Investigation of postural edema in the lower extremities of traffic control workers / Investigacao de edema postural de membros inferiores em agentes de transito

OBJECTIVE: Determine the prevalence of postural edema and investigate whether working posture - sitting down or standing up - affect its frequency. METHODS: Sixteen traffic control agents were assessed by water displacement volumetry and the results were analyzed in two groups, depending on working posture. Those who worked standing up for more than 4 hours were allocated to the SU group and those who worked sitting down for more than 4 hours were allocated to the SD group. Each worker was assessed before and after their working shift for three consecutive days. Data were analyzed using ANOVA and the test of equality of two proportions. The significance level was set at p ≤ 0.05. The assessment showed that members of both groups had postural edema of the lower extremities (p ≤ 0.001). RESULTS: When the frequency of postural edema was compared across groups, a trend was observed for greater edema formation in the SU group than in the SD group, although without statistically significant difference. CONCLUSION: It was concluded that traffic control agents suffer postural edema after 4 hours working in either of the postures investigated although with a predominance of edema formation among those who work standing up. .

OBJETIVO: Avaliar a ocorrência de edema postural (EP) e verificar se há diferença na sua formação entre as duas posturas de trabalho adotadas - em pé e sentada. MÉTODOS: Foram avaliados 16 trabalhadores agentes de trânsito por meio da volumetria por deslocamento de água, divididos em dois grupos de acordo com a posição de trabalho adotada. No Grupo em Pé (GP), foram alocados aqueles que trabalhavam em pé e, no Grupo Sentado (GS), aqueles que adotavam a posição sentada, ambos por mais de quatro horas consecutivas. Os dados foram coletados antes e após a jornada de trabalho por três dias consecutivos e tratados com os testes estatísticos ANOVA e Igualdade de duas proporções. O nível de significância adotado foi p ≤ 0,05. A avaliação revelou presença de edema postural de membros inferiores nas duas condições avaliadas (p ≤ 0,001). RESULTADOS: Na análise da diferença na formação de EP entre os grupos, observou-se tendência a maior formação no GP em comparação ao GS, contudo sem diferença estatisticamente significante. CONCLUSÃO: Concluiu-se que existiu EP em agentes de trânsito após quatro horas de trabalho nas duas condições avaliadas com predomínio na formação de edema na postura em pé. .

Relacao entre o nivel de atividade fisica estimado pelo Baltimore Activity Scale for Intermittent Claudication e a pedometria em pacientes com claudicacao intermitente / Correlation between physical activity levels of patients with intermittent claudication estimated using the Baltimore Activity Scale for Intermittent Claudication and a pedometer

CONTEXTO: Os pacientes com claudicação intermitente apresentam níveis reduzidos de atividade física. A Baltimore Activity Scale for Intermittent Claudication (BASIC) foi validada para quantificar o nível de atividade física destes pacientes. No entanto, esta validação se baseou em apenas dois dias de monitoramento com acelerômetros, de modo que ainda permanece incerto se a BASIC fornece informações sobre os níveis de atividade física semanal. OBJETIVO: Analisar a correlação entre o nível de atividade física estimada pela BASIC e o nível obtido pelo pedômetro em uma semana, em pacientes com claudicação intermitente. MÉTODOS: Foram estudados 150 pacientes com claudicação intermitente, com idade entre 30 e 80 anos. Foram obtidos os dados sociodemográficos e verificada a presença de comorbidades e de fatores de risco cardiovascular, e a BASIC. O pedômetro foi utilizado por sete dias consecutivos, sendo a análise feita em três diferentes períodos de monitorização (todos os dias, dias da semana e do fim de semana). RESULTADOS: Foi observada correlação entre a BASIC e a média de passos de todos os dias (rho=0,343; p<0,001), dos dias de semana (rho=0,336; p<0,001) e dos dias do final de semana (rho=0,317; p<0,001). CONCLUSÃO: Em pacientes com claudicação intermitente, o nível de atividade física estimado pela BASIC se correlaciona com o nível de atividade física semanal. .

BACKGROUND: The levels of physical activity of patients with intermittent claudication (IC) are usually reduced. The Baltimore Activity Scale for Intermittent Claudication (BASIC) was designed to measure physical activity levels of patients with IC, but its validation was conducted against only two days of monitoring with an accelerometer, and it remains unclear whether BASIC provides information about weekly physical activity levels. OBJECTIVE: To analyze the correlation between physical activity levels of patients with IC estimated using BASIC or a pedometer for one week. METHODS: This study included 150 patients with IC aged 30 to 80 years. Sociodemographic data, comorbidities, cardiovascular risk factors and BASIC scores were recorded. Pedometers were used for seven consecutive days, and data were analyzed for three different periods (all days, weekdays and weekends). RESULTS: BASIC scores and mean number of steps were correlated on all days (rho=0.343, p<0.001), weekdays (rho=0.336, p<0.001) and weekends (rho=0.317, p<0.001). CONCLUSION: In patients with IC, physical activity levels estimated using BASIC correlate with weekly physical activity levels. .

Estudio integral no invasivo de la estructura y función arterial: discusión de aspectos teóricos y prácticos del abordaje implementado en CUiiDARTE (centro universitario de investigación, innovación y diagnóstico arterial): [revisión] / Non-invasive integral study of arterial structure and function: discussion of theoretical and practical features of the approach implemented at CUiiDARTE (centro universitario de investigación, innovación y diagnóstico arterial): [review]

Los sistemas de prevención cardiovascular basados en la determinación de factores de riesgo presentan limitaciones para cuantificar el riesgo de un sujeto. Los factores de riesgo son predictores de aterosclerosis en la población, pero fallan en identificar qué sujetos desarrollarán la enfermedad y/o tendrán eventos cardiovasculares; los que frecuentemente se presentan en sujetos de riesgo bajo o intermedio. En este contexto, guías/consensos sugieren realizar estudios no invasivos en sujetos asintomáticos para estratificar el riesgo individual, detectar y tratar la aterosclerosis en etapa subclínica. Para ello se han propuesto diferentes abordajes que permiten caracterizar la estructura y/o función arterial por métodos no invasivos, brindando información complementaria, que adiciona a la obtenida con la determinación de los factores de riesgo. En Uruguay, recientemente se creó un centro universitario interdisciplinario (CUiiDARTE, Centro Universitario de Investigación, Innovación y Diagnóstico Arterial), que tiene entre sus objetivos implementar técnicas no invasivas para la evaluación integral de la estructura y función arterial, posibilitando dar respuesta a la necesidad de estratificación individualizada del riesgo cardiovascular y detección de aterosclerosis subclínica. En este trabajo se presenta el abordaje de evaluación vascular empleado en CUiiDARTE y basados en nuestra experiencia, se discuten aspectos teóricos y prácticos de los test no invasivos utilizados y parámetros estudiados.

Traditional risk factors-guided cardiovascular prevention/treatment has clear limitations in individual subjects management. Often, individuals with similar risk factor profiles have differences in the atherosclerosis development and are at different cardiovascular risk. Therefore, while risk factors are good predictors of atherosclerosis in a population, they cannot identify who will develop the disease and/or will have a cardiovascular event. In this context, there have been published guidelines calling for non-invasive atherosclerosis screening and risk stratification in asymptomatic subjects. Several approaches have been proposed for the vascular evaluation, and although the screening tests used vary among laboratories, in general terms their are underused. In Uruguay, it was recently created an interdisciplinary university center (CUiiDARTE, Centro Universitario de Investigación, Innovación y Diagnóstico Arterial), which has as a main aim the implementation of non-invasive techniques to evaluate the arterial structural and functional properties, that could allow stratifying the individual cardiovascular risk and identifying sub-clinical atherosclerosis. In this work we present the integral vascular approach used in CUiiDARTE and based in our experience we discuss, theoretical and practical issues related with the tests performed and parameters calculated.

Prevention of diabetic foot ulcers: Holy grail of foot clinics

Diabetic foot ulcer is a common and debilitating complication of diabetes. Often this is preventable by regular screening and addressing risk factors such as regular podiatry, good foot wear and early consultation with health care professionals. General measures such as good glycaemic control, prevention of cardiovascular risk factors and prevention of deformity should be aimed during the early stages of the disease. Diabetic subjects should be encouraged to actively participate in their foot care. Prevention of foot ulcers will reduce the rate of amputation, which is common in diabetic subjects

Exposiçäo ocupacional à vibraçäo transmitida através das mäos:uma revisäo sobre o distúrbio vascular periférico / Hand-transmitted vibration exposure:a review about the peripheric vascular disease

Trata das consequências da exposiçäo ocupacional à vibraçäo transmitida pelas mäos sobre a saúde do trabalhador