Assessment of health-related quality of life in patients with Chagas cardiomyopathy using Minnesota living with heart failure questionnaire: A validation study.

OBJECTIVE: Chagas cardiomyopathy (ChC) is the most severe clinical form of Chagas disease and, in association with psychosocial factors, can compromise the health-related quality of life (HRQoL) of affected patients. To date, there is no specific instrument to assess the HRQoL of these patients, and the Minnesota Living with Heart Failure Questionnaire (MLwHFQ), specific for heart failure, is being used both in research and current clinical practice. Therefore, we aimed to verify the validity of the MLwHFQ in the assessment of HRQoL of patients with ChC. METHODS: Fifty patients with ChC (50.6 ± 10.1 years, NYHA I-III) were evaluated. The MLwHFQ, Short-Form of Health Survey (SF-36), Beck Depression Inventory (BDI), and Human Activity Profile (HAP) were applied. All patients underwent echocardiography and Cardiopulmonary Exercise Testing (CPET). RESULTS: The MLwHFQ score correlated with almost all SF-36 domains (with r-value ranging from -0.38 to -0.69), except pain (p = 0.118). The MLwHFQ score also correlated with the BDI score (r = 0.748; p < 0.001), HAP score (r = -0.558; p = 0.001), peak oxygen uptake (r = -0.352; p = 0.01), and left ventricular ejection fraction (r = -0.329; p = 0.021). There was no significant difference in the score found on the MLwHFQ among NYHA classes (p = 0.101), as well as between patients with systolic dysfunction (n = 30) and preserved cardiac function (n = 20) (p = 0.058). Similarly, there was no significant difference in the score found on the physical (p = 0.423) and mental (p = 0.858) components of SF-36 between patients with systolic dysfunction and preserved cardiac function (p = 0.271 and p = 0.609, respectively). There was also no difference in the mental component of SF-36 among NYHA classes (p = 0.673). However, the HRQoL using the physical component of SF-36 was worse in advanced NYHA classes (p = 0.014). CONCLUSION: MLwHF correlated with most SF-36 HRQoL domains, depressive symptoms, physical activity, and systolic function and seems to be valid in assessing the HRQoL of ChC patients.

Pitaya as a New Alternative Crop for Iberian Peninsula: Biology and Edaphoclimatic Requirements.

Pitaya is one of the fruit species whose demand has increased in recent years due to the numerous health benefits and lucrative price of the fruit and its by-products. In Europe, the Iberian Peninsula and other Mediterranean countries are the ones with favorable climatic conditions for its cultivation. This document describes much of the history of pitaya in the Iberian Peninsula and the difficulties related to its cultivation. A bibliographical survey was carried out on the culture of pitaya in the world, focusing on the edaphoclimatic requirements, and on the possibility of this becoming a consolidated crop in the Iberian Peninsula. The relatively low water requirement of pitaya makes this crop sustainable among crops that require irrigation. In addition, we provide a perspective for use and research of this emerging crop. There has been an exponential growth of scientific publications on pitaya in the last decade; however, much more needs to be researched to know how to increase productivity as well as the sensory quality of fruits in different regions. This sustainable crop is a good option to diversify fruit production in the Iberian Peninsula.

Single puncture approach guided by transesophageal echocardiography for atrial fibrillation ablation in a patient with prior percutaneous septal closure: case report.

Background: Atrial septal defect (ASD) is associated with a risk of developing atrial fibrillation (AF) higher than in the general population, even after percutaneous or surgical septal closure. Catheter ablation is an effective treatment strategy for preventing recurrences and reducing the AF burden. However, electrophysiologists are faced with technical difficulties and the risk of complications with the left atrium access in patients with prior ASD percutaneous closure. Case summary: We report a case of a patient with highly symptomatic paroxysmal AF, with an ASD, closed percutaneously many years before, who underwent a successful catheter AF ablation, using a single transeptal (TSP) approach guided by transesophageal echocardiography (TEE). Discussion: In patients with ASD and an occluder device implanted, there is a potential risk for septal tear during the TSP passage, device dislodgement, or thrombus formation on the device. Atrial fibrillation ablation in this subset of patients has often been protracted and scarcely reported. TEE and intra-cardiac echocardiography have been increasingly used for interventional procedure guidance during AF ablation. As described here, AF ablation using a simplified single TSP guided by TEE is feasible, safe, and effective after device ASD closure.

Parental segregation study reveals rare benign and likely benign variants in a Brazilian cohort of rare diseases.

Genomic studies may generate massive amounts of data, bringing interpretation challenges. Efforts for the differentiation of benign and pathogenic variants gain importance. In this article, we used segregation analysis and other molecular data to reclassify to benign or likely benign several rare clinically curated variants of autosomal dominant inheritance from a cohort of 500 Brazilian patients with rare diseases. This study included only symptomatic patients who had undergone molecular investigation with exome sequencing for suspected diseases of genetic etiology. Variants clinically suspected as the causative etiology and harbored by genes associated with highly-penetrant conditions of autosomal dominant inheritance underwent Sanger confirmation in the proband and inheritance pattern determination because a "de novo" event was expected. Among all 327 variants studied, 321 variants were inherited from asymptomatic parents. Considering segregation analysis, we have reclassified 51 rare variants as benign and 211 as likely benign. In our study, the inheritance of a highly penetrant variant expected to be de novo for pathogenicity assumption was considered as a non-segregation and, therefore, a key step for benign or likely benign classification. Studies like ours may help to identify rare benign variants and improve the correct interpretation of genetic findings.

Popular health surveillance in traditional fishing communities and the ecology of knowledges in the fight against COVID-19. / Vigilância popular da saúde nas comunidades pesqueiras tradicionais e ecologia dos saberes no enfrentamento à COVID-19.

Considering the public health emergency of international importance caused by COVID-19, artisanal fishing workers, engaging in a dialogue with Brazilian leaders and scholars, created an Observatory on the impacts of this pandemic on fishing communities in March 2020. The purpose of this article is to analyze the experience of popular surveillance of fishermen and fisherwomen's health through daily reports produced at the Observatory. It is a monitoring process that allowed broadening the recognition of the diversity of vulnerable populations' ways of life that intertwine health, environment and work. The study used a qualitative, horizontal and emancipatory methodology and sought approaches to the practice of the ecology of knowledges, with the following results: shared construction of information and knowledges based on heterogeneous social experiences; practice of collective ombudsman with the appreciation of knowledges built in social struggles); joint assessment of public health inequities, territorial conflicts, and environmental, structural, and institutional racism; guidance of social leaders and fundraising through public notices. Thus, the dynamics and horizontality of learning based on solidarity and social emancipation from inter-knowledge are revealed.

Diante da emergência em saúde pública de importância internacional provocada pela COVID-19, trabalhadores da pesca artesanal, em diálogo com lideranças e acadêmicos brasileiros criaram, em março de 2020, um Observatório sobre os impactos dessa pandemia em comunidades pesqueiras. O objetivo deste artigo é analisar a experiência de vigilância popular da saúde de pescadores e pescadoras através de boletins diários produzidos no Observatório. Trata-se de um processo de monitoramento que possibilitou ampliar o reconhecimento da diversidade de modos de vida das populações vulneráveis que entrelaça saúde, ambiente e trabalho. O estudo utilizou metodologia qualitativa, horizontal e emancipatória e buscou aproximações à prática da ecologia dos saberes, tendo como resultados: construção compartilhada de informações e conhecimentos com base em experiências sociais heterogêneas; prática da ouvidoria coletiva com a valorização de saberes construídos nas lutas sociais; avaliação conjunta de iniquidades em saúde pública, conflitos territoriais e racismo ambiental, estrutural e institucional; orientação das lideranças sociais e captação de recursos através de editais públicos. Revela-se, assim, dinamicidade e horizontalidade de aprendizados com base na solidariedade e emancipação social a partir do interconhecimento.

Vigilância popular da saúde nas comunidades pesqueiras tradicionais e ecologia dos saberes no enfrentamento à COVID-19 / Popular health surveillance in traditional fishing communities and the ecology of knowledges in the fight against COVID-19

Resumo Diante da emergência em saúde pública de importância internacional provocada pela COVID-19, trabalhadores da pesca artesanal, em diálogo com lideranças e acadêmicos brasileiros criaram, em março de 2020, um Observatório sobre os impactos dessa pandemia em comunidades pesqueiras. O objetivo deste artigo é analisar a experiência de vigilância popular da saúde de pescadores e pescadoras através de boletins diários produzidos no Observatório. Trata-se de um processo de monitoramento que possibilitou ampliar o reconhecimento da diversidade de modos de vida das populações vulneráveis que entrelaça saúde, ambiente e trabalho. O estudo utilizou metodologia qualitativa, horizontal e emancipatória e buscou aproximações à prática da ecologia dos saberes, tendo como resultados: construção compartilhada de informações e conhecimentos com base em experiências sociais heterogêneas; prática da ouvidoria coletiva com a valorização de saberes construídos nas lutas sociais; avaliação conjunta de iniquidades em saúde pública, conflitos territoriais e racismo ambiental, estrutural e institucional; orientação das lideranças sociais e captação de recursos através de editais públicos. Revela-se, assim, dinamicidade e horizontalidade de aprendizados com base na solidariedade e emancipação social a partir do interconhecimento.

Abstract Considering the public health emergency of international importance caused by COVID-19, artisanal fishing workers, engaging in a dialogue with Brazilian leaders and scholars, created an Observatory on the impacts of this pandemic on fishing communities in March 2020. The purpose of this article is to analyze the experience of popular surveillance of fishermen and fisherwomen's health through daily reports produced at the Observatory. It is a monitoring process that allowed broadening the recognition of the diversity of vulnerable populations' ways of life that intertwine health, environment and work. The study used a qualitative, horizontal and emancipatory methodology and sought approaches to the practice of the ecology of knowledges, with the following results: shared construction of information and knowledges based on heterogeneous social experiences; practice of collective ombudsman with the appreciation of knowledges built in social struggles); joint assessment of public health inequities, territorial conflicts, and environmental, structural, and institutional racism; guidance of social leaders and fundraising through public notices. Thus, the dynamics and horizontality of learning based on solidarity and social emancipation from inter-knowledge are revealed.

Water Dynamics in Composite Aqueous Suspensions of Cellulose Nanocrystals and a Clay Mineral Studied through Magnetic Resonance Relaxometry.

1H spin-lattice relaxation time (T1) measurements were performed to probe the dynamic behavior of water in aqueous suspensions of cellulose nanocrystals (CNCs) and a layered smectite clay mineral with different degrees of concentration. 1H-T1 experiments were carried out over a wide frequency domain, ranging from a few kilohertz to 500 MHz, with the aid of conventional and fast field cycling nuclear magnetic resonance (NMR) techniques. The experimental relaxometry data illustrate differences between the dynamic behavior of bulk water and that confined in the vicinity of CNC-clay surfaces. Clay alone in moderate concentration was found to enforce almost no effect on the water dynamics, whereas introducing CNCs to the system presented a significantly enhanced relaxivity. The modeling of the relaxation dispersions allowed the determination of dynamical processes and variables explaining the dynamic behavior of water in CNC-clay suspensions. It turned out that reorientations mediated by translational displacements are a leading NMR relaxation mechanism for water interacting with the surfaces of CNC-clay particles in the low-frequency domain. In the high-frequency regime, however, the inner-sphere paramagnetic relaxation mechanism dominates, which is caused by the interaction of water protons with dissolved Fe ions.

Prevalência da hiperidrose primária e seu impacto no trabalho de profissionais de saúde / Prevalence of primary hyperidrosis and its impact on the work of health professionals

Avaliar a prevalência e o impacto da Hiperidrose Primária (HP) nas atividades laborais de profissionais de saúde de um hospital público referência em urgência e emergência. Trata-se de uma pesquisa transversal, descritiva, exploratória e quantitativa, realizada com profissionais de saúde de um hospital público referência em urgência e emergência do Estado de Sergipe, Brasil. Os instrumentos utilizados foram o questionário critérios de diagnósticos, de qualidade de vida e sobre impacto da HP nas atividades laborais. Empregaram-se os testes Shapiro-Wilk, Kruskal-Wallis e Mann-Whitney. Participaram do estudo 658 profissionais; a prevalência de HP encontrada foi 11%. Dos portadores de HP, 43% relataram apresentar dificuldades durante as atividades laborativas. Todas as atividades laborais no âmbito da saúde foram referidas com limitações na sua execução pelos profissionais avaliados, sendo a mais referida a escrita (88%), seguida da utilização de equipamentos de proteção individual (81%). A HP teve prevalência relevante nos profissionais de saúde com comprometimento negativo importante na sua qualidade de vida e laboral.

To evaluate the prevalence and impact of Primary Hyperhidrosis (PH) on the work activities of health professionals at a public hospital, a reference in Urgency and Emergency. This is a cross-sectional, descriptive, exploratory, quantitative study carried out with health professionals from a public hospital that is a reference in Urgency and Emergency in the state of Sergipe, Brazil. The instruments used were the questionnaire on diagnostic criteria, quality of life and the impact of PH on work activities. The Shapiro-Wilk, Kruskal-Wallis and Mann-Whitney tests were applied. Participants of this study were 658 professionals; the prevalence of PH was 11%. Among the patients with PH, 43% reported having difficulties during work activities. All work activities in the health field were mentioned with limitations in execution by the evaluated professionals, the most mentioned were writing (88%), followed by the use of personal protective equipment (81%). PH had a relevant prevalence in health professionals with significant negative impairment in their quality of life and work.

Potential role of microRNAs as biomarkers in human glioblastoma: a mini systematic review from 2015 to 2020.

Glioblastoma (GBM) is the most common, aggressive and malignant type of glioma, with poor prognosis, despite advances in medical knowledge and technology. It's known that some microRNAs (miRNAs) can be dysregulated and associated with tumors. We aim to investigate miRNAs that may have a role as potential biomarkers in human glioblastoma. A search was performed using PubMed, LILACS and SCIELO databases to find papers from 2015 to 2020, related to human in vitro and ex vivo data. From 99 articles, 10 were eligible and 13 dysregulated miRNAs were found with description of regulation, target(s), pathway(s) and mechanism(s). The miRNAs of interest were found and seem to be involved in development and progression of glioblastoma and used as target therapies. Understanding the mechanisms in which those miRNAs are involved and their role in epigenetic pathways that lead to cancer, as well as their potential in clinical application, may improve GBM clinical outcome (CRD42020182706, 07/10/2020, retrospectively registered).

Diagnostic power and clinical impact of exome sequencing in a cohort of 500 patients with rare diseases.

Rare diseases comprise a diverse group of conditions, most of which involve genetic causes. We describe the variable spectrum of findings and clinical impacts of exome sequencing (ES) in a cohort of 500 patients with rare diseases. In total, 164 primary findings were reported in 158 patients, representing an overall diagnostic yield of 31.6%. Most of the findings (61.6%) corresponded to autosomal dominant conditions, followed by autosomal recessive (25.6%) and X-linked (12.8%) conditions. These patients harbored 195 variants, among which 43.6% are novel in the literature. The rate of molecular diagnosis was considerably higher for prenatal samples (67%; 4/6), younger children (44%; 24/55), consanguinity (50%; 3/6), gastrointestinal/liver disease (44%; 16/36) and syndromic/malformative conditions (41%; 72/175). For 15.6% of the cohort patients, we observed a direct potential for the redirection of care with targeted therapy, tumor screening, medication adjustment and monitoring for disease-specific complications. Secondary findings were reported in 37 patients (7.4%). Based on cost-effectiveness studies in the literature, we speculate that the reports of secondary findings may influence an increase of 123.2 years in the life expectancy for our cohort, or 0.246 years/cohort patient. ES is a powerful method to identify the molecular bases of monogenic disorders and redirect clinical care.

Inclusão do surdo no trabalho: diálogos sobre trajetórias e reconhecimento social / Inclusion of deaf individuals at work: dialogues about trajectories and social recognition / Inclusión del sordo en el trabajo: diálogos sobre trayectorias y reconocimiento social

Este estudo contempla as experiências de deficiência de sujeitos surdos, considerando a inserção no trabalho. Orientada pelas teorias compreensivas, esta pesquisa valoriza as dimensões social e cultural do tema e as subjetividades emergentes dos encontros sociais. O propósito deste artigo foi refletir sobre a inclusão do servidor público com surdez, enquanto sujeito social e político, considerando a percepção da experiência desse trabalhador em instituições que adotam práticas inclusivas nos seus processos seletivos. Trata-se de uma pesquisa de natureza qualitativa, de caráter exploratório, orientada nas ciências sociais e humanas, desenvolvida a partir da análise de narrativas em um contexto institucional. Utilizou-se a modalidade de entrevista narrativa, mediada por entrevistador fluente em língua brasileira de sinais (Libras). A análise encontrou duas categorias autodeterminadas, referentes à identidade do sujeito: (1) "surdo" e (2) "deficiente auditivo". Afirmação identitária e estigmatização são dimensões em destaque a partir da identificação de elementos facilitadores e dificultadores do processo inclusivo do surdo no trabalho. Esses elementos se revelaram multifatoriais, intrínsecos e extrínsecos aos sujeitos, com ênfase nas barreiras comunicativas. Com base na teoria social do reconhecimento, a valorização da identidade de surdo, autoestima e participação social ganham relevo na agenda política desse grupo, com possibilidade de reconfigurar a noção de deficiência, afastando-a do lugar de opressão.

This study concerns the experiences of deaf individuals, considering their inclusion at work. Guided by comprehensive theories, this research values the social and cultural dimension of the topic and the emerging subjectivities in social encounters. Its purpose is to reflect on the inclusion of deaf public servants, as a social and political subject, considering their experiences in institutions whose selection processes adopt inclusive practices. A qualitative and exploratory research, founded on the social and human sciences, was developed by means on narrative analysis in an institutional context. Data was collected by means of narrative interview mediated by an interviewer fluent in Brazilian Sign Language (Libras). The analysis found two self-determined categories, referring to the subject's identity: (1) "deaf" and (2) "hearing impaired." Identity affirmation and stigmatization are highlighted as elements that can facilitate or hinder the inclusive process of deaf individuals at work. These factors proved to be multifactorial, intrinsic and extrinsic to the subjects, with an emphasis on communicative barriers. Based on the social theory of recognition, valorization of the "deaf" identity, self-esteem and social participation gain prominence in the political agenda of this group, with the possibility of reconfiguring the notion of disability, moving away from a place of oppression.

Este estudio contempla las experiencias de discapacidad de las personas sordas, considerando la inserción en el trabajo. Basándose en teorías integrales, este estudio valora la dimensión social y cultural del tema y las subjetividades que surgen de los encuentros sociales. El propósito de este artículo fue reflexionar sobre la inclusión del funcionario con sordera como sujeto social y político, considerando la experiencia de este trabajador en instituciones que adoptan prácticas inclusivas en sus procesos de selección. Se trató de una investigación cualitativa, exploratoria, con base en las ciencias sociales y humanas, desarrollada a partir del análisis de narrativas en un contexto institucional. Se utilizó la modalidad de entrevista narrativa, mediada por un entrevistador con fluidez en la comunicación en Lengua de Signos brasileña (Libras). El análisis encontró dos categorías autodeterminadas, referidas a la identidad del sujeto: (1) "sordo" y (2) "discapacitado auditivo". La afirmación de la identidad y el estigma son dimensiones destacadas a partir de la identificación de elementos que facilitan y dificultan el proceso inclusivo de las personas sordas en el trabajo. Estos resultaron ser multifactoriales, intrínsecos y extrínsecos a los sujetos, con énfasis en las barreras comunicativas. A partir de la teoría social del reconocimiento, la valorización de la identidad del sordo, la autoestima y la participación social cobran protagonismo en la agenda política de este grupo, con la posibilidad de reconfigurar la discapacidad como forma de opresión.

Impacto da hiperidrose nas atividades laborais da enfermagem em um hospital de urgência e emergência / Impact of hyperhidrosis on nursingwork activities in a hospital for urgent and emergency care / Impacto de la hiperhidrosis en las actividades de trabajo de enfermería en un hospital de emergencia

Objetivo: Avaliar a prevalência e o impacto da hiperidrose primária nas atividades e qualidade de vida dos profissionais de enfermagem de um hospital público. Métodos: estudo transversal com 363 profissionais de enfermagem de um Hospital Referência em Urgência e Emergência de Sergipe, Brasil. Utilizou-se questionário de critérios diagnósticos, qualidade de vida e sobre o impacto da hiperidrose primária nas atividades laborais. Resultados: a prevalência da hiperidrose primária foi de 11%, com a piora em situação de estresse em 27 (68%) dos profissionais e três (8%) referiram comprometimento nas atividades diárias. Todas as limitações foram referidas na execução de procedimentos de enfermagem, sendo as mais citadas avaliação escrita por 37 profissionais (93%) e utilização de equipamentos de proteção individual por 31 (79%). Conclusão: a hiperidrose primária teve alta prevalência nos profissionais de enfermagem com comprometimento negativo na qualidade de vida dos portadores, mesmo quando em grau leve e moderado

Objective: The study's main purpose has been to assess both the prevalence and impact of primary hyperhidrosis on the activities and quality of life of nursing professionals working in a public hospital. Methods: It is a crosssectional study with 363 nursing professionals from a Public Referral Hospital for Urgent and Emergency Care in the Sergipe State, Brazil. There was used a questionnaire addressing diagnostic criteria, quality of life and the impact of primary hyperhidrosis on work activities. Results: There was found a primary hyperhidrosis prevalence of 11% in nursing professionals, worsening under stress in 27 (68%) of the professionals, and three (8%) reported impairment in daily activities. All limitations were mentioned to be happening in the implementation of nursing procedures, the most cited being written assessment by 37 professionals (93%), and the use of personal protective equipment by 31 (79%). Conclusion: Primary hyperhidrosis had a high prevalence in nursing professionals ultimately producing a negative impact on bearer's quality of life, even when mild or moderate

Objetivo: Evaluar la prevalencia y el impacto de la hiperhidrosis primaria en las actividades y la calidad de vida de los profesionales de enfermería en un hospital público. Métodos: estudio transversal con 363 profesionales de enfermería de un hospital de referencia en urgencias y emergencias en Sergipe, Brasil. Se utilizó un cuestionario sobre criterios diagnósticos, calidad de vida y sobre el impacto de la hiperhidrosis primaria en las actividades laborales. Resultados: la prevalencia de hiperhidrosis primaria fue del 11%, con empeoramiento bajo estrés en 27 (68%) de los profesionales y tres (8%) informaron deterioro en las actividades diarias. Todas las limitaciones se mencionaron en la implementación de los procedimientos de enfermería, siendo la evaluación escrita más citada por 37 profesionales (93%) y el uso de equipos de protección personal por 31 (79%). Conclusión: la hiperhidrosis primaria tuvo una alta prevalencia en profesionales de enfermería con un deterioro negativo en la calidad de vida de los pacientes, incluso cuando era leve y moderada

Comparing exercise responses to aerobic plus resistance training between postmenopausal breast cancer survivors undergoing aromatase inhibitor therapy and healthy women.

Background: The aim of this study was to explore whether postmenopausal breast cancer survivors undergoing aromatase inhibitor therapy differ from healthy postmenopausal women in their response to the same aerobic + resistance training. Methods: The participants were separated into two groups: postmenopausal breast cancer survivors undergoing aromatase inhibitor therapy for an average of 20 months (18 women) and healthy postmenopausal women (24 women). We assessed aerobic capacity (predicted maximum oxygen uptake (VO2max) and maximum running velocity test (Vmax)) through a walking test, upper and lower body muscle strength using an estimated one-repetition maximum test, and body composition by dual-energy X-ray absorptiometry at baseline and at three, six, and nine months, respectively. The exercise program was performed three times/week over nine months and consisted of 40 min of machine-based strength training (seated cable row, bench press, leg extension, leg press, and leg curl, as well as bridge, abdominal, and standard plank exercises) followed by 30 min of treadmill walking. Analysis of variance (ANOVA) with repeated measures was used to compare the groups over time. Results: Postmenopausal breast cancer survivors undergoing aromatase inhibitor therapy and healthy postmenopausal women presented similar improvements in estimated lower body strength, predicted VO2max and Vmax, and body fat mass. For maximal upper body strength, there was a significant group x time interaction after six months of training (p = 0.01). The healthy postmenopausal women presented a significant increase in upper body strength after six months, while postmenopausal breast cancer survivors undergoing aromatase inhibitor therapy demonstrated an improvement only at nine months of training. The breast cancer survivors undergoing aromatase inhibitor therapy presented increased lean mass while healthy postmenopausal women maintained values over time (Breast cancer: 33.7 ± 3.9(Pre) vs. 34.1 ± 3.4 kg (Post) and healthy women: 36.4 ± 5.1 (Pre) vs. 36.4 ± 5.0 kg (Post), p = 0.004). Conclusion: Our findings suggest that postmenopausal women undergoing aromatase inhibitor therapy for breast cancer demonstrated adaptations and similar trainability to the same regimen of resistance + aerobic training as healthy postmenopausal women. Implications for Rehabilitation Combined exercise program (aerobic plus resistance) is an important non-pharmacological strategies to improve strength, aerobic capacity, and body composition in breast cancer survivors undergoing aromatase inhibitor therapy. Furthermore, it is important to highlight that the time of intervention seems to influence the upper body strength response in this population. This study showed that trainers and other specialists do not need to modify the prescription of exercise related to healthy women, since the combined exercise program induced similar benefits in strength, aerobic capacity, and body composition in postmenopausal breast cancer survivors undergoing aromatase inhibitor therapy and healthy postmenopausal women.

Impacto de um programa de tratamento em pacientes com alterações na coluna / Impact of a treatment program on patients with spine alterations / Impacto de un programa de tratamiento de pacientes con alteraciones de la columna

OBJETIVO: Avaliar o impacto de um programa de tratamento fisioterápico em pacientes com alterações na coluna. MÉTODOS: Trata-se de um estudo experimental, longitudinal, quantitativo, realizado no município de Araxá, Minas Gerais, Brasil. Participaram 81 pacientes do projeto Escola da Coluna, entre os meses de maio 2016 a abril de 2017, que deveriam apresentar alguma patologia de coluna, com encaminhamento médico específico e concordar em participar do projeto. Os participantes foram submetidos ao Pilates ou à Reeducação Postural Global, duas vezes por semana durante três meses de tratamento, em grupo, com duração média de 50 minutos. Realizou-se avaliação inicial e final dos distúrbios osteomusculares pelo questionário Nórdico de Sintomas Osteomusculares e avaliação do nível de incapacidade de pelo índice de Owestry. Ao final do programa os pacientes responderam a um questionário para avaliar a satisfação com os resultados obtidos. RESULTADOS: Os participantes tinham idade média de 49,7±12,34 anos. A média obtida com o questionário Owestry foi de 16,65±8,08 antes da intervenção e 11,63±7,89 após a intervenção. Houve maior proporção de dor incapacitante moderada (50,6%, n=41) antes do tratamento passando para 100% de dor incapacitante leve. Em relação aos resultados obtidos pelo questionário Nórdico de Sintomas Osteomusculares, a maioria (76,5%, n=62) apresentou dor na região lombar, seguido pelo pescoço e região dorsal, ambas com 49,4%, n=40. CONCLUSÃO: O programa de tratamento fisioterápico, por meio da Escola de Coluna, propiciou melhora geral no quadro clínico dos pacientes, principalmente na funcionalidade, limitação e dor.

OBJECTIVE: To evaluate the impact of a physiotherapy treatment program on patients with spine alterations. METHODS: This is an experimental, longitudinal, quantitative study carried out in the city of Araxá, Minas Gerais, Brazil. Participants were 81 patients from the Back School project, between May 2016 and April 2017, who should present some spine pathology, with specific medical referral, and agree to participate in the project. The participants were submitted to Pilates or global postural reeducation sessions twice a week during the three-month treatment, in a group, with an average duration of 50 minutes. Initial and final evaluation of musculoskeletal disorders was performed through the Nordic Musculoskeletal Questionnaire and the level of disability was assessed with use of the Oswestry index. At the end of the program the patients answered a questionnaire for assessment of their satisfaction with the results obtained. RESULTS: The participants' mean age was 49.7±12.34 years. The mean Oswestry index was 16.65±8.08, before the intervention, and 11.63±7.89 after the intervention. Moderate disabling pain was found in highest proportion (50.6%, n=41) before treatment, changing to 100% of mild disabling pain. Regarding the results obtained by the Nordic Musculoskeletal Questionnaire, the majority (76.5%, n=62) presented pain in the lumbar region, followed by the neck and dorsal region, both with 49.4%, n=40. CONCLUSION: The physiotherapy treatment program, by means of the Back School project, gave rise to an overall improvement in the patients' clinical status, particularly in functionality, limitation and pain.

OBJETIVO: Evaluar el impacto de un programa de tratamiento fisioterapéutico de pacientes con alteraciones de la columna. MÉTODOS: Se trata de un estudio experimental, longitudinal y cuantitativo realizado en el municipio de Araxá, Minas Gerais, Brasil. Participaron 81 pacientes del proyecto Escuela de la Columna entre los meses de mayo de 2016 y abril de 2017 que presentaban alguna patología de la columna, que tenían solicitación de médico específico y que estaban de acuerdo en participar del proyecto. Los participantes hicieron clases de Pilates o de Reeducación Postural Global, dos veces a la semana durante tres meses de tratamiento en grupo y con duración media de 50 minutos. Se realizó la evaluación inicial y final de los disturbios osteomusculares por el cuestionario Nórdico de Síntomas Osteomusculares y la evaluación del nivel de incapacidad por el índice de Owestry. Al finalizar el programa los pacientes contestaron un cuestionario para evaluar la satisfacción de los resultados obtenidos. RESULTADOS: Los participantes tenían edad media de 49,7±12,34 años. La media del cuestionario Owestry fue de 16,65±8,08 antes de la intervención y de 11,63±7,89 después. Hubo mayor proporción del dolor incapacitante moderado (50,6%, n=41) antes del tratamiento cambiando para el 100% después. Respecto los resultados del cuestionario Nórdico de Síntomas Osteomusculares la mayoría (76,5%, n=62) presentó dolor en la región lumbar seguida del cuello y región dorsal ambas con el 49,4%, n=40. CONCLUSIÓN: El programa de tratamiento fisioterapéutico a través de la Escuela de Columna ha proporcionado la mejora general del cuadro clínico de los pacientes principalmente de la funcionalidad, la limitación y el dolor.

Avaliação do risco de queda e equilíbrio em mulheres no climatério / Assessment of the risk of falls and balance in climacteric women / Evaluación del riesgo de caída y equilibrio en las mujeres en el climaterio

O objetivo do estudo foi avaliar o equilíbrio e o risco de quedas de mulheres ativas e sedentárias no climatério. Participaram do estudo 14 mulheres, com idades entre 45 e 80 anos. Foi utilizada a Escala de Equilíbrio de Berg e o Índice de Tinetti. Os resultados mostraram que o equilíbrio estático e dinâmico é maior e o risco de quedas é menor para praticantes de atividade física. Concluímos que a prática de atividade física tende a reduzir o risco de quedas, melhora o equilíbrio e a aptidão funcional, trazendo grandes benefícios para a saúde.

The objective of the study was to evaluate the balance and risk of falls of active and sedentary women in the climacteric period. A total of 14 women, aged between 45 and 80 years, participated in the study. The Berg's Balance Scale and the Tinetti Index were used. The results showed that the static and dynamic balance is greater and the risk of falls is lower for physical activity practitioners. Conclude that the practice of physical activity tends to reduce the risk of falls, improves balance and functional aptitude, bringing great health benefits.

El objetivo del estudio fue evaluar el equilibrio y el riesgo de caídas de mujeres activas y sedentarias en el climaterio. Participaron del estudio 14 mujeres, con edades entre 45 y 80 años. Se utilizó la Escala de Equilibrio de Berg y el Índice de Tinetti. Los resultados mostraron que el equilibrio estático y dinámico es mayor y el riesgo de caídas es menor para los practicantes de actividad física. Concluimos que la práctica de actividad física tiende a reducir el riesgo de caídas, mejora el equilibrio y la aptitud funcional, aportando grandes beneficios para la salud.

Perfil epidemiológico dos pacientes atendidos na clínica escola de fisioterapia do Uniaraxá no setor de hidroterapia / Epidemiological profile of patients attended in the clinic school of physiotherapy of Uniaraxá in the hydrotherapy sector

Segundo o Conselho Federal de Fisioterapia e Terapia Ocupacional a fisioterapia "é uma ciência da Saúde que estuda, previne e trata os distúrbios cinéticos funcionais intercorrentes em órgãos e sistemas do corpo humano, gerados por alterações genéticas, por traumas e por doenças adquiridas". A hidroterapia, é um dos recursos mais antigos utilizados pela fisioterapia, sendo definido como o uso externo da água aquecida com propósitos terapêuticos. No Centro Universitário do Planalto de Araxá, o serviço de fisioterapia aquática é realizado através da Clínica Escola de Fisioterapia do UNIARAXÁ, por estagiários do curso, supervisionados por fisioterapeutas licenciados. O Objetivo deste estudo foi traçar o perfil epidemiológico dos pacientes atendidos no setor de Hidroterapia, na clínica escola do UNIARAXÁ. Portanto esse trabalho mostra sua importância em fornecer um conhecimento maior da população estudada. A abordagem deste trabalho caracteriza-se como quantitativo e observacional descritivo. Neste estudo realizou-se uma pesquisa com 113 pacientes, por meio de fichas de avaliação fisioterapêutica. Identificou-se nos prontuários no período de junho de 2015 a dezembro de 2015, o gênero, a idade, o estado civil, o diagnóstico clínico e o tempo de tratamento. O diagnóstico clínico predominante foi o gonartrose, logo em seguida fibromialgia e artrose em coluna vertebral(AU)

According to the Federal Council of Physical Therapy and Occupational Therapy physical therapy "is a science of health that studies, prevents and treats intercurrent functional kinetic disorders in organs and body systems, generated by genetic alterations, by trauma and acquired diseases". Within the aquatic physical therapy we have hydrotherapy. The University Center of Plateau Araxá, the aquatic physical therapy is conducted through the Clinical School of Physiotherapy UNIARAXÁ for course trainees, supervised by licensed physical therapists. The objective of this study was to trace the epidemiological profile of patients seen in the hydrotherapy sector in medical school UNIARAXÁ. The approach of this work is characterized as quantitative and descriptive observational. In this study we carried out a survey of 113 patients through physical therapy evaluation forms. It was identified in the records from June 2015 to December 2015, the gender, age, marital status, clinical diagnosis and treatment time. The most common clinical diagnosis was gonarthrosis, then immediately fibromyalgia and osteoarthritis in the spine. Therefore this work shows its importance in providing a better understanding of the studied population. Through the patient profile of knowledge treated in the hydrotherapy sector, and the most frequent pathologies, we can do a better planning of the treatment, including specific guidelines for patients seen(AU)

Análise dos critérios utilizados para aspiração traqueal em unidades de terapia intensiva de hospitais de Araxá ­ MG / Analysis of criteria used for traqueal aspiration in intensive therapy units of Araxá hospitals ­ MG

Em pacientes que se encontram internados na Unidade de Terapia Intensiva muitas vezes é necessário o uso de ventilação mecânica, para manutenção das vias aéreas superiores. Essa necessidade limita a mobilização e a expectoração das secreções brônquicas, sendo necessário fazer uso de aspiração traqueal. O Objetivo foi avaliar os critérios utilizados para aspiração traqueal em unidades de Terapia Intensiva de hospitais de Araxá-MG. Trata-se de um estudo previamente aprovado pelo CEP-Uniaraxá e pelos hospitais envolvidos na pesquisa, do tipo transversal, descritiva e quali-quantitativo. Foi aplicado um questionário composto por 9 questões discursivas entregues aos profissionais das instituições participantes. Resultados foram avaliados 15 profissionais sendo 40% Técnicos em enfermagem, 27% Enfermeiros 27% Fisioterapeutas e 6% Auxiliares de enfermagem. Quanto a importância da aspiração 41% dos participantes responderam que a desobstrução das vias aéreas pela aspiração traqueal é de extrema importância para o paciente. Concluímos que o procedimento de aspiração traz vários riscos aos pacientes. Requer atenção, cuidado e habilidade, o que nos faz concluir que é necessário um melhor aperfeiçoamento da técnica para um melhor atendimento e manutenção da saúde do paciente(AU)

In patients who are hospitalized in the Intensive Care Unit, it is often necessary to use mechanical ventilation to maintain the upper airways. This necessity limits the mobilization and the expectoration of the bronchial secretions, being necessary to make use of tracheal aspiration. The objective was to evaluate the criteria used for tracheal aspiration in Intensive Care units of hospitals in Araxá-MG. This is a study previously approved by CEP-Uniaraxá and the hospitals involved in the research, of a crosssectional, descriptive and quali-quantitative type. A questionnaire composed of 9 discursive questions was given to the professionals of the participating institutions. Results were evaluated 15 professionals being 40% Nursing technicians, 27% Nurses 27% Physiotherapists and 6% Nursing auxiliaries. Regarding the importance of aspiration, 41% of the participants answered that the airway clearance by tracheal aspiration is extremely important for the patient. We conclude that the aspiration procedure poses several risks to patients. It requires attention, care and skill, which makes us conclude that a better improvement of the technique is required for a better care and maintenance of the patient's health(AU)

Avaliação da aptidão física e funcional de idosos com prática de atividade física diferenciada / Evaluation of physical and functional fitness of older people with practice of differentiated physical activity / Evaluación de la aptitud física y funcional de los ancianos con práctica de actividad física diferenciada

O objetivo foi verificar e comparar o efeito da prática de exercício físico na aptidão física em idosos, com prática de atividades físicas diferenciadas e específicas. Como metodologia, foram formados 3 grupos de idosos e realizados testes por meio de protocolos e anamnese. Os resultados nos mostram que a atividade física regular nos grupos ativos apresenta diferença significativa no desempenho global quando comparado com o grupo sedentário. Concluiu-se que a prática de atividade física ou lúdica regular melhora o desempenho global dos idosos.

The objective was to verify and compare the effect of physical exercise practice on physical fitness in the elderly, with practice of differentiated and specific physical activities. As a methodology, 3 groups of elderly were formed and performed tests through protocols and anamnesis. The results show that regular physical activity in the active groups presents a significant difference in overall performance when compared to the sedentary group. It was concluded that the practice of regular physical activity or play improves the overall performance of the elderly.

El objetivo fue verificar y comparar el efecto de la práctica de ejercicio físico en la aptitud física en ancianos, con práctica de actividades físicas diferenciadas y específicas. Como metodología, se formaron 3 grupos de ancianos y se realizaron pruebas a través de protocolos y anamnesis. Los resultados nos muestran que la actividad física regular en los grupos activos presenta una diferencia significativa en el desempeño global en comparación con el grupo sedentario. Se concluyó que la práctica de actividad física o lúdica regular mejora el desempeño global de los ancianos.

Relationship between physical activity practice and metabolic profile of postmenopausal women under treatment with aromatase inhibitors for breast cancer.

OBJECTIVE: To analyze the relationship between physical activity practice and metabolic profile of postmenopausal women under treatment with aromatase inhibitors (AIs) for the treatment of breast cancer. STUDY DESIGN: Cross-sectional study, conducted with 101 postmenopausal women (aged 50-80 years). The sample was divided into two groups; group without cancer (GW; n=65) and breast cancer group treated with AIs (GC; n=36). Physical activity (PA) was evaluated by questionnaire. Correlations between physical activity and metabolic variables were made by Pearson's correlation coefficient and the magnitude of these relationships by linear regression. RESULTS: In GW, there were observed significant inverse correlations between physical activity and VLDL cholesterol (ß=-0.036; 95% CI=-0.068; -0.004); triglycerides (ß=-0.036; 95% CI=-0.015; -0.002); glycose (ß=-0.029; 95% CI=-0.047; -0.012); and C-reactive protein (ß=-0.44; 95% CI=-0.085; -0.003). However, for women under treatment of AIs there was no relationship between physical activity and metabolic variables. CONCLUSION: The amount of physical activity practice is inversely related to lipid profile, glucose and C-reactive protein in women without breast cancer. This relation was not observed in the cancer survivors, suggesting that the use of aromatase inhibitors could influence or low intensity of physical activity.

Mediators Go Together: High Production of CXCL9, CXCL10, IFN-γ, and TNF-α in HTLV-1-Associated Myelopathy/Tropical Spastic Paraparesis.

HTLV-1-associated myelopathy/tropical spastic paraparesis (HAM/TSP) is a chronic demyelinating and disabling syndrome caused by human T lymphotropic virus 1 (HTLV-1). Although the pathogenic mechanisms that lead to HAM/TSP outcome have not been elucidated, genetic and immunological factors may be involved in the myelopathy occurrence. This study aimed to compare cytokines, chemokines, and nitric oxide (NO) levels in asymptomatic and HAM/TSP HTLV-1-infected patients. The study group consisted of 21 HAM/TSP and 48 asymptomatic HTLV-1 patients. Chemokines (CCL5, CCL2, CXCL8, CXCL9, and CXCL10) and cytokines [IL-2, interferon gamma (IFN-γ), tumor necrosis factor alpha (TNF-α), IL-4, IL-6, and IL-10] were measured using cytometric bead array, whereas NO production was measured after reaction of supernatants with nitrate reduction solution. CXCL9 and CXCL10 chemokines levels were found to be higher in the HAM/TSP group. CXCL9 was also strongly correlated with CXCL10 and both CXCL9 and CXCL10 were moderately correlated with CCL2 and CCL5 levels, in both HAM/TSP and asymptomatic groups. There was no significant difference related to NO, IL-4, IL-6, and IL-10 levels between the clinical groups but TNF-α and IFN-γ levels were increased in HAM/TSP patients. Thus, factors such as CXCL9, CXCL10, TNF-α, and IFN-γ could be good prognostic biomarker candidates, and further studies may help to clarify their association with HAM/TSP immunopathogenesis.