Assessing the performance of AI chatbots in answering patients' common questions about low back pain.

OBJECTIVES: The aim of this study was to assess the accuracy and readability of the answers generated by large language model (LLM)-chatbots to common patient questions about low back pain (LBP). METHODS: This cross-sectional study analysed responses to 30 LBP-related questions, covering self-management, risk factors and treatment. The questions were developed by experienced clinicians and researchers and were piloted with a group of consumer representatives with lived experience of LBP. The inquiries were inputted in prompt form into ChatGPT 3.5, Bing, Bard (Gemini) and ChatGPT 4.0. Responses were evaluated in relation to their accuracy, readability and presence of disclaimers about health advice. The accuracy was assessed by comparing the recommendations generated with the main guidelines for LBP. The responses were analysed by two independent reviewers and classified as accurate, inaccurate or unclear. Readability was measured with the Flesch Reading Ease Score (FRES). RESULTS: Out of 120 responses yielding 1069 recommendations, 55.8% were accurate, 42.1% inaccurate and 1.9% unclear. Treatment and self-management domains showed the highest accuracy while risk factors had the most inaccuracies. Overall, LLM-chatbots provided answers that were 'reasonably difficult' to read, with a mean (SD) FRES score of 50.94 (3.06). Disclaimer about health advice was present around 70%-100% of the responses produced. CONCLUSIONS: The use of LLM-chatbots as tools for patient education and counselling in LBP shows promising but variable results. These chatbots generally provide moderately accurate recommendations. However, the accuracy may vary depending on the topic of each question. The reliability level of the answers was inadequate, potentially affecting the patient's ability to comprehend the information.

The state of the art in telerehabilitation for musculoskeletal conditions.

BACKGROUND: Given the rapid advances in communication technology and the need that emerged from the COVID-19 pandemic, telehealth initiatives have been widely used worldwide. This masterclass aims to provide an overview of telerehabilitation for musculoskeletal conditions, synthesizing the different terminologies used to describe telehealth and telerehabilitation, its effectiveness and how to use it in clinical practice, barriers and facilitators for the implementation in health services, and discuss the need of a curriculum education for the near future. MAIN BODY: Telerehabilitation refers to the use of information and communication technologies provided by any healthcare professionals for rehabilitation services. Telerehabilitation is a safe and effective option in the management of musculoskeletal conditions in different models of delivery. There are many technologies, with different costs and benefits, synchronous and asynchronous, that can be used for telerehabilitation: telephone, email, mobile health, messaging, web-based systems and videoconferences applications. To ensure a better practice of telerehabilitation, the clinician should certify safety and access, and appropriateness of environment, communication, technology, assessment, and therapeutic prescription. Despite the positive effect of telerehabilitation in musculoskeletal disorders, a suboptimal telerehabilitation implementation may have happened due to the COVID-19 pandemic, especially in countries where telehealth was not a reality, and clinicians lacked training and guidance. This emphasizes the need to identify the necessary curriculum content to guide future clinicians in their skills and knowledge for telerehabilitation. There are some challenges and barriers that must be carefully accounted for to contribute to a health service that is inclusive and relevant to health professionals and end users. CONCLUSIONS: Telerehabilitation can promote patient engagement in health care and plays an important role in improving health outcomes in patients with musculoskeletal conditions. Digital health technologies can also offer new opportunities to educate patients and facilitate the process of behavior change to a healthy lifestyle. Currently, the main needs in telerehabilitation are the inclusion of it in health curriculums in higher education and the development of cost-effectiveness and implementation trials, especially in low- and middle-income countries where access, investments and digital health literacy are limited.

Retrograde inhibition of hyperactive central pathways in nociplastic pain / Inibição retrógrada das vias centrais hiperativas nas dores nociplásticas

ABSTRACT BACKGROUND AND OBJECTIVES: Nociplastic pain occurs due to a combination of hyperexcitability and decreased inhibitory activity in the central nervous system, responsible for a state of amplification of different stimuli, present in many chronic disorders. Among them: fibromyalgia, chronic migraine, irritable bowel syndrome, myofascial pain syndrome and complex regional pain syndrome. Often, several of these diseases are associated. Nociplastic pain therapy is a challenge in clinical practice, since most traditional treatments are not effective in controlling symptoms, often causing difficulty in adherence or even interruption of treatment due to undesirable adverse effects. The objective of this article was to demonstrate the importance of identifying the presence of nociplastic pain in the patient's condition, and also the pathophysiological mechanisms involved. Thus, due to retrograde neuromodulation, a unique feature of the endocannabinoid system until now, evaluate the use of pharmaceutical grade medicines based on the cannabis plant as an adjunct in the therapy of pain and other symptoms associated with this disorder. CONTENTS: This article was addressed the pathophysiology of nociplastic pain, the physiology to the endocannabinoid system, the cannabis plant with its components and its use as an adjuvant medication in the multimodal treatment of nociplastic pain (due to retrograde neuromodulation), based on published scientific articles between 1981 and 2022. CONCLUSION: Although the scientific evidence supporting the use of medical cannabis in nociplastic pain therapy is insufficient so far, it can and should be considered as a possible adjuvant medication in multimodal pain therapy, always on an individual basis, when recommended treatments fail or are not tolerated.

RESUMO JUSTIFICATIVA E OBJETIVOS: A dor nociplástica ocorre por uma combinação de hiperexcitabilidade e diminuição da atividade inibitória no sistema nervoso central, responsável por um estado de amplificação de estímulos diversos, presente em muitas doenças crônicas. Entre essas doenças estão: fibromialgia, migrânea crônica, síndrome do intestino irritável, síndrome dolorosa miofascial e síndrome de dor complexa regional. Frequentemente, várias dessas doenças se apresentam associadas. A terapia da dor nociplástica é um desafio na prática clínica, uma vez que a maioria dos tratamentos tradicionais não são eficazes no controle dos sintomas, causando muitas vezes dificuldade de adesão ou até mesmo interrupção do tratamento, devido aos efeitos adversos indesejáveis. O objetivo deste artigo foi demonstrar a importância da identificação da presença da dor nociplástica no quadro do paciente, e do conhecimento dos mecanismos fisiopatológicos envolvidos. Dessa forma, devido à neuromodulação retrógrada, característica exclusiva do sistema endocanabinoide até o momento, avaliar a utilização de fármacos de grau farmacêutico à base da planta cannabis como coadjuvante na terapia da dor e dos outros sintomas associados a essa doença. CONTEÚDO: Este artigo abordou a fisiopatologia da dor nociplástica, a fisiologia do sistema endocanabinoide, a planta cannabis com seus componentes e sua utilização como medicação coadjuvante no tratamento multimodal da dor nociplástica (decorrente da neuromodulação retrógrada), com base em artigos científicos publicados entre 1981 e 2022. CONCLUSÃO: Apesar das evidências científicas que apoiam o uso da cannabis medicinal na terapia da dor nociplástica serem insuficientes até o momento, ela pode e deve ser considerada como um possível fármaco coadjuvante na terapia multimodal da dor, sempre de forma individualizada, quando os tratamentos preconizados falharem ou não forem tolerados.

Adult Congenital Heart Disease Outpatient Clinic. Descriptive Analysis of A 12-Year Experience in Brazil.

OBJECTIVE: Description of adult congenital heart disease (CHD) outpatient characteristics has not been reported and several aspects regarding these patients require attention. We describe the 12-year experience of a Brazilian unit. METHODS: The main characteristics of 1168 patients were reviewed annotating for each patient age, gender, city of residence, main diagnosis, functional class at last examination, defect complexity and in-hospital referral pattern. RESULTS: Increasing workload was documented. Among the CHD patients, 663 (57%) were between 14 and 30 years old and 920 (79%) lived in the referral region. Referrals were made by hospital cardiologists for 611 (52%) patients, while 519 (45%) were referred by pediatric cardiologists. Regarding CHD severity, 637 (55%) had a defect of mild complexity. Of the patients analyzed, 616 (53%) had undergone an intervention, mainly atrial septal defect (ASD) closure, correction of tetralogy of Fallot, ventricular septal defect (VSD) closure and relief of coarctation of the aorta (CoAo). The main diagnosis of the 552 (47%) patients not submitted to an intervention were ASD, VSD, aortic stenosis, complex CHD and pulmonary stenosis. Regarding functional class, 1016 (87%) were in class I and 280 (24%) were lost to follow-up. Seventy-three patients had died, mainly due to cardiac death. CONCLUSION: In a unit were complex pediatric congenital heart surgery started twenty years ago, an increasing adult CHD workload was documented. Referral came predominantly from cities around the unit, most patients had low complexity defects and were in functional class I, a significant loss of follow-up was documented, and the death of patients was mainly due to the heart defect.

Adult congenital heart disease outpatient clinic. descriptive analysis of a 12-year experience in Brazil

Abstract Objective: Description of adult congenital heart disease (CHD) outpatient characteristics has not been reported and several aspects regarding these patients require attention. We describe the 12-year experience of a Brazilian unit. Methods: The main characteristics of 1168 patients were reviewed annotating for each patient age, gender, city of residence, main diagnosis, functional class at last examination, defect complexity and in-hospital referral pattern. Results: Increasing workload was documented. Among the CHD patients, 663 (57%) were between 14 and 30 years old and 920 (79%) lived in the referral region. Referrals were made by hospital cardiologists for 611 (52%) patients, while 519 (45%) were referred by pediatric cardiologists. Regarding CHD severity, 637 (55%) had a defect of mild complexity. Of the patients analyzed, 616 (53%) had undergone an intervention, mainly atrial septal defect (ASD) closure, correction of tetralogy of Fallot, ventricular septal defect (VSD) closure and relief of coarctation of the aorta (CoAo). The main diagnosis of the 552 (47%) patients not submitted to an intervention were ASD, VSD, aortic stenosis, complex CHD and pulmonary stenosis. Regarding functional class, 1016 (87%) were in class I and 280 (24%) were lost to follow-up. Seventy-three patients had died, mainly due to cardiac death. Conclusion: In a unit were complex pediatric congenital heart surgery started twenty years ago, an increasing adult CHD workload was documented. Referral came predominantly from cities around the unit, most patients had low complexity defects and were in functional class I, a significant loss of follow-up was documented, and the death of patients was mainly due to the heart defect.

DHEA Treatment Effects on Redox Environment in Skeletal Muscle of Young and Aged Healthy Rats.

BACKGROUND: Dehydroepiandrosterone (DHEA) is an important precursor of active steroid hormone, produced abundantly by the adrenal cortex with an age-dependent pattern. OBJECTIVE: We investigated whether chronic DHEA administration impacts on redox status and on Akt protein activation in skeletal muscle during the aging process (3 and 24 months-old rats). METHODS: Rats received one weekly dose/5 weeks of DHEA (10 mg/kg) or vehicle. Gastrocnemius muscle was removed to evaluate glutathione system, hydrogen peroxide, antioxidant enzymes, and expression of Akt kinase protein. RESULTS: In the 3-months-old rats DHEA induced an increase in hydrogen peroxide when compared both to its control (276%) and the 24-months-old DHEA group (485%). Moreover, in the 24- months-old rats DHEA caused an increase in GSSG (41 and 28%), a decrease in reduced-GSH (55 and 51%), and a more oxidized redox status (reduction in GSH/GSSG ratio, 47 and 65 %) when compared to 3-month-old DHEA and to 24-months-old control groups, respectively. Both older groups had increased G6PDH (2.7 fold) and GST (1.7 fold) activities when compared to younger groups, independently of any DHEA treatment. However, there was no modulation of Akt protein (phosphorylated/total isoform). CONCLUSION: The results show that chronic DHEA administration to 3 and 24-months-old rats may not present positive effects regarding the redox environment in skeletal muscle without modulation of pro-survival Akt kinase. Due to the large-scale self-administration of DHEA as an "anti-aging" dietary supplement, it is crucial to investigate its molecular mechanisms over oxidative stressinduced related diseases.

Quality of life and levels of physical activity of residents living in therapeutic residential care facilities in Southern Brazil. / Qualidade de vida e níveis de atividade física de moradores de residências terapêuticas do sul do Brasil.

Interest in the quality of life of people with mental disorders living in therapeutic residential care facilities is an important indicator for the evaluation of therapeutic interventions in the area of health. Physical activity can contribute to a good quality of life. This study evaluated the quality of life and levels of physical activity of people living in therapeutic residential care facilities in the metropolitan area of Porto Alegre. This case series study (n = 68) used SF-36, EuroQol and IPAQ and social-demographic questions. The SF-36 results showed that the domain of general health received the lowest scores (57.47 ± 14.27). The highest scores were in terms of social aspects (77.39 ± 20.21) and physical aspects (77.57 ± 39.71). When using EuroQol, at least one problem (mild or extreme) in at least one dimension was evident among 82% of the residents. The physical activity levels showed that most of the participants were insufficiently active (48.5%) and 14.7% were sedentary. The domains of pain and mobility suggested that the residents were not being encouraged enough to perform physical activities. Knowledge about the perceptions of those living in therapeutic residential care facilities is critical in order to establish effective public policies.

O interesse na qualidade de vida de pessoas com transtornos mentais moradores de residências terapêuticas é um importante indicador para a avaliação da intervenção terapêutica na área da saúde. A atividade física pode contribuir para uma boa qualidade de vida. Avaliamos a qualidade de vida e os níveis de atividade física em moradores das residências terapêuticas da grande Porto Alegre. Estudo de série de casos (n = 68), tendo como instrumentos SF-36, EuroQol, IPAQ e questões sociodemográficas. Os resultados obtidos pelo SF-36 demonstraram que o domínio do estado geral de saúde foi o menor (57,47 ± 14,27). Os maiores scores encontrados foram nos aspectos sociais (77,39 ± 20,21) e nos físicos (77,57 ± 39,71). Ao menos um problema (moderado ou extremo), em no mínimo uma dimensão, foi evidenciado em 82% dos moradores por meio do EuroQol. Os níveis de atividade física mostraram que a maioria dos moradores são insuficientemente ativos (48,5%) e 14,7% sedentários. Os domínios dor e mobilidade sugerem que os moradores não são incentivados suficientemente à atividade física. Conhecer a percepção da qualidade de vida dos moradores das residências terapêuticas é fundamental para estabelecer políticas públicas eficazes.

Qualidade de vida e níveis de atividade física de moradores de residências terapêuticas do sul do Brasil / Quality of life and levels of physical activity of residents living in therapeutic residential care facilities in Southern Brazil

Resumo O interesse na qualidade de vida de pessoas com transtornos mentais moradores de residências terapêuticas é um importante indicador para a avaliação da intervenção terapêutica na área da saúde. A atividade física pode contribuir para uma boa qualidade de vida. Avaliamos a qualidade de vida e os níveis de atividade física em moradores das residências terapêuticas da grande Porto Alegre. Estudo de série de casos (n = 68), tendo como instrumentos SF-36, EuroQol, IPAQ e questões sociodemográficas. Os resultados obtidos pelo SF-36 demonstraram que o domínio do estado geral de saúde foi o menor (57,47 ± 14,27). Os maiores scores encontrados foram nos aspectos sociais (77,39 ± 20,21) e nos físicos (77,57 ± 39,71). Ao menos um problema (moderado ou extremo), em no mínimo uma dimensão, foi evidenciado em 82% dos moradores por meio do EuroQol. Os níveis de atividade física mostraram que a maioria dos moradores são insuficientemente ativos (48,5%) e 14,7% sedentários. Os domínios dor e mobilidade sugerem que os moradores não são incentivados suficientemente à atividade física. Conhecer a percepção da qualidade de vida dos moradores das residências terapêuticas é fundamental para estabelecer políticas públicas eficazes.

Abstract Interest in the quality of life of people with mental disorders living in therapeutic residential care facilities is an important indicator for the evaluation of therapeutic interventions in the area of health. Physical activity can contribute to a good quality of life. This study evaluated the quality of life and levels of physical activity of people living in therapeutic residential care facilities in the metropolitan area of Porto Alegre. This case series study (n = 68) used SF-36, EuroQol and IPAQ and social-demographic questions. The SF-36 results showed that the domain of general health received the lowest scores (57.47 ± 14.27). The highest scores were in terms of social aspects (77.39 ± 20.21) and physical aspects (77.57 ± 39.71). When using EuroQol, at least one problem (mild or extreme) in at least one dimension was evident among 82% of the residents. The physical activity levels showed that most of the participants were insufficiently active (48.5%) and 14.7% were sedentary. The domains of pain and mobility suggested that the residents were not being encouraged enough to perform physical activities. Knowledge about the perceptions of those living in therapeutic residential care facilities is critical in order to establish effective public policies.

Doping survey in the youth school games in brazil / Levantamento de doping nos jogos escolares da juventude no brasil / Levantamiento de doping en los juegos escolares de la juventud en brasil

ABSTRACT Introduction: Doping control is an important means for preventing the use of illegal substances and methods in sports. Objective: This study investigated the self-reported use of illegal substances among young Brazilian students in the Youth School Games, the main sporting event among school-aged athletes in Brazil with almost 2 million students during all the phases. Methods: Cross-sectional study with athletes of the Youth School Games 2006 aged 14-17 years. The subjects were randomly selected and completed an anonymous questionnaire about substances use. Chi-square test was used for comparison of proportions between different variables on self-reported use of substances. Univariate and multivariate analyzes and logistic regression were performed. Results: Among the 402 athletes (aged 14-17) who volunteered to participate, the results showed high prevalence of alcohol (35.8%), nutritional supplements (39.1%), and tobacco (5.4%). Regarding illegal drugs and doping, 1.7% reported the use of stimulants, 2.2% illicit drugs, 0.5% anabolic steroids, and 1.7% hormones and other similar substances. Moreover, a different use of stimulants was found (especially Judo and Table tennis), medications (especially Judo and Chess) and dietary supplements (especially Swimming and Judo, with over 50% reported use). Conclusion: The present study suggests that the use of substances among young athletes is similar to the results found among adult Olympic athletes as per International Olympic Committee and World Anti-Doping Agency, especially regarding the use of dietary supplements, anabolic steroids, and stimulants according to data collected by other studies. We consider that the findings of the present work indicate the need for specific efforts to monitor, prevent, and control use of substances among school athletes in big events and competitions, such as this research on doping in the Youth School Games.

RESUMO Introdução: O controle de dopagem é um meio importante para a prevenção do uso de substâncias e métodos ilegais no esporte. Objetivo: Este estudo investigou o uso autorrelatado de substâncias ilícitas entre jovens estudantes brasileiros nos Jogos Escolares da Juventude, o principal evento esportivo entre atletas em idade escolar do Brasil, com quase dois milhões de estudantes durante todas as fases. Métodos: Estudo transversal com atletas dos Jogos Escolares da Juventude de 2006 com idades entre 14 e 17 anos. Os sujeitos foram selecionados randomicamente e preencheram um questionário anônimo sobre o uso de substâncias. Foi utilizado teste do qui-quadrado para comparação de proporções entre as diferentes variáveis sobre o uso autorrelatado de substâncias. Foram realizadas análises univariada e multivariada e regressão logística. Resultados: Entre os 402 atletas (idade 14-17 anos) que tiveram participação voluntária, os resultados mostraram alta prevalência de álcool (35,8%), suplementos nutricionais (39,1%) e fumo (5,4%). Com relação às drogas ilegais e ao doping, 1,7% relataram o uso de estimulantes, 2,2% de drogas ilícitas, 0,5% de esteroides anabolizantes e 1,7% de hormônios e outras substâncias similares. Além disso, foi encontrado um uso diferente de estimulantes (especialmente judô e tênis de mesa), medicamentos (especialmente judô e xadrez) e suplementos dietéticos (especialmente natação e judô, com mais de 50% de uso relatado). Conclusão: O presente estudo sugere que o uso de substâncias entre jovens atletas é semelhante aos resultados encontrados entre os atletas adultos de acordo com o Comitê Olímpico Internacional e a Agência Mundial Antidoping, especialmente no que diz respeito ao uso de suplementos alimentares, esteroides anabolizantes e estimulantes, segundo os dados coletados por outros estudos. Consideramos que os resultados do presente trabalho indicam a necessidade de esforços específicos para monitor, prevenir e controlar o uso de substâncias entre atletas escolares em grandes eventos e competições, tais como esta pesquisa sobre dopagem nos Jogos Escolares da Juventude.

RESUMEN Introducción: El control de dopaje es un medio importante para la prevención del uso de sustancias y métodos ilegales en el deporte. Objetivo: Este estudio investigó el uso autoinformado de sustancias ilegales entre jóvenes estudiantes brasileños en los Juegos Escolares de la Juventud, el principal evento deportivo entre atletas en edad escolar de Brasil, con casi dos millones de estudiantes durante todas las fases. Métodos: Estudio transversal con atletas de los Juegos Escolares de la Juventud de 2006 con edades entre 14 y 17 años. Los sujetos fueron seleccionados aleatoriamente y llenaron un cuestionario anónimo sobre el uso de sustancias. Se utilizó la prueba del chi-cuadrado para la comparación de las proporciones entre las diferentes variables sobre el uso autoinformado de sustancias. Se realizaron análisis univariado y multivariado y regresión logística. Resultados: Entre los 402 atletas (edad 14-17 años) que tuvieron participación voluntaria, los resultados mostraron alta prevalencia de alcohol (35,8%), suplementos nutricionales (39,1%) y tabaco (5,4%). En cuanto a las drogas ilegales y al dopaje, el 1,7% relató el uso de estimulantes, el 2,2% de drogas ilícitas, el 0,5% de esteroides anabolizantes y el 1,7% de hormonas y otras sustancias similares. Además, se encontró un uso diferente de estimulantes (especialmente judo y tenis de mesa), medicamentos (especialmente judo y ajedrez) y suplementos dietéticos (especialmente natación y judo, con más del 50% de uso reportado). Conclusión: El presente estudio sugiere que el uso de sustancias entre los jóvenes atletas es similar a los resultados encontrados entre los atletas adultos de acuerdo con el Comité Olímpico Internacional y la Agencia Mundial Antidopaje, especialmente en lo que se refiere al uso de suplementos alimenticios, esteroides anabolizantes y estimulantes según los datos recogidos por otros estudios. Consideramos que los resultados del presente trabajo indican la necesidad de esfuerzos específicos para monitoreo, prevención y control del uso de sustancias entre atletas escolares en grandes eventos y competiciones, tales como esta investigación sobre dopaje en los Juegos Escolares de la Juventud.

Sociodemographic profile, family aspects, perception of health, functional capacity and depression in institutionalized elderly persons from the north coastal region of Rio Grande do Sul, Brazil / Perfil sociodemográfico, aspectos familiares, percepção de saúde, capacidade funcional e depressão em idosos institucionalizados no Litoral Norte do Rio Grande do Sul, Brasil

Abstract Objective: to describe sociodemographic and family relationships, health status, depression and degree of functional capacity in institutionalized elderly persons in eleven long-term care facilities for the elderly in the north coastal region of Rio Grande do Sul, Brazil. Methods: a cross-sectional study was carried out of 60 institutionalized elderly persons without cognitive impairment, confirmed by a score greater than 13 in the Mini Mental State Exam. Questionnaires were used to obtain data on sociodemographic conditions, family relationships, and self-perception of health. Functional capacity was evaluated with the Barthel Index and the Geriatric Depression Scale was applied. Results: A predominance of women, widowed and single, with a of low level of education and precarious financial status, most of whom who did not have children, was observed. The elderly persons complained about difficulty walking (38.3%), generalized pain (16.7%) and vision problems (13.3%). The majority (95%) reported suffering from two to three chronic diseases and making daily use of three or more drugs. Although 55% of the participants presented depressive symptoms and morbidity, they reported functional independence and 50% rated their health as good. Conclusions: These data contributed to the knowledge of the health status and functional capacity of these institutionalized elderly persons, aiming to improve the care provided to this public. AU

Resumo Objetivo: descrever características sociodemográficas, familiares, situação de saúde, depressão e grau de capacidade funcional em idosos institucionalizados em 11 instituições de longa permanência para Idosos, na região do Litoral Norte do Rio Grande do Sul, Brasil. Métodos: Estudo descritivo transversal que utilizou questionários para obtenção de dados sobre condições sociodemográficas, aspectos familiares, sobre a autopercepção de saúde, bem como a capacidade funcional (Índice de Barthel) e a Escala de Depressão Geriátrica de 60 idosos institucionalizados sem deficiência cognitiva, confirmada após apresentarem pontuação superior a 13 no Miniexame de Estado Mental. Resultados: Houve predominância do sexo feminino, viúvos e solteiros, com baixa escolaridade e situação financeira precária, e a maioria, sem filhos. Os idosos queixaram-se das dificuldades para andar (38,3%), da dor generalizada (16,7%) e dos problemas de visão (13,3%). A grande maioria (95%) relatou ter de duas a três doenças crônicas e fazer uso diário de três ou mais medicamentos. Apesar de 55% apresentarem sintomas depressivos e morbidades, os idosos apresentaram valores compatíveis com independência funcional de acordo com o índice de Barthel e classificaram sua saúde como boa. Conclusões: Esses dados contribuíram para conhecer as condições de saúde e capacidade funcional desses idosos institucionalizados, visando qualificar a assistência a esse público. AU

Desmoid Tumor After a Minimally Invasive Atrial Septal Defect Closure in an Adolescent.

The surgical closure of secundum atrial septal defect (ASD) is frequently performed. The minimally invasive approach, currently adopted by many centers as a way to preserve aesthetic appearance, particularly in female patients, seems to be safe. We describe the case of an adolescent who developed a desmoid tumor soon after a minimally invasive operation for surgical closure of a secundum ASD.

Percepção da imagem corporal em escolares do norte do Brasil / Body image perception in scholars of a school in the Brazilian north region

INTRODUCTION: In the adolescence period, an individual experiences biopsychosocial changes and dissatisfaction with body image is quite prevalent at this stage OBJECTIVE: To investigate the prevalence of body image dissatisfaction and its association with demographic and psychosocial factors, sexual maturity, nutritional condition and lifestyle METHODS: Cross-sectional study with a sample representing 831 eighth grade students from Porto Velho, Rondônia, Brazil, stratified into clusters. The data were obtained by questionnaires - the Body Shape Questionnaire and Global School-based Student Health Survey - and anthropometry. The associations of interest were tested in a multivariate analysis with Cox regression adjusted for cross-sectional studies RESULTS: The prevalence of body image dissatisfaction was 22 per cent. The outcome was significantly more prevalent among girls (PR: 4.69; CI: 95%: 3.09 - 7.12), young Caucasians (PR: 1.32; CI: 95%: 1.02 - 1.72), those who used tobacco (RP: 1.53; CI: 95%: 1.12 - 2.09), who were overweight or obese (PR: 2.77; CI: 95%: 2.18 - 3.51), and who reported feelings of sadness (PR: 1.35; CI: 95%: 1.05 - 1.73) and loneliness (PR: 1.66; CI: 95%: 1.30 - 2.11). The students with lower weight were more satisfied with their image CONCLUSION: The results point to the need for parents, educators and health professionals to act jointly in developing actions that reinforce the positive qualities of youth, especially in girls. Encouraging physical activity and healthy habits can promote overall health, improving satisfaction with body image

INTRODUÇÃO: Enquanto evidências sugerem que níveis de coordenação motora e de índice de massa corporal (IMC) estão negativamente correlacionados, pouco se sabe sobre a influência dos níveis de atividade física na associação entre essas variáveis em adolescentes OBJETIVO: Analisar as associações entre os níveis de coordenação motora e o IMC em adolescentes com peso saudável e com sobrepeso/obesos, controlando pelos níveis de atividade física MÉTODO: Cinquenta e seis escolares (50% adolescentes com sobrepeso/obesos), entre 12 e 14 anos, participaram do estudo. Os instrumentos Physical Activity Questionnaire for Older Children e o Körperkoordinationstest für Kinder foram usados para avaliar os níveis de atividade física e de coordenação motora, respectivamente. Correlações bivariadas e parciais foram usadas para analisar o inter-relacionamento entre os níveis de coordenação motora, IMC e atividade física. O teste de Análise de Covariância foi utilizado para comparar os níveis de coordenação entre adolescentes com peso saudável e com sobrepeso/obesos, considerando o nível de atividade física como covariável RESULTADOS: Foram encontradas correlações significativamente negativas (p < 0,05), de fraca a moderada, entre IMC e níveis de coordenação no grupo como um todo, nos grupos com peso saudável e com sobrepeso/obesos. No entanto, quando controladas pelos níveis de atividade física, não foram observadas correlações significativas no grupo com peso saudável. Ademais, adolescentes com sobrepeso/obesos apresentaram menores níveis de coordenação motora que adolescentes com peso saudável CONCLUSÃO: Os níveis de atividade física influenciam a associação entre os níveis de coordenação motora e IMC em adolescentes com peso saudável, mas não em adolescentes com sobrepeso/obesos

Conhecimento de adolescentes do ensino médio sobre DST/AIDS no sul do Brasil / The knowledge of high school teenagers about STD/AIDS in southern Brazil

Esta pesquisa objetivou investigar o conhecimento sobre DST/AIDS em adolescentes de Ensino Médio de Escolas Públicas Estaduais de Charqueadas/RS. É um estudo descritivo e qualitativo realizado mediante entrevista semiestruturada. Para a análise dos dados, foi utilizada a análise de conteúdo, na modalidade temática. Os resultados mostram que os adolescentes têm o conhecimento sobre o que são as DST/AIDS, suas formas de transmissão na relação sexual, preservativos são usados como proteção e que algumas DST não têm cura. Porém, eles têm dúvidas quanto às formas de transmissão sem o contato sexual, à vulnerabilidade pelo não uso do preservativo, ao consumo de bebidas alcoólicas e de drogas ilícitas. Pais e amigos são fontes de conhecimento sobre DST/AIDS fora da escola. Conclui-se que inovações no processo de ensino frente a essa temática devem ser adotadas pelas escolas.

This research aimed to investigate the knowledge of adolescents who go to state public high schools in Charqueadas/RS - have about Sexually Transmitted Diseases (STD) and Acquired Immune Deficiency Syndrome (AIDS). It is a qualitative and descriptive study using semi-structured interview. For data analysis was used content analysis in the thematic mode. The results show that adolescents have some knowledge about what STD and AIDS are, the ways how these diseases are transmitted in sexual intercourse that condoms are used as protection and that some STD have no cure. However, they have doubts about how these diseases can be transmitted without sexual relations, their vulnerability in case they do not use condoms in all sexual relations and the consumption of alcoholic drinks and illicit drugs. Parents and friends provide STD and AIDS knowledge outside school. It is concluded that improvements and innovations in the teaching process forward to this issue should be adopted by schools.

Fatores associados ao uso de drogas: depoimentos de usuários de um CAPS AD / Factors associated with the use of drugs: statements from users of a CAPS AD

A pesquisa teve por objetivos identificar os fatores que influenciam e protegem do uso de álcool e outras drogas e identificar as ações que contornam o tratamento e a reabilitação de usuários de um Centro de Atenção Psicossocial. Trata-se de uma pesquisa qualitativa e os instrumentos utilizados foram entrevistas semiestruturadas. Os resultados evidenciam como fatores de risco a tristeza, a solidão, as festas, o uso de substâncias na família e as companhias. Como fatores de proteção estão a família e os amigos, que também podem ser caracterizados como fatores de risco. O Centro de Atenção Psicossocial, além de oferecer acolhimento, atividades terapêuticas e educativas, apresenta duas características que facilitam o tratamento dos usuários, o território onde está localizado (de alta vulnerabilidade psicossocial) e a modalidade de atendimento (três turnos). Conclui-se que o tratamento oferecido subsidia a reabilitação psicossocial, reforçando a reconstrução de projetos de vida.(AU)

This research aims to identify factors that influence and protect for alcohol and other drugs use. In addition, to detect its purpose is the importance of actions that outline treatment and rehabilitation of alcohol and other drugs users developed at Psychosocial Care Center. This is a qualitative research using semi-structured interviews. Risk factors for the outcome were sadness, loneliness, parties, family history of drugs use and companies. As protective factors are family and friends, which can also be seen as risk factors. Besides to provide care, therapeutic and educational activities, the Psychosocial Care Center has two features that facilitate users´s treatment: the territory where it is located (of high psychosocial vulnerability) and the type of service (three shifts). The conclusion is that the treatment offered subsidizes psychosocial rehabilitation, strengthening the reconstruction of life projects.(AU)

Imagem corporal, atividade física e estado nutricional em adolescentes no sul do Brasil / Body image, physical activity and nutritional status in adolescents in southern Brazil

Este estudo objetivou descrever a frequência da prática de exercícios e o tempo gasto em atividades sedentárias, avaliar o índice de massa corporal (IMC) e correlacioná-lo com a percepção da imagem corporal por meio do Body Shape Questionnaire (BSQ). Foram coletados dados de 336 escolares de Gravataí/RS. Foi encontrada uma correlação significativa entre BSQ e IMC (r= 0,39 e p<0,01). Nas adolescentes, o IMC foi de 20.43±3.56 kg/m² e o BSQ de 82.30±31.37. Nos adolescentes, o IMC foi 20.31±3.82 kg/m² e o BSQ de 53.10±19.25. Houve maior preocupação das adolescentes em relação à imagem corporal e menor frequência e tempo de prática de atividade física quando comparado aos adolescentes. Mais de 80% dos estudantes realiza deslocamento ativo para a escola. Os resultados sugerem que as adolescentes são mais sedentárias e preocupadas com a imagem corporal do que os adolescentes.(AU)

This study aimed to describe the frequency of exercise and time spent in sedentary activities, evaluate the body mass index (BMI) and correlate it with the perception of body image by Body Shape Questionnaire (BSQ). Data were collected from 336 students from Gravataí/RS. A significant correlation between BSQ and BMI (r = 0.39 P<0.01) was found. Teenage girls' BMI was 20.43±3.56 kg/m² and the BSQ result was 82.30±31.37. BMI of teenage boys was 20.31±3.82 kg/m² and the BSQ was 53.10±19.25. There was a greater concern for adolescent girls regarding body image and lower frequency and time physical activity compared to adolescent boys. More than 80% of the sample performs active commuting to school. The results suggest that teenage girls are more sedentary and concerned with body image than teenage boys.(AU)

Imagem corporal, atividade física e estado nutricional em adolescentes no sul do Brasil / Body image, physical activity and nutritional status in adolescents in southern Brazil

Este estudo objetivou descrever a frequência da prática de exercícios e o tempo gasto em atividades sedentárias, avaliar o índice de massa corporal (IMC) e correlacioná-lo com a percepção da imagem corporal por meio do Body Shape Questionnaire (BSQ). Foram coletados dados de 336 escolares de Gravataí/RS. Foi encontrada uma correlação significativa entre BSQ e IMC (r= 0,39 e p<0,01). Nas adolescentes, o IMC foi de 20.43±3.56 kg/m² e o BSQ de 82.30±31.37. Nos adolescentes, o IMC foi 20.31±3.82 kg/m² e o BSQ de 53.10±19.25. Houve maior preocupação das adolescentes em relação à imagem corporal e menor frequência e tempo de prática de atividade física quando comparado aos adolescentes. Mais de 80% dos estudantes realiza deslocamento ativo para a escola. Os resultados sugerem que as adolescentes são mais sedentárias e preocupadas com a imagem corporal do que os adolescentes.(AU)

This study aimed to describe the frequency of exercise and time spent in sedentary activities, evaluate the body mass index (BMI) and correlate it with the perception of body image by Body Shape Questionnaire (BSQ). Data were collected from 336 students from Gravataí/RS. A significant correlation between BSQ and BMI (r = 0.39 P<0.01) was found. Teenage girls' BMI was 20.43±3.56 kg/m² and the BSQ result was 82.30±31.37. BMI of teenage boys was 20.31±3.82 kg/m² and the BSQ was 53.10±19.25. There was a greater concern for adolescent girls regarding body image and lower frequency and time physical activity compared to adolescent boys. More than 80% of the sample performs active commuting to school. The results suggest that teenage girls are more sedentary and concerned with body image than teenage boys.(AU)

Fatores associados ao uso de drogas: depoimentos de usuários de um CAPS AD / Factors associated with the use of drugs: statements from users of a CAPS AD

A pesquisa teve por objetivos identificar os fatores que influenciam e protegem do uso de álcool e outras drogas e identificar as ações que contornam o tratamento e a reabilitação de usuários de um Centro de Atenção Psicossocial. Trata-se de uma pesquisa qualitativa e os instrumentos utilizados foram entrevistas semiestruturadas. Os resultados evidenciam como fatores de risco a tristeza, a solidão, as festas, o uso de substâncias na família e as companhias. Como fatores de proteção estão a família e os amigos, que também podem ser caracterizados como fatores de risco. O Centro de Atenção Psicossocial, além de oferecer acolhimento, atividades terapêuticas e educativas, apresenta duas características que facilitam o tratamento dos usuários, o território onde está localizado (de alta vulnerabilidade psicossocial) e a modalidade de atendimento (três turnos). Conclui-se que o tratamento oferecido subsidia a reabilitação psicossocial, reforçando a reconstrução de projetos de vida.(AU)

This research aims to identify factors that influence and protect for alcohol and other drugs use. In addition, to detect its purpose is the importance of actions that outline treatment and rehabilitation of alcohol and other drugs users developed at Psychosocial Care Center. This is a qualitative research using semi-structured interviews. Risk factors for the outcome were sadness, loneliness, parties, family history of drugs use and companies. As protective factors are family and friends, which can also be seen as risk factors. Besides to provide care, therapeutic and educational activities, the Psychosocial Care Center has two features that facilitate users´s treatment: the territory where it is located (of high psychosocial vulnerability) and the type of service (three shifts). The conclusion is that the treatment offered subsidizes psychosocial rehabilitation, strengthening the reconstruction of life projects.(AU)

Estresse em adolescentes: estudo com escolares de uma cidade do sul do Brasil / Stress in adolescencents: a study with schoolars from a city in southern Brazil

Estudo analítico transversal com objetivo de avaliar a prevalência e os fatores associados ao estresse em adolescentes escolares de Canoas/RS. Participaram do estudo 475 adolescentes, de 14 a 18 anos, que responderam a Escala de Stress para Adolescentes (ESA) e a um questionário sobre dados sociodemográficos, relações familiares, sexualidade, uso de drogas e comportamento de risco. Os resultados apontaram prevalência de estresse de 10,9 %. Além do ambiente familiar, os fatores associados a níveis mais elevados de estresse foram 'achar possível contrair AIDS', 'ter sofrido acidente no último ano', 'não ter usado camisinha na primeira e na última transa' e 'já ter tido alguma DST'. Conclui-se que especialmente o ambiente familiar e as práticas sexuais são significativos ao aumento de estresse em jovens e, portanto, necessitam de intervenções que promovam comportamentos saudáveis para esta população.(AU)

Study with analytic cross sectional design that aimed to evaluate the prevalence and associated factors related to stress in school adolescents from the city of Canoas/RS. The sample consisted of 475 adolescents, aged 14-18 years, who answered the Stress Scale for Adolescents and a questionnaire about socio-demographic data, family relations, sexuality, drug use and risk behavior. The results revealed 10.9% of stress prevalence in the adolescents. Besides the family environment, factors associated with higher levels of stress were 'possibility to contract AIDS', 'having suffered an injury in the last year', 'have not used a condom in the first and in last sex intercourse' and 'have had an STD'. In conclusion, the family environment and sexual practices are especially significant to the increased stress in the studied adolescents and therefore require interventions that promote healthy behaviors for this population.(AU)

Dehydroepiandrosterone improves hepatic antioxidant reserve and stimulates Akt signaling in young and old rats.

This study examined, in the liver of young and old (3- and 24-month-old, respectively) healthy Wistar rats, the in vivo effect of dehydroepiandrosterone (DHEA) (10mg/kg body weight) administered subcutaneously for 5 weeks. Reduced (GSH) and oxidized (GSSG) glutathione levels, glucose-6-phosphate dehydrogenase (G6PDH), glutathione-S-transferase (GST), glutathione peroxidase (GPx) and catalase (CAT) activities, hydrogen peroxide concentration, GST and p-Akt/Akt immunocontent ratio were assessed in hepatic tissue. DHEA treatment significantly increased total glutathione content (17%) and GSH (22%) in 3- and 24-month-old treated groups when compared to control groups. The aging factor increased G6PDH (51%) and GPx (22%) activities as well as the hydrogen peroxide concentration (33%), independently of treatment. DHEA treatment increased p-Akt (54%) and p-Akt/Akt ratio (36%) immunocontents in both treated groups. Increased serum levels of alanine aminotransferase (ALT) in aged rats were reduced by DHEA treatment (34%).