Effects of a multicomponent training and detraining on frailty status, physical activity level, sedentary behavior patterns and physical performance of pre-frail older adults: a randomized controlled trial.

PURPOSE: To evaluate the effects of a multicomponent training protocol and detraining on frailty status, physical activity level, sedentary behavior patterns, and physical performance in pre-frail older adults. METHODS: A randomized controlled blinded trial was conducted with pre-frail older adults (74.8 ± 6.4 years, 70.4% female), who were allocated to receive a multicomponent training (MulTI = 16) or control group (CG = 11), which received guidance to maintain their daily living habits. Assessments of the frailty phenotype, physical activity levels measured by accelerometer, and physical performance (gait speed, timed up and go, short physical performance battery) were conducted at pre-intervention, post-intervention (16 weeks), and follow-up (6 weeks). The effect of the intervention was analyzed using the marginal homogeneity test and the two-way ANOVA with repeated measures. RESULTS: All older adults who received the MulTI reversed their frailty status to non-frail (p < 0.001), and after follow-up, 87.5% remained non-frail. In the CG, one older adult reversed their frailty status to non-frail and another became frail (p > 0.05), maintaining this status after the follow-up period. Furthermore, only the older adults in the MulTI showed an improvement in gait speed post-intervention, which was maintained through follow-up (p = 0.008). No changes were observed in the other variables. CONCLUSION: The MulTI was efficient to reverse the process of frailty and improving gait speed in pre-frail older adults. However, receiving only the MulTI was not sufficient to increase physical activity levels and reduce sedentary behavior patterns, necessitating the implementation of behavioral change strategies. TRIAL REGISTRATION: ClinicalTrials.gov NCT03110419.

Effects of a Multifactorial Program with Case Management for Falls Prevention on Functional Outcomes in Community-Dwelling Older People: A Randomized Clinical Study.

Falls are among the top 10 causes of years lived with disability in people aged 75 and over. Preventive programs like case management (CM) are crucial. OBJECTIVES: To evaluate the effects of a multifactorial fall prevention program based on CM on physical performance, the presence of pain, and the risk of falls and fractures in older people who have suffered falls. METHODS: This randomized, single-blind clinical trial with parallel groups, Intervention Group (IG) and Control Group (CG), was composed of 55 older people with a history of falling, living in the community. All participants underwent an initial assessment via video call (containing anamnesis, timed up-and-go test, falls risk score, short physical performance battery, and clinical frax). The IG underwent CM, the physical exercise protocol, and the cognitive stimulation protocol. The CG was monitored through telephone calls and received general health and fall guidance. RESULTS: No significant results were found in the physical capacity, the presence of pain, the risk of falls, or the fractures between the Intervention and Control Groups and between assessments. CONCLUSION: This program was not effective in improving functional performance, but it was important for characterizing pain and the probability of fracture in the next 10 years in this population.

Effects of Detraining on Physical Capacity and Its Relationship With Depressive Symptoms, Quality of Life and Sedentary Behavior in Community-Dwelling Older Adults: A Longitudinal Study.

BACKGROUND: Detraining is the partial or complete loss of physical training-induced adaptations as a result of exercise interruption or reduction. The COVID-19 pandemic led to the discontinuation of many older adult exercise programs and led to increased depressive symptoms (DS), increased sedentary behavior (SB), and decreased quality of life (QoL). OBJECTIVE: To evaluate the effects of detraining, in the pandemic, on physical capacity and its relationship with DS, QoL, and SB of community-dwelling older adults. METHODS: The physical capacity (static balance, dynamic balance, and lower limb and handgrip strength) of 35 participants was assessed prepandemic and after 18 and 24 months of the pandemic. DS, QoL, and SB were evaluated only at 18-month period. The analysis of variance for repeated measures or the Friedman and Pearson or Spearman tests were used for statistical analysis. RESULTS: There was a decline in dynamic balance (p < .001) and strength in the lower limbs (p < .001) in the first 18 months, as well as maintenance in the following 6 months. The reduction in dynamic balance during the 18 months of the pandemic was associated with greater DS (p = .015; r = .414) and worse QoL (p = .024; r = -.381) in this period. More time spent on SB (p = .024; r = .386) in the 18th month was associated with worse dynamic balance in the following 6 months. CONCLUSION: Detraining in the pandemic setting led to long-lasting harmful effects, which can last for 2 years, on the physical capacity of community-dwelling older adults. IMPLICATION: Our findings highlight how periods of detraining can interfere in physical and mental health of older adults.

Effects of case management based on preventing falls in older people: A systematic review.

BACKGROUND: Falls among older adults can lead to negative consequences with physical, functional, social, and psychological functioning, and a high prevalence of mortality. However, it is still unclear whether case management can reduce the number of falls in this population. AIMS: The aims of this review were to analyze the effects of case management on preventing falls and reducing risk factors for falls in older people. METHODS: A systematic review was conducted, searching for and synthesizing clinical trials involving case management in older people who had falls or risk for fall outcomes. Two authors extracted data using predefined data fields, and risk of bias was assessed by the Physiotherapy Evidence Database (PEDro) scale. RESULTS: Twelve studies were included in the final review. Case management in older people did not significantly reduce the number of falls, falls per person, or severity of falls compared to control groups. Adherence to recommendations in case management ranged from 25% to 88%. LINKING EVIDENCE TO ACTION: There is limited evidence of reduced rates of falls and specific risk factors for falls among people who received case management interventions. Randomized trials with good quality are needed.

Can timed up and go subtasks predict functional decline in older adults with cognitive impairment?

Even in the early stages of cognitive impairment, older people can present important motor alterations. However, there are no studies that have investigated Timed Up and Go (TUG) and its subtasks in predicting impairment of functional capacity over time in this population. Objectives: The aim of this study was to verify if the TUG test and its subtasks can predict functional decline over 32 months in older adults with mild cognitive impairment (MCI) and mild Alzheimer's disease (AD). Methods: This is a prospective 32-month follow-up study, including at baseline 78 older adults (MCI: n=40; AD: n=38). The TUG and its subtasks (e.g., sit-to-stand, walking forward, turn, walking back, and turn-to-sit) were performed at baseline using the Qualisys Motion system. Functional capacity was assessed at baseline and after 32 months. Results: After follow-up, the sample had 45 older adults (MCI: n=25; AD: n=20). Of these, 28 declined functional capacity (MCI: n=13; AD: n=15). No TUG variable significantly predicted (p>0.05) functional decline in both groups, by univariate logistic regression analysis with the covariate gender. Conclusions: Although older adults with MCI and mild AD declined functional capacity, the TUG test and its subtasks could not predict this decline over 32 months.

Mesmo nos estágios iniciais do comprometimento cognitivo, os idosos podem apresentar alterações motoras importantes. No entanto, não há estudos que tenham investigado o timed up and go (TUG) e suas subtarefas como preditores do comprometimento da capacidade funcional ao longo do tempo nessa população. Objetivos: O objetivo deste estudo foi verificar se o teste timed up and go (TUG) e suas subtarefas podem predizer o declínio funcional ao longo de 32 meses em idosos com comprometimento cognitivo leve (CCL) e doença de Alzheimer leve (DA). Métodos: Este é um estudo prospectivo de acompanhamento de 32 meses, que incluiu no início do estudo 78 idosos (CCL: n=40; DA: n=38). O TUG e suas subtarefas (sentar para levantar, caminhar para frente, virar, caminhar para trás e girar para sentar) foram realizados na linha de base pelo sistema Qualisys Motion. A capacidade funcional foi avaliada no início e após 32 meses. Resultados: Depois do seguimento, a amostra foi composta de 45 idosos (CCL: n=25; DA: n=20). Destes, 28 tiveram a capacidade funcional diminuída (CCL: n=13; DA: n=15). Nenhuma variável do TUG previu declínio funcional significativamente estatístico (p>0,05) em nenhum dos grupos, por meio da análise de regressão logística univariada com a covariável sexo. Conclusões: Embora os idosos com CCL e DA leve tenham tido sua capacidade funcional diminuída, o teste TUG e suas subtarefas não puderam prever esse declínio em 32 meses.

Can timed up and go subtasks predict functional decline in older adults with cognitive impairment? / As subtarefas do timed up and go podem predizer o declínio funcional em idosos com comprometimento cognitivo?

ABSTRACT. Even in the early stages of cognitive impairment, older people can present important motor alterations. However, there are no studies that have investigated Timed Up and Go (TUG) and its subtasks in predicting impairment of functional capacity over time in this population. Objectives: The aim of this study was to verify if the TUG test and its subtasks can predict functional decline over 32 months in older adults with mild cognitive impairment (MCI) and mild Alzheimer's disease (AD). Methods: This is a prospective 32-month follow-up study, including at baseline 78 older adults (MCI: n=40; AD: n=38). The TUG and its subtasks (e.g., sit-to-stand, walking forward, turn, walking back, and turn-to-sit) were performed at baseline using the Qualisys Motion system. Functional capacity was assessed at baseline and after 32 months. Results: After follow-up, the sample had 45 older adults (MCI: n=25; AD: n=20). Of these, 28 declined functional capacity (MCI: n=13; AD: n=15). No TUG variable significantly predicted (p>0.05) functional decline in both groups, by univariate logistic regression analysis with the covariate gender. Conclusions: Although older adults with MCI and mild AD declined functional capacity, the TUG test and its subtasks could not predict this decline over 32 months.

RESUMO Mesmo nos estágios iniciais do comprometimento cognitivo, os idosos podem apresentar alterações motoras importantes. No entanto, não há estudos que tenham investigado o timed up and go (TUG) e suas subtarefas como preditores do comprometimento da capacidade funcional ao longo do tempo nessa população. Objetivos: O objetivo deste estudo foi verificar se o teste timed up and go (TUG) e suas subtarefas podem predizer o declínio funcional ao longo de 32 meses em idosos com comprometimento cognitivo leve (CCL) e doença de Alzheimer leve (DA). Métodos: Este é um estudo prospectivo de acompanhamento de 32 meses, que incluiu no início do estudo 78 idosos (CCL: n=40; DA: n=38). O TUG e suas subtarefas (sentar para levantar, caminhar para frente, virar, caminhar para trás e girar para sentar) foram realizados na linha de base pelo sistema Qualisys Motion. A capacidade funcional foi avaliada no início e após 32 meses. Resultados: Depois do seguimento, a amostra foi composta de 45 idosos (CCL: n=25; DA: n=20). Destes, 28 tiveram a capacidade funcional diminuída (CCL: n=13; DA: n=15). Nenhuma variável do TUG previu declínio funcional significativamente estatístico (p>0,05) em nenhum dos grupos, por meio da análise de regressão logística univariada com a covariável sexo. Conclusões: Embora os idosos com CCL e DA leve tenham tido sua capacidade funcional diminuída, o teste TUG e suas subtarefas não puderam prever esse declínio em 32 meses.

Self-management strategies and multicomponent training to mitigate the effects of the interruption of physical exercise programmes in the pandemic context on functionality, sedentary behaviour, physical capacity, mental health, body composition and quality of life in older adults: a blinded randomized controlled study protocol.

BACKGROUND: Considering the confinement recommended by the World Health Organization due to the pandemic caused by COVID-19, many community physical exercise programmes for older adults have had their activities cancelled. In this context, proposing strategies to recover the possible adverse effects of the confinement period is pertinent. The use of self-management strategies associated with regular physical activity reduces sedentary behaviour and improves physical capacity in older adults. Thus, the purpose of this study was to describe a multicomponent training programme combined with a self-management strategy protocol to mitigate the effects of interruptions in physical exercise programmes on functionality, physical capacity, mental health, body composition and quality of life in older adults. METHODS: This will be a blinded, randomized and controlled clinical trial performed in São Carlos, SP, Brazil. Eighty older adults will be divided into two groups: multicomponent training (Multi) and multicomponent training + self-management strategies (Multi+SM). The intervention will be performed over 16 weeks on three alternate days of every week, with 50-min sessions. The assessment of physical capacity will be performed before the interruption of physical exercise programmes (T0: initial assessment, March 2020), preintervention (T1: immediately after the return of the exercise programme) and postintervention (T2). The assessments of physical activity level, quality of life, mental health, functionality and body composition will be performed at T1 and T2. DISCUSSION: The results from this MC+SM protocol will allow us to contribute clinical support to evaluate the variables analysed and to guide future public health policies with the aim of minimizing the possible deleterious effects arising from the physical exercise interruption periods caused by epidemics and pandemics. TRIAL REGISTRATION: RBR-10zs97gk . Prospectively registered in Brazilian Registry of Clinical Trials (ReBEC) on 17 June 2021. Registry name: Use of self-management strategies combined with multicomponent training to mitigate the effects of social distancing due to COVID-19 on capacity, physical capacity, mental health and quality of life in older adults - A blind, randomized and controlled clinical trial.

A Case Management Program at Home to Reduce Fall Risk in Older Adults (the MAGIC Study): Protocol for a Single-Blind Randomized Controlled Trial.

BACKGROUND: Individual case management programs may be particularly effective in reducing fall risk as they can better identify barriers and facilitators to health recommendations. OBJECTIVE: This paper describes the protocol for a single-blind, parallel-group randomized controlled trial that aims to investigate the effectiveness and cost-effectiveness of a home-based multifactorial program targeting fall risk factors among people aged 60 years and over who have fallen at least twice in the past 12 months (the MAGIC trial). METHODS: Older people with a history of at least 2 falls in the last year will be divided into 2 groups. The intervention group will receive case management at home for reducing the risk of falls, including a multidimensional assessment, explanation of fall risk factors, and elaboration and monitoring of an individualized intervention plan based on the identified fall risk factors, personal preferences, and available resources. The control group will be monitored once a month. Assessments (clinical data, fall risk awareness, physical and mental factors, safety at home, feet and shoes, and risk and rate of falls) will be carried out at baseline, after 16 weeks of the intervention, and at the posttrial 6-week and 1-year follow-up. After 16 weeks of the intervention, satisfaction and adherence to the intervention will also be assessed. Economic health will be evaluated for the period up to the posttrial 1-year follow-up. RESULTS: Data collection started in April 2021, and we expected to end recruitment in December 2021. This case management program will address multifactorial assessments using validated tools and the implementation of individualized intervention plans focused on reducing fall risk factors. CONCLUSIONS: This trial may provide reliable and valuable information about the effectiveness of case management for increasing fall risk awareness and reducing fall risk in older people. TRIAL REGISTRATION: Brazilian Clinical Trials Registry (ReBec) RBR-3t85fd; https://ensaiosclinicos.gov.br/rg/RBR-3t85fd. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): DERR1-10.2196/34796.

Progression of Gait Changes in Older Adults With Mild Cognitive Impairment: A Systematic Review.

BACKGROUND AND PURPOSE: The identification of altered gait and its progression over time is important to gaining a better understanding of the clinical aspects of mild cognitive impairment (MCI) in older adults. The aim of the present systematic review was to determine changes in gait variables over time among older adults with MCI. METHODS: The PubMed, Web of Science, Scopus, and Science Direct databases were searched for relevant articles using the following keywords and Medical Subject Headings: Aged AND "Mild cognitive impairment" AND (gait OR locomotion). A hand search was also performed of the reference lists of the selected articles in an attempt to find additional records. The following were the inclusion criteria: longitudinal studies and clinical trials involving a control group without intervention; samples of individuals 65 years or older; and characterization of gait using a single or dual task. RESULTS AND DISCUSSION: The initial search led to the retrieval of 6979 studies, 9 of which met the inclusion criteria. The duration of follow-up among the studies ranged from 6 months to 2 years. Most trials investigated gait speed. Other gait variables were step length, time required to walk a given distance, and mean weekly gait speed. Altered gait progressed in older adults with MCI. The main alterations were gait speed and variability in daily number of steps in follow-up periods lasting more than 1 year. No significant changes in gait variables were found in shorter follow-up periods (up to 6 months). CONCLUSIONS: The progression of gait changes in older adults with MCI has been underinvestigated. MCI leads to reduced gait speed in longer follow-up periods. Such information can contribute to the determination of motor interventions for older adults with MCI, especially in the early stages.

Perfil das manifestações musculoesqueléticas em esclerose sistêmica e associação com fator reumatoide / Profile of musculoskeletal manifestations in systemic sclerosis and association with rheumatoid factor

A esclerose sistêmica (ES) é doença sistêmica crônica e autoimune. Estima-se que dor musculoesquelética esteja presente entre 40-80% dos pacientes, sobretudo naqueles com doença difusa precoce. O objetivo deste trabalho foi estudar a prevalência de manifestações musculoesqueléticas em ES, verificar se sua presença altera o perfil clínico, qual a prevalência de fator reumatoide na ES e sua associação com manifestações musculoesqueléticas. É estudo retrospectivo envolvendo 48 pacientes com ES. Foram coletados dados sobre epidemiologia, manifestações clínicas e exames laboratoriais Coletou-se também o valor do HAQ. Em conclusão, manifestações articulares da ES estão associadas com pior funcionalidade e a miosite aparece nos mais jovens. Um quarto dos pacientes é positivo para fator reumatoide, mas ele não se associa com as manifestações musculoesqueléticas.

Systemic sclerosis (SSc) is a chronic and autoimmune systemic disease. It is estimated that musculoskeletal pain is present in 40-80% of patients, especially those with early diffuse disease. The objective of this work was to study the prevalence of musculoskeletal manifestations in SSc, verify if its presence alters the clinical profile, the prevalence of rheumatoid factor in SSc and its association with musculoskeletal manifestations. It is a retrospective study involving 48 patients with SSc. Data on epidemiology, clinical manifestations and laboratory tests were collected. The HAQ value was also collected. In conclusion, joint manifestations of SSc are associated with worse functionality and myositis appears in the youngest. A quarter of patients are positive for rheumatoid factor but it is not associated with musculoskeletal manifestations.

Artéria tibial aberrante: revisão da literatura / Aberrant tibial artery: a literature review

A artéria tibial anterior, originária da artéria poplítea, normalmente se ramifica abaixo da articulação do joelho, passando posteriormente ao músculo poplíteo. Desta forma, a existência da artéria tibial aberrante ocorre quando sua ramificação está alterada, podendo se formar em diferentes alturas da artéria poplítea e realizar cursos alterados em relação aos músculos e articulações. Essas variações podem aumentar o risco de lesões intra-operatórias. O objetivo deste estudo foi realizar revisão de literatura sobre o tema pouco abordado, visando promover maior conhecimento e prevenção de iatrogenia nos atos operatórios. Foi realizada busca em bases de dados eletrônicas (PubMed, Scielo e Biblioteca Virtual em Saúde) utilizando os seguintes descritores: artérias da tíbia, artéria poplítea, e variação anatômica. Para a seleção dos artigos, foram utilizados os seguintes critérios de inclusão: resultados de pesquisa com relevância ao tema proposto, por meio de leitura crítica de cada artigo selecionado e em seguida, foram realizadas comparações das informações de cada um deles. Foram selecionados 10 artigos. Em conclusão, a presença de artéria tibial anterior aberrante é alteração anatômica de baixa incidência, mas é responsável por intercorrências durante procedimentos cirúrgicos, devido à sua localização próxima à tíbia. Sugere-se realização de exames de imagens para diagnóstico pré-operatório dessa anormalidade anatômica.

The anterior tibial artery, originating from the popliteal artery, normally branches below the knee joint, passing posteriorly to the popliteal muscle. In this way, the existence of the aberrant tibial artery occurs when its branch is altered, being able to form at different heights of the popliteal artery and carry out altered courses in relation to the muscles and joints. These variations can increase the risk of intraoperative injuries. So, the proposal to this review was to promote greater knowledge and prevention of iatrogenesis in surgical procedures. A search was performed in electronic databases (PubMed, Scielo and Virtual Health Library) using the following descriptors: tibial arteries, popliteal artery, and anatomical variation. For the selection of articles, the following inclusion criteria were used: research results with relevance to the proposed topic, through a critical reading of each selected article and then comparisons of the information on each of them were carried out. 10 articles were selected. In conclusion, the presence of an aberrant anterior tibial artery is an anatomical alteration of low incidence, but it is responsible for complications during surgical procedures, due to its location close to the tibia. It is suggested to perform imaging tests for preoperative diagnosis of this anatomical abnormality.

Avaliação comparativa do perfil clínico, laboratorial e de tratamento da artrite psoriásica por gênero e subtipo da artrite / Comparative evaluation of the clinical, laboratory and treatment profile of psoriasic arthritis by gender and arthritis subtype

A artrite psoriásica (AP) é inflamatória, autoimune e associada à psoríase cutânea. Fatores hormonais e cromossomos sexuais foram identificados como possíveis fatores patogenéticos indutores de dimorfismo sexual imunológico, refletindo na apresentação de doenças autoimunes e conduta. O objetivo desta pesquisa foi comparar diferenças em prevalência de subtipos da AP, nas manifestações clínicas articulares e extra-articulares, assim como no tratamento. Foi observacional transversal com avaliação descritiva e retrospectiva. Foram coletados dados epidemiológicos, subtipo de doença, perfil laboratorial, manifestações clínicas extra-articulares e histórico de medicamentos. A população com AP encontrada foi tipicamente masculina, meia-idade, menos de uma década com a doença e com provas inflamatórias elevadas. A principal manifestação extra-articular encontrada foi dactilite e a medicação foi metotrexato. Os homens tiveram mais acometimento ungueal e cessaram mais o tabagismo, quando comparados às mulheres.

Psoriatic arthritis (PA) is an autoimmune inflammatory disease and associated with cutaneous psoriasis. Hormonal factors and sex chromosomes were identified as possible pathogenic factors inducing immunological sexual dimorphism, reflecting on the presentation of autoimmune diseases and behavior. The aim of this research was to compare differences in the prevalence of PA subtypes, in articular and extra-articular clinical manifestations, and in treatment. It was observational cross-sectional with descriptive and retrospective evaluation. Epidemiological data, disease subtype, laboratory profile, extra-articular clinical manifestations and medication history were collected. The population with PA found was typically male, middle-aged, less than a decade with the disease, and with high inflammatory evidence. The main extra-articular manifestation found was dactylitis and the medication was methotrexate. Men had more nail involvement and stopped smoking more when compared to women.

Autoimunidade em pacientes com endometriose: associação clinicolaboratorial / Autoimmunity in patients with endometriosis: clinical-laboratory association

A endometriose é condição ginecológica crônica, caracterizada pela presença de tecido semelhante ao endométrio fora da cavidade uterina. Apesar da causa ser complexa e pouco elucidada, estudos sugerem fortes associações entre endometriose e anormalidades no sistema imunológico. Assim é importante determinar a prevalência de fator anti nuclear (FAN) e anti-DNA em pacientes diagnosticadas com endometriose e suas associações. Foi realizado estudo transversal analítico para elucidar o tema. A amostra foi composta por 94 pacientes com diagnóstico de endometriose confirmado por videolaparoscopia e biópsia com estudo anatomopatológico. Como grupo controle foram utilizados 91 pacientes pareados em idade e gênero. Em conclusão, pacientes com endometriose apresentam maior prevalência de FAN em relação ao grupo controle. A positividade do FAN não tem associação com o estadiamento ASRM da endometriose e gravidade da doença. As pacientes com endometriose não apresentaram reatividade para o anticorpo anti-ds-DNA.

Endometriosis is a chronic gynecological condition, characterized by the presence of tissue similar to the endometrium outside the uterine cavity. Although the etiology is complex and poorly understood, studies suggest strong associations between endometriosis and abnormalities in the immune system. Thus, it is important to determine the prevalence of anti-nuclear factor (ANA) and anti-DNA in patients diagnosed with endometriosis and their associations. An analytical cross-sectional study was carried out to elucidate the topic. The sample consisted of 94 patients with a diagnosis of endometriosis confirmed by videolaparoscopy and biopsy with anatomopathological study. As a control group, 91 patients matched for age and gender were used. In conclusion, patients with endometriosis have a higher prevalence of ANA compared to the control group. ANA positivity is not associated with ASRM staging of endometriosis and disease severity. Patients with endometriosis did not show reactivity to anti-ds-DNA antibody.

Modelo experimental de infarto agudo do miocárdio em coelhos / Experimental model of acute myocardial infarction in rabbits

Relacionado às doenças cardiovasculares, o infarto agudo do miocárdio (IAM) é a primeira causa de morte entre pacientes com doença coronariana em todo o mundo. Estudos com animais são utilizados devido à similaridade com a fisiologia e anatomia humanas. Relatos demostram utilização experimental com coelhos, pois a sua anatomia coronariana é similar aos humanos. Esta pesquisa teve por objetivo reproduzir e validar o modelo experimental controlado de IAM da parede apical anterolateral do ventrículo esquerdo em coelhos através da ligadura do ramo da artéria coronária esquerda. Foi selecionado um coelho macho para indução de IAM por ligadura coronariana. A intervenção cirúrgica consistiu na ligadura do ramo coronariano por meio de toracotomia póstero-lateral esquerda. O coração foi submetido à avaliação anatomopatológica e morfométrica para se estimar o volume percentual infartado. Em conclusão, o IAM foi alcançado com a ligadura coronariana controlada, histologicamente transmural extenso, mostrando-se eficaz e reprodutível para avaliação de novas intervenções terapêuticas e abordagens regenerativas.

Related to cardiovascular diseases, acute myocardial infarction (AMI) is the leading cause of death among patients with coronary artery disease worldwide. Animal studies are used because of their similarity to human physiology and anatomy. Reports demonstrate experimental use with rabbits, as their coronary anatomy is similar to humans. This research aimed to reproduce and validate the controlled experimental model of AMI of the anterolateral apical wall of the left ventricle in rabbits through ligation of the branch of the left coronary artery. A male rabbit was selected for induction of AMI by coronary ligation. Surgical intervention consisted of ligation of the coronary branch through a left posterolateral thoracotomy. The heart was submitted to anatomopathological and morphometric evaluation to estimate the infarcted percentage volume. In conclusion, AMI was achieved with controlled, histologically extensive transmural coronary ligation, proving to be effective and reproducible for the evaluation of new therapeutic interventions and regenerative approaches.

Perfil epidemiológico nutricional dos pacientes em hemodiálise / Nutritional epidemiological profile of patients in hemodialysis

Racional: A insuficiência renal crônica compromete as funções fisiológicas dos rins, e leva o paciente a diálise como terapia; contudo, essa condição gera suscetibilidade à desnutrição. Objetivo: Descrever o perfil epidemiológico e nutricional dos pacientes em hemodiálise e compará-los em relação à doença renal de base. Métodos: Trata-se de estudo retrospectivo, descritivo e transversal, realizado em hospital terciário. Foram coletados dados demográficos, clínicos, antropométricos e laboratoriais de pacientes que estiveram em diálise. Foram incluídos pacientes com insuficiência renal crônica e excluídos menores de 18 anos, com dados insuficientes ou com comorbidades que alterassem processo nutricional. Resultados: Observaram-se 4 principais causas para doença renal crônica: hipertensão arterial crônica, doença renal policística, doença renal terminal e nefropatia diabética, que foi a mais prevalente. Conclusão: O perfil foi: feminino, com 60 anos de idade e que fazia tratamento dialítico há 2,6 anos, com sobrepeso, anêmica e sem depleção. Entre os grupos houve diferenças estatisticamente significativas quanto aos fatores demográficos, mas como tinham quadro dialítico recente, havia poucas evidências de desnutrição.

Background: Chronic renal failure compromises the physiological functions of the kidneys, and leads the patient to dialysis as a therapy, however, this condition generates a susceptibility to malnutrition. Objective: To describe the epidemiological and nutritional profile of hemodialysis patients and compare them in relation to the underlying renal disease. Methods: This is a retrospective, descriptive and cross-sectional study carried out in a tertiary hospital. Demographic, clinical, anthropometric and laboratory data were collected from patients who were on dialysis. Patients with chronic renal failure were included and those under 18 years of age, with insufficient data or with comorbidities that altered the nutritional process, were excluded. Results: Four main causes of chronic kidney disease were observed: chronic arterial hypertension, polycystic kidney disease, end-stage renal disease and diabetic nephropathy, which was the most prevalent. Conclusion: The profile was: female, 60 years old and undergoing dialysis for 2.6 years, overweight, anemic and without depletion. There were statistically significant differences between the groups regarding demographic factors, but as they had recent dialysis, there was little evidence of malnutrition.

Subjective memory complaint and its relationship with cognitive changes and physical vulnerability of community-dwelling older adults.

Memory complaint (MC) is common in older adults and can be confirmed by people close to them, such as family members and caregivers. Studies show an association between MC and cognitive impairment and, hence, physical vulnerability may exacerbate MC. However, the relationship between MC and physical vulnerability is not yet clear in the literature.\. OBJECTIVE: to investigate the association between MC, cognitive impairment, and physical vulnerability. METHODS: this is a cross-sectional study. We evaluated 100 older adults with a mean age of 65 years or over. The Memory Complaint Scale (MCS), Addenbrooke's Cognitive Examination-Revised (ACE-R), Mini-Mental State Examination (MMSE), Vulnerable Elderly Research-13 (VES-13), Geriatric Depression Scale and a sociodemographic questionnaire were applied. RESULTS: participants were divided into two groups according to results on the MCS-A (elderly) and MCS-B (informant). Correlations were found between the MCS-A and the MMSE (p=.045/ρ=.201), ACE-R/Visual-Spatial (p=.048/ρ=.199), and ACE-R/Attention-Orientation (p=.026/ρ=.223). For the MCS-B, correlations were found with total score on the ACE-R (p=.044/ρ=-.202) and the ACE-R/Visual-Spatial (p=0.003/ρ=-.291). CONCLUSION: MC reported by the informant indicate the need to assess, in more depth, the cognition of the older adult. Thus, for clinical practice, screening of MC through an informant is advised.

A queixa de memória (QM) é comum em idosos e pode ser confirmada por pessoas próximas a ele, como familiares e cuidadores. Estudos apontam associação entre QM e alterações cognitivas e, nesse sentido, a vulnerabilidade física poderia exacerbá-la. Porém, a relação entre QM e vulnerabilidade física ainda não está clara na literatura. OBJETIVO: investigar a relação entre QM, alterações cognitivas e vulnerabilidade física. MÉTODOS: trata-se de um estudo transversal. Foram avaliados 100 idosos com idade igual ou superior a 65 anos. Utilizou-se a Escala de Queixa de Memória (EQM), Exame Cognitivo de Addenbrooke - Revisado (ACE-R), Mini Exame do Estado Mental (MEEM), Vulnerable Elders Survey-13 (VES-13), Escala de Depressão Geriátrica e questionário sociodemográfico. RESULTADOS: os participantes foram divididos em dois grupos de acordo com os resultados da EQM formas A (idoso) e B (informante). Encontrou-se correlação entre a EQM-A e MEEM (p=.045/ρ=.201), ACE-R Atenção e Orientação (p=.026/ρ=.223) e ACE-R/Visual-Espacial (p=.048/ρ=.199). Na EQM-B encontrou-se correlação entre pontuação total do ACE-R (p=.044/ρ=-.202) e ACE-R/Visual-Espacial. (p=.003/ρ=-.291). CONCLUSÃO: o relato de QM a partir do informante aponta a necessidade de avaliação mais aprofundada da cognição dos idosos. Assim, para a prática clínica, o rastreio de QM do informante é aconselhado.