Disability as a determinant of fatigue in MS patients.

INTRODUCTION: Fatigue is one of the most frequent and disabling symptoms in multiple sclerosis (MS). Central, psychological, and peripheral factors may contribute to the occurrence of fatigue. OBJECTIVES: The current study aimed to evaluate potential fatigue determinants in patients with relapsing-remitting MS with a low functional impairment. METHODS: We compared inflammatory markers, respiratory pressures, disability, and quality of life in 39 relapsing-remitting MS patients with and without fatigue. RESULTS: Patients with relapsing-remitting MS with fatigue had higher Expanded Disability Status Scale scores (p = 0.002). We observed a significant association between the results of the Guy Neurological Disability Scale, the Functional Assessment of MS Quality of Life Rating Scale and the presence of fatigue (p < 0.05). CONCLUSIONS: The degree of functional impairment is a determinant for the presence of fatigue in MS patients, but respiratory function and inflammatory markers are not.

Disability as a determinant of fatigue in MS patients / Incapacidade como determinante da fadiga em pacientes com EM

ABSTRACT Fatigue is one of the most frequent and disabling symptoms in multiple sclerosis (MS). Central, psychological, and peripheral factors may contribute to the occurrence of fatigue. Objectives: The current study aimed to evaluate potential fatigue determinants in patients with relapsing-remitting MS with a low functional impairment. Methods: We compared inflammatory markers, respiratory pressures, disability, and quality of life in 39 relapsing-remitting MS patients with and without fatigue. Results: Patients with relapsing-remitting MS with fatigue had higher Expanded Disability Status Scale scores (p = 0.002). We observed a significant association between the results of the Guy Neurological Disability Scale, the Functional Assessment of MS Quality of Life Rating Scale and the presence of fatigue (p < 0.05). Conclusions: The degree of functional impairment is a determinant for the presence of fatigue in MS patients, but respiratory function and inflammatory markers are not.

RESUMO A fadiga é um dos sintomas mais frequentes e incapacitantes na esclerose múltipla (EM). Fatores centrais, psicológicos e periféricos podem contribuir para a ocorrência de fadiga. Objetivos: O presente estudo teve como objetivo avaliar potenciais determinantes de fadiga em pacientes com EM remitente-recorrente (EMRR) com baixo nível de incapacidade funcional. Métodos: Foram comparados marcadores inflamatórios, pressões respiratórias, incapacidade e qualidade de vida em 39 pacientes com EMRR com e sem fadiga. Resultados: Pacientes com EMRR com fadiga apresentaram maior Escala de Incapacidade Funcional Expandida (p = 0,002). Observamos uma associação significativa entre os resultados da Escala de Incapacidade Neurológica de Guy e Escala de Avaliação da Qualidade de Vida Funcional com a presença de fadiga (valores de p < 0,05). Conclusão: O grau de comprometimento funcional, mas não a função respiratória e os marcadores inflamatórios, são determinantes para a presença de fadiga em pacientes com EM.

Cerebrospinal Fluid Levels of Angiotensin-Converting Enzyme Are Associated with Amyloid-ß42 Burden in Alzheimer's Disease.

This study was designed to determine whether the levels of renin-angiotensin system (RAS) components are associated with Alzheimer's disease (AD) pathology. Cerebrospinal fluid levels of Angiotensin (Ang) II, Ang-(1-7), angiotensin-converting enzyme (ACE), ACE2, Amyloid-ß (Aß)40, Aß42, total tau (hTau), and phospho-tau (pTau) were measured in 18 patients with AD and 10 controls. Patients with AD presented decreased levels of ACE when compared with controls. We found a significant positive correlation between ACE and Aß42 levels among patients. Our results strengthen the hypothesis that ACE is associated with Aß pathology in AD.

Silica exposure and disease in semi-precious stone craftsmen, Minas Gerais, Brazil.

BACKGROUND: Brazil is an exporter of precious stones and craftsmen often work in poor conditions. We assessed silica-related diseases among crystal craftsmen and the complexity of its control. METHODS: Case-series including 118 subjects evaluated from 2006 to 2015, based on medical interviews, chest X-rays, spirometry, and respirable silica samples. RESULTS: Median age and length of exposure were 32 and 13 years, respectively. Silicosis, with 1/0 as a threshold, was diagnosed radiologically in 57 individuals (48.3%). Respirable silica concentrations were 0.9-29.3 times greater than the Brazilian occupational exposure limit. A Receiver Operating Characteristic (ROC) curve with the same diagnosis threshold showed best discrimination at a cut point of 12.5 years of exposure, corresponding to 4.85 mg-y/m3 of cumulative silica exposure. There was a significant decline in FEV1 across radiological and cumulative silica exposure categories. Eleven individuals (9.3%) had mycobacterial diseases at baseline or follow-up. CONCLUSION: Crystal craftsmen continue to suffer from silicosis, lung function impairment, comorbidity, and death due to silicosis. To date collective protection in some work sheds has not diminished silica levels. Long-term follow-up is needed to evaluate further improvements in preventive measures. Am. J. Ind. Med. 60:239-247, 2017. © 2017 Wiley Periodicals, Inc.

Influence of aerobic training on cardiovascular and metabolic parameters in ederly hypertensive women.

BACKGROUND: Treatment of hypertension includes pharmacological and nonpharmacological interventions. Among the nonpharmacological interventions emphasizes the practice of regular physical exercise. However, the effects of aerobic exercise training on cardiovascular and metabolic parameters in elderly hypertensive women are still controversial. OBJECTIVES: The purpose of this study was to assess the effects of a walking program on metabolic and cardiovascular parameters at rest and during the recovery period following maximal exercise by hypertensive elderly women. METHODS: Twelve elderly women with hypertension started a 2-week walking program. Rest blood cholesterol and anthropometric data, as well as blood pressure and heart rate at rest and after progressive maximal exercise were measured before and after training. RESULTS: There were significant differences between the pre- and posttraining periods in VO(2)max, systolic blood pressure, diastolic blood pressure, and mean blood pressure. There were no changes in serum cholesterol levels after the training. During the recovery period following the progressive test, the fall in heart rate and mean blood pressure after 10 minutes of recovery was significantly higher after training. CONCLUSION: The proposed walking program did not alter serum cholesterol, but it did reduce resting blood pressure, improve aerobic performance and accelerate the fall in heart rate and mean blood pressure during the postprogressive maximal aerobic exercise recovery period in elderly hypertensive women.