Effects of lower limb muscle strengthening on interface pressure in older adults undergoing inelastic compression: Randomized controlled clinical trial.

OBJECTIVE: To analyze the effects of lower limb muscle strengthening on interface pressure (IP), static stiffness index (SSI), dynamic stiffness index (DSI), and walking pressure amplitude (WPA) in older adults undergoing inelastic compression therapy. METHOD: Forty-three healthy older adults of both sexes (Age: 66.2 ± 4.4 years) met the eligibility criteria and completed all stages of the study (Resistance Training - RT: N = 20; Control - CONT: N = 23). Body composition, strength and functional mobility of lower limbs, IP, SSI, DSI, and WPA were evaluated before and after intervention. RESULTS: The two-way ANOVA with repeated measures demonstrated a significant time-group interaction effect on muscular strength for 1-RM [F (1, 41) = 21.091; p ≤ 0.001], IP in the orthostatic position [F (1, 41) = 5.124; p ≤ 0.05], minimum WPA [F (1, 41) = 10.999; p ≤ 0.05], maximum WPA [F (1, 41) = 8.315; p ≤ 0.05], DSI minimum (F (1, 41) = 4.608; p ≤ 0.05), DSI maximum (F (1, 41) = 8.926; p ≤ 0.05), and on the delta DSI (F (1, 41) = 7.891; p ≤ 0.05). CONCLUSIONS: In RT group, the increase in lower limb muscle strength was accompanied by an increase in IP in foot dorsiflexion and plantar flexion maneuvers, both in the standing position (DSI) and during gait (WPA).

Effects of a physical exercise or motor activity protocol on cognitive function, lipid profile, and BDNF levels in older adults with mild cognitive impairment.

This study analyzed the effects of a physical exercise program compared to the complexity of the motor task on the cognitive function, brain-derived neurotrophic factor (BDNF) levels, and lipid profile of older adults with mild cognitive impairment (MCI). Twenty-seven participants were randomized into three intervention groups: Physical Exercise (PE), Motor Task (MT), and Physical Exercise associated with Motor Task (PE + MT). Six months of intervention twice a week resulted in improvements in cognitive function, total cholesterol (TC), and LDL cholesterol (LDL-C) in the PE (p < 0.05). In the PE + MT, in addition to improved cognitive capacity, there was also a reduction in non-HDL cholesterol (NHDL-C) and LDL cholesterol (LDL-C) levels (p < 0.05), while in the MT, the values of TC, NHDL-C, and LDL-C decreased as a result of the intervention. BDNF levels were not affected by the interventions. In conclusion, PE alone or combined with MT is effective in promoting improvements in overall cognitive function and lipid profile in older adults with MCI; and BDNF seems not to be a sensitive marker for people with mild cognitive impairment.

Toxicological effects of acute and repeated doses (180 days) of fruits from Malpighia emarginata (acerola) in rodents.

Malpighia emarginata has a high amount of vitamin C with pharmacological or food preservation potential. However, despite its wide use and application possibilities its toxicity in repeated doses and for a long time (6 months) has not yet been studied. In this context, this study aimed to evaluate the acute toxicity and repeated doses from fruits of this plant. The extract was produced with the pulp (EMe) of the lyophilized fruit and submitted to chromatographic and spectroscopic analysis (HPLC and ESI-IT-MSn). In the acute test, the EMe was administered orally and parenterally to rodents (mice and rats) for 14 days, at a dose of 2000 mg/kg. Subsequently, the repeated dose toxicity test was administered orally for 180 days at doses of 50, 300 or 1000 mg/kg. The HPLC assay revealed a high concentration of vitamin C (16.3%), and spectroscopic analyses pointed to the presence of five other polyphenolic compounds. In the acute test, the plant extract showed no apparent toxicity or lethality in rodents. The LD50 was estimated to be greater than 2000 mg/kg and falls into category 5 (low toxicity). In the repeated dose assay, there was no evidence of toxicity, and no differences were observed in water intake, food, weight development, or behavior of the animals in relation to the vehicle group (water). However, hematological and biochemical evaluations pointed out some nonconformities in the levels of cholesterol, leukocytes, and neutrophils of the male rats, but overall, these results did not reveal significant toxicity. Therefore, the Level of Unobserved Adverse Effects (NOAEL) was 1000 mg/kg. Together, the results suggest that the extract obtained from the fruits of M. emarginata does not present representative toxicity in rodents.

Resistance training reduces platelet activation in hypertensive women: the role of purinergic signaling.

BACKGROUND AND AIM: Essential arterial hypertension is a risk factor for stroke, myocardial infarction, heart failure, and arterial aneurysm, which are related to the activation of platelets. Purinergic signaling has a central role in platelet aggregation. Although ATP and ADP can act as a proaggregant agent, adenosine inhibits platelet aggregation and reduces vascular injury. Physical exercise exhibits antiaggregant properties and can modulate purinergic system. The aim of this study was to evaluate the effect of 6 months of resistance training on purinergic system components in platelets and on platelet activation, hemodynamic and anthropometric parameters in hypertensive woman. METHOD: A total of 31 hypertensive and 28 normotensive middle-aged sedentary women were submitted to 6 months of resistance training. Purinergic enzymes activities were assessed in platelets; ATP and Tromboxane B2 (TXB2) levels were measured in serum. Blood pressure (BP), BMI, and body fat were also measured. All variables were statistically analyzed, considering P value less than 0.05. RESULTS: Six months of resistance training was able to significantly reduce BP, ATP, and TXB2 levels as well as NTPDase, ecto-5'nucleotidase, and ADA activities in hypertensive group. After 6 months of resistance training, purinergic system components and TXB2 of hypertensive group were similar to normotensive group in platelets, demonstrating that resistance training was able to modulate platelet activation. A positive correlation was found between BP, enzyme activities, and levels of ATP and TXB2. CONCLUSION: Our findings demonstrated the relationship between purinergic signaling and platelet activation in hypertension and suggests that resistance training serve as tool to reduce platelet aggregation in hypertensive woman by modulating purinergic system.

The use of a single resistance exercise with or without blood flow restriction in the treatment of pain in knee osteoarthritis: a randomized clinical trial / A utilização de um único exercício resistido com ou sem restrição do fluxo sanguíneo no tratamento da dor na osteoartrite de joelho: um ensaio clínico randomizado

ABSTRACT BACKGROUND AND OBJECTIVES: Physical exercise is an efficient non-pharmacological strategy for the treatment of knee osteoarthritis (KOA). Blood flow restriction (BFR) is a technique known to enhance strength and hypertrophy gains when combined with low-intensity resistance exercise. This study aimed to analyze the effects of 12 weeks of low-intensity resistance training with and without blood flow restriction (BFR) on pain control and strength improvement in patients with KOA. METHODS: Two intervention groups performed low-intensity resistance exercise (knee joint extension on the leg extension chair at 30% of one repetition maximum) with (LI+BFR, n=13) or without blood flow restriction (LI, n=13), twice a week for 12 weeks. Preand post-test of one repetition maximum, functional strength (Chair-test), peak torque for unilateral knee extension exercise and pain (Visual Analogue Scale) were evaluated. RESULTS: No statistically significant differences were observed between treatments in pain reduction (p>0.05). Both interventions increased muscle strength and functional strength after 12 weeks of intervention (p<0.05). The peak torque for knee joint extension increased only in the LI+BFR group (p<0.05). Has no difference in reducing pain in patients with KOA among the groups (p< 0.05), both in the LI+BFR and the LI group. CONCLUSION: The results of the present study showed that BFR associated with low-intensity resistance exercise does not produce additional effects in terms of pain reduction and strength gain in patients with knee osteoarthritis, when compared to resistance exercise alone.

RESUMO JUSTIFICATIVA E OBJETIVOS: O exercício físico é uma estratégia não farmacológica eficiente para o tratamento da osteoartrite de joelho (OAJ). A restrição do fluxo sanguíneo (RFS) é uma técnica conhecida por potencializar o ganho de força e hipertrofia quando combinada com exercícios de resistência de baixa intensidade. Este estudo teve como objetivo analisar os efeitos de 12 semanas de treinamento de resistência de baixa intensidade com e sem restrição de fluxo sanguíneo (RFS) no controle da dor e melhora da força em pacientes com OAJ. MÉTODOS: Dois grupos de intervenção realizaram exercício resistido de baixa intensidade (extensão da articulação do joelho na cadeira extensora a 30% de uma repetição máxima) com (ER+RFS, n=13) ou sem restrição do fluxo sanguíneo (ER, n=13), duas vezes por semana durante 12 semanas. Foram avaliados pré e pós-teste de uma repetição máxima, força funcional (Chair-test), pico de torque para exercício de extensão de joelho unilateral e dor (Escala Analógica Visual). RESULTADOS: Não foram observadas diferenças estatisticamente significativas entre os tratamentos na redução da dor (p>0,05). Ambas as intervenções aumentaram a força muscular e a força funcional após 12 semanas de intervenção (p<0,05). O pico de torque para extensão da articulação do joelho aumentou apenas no grupo ER+RFS (p<0,05). A dor crônica relacionada à OAJ não apresentou diferença estatisticamente significativa na redução da dor (p> 0,05) em resposta a ambas as intervenções. CONCLUSÃO: Os resultados do presente estudo evidenciaram que a RFS associada ao exercício de resistência de baixa intensidade não prouduz efeitos adicinais na redução da dor e no ganho de força em pacientes com osteoartrite de joelho, quando comparada apenas ao exercício de resistência.

Functional Capacity, Lipid Profile, and Associated Factors in Older Adults Living in Urban and Rural Areas.

This study aimed to analyze the relationship between sociodemographic and lifestyle variables, functional strength, aerobic capacity, and lipid profile of older adults living in urban and rural areas. For this purpose, 208 older adults were evaluated (132 living in rural areas and 73 living in urban areas). Sociodemographic data were collected, and functional strength, aerobic capacity, and lipid profile of older adults living in the southern region of Brazil were evaluated. Only total cholesterol and LDL cholesterol were associated with place of residence (p < 0.05), and living in the countryside was associated with low aerobic capacity (p=0.010). The use of medication (OR = 3.01; p=0.012) and smoking (OR = 0.30; p=0.027) were the only variables that explained aerobic performance, regardless of place of residence. In conclusion, place of residence is not a factor that, alone or in combination with other conditions, affects the functional performance or lipid profile of the older adult population.

Acute effects of the resistance exercise associated with different blood flow restriction pressures on bone remodeling biomarkers.

Background: The present study analyzed the acute responses of parathyroid hormone (PTH) and bone-specific alkaline phosphatase (BSAP) to the low-intensity resistance exercise with blood flow restriction using different occlusion pressures. Methods: Twelve women completed the three protocols of this crossover study: resistance exercise without blood flow restriction (RE), resistance exercise with blood flow restriction and occlusion pressure corresponding to 70% of systolic blood pressure (RE + BFR70), and resistance exercise with blood flow restriction and occlusion pressure corresponding 130% of systolic blood pressure (RE + BFR130). All exercises were performed in a guided squat apparatus with load corresponded to 30% of one-repetition maximum test. Results: Relative to resting levels, PTH concentrations decreased significantly (p = .000) post-exercise in all groups and increased significantly (p = .000) 15 min post-exercise in RE + BFR70 and RE + BFR130 groups; PTH concentrations returned to resting levels after the 30-min recovery period in all groups. There was no significant difference (p >.05) between BSAP values at rest and 30 min post-exercise. Conclusion: In conclusion, our results showed that protocols with blood flow restriction using occlusion pressures equivalent to 70% and 130% of systolic blood pressure were more effective than RE alone to induce PTH peaks, and to promote a metabolic condition favorable to bone anabolism.

Mulheres na gestão do ensino superior: adoecimento e estratégias de enfrentamento das demandas do trabalho / Women in the management of higher education: illness and strategies to cope with the work demands

Resumo Este artigo investiga o adoecimento e as estratégias de enfrentamento do sofrimento no trabalho entre mulheres em cargos de gestão no ensino superior. Para tal, foi realizado estudo de caso quali-quantitativo, do qual participaram 34 mulheres, que responderam ao questionário sociodemográfico e de Avaliação de Prazer e Sofrimento no Trabalho, além disso, destas, sete responderam a uma entrevista. Os dados quantitativos foram submetidos à análise estatística e, os qualitativos, à análise de conteúdo, com apoio no referencial teórico da Psicodinâmica do Trabalho para discussão dos dados. Na amostra, 52,9% das mulheres indicaram manifestações sintomáticas ou agravos à saúde e estabeleceram relação deles com o trabalho. As gestoras indicaram predominantemente estratégias de enfrentamento individuais, incluindo psicoterapia, uso de medicação, prática de terapias integrativas, espirituais e atividades físicas, além das pausas e de alguns recursos de enfrentamento coletivo, tais como encontro e conversa com colegas, amigos e familiares. Concluímos que são necessárias estratégias institucionais para reduzir o sofrimento e desgaste destas profissionais, prevenir o adoecimento e promover o prazer no trabalho.

Abstract This article aims to investigate illness and coping strategies for suffering at work among women in higher education management. This is a qualitative and quantitative case study conducted with 34 women. A sociodemographic questionnaire and the Pleasure and Suffering at Work Indicator Scale were applied to all participants, and an interview was conducted with seven of them. Quantitative data underwent statistical analysis and qualitative data underwent content analysis, being discussed in the light of the Psychodynamics of Work. The results show that 52.9% of the women presented with symptomatic manifestations or health problems, which they considered as work-related. The coping strategies adopted for work demands were mostly individual, including psychotherapy, medication, integrative therapies, spiritual and physical activities, as well as rest breaks. They also reported some collective coping strategies, such as meeting and talking to colleagues, friends, and family. Thus, authorities must develop institutional strategies to reduce occupational suffering, prevent illness, and promote work pleasure.

Exercise with blood flow restriction as a new tool for health improvement in hypertensive elderly women: the role of purinergic enzymes.

BACKGROUND: Purinergic signaling has been considered one of the mechanisms by which exercise exerts its antihypertensive effects; and research on the effects of blow flow restriction (BFR) exercise has increased as an alternative for elderly hypertensive patients. We analyzed the acute responses of NTPDase and adenosine deaminase (ADA) activities to low intensity aerobic exercise (LIAE) with BFR in lymphocytes of hypertensive elderly women. METHODS: Sixteen hypertensive elderly women performed three exercise protocols: LIAE; high intensity aerobic exercise (HIAE) and LIAE+BFR. Blood pressure, heart rate and blood collection were carried out before exercise, immediately after exercise and 30 min after exercise. NTPDase and ADA activities were measured in lymphocytes. RESULTS: Our results showed that LIAE+BFR triggered the same stimuli when compared to HIAE exercise regarding to NTPDases activities, suggesting that both protocols trigger an augment of these enzyme activities in response to: 1) increase in ATP release during exercise; and 2) need of adenosine generation to promotes anti-inflammatory responses in the recovery period. HIAE protocol was more effective than the others to trigger combined hypotensive and anti-inflammatory effects in the recovery period. CONCLUSIONS: This study showed that BFR is a good tool to promote anti-inflammatory effects similar (not equal) to HIAE. Moreover, LIAE+BFR promotes much more stimuli and adaptations related to immune functions than low intensity protocols, bringing more benefits for the hypertensive elderly population.

Resistance training affects the hemodynamic parameters of hypertensive and normotensive women differently, and regardless of performance improvement.

BACKGROUND: Although the positive effects of resistance training (RT) on strength and functional capacity have been well evidenced in the scientific literature, the effects of RT on blood pressure and the relationship of these responses with performance improvement are not yet well established. OBJECTIVE: This study aimed to analyze the effects of three and six months of RT on the hemodynamic parameters and functional capacity of hypertensive and normotensive women. METHOD: Sixteen hypertensive and 15 normotensive elderly women participated in a RT protocol designed to increase muscle strength and hypertrophy, lasting six months, twice a week. RESULTS: Systolic blood pressure (SBP) had a reduction at six months only in hypertensive patients, while diastolic blood pressure (DBP) decreased at six months of intervention in both groups (p < 0.05). SBP showed differences between the groups in the pretest (p < 0.05), but not at three and six months of intervention (p > 0.05). Heart rate (HR) was reduced at three months in hypertensive patients, and at six months in the normotensive (p < 0.05). The strength and functional mobility of both hypertensive and normotensive individuals significantly increased at three and six months of intervention (p < 0.05). Hypertensive women showed increased strength at all moments, while normotensive ones showed improvement only at six months. CONCLUSION: Moderate to high intensity RT improves the hemodynamic parameters of hypertensive and normotensive women differently, and independently of strength gain and functional capacity improvement.

Gastroprotective activity of hydroalcoholic extract of the leaves of Urera baccifera in rodents.

ETHNOPHARMACOLOGICAL IMPORTANCE: The species Urera baccifera (L.) Gaudich. ex Wedd. (Urticaceae) is native to the Americas and is distributed widely throughout Brazil, where it is known as urtiga-brava, urtiga-vermelha, or urtigão. The leaves are often used as anti-inflammatory and antirheumatic agents and for the treatment of gastric disorders. However, the pharmacological mode of action underlying the gastroprotection induced by this species has not been investigated. AIM OF THE STUDY: To contribute to the knowledge of the gastroprotective mode of action of the hydroalcoholic extract of U. baccifera (HEU) leaves. MATERIALS AND METHODS: Antiulcerogenic effect of HEU against ethanol-induced acute gastric ulcer was evaluated in rats and mice at doses of 3-300 mg/kg. NO-synthase inhibitor (L-NAME), SH blocker (NEM), cyclooxygenase inhibitor (indomethacin) and alpha 2-adrenergic receptor antagonist yohimbine were used to evaluate the participation of cytoprotective factors in HEU gastroprotection. Moreover, the levels of reduced gluthatione (GSH) and cytokines (TNF, IL-6, IL4 and IL-10), as well as the enzymatic activity of gluthatione S-transferase (GST), myeloperoxidase (MPO), superoxide dismutase (SOD) and catalase (CAT) were measure. Moreover, the samples were analyzed histologically and the antisecretory capability of HEU were quantified using pylorus ligated rats. RESULTS: The phytochemical analysis of HEU (UPLC/ESI-IT-MS) identified the flavonoids diosmetin and apigenin glucuronide. Furthermore, HEU decreased the occurrence of ethanol-induced ulcers at 30 and 300 mg/kg by 57% and 66%, respectively, compared with the vehicle. The gastroprotective effects were accompanied by increased GSH levels and GST and SOD activity as well as by reduced MPO activity in vivo and in vitro, revealing antioxidant effects and inhibition of neutrophil infiltration. The beneficial effects of 30 and 300 mg/kg HEU were also observed upon histological analyses. Regarding the mode of action, the gastroprotective effect of HEU was abolished by the pre-administration of L-NAME, NEM, indomethacin or yohimbine. Moreover, HEU was able to decrease the IL-6, IL-4 and IL-10 in ulcerated tissue, as well as the pepsin activity of the gastric juice in pylorus-ligated rats. CONCLUSION: Together, the results confirmed that the gastroprotection elicited by HEU was due reduction in oxidative damage, neutrophil migration, and peptic activity. This work validates the popular use of U. baccifera to treat gastric disorders and supports important future research for the identification of gastroprotective molecules from this species.

Acute effects of strength exercise with blood flow restriction on the arterial resistance index / Efeitos agudos do exercício de força com restrição do fluxo sanguíneo sobre o índice de resistência arterial

ABSTRACT The present study aimed to evaluate the acute behavior of the brachial artery resistance index (BARI) and popliteal artery resistance index (PARI) in response to low intensity strength exercises involving small (SMG) and large muscle groups (LMG) performed with and without blood flow restriction. Eleven men (age 23 ± 3.29 years) underwent a four-arm, randomized, cross-over experiment: Small muscle group exercise (SMG), small muscle groups with blood flow restriction (SMG+BFR), large muscle groups (LMG) and large muscle groups with blood flow restriction (LMG+BFR). The behavior of BARI and PARI was evaluated at rest, immediately after exercise, and at 15 and 30 minutes during recovery. Data analysis showed a significant reduction of the BARI from rest to post-exercise only in the protocols involving SMG, regardless of the BFR (p <0.05). Protocols involving LMG, with or without BFR, did not affect PARI (p> 0.05), but were efficient to promote significant increases in BARI (p <0.05) immediately after exercise. Our findings indicate that the exercises involving SMG, regardless of BFR, are efficient to promote local vasodilatation (brachial artery), but without systemic effects. None of the analyzed protocols affected the PARI behavior.

RESUMO O presente estudo objetivou avaliar o comportamento agudo do índice de resistência da artéria braquial (IRAB) e da artéria poplítea (IRAP) em resposta a exercícios de força de baixa intensidade envolvendo pequenos (PGM) e grandes grupos musculares (GGM), realizado com e sem restrição de fluxo sanguíneo. Onze homens (idade 23 ± 3,29 anos) realizaram um experimento randomizado, cruzado, com quatro braços: Exercício para pequenos grupos musculares (PGM), pequenos grupos musculares com restrição de fluxo sanguíneo (PGM+RFS), grandes grupos musculares (GGM) e grandes grupos musculares com restrição de fluxo sanguíneo (GGM+RFS). O comportamento de IRAB e IRAP foi avaliado em repouso, mediatamente após o exercício, e aos 15 e 30 minutos da recuperação. A análise dos dados mostrou uma redução significativa do IRAB do repouso para o pós-exercício apenas nos protocolos de PGM com ou sem RFS (p <0,05). Protocolos envolvendo GGM, independentemente do BFR, não afetaram o IRAP (p> 0,05), porém, foram eficientes para promover aumentos significativos do IRAB (p <0,05) imediatamente após o exercício. Nossos achados indicam que os exercícios envolvendo PGM, independentemente da BFR, são capazes de promover a vasodilatação local (artéria braquial), porém, sem efeitos sistêmicos. Nenhum dos protocolos analisados afetou o comportamento do IRAP.

Exposição ambiental/ocupacional aos agrotóxicos em gestantes residentes em um município rural / Environmental/occupational exposure to pesticides of pregnant women living in a countryside municipality / Exposición ambiental/ocupacional a los agrotóxicos en gestantes residentes en un municipio rural

Objective: The study's goal has been to analyze if environmental or occupational exposure to pesticides can produce changes in pregnant women living in a countryside municipality. Methods: The participants of this study were twenty-three pregnant women, who both answered a questionnaire and donated biological material in order to perform Micronucleus (MN) Tests in lymphocytes, oral epithelial cells, and also for measuring the enzyme activity of erythrocyte acetylcholinesterase. Results: Considering the total analyzed samples, the following was found: an average of 8 ± 2.92 MN/1000 oral epithelial cells from urban participants; an average of 6.82 ± 3.43 MN/1000 oral epithelial cells from rural participants; and 100% of the microscope slides contained cells with two MN, which shows high intensity lesions to the DNA. There was found a high frequency of spontaneous abortions (34.8%), greater than in Brazil. Conclusion: The exposure of pregnant women living in a countryside municipality to pesticides may increase the rate of spontaneous abortions, as well as the chances of mutagenic effects

Objetivo: Analisar se a exposição ambiental ou ocupacional aos agrotóxicos causa alterações em gestantes residentes em um município rural. Métodos: Compuseram a amostra 23 gestantes, que responderam a um questionário e doaram amostras biológicas para a realização dos testes de micronúcleos (MN) em linfócitos, em células do epitélio oral, e para a dosagem da atividade da enzima acetilcolinesterase eritrocitária. Resultados: Obteve-se uma média de 8 ± 2,92 MN/1000 células do epitélio oral analisadas em amostras de participantes da zona urbana, 6,82 ± 3,43 MN/1000 de participantes da zona rural, e 100% das lâminas continham células com dois MN, o que demonstra lesões ao DNA de maior intensidade. Encontrou-se uma frequência elevada de casos de abortos espontâneos (34,8%), superior à encontrada no Brasil. Conclusão: A exposição de gestantes residentes em um município rural aos agrotóxicos eleva a taxa de abortos espontâneos, bem como as chances de ocorrência de efeitos mutagênicos

Objetivo: Analizar si la exposición ambiental o ocupacional a los agrotóxicos causa cambios en gestantes residentes en un municipio rural. Métodos: Compusieron la muestra 23 gestantes, que respondieron a un cuestionario y donaron muestras biológicas para la realización de las pruebas de micronúcleos (MN) en linfocitos, en células del epitelio oral, y para la dosificación de la actividad de la enzima acetilcolinesterasa eritrocitaria. Resultados: Se obtuvieron una media de 8 ± 2,92 MN / 1000 células del epitelio oral analizadas en muestras de participantes de la zona urbana, 6,82 ± 3,43 MN / 1000 de participantes de la zona rural, y el 100% de las láminas contenían células con dos MN, lo que demuestra lesiones al ADN de mayor intensidad. Se encontró una frecuencia elevada de casos de abortos espontáneos (34,8%), superior a la encontrada en Brasil. Conclusión: La exposición de gestantes residentes en un municipio rural a los agrotóxicos eleva la tasa de abortos espontáneos, así como las posibilidades de ocurrencia de efectos mutagênicos

Oral health condition of elderly people with Parkinson disease / Condição de saúde bucal de idosos com doença de Parkinson

The oral hygiene of individuals with Parkinson disease (PD) is markedly impaired by difficulties in toothbrushing due to motor impairment and tremors. Additionally, it appears that other features associated with PD have an impact on the quality of oral health. Objective: this cross-sectional observational study characterized the oral health condition of individuals with PD. Methods: fifty individuals with PD, aged 53 to 94 years, users of medication for such condition were examined. The research participants had their oral cavities examined to assess prosthetic use and need; index of Decayed, Missing and Filled Teeth (DMFT); Community Periodontal Index (CPI); Periodontal Attachment Loss (PAL); and oral mucosa. In addition, a questionnaire was applied to obtain personal data, general health, and oral health. The data were analyzed using descriptive statistics. Results: a high prosthetic use was observed in the upper arch (92%), while the lower arch revealed high prosthetic need (66%). The DMFT index showed a high number of missing teeth, CPI showed a prevalence of 43% of dental calculus, and PAL revealed 28% of attachment loss of 4-5 mm. The most frequent findings in the assessment of oral mucosa were denture stomatitis and inflammatory fibrous hyperplasia. Conclusion: PD patients refer xerostomia and present high number of missing teeth, a minority of healthy teeth, and oral lesions, representing a target population for specialized oral health care. (AU)

A higiene bucal de indivíduos com doença de Parkinson (DP) é claramente prejudicada por dificuldades na escovação devido ao comprometimento motor e aos tremores. Além disso, outros aspectos relacionados à doença parecem impactar a qualidade da saúde bucal. Objetivo: este estudo observacional seccional caracterizou a condição de saúde bucal de indivíduos com DP. Métodos: foram examinados cinquenta indivíduos com DP, com idades variando entre 53 e 94 anos, que utilizavam medicamentos para DP. Os participantes da pesquisa foram submetidos a exame bucal para avaliar: uso e necessidade de prótese, índice de dentes cariados, perdidos e obturados (CPOD), Índice Periodontal Comunitário (IPC), Índice de Perda de Inserção Periodontal (PIP) e mucosa bucal. Além disso, foi aplicado um questionário para obtenção de dados pessoais e sobre saúde geral e saúde bucal. Os dados foram analisados usando estatística descritiva. Resultados: observou-se alto percentual de uso de prótese superior (92%), enquanto o arco inferior apresentou elevada necessidade de prótese (66%). O CPOD revelou um alto número de dentes perdidos; o IPC apresentou prevalência de 43% de cálculo dentário; e o PIP revelou 28% de perda de inserção de 4-5 mm. Os achados mais frequentes na avaliação da mucosa bucal foram estomatite por dentadura e hiperplasia fibrosa inflamatória. Conclusão: os indivíduos com DP mencionam xerostomia, apresentam alto número de dentes faltantes, um número reduzido de dentes saudáveis e lesões bucais, representando uma população-alvo para o cuidado de saúde bucal especializado. (AU)

Oral health profile of participants of an elderly cohabitation program in the state of Santa Catarina, Brazil / Perfil de saúde bucal dos participantes de um programa de convivência de idosos em Santa Catarina, Brasil

Abstract Introduction Cohabitation and social interaction programs have been shown to enhance several aspects of the quality of life of the elderly. Objective This observational study assessed the oral health and oral health perception of participants of an elderly cohabitation program in the state of Santa Catarina, Brazil. Material and method Calibrated dental students examined/interviewed 235 participants of the program. The oral examination considered Decayed, Missing, and Filled Teeth (DMFT) index, Community Periodontal Index (CPI), Periodontal Attachment Loss (PAL), use and need of prostheses, and presence of oral mucosal lesions. Oral health perception was verified with the Geriatric Oral Health Assessment Index (GOHAI) questionnaire. Data were analyzed with descriptive statistics and chi-square test (α=0.05). Result The mean DMFT index was 24.3 teeth, with emphasis on the 'Missing' category. Upper and lower prosthetic needs were 53.6 and 71.1%, respectively. Fifty-five per cent of participants presented oral mucosal lesions. Moderate oral health perception prevailed (43%), with mean GOHAI score of 29.9. The negative perception on physical and pain/discomfort dimensions was statistically associated with lower prosthetic need (p<0.05). Conclusion The participants of the cohabitation program presented poor oral health and prevalence of moderate oral health perception. Lower prosthetic need was associated with negative perception.

Resumo Introdução Programas de convívio e interação social tem melhorado vários aspectos da qualidade de vida de idosos. Objetivo Este estudo observacional avaliou a saúde bucal e a percepção de saúde bucal de participantes de um programa de convívio de idosos em Santa Catarina, Brasil. Material e método Duzentos e trinta e cinco participantes do programa Cidade do Idoso foram examinados/entrevistados por estudantes calibrados. O exame bucal considerou: índice de dentes cariados, perdidos e obturados (CPO-D), Índice Periodontal Comunitário (IPC), índice de Perda de Inserção Periodontal (PIP), uso e necessidade de prótese e presença de lesões de mucosa bucal. A percepção de saúde bucal foi verificada pelo Índice de Avaliação de Saúde Bucal Geriátrica (GOHAI). Os dados foram analisados com estatística descritiva e teste qui-quadrado (α=0,05). Resultado O CPO-D médio foi de 24,3 dentes, com ênfase à categoria 'perdidos'. Necessidade de prótese superior e inferior correspondeu a 53,6 e 71,1%, respectivamente; 55% apresentaram lesões de mucosa bucal. Uma percepção de saúde bucal moderada prevaleceu (43%), com um escore médio do GOHAI de 29,9. Uma percepção negativa nas dimensões física e dor/desconforto foi estatisticamente associada com a necessidade de prótese inferior (p<0,05). Conclusão Os participantes do programa Cidade do Idoso apresentaram uma saúde bucal precária e uma percepção de saúde bucal predominantemente moderada. A necessidade de prótese inferior foi associada a uma percepção negativa de saúde bucal.

Hemodynamic responses to strength exercise with blood flow restriction in small muscle groups / Respostas hemodinâmicas ao exercício de força com restrição de fluxo sanguíneo em pequenos grupos musculares

Abstract The aim of this study was to analyze the acute hemodynamic responses to strength exercise with blood flow restriction involving small muscle groups. The sample consisted of 10 male volunteers (22.6 ± 2.07 years, 1.78 ± 0.06 m, 76.32 ± 13.36 kg) who randomly performed two experimental protocols involving the elbow flexion exercise with the dominant arm: strength exercise of the elbow flexors with blood flow restriction (EFBFR) and strength exercise of the elbow flexors without blood flow restriction (EEF). A cross-over design with a seven to ten days interval between the experimental protocols was used. Systolic blood pressure (SBP), diastolic (DBP) and mean (MAP), pulse pressure (PP), heart rate (HR) and double product (DP) were evaluated at rest, immediately after exercise and at 15 minutes of recovery. SBP, DBP and MAP presented a significant increase (p <0.05) immediately after EFBFR when compared to the protocol without blood flow restriction, returning to rest values at the 15 minutes of recovery. DBP significantly reduced (p <0.05) in the recovery period only in the EFBFR experiment and HR increased post-effort in both experiments. The PP and DP did not change between the different times, regardless of the protocol.The results of the present study allow us to conclude that strength exercise with BFR involving small muscle groups was more efficient than exercise without BFR to promote acute changes in hemodynamic responses and that BFR did not represent a cardiovascular risk considering its effects on PP.

Resumo O presente estudo objetivou analisar as respostas hemodinâmicas agudas ao exercício de força com restrição do fluxo sanguíneo (RFS) realizado com pequenos grupos musculares. A amostra foi composta por 10 voluntários do sexo masculino (22,6 ± 2,07 anos, 1,78 ± 0,06 m, 76,32 ± 13,36 kg), que realizaram de forma aleatória os protocolos envolvendo o exercício de flexão da articulação do cotovelo, com membro dominante (rosca concentrada de bíceps) realizado com (ERFS) e sem restrição do fluxo sanguíneo (ESR). Utilizou-se o desenho cruzado, com intervalo de sete a dez dias entre os experimentos. Foram avaliadas: pressão arterial sistólica (PAS), diastólica (PAD) e média (PAM); pressão de pulso (PP), frequência cardíaca (FC) e duplo produto (DP), em repouso, imediatamente após o esforço, e após o esforço na fase de recuperação de 15 minutos. A PAS, PAD e PAM apresentaram elevação significativa (p <0,05) imediatamente após a realização do ERFS, quando comparadas ao protocolo sem restrição, retornando aos valores de repouso após a recuperação. A PAD reduziu significativamente (p <0,05) na recuperação, apenas no experimento ERFS e a FC elevou no pós-esforço em ambos os experimentos. A PP e o DP não sofreram alterações entre os diferentes momentos de avaliação, independentemente do protocolo. Os resultados do presente estudo permitem concluir que o exercício de força com RFS envolvendo pequenos grupos musculares foi mais eficiente que o exercício sem restrição para promover alterações agudas das respostas hemodinâmicas e que a RFS não representou um risco cardiovascular, considerando seus efeitos sobre a PP.

Acute responses of hemodynamic and oxidative stress parameters to aerobic exercise with blood flow restriction in hypertensive elderly women.

Systemic arterial hypertension has been associated with the majority deaths from cardiovascular disease, especially among the elderly population, and the imbalance between antioxidant and pro-oxidants has been associated with hypertension. This study analyzed the acute responses of cardiorespiratory and oxidative stress parameters to low intensity aerobic exercise (LIAE) with blood flow restriction (BFR) in hypertensive elderly women. The experimental group consisted of 16 hypertensive women (67.2 ± 3.7 years) who underwent a progressive treadmill test and performed three exercise protocols in random order: high intensity (HIAE), low intensity aerobic exercise (LIAE) and low intensity aerobic exercise with blood flow restriction (LIAE + BFR). Data analysis showed that blood pressure and heart rate augmented from rest to post effort (p < 0.05) and reduced from post effort to recovery (p < 0.05) in all protocols. The values of lipid peroxidation were higher after 30 min of recovery when compared to the moment at rest in the LILIAE + BFR (p < 0.05). The same occurred with glutathione-S-transferase and superoxide dismutase activity. However, non-protein thiols levels (NPSH) reduced after 30 min of recovery when compared to the moment at rest in the LILIAE + BFR protocol (p < 0.05). In the HIAE and LIAE + BFR protocols, the levels of NPSH were lower at 30 min of recovery when compared to the same moment in the LIAE protocol (p < 0.05). LIAE + RBF produces an oxidative status and hemodynamic stimulus similar to HIAE. Taken together, these results support the indication of LIAE with BFR in chronic intervention protocols, with potential benefits for the hypertensive elderly population.

Polifarmácia e fatores associados em idosos diabéticos / Polypharmacy and associated factors in elderly diabetic / Factores asociados con la polifarmacia en los ancianos diabéticos

RESUMO Objetivos Objetivou-se no presente estudo analisar os fatores associados à polimedicação, bem como, a utilização de medicamentos potencialmente inapropriados (MPI) em idosos diabéticos. Metodologia Foram avaliados 127 idosos com diagnóstico de diabetes mellitus tipo 2, sendo 41 do sexo masculino (idade = 69,9 ± 6,9 anos) e 86 do sexo feminino (idade = 71,1 ± 7,7 anos). Para avaliação das condições de saúde, uso de medicamentos, polimedicação e fatores associados, utilizou-se o questionário adaptado de Morais. Os medicamentos foram classificados de acordo com a Anatomical-Therapeutical-Chemical Classification System e para identificação dos MPI, adotou-se os critérios de Beers-Fick e PRISCUS. Para análise dos dados utilizou-se a estatística descritiva e os testes qui-quadrado de Pearson e Exato de Fisher. Resultados Na população estudada constatou-se que 100% utilizava medicamentos. O consumo médio foi de 5,8 fármacos por indivíduo, variando de 2 a 14, com uma prevalência de polifarmácia de 85%. Dentre os fatores estudados, apenas a aposentadoria apresentou uma associação estatisticamente significante (p<0,05) com a polimedicação. As patologias mais prevalentes foram: hipertensão arterial (92,8%), problemas cardíacos (70,8%), circulatórios (40,8%) e problemas osteoarticulares (44,5%). Dos fármacos utilizados pelos idosos, 12 deles foram considerados potencialmente inapropriados e 47,2% dos sujeitos estudados fazem uso destes medicamentos regularmente. Conclusão Desta forma, este estudo instiga novas formas de pensar a Assistência Farmacêutica, como uma prática vista sob a ótica integral e não pensada somente como compra e dispensação de medicamentos.(AU)

ABSTRACT Objectives The objective of this study was to evaluate factors related to polypharmacy and the use of potentially inappropriate medications (PIM) in elderly patients with diabetes. Methods We studied 127 elderly diagnosed with type 2 diabetes, 41 males (age = 69.9 ± 6.9 years) and 86 women (age = 71.1 ± 7.7 years). For evaluation of health conditions, medication use, polypharmacy and associated factors, we used the questionnaire adapted from Morais. The drugs were classified according to the Anatomical Therapeutic-Chemical Classification System, and for identification of MPI, we adopted the criteria of Beers-Fick and PRISCUS. For data analysis, we used descriptive statistics and chi-square and Fisher Exact tests. Results In this population, 100% of elderly using drugs. The average consumption was 5.8 per individual drug, varying from two to 14, and the prevalence of polypharmacy was 85%. Among the factors studied, only the retirement showed a statistically significant association (p <0.05) with polypharmacy. The most prevalent diseases were hypertension (92.8%), heart problems (70.8%), circulatory (40.8%) and musculoskeletal problems (44.5%). Of drugs used by the elderly, 12 of them were considered potentially inappropriate and 47.2% of the study subjects make use of these medicines regularly. Conclusions Thus, this study urges new thinking pharmaceutical assistance, as a practical view in full perspective and not meant only as purchasing and dispensing drugs.(AU)

RESUMEN Objetivos El objetivo de este estudio fue evaluar los factores asociados a la polifarmacia y el uso de medicamentos potencialmente inapropiados (MPI) en ancianos con diabetes. Métodos Se estudiaron 41 varones (edad = 69,9 ± 6,9 años) y 86 mujeres (edad = 71,1 ± 7,7 años), diagnosticados con diabetes tipo 2. Para la evaluación de las condiciones de salud, uso de medicamentos, polifarmacia y factores asociados, se utilizó el cuestionario adaptado de Morais. Los fármacos se clasificaron de acuerdo con el Sistema de Clasificación Terapéutico-Químico y Anatómico y para identificar el MPI adoptamos los criterios de Beers-Fick y Prisco. Para el análisis de datos utilizamos estadística descriptiva y pruebas de chi-cuadrado de Pearson y Test Exacto de Fisher. Resultados Toda la población estudiada usaban medicación. El consumo promedio fue de 5,8 fármacos por persona, desde 2 a 14, con una prevalencia de polifarmacia de 85%. Entre los factores estudiados, sólo el retiro o jubilación mostró una asociación estadísticamente significativa (p<0,05) con la polifarmacia. Las enfermedades más prevalentes fueron: hipertensión arterial (92,8%), problemas cardíacos (70,8%), circulatorios (40,8%) y problemas osteoarticulares (44,5%). Doce de los medicamentos utilizada por ancianos fueron considerados potencialmente inapropiados y el 47,2% de los sujetos del estudio hicieron uso de estas medicinas con regularidad. Conclusiones Los datos de este estudio sugieren nuevas formas de pensar acerca de la asistencia farmacéutica, desde un punto de vista práctico y sistémico, y no sólo como la compra y distribución de medicamentos.(AU)

Effects of hydroalcoholic extract of Celtis iguanaea on markers of cardiovascular diseases and glucose metabolism in cholesterol-fed rats

ABSTRACT Celtis iguanaea (Jacq.) Sarg., Cannabaceae, is popularly used in the treatment of diabetes mellitus. However, chemical and pharmacological investigations are lacking. In this study, we investigated the effects of the hydroalcoholic extract from C. iguanaea on markers of cardiovascular diseases and the glucose metabolism in cholesterol-fed rats. Therefore, hypercholesterolemic rats (1% cholesterol) were orally treated with C. iguanaea extract (C-150, CI-300, or CI-600 mg/kg) or simvastatin (4 mg/kg) (n = 6) once a day (30 days) with a hypercholesterolemic diet. A control group (C) was given saline. C. iguanaea extract showed significant decreases in serum levels of total cholesterol, LDL-cholesterol, HMG-CoA-reductase, interleukin-1 and 6, TNF-α and IFN-γ when compared to group C (p < 0.001). Hypoglycemic effects were observed along with a decrease of the activity of sucrase (CI-600), maltase (CI-150, CI-300), and an increase in muscle glycogen levels (CI-300). Antioxidant effects were observed in plasma by the decrease of TBARS and increase of nonprotein thiols levels (CI-600). The histopathological analysis showed a significant decrease in the liver fat area for C. iguanaea extract compared to group C (p < 0.001). Our results suggest that the biological effects of C. iguanaea extract could be related to the flavonoids that possibly exert antioxidant, enzymatic inhibitory, and insulin-mimetic effects.

[Polypharmacy and associated factors in elderly diabetic]. / Polifarmácia e fatores associados em idosos diabéticos.

OBJECTIVES: The objective of this study was to evaluate factors related to polypharmacy and the use of potentially inappropriate medications (PIM) in elderly patients with diabetes. METHODS: We studied 127 elderly diagnosed with type 2 diabetes, 41 males (age = 69.9 ± 6.9 years) and 86 women (age = 71.1 ± 7.7 years). For evaluation of health conditions, medication use, polypharmacy and associated factors, we used the questionnaire adapted from Morais. The drugs were classified according to the Anatomical Therapeutic-Chemical Classification System, and for identification of MPI, we adopted the criteria of Beers-Fick and PRISCUS. For data analysis, we used descriptive statistics and chi-square and Fisher Exact tests. RESULTS: In this population, 100% of elderly using drugs. The average consumption was 5.8 per individual drug, varying from two to 14, and the prevalence of polypharmacy was 85%. Among the factors studied, only the retirement showed a statistically significant association (p <0.05) with polypharmacy. The most prevalent diseases were hypertension (92.8%), heart problems (70.8%), circulatory (40.8%) and musculoskeletal problems (44.5%). Of drugs used by the elderly, 12 of them were considered potentially inappropriate and 47.2% of the study subjects make use of these medicines regularly. CONCLUSIONS: Thus, this study urges new thinking pharmaceutical assistance, as a practical view in full perspective and not meant only as purchasing and dispensing drugs.