Muscle Strength of Lower Limbs as a Postoperative Predictor in Bariatric Surgery.

OBJECTIVE: The aim of our study was to assess postoperative lower limbs muscle strength (MS) as a predictor of late surgical success (36 months). METHODS: Body composition analyses and isokinetic dynamometry evaluation were performed before (T0: n=123), six months (T1: n=123) and 36 months (T2: n=79) after Roux-en-y gastric bypass (RYGB). Surgical success (SS) was defined as ≥ 50% excess weight loss (EWL) 36 months after surgery or ≤ 50% surgical failure (SF). RESULTS: There was no difference between relative MS extension (Ext) and flexion (Flex) in T1 and T2. There was also, no difference between relative MS Ext and Flex in T1 and T2 between patients with SS and SF. There was a difference in relative MS Ext (144.9 ± 39.8 Nm/kg x 125.5 ± 29.2 Nm/kg; p=0.04) and Flex (73.6 ± 21.8 Nm/kg x 60.4 ± 15.8 Nm/kg; p=0.02) between SS and SF patients only in T2. Patients with an increment in Ext and Flex MS ≥4 Nm/kg at T1 had approximately 76% of SS at 36 months. CONCLUSION: An increase of lower limbs MS ≥4 Nm/kg 6 months after RYGB predicts SS at 36 months. CLINICALTRIALS: gov ID: NCT04129801.

Effect of concurrent training in unilateral transtibial amputees using Paralympic athletes as a control group.

CONTEXT: Transtibial Amputation (TA) predisposes to a sedentary lifestyle. OBJECTIVES: To evaluate the efficiency of a short-term (8-week) Concurrent Training (CT) program in Unilateral Transtibial Amputees (UTA) and to compare it with the physical condition of a group of Paralympic athletes in preparation for the Rio de Janeiro Paralympics. DESIGN: This was a longitudinal, prospective and controlled trial study. METHODS: Thirty-four male subjects with UTA and using prostheses for six months or more were selected for this study. They were divided into two groups: Group 1 (G1) ‒ 17 non-athlete and untrained UTA and Group 2 (G2) ‒ 17 paralympic athletes with active UTA in the training phase. G1 was evaluated before and after eight weeks of CT and G2 made a single evaluation for control. All were submitted to anamnesis, clinical evaluation (blood pressure, electrocardiogram, and heart rate) and cardiopulmonary exercise testing on a lower limb cycle ergometer, and isokinetic knee dynamometry. The CT of G1 included resistance exercise and aerobic interval training on a stationary bicycle and G2 followed the training of the Paralympic teams. RESULTS: Patients were retested by the same methods after CT. The two most important central dependent variables (maximal oxygen uptake and muscular strength) increased by 22% and knee extensor and flexor strength by 106% and 97%, respectively. CONCLUSION: After eight weeks of CT, there was an improvement in general functional condition, muscle strength, and cardiorespiratory performance improving protection against chronic diseases and quality of life.

Lack of molecular evidence of fecal-borne viruses in capybaras from São Paulo state, Brazil, 2018-2020: a minor public health issue.

Capybara (Hydrochoerus hydrochaeris) is the world's largest rodent species distributed throughout South America. These animals are incredibly tolerant to anthropogenic environments and are occupying large urban centers. Capybaras are known to carry potentially zoonotic agents, including R. rickettsia, Leishmania spp., Leptospira spp., Trypanosoma spp., Salmonella spp., Toxoplasma gondii, and rabies virus. Focusing on the importance of monitoring potential sources of emerging zoonotic viruses and new viral reservoirs, the aim of the present study was to assess the presence of fecal-borne viruses in the feces of capybaras living in urban parks in São Paulo state, Brazil. A total of 337 fecal samples were collected between 2018 and 2020 and screened for the following: (i) Rotavirus group A (RVA) by ELISA; (ii) non-RVA species and Picobirnavirus (PBV) using PAGE; (iii) Human Bocaparvovirus (HBoV), Bufavirus (BuV), Tusavirus (TuV), and Cutavirus (CuV) qPCR; (iv) Human Enterovirus (EV), Norovirus GII (NoV), and Hantavirus by in houses RT-qPCR; (v) SARS-CoV-2 via commercial RT-qPCR kit assay; and (vi) Astrovirus (AstV) and Adenovirus (AdV) using conventional nested (RT)-PCRs. All fecal samples tested were negative for fecal-borne viruses. This study adds further evidence that the fecal-borne viruses is a minor public health issue in Brazilian capybaras, at least during the surveillance period and surveyed areas. Continuous monitoring of sylvatic animals is essential to prevent and control the emergence or re-emergence of newly discovered virus as well as viruses with known zoonotic potential.

Effect of concurrent training in unilateral transtibial amputees using Paralympic athletes as a control group

Abstract Context: Transtibial Amputation (TA) predisposes to a sedentary lifestyle. Objectives: To evaluate the efficiency of a short-term (8-week) Concurrent Training (CT) program in Unilateral Transtibial Amputees (UTA) and to compare it with the physical condition of a group of Paralympic athletes in preparation for the Rio de Janeiro Paralympics. Design: This was a longitudinal, prospective and controlled trial study. Methods: Thirty-four male subjects with UTA and using prostheses for six months or more were selected for this study. They were divided into two groups: Group 1 (G1) - 17 non-athlete and untrained UTA and Group 2 (G2) - 17 paralympic athletes with active UTA in the training phase. G1 was evaluated before and after eight weeks of CT and G2 made a single evaluation for control. All were submitted to anamnesis, clinical evaluation (blood pressure, electrocardiogram, and heart rate) and cardiopulmonary exercise testing on a lower limb cycle ergometer, and isokinetic knee dynamometry. The CT of G1 included resistance exercise and aerobic interval training on a stationary bicycle and G2 followed the training of the Paralympic teams. Results: Patients were retested by the same methods after CT. The two most important central dependent variables (maximal oxygen uptake and muscular strength) increased by 22% and knee extensor and flexor strength by 106% and 97%, respectively. Conclusion: After eight weeks of CT, there was an improvement in general functional condition, muscle strength, and cardiorespiratory performance improving protection against chronic diseases and quality of life.

Self-Reported Mask Use in SARS-CoV-2 Vaccinated and Unvaccinated Populations

Wearing a facemask can help to decrease the transmission of COVID-19. We investigated self-reported mask use among subjects aged 18 years and older participating in the COVID-19 Community Research Partnership (CRP), a prospective longitudinal COVID-19 surveillance study in the mid-Atlantic and southeastern United States. We included those participants who completed [≥]5 daily surveys each month from December 1, 2020 through August 31, 2021. Mask use was defined as self-reported use of a face mask or face covering on every interaction with others outside the household within a distance of less than 6 feet. Participants were considered vaccinated if they reported receiving [≥]1 COVID-19 vaccine dose. Participants (n=17,522) were 91% non-Hispanic White, 68% female, median age 57 years, 26% healthcare workers, with 95% self-reported receiving [≥]1 COVID-19 vaccine dose through August; mean daily survey response was 85%. Mask use was higher among vaccinated than unvaccinated participants across the study period, regardless of the month of the first dose. Mask use remained relatively stable from December 2020 through April (range 71-80% unvaccinated; 86-93% vaccinated) and declined in both groups beginning in mid-May 2021 to 34% and 42% respectively in June 2021; mask use has increased again since July 2021. Mask use by all was lower during weekends and on Christmas and Easter, regardless of vaccination status. Independent predictors of higher mask use were vaccination, age [≥]65 years, female sex, racial or ethnic minority group, and healthcare worker occupation, whereas a history of self-reported prior COVID-19 illness was associated with lower use.

Factors associated with immunization against hepatitis B among primary health care professionals.

Introduction: The hepatitis B virus is the cause of one of the major public health problems worldwide. The infection may affect the entire population equally; however, health care professionals are part of a group that is more vulnerable to the disease, since they are exposed to both occupational and daily hazards. Objectives: To investigate the prevalence and factors associated with the immunization of health care professionals against the hepatitis virus type B, in the city of Montes Claros, state of Minas Gerais, Brazil. Methods: This was a cross-sectional and quantitative study, conducted with primary health care professionals. Using a random cluster sampling, 209 medical professionals, nurses, and nursing technicians who were interested in participating in the research were selected. A structured questionnaire was applied, and blood sampling was performed for the analysis of hepatitis B surface antibody titers. Finally, a descriptive and bivariate statistical analysis was conducted. Results: Data have shown that 91.8% of the professionals had complete immunization against the hepatitis B virus, that is, they had taken the three recommended doses of the vaccine. However, 13.9% of the sample, even after vaccination, was non-reactive (titers < 10 IU/mL hepatitis B surface antibody). Most of the professionals (94.3%) had direct contact with needlesticks/sharps at work and none of the participants reported a previous infection by the virus. Conclusions: Although most participants had complete immunization, the total result of individuals who did not obtain seroconversion was eminent, so the importance of the hepatitis B surface antibody test must be disseminated in the context of public health.

Introdução: O vírus da hepatite B é o causador de um dos grandes problemas de saúde pública mundial. A infecção pode acometer toda a população de igual maneira; entretanto, os profissionais de saúde são parte de um grupo mais vulnerável à doença, visto que são expostos tanto ao risco ocupacional quanto ao risco cotidiano. Objetivos: Investigar a prevalência e os fatores associados à imunização de profissionais de saúde contra o vírus da hepatite viral tipo B na cidade de Montes Claros, Minas Gerais, Brasil. Métodos: Tratou-se de um estudo transversal e quantitativo, realizado com profissionais de saúde da atenção primária. Por amostragem aleatória por conglomerado, foram selecionados 209 profissionais médicos, enfermeiros e técnicos de enfermagem que tiveram interesse em participar da pesquisa. Foi aplicado um questionário estruturado, e foi realizada coleta de sangue para análise de títulos de anticorpo contra o antígeno de superfície da hepatite B. Por fim, a análise estatística descritiva e bivariada foi efetuada. Resultados: Os dados evidenciaram que 91,8% dos profissionais tinham imunização completa contra o vírus da hepatite B - ou seja, haviam tomado as três doses preconizadas da vacina. Entretanto, 13,9% da amostra, mesmo após a vacinação, se mostrou não reagente (títulos < 10 UI/mL de anticorpo contra o antígeno de superfície da hepatite B). A maioria (94,3%) dos profissionais tinha contato direto no trabalho com materiais perfurocortantes, e nenhum participante relatou infecção prévia pelo vírus. Conclusões: Apesar do fato de que a maioria dos participantes tinha imunização completa, o resultado total de indivíduos que não obtiveram soroconversão foi eminente, de modo que há de se divulgar a valia do exame de anticorpo contra o antígeno de superfície da hepatite B no contexto de saúde pública.

Real-time monitoring and analysis of SARS-CoV-2 nanopore sequencing with minoTour.

MotivationThe ongoing SARS-CoV-2 pandemic has demonstrated the utility of real-time analysis of sequencing data, with a wide range of databases and resources for analysis now available. Here we show how the real-time nature of Oxford Nanopore Technologies sequencers can accelerate consensus generation, lineage and variant status assignment. We exploit the fact that multiplexed viral sequencing libraries quickly generate sufficient data for the majority of samples, with diminishing returns on remaining samples as the sequencing run progresses. We demonstrate methods to determine when a sequencing run has passed this point in order to reduce the time required and cost of sequencing. ResultsWe extended MinoTour, our real-time analysis and monitoring platform for nanopore sequencers, to provide SARS-CoV2 analysis using ARTIC network pipelines. We additionally developed an algorithm to predict which samples will achieve sufficient coverage, automatically running the ARTIC medaka informatics pipeline once specific coverage thresholds have been reached on these samples. After testing on run data, we find significant run time savings are possible, enabling flow cells to be used more efficiently and enabling higher throughput data analysis. The resultant consensus genomes are assigned both PANGO lineage and variant status as defined by Public Health England. Samples from within individual runs are used to generate phylogenetic trees incorporating optional background samples as well as summaries of individual SNPs. As minoTour uses ARTIC pipelines, new primer schemes and pathogens can be added to allow minoTour to aid in real-time analysis of pathogens in the future. Availability and ImplementationSource code and documentation is available at https://github.com/LooseLab/minotourapp. Supplementary informationSupplementary data are available from https://github.com/LooseLab/artic_minotour_analyses.

Intervenções psicoeducativas com contributos de Mindfulness, para redução da ansiedade, realizadas pelo EEESMP, em contexto de Hospital de Dia de Psiquiatria / Psychoeducational interventions with Mindfulness contributions, for anxiety reduction, carried out by the EEESMP, in a Psychiatric Day Hospital context

Viver com ansiedade, é mais frequente do que se imagina e afeta milhões de pessoas por todo o mundo diariamente. Cuidar de uma pessoa com ansiedade, é desafiador não apenas no ato de cuidar, mas também na promoção e manutenção do seu bem-estar, acarretando sofrimento para a pessoa e para a sua família. As intervenções psicoeducativas com contributos de Mindfulness, são eficazes para a redução da mesma. O presente relatório de Estágio pretende refletir sobre a importância das intervenções psicoeducativas com contributos de Mindfulness e descrever reflexivamente a aquisição de competências no Mestrado. O relatório suporta-se na Metodologia de Projeto tendo-se recorrido à Revisão Sistemática da Literatura para reunir evidência científica e elaborar uma proposta de cuidados. A implementação de intervenções psicoeducativas pelo Enfermeiro Especialista em Enfermagem de Saúde Mental e Psiquiátrica promove a redução da ansiedade. As metodologias adotadas possibilitaram a consecução dos objetivos propostos.

Living with anxiety is more frequent than you think and affects millions of people around the world on a daily basis. Taking care of a person with anxiety is challenging not only in the act of taking care, but also in promoting and maintaining their well-being, causing suffering for the person and their family. Psychoeducational interventions with contributions from Mindfulness are effective in reducing it. This Internship report aims to reflect on the importance of psychoeducational interventions with contributions from Mindfulness and to reflexively describe the acquisition of skills in the master's degree. The report is based on the Project Methodology, having resorted to the Systematic Literature Review to gather scientific evidence and elaborate a care proposal. The implementation of psychoeducational interventions by the Specialist Nurse in Mental Health and Psychiatric Nursing promotes the reduction of anxiety. The adopted methodologies made it possible to achieve the proposed objectives.

Functional health literacy in hypertensive elders at primary health care.

OBJECTIVE: to assess the relationship between inadequate functional health literacy and inadequate blood pressure control in older people with hypertension in Primary Health Care. METHOD: a cross-sectional study with sample calculated at 392. SAHLPA-18 tool was used for functional health literacy; blood pressure was measured; sociodemographic and clinical data were collected. Hierarchical logistic regression was used. RESULTS: (high) inadequate blood pressure and (low) functional inadequate health literacy were present in 41.6% and 54.6% of the people, respectively. Factors associated with inadequate blood pressure were: inadequate functional health literacy, black-brown skin color, overweight-obesity, hypertension diagnosis time, non-adherence to exercise/diet, drug treatment. Schooling had no association with inadequate blood pressure. CONCLUSION: hypertensive elderly people with inadequate health literacy were more likely to have inadequate blood pressure. Thus, health professionals need to value functional health literacy as a possible component to control blood pressure.

Evaluating the effects of exercise on cognitive function in hypertensive and diabetic patients using the mental test and training system.

OBJECTIVES: Systemic arterial hypertension (SAH) and diabetes mellitus (DM) are important risk factors for developing cognitive impairment. General life-style changes including physical training are known to reduce elevated blood pressure and sugar levels, as well as improve mental health. The objective of this study was to evaluate whether supervised physical exercise enhances the cognitive status of patients with chronic diseases. METHODS: Volunteers with SAH, DM or SAH + DM participated in either aerobic or resistance training during a period of 12 weeks. Several domains of cognitive functions were evaluated using the mental test and training system before and after the 3 months. RESULTS: Participants with either of these chronic diseases demonstrated significantly improved attention and concentration, but not reaction time, following the supervised exercise. CONCLUSIONS: Structured physical training promotes several aspects of cognitive functions in diabetic and hypertensive patients.

Functional health literacy in hypertensive elders at primary health care / Alfabetismo funcional en salud en personas hipertensas en la atención primaria / Alfabetismo funcional em saúde em pessoas idosas hipertensas na atenção primária

ABSTRACT Objective: to assess the relationship between inadequate functional health literacy and inadequate blood pressure control in older people with hypertension in Primary Health Care. Method: a cross-sectional study with sample calculated at 392. SAHLPA-18 tool was used for functional health literacy; blood pressure was measured; sociodemographic and clinical data were collected. Hierarchical logistic regression was used. Results: (high) inadequate blood pressure and (low) functional inadequate health literacy were present in 41.6% and 54.6% of the people, respectively. Factors associated with inadequate blood pressure were: inadequate functional health literacy, black-brown skin color, overweight-obesity, hypertension diagnosis time, non-adherence to exercise/diet, drug treatment. Schooling had no association with inadequate blood pressure Conclusion: hypertensive elderly people with inadequate health literacy were more likely to have inadequate blood pressure. Thus, health professionals need to value functional health literacy as a possible component to control blood pressure.

RESUMEN Objetivo: evaluar la relación entre alfabetismo funcional en salud inadecuada y control inadecuado de la presión arterial en personas ancianas hipertensas em la Atención Primaria de Salud. Método: estudio transversal com muestra calculada en 392. Se utilizó instrumento SAHLPA-18 para alfabetismo funcional en salud; a la presión arterial; recogidos datos sociodemográficos y clínicos. Se utilizo La regresión logística jerárquica. Resultados: La presión arterial inadecuada (alta) y el alfabetismo funcional en salud inadecuada (bajo) estaban presentes en el 41,6% y el 54,6% de las personas, respectivamente. Los factores asociados com la presión arterial inadecuada fueron: alfabetismo funcional en salud inadecuada, color parda-negra, sobrepeso-obesidad, tiempo de diagnóstico de la hipertensión, no adhesión a ejercicio/dieta, no adhesión al tratamiento medicamentoso. El nivel de escolaridad no tuvo asociación con la presión arterial inadecuada. Conclusión: las personas mayores hipertensas con alfabetismo funcional em salud inadecuada presentaron más posibilidades de tener presión arterial inadecuada. Así, los profesionales de La salud necesitan valorizar el alfabetismo funcional en salud como posible componente para controlar la presión arterial.

RESUMO Objetivo: avaliar a relação entre alfabetismo funcional em saúde inadequado e controle inadequado da pressão arterial em pessoas idosas hipertensas na Atenção Primária. Método: estudo transversal com amostra calculada em 392. Foi usado instrumento SAHLPA-18 para alfabetismo funcional em saúde; aferida a pressão arterial; coletados dados sociodemográficos e clínicos. Utilizou-se regressão logística hierárquica. Resultados: pressão arterial inadequada(alta) e alfabetismo funcional em saúde inadequado(baixo) estavam presentes em 41,6% e 54,6% das pessoas, respectivamente. Fatores associados com pressão arterial inadequada foram: alfabetismo funcional em saúde inadequado, cor parda-negra, sobrepeso-obesidade, tempo de diagnóstico da hipertensão, não adesão a exercício/dieta, não adesão a tratamento medicamentoso. O nível de escolaridade não teve associação com pressão arterial inadequada. Conclusão: pessoas idosas hipertensas com alfabetismo funcional em saúde inadequado apresentaram mais chance de ter pressão arterial inadequada. Assim, profissionais de saúde precisam valorizar o alfabetismo funcional em saúde como possível componente para controlar a pressão arterial.

Muscle strength and body composition in severe obesity.

OBJECTIVE:: The aim of our study was to evaluate associations between maximum voluntary contraction torques of the lower limbs and body composition for subjects with severe obesity. METHODS:: Body composition was evaluated by bioelectrical impedance analysis, and maximum voluntary contraction torques of the lower limbs were measured using an isokinetic dynamometer. One hundred thirty-two patients were enrolled (100 females and 32 males). Eighty-seven patients had a body mass index between 40 and 49.9 kg/m2 (the A group), and 45 patients had a body mass index between 50 and 59.9 kg/m2 (the B group). RESULTS:: Absolute extension and flexion torques had weak associations with fat-free mass but a moderate association with absolute extension torque and fat-free mass of the lower limbs. There were no significant differences between the A and B groups with respect to absolute extension and flexion torques. For the A group, absolute extension and flexion torques were moderately associated with fat-free mass and with fat-free mass of the lower limbs. For the B group, there were only moderate associations between absolute extension and flexion torques with fat-free mass of the lower limbs. CONCLUSIONS:: Our findings demonstrate that both groups exhibited similar absolute torque values. There were weak to moderate associations between absolute extension and flexion torques and fat-free mass but a moderate association with fat-free mass of the lower limbs. Individuals with severe obesity should strive for greater absolute torques, fat-free mass and especially fat-free mass of the lower limbs to prevent functional limitations and physical incapacity.

Muscle strength and body composition in severe obesity

OBJECTIVE: The aim of our study was to evaluate associations between maximum voluntary contraction torques of the lower limbs and body composition for subjects with severe obesity. METHODS: Body composition was evaluated by bioelectrical impedance analysis, and maximum voluntary contraction torques of the lower limbs were measured using an isokinetic dynamometer. One hundred thirty-two patients were enrolled (100 females and 32 males). Eighty-seven patients had a body mass index between 40 and 49.9 kg/m2 (the A group), and 45 patients had a body mass index between 50 and 59.9 kg/m2 (the B group). RESULTS: Absolute extension and flexion torques had weak associations with fat-free mass but a moderate association with absolute extension torque and fat-free mass of the lower limbs. There were no significant differences between the A and B groups with respect to absolute extension and flexion torques. For the A group, absolute extension and flexion torques were moderately associated with fat-free mass and with fat-free mass of the lower limbs. For the B group, there were only moderate associations between absolute extension and flexion torques with fat-free mass of the lower limbs. CONCLUSIONS: Our findings demonstrate that both groups exhibited similar absolute torque values. There were weak to moderate associations between absolute extension and flexion torques and fat-free mass but a moderate association with fat-free mass of the lower limbs. Individuals with severe obesity should strive for greater absolute torques, fat-free mass and especially fat-free mass of the lower limbs to prevent functional limitations and physical incapacity.

Papilomavírus Humano (HPV) e sua associação entre lesões cervical e anal em mulheres / Human papillomavirus (HPV) and its association between cervical and anal injuries in women

Introdução: Entre as doenças virais sexualmente transmissíveis, a infecção pelo Papilomavírus Humano (HPV) configura-se como a mais comum, e sua incidência vem aumentando acentuadamente nos últimos trinta anos. A infecção anal por subtipos específicos do HPV predispõe o indivíduo à neoplasia intraepitelial anal, que pode evoluir para o câncer de forma similar ao colo uterino. Objetivo: avaliar a associação tipo-específica entre infecções anais e cervicais, assim como os aspectos citopatológicos das lesões anais pelo vírus HPV em mulheres de São Luís, Maranhão. Métodos: Estudo analítico transversal com 27 mulheres atendidas no Centro de Pesquisa Clínica da UFMA, entre agosto de 2012 e julho de 2015, mediante entrevista e realização de exames complementares. Resultados: As mulheres tinham, em média, 32 anos. Em relação ao resultado do PCR, 77,7% das pacientes apresentaram resultado positivo para HPV anal, sendo o subtipo 16 o mais frequente (47,6%). Na região cervical, 88,8% apresentaram PCR positivo, sendo o mais comum o subtipo 16 (47,8%). A coinfecção anal e cervical pelo HPV foi observada em 74% das mulheres. 93,3% dos resultados de citologia anal não apresentaram alteração, assim como 72,2% das anuscopias realizadas. Conclusões: A infecção cervical por HPV é um fator sugestivo de risco para o desenvolvimento da infecção na região anal. (AU)

Introduction: Human Papillomavirus (HPV) infection is characterized as the most common among the sexually transmitted viral diseases and its incidence has been increasing dramatically in the last thirty years. Anal infection with specific HPV subtypes predisposes the individual to anal intraepithelial neoplasia, which can develop into cancer similar to the cervix. Objective: to evaluate the type-specific association between anal and cervical infections, as well as cytological aspects of anal lesions by HPV in women of São Luís, Maranhão. Methods: Cross-sectional study with 27 women assisted in the Clinical Research Center of UFMA, between August 2012 and July 2015, by means of interviews and examinations. Results: The patients had an average of 32 years. Regarding the result of PCR, 77.7% of patients tested positive for anal HPV 16 subtype being the most frequent (47.6%). In the cervical region, 88.8% had positive PCR, the most common subtype 16 (47.8%). The anal and cervical HPV co-infection was observed in 74% of women. As for anal cytology, 93,3% of patients had normal results, as well as 72,2% of anuscopias. Conclusion: The cervical HPV is a suggestive risk factor for the development of infection in the anal area. (AU)

Post-analysis methods for lactate threshold depend on training intensity and aerobic capacity in runners. An experimental laboratory study / Métodos de pós-análise do limiar do lactato dependem da intensidade de treinamento e da capacidade aeróbica dos corredores. Um estudo laboratorial experimental

ABSTRACT CONTEXT AND OBJECTIVE: This study aimed to evaluate different mathematical post-analysis methods of determining lactate threshold in highly and lowly trained endurance runners. DESIGN AND SETTING: Experimental laboratory study, in a tertiary-level public university hospital. METHOD: Twenty-seven male endurance runners were divided into two training load groups: lowly trained (frequency < 4 times per week, < 6 consecutive months, training velocity ≥ 5.0 min/km) and highly trained (frequency ≥ 4 times per week, ≥ 6 consecutive months, training velocity < 5.0 min/km). The subjects performed an incremental treadmill protocol, with 1 km/h increases at each subsequent 4-minute stage. ­Fingerprint ­blood-lactate analysis was performed at the end of each stage. The lactate threshold (i.e. the running velocity at which blood lactate levels began to exponentially increase) was measured using three different methods: increase in blood lactate of 1 mmol/l at stages (DT1), absolute 4 mmol/l blood lactate concentration (4 mmol), and the semi-log method (semi-log). ANOVA was used to compare different lactate threshold methods and training groups. RESULTS: Highly trained athletes showed significantly greater lactate thresholds than lowly trained runners, regardless of the calculation method used. When all the subject data were combined, DT1 and semi-log were not different, while 4 mmol was significantly lower than the other two methods. These same trends were observed when comparing lactate threshold methods in the lowly trained group. However, 4 mmol was only significantly lower than DT1 in the highly trained group. CONCLUSION: The 4 mmol protocol did not show lactate threshold measurements comparable with DT1 and semi-log protocols among lowly trained athletes.

RESUMO CONTEXTO E OBJETIVO: O objetivo do presente estudo é avaliar modelos matemáticos de pós-análise do limiar de lactato em grupos de corredores de longa distância muito ou pouco treinados. TIPO DE ESTUDO E LOCAL: Estudo laboratorial experimental. Hospital Público Universitário Terciário. MÉTODO: Vinte e sete corredores homens foram divididos em: pouco treinados (frequência < 4 vezes por semana, < 6 meses, velocidade ≥ 5,0 minutos/km) e muito treinados (frequência ≥ 4 vezes por semana, ≥ 6 meses, velocidade < 5,0 minutos/km). Os participantes foram submetidos a protocolo de esteira escalonado (1% inclinação) = 1 km/h por fase (4 minutos). Ao fim de cada estágio, análise da "impressão digital" metabolômica foi realizada. O limiar do lactato (i.e. velocidade em que o lactato sanguíneo aumenta exponencialmente) foi medido utilizando-se três métodos: aumento de 1 mmol/l da concentração, concentração absoluta de 4 mmol e método semi-log. ANOVA foi utilizada para comparar os diferentes limiares de lactato e grupos. RESULTADO: Atletas muito treinados apresentaram limiares de lactato maiores que os corredores pouco treinados, independentemente do método de cálculo utilizado. Comparando todos os corredores juntos, as análises de aumento de 1 mmol/l e semi-log não foram diferentes, enquanto a concentração absoluta de 4 mmol/l foi significativamente mais baixa que as dos dois outros métodos. Essas mesmas tendências foram observadas ao se compararem os métodos de limiar de lactato no grupo menos treinado. Entretanto, a análise absoluta de 4 mmol/l foi menor do que a do aumento de 1 mmol/l no grupo muito treinado. CONCLUSÃO: O método concentração absoluta de 4 mmol não mostrou mensurações comparáveis de limiar do lactato quando comparado com os protocolos aumento de 1 mmol/l e semi-log nos atletas pouco treinados.

Efficacy and safety of a cisplatin and paclitaxel induction regimen followed by chemoradiotherapy for patients with locally advanced head and neck squamous cell carcinoma.

BACKGROUND: The purpose of this phase II trial was to evaluate the tolerability, safety, and efficacy of a non-5-fluorouracil (5-FU)-based induction chemotherapy followed by chemoradiotherapy (CRT) for patients with locally advanced head and neck squamous cell carcinoma (HNSCC). METHODS: Sixty patients with stage III to IV HNSCC were treated with induction paclitaxel and cisplatin (TP; paclitaxel 175 mg/m(2) and cisplatin 80 mg/m(2) , 3 cycles) followed by CRT (cisplatin 100 mg/m(2) ; D1, 22, and 43 of radiotherapy). RESULTS: Fifty-six patients (93.3%) completed 3 cycles of induction TP (no treatment-related deaths), 52 (86.7%) completed definitive CRT per protocol (adverse event [AE] grade ≥2 in 53.3%). The overall response rate after induction TP was 82.5% for patients with resectable disease and 55.5% for unresectable disease (p = .023), and complete response (CR) rate after CRT was 70.0% for patients with resectable disease and 30.0% for unresectable disease (p = .005). CONCLUSION: Induction TP followed by cisplatin based-CRT was well-tolerated, safe, and had high overall response rate in selected patients with locally advanced HNSCC. © 2015 Wiley Periodicals, Inc. Head Neck 38: E970-E980, 2016.

Post-analysis methods for lactate threshold depend on training intensity and aerobic capacity in runners. An experimental laboratory study.

CONTEXT AND OBJECTIVE: This study aimed to evaluate different mathematical post-analysis methods of determining lactate threshold in highly and lowly trained endurance runners. DESIGN AND SETTING: Experimental laboratory study, in a tertiary-level public university hospital. METHOD: Twenty-seven male endurance runners were divided into two training load groups: lowly trained (frequency < 4 times per week, < 6 consecutive months, training velocity ≥ 5.0 min/km) and highly trained (frequency ≥ 4 times per week, ≥ 6 consecutive months, training velocity < 5.0 min/km). The subjects performed an incremental treadmill protocol, with 1 km/h increases at each subsequent 4-minute stage. -Fingerprint -blood-lactate analysis was performed at the end of each stage. The lactate threshold (i.e. the running velocity at which blood lactate levels began to exponentially increase) was measured using three different methods: increase in blood lactate of 1 mmol/l at stages (DT1), absolute 4 mmol/l blood lactate concentration (4 mmol), and the semi-log method (semi-log). ANOVA was used to compare different lactate threshold methods and training groups. RESULTS: Highly trained athletes showed significantly greater lactate thresholds than lowly trained runners, regardless of the calculation method used. When all the subject data were combined, DT1 and semi-log were not different, while 4 mmol was significantly lower than the other two methods. These same trends were observed when comparing lactate threshold methods in the lowly trained group. However, 4 mmol was only significantly lower than DT1 in the highly trained group. CONCLUSION: The 4 mmol protocol did not show lactate threshold measurements comparable with DT1 and semi-log protocols among lowly trained athletes.

Adiponectina: caracterização, ação metabólica e cardiovascular / Adiponectin: characterization, metabolic and cardiovascular action

Nas últimas duas décadas, o entendimento da biologia do tecido adiposo sofreu mudanças revolucionárias, passando de principal sítio de armazenamento energético a importante órgão endócrino responsável pela produçãoe secreção de proteínas, peptídeos e não peptídeos bioativos. Dentre as proteínas secretadas pelos adipócitos, aadiponectina (APN) é a mais abundante, apresentando ações fisiológicas importantes no sistema cardiovasculare endócrino, envolvendo a sensibilização da ação insulínica e regulação do metabolismo energético corporal, incluindo o coração. Esta revisão tem por objetivo descrever a ação da APN sobre o sistema cardiovascular. Foramincluídos artigos originais realizados com animais ou humanos. Consultadas as bases de dados Pubmed e Medlineentre os anos de 1994 e 2013. Não foram incluídos relatos de caso, estudos-piloto ou estudos de revisão. Utilizou-se como palavras-chave os descritores em ciências da saúde e MeSH específico para o Medline. Oscruzamentos realizados foram: Adiponectin AND Obesity, Adiponectin AND Metabolism e Adiponectin AND Cardiovascular Disease. Encontrados 303 artigos, excluídos 204 e selecionados 31 artigos que compuseram esteestudo. No contexto geral desta revisão a APN apresenta efeitos anti-inflamatórios e ateroprotetores no tecidovascular e ainda ação sensibilizadora para a insulina nos tecidos envolvidos nos metabolismos glicídico e lipídico. Assim, é considerado biomarcador importante para o desenvolvimento de doenças cardiovasculares.

In the last two decades, the understanding of adipose tissue biology underwent revolutionary changes, from a major energy storage site to an important endocrine organ responsible for the production and secretion of proteins, peptides and non-bioactive peptides. Among the proteins secreted by adipocytes, adiponectin (APN) is the most abundant, with important physiological actions in the cardiovascular and endocrine system, involving the sensitization of insulin action and regulation of body energy metabolism, including the heart. This review aims to describe the action of APN on the cardiovascular system. It includes original manuscripts with humans or animals. The databases PubMed and Medline, from years 1994 to 2013, were searched. Case reports, pilot studies or review studies have not been included. The health science descriptors and MeSH specific for Medline were used as keywords. The following cross searches were carried out: Adiponectin AND Obesity, Adiponectin AND Metabolism and Adiponectin AND Cardiovascular Disease. We found 303 manuscripts, excluded 204 and selected 31 manuscripts that were included this study. Inthe general context of this review, APN presents anti-inflammatory and ateroprotector effects in the vascular tissue and an insulin sensitizing action in tissues involved in glucose and lipid metabolism. It is thus considered an important biomarker for the developmentof cardiovascular diseases.

Correlation between Body Composition and Walking Capacity in Severe Obesity.

BACKGROUND: Obesity is associated with mobility reduction due to mechanical factors and excessive body fat. The six-minute walk test (6MWT) has been used to assess functional capacity in severe obesity. OBJECTIVE: To determine the association of BMI, total and segmental body composition with distance walked (6MWD) during the six-minute walk test (6MWT) according to gender and obesity grade. SETTING: University of São Paulo Medical School, Brazil; Public Practice. METHODS: Functional capacity was assessed by 6MWD and body composition (%) by bioelectrical impedance analysis in 90 patients. RESULTS: The mean 6MWD was 514.9 ± 50.3 m for both genders. The male group (M: 545.2 ± 46.9 m) showed a 6MWD higher (p = 0.002) than the female group (F: 505.6 ± 47.9 m). The morbid obese group (MO: 524.7 ± 44.0 m) also showed a 6MWD higher (p = 0.014) than the super obese group (SO: 494.2 ± 57.0 m). There was a positive relationship between 6MWD and fat free mass (FFM), FFM of upper limps (FFM_UL), trunk (FFM_TR) and lower limbs (FFM_LL). Female group presented a positive relationship between 6MWD and FFM, FFM_UL and FFM_LL and male group presented a positive relationship between 6MWD and FFM_TR. In morbid obese group there was a positive relationship between 6MWD with FFM, FFM_UL, FFM_TR and FFM_LL. The super obese group presented a positive relationship between 6MWD with FFM, FFM_TR and FFM_LL. CONCLUSIONS: Total and segmental FFM is associated with a better walking capacity than BMI.

Saneamento: promoção da saúde, qualidade de vida, sustentabilidade ambiental / Sanitation: health promotion, quality of life, environmental sustainability

Como serviço público, o saneamento se originou na era moderna,quando das grandes epidemias de cólera ocorridas em meados do século XIX. A visão higienista de então ainda é hegemônica. Um novo olhar deve incorporar a perspectiva do modelo de desenvolvimento e a compreensão de nossa relação com o ambiente. Tal perspectiva sobre o ambiente ainda é muito recente e as respostas dos Estados-nação diante da força das grandes corporações ainda se mostram insuficientes. Neste livro são assumidos pontos de vistas sobre o saneamento e apresentadas novas propostas baseadas nos conceitos de promoção da saúde e de sustentabilidade ambiental. Aqui, há uma inversão de olhar:não chegamos às pessoas partindo dos sistemas ou das obras físicas; ao invés disso, procuramos partir das pessoas, do modo como vivem, de sua cultura e sua inserção social e, com base nessas variáveis, buscar soluções. Considerar a cultura, as características socioeconômicas e as condições de vida das pessoas permite buscar soluções tecnológicas e de gestão socioculturalmente adequadas. Por, historicamente, não ter levado em contra os referidos aspectos, o saneamento tem se mostrado uma das políticas públicas mais atrasadas do Brasil. Neste pequeno livro, propomos novos olhares e novas estratégias em saneamento, tendo como fio condutor as relações entre desenvolvimento, ambiente e saúde, e como dimensões norteadoras a promoção da saúde, a sustentabilidade ambienta e o trinômio tecnologia, gestão e aspectos socioculturais. Ao propor que o saneamento envolva novos atores sociais, novos olhares dos especialistas e especialistas de novas áreas, procuramos contribuir para renovar as abordagens nessa área. (AU)