The Impact of Exercise on Interleukin-6 to Counteract Immunosenescence: Methodological Quality and Overview of Systematic Reviews.

OBJECTIVE: This study evaluated the methodological quality of published systematic reviews on randomized and non-randomized clinical trials to synthesize evidence on the association between IL-6, immunosenescence, and aerobic and/or resistance exercise. METHOD: The Preferred Reporting Items for Overviews of Systematic Reviews (PRIO-harms) guideline was used, with registration number CRD42022346142-PROSPERO. Relevant databases such as Cochrane Library, PubMed, Web of Science, Scopus, and Google Scholar were searched using English Medical Subject Headings terms. Inclusion criteria were systematic reviews analyzing aerobic exercise, resistance exercise, or a combination of both and assessing IL-6 as a biomarker of cellular immunosenescence in humans. The Measurement Tool to Assess Systematic Reviews 2 (AMSTAR-2) was employed. RESULTS: Out of 742 identified articles, 18 were eligible, and 13 were selected for analysis. Sample sizes ranged from 249 to 1421 participants, mostly female, with ages ranging from 17 to 95 years. Aerobic exercise was the most studied type (46.15%), followed by combined exercise (38.46%) and resistance exercise (15.38%). Aerobic exercise showed a statistically significant reduction in IL-6, C-reactive protein (CRP), and tumor necrosis factor-alpha (TNF-α) levels. Among the 13 reviews analyzed using AMSTAR-2, 8 were rated as critically low quality, and 5 were classified as low quality. CONCLUSION: Aerobic exercise has anti-inflammatory properties and the potential to modulate IL-6, CRP, and TNF-α levels in immunosenescence. However, the limited methodological quality of the analyzed systematic reviews highlights the urgent need for robust, high-quality studies to improve access to information and facilitate evidence-based decision-making in healthcare.

MPOX, o que sabemos sobre propagação e controle: uma revisão integrativa / MPOX, what we know about propagation and control: an integrative review / Viruela del mono, qué sabemos sobre la propagación y el control: una revisión integradora

Esta é uma revisão integrativa que busca compreender os fatores associados à propagação e controle de mpox, seguindo as recomendações estabelecidas pela declaração Preferred Reporting Items for Systematic Reviews and Meta-Analyses. A consulta foi feita nas bases de dados PubMed, Lilacs e Cochrane Library. Foram selecionados quinze artigos, com amostra majoritária de homens que fazem sexo sem proteção com homens e homens que viajaram para locais com surto da doença ou tiveram contato com pessoas infectadas. Os principais fatores associados à infecção e à propagação da doença foram históricos de viagem, sexo desprotegido, ingestão de carne possivelmente contaminada, aglomerados e contato próximo com pessoa sintomática. Quanto aos fatores relacionados à prevenção, estão principalmente associados à triagem de casos suspeitos, hábitos de higiene pessoal, uso de equipamentos de proteção individual e isolamento do doente.

This integrative review examines the factors associated with mpox spread and control, following the recommendations established by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Bibliographic search was conducted on the PubMed, Lilacs and Cochrane Library databases. The final sample included 15 articles, mostly composed of men who have unprotected sex with men and men who traveled to places with a mpox outbreak or had contact with infected people. Travel history, unprotected sex, eating potentially contaminated meat, crowding and close contact with a symptomatic person were the main factors associated with mpox infection and spread. Prevention is mainly associated with the screening of suspected cases, personal hygiene habits, use of personal protective equipment and patient isolation.

Este estudio realiza una revisión integradora para comprender los factores asociados con la propagación y el control de la viruela del mono, siguiendo las recomendaciones establecidas por Preferred Reporting Items for Systematic Reviews and Meta-Analyses. Se consultaron las bases de datos PubMed, Lilacs y Cochrane Library. Se seleccionaron quince artículos, con una muestra mayoritaria de hombres que tienen sexo con hombres sin protección y hombres que viajaron a lugares con brote de la enfermedad o que tuvieron contacto con personas infectadas. Los principales factores asociados con la infección y la propagación de la enfermedad fueron el historial de viajes, las relaciones sexuales sin protección, el consumo de carne potencialmente contaminada, el hacinamiento y el contacto cercano con una persona sintomática. Los factores relacionados con la prevención están asociados principalmente con el tamizaje de casos sospechosos, los hábitos de higiene personal, el uso de equipos de protección personal y el aislamiento del paciente.

MicroRNA as potential biomarker for severity, progression, and therapeutic monitoring in animal models of limb-girdle muscular dystrophy: a systematic review.

Limb-girdle muscular dystrophies (LGMD) constitute a heterogeneous group of neuromuscular disorders in which there are alterations in proteins responsible for the preservation of muscle architecture and function, leading to proximal and progressive muscle weakness. There is, however, significant phenotypic and genotypic variation, as well as difficulty in establishing biomarkers that help to define pathogenic mechanisms and assess disease severity and progression. In this field, there is special attention to microRNAs, small non-coding RNA molecules related to the regulation of gene expression and, consequently, the production of proteins. Thus, this research aimed to verify the correlation between the expression of microRNAs and the severity, progression, and therapeutic response of LGMD animal models. A search was carried out in the PubMed, Embase, Scopus, ScienceDirect, Cochrane, and SciELO databases, with articles in English and without a time limit. The PRISMA 2020 checklist was used, and the protocol of this review was submitted to PROSPERO. The bibliographic survey of the 434 records found that 5 original articles met the inclusion criteria. The studies explored myomicroRNAs or miRNA panels with gene expression analysis. The analysis demonstrates that miR-1, 133a, and 206 are differentially expressed in serum and muscle. They change according to the degree of inflammation, fibrosis, muscle regeneration, and progression of the dystrophic process. MicroRNAs are up-regulated in dystrophic muscles, which are reversed after treatment in a dose-dependent manner. The present study inferred that miRs are essential in severity, progression, and therapeutic response in LGMD models and may be a useful biomarker in clinical research and prognosis. However, the practical application of these findings should be further explored.

Impact of Exercise Interventions on Sustained Brain Health Outcomes in Frail Older Individuals: A Comprehensive Review of Systematic Reviews.

Several systematic review studies highlight exercise's positive impact on brain health outcomes for frail individuals. This study adopts a Comprehensive Review of reviews (CRs) approach to amalgamate data from existing reviews, focusing on exercise's influence on brain health outcomes in older frail and pre-frail adults. The methodology involves a thorough search of Portuguese, Spanish, and English-indexed databases (i.e., Ebsco Health, Scielo, ERIC, LILACS, Medline, Web of Science, SportDiscus) from 1990 to 2022, with the AMSTAR-2 tool assessing evidence robustness. The search terms "physical exercise", "elderly frail", and "systematic review" were employed. Results: Out of 12 systematically reviewed studies, four presented high-quality (with metanalyses), while eight exhibit critically low quality. Positive trends emerge in specific cognitive and neuromotor aspects, yet challenges persist in psychosocial domains, complex cognitive tasks, and ADL outcomes. This study yields reasonable and promising evidence regarding exercise's influence on quality of life and depression in frail older individuals. However, the impact on biochemical markers remains inconclusive, emphasizing the need for standardized methodologies. Conclusions: The findings highlight the importance of acknowledging methodological nuances for clinicians and policymakers when translating these results into impactful interventions for aging populations. This emphasizes the necessity for a comprehensive and customized approach to exercise interventions aimed at fostering the sustainability of overall well-being in older individuals, aligning with United Nations Sustainable Development Goal 3.

Mpox: Aspectos epidemiológicos, imunopatogênicos e manejo pré e pós-infecção / Mpox: Epidemiological, immunopathogenic aspects and pre- and post-infection management

Mpoxou Varíola M é uma zoonose causada por vírus do gênero Orthopoxvirus, causadores também da varíola comum. É uma doença considerada rara e autolimitada, sendo endêmica em países africanos. Entretanto, no ano de 2022 ganhou destaque devido ao surto global que se iniciou, quando o mundo ainda se recuperava da pandemia da COVID-19. Dessa forma, por se tratar de uma doença emergente, a presente revisão visa pontuar aspectos gerais do que se sabe até o momento sobre a Mpox, desde sua imunopatogenia até as formas atuais de prevenção e cuidados pós-infecção

Mpox or Variola M is a zoonosis caused by viruses of the genus Orthopoxvirus, which also cause smallpox. It is a disease considered rare and self-limiting, being endemic in African countries. However, in 2022, it gained prominence due to the global outbreak that began when the world was still recovering from the COVID-19 pandemic. Thus, as it is an emerging disease, this review aims to point out general aspects of what is known so far about Mpox, from its immunopathogenesis to current forms of prevention and post-infection care

Effectiveness of a diabetes educational intervention at primary school.

Background: Brazil ranks fifth in the world in the number of adults with diabetes, and third for type 1 diabetes. Conducting educational actions on this topic in public schools in this country is extremely important, since it can assist in the early adoption of good life habits and in a better care for students in this condition. Objective: The aim of this study was to assess the effectiveness of an educational intervention about diabetes for students and school staff. Methods: This is an interventional non-randomized longitudinal study, in which interviews were conducted before and after a playful intervention with the use of theater play and games for students and plus a training for the school staff. Results: A total of 89 participants completed the study, being 73 students aged 7 to 12 years old, and 16 school staff. As a result, there was a positive change in knowledge and perception of diabetes by the students. The greatest changes in the answers among the participants, at the post-intervention period, were related to the possibility of consuming something with sugar by those with diabetes, and particularly how to cope in hypoglycemia situations by the school staff. Conclusions: Actions like these must be encouraged within the school environment, especially in countries with high prevalence of diabetes.

Behavior changes in children/adolescents with attention deficit hyperactivity disorder during the COVID-19 pandemic: a systematic review / Mudanças comportamentais em crianças/adolescentes com transtorno de déficit de atenção e hiperatividade durante a pandemia de COVID-19: uma revisão sistemática

Abstract Objectives: to describe behavioral changes related to mental health in children and adolescents with Attention Deficit Hyperactivity Disorder during social isolation due to the COVID-19 pandemic. Methods: this is a systematic review conducted under the PRISMA protocol (2020) in the PubMed, SciELO and VHL databases, with a period of 2019-2022. Results: 3,735 studies were screened and ten were selected, according to the eligibility criteria. The sample had 4,688 participants. There was evidence of a worsening of signs and symptoms regarding the mental health of this population, expressed mainly through changes in mood, with increased anxiety, sadness or depressed symptoms, in addition to increased hyperactivity. Behavioral changes also included reduced sleep quality and physical activity, and increased use of digital technologies and screen time. Conclusions: it was described that children and youth groups, especially those with attention deficit hyperactivity disorder, had increased emotional symptoms and conduct problems when compared to before the pandemic, making it possible to recognize the negative repercussions of the changes imposed by it. These factors are important for planning more effective care strategies.

Resumo Objetivos: descrever mudanças comportamentais, relacionadas à saúde mental, em crianças e adolescentes com Transtorno de Déficit de Atenção e Hiperatividade durante o isolamento social devido à pandemia da COVID-19. Métodos: trata-se de uma revisão sistemática conduzida sob protocolo PRISMA (2020) nas bases de dados PubMed, SciELO e BVS, com período de 2019-2022. Resultados: foram triados 3.735 estudos e selecionados dez, de acordo com os critérios de elegibilidade. A amostra contou com 4.688 participantes. Evidenciou-se um agravamento de sinais e sintomas quanto à saúde mental dessa população expresso principalmente através de mudanças no estado de humor, com aumento da ansiedade, tristeza ou sintoma deprimido, além do aumento da hiperatividade. As mudanças comportamentais incluíram ainda redução da qualidade do sono e da prática de atividades físicas e aumento do uso de tecnologias digitais e tempo de tela. Conclusões: foi descrito que os grupos infanto-juvenis, sobretudo com Transtorno de Déficit de Atenção e Hiperatividade, tinham sintomas emocionais e problemas de conduta aumentados quando comparados a antes da pandemia, sendo possível reconhecer as repercussões negativas das mudanças impostas por ela. Esses fatores são importantes para o planejamento de estratégias de cuidado mais efetivas.

(Des)conhecimento do diabetes nas escolas: percepção de crianças e adolescentes / (Un)Awareness of diabetes in schools: perception of children and adolescents

Resumo Objetivo: Verificar a percepção sobre o diabetes dos alunos de escolas públicas. Métodos: Estudo descritivo transversal, com entrevista aos alunos sobre diabetes (sinais e sintomas, alimentação e questões sobre o autocuidado no ambiente escolar), com análise de conteúdo para a questão aberta, expressa em número de ocorrências, e demais resultados em frequência, média e desvio padrão. Resultados: 302 estudantes, com 9,1±1,5 anos e 54% do sexo feminino. Termos associados a consequências negativas tiveram 91 ocorrências para "o que é diabetes". Para 95,4% dos entrevistados a pessoa com diabetes não pode comer doces, e para 32,8% o diabetes é transmitido de uma pessoa para outra. Apenas 34,8% afirmaram que o colega com diabetes pode participar de atividades físicas/recreativas, e 32,1% responderam que ele não poderia lanchar junto com os demais. Somente 29,2% dos entrevistados reconheceram que o colega com diabetes precisaria ter consigo algo com açúcar para momentos em que se sinta mal. Conclusões: Estes achados reforçam a necessidade de melhorar o conhecimento e a percepção dos estudantes sobre o diabetes no ambiente escolar, propiciando condições mais harmoniosas e seguras de manejo do diabetes nestes espaços.

Abstract Objective: To verify the students' perception about diabetes in public schools. Methods: Descriptive cross-sectional study, with students' interview to access their diabetes knowledge (signs and symptoms, food, and diabetes self-care at school). Content analysis was used for the open question, expressed by number of occurrences, and frequencies, means and standard deviations for the other results. Results: 302 students, with 9,1±1,5 years and 54% female. For "what is diabetes" there were 91 occurrences associated with negative consequences. For 95.4% of interviewees, people with diabetes cannot eat sweets, and for 32.8% diabetes is transmitted from person to person. Only 34.8% stated that the classmate with diabetes can participate in physical/recreational activities; and 32.1% replied that he/she could not have a snack with the others. Only 29.2% of the interviewees recognized that the classmate with diabetes would need to have something with sugar to eat/drink in case he/she feel bad. Conclusions: These results reinforce the need for action of diabetes education to improve students' knowledge and perception about diabetes in the school, as well as better management for students with this condition at that environment.

Enfoque bioético: produção do conhecimento em enfermagem no Brasil / Bioethical approach: production of nursing knowledge in Brazil / Enfoque bioético: producción de conocimiento en enfermería en Brasil

Resumo Este artigo busca contribuir para o processo de reflexão crítica sobre a produção do conhecimento em enfermagem com enfoque bioético em publicações brasileiras. Trata-se de revisão bibliográfica realizada por meio de buscas na SciELO utilizando os descritores "enfermagem", "bioética" e "ética", incluindo artigos publicados entre 1999 e 2019. Como resultado, identificaram-se 43 artigos e, após aplicar critérios de inclusão e exclusão, foram selecionados 16 trabalhos, cujos temas eram ensino da ética/bioética para o curso de enfermagem, seguido por terapia intensiva/ou terminalidade, doação de órgãos e atendimento/ação/cuidar em saúde. Verificou-se transição entre os temas emergentes considerando o contexto histórico no decorrer dos anos e o interesse da área.

Abstract This article seeks to contribute to critical reflections on the production of nursing knowledge with a bioethical focus in Brazilian publications. This is a literature review conducted by searching the SciELO platform using the descriptors "nursing," "bioethics" and "ethics," including articles published between 1999 and 2019. As a result, 43 articles were identified and, after applying inclusion and exclusion criteria, 16 were selected, approaching teaching ethics/bioethics for the nursing course, followed by intensive care/or terminality, organ donation and health care/action/care. A transition in the emerging themes was observed considering the historical context over the years and the interest in the area.

Resumen Este artículo pretende contribuir a la reflexión crítica sobre la producción de conocimiento en enfermería con enfoque bioético en las publicaciones brasileñas. Se trata de una revisión bibliográfica realizada en SciELO utilizando los descriptores "enfermagem", "bioética" y "ética" para artículos publicados entre 1999 y 2019. Los resultados identificaron 43 artículos y, después de aplicar los criterios de inclusión y exclusión, se seleccionaron 16 trabajos que abordaron temas como la enseñanza de la ética/bioética en la carrera de enfermería, los cuidados intensivos/fin de la vida, la donación de órganos y la atención/acción/cuidado en salud. Hubo una transición entre los temas emergentes considerando el contexto histórico a lo largo de los años y el interés del área.

Systematic review of circulating MICRORNAS as biomarkers of cervical carcinogenesis.

BACKGROUND: Cervical cancer is a preventable disease, but it is a major public health problem despite having a good prognosis when diagnosed early. Although the Pap smear has led to huge drops in rates of cervical cancer and death from the disease, it has some limitations, making new approaches necessary for early diagnosis and biomarkers discovery. MiRNAs have been considered a new class of non-invasive biomarkers and may have great clinical value for screening early-stage cervical intraepithelial neoplasia. Well-designed studies have emerged as a necessary strategy for the identification of miRNAs that could be used safely and reliably for a differential diagnosis. This review aims to provide an up-to-date perspective on the assessment of circulating miRNA expression from precursor lesions to cervical cancer, identifying circulating miRNAs or specific miRNA signatures that can be used as potential biomarkers of different stages of cervical carcinogenesis. METHODS: A systematic review was performed and searches were conducted in the PubMed, LILACS, and Scopus electronic databases. RESULTS: Most studies involved Chinese ethnic women and searched for circulating miRNAs in serum samples. Thirty three microRNAs were evaluated in the eligible studies and 17 (miR-196a, miR-16-2, miR-497, miR-1290, miR-425-5p, hsa-miR- 92a, miR-1266, miR-9, miR-192, miR-205, miR-21, miR-152, miR-15b, miR-34a, miR-218, miR-199a-5p and miR-155-5p) showed up-regulation in women with precursor lesion and cervical cancer and 16 microRNAs showed decreased expression in these same groups of women compared to healthy controls (miR-195, miR-2861, miR-145, miR-214, miR-34a, miR-200a, let-7d-3p, miR-30d-5p, miR-638, miR-203a-3p, miR-1914-5p, miR-521, miR-125b, miR-370, miR-218 and miR-100). CONCLUSION: Therefore, defining promising circulating miRNAs or specific miRNA signatures of biological fluid samples can be useful for the screening, diagnosis, prognosis and clinical monitoring of women undergoing cervical carcinogenesis, but greater standardization of studies seems to be necessary for greater consolidation of information.

The Role of miRNAs in the Prognosis of Triple-Negative Breast Cancer: A Systematic Review and Meta-Analysis.

Breast cancer is one of the most common malignancies among women around the world. The basal or triple-negative subtype (TNBC) is a heterogeneous group of tumors, characterized by its aggressive and metastatic nature, with low survival and worse prognosis. Research on genetic biomarkers, such as microRNAs (miRs) in TNBC, demonstrate their relevance in the prognosis of the disease. Therefore, the objective of this research was to verify the role of miRs in the prognosis of TNBC. A search was carried out in the PubMed (MEDLINE), Web of Science, and Scopus databases, with articles in the English language from 2010 to 2022. Only articles that analyzed the role of miRNAs in the prognosis of TNBC and that met the criteria of the MOOSE method were included. For the preparation and planning of this systematic review, a PRISMA checklist and the MOOSE method were used. The Newcastle-Ottawa Scale was used to analyze the quality of the included studies. The excluded criteria considered were: (1) studies that presented duplication in the databases; (2) reviews of the literature, clinical case reports, meta-analyses, conference abstracts, letters to the editor, theses, dissertations, and book chapters; (3) studies that stratified only women diagnosed with other subtypes of breast cancer subtypes; (4) experiments without a control or comparison group. After the bibliographic survey of the 2.274 articles found, 43 articles met the inclusion criteria, totaling 5421 patients with TNBC analyzed for this review. Six miRs (miR-155, miR-21, miR-27a/b/, miR-374a/b, miR-30a/c/e, and miR-301a) were included in the meta-analysis. A low expression of miR-155 was associated with reduced overall survival (OS) (HR: 0.68, 95% CI: 0.58-0.81). A high expression of miR-21 was a predictor of OS reduction (HR: 2.56; 95% CI: 1.49-4.40). In addition, high levels of miR-27a/b and miR-301a/b were associated with lower OS, while the decreased expression levels of miR-30 and miR-374a/b were associated with worse relapse-free survival (RFS) and shorter disease-free survival (DFS), respectively. The present study revealed that miRs play essential roles in the development of metastases, in addition to acting as suppressors of the disease, thus improving the prognosis of TNBC. However, the clinical application of these findings has not yet been investigated.

Circulating MicroRNAs as Novel Potential Diagnostic Biomarkers for Osteosarcoma: A Systematic Review.

Osteosarcoma (OS) is a fast-progressing bone tumor with high incidence in children and adolescents. The main diagnostic methods for OS are imaging exams and biopsies. In spite of the several resources available for detecting the disease, establishing an early diagnosis is still difficult, resulting in worse prognosis and lower survival rates for patients with OS. The identification of novel biomarkers would be helpful, and recently, circulating microRNAs (miRNAs) have been pointed to as possible non-invasive biomarkers. In order to assess the effectiveness of miRNA research, we performed a systematic review to assess the potential role of circulating miRNAs as biomarkers for OS diagnosis. We performed a search in various databases-PubMed, LILACS (Literatura Latino-americana e do Caribe em Ciências da Saúde), VHL (Virtual Health Library), Elsevier, Web of Science, Gale Academic One File-using the terms: "Circulating microRNAs" OR "plasma microRNAs" OR "serum microRNAs" OR "blood microRNAs" OR "cell-free microRNAs" OR "exosome microRNAs" OR "extracellular vesicles microRNAs" OR "liquid biopsy" AND "osteosarcoma" AND "diagnostic". We found 35 eligible studies that were independently identified and had had their quality assessed according to Quality Assessment of Diagnostic Accuracy Studies (QUADAS-2) guidelines. Despite the useful number of publications on this subject and the fact that several microRNAs showed excellent diagnostic performance for OS, the lack of consistency in results suggests that additional prospective studies are needed to confirm the role of circulating miRNAs as non-invasive biomarkers in OS.

Atividade física para gestantes e mulheres no pós-parto: Guia de Atividade Física para a População Brasileira / Physical activity for pregnant and postpartum women: Physical Activity Guidelines for the Brazilian Population

Este artigo tem por objetivo apresentar as recomendações de atividade física para gestantes e mu-lheres no pós-parto desenvolvidas para o Guia de Atividade Física para a População Brasileira. Para isso, utilizou-se uma abordagem de métodos mistos que incluiu quatro etapas: 1) levantamento das diretrizes internacionais mais recentes; 2) revisão narrativa de literatura sobre efeitos da prática de atividade física durante a gestação para a saúde da mulher e do bebê; 3) escuta com gestantes, mu-lheres no pós-parto, profissionais e pesquisadores; 4) consulta pública. As evidências sumarizadas suportam que a prática de atividade física durante a gestação e no período pós-parto é segura, traz be-nefícios à saúde da mãe e do bebê, e reduz os riscos de algumas complicações relacionadas à gestação. Gestantes devem ser incentivadas a realizar pelo menos 150 minutos por semana de atividade física de intensidade moderada. Gestantes com contraindicações devem procurar auxílio de profissionais qualificados. Em alguns casos, a prática de atividade física durante a gestação não é recomendada. Este documento servirá como ferramenta para nortear profissionais de saúde que atuam com ges-tantes e mulheres no pós-parto e irá orientar a população-alvo quanto a prática de atividade física

This manuscript aims to present the recommendations of physical activity for pregnant and postpartum women developed for the Physical Activity Guidelines for the Brazilian Population. A mixed-method ap-proach that included four steps was used: 1) review of the most recent international guidelines for physical activity during pregnancy; 2) narrative literature review on the effects of physical activity during pregnancy on the health of the woman and the baby; 3) consultation with pregnant women, postpartum women, pro-fessionals and researchers; 4) public consultation. The summarized evidence supports that physical activity during pregnancy and in the postpartum is safe, has benefits to the health of the mother and baby, and reduces the risks of some complications related to pregnancy. Pregnancy should be encouraged to do at least 150 min-utes a week of moderate intensity physical activity. Pregnancy women with contraindications should seek help from qualified professionals. In some cases, physical activity during pregnancy is not recommended. This document will be used as a tool to guide health professionals who work with pregnant women and women in the postpartum period. Also, it will inform and guide women during pregnancy and postpartum about the benefits of physical activity

Influence of the Amazonian context on the frailty of older adults: A population-based study.

The study aimed to identify the prevalence of frailty syndrome and its associated factors in older adults residents in an urban area in the interior of Amazonas, Brazil. This is a population-based cross-sectional study with a sample of 265 older adults (60 years or older), representative of the urban area of Coari-AM. Using the adapted Fried phenotype, those with 3 criteria or more were considered frail. Socio-demographic, health, and functionality information was collected. Multivariate analysis was used through Poisson regression with robust variance, using a hierarchical method for the dichotomous outcome of frailty. The prevalence of frailty was 9.4 % and in the final multivariate analysis model the factors associated with frailty were: advanced age (PR: 4.1; 95 % CI: 1.8-9.3), income less than one minimum wage (PR: 3.4; 1.7-6.9), masonry housing (PR: 3.3; 1.3-8.2), never having lived in a riverside community (PR: 2.7; 1.4-5.4), use of 3 medications or more (PR: 3.1; 1,4-6.9), history of falling (PR: 2.3; 1.1-4.9), and fear of falling (PR: 4.1; 1.3-13.0). The study concluded that the prevalence of frailty in Coari-AM was lower than other Brazilian cities with a similar HDI. In addition to factors associated with frailty already well described in the literature, the influence of the Amazonian culture and environment during the course of life was shown to have a possible protective effect on health outcomes in later life.

Valores médios percorridos no teste de caminhada de seis minutos em crianças saudáveis de Coari (AM) / Valores medios recorridos por niños sanos de Coari (AM, Brasil) en la prueba de caminata de seis minutos / Mean values for the 6-minute walk test in healthy children of Coari (AM), Brazil

RESUMO O objetivo desta pesquisa foi estabelecer valores médios percorridos para o teste de caminhada de seis minutos em crianças saudáveis no Norte do Brasil. Este foi um estudo experimental, randomizado, cego e transversal que avaliou 63 crianças saudáveis do sexo masculino e feminino, de 10 a 12 anos, que após terem seus dados antropométricos registrados foram treinadas e instruídas para a realização do teste conforme recomendações da American Thoracic Society, após avaliação-padrão. O teste foi realizado numa pista reta de 30 metros, com marcações a cada 3 metros e cones indicando onde o retorno deveria ser feito para a continuidade do teste. Ao final, foi refeita a avaliação pré-teste. Foi observado índice de massa corporal muito baixo nos meninos de 11 anos, e normal nas outras faixas. A frequência cardíaca imediata pós-teste apresentou-se significativamente elevada em todos os grupos (p<0,001), enquanto todos os outros dados cardiovasculares colhidos não apresentaram alterações. As distâncias percorridas foram significativamente inferiores às previstas por equação-padrão para todos os grupos e sexos (p<0,0001). O valor médio percorrido encontrado em meninas foi de 436,30±56,74m e 460,80±63,90m em meninos, enquanto a média geral foi de 445,70±54,10m, abaixo dos valores esperados para a amostra. O resultado obtido pelo grupo estudado, menor que a média esperada, pode ser creditado ao fenótipo regional, mas o Índice de Desenvolvimento muito mais baixo que a média brasileira deve ter sua influência mais bem estudada. Espera-se que os achados contribuam no apontamento de valores de referência do teste em crianças do Norte brasileiro.

RESUMEN El presente estudio tuvo como objetivo establecer los valores medios recorridos por niños sanos en el Norte de Brasil en la prueba de caminata de seis minutos. Este estudio es experimental, aleatorizado, ciego y transversal, que evaluó a 63 niños y niñas sanos/as, de edades entre 10 y 12 años, y tras registrados sus datos antropométricos recibieron capacitación e instrucción para realizar la prueba según lo recomendado por American Thoracic Society, después de la evaluación estándar. La prueba se realizó en una pista recta de 30 metros, con marcas cada 3 metros y conos que indicaban dónde debe realizarse el retorno para la continuidad de la prueba. Al final, se rehízo la evaluación previa a la prueba. Se observó un índice de masa corporal muy bajo en niños de 11 años, pero normal en otros grupos de edad. La frecuencia cardíaca inmediata posprueba fue significativamente elevada en todos los grupos (p<0,001), mientras que no cambiaron los demás datos cardiovasculares recopilados. Las distancias recorridas fueron significativamente más bajas que las predichas por la ecuación estándar para los grupos y géneros (p<0,0001). Los valores medios encontrados fueron de 436,30±56,74m en las niñas y 460,80±63,90m en los niños, mientras que el promedio general fue de 445,70±54,10m, por debajo de los valores esperados para la muestra. El resultado obtenido en el grupo estudiado, inferior al promedio esperado, puede acreditar al fenotipo regional, pero el Índice de Desarrollo mucho más bajo que el promedio brasileño debe tener su influencia mejor estudiada. Se espera que los hallazgos contribuyan al establecimiento de valores de referencia para la prueba en niños del Norte de Brasil.

ABSTRACT The objective of this research was to establish mean values covered for the six-minute walk test in healthy children in Northern Brazil. This was an experimental, randomized, blind and cross-sectional study that evaluated 63 healthy male and female children, aged 10 to 12 years, who after having their anthropometric data recorded were trained and instructed to perform the test as recommended by the American Thoracic Society, after standard assessment. The test was carried out on a straight track of 30 meters, with markings every 3 meters and cones indicating where the return should be made for the test continuity. At the end, the pre-test evaluation was redone. Very low body mass index was observed in 11-year-old boys, and normal in other age groups. The post-test immediate heart rate was significantly elevated in all groups (p<0.001), while all other cardiovascular data collected did not change. The distances covered were significantly lower than those predicted by the standard equation for all groups and sexes (p<0.0001). The average value found in girls was 436.30±56.74m and 460.80±63.90m in boys, while the general average was 445.70±54.10m, below the expected values for the sample. The result obtained by the studied group, less than the expected average, can be credited to the regional phenotype, but the Development Index much lower than the Brazilian average should have its influence better studied. The findings are expected to contribute to the establishment of reference values for the test in children from northern Brazil.

Functional Independence of Adults and the Elderly Attended by a Family Health Strategy in Teixeira de Freitas-BA / Independência Funcional de Adultos e Idosos Atendidos por uma Estratégia de Saúde da Família em Teixeira de Freitas-BA

Aging is related to several morphological and functional changes in the individuals' body that directly reflects on their functional independence. This affects both maintaining the ability to perform Basic Activities of Daily Living and the Instrumental Activities of Daily Living. The present study aimed to verify the level of functional independence in adults and the elderly attended by a Family Health Strategy in Teixeira de Freitas-BA. It is an observational study of transverse and descriptive design composed of 30 participants who answered a semi-structured questionnaire and socioeconomic Functional Independence Measure instrument (MIF). Spearman's correlation coefficient was used to analyze the correlation among the variables. Through MIF it was possible to identify a total of 123.1 ± 4.47 points for the participants, which indicates complete independence in performing routine tasks. The memory factor was the component that scored lower, followed by problem resolution. A strong correlation (r = 0.71) was found between the total MIF score and the social cognition factor. Therefore, one notices the need for investments in appropriate professionals as well as improvement in public health policies in order to active and healthy aging. (AU)

O envelhecimento está relacionado à diversas alterações morfológicas e funcionais no organismo dos indivíduos que reflete diretamente na independência funcional destes. Isso afeta tanto na manutenção da habilidade de realizar Atividades Básicas da Vida Diária quanto nas Atividades Instrumentais da Vida Diária. O presente estudo teve por objetivo verificar o nível de independência funcional em adultos e idosos atendidos por uma Estratégia Saúde da Família em Teixeira de Freitas-BA. É um estudo observacional de delineamento transversal e descritivo, foi composto por 30 participantes que responderam a um questionário socioeconômico semiestruturado e o instrumento de Medida de Independência Funcional (MIF). Para as análises foi utilizado o coeficiente de correlação de Spearman para avaliar a correlação existente entre as variáveis. Por meio da MIF foi possível identificar um total de 123,1±4,47 pontos para os participantes, o que indica a independência completa na realização de tarefas de rotina. O fator memória foi o componente que obteve menor pontuação, seguido de resolução de problemas. Constatou-se nesse estudo uma correlação forte (r=0,71) entre a pontuação total da MIF e o fator cognição social. Assim, percebe-se a necessidade de investimentos em profissionais adequados bem como melhoria nas políticas públicas de saúde a fim de promover um envelhecimento ativo e saudável. (AU)

Muscle Skeletal Disorders and Factors of Stress in Handball Athletes / Distúrbios Músculo Esqueléticos e Fatores de Estresse em Atletas de Handebol

The increasing demand for competitive exercises causes a high level of stress and risk of injury to performance athletes. To verify the prevalence of stress symptoms and musculoskeletal disorders in Coari-AM handball 6 locks. The study included athletes from the aforementioned municipality handball. After regular workouts, the questionnaires were applied: Nordic Skeletal Muscle Disorders and Daily Analysis of Life Demands in Athletes- DALDA. The participants were 45 athletes aged between: 15.24 ± 1.64 years, being 64.44% male and 35.55% female. The most affected regions by pain, tingling/numbness in the last 12 months were: knee (57.77%) and ankle/feet (48.88%), shoulders (42.22%) and upper back (42.2%). As for musculoskeletal disorders, the most affected regions that compromised normal activities in the last 12 months were knees (24.44%), ankles/feet (22.22%), hips/thighs (11.11%) and upper back (11.11%). DALDA evaluated the Sources and Symptoms of Stress in part A, the climate appeared as the main cause of stress (44.44%) followed by sleep issues (20%). In part B, muscle pain (40.00%) appeared as the main cause followed by fatigue (28.89%). In order for the athlete to present better performance in sports practices it is necessary to balance the internal and external factors and an adequate sports practice. (AU).

O aumento da demanda por exercícios competitivos provocou elevação do nível de estresse e do risco de lesões para atletas de todas as esferas de rendimento. Verificar a prevalência de sintomas de estresse e distúrbios músculo esqueléticos em atletas de handebol de Coari-AM. Participaram do estudo atletas de handebol do município supracitado. Após treinos regulares foram aplicados os questionários: Nórdico de Distúrbios Músculo Esquelético e o Daily Analysis of Life Demands in Athletes- DALDA. Participaram 45 atletas com idade média:15,24±1,64 anos, dos gêneros masculino 64,44% e feminino 35,55%. As regiões mais acometidas por problemas como dor, formigamento/dormência nos últimos 12 meses foram: o joelho (57,77%) e tornozelo/pés (48,88%), ombros (42,22%) e parte superior das costas (42,2%). No que se refere a sintomas de distúrbios músculo esqueléticos, as regiões mais afetadas e que comprometeram o desempenho de atividades normais nos últimos 12 meses foram joelhos (24,44%), tornozelos/pés (22,22%), quadril/coxas (11,11%) e parte superior das costas (11,11%). O DALDA avaliou as Fontes e Sintomas de Estresse, na parte A, o clima apareceu como a principal causa de estresse (44,44%) seguido por problemas no sono (20%). Já na parte B, as dores musculares (40,00%) apareceram como a principal causa seguido do cansaço (28,89%) Para que o atleta demostre um melhor desempenho nas práticas esportiva é necessário o equilíbrio entre os fatores internos e externos e uma prática esportiva adequada. (AU)

Cardiac autonomic modulation in obese and eutrophic children: systematic review and metaanalysis / Modulação autonômica cardíaca em crianças obesas e eutróficas: revisão sistemática e metanálise

Abstract This study aimed to verify the influence of childhood obesity on the regulation of cardiac autonomic modulation through the heart rate variability of obese and eutrophic children. The study consisted of a systematic review and meta-analysis in five PubMed, Scielo, Cochrane Library, BVS/Lilacs and Medline databases. Of the 60 articles found, 15 met the pre-established criteria. These studies were submitted to evaluation of methodological quality and risk of bias, and the Joanna Briggs Institute Critical Appraisal Checklist for Prevalence Studies ( JBI) was applied. Meta-analysis was performed with the Review Manager 5.3 software for variables related to the alteration of cardiac autonomic modulation. Fifteen studies were used for meta-analysis, all were classified with high methodological quality (7 to 9 points), 13 presented results showing alteration of autonomic cardiac modulation in obese children in comparison with eutrophic children, and only two presented indicatives that refute this hypothesis. The present study identified reduction in the parasympathetic activity of the obese group in relation to the eutrophic group through the variables studied. The use of RMSSD, pNN50 and SDNN variables is recommended in future studies, as their results were significant for this meta-analysis.

Resumo Este trabalho teve por objetivo verificar a influência da obesidade infantil na regulação da modulação autonômica cardíaca, por meio da variabilidade da frequência cardíaca de crianças obesas e eutróficas. O estudo consistiu em uma revisão sistemática e metanálise em cinco bases de dados PubMed, Scielo, Cochrane Library, BVS (Biblioteca Virtual em Saúde)/ Lilacs e Medline. Dos 60 artigos encontrados, 15 atenderam aos critérios pré-estabelecidos. Esses estudos foram submetidos a avaliação da qualidade metodológica e risco de viés, sendo aplicado o Critical Appraisal Checklist for Prevalence Studies do Joanna Briggs Institute ( JBI). Aplicou-se metanálise com o software Review Manager 5.3 para as variáveis que estão relacionadas à alteração da modulação autonômica cardíaca. Foram utilizados 15 estudos para a metanálise, todos foram classificados com alta qualidade metodológica (7 a 9 pontos), 13 apresentaram resultadosmostrando alteração da modulação autonômica cardíaca em crianças obesas em comparação com crianças eutróficas e apenas dois apresentaram indicativos que refutam essa hipótese. O presente estudo identificou a redução da atividade parassimpática no grupo obeso em relação ao grupo eutrófico através das variáveis trabalhadas. Recomenda-se a utilização das variáveis RMSSD, pNN50 e SDNN em estudos futuros, pois seus resultados foram significativos para esta metanálise.

Factors associated with low levels of physical activity among elderly residents in a small urban area in the interior of the Brazilian Amazon.

The aim of the present study was to investigate levels of physical activity and risk factors for inactivity in older adults living in an urban area in the interior of the Amazonas state, Brazil. Data were collected between 2013 and 2015 from 274 individuals 60 years of age or older who resided in the interior of the Brazilian Amazon. Sociodemographic, general health, functional capacity and physical performance were associated with self-referred physical activity level. A multivariate analysis, after adjustment, showed that being a man, having a body mass index above 27kg/m2, never having lived in riverside communities and having less than three associated chronic diseases were independent risk factors for low levels of physical activity among elderly residing in the interior of the Brazilian Amazon. Few studies have been conducted about the characteristics that are singular to this population. Our results suggest that the physical activity level and, consequently, the aging process of the elderly is influenced by where they have resided throughout their lives. Additionally, the results showed particular risk factors associated with low physical activity level among older adults residing in the interior of the state of Amazonas.

Nível de atividade física dos idosos atendidos por uma estratégia de saúde da família em Teixeira De Freitas-BA / Level of physical activity of elderly persons attended by a family health strategy in Teixeira de Freitas-BA

Introdução: na população idosa a prática de exercícios leva a muitos benefícios na aptidão física e capacidade funcional, além da redução de determinadas condições clínicas que os colocam em condições de fragilidade, sobretudo da pressão arterial e dos fatores de risco para doenças cardiovasculares. Objetivo: verificar o nível de atividade física dos idosos atendidos por uma Estratégia de Saúde da Família em Teixeira de Freitas-BA. Métodos: trata-se de um estudo descritivo aprovado pelo Comitê de Ética em Pesquisa da Universidade Estadual de Feira de Santana sob parecer de nº 1.742.967. A amostra foi constituída por 21 idosos residentes na área urbana de Teixeira de Freitas, que frequentam a Unidade Básica de Saúde Wilson Brito que, após anuência, foram entrevistados através de questionários de aspectos socioeconômicos e demográficos, além do International Physical Activity Questionnaire (IPAQ), versão longa específica para idosos, no qual foram avaliados quanto ao nível de atividade física habitual. Resultados: todas as informações coletadas no estudo foram tabuladas em banco de dados distribuído em planilhas eletrônicas do EXCEL e analisadas pelo software STATA. Observou-se que os participantes tinham idade média de 65,48 ±5,29 anos. Quanto ao nível de atividade física, através da análise pelo IPAQ, apenas 08 pessoas possuem nível de atividade física suficiente, constatando-se valores acima de 150 minutos na semana, indicando que a maioria dessa população pode estar suscetível a doenças. Conclusão: a maioria da amostra não possui prática regular de atividade física. Assim, torna-se necessária a implementação de programas que promovam a atividade física nesse grupo.

Introduction: in the elderly population the practice of exercise leads to many benefits in physical fitness and functional capacity, besides the reduction of certain clinical conditions that put them in conditions of fragility, especially high blood pressure and other risk factors for cardiovascular diseases. Objective: verify the level of physical activity of the elderly attended by a Family Health Strategy in Teixeira de Freitas-BA. Methods: this is a descriptive study approved by the Research Ethics Committee of Feira de Santana State University under opinion Nº 1,742,967. The sample consisted of 21 elderly people living in the urban area of Teixeira de Freitas, who attend the Wilson Brito Basic Health Unit, who were interviewed through questionnaires of socioeconomic and demographic aspects, as well as the International Physical Activity Questionnaire (IPAQ), a long version specific to the elderly, in which they were evaluated for the level of habitual physical activity. Results: all the information collected in the study was tabulated in a database distributed in EXCEL spreadsheets and analyzed by the STATA software. It was observed that the participants had a mean age of 65.48 ± 5.29 years. Regarding the level of physical activity, through analysis by the IPAQ, only 08 people have sufficient physical activity level, with values above 150 minutes in the week, indicating that the majority of this population may be susceptible to diseases. Conclusion: most of the sample does not practice regular physical activity. Thus, it is necessary to implement programs that promote physical activity in this group.