We recently read the opinion piece titled“Why people should run after positive affective experiences instead of health benefits”,which was carried out by Maltagliati et al.^(1)and published in the Journal of Sport a...We recently read the opinion piece titled“Why people should run after positive affective experiences instead of health benefits”,which was carried out by Maltagliati et al.^(1)and published in the Journal of Sport and Health Science.The article started an important discussion about a physical activity(PA)promotion approach that encourages the use of affective experience to PA activity.Although we agree with the authors’point of view and believe that its message can generate an important insight for PA promotion,the authors presented a scenario where behavior change seems to be exclusively dependent on the individual.Recognizing the existence of other barriers to an active lifestyle(e.g.,social inequalities)could enhance the authors’suggested approach because many people live in conditions that reduce their opportunities to engage in affective experiences related to PA;furthermore,affective experiences can vary depending on individual context.展开更多
Background:Guidelines recommend that adolescents should accumulate an average of 60 min per day of moderate-to-vigorous physical activity(MVPA).However,using only this cut-off could hide important information.For inst...Background:Guidelines recommend that adolescents should accumulate an average of 60 min per day of moderate-to-vigorous physical activity(MVPA).However,using only this cut-off could hide important information.For instance,from a population-level point of view,increasing physical activity for those with no or low physical activity could provide more health benefits than increasing physical activity for those with intermediate levels.Also,including a more sensitive cut-point of≥1 days per week could be an additional strategy for identifying those with low access/opportunities for physical activity practice.Thus,the current study aims to estimate the prevalence of≥60 min of MVPA≥1 days per week among adolescents globally,and to describe any relevant gender inequalities.Methods:We used representative datasets from 146 countries/territories collected between 2003 and 2019.MVPA was self-reported.Participants were grouped into younger(≤14 years old)and older(>14 years old)adolescents.Crude Poisson regression models were used to identify the relative differences in≥60 min of MVPA≥1 days per week between boys and girls,and random-effects meta-analysis models were used to identify the pooled estimates.Analyses were stratified by country and region.Results:Approximately 80%of both younger and older adolescents reported≥60 min of MVPA≥1 days per week.This prevalence was≥94%in Europe and Central Asia and North America,while the estimates for the other regions were<77%.The prevalence of≥60 min of MVPA≥1 days per week was higher among boys than girls,with the largest differences occurring among the oldest adolescents(Prevalence ratio_(≤14y)=1.04(95%confidence interval(95%CI)):1.03-1.04)vs.Prevalence ratio_(>14y)=1.09(95%CI:1.08-1.10)).Conclusion:Approximately 8 out of 10 adolescents reported accumulating≥60 min of MVPA≥1 days per week,with notable differences between regions.Gender differences were observed in several countries,especially among the oldest adolescents.Priorities for physical activity promotion among adolescents should include increasing access/opportunities for physical activity among those who do not achieve≥60 min of MVPA≥1 days per week and reducing gender inequalities.展开更多
Introduction: Child obesity has important consequences on the child’s health and is related to the risk of developing chronic diseases. That brings up the need for research assessing the impact of obesity-and overwei...Introduction: Child obesity has important consequences on the child’s health and is related to the risk of developing chronic diseases. That brings up the need for research assessing the impact of obesity-and overweight-reduction programs with close attention to methodology aspects and precise indicators of the impact of such programs. Goal: Assessing the impact of a physical activity program on the plasma concentrations of adiponectin, leptin, and ghrelin in overweight and obese schoolchildren. Methods: Randomized controlled trial, double-blind, with 6-to 9-year-old overweight and obese school-children. A sample of 79 schoolchildren randomly distributed into control and intervention groups was subjected to a physical activity program. The levels of adiponectin, leptin, ghrelin, body mass index, body fat percentage, anthropometry, lipid profile and glycemia were evaluated. The program’s impact was assessed through multivariate linear regression models. Result: When comparing the groups, a significant difference was found for adiponectin, which shows an increase in the proportion of subjects with higher adiponectin concentrations for the intervention group and a reduction in body mass index and body fat percentage. Conclusion: The impact of the intervention program was positive in increasing adiponectin levels associated with a reduction in body mass index and body fat percentage.展开更多
Cells are constantly subjected to cytotoxic and genotoxic insults resulting in the accumulation of unrepaired damaged DNA,which leads to neuronal death.In this way,DNA damage has been implicated in the pathogenesis of...Cells are constantly subjected to cytotoxic and genotoxic insults resulting in the accumulation of unrepaired damaged DNA,which leads to neuronal death.In this way,DNA damage has been implicated in the pathogenesis of neurological disorders,cancer,and aging.Lifestyle factors,such as physical exercise,are neuroprotective and increase brain function by improving cognition,learning,and memory,in addition to regulating the cellular redox milieu.Several mechanisms are associated with the effects of exercise in the brain,such as reduced production of oxidants,up-regulation of antioxidant capacity,and a consequent decrease in nuclear DNA damage.Furthermore,physical exercise is a potential strategy for further DNA damage repair.However,the neuroplasticity molecules that respond to different aspects of physical exercise remain unknown.In this review,we discuss the influence of exercise on DNA damage and adjacent mechanisms in the brain.We discuss the results of several studies that focus on the effects of physical exercise on brain DNA damage.展开更多
Various conditions affecting nerve cells and the nervous system due to the loss of neurons and their connecting networks are described under the superordinate phrase“Neurodegenerative diseases”.Such diseases lead to...Various conditions affecting nerve cells and the nervous system due to the loss of neurons and their connecting networks are described under the superordinate phrase“Neurodegenerative diseases”.Such diseases lead to disability due to gradual neuronal death in both the central nervous system and the peripheral nervous system.While many of these diseases have unknown causes,sometimes these are due to medical conditions such as alcoholism,a tumor,or a stroke,or other causes which may include genetic mutations,toxins,chemicals,and viruses.展开更多
Introduction: Cognitive impairment has been identified in 30% - 50% of the population with Amyotrophic Lateral Sclerosis (ALS). Among these patients, dysphagia is not only a very common symptom but also one of the mai...Introduction: Cognitive impairment has been identified in 30% - 50% of the population with Amyotrophic Lateral Sclerosis (ALS). Among these patients, dysphagia is not only a very common symptom but also one of the main bulbar symptoms. Objective: To correlate cognitive function and dysphagia in patients with ALS. Methods: a cross-sectional study. Criteria for inclusion were an ALS diagnosis and the signing of the consent form. Criteria for exclusion were patients who had undergone speech therapy, patients within sufficient oral language skills to participate in cognitive tests, patients receiving enteral feeding and patients who withdrew from the study before completing all the stages. Evaluations of cognition and dysphagia were performed. Results: The initial sample consisted of 86 participants, 69 of which fell under exclusion criteria. Seventeen patients were evaluated, with a mean age of 49.8 (±11.3) and a mean education period of 7.1 (±2.8) years. Disease evolution was analyzed in months, with a median of 24 (P25 = 10;P75 = 72) months. In this sample, 70.6% of patients were male (p = 0.019). Among the tests performed, those of executive functions were correlated with dysphagia: FAB (p = 0.019) and Trail Making Test A (p = 0.006). Conclusion: This pilot study suggests a correlation between executive functions and dysphagia.展开更多
Background: Uterine arteriovenous malformation (AVM) is a rare, potentially life-threatening cause of abnormal uterine bleeding that can be acquired following a cesarean section. The diagnosis is difficult, often misd...Background: Uterine arteriovenous malformation (AVM) is a rare, potentially life-threatening cause of abnormal uterine bleeding that can be acquired following a cesarean section. The diagnosis is difficult, often misdiagnosed with retained products of conception and placenta accreta. Transarterial embolization (TAE) is a</span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">n</span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;"> efficacious and effective method of treating AVM, particularly in patients of reproductive age.</span></span></span><span><span><span style="font-family:""> </span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">Case Report: A 41-year-old, nulliparous</span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;"> woman</span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">, started with a history of abnormal uterine bleeding 30 days after a cesarean section. She didn’t have anaemia and beta-human chorionic gonadotropin (beta-hCG) was negative. The transvaginal color Doppler ultrasound showed multiple vascular channels within myometrium showing colored mosaic patterns suggesting AVM, confirmed by Magnetic Resonance Imaging. The patient was referred to perform a Computed Tomography Angiography and right uterine artery embolization without any vascular complications.</span></span></span><span><span><span style="font-family:""> </span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">Conclusion: AVM is a rare consequence of cesarean section but has to be considered in cases of persistent uterine bleeding in the puerperium. Embolization is a safe and effective choice treatment of AVM and an alternative and less invasive option for patients wishing to preserve fertility.展开更多
<strong>Introduction:</strong><span><span><span style="font-family:""><span style="font-family:Verdana;"> Prematurity is a public health problem in Brazil, ...<strong>Introduction:</strong><span><span><span style="font-family:""><span style="font-family:Verdana;"> Prematurity is a public health problem in Brazil, with 12% of deliveries occurring before 37 weeks of gestation. The measurement of the cervix in the second trimester is already established as a method of screening for prematurity and some studies point out advantages to start this screening in the first trimester. </span><b><span style="font-family:Verdana;">Objective:</span></b><span style="font-family:Verdana;"> To define the correlation between the length of the endocervix by transvaginal ultrasound in the first trimester (11 to 14 weeks) with spontaneous early deliveries. </span><b><span style="font-family:Verdana;">Method:</span></b><span style="font-family:Verdana;"> A prospective and observational study realized in a suplementar and private ultrasound clinic and hospital of Porto Alegre, Brazil between 2019-2020. Ultrasound screening of cervix was performed in singleton pregnancies in first and second trimester of pregnancy and correlated with age of delivery. </span><b><span style="font-family:Verdana;">Results:</span></b><span style="font-family:Verdana;"> 142 pregnant women were studied, 80% were in the first pregnancy. The average age was 33.8 years. The rate of prematurity was 18% before 37 weeks and 4% before 34 weeks. The average of cervix measured in the first and second trimesters in deliveries before 34 weeks was 32.7 mm and 29.3 mm, respectively. In term deliveries the median cervical length was 38.8 mm and 37.8 mm, respectively. When analyzing the measurements of the cervix in the second trimester, the cervix was smaller (p = 0.008) among deliveries below 34 weeks (29</span></span></span></span><span><span><span style="font-family:""> </span></span></span><span><span><span style="font-family:""><span style="font-family:Verdana;">mm) than deliveries after 37 weeks. No statistically related differences were found between preterm birth and first trimester cervix measurements. </span><b><span style="font-family:Verdana;">Conclusions</span></b><span style="font-family:Verdana;">: In this study, we did not observe a statistically significant relationship between first trimester cervix measurement and prematurity. More studies are needed to evaluate this finding. However, the measurement of the cervix in the second trimester is different from that found in the literature. This suggest</span></span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">s</span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;"> a possible new cut-off point that increases the sensitivity of transvaginal ultrasound as a method of preventing prematurity.</span></span></span>展开更多
Traffic-related air pollution is an alarming source of pollutants exposure and consequently to the development of several adverse health effects. Otherwise, green spaces are reported to improve health status. Although...Traffic-related air pollution is an alarming source of pollutants exposure and consequently to the development of several adverse health effects. Otherwise, green spaces are reported to improve health status. Although, in an urban scenario most of these areas are located near air pollutants sources, as vehicle fleet. Thus, the aim of the present study was to determine, during one year, the levels of nitrogen dioxide (NO2) and ozone (O3) in the main parks from Porto Alegre—Brazil. This study focused on three urban parks: Germania, Moinhos de Vento and Marinha do Brasil Park. Nitrogen dioxide and ozone measurements were accessed by passive monitoring in four campaigns including all seasons and performed at distances of 0 m, 15 m, 30 m, 45 m, 60 m and 75 m from the main road at each park. NO2 and O3 concentration among the parks was not different (p > 0.05), as well as the mean concentration of NO2 and O3 of all parks in the six sites did not differ (p > 0.05). However, season 1 and 3 showed increased NO2 and O3 concentration. Temperature were decreased in season 1 and 3 (p p > 0.05). Traffic flow was higher in Moinhos de Vento Park and Marinha do Brasil Park compared to Germania Park (p 2 and O3 concentration in urban parks from Porto Alegre.展开更多
The aim of this study was to gather information on the use of stable isotopes to measure total body water and body composition scan in children. We selected studies in the last 13 years, in addition to classical studi...The aim of this study was to gather information on the use of stable isotopes to measure total body water and body composition scan in children. We selected studies in the last 13 years, in addition to classical studies on the subject, indexed in the database PubMed, LILACS, BVS and SciELO. The body composition was characterized by the amount of bone tissue, muscle and adipose tissue, also including the organs as well as levels of body water. Your knowledge becomes increasingly important in light of the changes that occur in the nutritional status of various types of diseases in frameworks, such as diabetes mellitus, protein energy malnutrition, in cases of obesity and metabolic syndrome. The ability to accurately assess body fat mass especially in children is associated with the importance of effective strategies for prevention and treatment of childhood obesity. Historically, in addition to clinical applications, measurements of total body water were used to determine body composition in nutritional studies. To the knowledge of the body composition, the body water can be measured and used by the ingestion of a dose of labeled water. The measured isotope enrichment is a function of the amount of body water. The method of deuterium is particularly interesting for the assessment of body composition in children, due to its characteristics of collection and analysis.展开更多
The present study sought to assess the rational use of antimicrobial agents in a Brazilian intensive care unit (ICU) and its association with antimicrobial resistance in elderly patients admitted to the unit. Results:...The present study sought to assess the rational use of antimicrobial agents in a Brazilian intensive care unit (ICU) and its association with antimicrobial resistance in elderly patients admitted to the unit. Results: Choice of empiric and sensitivity-guided therapy was inadequate in > 80% and 59% of cases respectively. Inadequate antimicrobial therapy, whether empiric or sensitivity-guided, was positively correlated with bacterial resistance (r = 0.316;p = 0.001). Sensitivity testing revealed a 46.5% resistance rate to eight out of the ten most commonly used antibiotics. Multiple drug-resistant organisms were found in 40.8% of patients. A significant increase was observed in the number of multidrug-resistant samples between 2006/2007 and 2008 (r = 0.41, p = 0.006), (r = 0.598, p = 0.001), (r = 0.688, p = 0.00). Conclusion: We found a high rate of antibiotic misuse in the study sample. Inadequate therapy was correlated with resistance to antimicrobial agents.展开更多
Access can be understood as the sum of a number of elements of the interface between patients and the health care system. This study took a comprehensive approach to the dimensions of access to medications, employing ...Access can be understood as the sum of a number of elements of the interface between patients and the health care system. This study took a comprehensive approach to the dimensions of access to medications, employing indicators to evaluate the dimensions of access to antihypertensive medications in Ceilandia, DF, Brazil. This was a cross-sectional epidemiological study, administering questionnaires during home visits. The survey covered epidemiological and socioeconomic profiles, behavioral habits and the dimensions of access to antihypertensive medications comprising physical, financial, and geographic availability and accept ability according to the hypertensive population of Ceilandia. The total sample comprised 400 individuals and the hypertensive subset numbered 140 (35%). Indicators of physical availability of medications revealed that users found it difficult to acquire their drugs on almost one third of occasions and in some cases were unable to access any of these products. The greatest barriers to access were reported by users of pharmacies belonging to the Brazilian National Health Service (SUS) and on the “People’s Pharmacies” network. More than one third of the hypertensive sample spent their own money on medications they could not find at these pharmacies. The majority of the hypertensive subsets were overweight/obese, a minority engaged in physical activity and 40% were smokers/ex-smokers. More women reduced their salt intake. Men had higher incomes, educational level, and socioeconomic status. Failure to keep the public health care system supplied has prejudiced access to essential medications for hypertension treatment, transferring the costs onto users. This population has lifestyle habits that increase the risk of exacerbation of hypertension. These results reveal a need for effective public policies to ensure access to antihypertensive medications and involve users of the health care system in changing their habits and behaviors in order to achieve adequate and lasting control of systemic arterial hypertension.展开更多
This study aimed to evaluate the efficacy of an individualized remote exercise program on the improvement of body composition and physical fitness of a heterogeneous group of patients who completed breast cancer treat...This study aimed to evaluate the efficacy of an individualized remote exercise program on the improvement of body composition and physical fitness of a heterogeneous group of patients who completed breast cancer treatment.This prospective study included 107 women aged 18 to 60,shortly after curative treatment for localized breast cancer,at the Erasto Gaertner Cancer Hospital(HEG)in Curitiba,PR,Brazil.Body composition,maximal oxygen consumption,and muscle resistance were evaluated after nine months of intervention while considering adherence to the program,level of physical activity,presence of binge eating disorder,tumor classification,and treatment type.Seventy-eight women(72.8%)adhered to the training program.Adherent participants showed significant changes in body mass([-4.3±3.6]kg;p<0.0001),body mass index([-1.6±1.5]kg·m^(−2);p<0.0001),body fat(−3.4%±3.1%;p<0.0001),maximal oxygen consumption([7.5±2.0]ml·kg^(−1)·min^(−1));p<0.0001),and abdominal resistance([11.2±2.8]reps;p<0.0001).In contrast,these variables did not change significantly in the non-adherent group.Among the adherent participants,those subclassified in the severe binge group showed a more noticeable reduction in body mass,body mass index,and body fat(p<0.05)than those in the non-binge group.Individualized remotely-guided physical exercise programs can improve the body composition and physical fitness of women undergoing post-breast cancer surveillance,regardless of pathological history or treatment.展开更多
Cardiac rehabilitation protocols applied during the inhospital phase(phaseⅠ)are subjective and their results are contested when evaluated considering what should be the three basic principles of exercise prescription...Cardiac rehabilitation protocols applied during the inhospital phase(phaseⅠ)are subjective and their results are contested when evaluated considering what should be the three basic principles of exercise prescription:specificity,overload and reversibility.In this review,we focus on the problems associated with the models of exercise prescription applied at this early stage in-hospital and adopted today,especially the lack of clinical studies demonstrating its effectiveness.Moreover,we present the concept of"periodization"as a useful tool in the search for better results.展开更多
AIM: To evaluate the prevalence of celiac disease in a group of Brazilian individuals over 60 years of age and compare it with the previously known prevalence in a pediatric group living in the same geographical area....AIM: To evaluate the prevalence of celiac disease in a group of Brazilian individuals over 60 years of age and compare it with the previously known prevalence in a pediatric group living in the same geographical area.METHODS: The research protocol was approved by the Ethics Committee of the University of Brasilia School of Medicine, Brasilia, Brazil. Blood samples from 946 individuals (295 male and 651 female) aged 60 years or older were collected between May 2010 and July 2011. The study subjects' mean and median ages were 68.1 and 67 years, respectively, ranging from 60 to 92 years. That age distribution closely corresponded to the age distribution of the Brazilian population according to the Brazilian 2010 census. The participants were consecutive and unselected outpatients undergoing blood tests at the University of Brasilia Hospital's Clinical Pathology Laboratory. All sera were tested for immunoglobulin A anti-transglutaminase antibodies (IgA-tTG) by enzymelinked immunosorbent assay, and those that were positive were further tested for immunoglobulin A antiendomysium antibodies (IgA-EMA). Human leukocyte antigen (HLA) genotyping was performed for all individuals who exhibited positive serologic results for IgA-tTG and/or IgA-EMA.RESULTS: Out of the 946 studied patients, only one previously diagnosed case of biopsy-proven celiac disease was detected. For the remaining subjects, nine serum samples tested positive for IgA-tTG antibodies; however, none of them tested positive for IgA-EMA antibodies. The HLA genotyping of those nine subjects revealed that one was carrying DQA1*0501 and two were carrying DQB1*0201 alleles. These data showed that, among those 946 elderly individuals, the prevalence of celiac disease (CD) was 0.1% (95%CI: 0.00-0.59). The prevalence of CD for the elderly group was compared with that observed for the group of 2034 children younger than 15 years (age range, 1-14 years; mean age, 8 years) who took part in our previous CD prevalence screening study. All the children came from the same geographical region and shared a similar ethnic and low-income background. As in the elderly group in the current study, the younger group was made up of consecutive outpatients who underwent blood evaluation at the University of Brasilia Hospital's Clinical Laboratory. The prevalence of biopsy-proven CD among those children was 0.54% (95%CI: 0.27-0.57). The comparative analysis between the two groups resulted in the following values: odds ratio = 0.19 (95%CI: 0.01-1.45) Fisher testP = 0.06. CONCLUSION: The prevalence of CD among the children of our previous study was 5.4 times higher than that found in the present elderly group.展开更多
A wealth of pre-clinical reports and data derived from human subjects and brain autopsies suggest that microbial infections are relevant to Alzheimer’s disease(AD).This has inspired the hypothesis that microbial infe...A wealth of pre-clinical reports and data derived from human subjects and brain autopsies suggest that microbial infections are relevant to Alzheimer’s disease(AD).This has inspired the hypothesis that microbial infections increase the risk or even trigger the onset of AD.Multiple models have been developed to explain the increase in pathogenic microbes in AD patients.Although this hypothesis is well accepted in the field,it is not yet clear whether microbial neuroinvasion is a cause of AD or a consequence of the pathological changes experienced by the demented brain.Along the same line,the gut microbiome has also been proposed as a modulator of AD.In this review,we focus on human-based evidence demonstrating the elevated abundance of microbes and microbe-derived molecules in AD hosts as well as their interactions with AD hallmarks.Further,the direct-purpose and potential off-target effects underpinning the efficacy of anti-microbial treatments in AD are also addressed.展开更多
基金supported by the Coordination for the Improvement of Higher Education Personnel (CAPES) with a PhD scholarship (CAPES process:88887.605034/2021-00)a Research Internship Abroad scholarship (CAPES process:88881.846428/2023-01)+1 种基金supported by the Sao Paulo Research Foundation (FAPESP) with a PhD scholarship (process:2019/24124-7)a Research Internship Abroad scholarship (process:2023/00790-3)
文摘We recently read the opinion piece titled“Why people should run after positive affective experiences instead of health benefits”,which was carried out by Maltagliati et al.^(1)and published in the Journal of Sport and Health Science.The article started an important discussion about a physical activity(PA)promotion approach that encourages the use of affective experience to PA activity.Although we agree with the authors’point of view and believe that its message can generate an important insight for PA promotion,the authors presented a scenario where behavior change seems to be exclusively dependent on the individual.Recognizing the existence of other barriers to an active lifestyle(e.g.,social inequalities)could enhance the authors’suggested approach because many people live in conditions that reduce their opportunities to engage in affective experiences related to PA;furthermore,affective experiences can vary depending on individual context.
基金supported by the Brazilian Coordination for the Improvement of Higher Education Personnel(CAPES)with a PhD scholarship(CAPES process:88887.605034/2021-00,88887.605029/2021-00,and 88887.694146/2022-00,respectively)supported by the S?o Paulo Research Foundation(FAPESP)with a PhD scholarship(FAPESP process:2019/24124-7)。
文摘Background:Guidelines recommend that adolescents should accumulate an average of 60 min per day of moderate-to-vigorous physical activity(MVPA).However,using only this cut-off could hide important information.For instance,from a population-level point of view,increasing physical activity for those with no or low physical activity could provide more health benefits than increasing physical activity for those with intermediate levels.Also,including a more sensitive cut-point of≥1 days per week could be an additional strategy for identifying those with low access/opportunities for physical activity practice.Thus,the current study aims to estimate the prevalence of≥60 min of MVPA≥1 days per week among adolescents globally,and to describe any relevant gender inequalities.Methods:We used representative datasets from 146 countries/territories collected between 2003 and 2019.MVPA was self-reported.Participants were grouped into younger(≤14 years old)and older(>14 years old)adolescents.Crude Poisson regression models were used to identify the relative differences in≥60 min of MVPA≥1 days per week between boys and girls,and random-effects meta-analysis models were used to identify the pooled estimates.Analyses were stratified by country and region.Results:Approximately 80%of both younger and older adolescents reported≥60 min of MVPA≥1 days per week.This prevalence was≥94%in Europe and Central Asia and North America,while the estimates for the other regions were<77%.The prevalence of≥60 min of MVPA≥1 days per week was higher among boys than girls,with the largest differences occurring among the oldest adolescents(Prevalence ratio_(≤14y)=1.04(95%confidence interval(95%CI)):1.03-1.04)vs.Prevalence ratio_(>14y)=1.09(95%CI:1.08-1.10)).Conclusion:Approximately 8 out of 10 adolescents reported accumulating≥60 min of MVPA≥1 days per week,with notable differences between regions.Gender differences were observed in several countries,especially among the oldest adolescents.Priorities for physical activity promotion among adolescents should include increasing access/opportunities for physical activity among those who do not achieve≥60 min of MVPA≥1 days per week and reducing gender inequalities.
文摘Introduction: Child obesity has important consequences on the child’s health and is related to the risk of developing chronic diseases. That brings up the need for research assessing the impact of obesity-and overweight-reduction programs with close attention to methodology aspects and precise indicators of the impact of such programs. Goal: Assessing the impact of a physical activity program on the plasma concentrations of adiponectin, leptin, and ghrelin in overweight and obese schoolchildren. Methods: Randomized controlled trial, double-blind, with 6-to 9-year-old overweight and obese school-children. A sample of 79 schoolchildren randomly distributed into control and intervention groups was subjected to a physical activity program. The levels of adiponectin, leptin, ghrelin, body mass index, body fat percentage, anthropometry, lipid profile and glycemia were evaluated. The program’s impact was assessed through multivariate linear regression models. Result: When comparing the groups, a significant difference was found for adiponectin, which shows an increase in the proportion of subjects with higher adiponectin concentrations for the intervention group and a reduction in body mass index and body fat percentage. Conclusion: The impact of the intervention program was positive in increasing adiponectin levels associated with a reduction in body mass index and body fat percentage.
文摘Cells are constantly subjected to cytotoxic and genotoxic insults resulting in the accumulation of unrepaired damaged DNA,which leads to neuronal death.In this way,DNA damage has been implicated in the pathogenesis of neurological disorders,cancer,and aging.Lifestyle factors,such as physical exercise,are neuroprotective and increase brain function by improving cognition,learning,and memory,in addition to regulating the cellular redox milieu.Several mechanisms are associated with the effects of exercise in the brain,such as reduced production of oxidants,up-regulation of antioxidant capacity,and a consequent decrease in nuclear DNA damage.Furthermore,physical exercise is a potential strategy for further DNA damage repair.However,the neuroplasticity molecules that respond to different aspects of physical exercise remain unknown.In this review,we discuss the influence of exercise on DNA damage and adjacent mechanisms in the brain.We discuss the results of several studies that focus on the effects of physical exercise on brain DNA damage.
基金The present work was supported by CAPES-001(to PCLS).
文摘Various conditions affecting nerve cells and the nervous system due to the loss of neurons and their connecting networks are described under the superordinate phrase“Neurodegenerative diseases”.Such diseases lead to disability due to gradual neuronal death in both the central nervous system and the peripheral nervous system.While many of these diseases have unknown causes,sometimes these are due to medical conditions such as alcoholism,a tumor,or a stroke,or other causes which may include genetic mutations,toxins,chemicals,and viruses.
文摘Introduction: Cognitive impairment has been identified in 30% - 50% of the population with Amyotrophic Lateral Sclerosis (ALS). Among these patients, dysphagia is not only a very common symptom but also one of the main bulbar symptoms. Objective: To correlate cognitive function and dysphagia in patients with ALS. Methods: a cross-sectional study. Criteria for inclusion were an ALS diagnosis and the signing of the consent form. Criteria for exclusion were patients who had undergone speech therapy, patients within sufficient oral language skills to participate in cognitive tests, patients receiving enteral feeding and patients who withdrew from the study before completing all the stages. Evaluations of cognition and dysphagia were performed. Results: The initial sample consisted of 86 participants, 69 of which fell under exclusion criteria. Seventeen patients were evaluated, with a mean age of 49.8 (±11.3) and a mean education period of 7.1 (±2.8) years. Disease evolution was analyzed in months, with a median of 24 (P25 = 10;P75 = 72) months. In this sample, 70.6% of patients were male (p = 0.019). Among the tests performed, those of executive functions were correlated with dysphagia: FAB (p = 0.019) and Trail Making Test A (p = 0.006). Conclusion: This pilot study suggests a correlation between executive functions and dysphagia.
文摘Background: Uterine arteriovenous malformation (AVM) is a rare, potentially life-threatening cause of abnormal uterine bleeding that can be acquired following a cesarean section. The diagnosis is difficult, often misdiagnosed with retained products of conception and placenta accreta. Transarterial embolization (TAE) is a</span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">n</span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;"> efficacious and effective method of treating AVM, particularly in patients of reproductive age.</span></span></span><span><span><span style="font-family:""> </span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">Case Report: A 41-year-old, nulliparous</span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;"> woman</span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">, started with a history of abnormal uterine bleeding 30 days after a cesarean section. She didn’t have anaemia and beta-human chorionic gonadotropin (beta-hCG) was negative. The transvaginal color Doppler ultrasound showed multiple vascular channels within myometrium showing colored mosaic patterns suggesting AVM, confirmed by Magnetic Resonance Imaging. The patient was referred to perform a Computed Tomography Angiography and right uterine artery embolization without any vascular complications.</span></span></span><span><span><span style="font-family:""> </span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">Conclusion: AVM is a rare consequence of cesarean section but has to be considered in cases of persistent uterine bleeding in the puerperium. Embolization is a safe and effective choice treatment of AVM and an alternative and less invasive option for patients wishing to preserve fertility.
文摘<strong>Introduction:</strong><span><span><span style="font-family:""><span style="font-family:Verdana;"> Prematurity is a public health problem in Brazil, with 12% of deliveries occurring before 37 weeks of gestation. The measurement of the cervix in the second trimester is already established as a method of screening for prematurity and some studies point out advantages to start this screening in the first trimester. </span><b><span style="font-family:Verdana;">Objective:</span></b><span style="font-family:Verdana;"> To define the correlation between the length of the endocervix by transvaginal ultrasound in the first trimester (11 to 14 weeks) with spontaneous early deliveries. </span><b><span style="font-family:Verdana;">Method:</span></b><span style="font-family:Verdana;"> A prospective and observational study realized in a suplementar and private ultrasound clinic and hospital of Porto Alegre, Brazil between 2019-2020. Ultrasound screening of cervix was performed in singleton pregnancies in first and second trimester of pregnancy and correlated with age of delivery. </span><b><span style="font-family:Verdana;">Results:</span></b><span style="font-family:Verdana;"> 142 pregnant women were studied, 80% were in the first pregnancy. The average age was 33.8 years. The rate of prematurity was 18% before 37 weeks and 4% before 34 weeks. The average of cervix measured in the first and second trimesters in deliveries before 34 weeks was 32.7 mm and 29.3 mm, respectively. In term deliveries the median cervical length was 38.8 mm and 37.8 mm, respectively. When analyzing the measurements of the cervix in the second trimester, the cervix was smaller (p = 0.008) among deliveries below 34 weeks (29</span></span></span></span><span><span><span style="font-family:""> </span></span></span><span><span><span style="font-family:""><span style="font-family:Verdana;">mm) than deliveries after 37 weeks. No statistically related differences were found between preterm birth and first trimester cervix measurements. </span><b><span style="font-family:Verdana;">Conclusions</span></b><span style="font-family:Verdana;">: In this study, we did not observe a statistically significant relationship between first trimester cervix measurement and prematurity. More studies are needed to evaluate this finding. However, the measurement of the cervix in the second trimester is different from that found in the literature. This suggest</span></span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">s</span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;"> a possible new cut-off point that increases the sensitivity of transvaginal ultrasound as a method of preventing prematurity.</span></span></span>
基金support funding from Fundacao de Amparo a Pesquisa do Estado do Rio Grande do Sul(FAPERGS).
文摘Traffic-related air pollution is an alarming source of pollutants exposure and consequently to the development of several adverse health effects. Otherwise, green spaces are reported to improve health status. Although, in an urban scenario most of these areas are located near air pollutants sources, as vehicle fleet. Thus, the aim of the present study was to determine, during one year, the levels of nitrogen dioxide (NO2) and ozone (O3) in the main parks from Porto Alegre—Brazil. This study focused on three urban parks: Germania, Moinhos de Vento and Marinha do Brasil Park. Nitrogen dioxide and ozone measurements were accessed by passive monitoring in four campaigns including all seasons and performed at distances of 0 m, 15 m, 30 m, 45 m, 60 m and 75 m from the main road at each park. NO2 and O3 concentration among the parks was not different (p > 0.05), as well as the mean concentration of NO2 and O3 of all parks in the six sites did not differ (p > 0.05). However, season 1 and 3 showed increased NO2 and O3 concentration. Temperature were decreased in season 1 and 3 (p p > 0.05). Traffic flow was higher in Moinhos de Vento Park and Marinha do Brasil Park compared to Germania Park (p 2 and O3 concentration in urban parks from Porto Alegre.
基金CAPES Graduate Program in Health Sciences of UFSJ
文摘The aim of this study was to gather information on the use of stable isotopes to measure total body water and body composition scan in children. We selected studies in the last 13 years, in addition to classical studies on the subject, indexed in the database PubMed, LILACS, BVS and SciELO. The body composition was characterized by the amount of bone tissue, muscle and adipose tissue, also including the organs as well as levels of body water. Your knowledge becomes increasingly important in light of the changes that occur in the nutritional status of various types of diseases in frameworks, such as diabetes mellitus, protein energy malnutrition, in cases of obesity and metabolic syndrome. The ability to accurately assess body fat mass especially in children is associated with the importance of effective strategies for prevention and treatment of childhood obesity. Historically, in addition to clinical applications, measurements of total body water were used to determine body composition in nutritional studies. To the knowledge of the body composition, the body water can be measured and used by the ingestion of a dose of labeled water. The measured isotope enrichment is a function of the amount of body water. The method of deuterium is particularly interesting for the assessment of body composition in children, due to its characteristics of collection and analysis.
文摘The present study sought to assess the rational use of antimicrobial agents in a Brazilian intensive care unit (ICU) and its association with antimicrobial resistance in elderly patients admitted to the unit. Results: Choice of empiric and sensitivity-guided therapy was inadequate in > 80% and 59% of cases respectively. Inadequate antimicrobial therapy, whether empiric or sensitivity-guided, was positively correlated with bacterial resistance (r = 0.316;p = 0.001). Sensitivity testing revealed a 46.5% resistance rate to eight out of the ten most commonly used antibiotics. Multiple drug-resistant organisms were found in 40.8% of patients. A significant increase was observed in the number of multidrug-resistant samples between 2006/2007 and 2008 (r = 0.41, p = 0.006), (r = 0.598, p = 0.001), (r = 0.688, p = 0.00). Conclusion: We found a high rate of antibiotic misuse in the study sample. Inadequate therapy was correlated with resistance to antimicrobial agents.
文摘Access can be understood as the sum of a number of elements of the interface between patients and the health care system. This study took a comprehensive approach to the dimensions of access to medications, employing indicators to evaluate the dimensions of access to antihypertensive medications in Ceilandia, DF, Brazil. This was a cross-sectional epidemiological study, administering questionnaires during home visits. The survey covered epidemiological and socioeconomic profiles, behavioral habits and the dimensions of access to antihypertensive medications comprising physical, financial, and geographic availability and accept ability according to the hypertensive population of Ceilandia. The total sample comprised 400 individuals and the hypertensive subset numbered 140 (35%). Indicators of physical availability of medications revealed that users found it difficult to acquire their drugs on almost one third of occasions and in some cases were unable to access any of these products. The greatest barriers to access were reported by users of pharmacies belonging to the Brazilian National Health Service (SUS) and on the “People’s Pharmacies” network. More than one third of the hypertensive sample spent their own money on medications they could not find at these pharmacies. The majority of the hypertensive subsets were overweight/obese, a minority engaged in physical activity and 40% were smokers/ex-smokers. More women reduced their salt intake. Men had higher incomes, educational level, and socioeconomic status. Failure to keep the public health care system supplied has prejudiced access to essential medications for hypertension treatment, transferring the costs onto users. This population has lifestyle habits that increase the risk of exacerbation of hypertension. These results reveal a need for effective public policies to ensure access to antihypertensive medications and involve users of the health care system in changing their habits and behaviors in order to achieve adequate and lasting control of systemic arterial hypertension.
文摘This study aimed to evaluate the efficacy of an individualized remote exercise program on the improvement of body composition and physical fitness of a heterogeneous group of patients who completed breast cancer treatment.This prospective study included 107 women aged 18 to 60,shortly after curative treatment for localized breast cancer,at the Erasto Gaertner Cancer Hospital(HEG)in Curitiba,PR,Brazil.Body composition,maximal oxygen consumption,and muscle resistance were evaluated after nine months of intervention while considering adherence to the program,level of physical activity,presence of binge eating disorder,tumor classification,and treatment type.Seventy-eight women(72.8%)adhered to the training program.Adherent participants showed significant changes in body mass([-4.3±3.6]kg;p<0.0001),body mass index([-1.6±1.5]kg·m^(−2);p<0.0001),body fat(−3.4%±3.1%;p<0.0001),maximal oxygen consumption([7.5±2.0]ml·kg^(−1)·min^(−1));p<0.0001),and abdominal resistance([11.2±2.8]reps;p<0.0001).In contrast,these variables did not change significantly in the non-adherent group.Among the adherent participants,those subclassified in the severe binge group showed a more noticeable reduction in body mass,body mass index,and body fat(p<0.05)than those in the non-binge group.Individualized remotely-guided physical exercise programs can improve the body composition and physical fitness of women undergoing post-breast cancer surveillance,regardless of pathological history or treatment.
文摘Cardiac rehabilitation protocols applied during the inhospital phase(phaseⅠ)are subjective and their results are contested when evaluated considering what should be the three basic principles of exercise prescription:specificity,overload and reversibility.In this review,we focus on the problems associated with the models of exercise prescription applied at this early stage in-hospital and adopted today,especially the lack of clinical studies demonstrating its effectiveness.Moreover,we present the concept of"periodization"as a useful tool in the search for better results.
文摘AIM: To evaluate the prevalence of celiac disease in a group of Brazilian individuals over 60 years of age and compare it with the previously known prevalence in a pediatric group living in the same geographical area.METHODS: The research protocol was approved by the Ethics Committee of the University of Brasilia School of Medicine, Brasilia, Brazil. Blood samples from 946 individuals (295 male and 651 female) aged 60 years or older were collected between May 2010 and July 2011. The study subjects' mean and median ages were 68.1 and 67 years, respectively, ranging from 60 to 92 years. That age distribution closely corresponded to the age distribution of the Brazilian population according to the Brazilian 2010 census. The participants were consecutive and unselected outpatients undergoing blood tests at the University of Brasilia Hospital's Clinical Pathology Laboratory. All sera were tested for immunoglobulin A anti-transglutaminase antibodies (IgA-tTG) by enzymelinked immunosorbent assay, and those that were positive were further tested for immunoglobulin A antiendomysium antibodies (IgA-EMA). Human leukocyte antigen (HLA) genotyping was performed for all individuals who exhibited positive serologic results for IgA-tTG and/or IgA-EMA.RESULTS: Out of the 946 studied patients, only one previously diagnosed case of biopsy-proven celiac disease was detected. For the remaining subjects, nine serum samples tested positive for IgA-tTG antibodies; however, none of them tested positive for IgA-EMA antibodies. The HLA genotyping of those nine subjects revealed that one was carrying DQA1*0501 and two were carrying DQB1*0201 alleles. These data showed that, among those 946 elderly individuals, the prevalence of celiac disease (CD) was 0.1% (95%CI: 0.00-0.59). The prevalence of CD for the elderly group was compared with that observed for the group of 2034 children younger than 15 years (age range, 1-14 years; mean age, 8 years) who took part in our previous CD prevalence screening study. All the children came from the same geographical region and shared a similar ethnic and low-income background. As in the elderly group in the current study, the younger group was made up of consecutive outpatients who underwent blood evaluation at the University of Brasilia Hospital's Clinical Laboratory. The prevalence of biopsy-proven CD among those children was 0.54% (95%CI: 0.27-0.57). The comparative analysis between the two groups resulted in the following values: odds ratio = 0.19 (95%CI: 0.01-1.45) Fisher testP = 0.06. CONCLUSION: The prevalence of CD among the children of our previous study was 5.4 times higher than that found in the present elderly group.
基金supported by grants from NIH(RF1AG072491 to RM and TB),the Alzheimer’s Association(AARGD-22-972125 to RM and AARG-D-NTF-19-61645 to TB)the Texas Alzheimer’s Research and Care Consortium(AGT009122 to RM and TB).
文摘A wealth of pre-clinical reports and data derived from human subjects and brain autopsies suggest that microbial infections are relevant to Alzheimer’s disease(AD).This has inspired the hypothesis that microbial infections increase the risk or even trigger the onset of AD.Multiple models have been developed to explain the increase in pathogenic microbes in AD patients.Although this hypothesis is well accepted in the field,it is not yet clear whether microbial neuroinvasion is a cause of AD or a consequence of the pathological changes experienced by the demented brain.Along the same line,the gut microbiome has also been proposed as a modulator of AD.In this review,we focus on human-based evidence demonstrating the elevated abundance of microbes and microbe-derived molecules in AD hosts as well as their interactions with AD hallmarks.Further,the direct-purpose and potential off-target effects underpinning the efficacy of anti-microbial treatments in AD are also addressed.
