The beneficial effects of a water-based aerobic exercise session on the blood lipids of women with dyslipidemia are independent of their training status

OBJECTIVES: To evaluate the acute effects of a session of water-based aerobic exercise on the blood lipid levels of women with dyslipidemia and to compare these results according to their training status. METHOD: Fourteen premenopausal women with dyslipidemia, aged 40-50 years, participated in two water-based aerobic exercise sessions, the first when they were generally sedentary and the second after they were trained with a water-based aerobic training program for 12 weeks. Both experimental sessions were performed using the same protocol, lasted 45 min, and incorporated an interval method, alternating 3 min at a rating of perceived exertion (RPE) of 13 and 2 min at an RPE of 9. Total cholesterol (TC), triglycerides (TG), low-density lipoprotein (LDL), high-density lipoprotein (HDL), and lipoprotein lipase enzyme (LPL) were obtained through venous blood collection before and immediately after each session. A generalized estimating equation method and Bonferroni tests were conducted (with time and training status as factors) for statistical analyses. RESULTS: At enrollment, the mean age of the participants was 46.57 years (95% confidence interval [CI] 44.81−48.34). The statistical analyses showed a significant time effect for all variables (TC: p=0.008; TG: p=0.012; HDL: p<0.001; LPL: p<0.001) except for LDL (p=0.307). However, the training status effect was not significant for any variable (TC: p=0.527; TG: p=0.899; HDL: p=0.938; LDL: p=0.522; LPL: p=0.737). These results indicate that the TC and TG levels reduced and the HDL and LPL concentrations increased from pre- to post-session in similar magnitudes in both sedentary and trained women. CONCLUSIONS: A single water-based aerobic exercise session is sufficient and effective to beneficially modify the lipid profile of women with dyslipidemia, regardless of their training status.

Cirurgia videolaparoscópica nas doenças biliopancreáticas / Laparoscopic surgery in pancreatobiliary diseases

Com a experiência adquirida na cirurgia da vesícula biliar, a videocirurgia está sendo indicada cada vez mais em outras doenças. Decorridos 15 anos da primeira cirurgia, os autores avaliam os resultados e analisam as perspectivas deste procedimento nas doenças biliopancreáticas. Seguem a proposta que divide este procedimento em procedimentos de rotina, avaliação e desenvolvimento. Nas doenças da vesícula biliar, a colecistectomia laparoscópica é considerada padrão ouro, levando vantagem em todos os itens sobre a laparotômica, excluídas as lesões da via biliar e o vazamento biliar pelo coto cístico. Enfatizam situaçõesespeciais: da colecistite aguda, da colecistectomia durante a gravidez, da vesícula em porcelana e do câncerda vesícula. Comentam as perspectivas da videocirurgia nas complicações da colecistectomia laparoscópica. No tratamento da coledocolitíase, consideram o procedimento como em avaliação pela falta de ensaios clínicos prospectivos randomizados com grupo controle comparáveis e acompanhados por prazo de tempo maior. Nas doenças do pâncreas, a videocirurgia é um procedimento em desenvolvimento, com exceção da pancreatite aguda biliar não complicada, que se beneficia com a colecistectomia laparoscópica. O mesmoocorre com as cirurgias de derivação para desobstrução da via biliar. Embora factíveis dentro dos princípios da cirurgia convencional, faltam estudos comparativos com outras técnicas existentes analisando eficácia e efetividade.

With the acquired experience with laparoscopic cholecystectomy, videosurgery has been used more andmore for treatment of other diseases. Since the first surgery, nearly 15 years ago, the authors evaluate the outcome and the perspectives of this procedure in pancreatic-billiary diseases. They followed the proposition which divides these procedures in routine procedures, in evaluation and in development. In gallbladder diseases the laparoscopic cholecystectomy is considered gold-standard, taking advantage upon opencholecystectomy, excluding bile duct injury and cystic stump leakage. They emphasize the aspects related to acute cholecystitis, cholecystectomy during pregnancy, calcified gallbladder and cancer. The laparoscopic cholecystectomy during pregnancy is considered as a procedure in evaluation. Long term effects of pneumoperitonium on foetus are not well known. The approach in calcified gallbladder, because the high incidence of adenocarcinoma, remains questionable. Perspectives of videosurgery in complications of laparoscopic cholecystectomy are commented. Cystic stump leakage, misplaced clips and partial section or laceration of main biliary tract could be treated by new videosurgery in selected situations. In the treatment of choledocolithiasis, they consider the procedure as one for evaluation, due to the lack ofrandomized prospective trials. Until now, videocholedocolitotomy is reserved to specialized centers. Inpancreatic diseases, videosurgery is a procedure in development, except for the non-complicated acute biliary pancreatitis, in which benefits with laparoscopic cholecystectomy has been shown. The same occurs with diversion surgeries for desobstruction of the biliary tree. Although performed within the conventional surgery principles there is a lack of comparative studies with other techniques analysingefficacy and efficiency.