RESUMO
This article raises considerations about the use of Cardiovascular Risk (CVR) stratification tools in Primary Health Care (PHC), focusing on the behavior of non-laboratory models as an alternative to laboratory predictions. This reflection is based on empirical research with a cross-sectional and exploratory methodology, focused on the behavior of two scales in an adult population (aged 40 to 74), with comorbidities (Hypertension and/or Diabetes) and without recorded cardiovascular events, in a medium-sized city in Minas Gerais. In the work, titled the "CardioRisk" project, the degree of agreement between CVR stratification performed by the Framingham Global Risk Score, using cholesterol information, and the non-laboratory version of the HEARTS calculator, which uses Body Mass Index instead of serum data, was evaluated. In this paper, the overall results of the research are analyzed, in which, for the constituted sample, a minimal agreement was found between the stratifiers. Recommendations are also presented regarding the management of CVR in the context of PHC, highlighting the importance of a comprehensive assessment of patients at notable risk, such as people with Diabetes.
Este artigo levanta considerações sobre o uso de ferramentas de estratificação do Risco Cardiovascular (RCV) na Atenção Primária à Saúde (APS), com foco no comportamento de modelos não-laboratoriais como alternativa às predições laboratoriais. Reflete-se sobre tal objeto a partir de pesquisa empírica de metodologia transversal e exploratória, voltada para o comportamento de duas escalas em uma população adulta (entre 40 e 74 anos), com comorbidades (Hipertensão e/ou Diabetes) e sem agravos cardiovasculares registrados, em uma cidade de médio porte de Minas Gerais. No trabalho, intitulado projeto "CardioRisco", avaliou-se o grau de concordância entre a estratificação de RCV realizada pelo Escore de Risco Global de Framingham, a partir de informação sobre colesterol, e pela versão não-laboratorial da calculadora HEARTS, que utiliza o Índice de Massa Corporal em substituição ao dado sérico. Neste artigo, analisa-se o resultado geral da pesquisa, no qual, para a amostra constituída, constatou-se uma concordância mínima entre os estratificadores, bem como apresenta-se recomendações em relação ao manejo do RCV no contexto da APS, com destaque para a importância da avaliação integral do paciente de notório risco, como pessoas com Diabetes.
RESUMO
Parkinson's Disease (PD) affects the cardiorespiratory system, causing an increase in the left ventricular mass in the heart and respiratory muscle weakness in relation to healthy individuals. The objective of this study was to investigate the effects of progressive resistive physical exercise on the vertical ladder on the histomorphometry of cardiac tissue and respiratory muscles in rats with PD. Seventy male Wistar rats, aged 40 days old, were divided into Parkinson's (PD) and Sham (SH) groups; they were also subdivided into groups that performed progressive resistive physical exercise on the vertical ladder Before Surgery (ExBS), After Surgery (ExAS), and Before and After Surgery (ExBAS). The physical training was carried out before and/or after PD induction. Exercise was performed five times a week for 25 min/day for four or eight weeks. PD induction was conducted via electrolytic stimulation of the Substantia nigra of the animals' brains, adopting the following stereotaxic table coordinates: -4.9; lateral medium equal to 1.7, and dorsoventral equal to 8.1. For the morphometric analysis of the heart, the following variables were calculated: relative weight and diameter and thickness of the left ventricle. The diaphragm and the myocardial, intercostal, and abdominal muscles were stained with Hematoxylin and Eosin (HE). The histomorphometric analysis was performed using the ImageJ software to assess the cross-sectional area of muscles and the number of muscle fibers. Progressive resistance exercise promoted the hypertrophy of respiratory muscles and the left ventricle in animals with PD.