Quantitative relationship between physical activity and antihypertensives in elderly women / Relación cuantitativa entre actividad física y antihipertensivos en ancianas / Relação quantitativa entre atividade física e anti-hipertensivos em idosas

ABSTRACT Introduction: Physical activity is an important tool to manage systemic arterial hypertension. However, less is known about the relationship of physical activity with the number of antihypertensive drugs used by older adults. Objective: The aim of this study was to compare the number of antihypertensive drugs used by older female adults (aged ≥ 60 years) with a low level of physical activity with the number used by those with a high level of physical activity, and to verify how many participants used more than two antihypertensive drugs. Methods: Twenty-eight physically active older women with systemic arterial hypertension who participated in a physical activity program for community-dwelling older female adults were divided into two groups: participants who presented lower habitual physical activity levels were placed in group 1 and participants that presented higher habitual physical activity levels were placed in group 2, according to the Baecke questionnaire. In addition, the number of antihypertensive drugs used by participants was collected. Results: The number of prescribed antihypertensive drugs was 2.0 (median) for both groups investigated. There was no significant difference between groups regarding the number of antihypertensive tablets prescribed (p>0.05). Although there was no statistical difference, a higher proportion of participants from the lower physical activity group used more than two antihypertensive drugs. Conclusion: The level of habitual physical activity did not affect the number of antihypertensive tablets used by hypertensive elderly women. Level of evidence II; Therapeutic studies - investigation of treatment results.

RESUMEN Introducción: La actividad física es una herramienta importante para el manejo de la hipertensión arterial sistémica. Sin embargo, se sabe poco sobre la relación de la actividad física con la cantidad de medicamentos antihipertensivos utilizados por las ancianas. Objetivo: El objetivo de este estudio fue hacer una comparación entre el número de medicamentos antihipertensivos utilizados por mujeres adultas mayores (≥ 60 años) y bajo nivel de actividad física con el número utilizado por aquellas con alto nivel de actividad física, y verificar cuántas de las participantes usaron más de dos medicamentos antihipertensivos. Métodos: Veintiocho ancianas físicamente activas con hipertensión arterial sistémica que participaron en un programa de actividad física para mujeres adultas mayores residentes en la comunidad fueran divididas en dos grupos: las participantes que presentaron niveles más bajos de actividad física habitual se ubicaron en el grupo 1 y las participantes que presentaron los mayores niveles de actividad física se ubicaron en el grupo 2, según el cuestionario de Baecke. Además, se recogió el número de medicamentos antihipertensivos utilizados por las participantes. Resultados: El número de comprimidos antihipertensivos prescritos fue de 2,0 (mediana) para ambos grupos investigados. No hubo diferencia significativa entre los grupos en cuanto al número de medicamentos antihipertensivos prescritos (p>0,05). Aunque no hubo diferencia estadística, una mayor proporción de participantes del grupo de menor actividad física usó más de dos medicamentos antihipertensivos. Conclusión: El nivel de actividad física habitual no afectó el número de comprimidos antihipertensivos utilizados por las ancianas hipertensas. Nivel de evidencia II; Estudios terapéuticos: investigación de los resultados del tratamiento.

RESUMO Introdução: A atividade física é uma importante ferramenta no manejo da hipertensão arterial sistêmica. No entanto, pouco se sabe sobre a relação entre a atividade física e a quantidade de anti-hipertensivos usados por idosos. Objetivo: O objetivo deste estudo foi realizar uma comparação entre o número de anti-hipertensivos usados por idosas (≥ 60 anos) com baixo nível de atividade física com o número usado por aquelas com alto nível de atividade física, verificando quantas participantes usaram mais de dois anti-hipertensivos. Métodos: Vinte e oito idosas fisicamente ativas com hipertensão arterial sistêmica que participavam de um programa de atividade física para idosas da comunidade foram divididas em dois grupos: as participantes que apresentaram níveis mais baixos de atividade física habitual foram colocadas no grupo 1 e as participantes que apresentaram maiores níveis de atividade física foram colocados no grupo 2, de acordo com o questionário de Baecke. Ademais, coletou-se o número de medicamentos anti-hipertensivos utilizados pelas participantes. Resultados: O número de fármacos anti-hipertensivos prescritos foi de 2,0 (mediana) para ambos os grupos investigados. Não houve diferença significativa entre os grupos quanto ao número de comprimidos anti-hipertensivos prescritos (p>0,05). Embora não tenha havido diferença estatística, uma maior proporção de participantes entre o grupo de menor atividade física utilizava mais de dois anti-hipertensivos. Conclusão: O nível de atividade física habitual não afetou a quantidade de comprimidos anti-hipertensivos utilizados pelas idosas hipertensas. Nível de evidência II; Estudos terapêuticos - Investigação dos resultados do tratamento.

Knowledge of healthcare professionals about poliomyelitis and postpoliomyelitis: a cross-sectional study

ABSTRACT BACKGROUND: Postpoliomyelitis syndrome is a clinical condition that can affect poliomyelitis survivors. OBJECTIVE: Our aim was to evaluate knowledge of poliomyelitis and postpoliomyelitis syndrome among Brazilian healthcare professionals. DESIGN AND SETTING: Cross-sectional study conducted at a Brazilian public higher education institution located in the state of Goiás. METHODS: The participants (n = 578) were Brazilian physicians, physical therapists, nurses, nutritionists and psychologists. A self-administered questionnaire (30 questions) was designed to probe knowledge about poliomyelitis and postpoliomyelitis syndrome. From the questionnaire, we created a structured test to objectively evaluate the knowledge of these professionals. The test was composed of 20 questions and was scored over a range from 0 (totally ill-informed) to 20 (totally well-informed). RESULTS: In general, the physicians, physical therapists and nurses demonstrated better understanding of poliomyelitis and postpoliomyelitis syndrome. The healthcare professionals who had received previous information about poliomyelitis and postpoliomyelitis syndrome had significantly higher scores than those who had never received information (P < 0.001). On average, this difference was approximately 28.6%. CONCLUSIONS: The findings from the present study indicate that there is a critical need for improvement of knowledge about postpoliomyelitis syndrome among Brazilian healthcare professionals. The services provided by these professionals may therefore become compromised. Furthermore, public healthcare initiatives should be implemented to improve knowledge among healthcare professionals.

Breve reseña del reflejo trigémino cardíaco / Trigeminocardiac Reflex: an Overview

RESUMEN El reflejo trigémino cardíaco es un reflejo único del tallo cerebral que se manifiesta como perturbaciones cardiorespiratorias, y ocurre principalmente en cirugías o intervenciones de la base del cráneo. Sin embargo, recientemente se lo ha vinculado a muchos procedimientos de neurocirugía e intervenciones neurológicas y condiciones no relacionadas a neurocirugía y no quirúrgicas. Este reflejo presenta muchas alteraciones cardiovasculares que pueden provocar complicaciones adversas, empeorar la evolución y producir problemas diagnósticos. Esta reseña intenta profundizar su definición, mecanismos, fisiopatología, manifestaciones, diagnóstico y manejo.

ABSTRACT Trigemino-cardiac reflex is a unique brain stem reflex that manifests as negative cardio-respiratory perturbations. This reflex is largely reported in skull base surgeries/interventions; however, in recent times, it has been also linked with many neurosurgical, neurointerventional procedures, non-neurosurgical and non-surgical conditions. This reflex presents with many cardiovascular changes that can create catastrophic complications, worse outcome as well as diagnostic dilemmas. Therefore, this narrative review intends to elaborate on its mechanisms, definition, pathophysiology, manifestations, diagnosis and management.

Runners in their forties dominate ultra-marathons from 50 to 3,100 miles

OBJECTIVES: This study investigated performance trends and the age of peak running speed in ultra-marathons from 50 to 3,100 miles. METHODS: The running speed and age of the fastest competitors in 50-, 100-, 200-, 1,000- and 3,100-mile events held worldwide from 1971 to 2012 were analyzed using single- and multi-level regression analyses. RESULTS: The number of events and competitors increased exponentially in 50- and 100-mile events. For the annual fastest runners, women improved in 50-mile events, but not men. In 100-mile events, both women and men improved their performance. In 1,000-mile events, men became slower. For the annual top ten runners, women improved in 50- and 100-mile events, whereas the performance of men remained unchanged in 50- and 3,100-mile events but improved in 100-mile events. The age of the annual fastest runners was approximately 35 years for both women and men in 50-mile events and approximately 35 years for women in 100-mile events. For men, the age of the annual fastest runners in 100-mile events was higher at 38 years. For the annual fastest runners of 1,000-mile events, the women were approximately 43 years of age, whereas for men, the age increased to 48 years of age. For the annual fastest runners of 3,100-mile events, the age in women decreased to 35 years and was approximately 39 years in men. CONCLUSION: The running speed of the fastest competitors increased for both women and men in 100-mile events but only for women in 50-mile events. The age of peak running speed increased in men with increasing race distance to approximately 45 years in 1,000-mile events, whereas it decreased to approximately 39 years in 3,100-mile events. In women, the upper age of peak running speed increased to approximately 51 years in 3,100-mile events. .

Sex differences in 24-hour ultra-marathon performance - A retrospective data analysis from 1977 to 2012

OBJECTIVES: This study examined the changes in running performance and the sex differences between women and men in 24-hour ultra-marathons held worldwide from 1977 to 2012. METHOD: Changes in running speed and ages of the fastest 24-hour ultra-marathoners were determined using single- and multi-level regression analyses. RESULTS: From 1977 to 2012, the sex differences in 24-hour ultra-marathon performance were 4.6±0.5% for all women and men, 13.3% for the annual fastest finishers, 12.9±0.8% for the top 10 and 12.2±0.4% for the top 100 finishers. Over time, the sex differences decreased for the annual fastest finishers to 17%, for the annual 10 fastest finishers to 11.3±2.2% and for the annual 100 fastest finishers to 14.2±1.8%. For the annual fastest men, the age of peak running speed increased from 23 years (1977) to 53 years (2012). For the annual 10 and 100 fastest men, the ages of peak running speed were unchanged at 40.9±2.5 and 44.4±1.1 years, respectively. For women, the ages of the annual fastest, the annual 10 fastest and the annual 100 fastest remained unchanged at 43.0±6.1, 43.2±2.6 and 43.8±0.8 years, respectively. CONCLUSION: The gap between the annual top, annual top 10 and annual top 100 female and male 24-hour ultra-marathoners decreased over the last 35 years; however, it seems unlikely that women will outrun men in 24-hour ultra-marathons in the near future. The fastest 24-hour ultra-marathoners worldwide achieved their peak performance at the age of master athletes (>35 years). .

Analysis of performance and age of the fastest 100-mile ultra-marathoners worldwide

OBJECTIVES: The performance and age of peak ultra-endurance performance have been investigated in single races and single race series but not using worldwide participation data. The purpose of this study was to examine the changes in running performance and the age of peak running performance of the best 100-mile ultra-marathoners worldwide. METHOD: The race times and ages of the annual ten fastest women and men were analyzed among a total of 35,956 finishes (6,862 for women and 29,094 for men) competing between 1998 and 2011 in 100-mile ultra-marathons. RESULTS: The annual top ten performances improved by 13.7% from 1,132±61.8 min in 1998 to 977.6±77.1 min in 2011 for women and by 14.5% from 959.2±36.4 min in 1998 to 820.6±25.7 min in 2011 for men. The mean ages of the annual top ten fastest runners were 39.2±6.2 years for women and 37.2±6.1 years for men. The age of peak running performance was not different between women and men (p>0.05) and showed no changes across the years. CONCLUSION: These findings indicated that the fastest female and male 100-mile ultra-marathoners improved their race time by ∼14% across the 1998-2011 period at an age when they had to be classified as master athletes. Future studies should analyze longer running distances (>200 km) to investigate whether the age of peak performance increases with increased distance in ultra-marathon running. .

Predictor variables for half marathon race time in recreational female runners

INTRODUCTION: The relationship between skin-fold thickness and running performance has been investigated from 100 m to the marathon distance, except the half marathon distance. OBJECTIVE: To investigate whether anthropometry characteristics or training practices were related to race time in 42 recreational female half marathoners to determine the predictor variables of half-marathon race time and to inform future novice female half marathoners. METHODS: Observational field study at the 'Half Marathon Basel' in Switzerland. RESULTS: In the bivariate analysis, body mass (r = 0.60), body mass index (r = 0.48), body fat (r = 0.56), skin-fold at pectoral (r = 0.61), mid-axilla (r = 0.69), triceps (r = 0.49), subscapular (r = 0.61), abdominal (r = 0.59), suprailiac (r = 0.55) medial calf (r = 0.53) site, and speed of the training sessions (r = -0.68) correlated to race time. Mid-axilla skin-fold (p = 0.04) and speed of the training sessions (p = 0.0001) remained significant after multi-variate analysis. Race time in a half marathon might be predicted by the following equation (r² = 0.71): Race time (min) = 166.7 + 1.7x (mid-axilla skin-fold, mm) - 6.4x (speed in training, km/h). Running speed during training was related to skinfold thickness at mid-axilla (r = -0.31), subscapular (r = -0.38), abdominal (r = -0.44), suprailiacal (r = -0.41), the sum of eight skin-folds (r = -0.36) and percent body fat (r = -0.31). CONCLUSION: Anthropometric and training variables were related to half-marathon race time in recreational female runners. Skin-fold thicknesses at various upper body locations were related to training intensity. High running speed in training appears to be important for fast half-marathon race times and may reduce upper body skin-fold thicknesses in recreational female half marathoners.