Effects of traditional concurrent training and multicomponent training composed by strength training and dance classes on functional and cognitive capacity of older adults: a study protocol / Efeitos do treinamento combinado tradicional e do treinamento multicomponente composto por treinamento de força e aulas de dança na capacidade funcional e cognitiva de idosos: protocolo de estudo

The combination of strength and aerobic training (concurrent training - TG) has been a widely used intervention for improving health outcomes. Also, dance has been well described as a great aerobic activity and can be an interesting option to compose an alternative multicomponent training pro-gram. Therefore, the aim of the present protocol study is to describe the methods that will be used in a randomized controlled trial (RCT) design to identify and compare the impacts of traditional TG composed by strength and aerobic training and a multicomponent training consisting of strength training combined with dance classes (DG) on functional and cognitive capacity and quality of life of older people. The sample of RCT will consist of men and women aged between 60 and 75 years. Both interventions will occur twice a week for 12 weeks with progressive intensity and volume. Functional capacity will be assessed by gait, balance, sitting and standing and climbing tests. Strength will be assessed through one repetition maximum test (1RM) in knee extension exercise, and handgrip using a hand dynamometer. Muscle thickness will be assessed using quadriceps ultrasound. Muscle power will be assessed in the knee extension exercise at 30 and 70% of 1RM using an encoder. Aerobic capacity will be assessed using the 6-minute walk test. Quality of life and cognitive performance will be assessed by questionnaires. Comparisons between groups over time will be carried out using Generalized Estimating Equations with a significance level of p<0.01. This protocol follows the rec-ommendations of SPIRIT-2013.

A combinação de treinamento de força e aeróbico (treinamento combinado - TC) tem sido uma interven-ção amplamente utilizada para melhorar desfechos de saúde. Além disso, a dança tem sido bem descrita na literatura como uma ótima atividade aeróbica e pode ser uma opção interessante para compor um programa alternativo de treinamento multicomponente. Portanto, o objetivo do presente protocolo de estudo é descrever os métodos que serão utilizados em um ensaio clínico randomizado (ECR) que visa identificar e comparar os impactos do TC tradicional composto por treinamento de força e aeróbico e de um treinamento multi-componente composto por treinamento de força combinado com aulas de dança sobre capacidade funcional, cognitiva e qualidade de vida de idosos. A amostra do ECR será composta por homens e mulheres com idade entre 60 e 75 anos. Ambas as intervenções ocorrerão duas vezes por semana durante 12 semanas com intensidade e volume progressivos. A capacidade funcional será avaliada por meio de testes de marcha, equilíbrio, sentar e levantar e subir escadas. A força será avaliada por meio do teste de uma repetição máxima (1RM) no exercício de extensão de joelhos e por meio do teste de preensão palmar com o dinamômetro manual. A espessura muscular será avaliada por meio de ultrassonografia do quadríceps. A potência muscular será ava-liada no exercício de extensão de joelhos a 30 e 70% de 1RM por meio de um transdutor linear de posição. A capacidade aeróbica será avaliada por meio do teste de caminhada de 6 minutos. A qualidade de vida e o desempenho cognitivo serão avaliados por meio de questionários. As comparações entre os grupos ao longo do tempo serão realizadas por meio de Equações de Estimativas Generalizadas com nível de significância p<0,01. Este protocolo segue as recomendações do SPIRIT-2013.

La preparación especial de fuerza rápida en balistas con discapacidad físico-motriz por amputación

En el Campeonato Nacional de Paratletismo, en Cuba, los resultados competitivos de las balistas con discapacidad físico-motriz por amputación muestran un decrecimiento, en varias categorías. Se detectaron insuficiencias en la dosificación de las cargas, en la utilización de métodos, medios y procedimientos; además de una inadecuada orientación metodológica. Se trazó como objetivo diseñar una metodología para la planificación de la capacidad fuerza rápida en la etapa de preparación especial de balistas con discapacidad físico-motriz por amputación. Se realizó una investigación de tipo descriptiva y cuantitativa en el periodo comprendido entre el 2019-2022, el estudio se centró en el proceso de planificación y entrenamiento de la fuerza rápida en la etapa de preparación especial analizado y descrito, a través de métodos empíricos como la revisión de documentos, encuesta, entrevista y la triangulación metodológica, ello permitió evaluar su estado actual. Colaboraron como muestra atletas, entrenadores y directivos de nivel provincial y nacional. La metodología propuesta es viable y factible, con una efectividad esperada para el contexto deportivo actual y con posibilidades de generalización en otros eventos de lanzamiento. La propuesta diseñada enriquece la teoría del entrenamiento deportivo en atletas con discapacidad.

Nos Campeonatos Nacionais de Paratletismo em Cuba, os resultados competitivos dos balistas com deficiências físico-motoras por amputação mostram uma diminuição em várias categorias. Foram detectadas insuficiências na dosagem de cargas, no uso de métodos, meios e procedimentos, bem como uma orientação metodológica inadequada. O objetivo foi elaborar uma metodologia para o planejamento da capacidade de força rápida na fase de preparação especial de balistas com deficiência físico-motora decorrente de amputação. Foi realizada uma pesquisa descritiva e quantitativa no período entre 2019-2022, o estudo focou no processo de planejamento e treinamento da força rápida na fase de preparação especial analisada e descrita, por meio de métodos empíricos como revisão de documentos, pesquisa, entrevista e triangulação metodológica, o que permitiu avaliar seu estado atual. Atletas, técnicos e gerentes em nível provincial e nacional colaboraram como amostra. A metodologia proposta é viável e factível, com uma eficácia esperada para o contexto esportivo atual e com possibilidades de generalização em outros eventos de arremesso. A proposta elaborada enriquece a teoria do treinamento esportivo em atletas com deficiências.

In the National Para-Athletics Championship in Cuba, the competitive results of shot put athletes with physical-motor disabilities due to amputation show a decrease in several categories. Deficiencies were detected in the dosage of loads, in the use of methods, means and procedures; in addition to inadequate methodological guidance. The objective was to design a methodology for planning rapid strength capacity in the special preparation stage of shot put athletes with physical - motor disabilities due to amputation. A descriptive and quantitative research was carried out in the period between 2019-2022, the study focused on the planning and training process of rapid strength in the special preparation stage analyzed and described, through empirical methods such as the review of documents, survey, interview and methodological triangulation made it possible to evaluate its current state. Athletes, coaches and managers from provincial and national levels collaborated as a sample. The proposed methodology is viable and feasible, with expected effectiveness for the current sporting context and with possibilities of generalization in other throwing events. The designed proposal enriches the theory of sports training in athletes with disabilities.

Different Body Partialization Procedures Considering Maximum Strength and Explosiveness: Factorial Analysis Approach

SUMMARY: The aim of this study was to determine the sensitivity of different methods of partialization, in terms of different body component indices in relation to indicators of strength and explosiveness. The research involved 187 subjects who were divided into two groups based on sex. This research consisted of measuring body composition characteristics by multichannel bioimpedance analysis (BIA) InBody 720, as well as contractile characteristics of different muscle groups with tenziometric Dinamometry method. Based on the results of the factor analysis we found that regardless of the sex the most sensitive variable for partialization of absolute body isometric strength variable (ABiS) is partialization by allometric scaling (0.964 for females and 0.947 for males explained factor variance). However, in the case of absolute body isometric explosiveness (ABiE), the results of this study have demonstrated that partialization relative to skeletal muscle mass according to the body longitudinality - skeletal muscle mass index (SMMI) is the methodological choice disregarding the sex (0.982 for females and 0.980 for males explained factor variance). The results of the study have shown that for the purpose of scaling the maximal strength relative to body composition, the allometric method can be considered as a choice, while for the partialization of maximal isometric explosiveness skeletal muscle mass index is the best choice insensitive of the sex.

El objetivo de este estudio fue determinar la sensibilidad de distintos métodos de parcialización, en términos de diferentes índices de componentes corporales en relación a los indicadores de fuerza y explosividad. En la investigación participaron 187 sujetos que se dividieron según el sexo en dos grupos. Esta investigación consistió en medir las características de composición corporal mediante análisis de bioimpedancia multicanal (BIA) InBody 720, así como las características contráctiles de diferentes grupos musculares con el método de Dinamometría tenciométrica. Con base en los resultados del análisis factorial, encontramos que, independientemente del sexo, la variable más sensible para la parcialización de la variable de fuerza isométrica corporal absoluta (ABiS) fue la parcialización mediante escala alométrica (0,964 para las mujeres y 0,947 para los hombres). Sin embargo, en el caso de la explosividad isométrica corporal absoluta (ABiE), los resultados de este estudio han demostrado que la parcialización relativa a la masa del músculo esquelético según la longitudinalidad del cuerpo - índice de masa del músculo esquelético (SMMI) es la opción metodológica sin tener en cuenta el sexo (0,982 para las mujeres y 0,980 para los hombres). Los resultados del estudio han demostrado que para escalar la fuerza máxima en relación con la composición corporal, el método alométrico puede considerarse como una opción, mientras que para la parcialización de la explosividad isométrica máxima, el índice de masa del músculo esquelético es la mejor opción independiente del sexo.

Effect of different decontamination agents on the bond strength of CAD/CAM blocks and repair composite materials / Efecto de diferentes agentes descontaminantes sobre la resistencia de unión de bloques CAD/CAM y resinas compuestas

Abstract The purpose of this study was to examine the effect of different decontamination agents on the bond strength of saliva-contaminated CAD/CAM blocks and repair composite materials. Two hunderd eighty 3-mm-thick specimens were prepared from four different CAD/CAM materials: Katana Zirconia UTML disc, IPS e.max CAD block, Shofu block, and Vita Enamic block. Each material was divided into seven different subgroups (N=70). Group 1 had a clean surface. The other groups were comprised of the samples, which were contaminated with human saliva: group 2: negative control (non-cleaned); group 3: cleaned with water spray; group 4: cleaned with 70% ethanol; group 5: cleaned with Ivoclean; group 6: cleaned with Katana Cleaner; and group 7: cleaned with phosphoric acid. After the decontamination protocols, the resin composite cylinders were bonded to the CAD/CAM surfaces with a thin layer of dual-cured resin cement. The samples were stored for 24 hours at 37°C in distilled water. Then, they were subjected to a shear bond strength test (SBS). The values were recorded, and fracture types were evaluated using a microscope. Data were analyzed using two-way ANOVA and Tukey's post-hoc test. Generally, all decontaminating agents improved the SBS of composites to Katana Zirconia UTML, IPS e.max, and Vita Enamic materials (p<0.05). However, for Shofu materials, group 6 samples exhibited significantly higher bond strength values as compared with group 2 samples (p=0.026). The highest SBS values were seen in the phosphoric acid-treated group in Katana zirconia materials (26.45 ± 9.38 MPa), whereas the lowest values were seen in group 2 samples in Shofu materials (13.17±3.40 MPa). Each decontaminant agent improved the bond strength of composites to the contaminated CAD/CAM materials. If saliva is not cleaned before adhesive procedure, SBS values may decrease. All decontamination agents can be used safely on zirconia, lithium-disilicate glass-ceramic, hybrid ceramic, and polymer-infiltrated ceramic surfaces.

Resumen El propósito de este estudio fue examinar el efecto de diferentes agentes descontaminantes sobre la fuerza de unión de bloques CAD/CAM contaminados con saliva y materiales compuestos de reparación. Se prepararon doscientas ochenta muestras de 3 mm de espesor a partir de cuatro materiales CAD/CAM diferentes: disco Katana Zirconia UTML, bloque IPS e.max CAD, bloque Shofu y bloque Vita Enamic. Cada material se dividió en siete subgrupos diferentes (N=70). El grupo 1 tenía una superficie limpia. Los otros grupos estaban compuestos por muestras que estaban contaminadas con saliva humana: grupo 2: control negativo (no limpio); grupo 3: limpiado con agua pulverizada; grupo 4: limpiado con etanol al 70%; grupo 5: limpiado con Ivoclean; grupo 6: limpiado con Katana Cleaner; y grupo 7: limpiado con ácido fosfórico. Después de los protocolos de descontaminación, los cilindros de composite de resina se adhirieron a las superficies CAD/CAM con una fina capa de cemento de resina de curado dual. Las muestras se almacenaron durante 24 horas a 37°C en agua destilada. Luego, fueron sometidos a una prueba de resistencia al corte (SBS). Se registraron los valores y se evaluaron los tipos de fracturas utilizando un microscopio. Los datos se analizaron mediante ANOVA de dos factores y la prueba post-hoc de Tukey. En general, todos los agentes descontaminantes mejoraron el SBS de los composites con los materiales Katana Zirconia UTML, IPS e.max y Vita Enamic (p<0,05). Sin embargo, para los materiales Shofu, las muestras del grupo 6 exhibieron valores de fuerza de unión significativamente más altos en comparación con las muestras del grupo 2 (p=0,026). Los valores más altos de SBS se observaron en el grupo tratado con ácido fosfórico en materiales de circonio Katana (26,45 ± 9,38 MPa), mientras que los valores más bajos se observaron en las muestras del grupo 2 en materiales Shofu (13,17 ± 3,40 MPa). Cada agente descontaminante mejoró la fuerza de unión de los composites a los materiales CAD/CAM contaminados. Si no se limpia la saliva antes del procedimiento adhesivo, los valores de SBS pueden disminuir. Todos los agentes descontaminantes se pueden utilizar de forma segura en superficies de circonio, cerámica de vidrio de disilicato de litio, cerámica híbrida y cerámica con infiltraciones de polímeros.

Normative Data of Handgrip Strength in Macedonian Children and Adolescents According to Chronological and Biological Age / Datos Normativos de la Fuerza de Prensión Manual en Niños y Adolescentes Macedonios Según la Edad Cronológica y Biológica

SUMMARY: The handgrip strength is used as a means of individual's health prediction during life. It is used as an indicator of the nutrition status, bone fragility, presence of sarcopenia and it correlates with certain diseases and clinical complications. The research goal was to analyze the results of the hand dynamometry test, based on the chronological and biological age, and to offer normative and referent standards about children and adolescents from the Republic of North Macedonia. The study was conducted on a sample of 4031 respondents of both sexes at the age 6-14 years. In order to achieve the research goals, the measured characteristics were of the weight, height, sitting height and handgrip strength. The body mass index and biological maturity values (APHV) were obtained by using formulas. On the basis of the obtained results, it can be concluded that statistically significant differences in handgrip strength are established between the boys and girls of all age categories. Also, statistically significant differences between boys and girls are established in the hand dynamometry test of all APHV levels. In general, the use of the APHV allows a better categorization of the performance of the studied children and adolescents. With boys, the correlation between the chronological age and test was 68 %, and with girls - 77 %. The normative referent standards of the hand dynamometry test are presented in percentiles for both sexes. Thye hand dynamometry test's results during childhood and adolescence should be analyzed and interpret on the basis of biological age, and not on the chronological age. These tools can help specialists who work with children and adolescents in ethnic and epidemiological context.

La fuerza de prensión se utiliza como medio para predecir la salud del individuo durante la vida. Se utiliza como indicador del estado nutricional, fragilidad ósea, presencia de sarcopenia y se correlaciona con determinadas enfermedades y complicaciones clínicas. El objetivo de la investigación fue analizar los resultados de la prueba de dinamometría manual, con base en la edad cronológica y biológica, y ofrecer estándares normativos y referentes sobre niños y adolescentes de la República de Macedonia del Norte. El estudio se realizó en una muestra de 4031 encuestados de ambos sexos con edades comprendidas entre 6 y 14 años. Para lograr los objetivos de la investigación, las características medidas fueron el peso, la altura, la altura al sentarse y la fuerza de prensión. El índice de masa corporal y los valores de madurez biológica (APHV) se obtuvieron mediante fórmulas. Sobre la base de los resultados obtenidos, se puede concluir que se establecen diferencias estadísticamente significativas en la fuerza de prensión manual entre niños y niñas de todas las categorías de edad. Asimismo, se establecen diferencias estadísticamente significativas entre niños y niñas en la prueba de dinamometría manual de todos los niveles APHV. En general, el uso del APHV permite una mejor categorización del desempeño de los niños y adolescentes estudiados. En los niños, la correlación entre la edad cronológica y la prueba fue del 68 %, y en las niñas, del 77 %. Los estándares normativos referentes de la prueba de dinamometría manual se presentan en percentiles para ambos sexos. Los resultados de la prueba de dinamometría manual durante la infancia y la adolescencia deben analizarse e interpretarse en función de la edad biológica y no de la edad cronológica. Estas herramientas pueden ayudar a los especialistas que trabajan con niños y adolescentes en un contexto étnico y epidemiológico.

Dynapenia and sarcopenia: association with the diagnosis, duration and complication of type 2 diabetes mellitus in ELSA-Brasil / Dinapenia e sarcopenia: associação com o diagnóstico, duração e complicações de diabetes mellitus tipo 2 no ELSA-Brasil / Dinapenia y sarcopenia: asociación con el diagnóstico, duración y complicaciones de la diabetes mellitus tipo 2 en ELSA-Brasil

Abstract: Sarcopenia (the loss of muscle mass, strength and skeletal muscle function) increases mortality and the risk of hospitalization in the older population. Although it is known that older adults with type 2 diabetes mellitus (T2DM) have a higher risk of dynapenia and sarcopenia, few studies have investigated these conditions in middle-aged populations. The objective of this study was to investigate whether T2DM, its duration, the presence of albuminuria, and glycemic control are associated with sarcopenia and its components in adults. The cross-sectional analysis was based on data from visit 2 of the Brazilian Longitudinal Study of Adult Health (2012-2014). The 2018 European Working Group on Sarcopenia in Older People criteria were used to define dynapenia, low appendicular muscle mass (LAMM), and sarcopenia (absent/probable/confirmed). The explanatory variables were: T2DM; duration of T2DM; T2DM according to the presence of albuminuria; and glycemic control (HbA1C < 7%) among people with T2DM. A total of 12,132 participants (mean age = 55.5, SD: 8.9 years) were included. The odds ratio for LAMM was greater among those with T2DM, T2DM duration from 5 to 10 years, and T2DM without albuminuria. Chances of dynapenia were higher among those with T2DM, T2DM duration > 10 years, and T2DM with and without albuminuria. The variables T2DM, T2DM ≥ 10 years, and T2DM with albuminuria increased the odds of probable sarcopenia, and T2DM duration from 5 to 10 years increased the odds of confirmed sarcopenia. The results support the importance of frequently monitoring the musculoskeletal mass and strength of individuals with T2DM to prevent sarcopenia and related outcomes.

Resumo: A sarcopenia (perda de massa muscular, força e função muscular esquelética) aumenta a mortalidade e o risco de hospitalização em idosos. Idosos com diabetes mellitus tipo 2 (DMT2) apresentam risco elevado de desenvolver dinapenia e sarcopenia, mas poucos estudos investigaram populações de meia-idade. O objetivo foi investigar se DMT2, sua duração, a presença de albuminúria e o controle glicêmico estão associados à sarcopenia e seus componentes em adultos. Análise transversal baseada nos dados da segunda visita do Estudo Longitudinal de Saúde do Adulto (2012-2014). Os critérios do European Working Group on Sarcopenia in Older People [Grupo de Trabalho Europeu sobre Sarcopenia em Pessoas Idosas] de 2018 foram usados para definir dinapenia, baixa massa muscular apendicular e sarcopenia (ausente/provável/confirmada). As variáveis explicativas foram: DMT2; duração do DMT2; DMT2 de acordo com a presença de albuminúria; e controle glicêmico (HbA1c < 7%) entre pessoas com DMT2. Foram incluídos 12.132 participantes (idade média de 55,5; DP: 8,9 anos). A razão de chances para baixa massa muscular apendicular foi maior entre pessoas com DMT2, duração do DMT2 entre 5 e 10 anos e DMT2 sem albuminúria. As chances de dinapenia foram maiores entre pessoas com DMT2, duração do DMT2 > 10 anos e DMT2 com e sem albuminúria. DMT2, DMT2 ≥ 10 anos e DMT2 com albuminúria aumentaram as chances de sarcopenia provável e duração do DMT2 entre 5 e 10 anos aumentaram as chances de sarcopenia confirmada. Os resultados reforçam a importância do monitoramento frequente da massa e da força muscular em indivíduos com DMT2 para prevenir a sarcopenia e desfechos relacionados.

Resumen: La sarcopenia (pérdida de masa muscular, fuerza y función muscular esquelética) aumenta la mortalidad y el riesgo de hospitalización en ancianos. Los ancianos con diabetes mellitus tipo 2 (DMT2) presentan un mayor riesgo de sufrir dinapenia y sarcopenia, pero pocos estudios han investigado poblaciones de mediana edad. El objetivo fue investigar si la DMT2, su duración, la presencia de albuminuria y el control glucémico están asociados con la sarcopenia y sus componentes en adultos. Análisis transversal basado en los datos de la visita 2 del Estudio Longitudinal de Salud del Adulto en Brasil (2012-2014). Se utilizaron los criterios del European Working Group on Sarcopenia in Older People [Grupo de Trabajo Europeo sobre Sarcopenia en Personas Mayores] del 2018 para definir dinapenia, baja masa muscular apendicular y sarcopenia (ausente/probable/confirmada). Las variables explicativas fueron las siguientes: DMT2; duración de la DMT2; DMT2 según la presencia de albuminuria; y control glucémico (HbA1c < 7%) entre personas con DMT2. Se incluyeron 12.132 participantes (edad media = 55,5, DE: 8,9 años). La razón de probabilidades de masa muscular apendicular baja fue mayor entre personas con DMT2, duración de la DMT2 entre 5 y 10 años y DMT2 sin albuminuria. Las probabilidades de dinapenia fueron mayores entre las personas con DMT2, duración de la DMT2 > 10 años y DMT2 con y sin albuminuria. Las condiciones de DMT2, DMT2 ≥ 10 años y DMT2 con albuminuria aumentaron las probabilidades de sarcopenia probable y la duración de la DMT2 entre 5 y 10 años las probabilidades de sarcopenia confirmada. Los resultados refuerzan la importancia del monitoreo frecuente de la masa y de la fuerza musculoesquelética en individuos con DMT2 para prevenir la sarcopenia y los desenlaces relacionados.

Muscle strength in patients hospitalized for COVID-19 / Força muscular em pacientes hospitalizados por COVID-19

Abstract Introduction Complications arising from hospitalization due to COVID-19 have great impact on the physical health of individuals. One of the consequences that deserves attention is muscle weakness, which can be influenced by several factors, generating consequences that may need rehabilitation. Objective To relate the degree of peripheral and respiratory muscle strength to sociodemographic, clinical, and hospitalization variables close to discharge after hospitalization due to COVID-19. Methods This cross-sectional study analyzed data for 52 patients hospitalized for COVID-19 who were interviewed close to discharge to determine sociodemographic and clinical profiles and underwent muscle strength testing. Peripheral muscle strength was evaluated using the Medical Research Council scale, and respiratory strength was determined according to maximum inspiratory and expiratory pressure measured with a vacuometer. Hospitalization data were collected from patient medical records. Results Peripheral strength was reduced in 53.9% of the sample, and the related variables (p < 0.05) were age, weight, cancer, high blood pressure, physical therapy, and number of physiotherapy sessions. Inspiratory force was reduced by 50% of individuals and expiratory force in 60% individuals, and these reductions were related (p < 0.05) to sex, high blood pressure, age, and weight. Conclusion Close to COVID-19 hospital discharge, over 50% of patients exhibited peripheral and respiratory muscle weakness, associated with advanced age, hypertension, and low weight. Those with peripheral weakness received more physiotherapy and had more oncological diseases, while respiratory weakness was more common in men. This underscores the importance of preventive measures and post-hospitalization rehabili-tation programs, including physiotherapy, for muscle strength recovery.

Resumo Introdução As complicações decorrentes da hospitalização por COVID-19 têm grande impacto na saúde física dos indivíduos. Uma das consequências que merece atenção é a fraqueza muscular, que pode ser influenciada por diversos fatores, ge-rando consequências que podem necessitar de reabilitação. Objetivo Relacionar o grau de força muscular periférica e respiratória com variáveis sociodemográficas, clínicas e de internação próximo à alta após internação por COVID-19. Métodos Este estudo transversal analisou dados de 52 pa-cientes hospitalizados por COVID-19 que foram entrevistados próximo à alta para determinar perfis sociodemográficos e clínicos e que foram submetidos a testes de força muscular. A força muscular periférica foi avaliada pela escala do Medical Research Council, e a força respiratória foi determinada de acordo com a pressão inspiratória e expiratória máxima medida com vacuômetro. Os dados de internação foram coletados dos prontuários dos pacientes. Resultados A força periférica esteve reduzida em 53,9% da amostra e as variáveis relacionadas (p < 0,05) foram idade, peso, câncer, hipertensão, fisioterapia e número de sessões de fisioterapia. A força inspiratória foi reduzida em 50% dos indivíduos e a força expiratória em 60% dos indivíduos, e essas reduções foram relacionadas (p < 0,05) ao sexo, pressão arterial elevada, idade e peso. Conclusão Próximo à alta hospitalar da COVID-19, mais de 50% dos pacien-tes apresentavam fraqueza muscular periférica e respiratória associada à idade avançada, hipertensão e baixo peso. Aqueles com fraqueza periférica receberam mais fisioterapia e tiveram mais doenças oncológicas, enquanto a fraqueza respiratória foi mais comum em homens. Isto ressalta a importância de medidas preventivas e programas de reabilitação pós-hospitalização, incluindo fisioterapia, para a recuperação da força muscular.

Functional tests and isokinetic knee assessment in street runner athletes correlation / Correlación entre pruebas funcionales y evaluación isokinética de rodilla en practicantes de carrera de calle / Correlação entre testes funcionais e avaliação isocinética do joelho em atletas corredores de rua

ABSTRACT Introduction: The assessment of biomechanical changes related to the lower limbs is necessary in clinical practice to measure the potential risks of injury and the influences on existing dysfunction. Biomechanical changes related to previous ankle injuries are known to influence the performance of the entire lower limb. Objective: The aim of this study was to correlate muscle strength tests, performance tests and ankle stability with the Single Hop Test (SHT). Methods: 82 amateur runners were evaluated with isokinetic tests of quadriceps and hamstring muscle strength, as well as Y Balance Test (YBT), Weight-bearing Lung Test (WBLT), and the SHT. Results: The results showed there was a significant correlation between the SHT and the YBT in subjects with hamstring/quadriceps ratio (I/Q ratio) <0.55, and the length of the unilateral SHT with the peak torque of ipsilateral knee extensors. Conclusion: The study was successful in correlating the functional tests in question with the results obtained in isokinetic dynamometry. Level of Evidence V; Cross-Sectional Study.

RESUMEN Introducción: La evaluación de los cambios biomecánicos relacionados con las extremidades inferiores es necesaria en la práctica clínica para medir los riesgos potenciales de lesión y las influencias sobre la disfunción existente. Se sabe que los cambios biomecánicos relacionados con lesiones previas de tobillo influyen en el rendimiento de toda la extremidad inferior. Objetivo: Correlacionar las pruebas de fuerza muscular, las pruebas de rendimiento y la estabilidad del tobillo con la prueba de salto simple (Single Hop Test, SHT). Métodos: Se evaluó a 82 corredores aficionados con pruebas isocinéticas de fuerza muscular de cuádriceps e isquiotibiales, además de pruebas como Y Balance Test (YBT), Weight-bearing Lung Test (WBLT) y la prueba SHT. Resultados: Los resultados mostraron que existía una correlación significativa entre el SHT y el YBT en sujetos con ratio isquiotibiales/cuádriceps (ratio I/Q) <0,55, y la longitud del SHT unilateral con el par máximo de los extensores de la rodilla ipsilateral. Conclusión: El estudio logró correlacionar las pruebas funcionales en cuestión con los resultados obtenidos en la dinamometría isocinética. Nivel de Evidencia V; Estudio Transversal.

RESUMO Introdução: A avaliação de alterações biomecânicas relacionadas aos membros inferiores é necessária na prática clínica para mensurar os riscos potenciais de alguma lesão e as influencias sobre uma disfunção existente. As alterações biomecânicas relacionadas a lesões prévias de tornozelo são conhecidas pela influência na performance de todo o membro inferior. Objetivo: Correlacionar testes de força muscular, testes de performance e estabilidade do tornozelo com o teste de salto simples (Single Hop Test - SHT). Métodos: Foram avaliados 82 corredores amadores com testes isocinéticos de força muscular de quadríceps e isquiotibiais, além de testes Y Balance Test (YBT), Weight-bearing Lung Test (WBLT), e o SHT. Resultados: Os resultados demonstraram haver correlação significativa entre o SHT e o YBT nos indivíduos com relação Isquiotibiais/Quadríceps (relação I/Q) <0,55, e o comprimento do SHT unilateral com o pico de torque de extensores de joelho ipsilateral. Conclusão: O estudo foi bem sucedido em correlacionar os testes funcionais em questão com os resultados obtidos na dinamometria isocinética. Nível de Evidência V; Estudo Transversal.

Estado nutricional, força muscular e capacidade funcional em portadores de mieloma múltiplo / Nutritional status, muscle strength and functional capacity in patients with multiple myeloma

O mieloma múltiplo é uma neoplasia maligna caracterizada pela proliferação clonal de plasmócitos na medula óssea. O objetivo deste trabalho foi avaliar as possíveis associações entre o estado nutricional, força muscular e capacidade funcional de pacientes ambulatoriais portadores de mieloma múltiplo. Trata-se de estudo transversal realizado em amostra não probabilística de pacientes com mieloma múltiplo atendidos no Hospital das Clínicas, em Goiânia. Os dados foram coletados entre agosto e dezembro de 2015, utilizando-se de entrevistas e informações dos prontuários. O estado nutricional foi avaliado aplicando-se a Avaliação Subjetiva Global Produzida pelo Próprio Paciente; a força muscular medida por meio da Força do Aperto de Mão e a capacidade funcional, pela Escala de Performance de Karnofsky. O estudo foi aprovado pelo Comitê de Ética e Pesquisa do referido hospital. Foram avaliados 52 pacientes, em que 48,1% estavam desnutridos, 30,8% apresentavam baixa força muscular e 73,1%, comprometimento da capacidade funcional. A força muscular e a capacidade funcional foram menores nos desnutridos. Observou-se que aqueles que utilizavam corticoides apresentaram 18% menos chance de se tornarem desnutridos (OR=0,18; IC=0,05-0,62; p=0,011) porém, é importante considerar as possíveis causas de viés; por outro lado, os pacientes com baixa força muscular ou faziam quimioterapia apresentaram, aproximadamente, quatro vezes mais chances de desnutrição, respectivamente (OR=3,46; IC=0,99-12,08; p=0,047) (OR=3,64; IC=1,13-11,69; p=0,027). Concluiu-se que a desnutrição é comum nos pacientes portadores de mieloma múltiplo, indicando a necessidade premente de intervenção nutricional apropriada e precoce.

Multiple myeloma is a malignant neoplasm characterized by the clonal proliferation of plasma cells in the bone marrow. The objective of this study was to evaluate possible associations between nutritional status, muscle strength and functional capacity of outpatients with multiple myeloma. This is a cross-sectional study carried out on a non-probabilistic sample of patients with multiple myeloma treated at Hospital das Clínicas, in Goiânia. Data were collected between August and December 2015, using interviews and information from medical records. Nutritional status was assessed using the Patient Generated Subjective Global Assessment; muscular strength measured using Hand Grip Strength and functional capacity, using the Karnofsky Performance Scale. The study was approved by the Ethics and Research Committee of that hospital. 52 patients were evaluated, of which 48.1% were malnourished, 30.8% had low muscle strength and 73.1% had impaired functional capacity. Muscle strength and functional capacity were lower in malnourished individuals. It was observed that those who used corticosteroids were 18% less likely to become malnourished (OR=0.18; CI=0.05-0.62; p=0.011), however, it is important to consider the possible causes of bias; on the other hand, patients with low muscle strength or undergoing chemotherapy were approximately four times more likely to be malnourished, respectively (OR=3.46; CI=0.99-12.08; p=0.047) (OR=3.64; CI=1.13-11.69; p=0.027). It was concluded that malnutrition is common in patients with multiple myeloma, indicating the pressing need for appropriate and early nutritional intervention.

Correlation between Combined Urinary Metal Exposure and Grip Strength under Three Statistical Models: A Cross-sectional Study in Rural Guangxi / 生物医学与环境科学（英文）

OBJECTIVE@#This study aimed to investigate the potential relationship between urinary metals copper (Cu), arsenic (As), strontium (Sr), barium (Ba), iron (Fe), lead (Pb) and manganese (Mn) and grip strength.@*METHODS@#We used linear regression models, quantile g-computation and Bayesian kernel machine regression (BKMR) to assess the relationship between metals and grip strength.@*RESULTS@#In the multimetal linear regression, Cu (β = -2.119), As (β = -1.318), Sr (β = -2.480), Ba (β = 0.781), Fe (β = 1.130) and Mn (β = -0.404) were significantly correlated with grip strength ( P < 0.05). The results of the quantile g-computation showed that the risk of occurrence of grip strength reduction was -1.007 (95% confidence interval: -1.362, -0.652; P < 0.001) when each quartile of the mixture of the seven metals was increased. Bayesian kernel function regression model analysis showed that mixtures of the seven metals had a negative overall effect on grip strength, with Cu, As and Sr being negatively associated with grip strength levels. In the total population, potential interactions were observed between As and Mn and between Cu and Mn ( P interactions of 0.003 and 0.018, respectively).@*CONCLUSION@#In summary, this study suggests that combined exposure to metal mixtures is negatively associated with grip strength. Cu, Sr and As were negatively correlated with grip strength levels, and there were potential interactions between As and Mn and between Cu and Mn.

Relationship of balance in static single-leg stance to muscle strength and position sense of ankle in individuals with functional ankle instability / 中国康复理论与实践

ObjectiveTo analyze the relationship of the static single-leg stance balance with ankle muscles strength and position sense in individuals with functional ankle instability (FAI). MethodsFrom March to May, 2023, 44 FAI individuals were recruited in Hebei Normal University, and the maximum isokinetic muscle strength (60°/s and 180°/s) and position sense as ankle flexion, extension, inversion and eversion were measured using isokinetic dynamometer; while the center of pressure (COP) sway distance and envelope area were measured as static single-leg stance with eyes open or closed using three-dimensional force plate. ResultsThe maximum isokinetic torque as ankle eversion at 180°/s correlated with the COP anterior-posterior sway distance with eyes closed (r = -0.378, P < 0.05). ConclusionExplosive ankle eversion strength is related with the balance in static single-leg stance, which may help to evaluate and intervent the ankle function of FAI individuals.

Physical fitness and characteristics of cognitive function among people aged 55 to 75 years with high and low risk of dementia in communities in Beijing / 中国康复理论与实践

ObjectiveTo analyze the risk factors of dementia among healthy elderly individuals in the middle of their lives. MethodsA total of 175 participants aged 55 to 75 from two communities in Beijing were included from July, 2021 to April, 2023. Cardiovascular Risk Factors, Aging, and Incidence of Dementia (CAIDE) related risk factors and other demographic data were collected. According to the CAIDE assessment, participants with scores ≥ 9 were as high-risk group, and those with scores < 9 were as low-risk group. They were evaluated with Stroop Color Word Test (SCWT), two elements 1-back task paradigm and the revised Trail Making Test (TMT); measured the grip strength, 30 s forearm flexion tests and five sit-to-stand tests; the average step speed and step length of a 10-meter walk were recorded. ResultsThe average total score of CAIDE was 9.86 in the high-risk group, and was 4.95 in the low-risk group. There was no difference in age between two groups (P = 0.188). There were differences in the proportion of participants of male, less than seven years' education, systolic blood pressure > 140 mmHg, cholesterol > 6.5 mmol/L, body mass index > 30 kg/m2, and lack of physical activity between two groups (χ2 > 3.116, P < 0.05). The grip strength (t = -4.174), walking speed (t = -2.414), SCWT accuracy (Z = -2.684) were all worse in the high-risk group than in the low-risk group (P < 0.05). Logistic regression analysis showed that walking speed (OR = 25.483), grip strength (OR = 1.133) and SCWT accuracy (OR = 37.430) were independent influencing factors of dementia (P < 0.05). ConclusionWeaker grip strength, slower gait speed and worse inhibitory control might be independent influencing factors of dementia.

On the Time Value of Yu Weihan’s Spiritual Strength / 中国医学伦理学

Yu Weihan, academician of the Chinese Academy of Engineering, devoted his whole life to the prevention and control of endemic diseases and basically eradicated the epidemic of Keshan disease. Academician Yu Weihan’s struggle experience has left us with valuable spiritual wealth. His spiritual strength is manifested in many aspects, such as the spirit of bearing hardships first, the spirit of innovative daring to be the first, the spirit of craftsmen striving for perfection, the patriotic spirit of caring for the people, and the dedication of being indifferent to fame and wealth. His great medical feelings of bravely shouldering the mission, caring for the people and taking root in the grass-roots have forcefully answered the three important questions: what kind of doctor to be, who to be and how to be a good doctor in the learning and working career of doctors in the new era. He set an model for doctors in later generations and highlighted the value of this spiritual strength for the time.

Habitual physical activity and sedentary behavior as predictors of dynapenia in older adults: a cross-sectional study

ABSTRACT BACKGROUND: Dynapenia is a risk factor of mortality. Therefore, the development of low-cost and easy-to-apply tools is essential to optimize the health surveillance actions of older people. OBJECTIVES: To compare the time spent on habitual physical activity (HPA) and sedentary behavior (SB) among dynapenic and non-dynapenic older adults and ascertain the predictive ability of these behaviors on outcome. DESIGN AND SETTING: A cross-sectional population epidemiological survey was conducted involving 208 older adults. METHODS: HPA and SB were quantified using the International Physical Activity Questionnaire, and dynapenia was identified by handgrip strength (women: 18.37 kgf; men: 26.75 kgf). RESULTS: The prevalence was 24.50%. In both sexes, dynapenic individuals reported a HPA median time of 70.00 minutes/week (min/wk), while non-dynapenic women and men reported HPA median times of 240.00 and 280.00 min/wk, respectively (P < 0.05). For SB among dynapenic individuals, a median of 388.75 min/day was observed in women and 428.57 min/d in men. In contrast, non-dynapenic women and men had 291.42 and 274.28 min/day in SB (P < 0.05), respectively. The best cutoff HPA to discriminate the outcome was 150.00 min/wk in women (sensitivity: 73.30%; specificity: 60.67%) and 140.00 min/wk in men (sensitivity, 71.43%; specificity, 61.54%). The best cutoff SB was 381.43 min/day in women (sensitivity, 53.30%; specificity, 84.80%) and 351.43 min/day in men (sensitivity, 71.43%; specificity, 73.85%). CONCLUSION: Older individuals with dynapenia spent less time on HPA and more time in SB. Furthermore, HPA was found to be a better discriminator of dynapenic individuals, and SB better discriminated non-dynapenic individuals.

Clinical and functional evaluation of wrists and hands of spinal cord injured patients / Avaliação clínica e funcional de mãos e punhos de pacientes lesados medulares

ABSTRACT Introduction: The inability of the spinal cord to propagate sensory and motor stimuli as a result of the disruption of the nerve tracts is called spinal cord injury. Objective: This study analyzes clinically and radiologically the hands and wrists of spinal cord injured patients, evaluating their motor and sensitive functionality, in order to determine if these patients are more likely to develop degenerative alterations. Methods: 14 patients (8 paraplegics and 6 tetraplegics) were evaluated, undergoing anamnesis and clinical examination - a scale of muscular strength (MRC - Medical Research Council) and the amplitude measurement of the movement with a manual goniometer (ROM), were used for objective evaluation - and x-ray exams. The results were compared with pre-existing data from other studies. Results: When asked, only one of the 14 observed patients complained about constant wrist pain, described as level 3 (weak to moderate), based on the visual analog scale (VAS). The motor evaluation, MRC and ROM divided the group of patients into two subgroups: paraplegic and tetraplegic patients. The x-ray analysis showed, based on Kellgren and Lawrence classification, that all exam images fit grades 1 or 2 of osteoarthritis and osteoarthrosis. Conclusion: In conclusion, spinal cord injured patients showed none or minimal clinical and radiological signs of osteoarthritis on hands or wrists. Overall, the hands and wrists of spinal cord-injured patients behave similarly to noninjured patients. Level of Evidence III; Retrospective Comparative Study.

RESUMO Introdução: A incapacidade da medula espinhal de propagar estímulos sensoriais e motores como resultado do rompimento das vias nervosas é chamada de lesão da medula espinhal. Objetivo: Este estudo analisa clínica e radiograficamente mão e punhos de pacientes lesados medulares, avaliando função motora e sensitiva, a fim de determinar se estes pacientes estariam mais propensos a alterações degenerativas. Métodos: 14 pacientes (8 paraplégicos e 6 tetraplégicos) foram avaliados, passando por anamnese e exame clínico - sendo escala de força muscular (MRC - Medical Research Council) e a medição da amplitude de movimento com um goniômetro manual (ROM) foram utilizados para análise objetiva - e radiografias. Os dados obtidos foram comparados com literatura preexistente. Resultados: Quando questionados, apenas um dos 14 pacientes observados referiu dor crônica nos punhos, descrita como nível 3 (fraca a moderada), baseada na escala visual analógica. A avaliação motora, MRC e ROM dividiram os pacientes em 2 subgrupos: pacientes paraplégicos e tetraplégicos. A análise radiográfica mostrou, baseada na classificação de Kellgren e Lawrence, que todas as imagens se encaixam nos graus 1 ou 2 de osteoartrite e osteoartrose. Conclusão: Conclui-se, então, que pacientes lesados medulares apresentam nenhuma ou mínimas alterações clínicas e radiológicas para osteoartrite ou osteoartrose de punhos ou mãos. Ou seja, no geral, mãos e punhos de pacientes lesados medulares comportam-se como os pacientes sem lesão medular. Nível de Evidência III; Estudo Retrospectivo Comparativo.

Effect of ZrO2 paste, surface treatments, and storage on Weibull characteristics and resin bond strength to zirconia

Abstract The objective is to evaluate the effect of different surface treatments and storage on the shear strength of ultratranslucent zirconia. 36 blocks of ultra-translucent zirconia were fabricated (7x7x2mm) and sintered. Then, divided into 12 groups according to the "surface treatment" (C -Primer; Al -Sandblasting with Al2O3 + Primer; Si -Silicate + Primer; Gl -Glaze + HF + Primer; Z -Zirlink; Zp -Zirlink + Primer) and "storage" factors (ST-with 150 days/37º and without). After surface treatment, five cylinders (Ø=2mm; h=2.0mm) of resin cement (n=15) were constructed in each ceramic block; at the end, the shear strength test was performed (1mm/min, 50Kgf), and analysis of surface failures. 60 additional samples (2x2x2mm) were made for extras analysis (surface roughness, MEV, and EDS). Bond strength and surface roughness data were statistically evaluated by ANOVA (2 factors/1 factor), Tukey test (5%), and Weibull analysis, respectively. ANOVA (2-way) revealed that all factors were statistically significant for bond strength. The silicatization groups (SiST: 30.47AMPa; Si: 29.21AMPa) showed the highest bond strength values, regardless of storage (Tukey's test). While the groups treated with Zirlink (ZST: 2.76FMPa; Z: 5.27EFMPa) showed the lowest values, just similar to the GlST group (5.14EFMPa). The Weibull modulus (m) showed a statistical difference between groups (p=0.000). ANOVA (1 factor) revealed that the "surface treatment" factor (p=0.0000) was statistically significant for surface roughness. Therefore, the application of Zirlink and Glaze on pre-sintered zirconia did not promote efficient adhesion of the ultratranslucent zirconia to the resin cement, even when associated with a primer containing MDP.

Resumo O objetivo é avaliar o efeito de diferentes tratamentos superficiais e do envelhecimento na resistência ao cisalhamento da zircônia ultratranslúcida. Foram confeccionados 36 blocos de zircônia ultratranslúcida (7x7x2mm) e sinterizados. Em seguida, divididos em 12 grupos de acordo com o "tratamento de superfície" (C-Primer; Al-Jateamento com Al2O3+Primer; Si-Silicato+Primer; Gl -Glaze+HF+Primer; Z-Zirlink; Zp-Zirlink+Primer) e fatores de "armazenamento" (ST-com, 150 dias/37º e sem). Após o tratamento superficial, foram construídos cinco cilindros (Ø=2mm; h=2,0mm) de cimento resinoso (n=15) em cada bloco cerâmico; ao final foi realizado o ensaio de resistência ao cisalhamento (1mm/min, 50Kgf) e análise de falhas superficiais. Foram confeccionadas 60 amostras adicionais (2x2x2mm) para análises extras (rugosidade superficial, MEV e EDS). Os dados de resistência de união e rugosidade superficial foram avaliados estatisticamente por ANOVA (2 fatores/1fator), teste de Tukey (5%) e análise de Weibull, respectivamente. ANOVA (2 fatores) revelou que todos os fatores foram estatisticamente significativos para a resistência de união. Os grupos de silicatização (SiST: 30,47AMPa; Si: 29,21AMPa) apresentaram os maiores valores de resistência de união, independente do armazenamento (Tukey). Enquanto os grupos tratados com Zirlink (ZST: 2,76FMPa; Z: 5,27EFMPa) apresentaram os valores mais baixos, apenas semelhantes ao grupo GlST (5,14EFMPa). O módulo de Weibull (m) apresentou diferença estatística entre os grupos (p=0,000). A ANOVA (1 fator) revelou que o fator "tratamento superficial" (p=0,0000) foi estatisticamente significativo para rugosidade superficial. Portanto, a aplicação de Zirlink e do Glaze na zircônia pré-sinterizada não promoveu adesão eficiente da zircônia ultratranslúcida ao cimento resinoso, mesmo quando associada a primer contendo MDP.

Effect of Ceramic Thickness on the Bond Strength to Resin-Luting Agents before and after Thermal Cycling

Abstract This study investigated microshear bond strength (µSBS) of two (2) dual-cured resin-luting agents (RelyX™ Ultimate and RelyX™ U200) when photoactivated through varying thicknesses of lithium disilicate, with or without thermal cycling. Discs of IPS e.max Press of 0.5, 1.5, and 2 mm in thickness were obtained. Elastomer molds (3.0 mm in thickness) with four cylinder-shaped orifices 1.0 mm in diameter, were placed onto the ceramic surfaces and filled with resin-luting agents. A Mylar strip, glass plate, and load of 250 grams were placed over the filled mold. The load was removed and the resin-luting agents were photoactivated through the ceramics using a single-peak LED (Radii Plus.) All samples were stored in distilled water at 37oC for 24 h. Half of the samples were subjected to thermal cycling (3,000 cycles; 5ºC and 55ºC). All samples were then submitted to µSBS test using a universal testing machine (Instron 4411) at a crosshead speed of 0.5 mm/min. Data were submitted to three-way ANOVA and Tukey post-hoc test (α=0.05). The mean µSBS at 24 h was significantly higher than after thermal cycling (p<0.05). No statistical difference was found between resin-luting agents (p > 0.05). The mean µSBS for groups photoactivated through 0.5 mm ceramic were significantly higher than 1.5 mm and 2.0 mm (p < 0.05). In conclusion, increased ceramic thicknesses reduced the bond strength of tested resin-luting agents to lithium disilicate. No differences were found between resin-luting agents. Thermal cycling reduced the bond strength of both resin-luting agents.

Resumo: Este estudo investigou a resistência de união ao microcisalhamento (RUµC) de dois (2) agentes de cimentação de resina dual (RelyX™ Ultimate e RelyX™ U200) quando fotoativados através de diferentes espessuras de dissilicato de lítio, com ou sem ciclagem térmica. Discos do IPS e.max Press de 0,5, 1,5 e 2 mm de espessura foram obtidos. Moldes de elastômero (3,0 mm de espessura) com quatro orifícios cilíndricos de 1,0 mm de diâmetro foram colocados sobre as superfícies cerâmicas e preenchidos com agentes de cimentação de resina. Uma tira Mylar, placa de vidro e carga de 250 gramas foram colocadas sobre o molde preenchido. A carga foi removida e os agentes de cimentação resinosos foram fotoativados através da cerâmica usando um LED de pico-único (Radii Plus). Todas as amostras foram armazenadas em água deionizada a 37oC por 24 h. Metade das amostras foi submetida a ciclagem térmica (3.000 ciclos; 5ºC e 55ºC). Todas as amostras foram então submetidas ao teste de RUµC usando uma máquina de teste universal (Instron 4411) com velocidade de 0,5 mm/min. Os dados foram submetidos à Análise de Variância três fatores e ao teste post-hoc de Tukey (α = 0,05). A média de RUµC em 24 h foi significativamente maior do que após a ciclagem térmica (p < 0,05). Não houve diferença estatística entre os cimentos resinosos (p > 0,05). As médias de RUµC para grupos fotoativados através de cerâmica de 0,5 mm foram significativamente maiores do que 1,5 mm e 2,0 mm (p < 0,05). Em conclusão, o aumento da espessura da cerâmica reduziu a resistência de união dos agentes de cimentação resinosos ao dissilicato de lítio. Não foram encontradas diferenças entre os agentes de cimentação resinosos. A ciclagem térmica reduziu a resistência de união de ambos os agentes de cimentação resinosos.

Surface treatments of the zirconia-reinforced lithium disilicate ceramic in the adhesion to the resin cement

Abstract This study verified the effect of surface treatments of the zirconia-reinforced lithium disilicate ceramic bonded to resin cement. Ceramic blocks were divided according to treatments (n=10): FA+SRX (Fluoric acid + silane RX), FA+MDP (Fluoric acid + MDP), FA+SCF+MDP (Fluoric acid + silane CF + MDP), FA+MEP (Fluoric acid + MEP), and MEP (Self-etch primer). Resin cement cylinders were made in the ceramic blocks, photoactivated with 1,200 mW/cm² for 40s, stored in water at 37°C for 24h, and evaluated by the microshear strength test, optical failure descriptive analysis (%), surface characterization (SEM) and contact angle (Goniometer). Other samples were submitted to 10,000 thermocycles between 5°C and 55°C. Bond strength data were submitted to two-way ANOVA and Tukey's test. Contact angle to one-way ANOVA and Games-Howell's test (5%). At 24h, MEP showed higher bond strength, and FA+SRX the lower. FA+MDP and FA+SCF+MDP showed similar values and FA+MEP was intermediate. After thermocycling, FA+SCF+MDP, FA+MEP, and MEP showed higher values, and FA+SRX the lower while FA+MDP was intermediate. When the periods were compared, FA+MDP, FA+SCF+MDP, FA+MEP, and MEP showed higher values for 24h while FA+SRX was similar. SEM showed retentive surface and crystal exposure when treated with FA+SCF+MDP. The less retentive surface was obtained with MEP, and the other treatments promoted intermediate irregularities. In conclusion, surface treatment and thermocycling promoted different values of adhesive strength and contact angle in a zirconia-reinforced lithium silicate ceramic. Failures were predominantly adhesive, and the ceramic surface was characterized by different levels of roughness and selective exposure of crystals.

Resumo O objetivo neste estudo foi verificar o efeito de tratamentos de superfície da cerâmica de dissilicato de lítio reforçada com zircônia fixada ao cimento resinoso. Os blocos cerâmicos foram separados de acordo com os tratamentos (n=10): AF+SRX (ácido fluorídrico + silano), AF+MDP (ácido fluorídrico + MDP), AF+SCF+MDP (ácido fluorídrico + silano + MDP), AF+MEP (Ácido fluorídrico + MEP) e MEP (Primer auto condicionante). Cilindros de cimento resinoso foram confeccionados em cada bloco cerâmico, foto ativados com 1.200 mW/cm² por 40 segundos, armazenados em água a 37°C por 24 horas e avaliados pelo teste de resistência ao micro cisalhamento, falha por análise descritiva em microscopia óptica (%), caracterização da superfície por imagens MEV e ângulo de contato (Goniômetro). Outras amostras foram submetidas a 10.000 ciclos térmicos (5° e 55°C). Os dados de resistência de união foram submetidos a ANOVA dois fatores e teste de Tukey (5%). Ângulo de contato com ANOVA um fator e teste de Games-Howell (5%). Em 24 horas, MEP apresentou maior resistência de união e AF+S a menor. AF+MDP e AF+SCF+MDP apresentaram valores similares e AF+MEP foi intermediário. Após a ciclagem térmica, AF+SCF+MDP, AF+MEP e MEP apresentaram valores maiores e AF+SRX o menor enquanto AF+MDP foi intermediário. Quando comparados os períodos, AF+MDP, AF+SCF+MDP, AF+MEP e MEP apresentaram valores maiores em 24 horas enquanto AF+SRX foi similar. MEV mostrou superfície mais retentiva e exposição de cristais quando tratada com AF+SCF+MDP. A superfície menos retentiva foi obtida com MEP, e os demais tratamentos promoveram irregularidades de superfície intermediárias. Conclui-se que o tratamento superficial e a termociclagem promoveram diferentes valores de resistência adesiva e ângulo de contato em cerâmica de silicato de lítio reforçada com zircônia. As falhas foram predominantemente adesivas, e a superfície cerâmica foi caracterizada com diferentes níveis de rugosidade e exposição seletiva de cristais.

Correlation between low handgrip strength and metabolic syndrome in older adults: a systematic review

ABSTRACT Muscle weakness has been associated to insulin resistance and metabolic syndrome in the general population. However, it is still unclear whether this association is maintained in older adults. This study investigated correlations between low handgrip strength (HGS) and metabolic syndrome, or some of its components, in older adults through a systematic review of the literature. Searches were conducted in the Virtual Health Library Regional Portal, Scopus, Cochrane, Embase, MEDLINE/PubMed, SciELO, and Web of Science databases for relevant studies investigating muscle weakness (measured by hand dynamometer) and metabolic syndrome or its components in older adult populations, published up to September 2023. From the 2050 references initially identified, 20 studies, comprising a total of 31,264 older adults of both genders, completely met the inclusion/exclusion criteria. Eighteen studies showed that lower HGS was associated with metabolic syndrome or some of its risk factors, such as abdominal obesity, hyperglycemia, insulin resistance, dyslipidemia, or high blood pressure. Two studies found that older men with high blood pressure had increased HGS. Most studies included in this systematic review revealed a significant correlation between reduced HGS and metabolic syndrome or some of its components, especially abdominal obesity and insulin resistance. We conclude that below-average HGS can be associated with metabolic syndrome in older adults.

Insertion torque, flexural strength and surface alterations of stainless steel and titanium alloy orthodontic mini-implants: an in vitro study

ABSTRACT Objective: This study aimed to compare the insertion torque (IT), flexural strength (FS) and surface alterations between stainless steel (SS-MIs) and titanium alloy (Ti-MIs) orthodontic mini-implants. Methods: Twenty-four MIs (2 x 10 mm; SS-MIs, n = 12; Ti-MIs, n = 12) were inserted on artificial bone blocks of 20 lb/ft3 (20 PCF) and 40 lb/ft3 (40 PCF) density. The maximum IT was recorded using a digital torque meter. FS was evaluated at 2, 3 and 4 mm-deflection. Surface topography and chemical composition of MIs were assessed by scanning electron microscopy (SEM) and energy dispersive X-ray spectroscopy (EDS). General linear and mixed models were used to assess the effect of the MI type, bone density and deflection on the evaluated outcomes. Results: The IT of Ti-MIs was 1.1 Ncm greater than that obtained for the SS-MIs (p= 0.018). The IT for MIs inserted in 40 PCF test blocks was 5.4 Ncm greater than that for those inserted in 20 PCF test blocks (p < 0.001). SS-MIs inserted in higher density bone (40 PCF) had significantly higher flexural strength than the other groups, at 2 mm (98.7 ± 5.1 Ncm), 3 mm (112.0 ± 3.9 Ncm) and 4 mm (120.0 ± 3.4 Ncm) of deflection (p< 0.001). SEM evidenced fractures in the Ti-MIs. EDS revealed incorporation of 18% of C and 2.06% of O in the loaded SS-MIs, and 3.91% of C in the loaded Ti-MIs. Conclusions: Based on the findings of this in vitro study, it seems that SS-MIs offer sufficient stability and exhibit greater mechanical strength, compared to Ti-MIs when inserted into higher density bone.

RESUMO Objetivo: O objetivo deste estudo foi comparar o torque de inserção (TI), a resistência flexural (RF) e as alterações de superfície em mini-implantes ortodônticos de aço inoxidável (MIs-Ai) e de liga de titânio (MIs-Ti). Métodos: Vinte e quatro MIs (2 x 10 mm; MIs-Ai, n = 12; MIs-Ti, n = 12) foram inseridos em blocos de osso artificial de densidades de 20 lb/ft3 (20 PCF) e 40 lb/ft3 (40 PCF). O torque máximo de inserção foi registrado por meio de um torquímetro digital. A resistência flexural foi avaliada nas deflexões de 2, 3 e 4 mm. Topografia de superfície e composição química dos MIs foram avaliadas por Microscopia Eletrônica de Varredura (MEV) e Espectroscopia de Energia Dispersiva de Raios X (EDS). Modelos lineares gerais e mistos foram utilizados para avaliar o efeito do tipo de MI, da densidade óssea e da deflexão nos desfechos avaliados. Resultados: O TI dos MIs-Ti foi 1,1 Ncm maior do que o obtido para os MIs-Ai (P = 0,018). O TI para MIs inseridos em blocos de teste de 40 PCF foi 5,4 Ncm maior do que para aqueles inseridos em blocos de teste 20 PCF (p < 0,001). MIs-Ai inseridos em osso de maior densidade (40 PCF) apresentaram resistência flexural significativamente maior do que outros grupos, em deflexões de 2 mm (98,7 ± 5,1 Ncm), 3 mm (112,0 ± 3,9 Ncm) e 4 mm (120,0 ± 3,4 Ncm) (p < 0,001). A MEV evidenciou fraturas nos MIs-Ti. A EDS revelou incorporação de 18% de C e 2,06% de O nos MIs-Ai e 3,91% de C nos MIs-Ti, ambos submetidos a testes mecânicos. Conclusões: Com base nos resultados desse estudo in vitro, os MIs-Ai aparentam oferecer adequada estabilidade e maior resistência mecânica, em comparação aos MIs-Ti, quando inseridos em osso de maior densidade.