Efeito agudo da corrida aeróbica na pressão arterial em jovens adultos normotensos / Acute effects of aerobic running on blood pressure in young normotens adults

RESUMO O objetivo do presente estudo foi investigar o efeito hipotensivo induzido pela corrida aeróbica em jovens adultos. Trinta e um indivíduos (18 mulheres e 13 homens) foram submetidos a uma avaliação antropométrica e o protocolo de corrida proposto em uma esteira ergométrica durante 40 min entre 60 a 70% da frequência cardíaca de reserva. Realizaram-se medidas da pressão arterial sistólica (PAS) e pressão arterial diastólica (PAD) que posteriormente foram comparados antes e ao final do protocolo de corrida através do teste t de Student para as variáveis dependentes. Todos os testes foram assumidos com α = 0,05. Em comparação com a PAS antes (127,1 ± 11,5 mmHg) e após (119,9 ± 10,2 mmHg) a corrida, os resultados obtidos evidenciaram uma diminuição da pressão arterial sistólica, o qual resultou uma diferença média de -7,2 ± 6,2 mmHg, demonstrando uma diferença significativa (p = 0,00001). Entretanto, na PAD antes (73,6 ± 8,6 mmHg) e após (72,5 ± 7,8 mmHg) não demonstrou uma diferença significativa (p = 0,36) como efeito agudo na diminuição após a corrida. Portanto, conclui-se que a corrida em moderada intensidade e longa duração pode ser auxiliado no tratamento não farmacológico da hipertensão arterial e como melhoria na saúde cardiovascular.

ABSTRACT The aim of the present study was to investigate the acute effects of blood pressure induced by moderate intensity aerobic exercise in young adults. Thirty-one individuals (18 women and 13 men) were submitted an anthropometric evaluation and a 40-min running protocol between 60% and 70% of the reserve heart rate. Hemodynamic measurements, systolic blood pressure (SBP) and diastolic blood pressure (DBP) were carried out before and after the running protocol through Student's t-test for the dependent variables. All tests assumed α = 0.05. Significant differences were recorded between SBP before (127.1 ± 11.5 mmHg) and after (119.9 ± 10.2 mmHg) the running protocol. The results showed a decrease in systolic blood pressure, which resulted in a mean difference of -7.2 ± 6.2 mmHg, demonstrating a significant difference (p = 0.00001). However, in the DBP before (73.6 ± 8.6 mmHg) and after (72.5 ± 7.8 mmHg) no showing a significant difference (p = 0.36) as an acute effect on the decrease the running protocol. In conclusion, that moderate intensity and long duration running exercise can be aided in the non-pharmacological treatment of arterial hypertension and as an improvement in cardiovascular health.

Retratamento endodôntico não cirúrgico: relato de caso / Nonsurgical endodontic retreatment: case report

O uso de tecnologias em Endodontia contribui para a simplificação, precisão e qualificação do atendimento oferecido. O objetivo deste trabalho foi relatar um caso clínico de retratamento endodôntico não cirúrgico de um incisivo lateral superior, com a utilização de ferramentas tecnológicas disponíveis, respaldadas em conhecimentos científicos atualizados. Os equipamentos e materiais utilizados possibilitaram a realização do tratamento de forma eficiente. O exame radiográfico pós-operatório com seis meses revelou sinais de reparo da lesão apical, indicando o sucesso da terapia estabelecida.

The use of technologies in Endodontics contributes to simplification, accuracy and qualification of the service offered. The aim of this study was to report a case of nonsurgical endodontic retreatment of a maxillary lateral incisor, with the use of available technological tools, supported on updated scientific knowledge. The equip¬ments and materials allowed the performance of the treatment efficiently. Six months follow-up radiographic examination showed signs of repair of apical lesions, indicating the success of the established therapy.

Sensory Peripheral Nerve Function in Chilean Elderly Consuming Folic Acid Fortified Flour: Relationship to Plasma Folate and a Novel Combined Biomarker of B12 Status. European Journal of Nutrition & Food Safety. 2015 Special issue; 5(5): 1067-1068.

Objectives: It has been reported that low vitamin B12 status and high serum folate is associated with anemia and cognitive impairment. However, few data are available on neurophysiological outcomes, such as peripheral neurophysiology. The objective was to assess associations between folate, B12 and sensory peripheral nerve conduction in Chilean elderly exposed to folic acid fortification. Methods: The average of the left and right distal sensory conduction latency of the sural nerve, and conduction velocity of the right peroneus nerve were measured in 159 community-dwelling older Chilean. Serum folate, B12, Hcy, MMA, and holoTC were determined. B12 status was defined based on: w=log_10 (holoTC*B12)/(MMA*Hcy)-(age factor) (Fedosov SN, Clin. Chim. Acta. 2013). Nerve conduction, folate and B12 status were divided into tertiles. Results: Age was 70-78y (57% women). 62.9%, 10.7% and 26.4% were classified as having B12 adequacy (w>-0.5), transitional status (-1.5< w<-0.5) and deficiency (w<-1.5) respectively, while 15.1% presented high folate (>45.3 nmol/L). Nerve conduction velocity of the right peroneus nerve positively correlated with B12 status (r=0.21, p<0.05). In the highest tertile of both B12 (w) and folate only 6% were in lowest tertile of sural nerve conduction vs. 31.5% (p<0.001) with low B12 and high folate. In the highest tertile of both B12 (w) and folate 25% were in lowest tertile of peroneal nerve conduction velocity as compared with 63.2% with low B12 and high folate (p<0.001). Conclusions: Elderly with both high B12 and folate status were less likely to have poor sensory peripheral nerve conduction than those with low B12 and high folate.

Variación estacional del perfil lipídico en adultos aparentemente sanos de Santiago, Chile / Seasonal variations in the lipid profile of apparently healthy young adults living in Santiago, Chile.

El perfil lipídico depende de muchos factores. Sin embargo, las variaciones estacionales de estos componentes han sido escasamente establecidas en el hemisferio sur. El objetivo de este estudio fue determinar la variación estacional del perfil lipídico por un periodo de un año en un grupo de adultos aparentemente sanos de Santiago, Chile. El diseño del estudio fue observacional y prospectivo. Participaron en el estudio 50 voluntarios sanos de ambos sexos y de edades entre 23 a 62 años. En forma mensual y durante un año se midió el perfil lipídico. LDL fue significativamente mayor en invierno y primavera que en verano (p<0,01). Por el contrario HDL disminuye en invierno (p<0,05). Se concluye que existen variaciones estacionales en los niveles séricos de LDL y HDL. El patrón circanual está caracterizado por mayores niveles de LDL en invierno y primavera y menores niveles de HDL en invierno.

The lipid profile is impacted by numerous factors. However, the seasonal variations in this profile have not been well-established in the southern hemisphere. The aim of this study was to determine the seasonal variation of the lipid profile in apparently healthy adults from Santiago, Chile. The study design was observational and prospective, involving 50 healthy volunteers of both genders, aged 23-62 years. The lipid profile was measured at monthly intervals over the course of one year. LDL was significantly higher in winter -spring than in summer- fall (p <0.01). Conversely, HDL decreases significantly in winter (p<0,05). We conclude that there are seasonal variations in the serum levels of LDL and HDL. The circannual pattern is characterized by increased levels of LDL in winter-spring and low levels of HDL in winter.

Low prevalence of iron deficiency anemia between 1981 and 2010 in Chilean women of childbearing age / Baja prevalencia de anemia por deficiencia de hierro entre 1981 y 2010 en mujeres chilenas en edad fértil

Objective. To determine the prevalence of anemia and iron status among Chilean women of childbearing age between 1981 and 2010. Materials and methods. Calculation of the prevalence of anemia and iron status was based on multiple cross-sectional iron absorption studies performed in 888 women during this period of time. All studies included measurements of hemoglobin, mean corpuscular volume, zinc protoporphyrin, percentage of transferrin saturation and serum ferritin. Data were grouped by decade (1981-1990, 1991-2000, and 2001-2010). Results. Prevalence of anemia for these decades was 9, 6 and 10%, respectively (p=NS). Iron deficiency anemia was the main cause of anemia in all periods (55, 85 and 75%, respectively; p=NS). A high prevalence of women with normal iron status was observed for all periods (64, 69, and 67, respectively; p=NS). Prevalence of iron deficiency without anemia in 1981-1990, 1991-2000 and 2001-2010 was 7, 20 and 12%, respectively (p<0.05). Finally, prevalence of iron depleted stores was 20, 6 and 10%, respectively (p<0.05). Conclusions. Prevalence of iron deficiency anemia in Chilean women of childbearing age was mild between 1981 and 2010. More than 60% of childbearing age women presented normal iron status in all periods. However, prevalence of iron depleted stores was moderate during 1981-1990, and was mild during 1991-2000 and 2001-2010.

Objetivo. Determinar la prevalencia de anemia y el estado de nutrición de hierro entre 1981 y 2010 en mujeres chilenas en edad fértil. Material y métodos. La prevalencia de anemia y el estado de nutrición de hierro fueron calculados con base en múltiples estudios transversales de absorción de hierro realizados en 888 mujeres. Estos estudios incluían medición de hemoglobina, volumen corpuscular medio, zinc protoporfirina, porcentaje de saturación de transferrina y ferritina sérica. Los datos fueron agrupados por décadas (1981-1990, 1991-2000, y 2001-2010). Resultados. La prevalencia de anemia para estas décadas fue de 9, 6 y 10%, respectivamente (p=NS). La anemia por deficiencia de hierro fue la principal causa de anemia en los periodos evaluados (55, 85 y 75%, respectivamente; p=NS). Una alta prevalencia de mujeres con estado de nutrición normal de hierro fue observado en todos los periodos (64, 69, y 67%, respectivamente; p=NS). La prevalencia de deficiencia de hierro sin anemia fue de 7, 20 y 12%, respectivamente (p<0.05). Finalmente, la prevalencia de depleción de depósitos de hierro fue de 20, 6 y 10%, respectivamente (p<0.05). Conclusiones. La prevalencia de anemia por deficiencia de hierro en mujeres chilenas en edad fértil clasifica como leve entre 1981 y 2010. Más de 60% de las mujeres en edad fértil presentó estado nutricional normal de hierro en todos los periodos. Sin embargo, la depleción de depósitos de hierro fue moderada durante 1981-1990, y fue leve durante 1991-2000 y 2001-2010.

Folatos y vitamina B12 en la salud humana / Folate, vitamin B12 and human health

During the past decade the role of folate and vitamin B12 in human nutrition have been under constant re-examination. Basic knowledge on the metabolism and interactions between these essential nutrients has expanded and multiple complexities have been unraveled. These micronutrients have shared functions and intertwined metabolic pathways that define the size of the "methyl donor" pool utilized in multiple metabolic pathways; these include DNA methylation and synthesis of nucleic acids. In Chile, folate deficiency is virtually nonexistent, while vitamin B12 deficiency affects approximately 8.5-51% depending on the cut-off value used to define deficiency. Folate is found naturally mainly in vegetables or added as folic acid to staple foods. Vitamin B12 in its natural form is present only in foods of animal origin, which is why deficit is more common among strict vegetarians and populations with a low intake of animal foods. Poorfolate status in vulnerable women of childbearing age increases the risk of neural tube birth defects, so the critical time for the contribution of folic acid is several months before conception since neural tube closure occurs during the first weeks of life. The absorption of vitamin B12 from food is lower in older adults, who are considered to have higher risk of gastric mucosa atrophy, altered production of intrinsic factor and acid secretion. Deficiency of these vitamins is associated with hematological disorders. Vitamin B12 deficiency can also induce clinical and sub-clinical neurological and of other disorders. The purpose of this review is to provide an update on recent advances in the basic and applied knowledge of these vitamins relative to human health.

Banda gástrica com desvio jejunoileal: nova opção técnica em cirurgia bariátrica / Gastric band with jejunoileal by-pass: new option in bariatric surgery

RACIONAL: Os procedimentos cirúrgicos para tratamento da obesidade morbida têm sido eficientes na resolução desta afecção a curto e longo prazo. Com exceção da banda gástrica ajustável todos estes procedimentos de alguma forma são capazes de induzir a liberação de hormônios intestinais em função do desvio intestinal e desta forma exercerem um efeito metabólico. OBJETIVO: Com a intenção de obter efeitos semelhantes às operações que promovem um desvio intestinal, com as vantagens de baixa morbidade e mortalidade da BGA, foi proposto novo procedimento técnico associando à banda gástrica ajustável a um desvio jejunoileal. MÉTODO: O procedimento cirúrgico totalmente conduzido por videolaparoscopia, consiste na aplicação inicial da banda gástrica e a seguir a realização de anastomose látero-lateral a 80 cm do ângulo duodenojejunal e 120 cm da válvula ileocecal. RESULTADOS: Foram operados 10 pacientes com esta técnica, seis mulheres e quatro homens com IMC médio de 40 kg/m2. A perda média de excesso de peso nos seis primeiros meses foi de 51,56

. Em quatro pacientes diabéticos houve normalização dos níveis glicêmicos e suspensão do uso da medicação antidiabética. CONCLUSÃO: Adição de desvio jejunoileal látero-lateral à banda gástrica pode melhorar a perda de peso em pacientes portadores de obesidade mórbida e contribuir para o controle da diabete tipo II.

BACKGROUND: Current procedures for surgical treatment of morbid obesity have proved to be efficient in controlling the process in the short and long follow-up. The bariatric surgical procedures, with the exception of the adjustable gastric banding are capable, in one way or another, of inducing hormonal release due to the intestinal by-pass that they may promote and therefore offering a metabolic effect. AIM: With the intention to maintain the same results promoted by gastrojejunal diversion, while maintaining the lower mortality rates of the adjustable gastric banding technique, it is proposed a new procedure combining adjustable gastric banding with jejunoileal diversion. METHOD: The surgical procedure, performed completely through videolaparoscopy, consisted of the initial application of the adjustable gastric banding and then a jejunoileal laterolateral by-pass, 80 cm from the duodenojejunal angle, with the distal ileum, at 120 cm from the ileocecal valve. RESULTS: Ten patients were operated on, six women and four men, with mean BMI of 40 kg/m2. The average percentage of excess weight loss after the first six months was 51.56

. In four diabetic type II patients there was a normalization of glicemic and HbA1c levels with suspension of insulin and/or antidiabetic medications. CONCLUSION: The addition of a laparoscopic jejunoileal laterolateral by-pass to the adjustable gastric banding may enhance the efficacy of weight-loss and diabetes type II control in the treatment of morbid obesity and its resulting co-morbidities.

Stroke and snakebite: case report

Snakebites are common and lead to potential complications like neuromyopathies and strokes, these last associated with disturbances of blood coagulation. We report on a 65 years old woman of cerebral intraparenchymal hemorrhage associated with snakebite by a Bothrops jararaca that occurred in the Reconcavo of Bahia, BA, Brazil. The patient was submitted to a surgical evacuation of the hematoma, with a good result. This report is accompanied by a revision about the association among snakebite and neurological complications, emphasizing strokes. Statistics reveal a hight incidence of snakebite in the world, mainly in tropical countries and gets attention for his socioeconomic impact. The clinical and laboratorial characteristics to identify the victims that present a high risk of presenting strokes are discussed in order to identify early those patients, so that they may be treated in a more precocious and effective way.

Acidentes ofídicos são comuns e trazem como potenciais complicações neuromiopatias e doenças cerebrovasculares, estas últimas associadas a distúrbios da coagulação sanguínea. Relatamos sobre uma mulher de 65 anos com hemorragia cerebral intraparenquimatosa associado a acidente ofídico por Bothrops jararaca, ocorrido no Recôncavo Baiano, BA, Brasil. A paciente foi submetida à craniotomia para evacuação cirúrgica do hematoma, com bom desfecho final. Este relato é acompanhado de revisão sobre a associação entre ofidismo e complicações neurológicas, com enfoque as doenças cerebrovasculares. As estatísticas impressionam pela alta incidência de acidente ofídico no mundo, principalmente em países tropicais e chama atenção o seu impacto sócio-econômico. Discutimos os achados clínicos e laboratoriais que identificam quais vítimas apresentam maior risco de apresentar complicações cerebrovasculares a fim de se identificar precocemente esses pacientes, para que possam ser tratados de forma mais precoce e eficaz.