Resultados del aislamiento eléctrico de las venas pulmonares en pacientes menores y mayores de 70 años / Outcomes of pulmonary vein electrical isolation in patients younger than and older than 70 years

Resumen Introducción y objetivos: Comparar las características clínicas y los resultados de cohortes contemporáneas de pacientes menores y mayores de 70 años que han sido sometidos a ablación de fibrilación auricular (FA) mediante catéter. Métodos: Se llevó a cabo un estudio de cohortes retrospectivo en pacientes sometidos a ablación con catéter debido a la presencia de FA refractaria. Se realizó un seguimiento mínimo de 12 meses por paciente. Resultados: En el estudio se incluyeron un total de 239 pacientes sometidos a ablación de FA, de los cuales 171 (71,5%) pertenecían al grupo de edad < 70 años y 68 (28,5%) al grupo de edad > 70 años. La edad promedio de la población estudiada fue de 62,4 años (desviación estándar [DE] = 10,87). El grupo < 70 años presentó una edad promedio de 58,03 años (DE = 9,71), mientras que el grupo > 70 años tuvo una edad promedio de 73,4 años (DE = 3,05). Además, se observó una mayor prevalencia de FA paroxística en el grupo de pacientes menores de 70 años, mientras que en el grupo de pacientes mayores de 70 años se encontró una mayor prevalencia de FA persistente. Estas diferencias fueron estadísticamente significativas en ambos casos. Las tasas de recurrencia después del primer procedimiento de ablación fueron similares entre los dos grupos (21,43% en el grupo menor de 70 años frente a 23,53% en el grupo mayor de 70 años, p = 0,79). No se encontraron diferencias significativas en cuanto a complicaciones. El grupo menor de 70 años experimentó 18 complicaciones, mientras que el grupo mayor de 70 años tuvo 5 complicaciones, con un valor de p de 0,472. Conclusión: Los pacientes mayores de 70 años sometidos al primer procedimiento de ablación de FA por catéter presentan resultados clínicos similares a los pacientes menores de 70 años.

Abstract Introduction and objectives: The objective of this study is to compare the clinical characteristics and outcomes of contemporary cohorts of patients undergoing catheter ablation for atrial fibrillation (AF), stratified by age (< 70 years and ≥ 70 years). Methods: This retrospective cohort study included patients who underwent catheter ablation for refractory AF. The minimum follow-up duration per patient was 12 months. Results: A total of 239 patients were included in the study, with 171 (71.5%) in the < 70 years group and 68 (28.5%) in the ≥ 70 years group. The mean age of the study population was 62.4 years (SD 10.87). The < 70 years group had a mean age of 58.03 years (SD 9.71), while the ≥ 70 years group had a mean age of 73.4 years (SD 3.05). Furthermore, a higher proportion of paroxysmal AF was observed in patients < 70 years, whereas a higher proportion of persistent AF was found in patients ≥ 70 years. These differences were statistically significant. The recurrence rates after the initial ablation procedure were similar between the two groups (21.43% in the < 70 years group vs. 23.53% in the ≥ 70 years group, p = 0.79). Additionally, there were no significant differences in terms of complications. The < 70 years group experienced 18 complications, while the ≥ 70 years group had 5 complications (p = 0.472). Conclusion: The findings of this study suggest that patients aged 70 years and older who undergo their first catheter ablation procedure for AF demonstrate similar clinical outcomes compared to patients younger than 70 years.

Does the combination of resistance training and stretching increase cardiac overload?

OBJECTIVES: To compare the effects of combinations of resistance training (RT) and static stretching (SS) on heart rate (HR), systolic pressure (SBP), diastolic pressure (DBP), rate pressure product (RPP), oxygen saturation (SpO2), rating of perceived effort (RPE), and heart rate variability (HRV) in men. METHODS: Twelve normotensive healthy men participated in four protocols: a) SS+RT, b) RT+SS, c) RT, and d) SS. Variables were measured before, immediately after, and 15, 30, and 45 min after the sessions. RESULTS: The combination of SS and RT increased (p<0.001) HR when compared to the effects of the noncombined protocols (from 2.38 to 11.02%), and this result indicated metabolic compensation. Regarding DBP, there were differences (p<0.001) between the RT and SS groups (53.93±8.59 vs. 67.00±7.01 mmHg). SS has been shown to be able to reduce (p<0.001) SpO2 (4.67%) due to the occlusion caused by a reduction in the caliber of the blood vessels during SS compared to during rest. The increase in RPP (6.88% between RT and SS+RT) along with the HR results indicated higher metabolic stress than that reflected by the RPE (combined protocols increased RPE from 21.63 to 43.25%). The HRV analysis confirmed these results, showing increases (p<0.01) in the LF index between the combined and noncombined protocols. Compared to the effect of RT, the combination of SS and RT promoted a vagal suppression root mean square of the successive differences (RMSSD) index (from 9.51 to 21.52%) between the RT and SS+RT groups (p<0.01) and between the RT and RT+SS groups (p<0.001). CONCLUSION: Static stretching increases cardiac overload and RPE, reducing oxygen supply, especially when performed in combination with RT.

Acute effects of static versus proprioceptive neuromuscular facilitation stretching volume on the maximum number of repetitions and perceived exertion

Abstract AIMS The purpose of this study was to examine the acute effects between different volumes of static stretching (SS) and proprioceptive neuromuscular facilitation (PNF) stretching (30 and 60 seconds) on the maximum number of repetitions at 40 and 80% 1RM and rating of perceived exertion (RPE). METHODS Eleven recreationally-trained women (26.45 ± 5.27 years) performed ten experimental protocols using a repeated measures crossover design: (a) 30 s of SS followed by 40% of 1RM (SS1); (b) 60 s of SS followed by 40% of 1RM (SS2); (c) 30 s of SS followed by 80% of 1RM (SS3); (d) 60 s of SS followed by 80% of 1RM (SS4); (e) 30 s of PNF followed by 40% of 1RM (PNF1); (f) 60 s of PNF followed by 40% of 1RM (PNF2); (g) 30 s of PNF followed by 80% of 1RM (PNF3); (h) 60 s of PNF followed by 80% of 1RM (PNF4); (i) 40% of 1RM with no stretching (NS1); and (j) 80% of 1RM with no stretching (NS2). In both stretching protocols, shoulder girdle muscle exercises were performed. RESULTSStretching volume did not seem to significantly decrease the number of repetitions after a bench press session (p>0.05). However, RPE was greater for PNF2 (28.5±1.0; p=0.016) when compared with PNF1 (26.9±1.9). CONCLUSION Stretching volume does not seem to decrease the maximum number of repetitions after a bench press session; however, greater stretching volume appears to increase perception of effort in women when using PNF stretching of longer duration.

Acute effects of maximal isometric muscle action of the elbow extensors on contralateral dynamic task of the elbow flexors: a pilot study

Aim: the aim was to investigate the influence of a maximal isometric muscle action of the elbow extensors on the contralateral dynamic task of the elbow flexors. Methods Seventeen recreationally trained men (23.3 ± 4.9 yrs, BMI: 24.8 ± 2.2 Kg/m²) underwent two randomized different testing sessions separated by one week. In the control session (CON) all subjects performed a maximum number of repetitions test (RMs) at 75%1RM using the right elbow flexors. The experimental session (EXP) was similar to the CON; however, all subjects were instructed to perform RMs at 75%1RM by using the right elbow flexors and maintaining the maximal voluntary contraction of the left elbow extensors during the test. RMs, rating of perceived exertion (RPE), and training volume (TV) were measured and compared between sessions. Results: The EXP showed a significant 10.4% increase on the RMs (13.8 vs. 12.5, p < lt; 0.001, d = 0.44) and 12.1% increase in TV (238.0 vs. 212.4 kg, p >lt; 0.001, d = 0.43) than CON. No differences were observed for RPE between sessions. Conclusion: The maximum voluntary contraction of the left elbow extensors increased the RMs of the contralateral elbow flexors, reflecting a higher TV, and no differences in the RPE. Our results suggest that the investigated method may be a viable and practical alternative to increase the acute strength performance of elbow flexors when using submaximal loads.(AU)

A simple scoring system for predicting early major complications in spine surgery: the cumulative effect of age and size of surgery / Escore simples para predizer complicações precoces graves em cirurgia de coluna: o efeito cumulativo da idade e tamanho da cirurgia

ABSTRACT Objective To analyze the cumulative effect of risk factors associated with early major complications in postoperative spine surgery. Methods Retrospective analysis of 583 surgically-treated patients. Early “major” complications were defined as those that may lead to permanent detrimental effects or require further significant intervention. A balanced risk score was built using multiple logistic regression. Results Ninety-two early major complications occurred in 76 patients (13%). Age > 60 years and surgery of three or more levels proved to be significant independent risk factors in the multivariate analysis. The balanced scoring system was defined as: 0 points (no risk factor), 2 points (1 factor) or 4 points (2 factors). The incidence of early major complications in each category was 7% (0 points), 15% (2 points) and 29% (4 points) respectively. Conclusions This balanced scoring system, based on two risk factors, represents an important tool for both surgical indication and for patient counseling before surgery.

RESUMO Objetivo Analisar os efeitos cumulativos dos fatores de risco associados com complicações precoces graves relacionadas à cirurgia da coluna. Métodos Análise retrospectiva de 583 pacientes tratados cirurgicamente. Complicações graves foram definidas como as que pudessem levar a danos permanentes ou que necessitassem de reinterveção. Um escore foi construído usando modelo de regressão logística. Resultados Noventa e duas complicações precoces graves ocorreram em 76 pacientes (13%). Idade > 60 anos e cirurgia > 3 níveis foram identificadas como fatores de risco independentes na análise multivariada. O escore foi definido como: 0 pontos (nenhum fator de risco), 2 pontos (1 fator) ou 4 pontos (2 fatores). A incidência de complicação grave precoce em cada categoria foi 7% (0 pontos), 15% (2 pontos) e 29% (4 pontos). Conclusões Esse escore balanceado baseado em 2 fatores de risco representa uma ferramenta útil na indicação cirúrgica e para o aconselhamento dos pacientes antes da cirurgia.

Análise da ação do gel da Bryophyllum calycinum Salisb (folha santa) associado ao ultrassom na cicatrização de feridas cutâneas / Analysis of the action of Bryophyllum calycinum Salisb (holy sheet) gel associated with ultrasound in skin wound healing

Introdução: A cicatrização é uma cascata de eventos celulares que interagem para que ocorra a reconstituição do tecido. Objetivo: Analisar a ação do gel da Bryophyllum calycinum Salisb, associado ao ultrassom pulsado, na cicatrização de feridas. Métodos: Vinte ratos foram feridos, divididos em quatro grupos, tratados e observados diariamente. O Grupo1 não recebeu nenhum tratamento; o 2 foi tratado com ultrassom (modo pulsado 10%, frequência de 1 MHz, intensidade de 0,5 W/cm2, método de acoplamento direto com movimentos oscilatórios numa ERA de 1 cm2, durante dois minutos) + gel da B. calycinum Salisb a 2%; o 3, com gel da B. calycinum Salisb a 2%; o 4, com ultrassom. Resultados: O Grupo 2 teve maior redução das áreas feridas, diminuição do colágeno tipo III e aumento do tipo I, quando comparado ao controle. Conclusões: O gel da folha santa associado ao ultrassom é capaz de acelerar o processo de cicatrização tecidual.

Introduction: Healing is a cascade of cellular events that interact to occur replenish the tissue. Objective: To analyze the action of the Bryophyllum calycinum Salisb gel associated with the pulsed ultrasound in wound healing. Methods: Twenty rats were wounded and divided into four groups. After this, they were treated and observed daily. Group 1 did not receive any treatment; Group 2 was treated with ultrasound (10% pulsed mode, frequency of 1 MHz intensity of 0.5 W / cm2, direct coupling method with an oscillatory motion was 1 cm2 for two minutes) + Gel B. calycinum Salisb 2%; Group 3, with B. calycinum Salisb gel 2%; and Group 4, with ultrasound. Results: Group 2 had a greater reduction in wound areas, a decrease of type III collagen and an increase of the type I when compared to the control group. Conclusions: The gel of the holy sheet associated with ultrasound is able to accelerate the wound healing process.

Prevalência do polimorfismo C677T do gene MTHFR em uma população de idosos / Prevalence of MTHFR C677T polymorphism in an elderly population

Objetivo: determinar a prevalência do polimorfismo MTHFR C677T em uma amostra de 200 idosos da cidade de Parnaíba-PI e comparar suas freqüências genotípicas e alélicas com as observadas em outras populações. Método: a presença dopolimorfismo MTHFR C677T foi determinada pela técnica de reação em cadeia da polimerase seguida por tratamentocom a enzima de restrição HinfI (PCR-RFLP), acompanhado de eletroforese em gel de poliacrilamida 8%, corado comnitrato de prata. Resultados: dos 200 indivíduos estudados, 120 (60%) apresentaram genótipo homozigoto normal (CC);63 (31,5%) foram heterozigotos (CT) e 17 (8,5%) mostraram-se homozigotos TT. A frequência do alelo polimórfico T foide 23,4%. As frequências genotípicas mostraram-se sob equilíbrio de Hardy-Weinberg e não houve diferenças estatisticamentesignificantes quanto à distribuição do alelo T por sexo ou faixa etária. Conclusão: os resultados apresentadosneste estudo representam o primeiro relato indicativo da frequência deste polimorfismo em uma população piauiense. Afrequência do alelo T foi consideravelmente elevada (24,3%) comparada com a população geral e, portanto, estudos sãonecessários para investigar a contribuição desse polimorfismo na etiologia e/ou gravidade a determinadas doenças, nessapopulação.

Objective: to determine the prevalence of MTHFR C677T polymorphism in a sample of 200 elderly individuals fromParnaíba, Piauí, Brazil and to compare its genotypic and allelic frequencies with those observed in other populations.Method: the presence of MTHFR C677T polymorphism was evaluated by polymerase chain reaction followed by restrictionenzyme analysis with HinfI endonuclease (PCR-RFLP). After cleavage, the genotypes were evaluated by 8% silverstained polyacrylamide gel. Results: of the 200 individuals studied, 120 (60%) were homozygous normal (CC), 63 (31.5%) were heterozygous (CT) and 17 (8.5%) were homozygous TT. The frequency of the polymorphic allele T was23.4%. The genotypic frequencies were found to be in Hardy-Weinberg equilibrium and there was no statistically significantdifferences regarding the distribution of T-allele by sex or age. Conclusion: the results presented in this studyrepresent the first report of the MTHFR C677T polymorphism frequency in a population of Piauí. The T-allele frequencywas significantly higher (24.3%) compared to the general population and therefore studies are needed to investigate thecontribution of this polymorphism in the etiology and/or severity of certain diseases in this population