docking. Mice pretreated with Carvo were challenged and submitted to the protocols: paw edema, peritonitis, scratching behavior and anaphylactic shock reaction. Besides, we used histamine H1 receptor, cyclooxygenases (COX-1 and COX-2) and phospholipase A2, as targets for molecular docking analysis. Carvo inhibited the carrageenan-induced paw edema and decreased the peritoneal influx of polymorphonuclear cells on carrageenan-challenged mice without interfering with the mononuclear cell influx. Moreover, Carvo diminished the histamine, PGE2 and compound 48/80 induced paw edematogenic effect. The monoterpene also diminished the mice scratching behavior and, surprisingly, avoided the animal death caused by compound 48/80 in 30 min. Through the docking analysis, Carvo showed favorable binding energy to the histamine H1 receptor. This study demonstrates that Carvo attenuated the allergic inflammatory process, decreasing edema, cell migration, activation of mast cells and the histamine release, probably due to interaction of Carvo with the histamine H1 receptor, ameliorating the itching and the anaphylactic shock reaction. Therefore, the results of this study indicate that Carvo has anti-inflammatory properties by reducing the histamine effects.

Reliability and validity of specific quality of life assessment questionnaires related to chronic venous insufficiency: a systematic review / Confiabilidade e validade dos questionários específicos de avaliação da qualidade de vida relacionada à insuficiência venosa crônica: uma revisão sistemática

Abstract This systematic review aimed to discuss the main findings regarding the reliability and validity of health-related quality of life questionnaires for chronic venous insufficiency. Searches were performed on the MEDLINE, CINAHL, Web of Science, LILACS, and Scopus databases. The search terms used were related to "venous insufficiency", and "quality of life". The CIVIQ-20 and CIVIQ-14 instruments had adequate internal consistency and both were able to discriminate disease severity. The VEINES-QoL showed adequate internal consistency but was not able to discriminate disease severity. Most studies did not demonstrate a correlation between VEINES-QoL and the mental component of the SF-36. The AVVQ had inadequate reliability but its validity was also doubtful when compared to the SF-36. The VARIShort demonstrated good internal consistency, reproducibility, and validity, but only the original study was included. For venous leg ulcers, the CCVUQ showed adequate reliability and validity when compared to VLU-QoL.

Resumo Esta revisão sistemática objetivou discutir os principais achados sobre a confiabilidade e validade dos questionários de qualidade de vida relacionada à saúde na insuficiência venosa crônica. A busca foi realizada nas bases de dados MEDLINE, CINAHL, Web of Science, LILACS e Scopus. Os termos de busca foram relacionados a "insuficiência venosa" e "qualidade de vida". O Chronic Lower Limb Venous Insufficiency Questionnaire (CIVIQ)-20 e o CIVIQ-14 apresentaram consistência interna adequada e foram capazes de discriminar a gravidade da doença. O Venous Insufficiency Epidemiological and Economic Study - Quality of Life (VEINES-QoL) apresentou consistência interna adequada, mas não foi capaz de discriminar a gravidade da doença. A maioria dos estudos não demonstrou associação do VEINES-QoL com o componente mental do Short Form Health Survey (SF-36). O Aberdeen Varicose Vein Questionnaire (AVVQ) apresentou confiabilidade inadequada e validade duvidosa quando comparado ao SF-36. O VARIShort demonstrou consistência interna, reprodutibilidade e validade boas, mas apenas o estudo original foi incluído. Na úlcera venosa, o Charing Cross Venous Ulcer Questionnaire (CCVUQ) apresentou confiabilidade e validade adequadas quando comparado ao Venous Leg Ulcer Quality of Life (VLU-QoL).

Health-Related Quality of Life Reported by Patients With Chagas Disease: A Systematic Review of Qualitative Evidence With GRADE Recommendations

ABSTRACT Patients with Chagas disease have reduced health-related quality of life (HRQoL). Hence, we aimed to identify the factors that mostly affected their HRQoL. This was a systematic review of qualitative studies. The Latin American and Caribbean Health Sciences Literature, Medical Literature Analysis and Retrieval System Online, Excerpta Medica Database, Web of Science, and SciVerse Scopus databases were searched for relevant studies without language or date restrictions. The search and data analysis were performed by independent reviewers; all qualitative studies that reported the factors that had an impact on the HRQoL of patients with Chagas disease were included. The risk of bias was assessed using the Critical Appraisal Skills Program Qualitative Study Checklist; confidence in the evidence was evaluated using the Grading of Recommendations Assessment, Development and Evaluation-Confidence in the Evidence from Reviews of Qualitative approach. Five studies were included in this review: four in Brazil and one in California, United States, with immigrants from Central and South America. The sample consisted of 207 patients with chronic Chagas disease. Stigma, physical limitations, work absenteeism, emotional or mental aspects, fear of treatment, and fear of the future had the strongest impact on the HRQoL. All items showed moderate confidence except for fear of treatment (low confidence). The physical, emotional, mental, and cultural aspects affected the HRQoL of patients with chronic Chagas disease. Identification of these factors is important in the development of strategies aimed at improving the HRQoL of this population.

The health-related quality of life in patients with post-COVID-19 after hospitalization: a systematic review

ABSTRACT Symptoms in post-COVID-19 patients who require hospitalization can persist for months, significantly affecting their health-related quality of life (HRQoL). Thus, the present study aimed to discuss the main findings regarding HRQoL in post-COVID-19 patients who required hospitalization. An electronic search was performed in the MEDLINE, EMBASE, CINAHL, Web of Science, LILACS, and Scopus databases, without date and language restrictions, until July 2021. Twenty-four articles were included in the analysis. It seems that HRQoL partially improved soon after hospital discharge, although the negative impact on HRQoL may persist for months. The physical and mental aspects are affected because patients report pain, discomfort, anxiety, and depression. The HRQoL of COVID-19 infected patients was worse than that of uninfected patients. Additionally, HRQoL seemed worse in patients admitted to the intensive care unit than in those who remained in the ward. Improvements in HRQoL after hospital discharge are independent of imaging improvement, and there seems to be no association between HRQoL after hospital discharge and disease severity on hospital admission. Many factors have been identified as determinants of HRQoL, with women and advanced age being the most related to worse HRQOL, followed by the duration of invasive mechanical ventilation and the need for intensive care. Other factors included the presence and number of comorbidities, lower forced vital capacity, high body mass index, smoking history, undergraduate education, and unemployment. In conclusion, these findings may aid in clinical management and should be considered in the aftercare of patients.

The health-related quality of life in patients with Chagas disease: the state of the art

ABSTRACT Chagas disease (CD) is a neglected tropical disease associated with poverty in which patients are surrounded by stigma. These factors can contribute to reducing health-related quality of life (HRQoL). Therefore, a broad discussion of HRQoL in the CD population is required. This study aimed to discuss the main findings of HRQoL in patients with CD, focusing on the association between sociodemographic and lifestyle factors, echocardiographic and functional determinants, and the effect of non-invasive interventions on HRQoL. A literature search of the MEDLINE, Web of Science, CINAHL, Scopus, and LILACS databases was performed with no data or language restrictions. Twenty-two articles were included in this meta-analysis. In general, HRQoL is worse in patients with CD than in healthy individuals, particularly in the presence of cardiovascular and/or gastrointestinal symptoms. Sex, age, functional class, level of physical activity, healthy habits, and medications received could affect HRQoL. Among the echocardiographic and functional determinants, decreased systolic function seems to negatively affect HRQoL. No association with the peak oxygen uptake was observed in the maximal tests. By contrast, well-tolerated field tests with submaximal intensities were associated with HRQoL. Both pharmaceutical care and exercise training have a positive effect on the HRQoL of patients with Chagas cardiomyopathy, and the mental component can be a prognostic marker in this population. In conclusion, assessment of HRQoL can provide important information about the health status of patients with CD, and its use in clinical practice is warranted.

Coumarin (2H-1-Benzopyran-2-one) act against planktonic and biofilm forms of Staphylococcus aureus, Klebsiellapneumoniae and Pseudomonas aeruginosa

SUMMARY Introduction: biofilm-related infections caused by Staphylococcus aureus, Klebsiella pneumoniae and Pseudomonas aeruginosa are difficult to treat and few effective pharmacological options are currently available for this purpose. In this context, coumarin (2H-1-Benzopyran-2-one) has been reported to have antibacterial and antibiofilm activity, but this potential remains poorly understood. Aim: to investigate the action of coumarin on planktonic and biofilm forms of S. aureus, K. pneumoniae and P. aeruginosa. Results: a minimum inhibitory concentration (MIC) of coumarin ranging from 256 to 1024 fig/mL was observed, with a remarkable ability to inhibit the formation of biofilms and to act on mature biofilms in concentrations close to MIC. Conclusion: coumarin has strong activity against planktonic and biofilm forms on the three species of great relevance in the clinical scenario. These results are interesting to enable a pharmacological alternative for the treatment of these infections.

Introducción: las infecciones relacionadas con la biopelícula causadas por Staphylococcus aureus, Klebsiella pneumoniae y Pseudomonas aeruginosa son difíciles de tratar y actualmente existen pocas opciones farmacológicas eficaces para este propósito. En este contexto, se ha informado que la cumarina (2H-1-Benzopiran-2-ona) tiene actividad antibacteriana y antibiofilm, pero este potencial sigue siendo poco conocido. Objetivo: investigar la acción de la cumarina sobre formas planctónicas y de biopelículas de S. aureus, K. pneumoniae y P. aeruginosa. Resultados: se observó una concentración inhibitoria mínima (CMI) de cumarina en el rango de 256 a 1024 µg/mL, con una notable capacidad para inhibir la formación de biofilms y actuar sobre biofilms maduros en concentraciones cercanas a la CMI. Conclusión: la cumarina tiene una fuerte actividad contra las formas planctónicas y biofilm sobre las tres especies de gran relevancia en el escenario clínico. Estos resultados son interesantes para habilitar una alternativa farmacológica para el tratamiento de estas infecciones.

Introdução: as infecções relacionadas ao biofilme causadas por Staphylococcus aureus, Klebsiella pneumoniae e Pseudomonas aeruginosa são difíceis de tratar e poucas opções farmacológicas eficazes estão disponíveis atualmente para esse propósito. Nesse contexto, foi relatado que a cumarina (2H-1-benzopirano-2-ona) tem atividade antibacteriana e antibiofilme, mas esse potencial permanece pouco conhecido. Objetivo: investigar a ação da cumarina sobre as formas planctónicas e de biofilme de S. aureus, K. pneumoniae e P. aeruginosa. Resultados: observou-se uma concentração inibitória mínima (CIM) de cumarina variando de 256 a 1024 µg/mL, com notável capacidade de inibir a formação de biofilmes e de atuar sobre biofilmes maduros em concentrações próximas à CIM. Conclusão: a cumarina possui forte atividade contra as formas planctónicas e de biofilme sobre as três espécies de grande relevância no cenário clínico. Esses resultados são interessantes para possibilitar uma alternativa farmacológica para o tratamento dessas infecções.

In silico and in vitro analysis of a new potential antifungal substance, 2-Bromo-N-phenylacetamide, against invasive candidiasis isolates

SUMMARY Introduction: invasive candidiasis is related to high rates of morbidity and mortality. There are few classes of drugs available for the treatment of this type of infection and the index of resistant strains is increasing. Such circumstances highlight that the search for new pharmacotherapeutic alternatives is increasingly necessary. This study investigated 2-Bromo-N-phenylacetamide, a substance whose antifungal activity has not yet been reported. Objective: to evaluate its activity against invasive candidiasis isolates, by determining the minimum inhibitory and fungicide concentrations. Methodology: molecular docking was performed to investigate the possible mechanism of action of the substance. The substance was also associated with fluconazole, to assess the viability of the combination in clinical practice. The minimum inhibitory concen trations ranged between 4 to 32 jig/mL, and it acts in a fungicidal way. Results: molec ular docking suggests that 2-Bromo-N-phenylacetamide possibly acts on the fungal plasma membrane. And the association of 2-Bromo-N-phenylacetamide with flucon azole against resistant strains showed an indifferent effect. Conclusion: further studies should be carried out to elucidate the potential of this substance, which may become a future drug candidate to treat invasive candidiasis and other fungal infections.

Introducción: la candidiasis invasiva está relacionada con altas tasas de morbilidad y mortalidad. Hay pocas clases de medicamentos disponibles para el tratamiento de este tipo de infección y el índice de cepas resistentes está aumentando. Tales circunstancias ponen de relieve que la búsqueda de nuevas alternativas farmacoterapéuticas es cada vez más necesaria. Este estudio investigó la 2-Bromo-N-fenilacetamida, una sustancia cuya actividad antifúngica aún no se ha informado. Objetivo: evaluar su actividad frente a aislados de candidiasis invasiva, mediante la determinación de las concentra ciones mínimas inhibitorias y fungicidas. Metodología: se realizó un acoplamiento molecular para investigar el posible mecanismo de acción de la sustancia. La sustancia también se asoció con fluconazol, para evaluar la viabilidad de la combinación en la práctica clínica. Las concentraciones mínimas inhibidoras oscilaron entre 4 a 32 µg/mL y actúa de forma fungicida. Resultados: el acoplamiento molecular sugiere que la 2-Bromo-N-fenilacetamida posiblemente actúa sobre la membrana plasmática de los hongos. Y la asociación de 2-Brorno-Ar-fenilacetamida con fluconazol contra cepas resistentes mostró un efecto indiferente. Conclusión: deben realizarse más estudios para dilucidar el potencial de esta sustancia, que puede convertirse en un futuro candi dato a fármaco para tratar la candidiasis invasiva y otras infecciones fúngicas.

Introdução: a candidíase invasiva está relacionada a altas taxas de morbidade e morta lidade. Existem poucas classes de medicamentos disponíveis para o tratamento desse tipo de infecção e o índice de cepas resistentes está aumentando. Tais circunstâncias evidenciam que a busca por novas alternativas farmacoterapêuticas é cada vez mais necessária. Este estudo investigou a 2-Bromo-N-fenilacetamida, uma substância cuja atividade antifúngica ainda não foi relatada. Objetivo: avaliar sua atividade contra isolados de candidíase invasiva, por meio da determinação das concentrações mínimas inibitórias e fungicidas. Metodologia: o docking molecular foi realizado para inve stigar o possível mecanismo de ação da substância. A substância também foi associada ao fluconazol, para avaliar a viabilidade da associação na prática clínica. As concen trações inibitórias mínimas variaram entre 4 a 32 µg/Ml e atuam de forma fungicida. Resultados: o docking molecular sugere que a 2-Bromo-N-fenilacetamida possivel mente atua na membrana plasmática do fungo. E a associação de 2-Bromo-N-fenilace-tamida com fluconazol contra cepas resistentes mostrou efeito indiferente. Conclusão: Novos estudos devem ser realizados para elucidar o potencial dessa substância, que pode se tornar uma futura droga candidata ao tratamento de candidíase invasiva e outras infecções fúngicas.

Determinantes da capacidade funcional em pacientes com doença de chagas / Determinants of functional capacity in patients with chagas disease

Resumo Fundamento: A doença de Chagas leva à redução da capacidade funcional. Entretanto, o estágio em que o comprometimento funcional é detectável permanece obscuro. Objetivos: O presente estudo teve como objetivo comparar a capacidade funcional de pacientes em diferentes estágios da doença de Chagas e de indivíduos saudáveis e verificar os determinantes do consumo de oxigênio de pico (VO2pico). Métodos: Em um estudo transversal, foram selecionados 160 indivíduos, 35 saudáveis e 125 com doença de Chagas. No grupo chagásico, 61 (49%) estavam na forma indeterminada da doença, 45 (36%) com cardiomiopatia chagásica (CC) e função cardíaca preservada e 19 (15%) com disfunção cardíaca e CC dilatada. Os dados foram analisados por meio de análise de regressão univariada e multivariada. A significância estatística foi fixada em 5%. Resultados: Pacientes na forma indeterminada da doença apresentaram capacidade funcional semelhante a indivíduos saudáveis (p> 0,05). Pacientes com ChC e função cardíaca preservada apresentaram VO2pico menor que os pacientes na forma indeterminada (p <0,05), mas apresentaram valores de VO2pico semelhantes ao ChC dilatado (p = 0,46). A idade, sexo masculino, classe funcional da NYHA, pressão arterial diastólica, razão entre a velocidade do fluxo transmitral diastólico precoce e a velocidade anular mitral diastólica precoce, a fração de ejeção do ventrículo esquerdo (FEVE) e o diâmetro diastólico final do ventrículo esquerdo foram associados à capacidade funcional. Porém, apenas idade, sexo masculino, FEVE e classe funcional da NYHA permaneceram associados ao VO2pico no modelo final (R2 ajustado = 0,60). Conclusão: Pacientes com CC apresentam menor capacidade funcional do que pacientes na forma indeterminada. FEVE, idade, sexo masculino e classe funcional da NYHA foram determinantes do VO2pico em pacientes com doença de Chagas.

Abstract Background: Chagas disease leads to reduced functional capacity. However, the stage at which functional impairment is detectable remains unclear. Objectives: The present study was addressed to compare the functional capacity of patients at different stages of Chagas disease and healthy individuals and to verify the determinants of peak oxygen uptake (VO2peak). Methods: In a cross-sectional study, 160 individuals were selected, 35 healthy and 125 with Chagas disease. In the Chagasic group, 61 (49%) were in the indeterminate form of the disease, 45 (36%) with Chagas cardiomyopathy (ChC) and preserved cardiac function and 19 (15%) with cardiac dysfunction and dilated ChC. The data were analyzed using univariate and multivariate regression analysis. Statistical significance was set at 5%. Results: Patients in the indeterminate form of disease showed similar functional capacity to healthy individuals (p>0.05). Patients with ChC and preserved cardiac function had lower VO2peak than patients in the indeterminate form (p<0.05), but showed similar VO2peak values than dilated ChC (p=0.46). The age, male sex, NYHA functional class, diastolic blood pressure, ratio of the early diastolic transmitral flow velocity to early diastolic mitral annular velocity, left ventricular ejection fraction (LVEF) and left ventricular end-diastolic diameter were associated with functional capacity. However, only age, male sex, LVEF and NYHA functional class, remained associated with VO2peak in the final model (adjusted R2=0.60). Conclusion: Patients with ChC had lower functional capacity than patients in the indeterminate form. LVEF, age, male sex and NYHA functional class were determinants with VO2peak in patients with Chagas disease.

Relação entre tratamento protético, autoestima e qualidade de vida em pacientes idosos em tratamento hemodialítico / Relationship between prosthetic treatment, self-esteem and quality of life in elderly patients undergoing hemodialysis

Fundamento: O estado de saúde bucal pode ter influência física e psicológica sobre a vida dos indivíduos. Pode afetar simultaneamente o prazer na vida devido a interferência nas condições bucais, na fala, mastigação, sabor e deglutição, nos domínios sociais, sobre a aparência e autoconfiança dos indivíduos. Objetivo:Verificar se o tratamento protético odontológico é capaz de gerar melhoria na qualidade de vida e na autoestima de pacientes idosos submetidos a hemodiálise. Materiais e Métodos: Realizou-se um estudo intervencional com 26 pacientes submetidos à hemodiálise na cidade de Diamantina, Brasil. Os pacientes foram divididos em dois grupos de acordo com a realização do tratamento; com e sem tratamento. O grupo tratamento recebeu ajustes ou confecção de uma nova prótese odontológica, já o grupo sem tratamento recebeu apenas avaliação clínica e orientações sobre higiene bucal. A qualidade de vida foi avaliada através do instrumento Medical Outcomes Study 36-Item Short Form Health Questionnaire (SF-36) e Oral Health Impact Profile (OHIP) na sua versão 14. Já para a autoestima utilizou-se a Escala de Autoestima de Rosenberg. Resultados: A média de idade foi 69,08 anos (±05,90) e o índice CPO-D médio foi de 29,65 (±01,35). Houve significância estatística na dimensão aspecto emocional do SF-36 nos dois grupos. O grupo que recebeu tratamento apresentou significância na incapacidade física do OHIP-14 e melhora da autoestima. Conclusão: O tratamento protético odontológico gerou melhoria na qualidadede vida e impactou na autoestima de pacientes idosos submetidos à hemodiálise, sendo o impacto maior nos pacientes que realizaram tratamento protético

Background: Oral health status can have a physical and psychological influence on individuals' lives. It can simultaneously affect the pleasure in life due to interference in oral conditions, speech, chewing, taste and swallowing, in social domains, on the appearance and self-confidence of individuals. Objective:To verify whether dental prosthetic treatment is able to improve the quality of life and self-esteem of elderly patients undergoing hemodialysis. Materials and Methods: An interventional study was carried out with 26 patients undergoing hemodialysis in the city of Diamantina, Brazil. Patients were divided into two groups according to treatment completion; with and without treatment. The treatment group received adjustments or made a new dental prosthesis, while the group without treatment received only clinical evaluation and guidance on oral hygiene. Quality of life was assessed using the instrument Medical Outcomes Study 36-Item Short Form Health Questionnaire (SF-36) and Oral Health Impact Profile (OHIP) in its version 14. For self-esteem, the Rosenberg Self-Esteem Scale was used. Results:The mean age was 69.08 years (±05.90) and the mean DMFT index was 29.65 (±01.35). There was statistical significance in the emotional aspect dimension of the SF-36 in both groups. The group that received treatment showed significance in the physical disability of the OHIP-14 and improvement in self-esteem. Conclusion:Dental prosthetic treatment improved the quality of life and impacted the self-esteem of elderly patients undergoing hemodialysis, with the greatest impact on patients who underwent prosthetic treatment.

Influence of dental treatment on quality of life and self-esteem of hemodialysis-therapy patients

Background: Patients undergoing dialysis treatment have a worse quality of life and have higher rates of malnutrition, inflammation and hospitalization than the general population. Objective: This study aimed to evaluate the influence of dental treatment on the quality of life and self-esteem of hemodialysis-therapy patients. Materials and Methods: An interventional study was developed with 27 patients undergoing hemodialysis in Diamantina, Brazil. Initially, patients received a clinical evaluation of a dentist and responded to questionnaires to estimate the quality of life (Medical Outcomes Study 36-Item Short Form Health Questionnaire (SF-36) and Oral Health Impact Profile (OHIP) version 14) and self-esteem (Scale Self-Esteem of Rosenberg). After 45 days, the questionnaires were reapplied, and the patients received dental treatment to adapt the oral environment. After the treatment, 45 days were awaited to reapply the questionnaires. Descriptive analyzes were performed, Wilcoxon and Friedman tests were done. The level of significance was set at 5% (p <0.05). Results: Twenty-seven low-income and educated individuals participated in the study, most of whom were men. Hypertension and diabetes were not widely reported systemic diseases. There was statistical significance in SF-36 and OHIP-14 dimensions and improvement of self-esteem. Conclusion: Dental treatment interfered positively with the quality of life and self-esteem of patients undergoing hemodialysis.

Entre o legal e o real: estudo comparado entre a legislação esportiva de Brasil e Espanha / Between legal and real: a comparative study between sport legislation in Brazil and Spain / Entre lo legal y lo real: estudio comparativo entre la ley deportiva de Brasil y España

Resumo Este artigo resulta de pesquisa que se dedicou ao estudo comparado das políticas esportivas de Brasil e Espanha. Teve como como objetivo principal analisar - de forma comparativa - a legislação esportiva de ambos os países após a constitucionalização do direito ao esporte. Adotando os procedimentos de estudos comparados e a técnica de pesquisa de análise de conteúdo, foram estudadas as legislações infraconstitucionais de Brasil e Espanha que regulamentam o setor esportivo. As análises demonstram: (i) a constituição de uma arquitetura híbrida de gestão da política esportiva, que combina ação tutelar do Estado com autonomização/liberalização do setor privado; (ii) o estímulo à criação de entidades cuja natureza jurídica alinha-se à perspectiva empresarial; (iii) a diversificação de fontes de financiamento ao esporte, em especial o de alto rendimento, mais atrativo ao mercado devido ao potencial de impulsionar a atividade comercial.

Abstract This article is the result of a comparative study on sports policies in Brazil and Spain. Its main objective was to analyze - comparatively - the sports legislation from both countries after the right to sports entered their Constitutions. By following procedures from comparative studies and content analysis research techniques, we studied Brazil's and Spain's infra-constitutional laws regulating the sports sector. The analyses show: (i) the establishment of a hybrid sports policy management architecture combining tutelary action by the State with autonomy/liberalization of the private sector; (ii) encouragement towards creation of entities whose legal nature is aligned with a business perspective; (iii) diversification of funding sources for sports, especially for high-performance sports, which are more attractive to the market due to their potential to boost commercial activities.

Resumen Este artículo es el resultado de una investigación dedicada al estudio comparativo de las políticas deportivas en Brasil y España. Su objetivo principal era analizar, comparativamente, la legislación deportiva de ambos países después de la constitucionalización del derecho al deporte. Adoptando los procedimientos de estudios comparativos y la técnica de investigación de análisis de contenido, se estudiaron las leyes infraconstitucionales de Brasil y España que regulan el sector deportivo. Los análisis demuestran: (i) la constitución de una arquitectura híbrida de gestión de políticas deportivas, que combina la acción tutelar del Estado con la autonomía / liberalización del sector privado; (ii) alentar la creación de entidades cuya naturaleza jurídica esté alineada con la perspectiva comercial; (iii) la diversificación de las fuentes de financiamiento para el deporte, especialmente los de altos ingresos, más atractivos para el mercado debido al potencial para impulsar la actividad comercial.

Determinants of minute ventilation-carbon dioxide production relationship in Chagas cardiomyopathy

Abstract INTRODUCTION: The minute ventilation-carbon dioxide production relationship (VE/VCO2 slope) is among the main prognostic factors of Chagas cardiomyopathy whose determinants remain unknown. METHODS: Seventy-eight patients with Chagas cardiomyopathy were evaluated using clinical assessment, cardiopulmonary exercise test, echocardiography, and International Physical Activity Questionnaire. RESULTS: Age, functional class, International Physical Activity Questionnaire score, and dilated cardiomyopathy with systolic dysfunction were independent determinants of VE/VCO2 slope, and these variables explained 63% of its variance. CONCLUSIONS: The VE/VCO2 slope was related to age, functional class, physical activity level, and dilated cardiomyopathy with systolic dysfunction in patients with Chagas cardiomyopathy.

Hydrography rather than lip morphology better explains the evolutionary relationship between Gymnogeophagus labiatus and G. lacustris in Southern Brazil (Cichlidae: Geophagini)

Gymnogeophagus labiatus and G. lacustris have been long recognized as sister species exhibiting different ecological requirements. Gymnogeophagus labiatus occurs in rock bottom rivers in the hydrographic basins of Patos Lagoon (HBP) and Tramandaí River (HBT), while G. lacustris is exclusive from sand bottom coastal lagoons of the HBT. In this study, we used molecular markers, morphological measurements and data from nuptial male coloration to investigate the evolutionary relationship between these species in each hydrographic basin. We found, for all data sets, a closer relationship between G. labiatus and G. lacustris from the HBT than between G. labiatus populations from HBT and HBP. In particular, lip area had a large intraspecific plasticity, being uninformative to diagnose G. lacustris from G. labiatus. Molecular clock-based estimates suggest a recent divergence between species in the HBT (17,000 years ago), but not between G. labiatus from HBP and HBT (3.6 millions of years ago). Finally, we also found a divergent G. labiatus genetic lineage from the Camaquã River, in the HBP. These results show that the current taxonomy of G. labiatus and G. lacustris does not properly represent evolutionary lineages in these species.(AU)

Gymnogeophagus labiatus e G. lacustris vêm sendo consideradas espécies irmãs que possuem diferentes exigências ecológicas. Gymnogeophagus labiatus ocorre em rios de fundo de pedra nas bacias hidrográficas da Laguna dos Patos (HBP) e do rio Tramandaí (HBT), enquanto G. lacustris é exclusivo da HBT, ocorrendo em lagoas costeiras de fundo de arenoso. Nesse estudo, foram usados marcadores moleculares, medidas morfológicas e dados sobre a coloração nupcial em machos para investigar a relação evolutiva entre estas espécies em cada bacia hidrográfica. Para todos os conjuntos de dados foi observada uma relação mais próxima entre G. labiatus e G. lacustris da HBT do que entre as populações de G. labiatus da HBP e HBT. Em particular, a área do lábio teve uma grande plasticidade intraespecífica, não sendo informativa para diagnosticar G. lacustris de G. labiatus. Estimativas baseadas no relógio molecular sugeriram uma divergência recente entre as espécies da HBT (17.000 anos atrás), mas não entre as populações de G. labiatus da HBP e HBT (3,6 milhões de anos atrás). Finalmente, também foi encontrada uma linhagem genética de G. labiatus divergente no rio Camaquã, na HBP. Esses resultados mostram que a taxonomia atual de G. labiatus e G. lacustris não representa adequadamente as linhagens evolutivas nessas espécies.(AU)

Tradução para a língua portuguesa e análise das propriedades psicométricas do instrumento Patient Generated Index (PGI) para pacientes com doença pulmonar obstrutiva crônica: avaliação individualizada de qualidade de vida / Portuguese translation and validation of the Patient Generated Index (PGI) instrument for patients with Chronic Obstructive Pulmonary Disease: individualized quality of life assessment

RESUMO Objetivo Traduzir, adaptar e validar o Patient Generated Index (PGI) para brasileiros com doença pulmonar obstrutiva crônica (DPOC). Métodos 50 voluntários com DPOC, em sua maioria homens (74%), com 73,1 ± 8,9 anos de idade, VEF1 de 52,3 ± 14,5% do previsto e VEF1/CVF de 56,2 ± 8,6% do previsto, responderam ao PGI e ao Saint George Respiratory Questionnaire (SGRQ) e realizaram teste Glittre Activities of Daily Living (Glittre ADL). Após o período de 7-14 dias, o PGI foi novamente aplicado para análise da confiabilidade relativa e absoluta. Resultados A tradução ocorreu sem alterações no questionário. A pontuação obtida no PGI apontou fraca correlação com a pontuação total do SGRQ (r = −0,44; p < 0,001) e com o domínio impacto (r = −0,40; p < 0,05), moderada correlação com o domínio sintomas do SGRQ (r = −0,55; p < 0,001) e fraca correlação com o domínio atividades (r = −0,31; p < 0,05). Foram observadas fraca correlação entre o PGI e o Glittre ADL (r = −0,30; p < 0,05) e alta confiabilidade entre as medidas do PGI (CCIr = 0,94). Conclusão Este estudo mostra que a versão brasileira do PGI é um instrumento confiável e válido para medir a qualidade de vida relacionada à saúde em pacientes com DPOC. Trata-se de uma nova forma individualizada de avaliação de qualidade de vida centrada no paciente com DPOC.

ABSTRACT Objective To translate, adapt and validate the Patient Generated Index (PGI) for Brazilians with chronic obstructive pulmonary disease (COPD). Methods 50 volunteers with COPD, mostly men (74%), with 73.1 ± 8.9 years of age, FEV1 of 52.3 ± 14.5% of predicted and FEV1 / FVC of 56.2 ± 8.6% of predicted responded to PGI, to the Saint George Respiratory Questionnaire (SGRQ) and to perform Glittre Activities of Daily Living test (Glittre ADL). After 1-2 weeks, PGI was again applied for the analysis of relative and absolute reliability. Results The translation occurred without changes in the questionnaire. The score obtained in PGI had weak correlation with the SGRQ total score (r = -0.44, p <0.001) and with the impact domain (r = -0.40, p <0.05), presented a moderate correlation with the symptoms domain of the SGRQ (r = -0.55, p <0.001) and weak correlation with the activity domain (r = -0.31, p <0.05). A weak correlation was observed between PGI and Glittre ADL (r = -0.30; p <0.05). It was observed high reliability among the measures of PGI (ICCr = 0.94). Conclusion This study shows that the Brazilian version of PGI is a reliable and valid instrument to measure health-related quality of life (HRQL) in patients with COPD. It is a new and individualized form of evaluation of COPD patient-centered quality of life.

Exercise tests in Chagas cardiomyopathy: an overview of functional evaluation, prognostic significance, and current challenges

Abstract Patients with Chagas cardiomyopathy (ChC) usually progress with fatigue and dyspnea. Exercise tests are valuable for the functional evaluation of these patients. However, information about the applicability of the exercise tests is scattered, and no studies have systematically reviewed the results. Thus, the present review explored the general aspects and prognostic value of exercise tests in patients with ChC. A literature search of the MEDLINE, Web of Science, CINAHL, Scopus, and LILACS databases was performed to identify relevant studies. There were no data restrictions, and articles that met the objective of the study were selected. Articles written in English, Portuguese, and Spanish were considered, and 25 articles were finally included. The peak oxygen uptake (VO2peak) was correlated with demographic and echocardiographic variables. Echocardiographic features of the left ventricular diastolic function and right ventricular systolic function appeared to be determinants of functional capacity, in addition to age and sex. VO2peak was associated with higher mortality, especially in patients with dilated ChC. The minute ventilation/carbon dioxide production slope (VE/VCO2 slope) was a strong predictor of survival; however, more studies are needed to verify this observation. Field tests showed moderate to strong correlation with VO2peak and thus may be inexpensive tools for the functional evaluation of patients with ChC. However, few studies have verified their prognostic significance. While exercise tests are useful tools for functional assessment, information is scarce regarding further considerations, and many of the criteria are based on guidelines for other heart diseases.

Prevalence and determinants of depressive symptoms in patients with Chagas cardiomyopathy and predominantly preserved cardiac function

Abstract INTRODUCTION: Chagas cardiomyopathy (ChC) is highly stigmatized, and the presence of depressive symptoms may be a common feature. However, its determinants remain unclear. Therefore, the present study aimed to verify the prevalence of depression and the clinical, echocardiographic, functional, and quality of life factors associated with depressive symptoms in patients with ChC and predominantly preserved cardiac function. METHODS: Thirty-five patients with ChC (aged 40 to 60 years, 66% men, NYHA I-III) were evaluated by echocardiography, cardiopulmonary exercise testing, 6-minute walk test (6MWT), and Mini-Mental State Examination. Physical activity level was assessed using the Human Activity Profile (HAP) and health-related quality of life was assessed using the Short-Form Health Survey (SF-36). Depressive symptoms were evaluated using the Beck Depression Inventory. A cutoff point greater than 9 was indicative of depression. RESULTS: Depression was detected in 13 patients (37%). In the univariate analysis, female sex, NYHA functional class, body mass index, HAP score, mental summary of SF-36, peak oxygen uptake, and 6MWT distance were associated with depressive symptoms. The final model showed that only the HAP score (B = -0.533; 95% confidence interval [CI]: -0.804 to -0.262) and SF-36 mental summary (B = -0.269; 95% CI: -0.386 to -0.153) remained as independent predictors of depressive symptoms in patients with ChC. CONCLUSIONS: Depression was prevalent in patients with ChC and predominantly preserved cardiac function. Physical activity and mental health were independent risk factors for depressive symptoms.

Impact of lian gong on the quality of life of individuals with dizziness in primary care / Impacto do lian gong na qualidade de vida de indivíduos com tontura na atenção primária

ABSTRACT OBJECTIVE To assess the effects of the lian gong practice as a rehabilitation strategy in primary health care on the quality of life and functional capacity of people with dizziness. METHODS Randomized controlled clinical trial. Thirty-six people, who were complaining of dizziness or vertigo without the presence of central signs and were referred by the physician of primary health care participated in the study. The individuals were randomly allocated to the three experimental conditions: lian gong group (n = 11), vestibular rehabilitation group (n = 11) and control group (n = 14). The interventions were weekly, in group, with duration of 12 sessions. The participants were evaluated before and after the intervention regarding quality of life by the 36-Item Short Form Health Survey and the functional capacity by the Short Physical Performance Battery. RESULTS The scores of all domains of the Short Form Health Survey increased after intervention in the lian gong group. This variation was higher than that observed in the control group for the domains functional capacity, limitation by physical aspects and general health status, and also higher than that found after the intervention in the Vestibular Rehabilitation Group regarding pain. No differences were found in the Short Physical Performance Battery. CONCLUSIONS Based on the results presented, lian gong improves the quality of life of individuals with dizziness, without altering the functional capacity.

RESUMO OBJETIVO Avaliar os efeitos da prática do lian gong como estratégia de reabilitação na atenção primária à saúde sobre a qualidade de vida e capacidade funcional de pessoas com tontura. MÉTODOS Trata-se de ensaio clínico randomizado-controlado. Participaram 36 voluntários, com queixa de tontura ou vertigem sem a presença de sinais centrais, encaminhados pelo médico da atenção primária à saúde. Os indivíduos foram aleatoriamente alocados para as três condições experimentais: grupo lian gong (n = 11), grupo reabilitação vestibular (n = 11) e grupo controle (n = 14). As intervenções foram semanais, em grupo, com duração de 12 sessões. Os participantes foram avaliados antes e após a intervenção quanto à qualidade de vida pelo 36-Item Short Form Health Survey e quanto à capacidade funcional pelo Short Physical Performance Battery. RESULTADOS Observou-se aumento dos scores de todos os domínios do Short Form Health Survey após intervenção no grupo lian gong. Essa variação foi maior que a observada no grupo controle para os domínios capacidade funcional, limitação por aspectos físicos e estado geral de saúde, e também superior à encontrada após a intervenção grupo reabilitação vestibular no domínio dor. Não houveram diferenças no Short Physical Performance Battery. CONCLUSÕES Com base nos resultados apresentados, o lian gong melhora a qualidade de vida de indivíduos com tontura, sem alterar a capacidade funcional.

Sampling procedures and calculation for sample size determination: criteria and methods adopted in theses and dissertations in Human Movement Sciences - a descriptive study / Processos de amostragem e cálculo para determinação do tamanho da amostra: critérios e métodos adotados em teses e dissertações em Ciências do Movimento Humano - um estudo descritivo

Abstract Quantitative monographic studies systematically use inferential statistical procedures to test hypotheses. For this purpose, sampling procedures and sample sizes need to be adequate for the proposed procedures. The aim of this study was to identify the sample selection methods, as well as the performance and types of calculation to determine the sample size adopted in theses and dissertations developed in a graduate program in the field of Physical Education. Theses and dissertations defended between 2003 and 2013 were obtained through digital repository. Only quantitative studies were included, in which the following issues were analyzed: (1) sample selection criteria; (2) presence of sample calculation; (3) calculation type to estimate sample size. A total of 199 studies were included. Of these, 6% (n=11) used probabilistic methods for sample selection and 3% (n=6) used animal models. As for the accomplishment of sample calculations, 36% (n=72) studies reported having adopted this procedure. Of studies that performed sample calculations, 25% (n=18) used predictive equations, 67% (n=48) considered methods with statistical power as their base, 3% (n=2) used confidence interval, 4% (n=3) did not mention the method and 1% (n=1) was based on the type of statistical test to be used later. Non-probabilistic sampling methods predominate for the selection of subjects; most studies do not report adopting calculations to estimate sample size and, among those that reported the use, the models that consider statistical power as the main criterion are predominant.

Resumo Trabalhos monográficos quantitativos utilizam, sistematicamente, procedimentos estatísticos inferenciais para testar hipóteses. Para tanto, é necessário que os procedimentos de amostragem e os tamanhos amostrais estejam adequados aos procedimentos propostos. Objetivou-se identificar os métodos de seleção amostral, bem como a realização e os tipos de cálculo para determinação do tamanho amostral adotados em teses e dissertações desenvolvidas em um programa de pós-graduação no campo da Educação Física. As teses e dissertações, defendidas entre 2003 e 2013, foram obtidas via repositório digital. Foram incluídos apenas estudos de caráter quantitativo, nos quais analisou-se: (1) critério para seleção amostral; (2) presença de cálculo amostral; (3) tipo de cálculo para estimativa do tamanho amostral. Foram incluídos 199 trabalhos. Dentre estes, 6% (n=11) usaram métodos probabilísticos para seleção amostral e 3% (n=6) usaram amostra animal. Quanto à realização de cálculo amostral 36% (n=72) dos trabalhos relatam ter adotado. Dos estudos que citam ter realizado cálculos, 25% (n=18) usaram equações preditivas, 67% (n=48) consideraram métodos com o poder estatístico como base, 3% (n=2) usaram o intervalo de confiança, 4% (n=3) não citam o método e 1% (n=1) baseou-se no tipo de teste estatístico a ser usado posteriormente. Os métodos de amostragem não-probabilísticos predominam para a seleção dos sujeitos; grande parte dos estudos não relata adotar cálculos para a estimativa do tamanho amostral e dentre aqueles que citam utilizar, os modelos que consideram o poder estatístico como principal critério são predominantes.