Epidemiological profile of acute kidney injury in critically ill patients admitted to intensive care units: A Prospective Brazilian Cohort / Perfil epidemiológico de injúria renal aguda em pacientes críticos admitidos em unidades de terapia intensiva: uma coorte brasileira prospectiva

Abstract Introduction Acute kidney injury (AKI) is a frequent syndrome affecting patients admitted to intensive care units (ICU), and it is associated with poor clinical outcomes. The aim of the present study was to understand the epidemiological profile of patients with AKI admitted to ICUs. Methods Prospective cohort study, carried out in three ICUs in the Federal District, Brazil. Between October/2017 and December/2018, 8,131 patients were included in the cohort. AKI was defined according to the KDIGO criteria. The main outcomes assessed were AKI development and mortality within 28 days of hospitalization. Results Of the 8,131 patients followed up, 1,728 developed AKI (21.3%). Of the 1,728 patients with AKI, 1,060 (61.3%) developed stage 1, while stages 2 and 3 represented 154 (8.9%) and 514 (29.7%), respectively. Of these, 459 (26.6%) underwent renal replacement therapy. The mortality was 25.7% for those with AKI, and 4.9% for those without AKI. Discussion Patients with AKI had higher mortality rates when compared to those without AKI. Likewise, among patients with AKI, higher disease stages were associated with higher death occurrences. AKI incidence (21.3%) and mortality (25.7%) in our study is in line with the largest meta-analysis ever conducted, in which incidence and mortality of 21.6 and 23.9% were observed, respectively. These findings confirm the importance of establishing the KDIGO guideline for the definition and management of AKI in Brazilian ICUs.

Resumo Introdução A injúria renal aguda (IRA) é uma síndrome frequente em pacientes admitidos em unidades de terapia intensiva (UTI) e está associada a negativos desfechos clínicos. O objetivo do presente estudo foi conhecer o perfil epidemiológico de pacientes com IRA admitidos em UTIs. Métodos Estudo de coorte prospectiva, realizado em três UTIs do Distrito Federal, Brasil. Entre o período de outubro/2017 e dezembro/2018, 8.131 pacientes foram incluídos na coorte. A IRA foi definida de acordo com o critério KDIGO. Os principais desfechos avaliados foram o desenvolvimento de IRA e mortalidade dentro de 28 dias de internação. Resultados Dos 8.131 pacientes acompanhados, 1.728 desenvolveram IRA (21,3%). Dos 1.728 pacientes com IRA, 1.060 (61,3%) desenvolveram o estágio 1, já os estágios 2 e 3 representaram 154 (8,9%) e 514 (29,7%), respectivamente. Destes, um total de 459 (26,6%) realizou terapia renal substitutiva. A mortalidade observada foi de 25,7% para aqueles com IRA e 4,9% para os não IRA. Discussão Os pacientes com IRA, comparados aos não IRA, apresentaram maior mortalidade. Da mesma forma, entre os pacientes com IRA, os estágios superiores estiveram associados à maior ocorrência de óbito. A incidência de IRA (21,3%) e mortalidade (25,7%) em nosso estudo está em consonância com a maior meta-análise já conduzida, na qual foram observadas incidência e mortalidade de 21,6 e 23,9%, respectivamente. Esses achados confirmam a importância de se estabelecer a diretriz KDIGO para definição e manejo da IRA em UTIs brasileiras.

Epidemiological profile of acute kidney injury in critically ill patients admitted to intensive care units: A Prospective Brazilian Cohort.

INTRODUCTION: Acute kidney injury (AKI) is a frequent syndrome affecting patients admitted to intensive care units (ICU), and it is associated with poor clinical outcomes. The aim of the present study was to understand the epidemiological profile of patients with AKI admitted to ICUs. METHODS: Prospective cohort study, carried out in three ICUs in the Federal District, Brazil. Between October/2017 and December/2018, 8,131 patients were included in the cohort. AKI was defined according to the KDIGO criteria. The main outcomes assessed were AKI development and mortality within 28 days of hospitalization. RESULTS: Of the 8,131 patients followed up, 1,728 developed AKI (21.3%). Of the 1,728 patients with AKI, 1,060 (61.3%) developed stage 1, while stages 2 and 3 represented 154 (8.9%) and 514 (29.7%), respectively. Of these, 459 (26.6%) underwent renal replacement therapy. The mortality was 25.7% for those with AKI, and 4.9% for those without AKI. DISCUSSION: Patients with AKI had higher mortality rates when compared to those without AKI. Likewise, among patients with AKI, higher disease stages were associated with higher death occurrences. AKI incidence (21.3%) and mortality (25.7%) in our study is in line with the largest meta-analysis ever conducted, in which incidence and mortality of 21.6 and 23.9% were observed, respectively. These findings confirm the importance of establishing the KDIGO guideline for the definition and management of AKI in Brazilian ICUs.

Exercise interventions improve depression and anxiety in chronic kidney disease patients: a systematic review and meta-analysis.

PURPOSE: This systematic review examined the effects of exercise interventions on depression and anxiety in chronic kidney disease patients. METHODS: Electronic searches were conducted between August 2019 and February 2020 at PubMed, MEDLINE, Web of Science, EBSCO, Scopus, LILACS, EMBASE, Physiotherapy Evidence Database, and Cochrane Library databases. Original clinical trial studies that examined the effects of exercise on depression and anxiety in chronic kidney disease patients, stages 3-5, were included. A total of eight studies were included in the systematic review after applying the eligibility criteria, and six studies used for the meta-analysis procedures. RESULTS: The meta-analysis demonstrated statistical difference on depression in favour to exercise when compared to active control (SMD = - 0.66 [- 1.00, - 0.33], p < 0.0001) and passive control (MD = - 6.95 [- 8.76, - 5.14], p < 0.00001). Same results on anxiety demonstrated statistical difference between exercise and active control (SMD = - 0.78 [- 1.21, - 0.34], p = 0.0004). CONCLUSION: From the current limited number and quality of published studies, exercise seems to be more effective than sedentary control and other active control groups for improving depression and anxiety symptoms in chronic kidney disease patients.

Walking performance is associated with coronary artery calcification in very old adults.

BACKGROUND: Coronary artery calcification (CAC) scores have good predictive value for atherosclerosis-related outcomes in the geriatric population. The low availability of cardiac computed tomography is an obstacle to assess CAC in clinical practice. Thus, clinical signs with a good degree of association with CAC can help to estimate cardiovascular risk, particularly in low-income populations. OBJECTIVES: To assess whether clinical, biochemical and functional measures explain the CAC scores in older individuals. METHODS: We characterized 89 non-institutionalized older volunteers (≥ 80 years old) by means of a comprehensive biochemical and anthropometric evaluation along with assessments of CAC scores determined by computerized tomography, and tested their association with walking speed test (WS) and handgrip strength (HS) performance. RESULTS: Analyses of variance showed that body mass index (BMI) and waist circumference (WC) differed significantly (p ≤ 0.01 and p ≤ 0.03; respectively) across quartiles, so that subsequent tests were adjusted for anthropometry. ANCOVA revealed that the two lower quartiles of CAC had better performance in WS compared to the third and fourth quartiles (p ≤ 0.04). Multinomial logistic regression analysis showed that WS scores exhibit enough power (R2 = 0.379, p = 0.05) to explain CAC scores. There were no significant differences for HS between quartiles (p = 0.87). CONCLUSION: WS is associated and explain CAC scores, and may be useful to stratify atherosclerotic burden in apparently healthy very old individuals regardless of body composition.

Dynapenic abdominal obesity and the incidence of falls in older women: a prospective study.

BACKGROUND: Dynapenic abdominal obesity (D/AO) has been associated with negative outcomes in older people, including trait of falls. AIMS: To assess the association between D/AO and the incidence of falls over 18 months in older community-dwelling women. METHODS: A total of 201 older women (67.97 ± 6.02 years; 27.70 kg/m2) underwent waist circumference measurement, and had handgrip strength assessed using a hydraulic dynamometer. Dynapenia was classified using the lower tertile of handgrip strength, while abdominal obesity was considered as a waist circumference > 88 cm. D/AO was the combination of both aforementioned criteria. Volunteers were classified into four groups: normal, abdominal obesity, dynapenic, and D/AO. Participants were then tracked by phone calls for ascertainment of falls during a follow-up period of 18 months. Chi-square and multivariable Cox proportional regressions were conducted. RESULTS: The overall incidence of falls over the follow-up was 27.5%; and for normal, dynapenic, abdominal obesity, and D/AO were 14.7%, 17.2%, 27.5%, and 40.4% (X2 = 8.341; P = 0.039), respectively. D/AO was associated with a higher risk of falls (hazard ratio: 3.595 [95% CI: 1.317-9.815], even after adjustments for age, body mass index, physical activity level, regular use of medications, peripheral sensation, chronic diseases, and history of lower-limbs pain. CONCLUSIONS: D/AO is more closely related to falls than either dynapenia or abdominal obesity alone, and is independently associated with an increased incidence of falls in older women. These results provide support for the concept that the combined evaluation of muscle strength and central obesity may be clinically relevant in this population.

Critical velocity estimates running velocity in a 10-km running race in recreational runners / A velocidade crítica estima a velocidade de corrida em uma prova de 10-km em corredores recreacionais

Abstract The aim of this study was to compare the estimated running velocity in a critical velocity (CV) test with the real running velocity in a 10-km race. This is a cross-sectional study with a convenience sample of 34 runners, 20 males and 14 females (42,4 ± 11,0). The participants attended two days of testing and one day to participate in an official 10-km race. During the visits, the following tests were performed: i) 400-meter running track test and ii) 2000 meter running track test. They were randomly selected and held in official athletics track with at least 48 hours rest between them. The athletes were instructed to participate in the study properly recovered, fed and hydrated. The CV was calculated as the linear relation between distance and race time, corresponding to the slope of the linear regression line. Both tests occurred in similar climatic situations. We found good agreement between the velocities estimated through the CV test and the real running velocity of a 10-km race. Although there was a difference in velocities estimated by the CV test and the real 10-km race, the variation delta was low. Thus, these data indicate that the CV test seems to be a good tool for estimating the velocity of a 10-km race. The CV determined in the field with two fixed distances 400 and 2000 meter was valid to estimate the running velocity of a 10-km race.

Resumo Objetivou-se comparar a velocidade de corrida estimada em um teste de velocidade crítica com a velocidade real de corrida em uma corrida de 10 km. Estudo transversal com amostra de conveniência de 34 corredores, sendo 20 do sexo masculino e 14 do feminino (42,4 ± 11,0). Os participantes participaram de dois dias de testes e um dia para participar de uma corrida oficial de 10 km. Durante as visitas, foram realizados os seguintes testes: i) pista de atletismo de 400 metros e ii) pista de corrida de 2000 metros. Eles foram selecionados aleatoriamente e mantidos em pista de atletismo oficial com pelo menos 48 horas de descanso entre eles. Os atletas foram instruídos a participar do estudo devidamente recuperados, alimentados e hidratados. A velocidade crítica (CV) foi calculada como a relação linear entre distância e tempo de corrida, correspondendo à inclinação da linha de regressão linear. Ambos os testes ocorreram em situações climáticas semelhantes. Boa concordância entre as velocidades estimadas através do teste CV e o tempo real de teste de 10 km. Embora tenha havido uma diferença nas velocidades estimadas pelo teste CV e o tempo real de teste de 10 km, o delta de variação foi baixo. Assim, esses dados indicam que o teste CV parece ser uma boa ferramenta para estimar a velocidade de uma corrida de 10 km. O CV determinado no campo com duas distâncias fixas de 400 e 2000 metros foi válido para estimar a velocidade de corrida de 10 km.

The relationship of sports practice with motor performance, selective attention, cognitive flexibility and processing speed in children aged 7 to 10 years / A relação da prática esportiva com o desempenho motor, atenção seletiva, flexibilidade cognitiva e velocidade de processamento em crianças de 7 a 10 anos

INTRODUCTION: Sports initiation is usually started during childhood and adolescence, and the beneficial effects of this practice for physical and motor capacities are already known. Recent research has shown the potential of sports to stimulate and modify cognitive development. OBJECTIVE: To verify the relationship of sports practice during childhood on cardiorespiratory, motor, attention, cognitive flexibility and cognitive processing speed. METHODS: 130 students aged 7 to 10 years participated in the study, of which 68 were athletes and 62 non-athletes, divided into sports group and control group. The researchers carried out three visits for the application of the research instruments, which were carried out in a randomized manner within the school premises, divided into three blocks: 1) attention test for cancellation and test of tracks A and B (applied collectively); 2) jumping tests; 3) anamnesis, body composition and the Körperkoordination für Kinder (KTK) test. RESULTS: Children practicing sports obtained lower values in the weight (28 ± 10.08 kg vs 33.9 ± 15.3 kg), waist circumference (57.8 ± 7.7 cm vs 61.7 ± 9.6 cm) and circumference of the hip (69.1 ± 9.5 cm vs 72.8 ± 10.5 cm). In addition, we observed higher values in single-hops scores (96.9 ± 17.3 vs 85.6 ± 14.3) and lateral jumps scores (99.1 ± 18.8 vs 91.2 ± 18.0) compared to children who do not play sports. (p < 0.05). The high performance in single-heel jumps, side jumps, motor quotient, B-trails and B-A trails presented as predictors of sports practice (CI > 0.50_. CONCLUSION: The results indicated a positive relationship between children practicing sports in childhood and interesting benefits in the ability of cognitive flexibility, without expressing differences in motor coordination compared to non-practicing children.

INTRODUÇÃO: A iniciação esportiva é geralmente iniciada durante a infância e adolescência. Já é conhecido os efeitos benéficos desta prática para as capacidades físicas e motoras. Pesquisas recentes vêm demonstrando o potencial da prática esportiva em estimular e modificar o desenvolvimento cognitivo OBJETIVO: Analisar a relação da prática esportiva durante a infância na coordenação motora, atenção, flexibilidade cognitiva e velocidade de processamento cognitivo MÉTODO: Participaram do estudo 130 estudantes com idades entre 7 a 10 anos, sendo 68 praticantes de modalidades esportivas e 62 não praticantes de modalidades esportivas, divididos em grupo de esportistas (GE) e grupo controle (GC). Os pesquisadores realizaram três visitas para aplicação dos instrumentos de pesquisa, os quais foram realizados de forma aleatorizada dentro das dependências da escola, divididos em três blocos: 1) teste de atenção por cancelamento e teste de trilhas A e B (aplicados de forma coletiva); 2) testes de saltos; 3) anamnese, composição corporal e o teste Körperkoordination für Kinder (KTK) RESULTADOS: Crianças que praticam esporte obtiveram menores valores nas variáveis massa corporal (28 ± 10,08 kg vs 33,9 ± 15,3 kg), circunferência da cintura (57,8 ± 7,7 cm vs 61,7 ± 9,6 cm) e circunferência do quadril (69,1 ± 9,5 cm vs 72,8 ± 10,5 cm). Ademais, observam-se maiores valores nos dos saltos monopedais (96,9 ± 17,3 vs 85,6 ± 14,3) e saltos laterais (99,1 ± 18,8 vs 91,2 ± 18,0) em comparação às crianças que não praticam esporte (p < 0,05). O alto desempenho nos saltos monopedais, saltos laterais, quociente motor, trilhas B e Trilhas B-A apresentaram-se como preditores da prática esportiva (IC > 0,50) CONCLUSÃO: Os resultados indicaram relação positiva entre crianças praticantes de modalidades esportivas na infância e benefícios interessantes na capacidade da flexibilidade cognitiva, sem expressar diferenças na coordenação motora em comparação às crianças não praticantes

Frailty syndrome in older adults from the community and long-term care institutions: an exploratory analysis / Síndrome da fragilidade em idosos da comunidade e de instituições de longa permanência: uma análise exploratória

OBJECTIVES: To investigate the association between Frailty syndrome, lipid profile, anthropometric variables, and the functional capacity of older adults; and to analyze an explanatory model of variables with higher predictive capacity for Frailty syndrome. METHODS: This cross-sectional study included 36 and 86 older adults residing in long-term care facilities and in their households, respectively. Anamnesis was followed by evaluation of anthropometric data, risk of falls, functional tests, and biochemical tests. Frailty syndrome was determined according to the criteria suggested by Fried et al. RESULTS: Geriatric patients classified as frail were older; had higher medication consumption; and presented lower performance in handgrip strength, sit-to-stand, and gait speed tests as compared to pre- and non-frail older adults. CONCLUSION: Gait speed and sit-to-stand tests were significant predictors of Frailty syndrome. Specifically, a good performance in these tests represents a protection factor against Frailty syndrome. Furthermore, gait speed performance was explained by age, handgrip strength performance, and frailty status, while sit-to-stand performance was explained by risk of falls and muscular strength.

OBJETIVOS: Investigar a associação entre síndrome da fragilidade, perfil lipídico, variáveis antropométricas e capacidade funcional de idosos; e analisar um modelo explicativo de variáveis com maior capacidade preditiva para síndrome da fragilidade. MÉTODOS: Este estudo transversal incluiu 36 e 86 idosos residentes em instituições de longa permanência e em suas residências, respectivamente. A anamnese foi seguida pela avaliação dos dados antropométricos, risco de quedas, testes funcionais e testes bioquímicos. A síndrome da fragilidade foi determinada de acordo com os critérios sugeridos por Fried et al. RESULTADOS: Os idosos classificados como frágeis eram mais idosos; tiveram maior consumo de medicação; e apresentaram menor desempenho nos testes de força de preensão palmar, levantar e sentar e velocidade da marcha quando comparados aos idosos pré e não frágeis. CONCLUSÕES: Os testes velocidade da marcha e levantar e sentar foram preditores significativos de síndrome da fragilidade. Especificamente, um bom desempenho nesses testes representa um fator de proteção contra a síndrome da fragilidade. Além disso, o desempenho da velocidade da marcha foi explicado pela idade, desempenho da força de preensão palmar e estado de fragilidade, enquanto o desempenho do levantar e sentar foi explicado pelo risco de quedas e força muscular.

The Association Between Body Adiposity Measures, Postural Balance, Fear of Falling, and Fall Risk in Older Community-Dwelling Women.

BACKGROUND AND PURPOSE: Recent investigations demonstrate an association between obesity and the propensity of older adults to fall. The aim of this study was to investigate the association between body adiposity measures, postural balance, fear of falling, and risk of falls in older women. METHODS: One hundred forty-seven volunteers took part in this cross-sectional study. Participants underwent body composition assessment using dual-energy x-ray absorptiometry and had body mass index, waist circumference (WC), and body adiposity index measured. Postural balance was assessed using a force platform, while fear of falling and risk of falls were, respectively, evaluated by the Falls Efficacy Scale-International and the QuickScreen Clinical Falls Risk Assessment. RESULTS AND DISCUSSION: All adiposity measures were correlated to at least 1 postural stability parameter and to fear of falling (ρ= 0.163, P < .05 to r = 0.337, P < .001); however, WC was the index most strongly correlated to risk of falls (ρ= 0.325; P < .001). When obesity was classified using WC, it was observed that compared with nonobese individuals (n = 51), obese individuals (n = 96) exhibited greater center of pressure displacement in the anteroposterior and mediolateral axes, especially during conditions with feet apart (P < .05). The obese group also exhibited an increased fear of falling (28.04 vs 24.59; P = .002) and had a higher proportion of individuals with increased fall risk (72% vs 35%; P < .001). CONCLUSION: In summary, adiposity measures are associated with risk of falls in older women, which might be mediated by reduced postural balance and increased fear of falling. Among these indices, WC, an easy and low-cost assessment, demonstrated the strongest association with falls-related outcomes.

Stages of sarcopenia and the incidence of falls in older women: A prospective study.

The purpose of the present study was to assess the association between different stages of sarcopenia and the incidence of falls over 18 months in older community-dwelling women. 246 women (68.1 ±â€¯6.2 years) underwent body composition using dual-energy x-ray absorptiometry, knee extensors isokinetic peak torque, and Timed Up-and-Go assessments. The stages of sarcopenia were classified according to the European Working Group on Sarcopenia in Older People. Volunteers were classified into four groups as follows: nonsarcopenia, presarcopenia, sarcopenia, and severe sarcopenia. Participants were tracked by phone calls for ascertainment of falls during a follow-up period of 18 months. Cox proportional regressions were conducted. A total of 195 women were followed over the 18-month period. Proportions of each sarcopenia stage were 6.7%, 13.8%, and 12.8% for presarcopenia, sarcopenia, and severe sarcopenia, respectively. The proportion of fallers progressively increased according to the severity of sarcopenia, with 15.4%, 40.7%, and 72% for presarcopenia, sarcopenia, and severe sarcopenia, respectively (X2 = 30.637; p < 0.001). Severe sarcopenia was consistently associated with a higher risk of falls (hazard ratio: 3.843; 95% CI: 1.816-8.131), even after adjustments for age, body mass index, physical activity level, regular use of four or more medications, reduced peripheral sensation, presence of two or more chronic diseases, and history of lower-limbs pain. It is concluded that severe sarcopenia is independently associated with higher incidence of falls in older women. These results provide support for the concept that sarcopenia staging has clinical implications and might be an useful supplement to other routine falls risk assessment tools.

Effects of a 12-Week Exercise Training Program on Physical Function in Institutionalized Frail Elderly.

With the increase in life expectancy, the Brazilian elderly population has risen considerably. However, longevity is usually accompanied by problems such as the loss of functional capacity, cognitive decline, frailty syndrome, and deterioration in anthropometric parameters, particularly among those living in long-term care facilities. This randomized controlled trial aimed to verify the effects of exercise training on biochemical, inflammatory, and anthropometric indices and functional performance in institutionalized frail elderly. The sample consisted of 37 elderly people of both genders, aged 76.1 ± 7.7 years, who were randomly allocated into 2 groups: 13 individuals in the exercise group (EG) and 24 in the control group (CG). Anthropometrics, clinical history, functional tests, and biochemical evaluation were measured before and after the completion of a physical exercise program, which lasted for 12 weeks. The 12-week exercise program for frail elderly residents in a long-term care facility was efficient in improving muscle strength, speed, agility, and biochemical variables, with reversal of the frailty condition in a considerable number. However, no effects in anthropometric and inflammatory parameters were noted.

Serum Immune Mediators Independently Associate with Atherosclerosis in the Left (But Not Right) Carotid Territory of Older Individuals.

BACKGROUND AND AIM: Disturbance in the carotid arteries strongly predicts cerebrovascular events and correlates with a systemic inflammatory milieu. We investigated the relationship of a profile of 10 circulating inflammatory mediators with measures of carotid intima-media thickness (cIMT) in elderly subjects, taking traditional risk factors into account. METHODS: Clinical inspection for present and past chronic conditions and events, as well as biochemical and anthropometric measurements, was performed for patients in ambulatory setting. Scores of cIMT were obtained bilaterally in the distal common carotid artery wall. Serum concentrations of cytokines were assessed by bead-based, multiplexed flow cytometry immunoassays. RESULTS: Correlation analysis between log-transformed cytokines levels implicated the mediators interleukin-1ß (IL1ß), IL6, IL8, IL10, and tumor necrosis factor-α (TNFα) (P ≤ .005) with scores of the left cIMT. Stepwise multivariate regression showed that TNFα, IL1ß, and IL6 levels accounted for most of the variance in the cIMT scores. Comparison of cytokine levels across increasing tertiles of the left cIMT reproduced the positive association with TNFα and IL1ß levels. CONCLUSION: Five out of ten immune mediators independently correlated with cIMT of older subjects in a territory-sensitive manner. This possible contribution of immune mediators to an atherosclerotic process probably relates to the inflammaging process.

Habitual dietary intake and mediators of the inflammaging process in Brazilian older women.

AIM: This study aimed to assess whether the habitual intake of macronutrients by older women associates with circulating levels of important inflammaging mediators by means of a cross-sectional design with 229 Brazilian elderly women. METHODS: Laboratory tests determined serum IL1α, IL1ß, IL6, IL8, IL10, IL12 and TNFα by specific immunoassays. Food records of three alternate days were decomposed into usual intake of carbohydrates, proteins and lipids (and fractions), as well as total energy value (TEV) per patient. Moreover, the study has identified and controlled results for metabolic conditions known to influence the inflammatory profile: hypercholesterolemia, hypertension and diabetes. RESULTS AND DISCUSSION: Pearson's correlation test revealed that log10IL8 expressed a positive association with levels of saturated fatty acid (FA) (r = 0.173; p = 0.009) and total cholesterol intake (r = 0.223; p = 0.001). Similar analysis of the other mediators revealed no association with dietary intake. CONCLUSION: Higher intakes of total cholesterol and saturated FA seem to correlate with increased serum IL8 levels, being a possible mechanism by which this pro-atherogenic intake pattern may increase the risk of age-related chronic diseases with important inflammatory contribution.

Adaptation to Resistance Training Is Associated with Higher Phagocytic (but Not Oxidative) Activity in Neutrophils of Older Women.

Failure in antimicrobial activity contributes to high morbidity and mortality in the geriatric population. Little is known about the potential effect of resistance training (RT) on the functional properties of the innate immunity. This study aimed to investigate the influence of long-term RT on the endocytic and oxidative activities of neutrophils and monocytes in healthy older women. Our results indicate that the phagocytosis index (PhI) of neutrophils (but not of monocytes) in the RT-adapted group was significantly higher (P < 0.001; effect size, (d) = 0.90, 95% CI: [0.75-1.04]) compared to that in sedentary subjects. In contrast, the oxidative activity of either neutrophils or monocytes was not significantly influenced by RT. Also, total energy and carbohydrate intake as well as serum IL6 levels had a significant influence on the phagocytic activity of neutrophils (P = 0.04), being considered in the model. Multivariate regression identified the physical condition of the subject (ß = 0.425; P = 0.01) as a significant predictor of PhI. In conclusion, circulating neutrophils of older women adapted to a long-term RT program expressed higher phagocytic activity.

[Cognitive profile of elderly residents in Long-stay Institutions of Brasilia-DF]. / Perfil cognitivo de idosos residentes em Instituições de Longa Permanência de Brasília-DF.

Aging exposes the individuals to a number of limitations, such as the physical, nutritional and cognitive, which can cause them to hospitalization in long-stay institutions. In this study, it was aimed to evaluate to evaluate the cognitive profile of elderly institutionalized through three instruments. Sixty institutionalized elderly people in long-stay institutions underwent assessment through the Mini Mental State Examination (MMSE), the Trail Making Test and the Clinical Dementia Rating. It was found that the percentage of seniors with cognitive impairment by the MMSE was 30% of the sample, being more prevalent in women (36.2% of cognitive loss) compared to men (7.7% of cognitive loss). There was no consistency between the results obtained by the MMSE with the other instruments tested.

Perfil cognitivo de idosos residentes em Instituições de Longa Permanência de Brasília-DF / Cognitive profile of elderly residents in Long-stay Institutions of Brasilia-DF / Perfil cognitivo de los ancianos residentes en Instituciones de Larga Permanencia de Brasilia-DF

O envelhecimento expõe os indivíduos a uma série de limitações, como a capacidade física, nutricional e cognitiva, as quais podem leválos a internação em Instituições de Longa Permanência. Neste estudo, objetivou-se avaliar o perfil cognitivo de idosos institucionalizados por meio de três instrumentos. Sessenta idosos institucionalizados em Instituições de Longa Permanência foram submetidos à avaliação dos instrumentos Mini Exame do Estado Mental (MEEM), Teste de Trilha A e a Escala de Demência (CDR). Verificou-se que o percentual de idosos com perda cognitiva por meio do MEEM foi de 30% da amostra, sendo mais prevalente em mulheres (36,2% de perda cognitiva), quando comparado aos homens (7,7% de perda cognitiva). Não houve consistência entre os resultados verificados por meio do MEEM com os demais instrumentos testados.

Aging exposes the individuals to a number of limitations, such as the physical, nutritional and cognitive, which can cause them to hospitalization in long-stay institutions. In this study, it was aimed to evaluate to evaluate the cognitive profile of elderly institutionalized through three instruments. Sixty institutionalized elderly people in long-stay institutions underwent assessment through the Mini Mental State Examination (MMSE), the Trail Making Test and the Clinical Dementia Rating. It was found that the percentage of seniors with cognitive impairment by the MMSE was 30% of the sample, being more prevalent in women (36.2% of cognitive loss) compared to men (7.7% of cognitive loss). There was no consistency between the results obtained by the MMSE with the other instruments tested.

El envejecimiento expone a los individuos a una serie de limitaciones, como la capacidad física, nutricional y cognitiva, que pueden causar que se queden en instituciones de larga estadía. En este estudio, se tuvo como objetivo evaluar el perfil cognitivo de los ancianos institucionalizados a través de tres instrumentos. Sesenta personas mayores institucionalizadas en centros de larga estadía se sometieron a evaluación con los instrumentos Mini Examen del Estado Mental (MMSE), Pista de Pruebas A y Escala de Demencia. Se encontró que el porcentaje de personas mayores con deterioro cognitivo por el MMSE era 30% de la muestra, siendo más frecuente en las mujeres (36,2% con pérdida cognitiva) en comparación con los hombres (7,7% con pérdida cognitiva). No hubo consistencia entre los resultados obtenidos por el MMSE con los demás instrumentos probados.

Efeitos das intensidades de exercícios aeróbios e resistidos nas respostas de pressão arterial durante 24 horas em mulheres normotensas / Los efectos de las intensidades del ejercicio aeróbico y resistido en las respuestas de la presión arterial de 24 horas en mujeres normo tensas / Effects of aerobic and resistance exercise intensities on 24-hours blood pressure in normotensive women

The present study aimed to determine the effect of the intensity of aerobic and resistance exercise on the 24h BP response in normotensive women. Twenty-four women (aged 33 ± 9 years) performed five experimental sessions in randomized order: CON - no exercise; AE50 - 50% of heart rate reserve (HRR); AE70 - 70% of HRR; RE40 - 40% of 1repetition maximum (RM) and RE70 - 70% of 1RM. Systolic and diastolic BP and HR measurements were measured during 24h post-exercise at the participant's workplace. The AE50, AE70 and RE40 sessions led to the greatest and longest-lasting effects on the SBP, which persisted for up to 24h. For the DBP, the experimental sessions led to similar results; post exercise hypotension was observed until 7h post-exercise, with the exception of the AE70 session, which produced effects that persisted for 24h. Results shows that both aerobic and resistance exercise performed during the morning can decrease the mean BP above the baseline lasting 24 hours during a normal daily work. The aerobic exercise performed around 50% of HRR can better regulate both systolic and diastolic BP in this population.

O objetivo do presente estudo foi determinar os efeitos das intensidades de exercícios aeróbio e resistido nas respostas da pressão arterial de 24h em mulheres normotensas. Vinte e quatro mulheres (33 ± 9 anos) participarem de cinco sessões experimentais em ordem randomizada: CON - sem exercício; AE50 - 50% da freqüência cardíaca de reserva (FCR); AE70 - 70% da FCR; RE40 - 40% de 1 repetição máxima (RM) e RE70 - 70% da 1RM. As medidas das pressões sistólica (PAS) e diastólica (PAD) e a FC foram realizadas durante 24h após o exercício no local de trabalho. As sessões AE50, AE70 e RE40 demonstraram maiores e mais duradores efeitos na PAS, e permaneceram ate às 24h. Já na PAD houve respostas similares, com hipotensão até 7 horas após o exercício. Com exceção da sessão AE70, onde perdurou por 24h. Os resultados demonstraram que ambos os exercícios aeróbicos e resistidos realizados pela manha pode reduzir a PA abaixo da linha base e perdurar por 24h durante um dia normal de trabalho. O exercício aeróbio realizado a 50% da FCR pode proporcionar melhores resultados na regulação de ambas PAS e PAD nessa população.

El objetivo del presente estudio fue determinar los efectos de las intensidades del ejercicio aeróbico y resistido en las respuestas de la presión arterial de 24 horas en mujeres normo tensas. Veinticuatro mujeres (33 ± 9 anos) participaron de cinco sesiones experimentales en orden aleatoria: CON - sin ejercicio; AE50 - 50% de la frecuencia cardiaca de reserva (FCR); AE70 - 70% de la FCR; RE40 - 40% de 1 repetición máxima (RM) y RE70 - 70% de 1RM. Las medidas de la presión sistólica (PAS) y diastólica (PAD) y la FC fueron realizadas durante 24h después del ejercicio en el local de trabajo. Las sesiones AE50, AE70 y RE40 demostraron efectos mayores y mas duraderos en la PAS, y permanecieron durante las 24h. En la PAD hubiera respuestas similares, con hipotensión hasta 7 horas después del ejercicio. Con excepción de la sesión AE70, donde perduró por 24h. Los resultados demostraron que tanto los ejercicios aeróbicos cuanto los resistidos realizados por la mañana pueden reducir la PA abajo de la línea de base y perdurar por 24h durante un día normal de trabajo. El ejercicio aeróbico realizado a 50% de la FCR puede proporcionar mejores resultados en la regulación tanto de la PAS cuanto de la PAD en esa populación.

Impacto do treinamento resistido na força e hipertrofia muscular em HIV-soropositivos / Impact of resistance training on strength and muscle hypertrophy in HIV-seropositive

O presente estudo investigou o efeito de 24 semanas de treinamento resistido (TR) sobre a força e hipertrofia muscular de pacientes HIV-soropositivos. Participaram deste estudo 45 voluntários submetidos à terapia antirretroviral fortemente ativa (HAART), destes, 23 realizaram 3 sessões semanais, com 10 repetições a 80% 1RM. O teste de 1RM foi realizado de acordo com a metodologia proposta por Kraemer e Fry (1995), para estimativa da hipertrofia muscular adotou-se as equações de Frisancho (1984). Em comparação aos valores, o TR melhorou a força de 1RM nos exercícios de agachamento em 49% (21,0±4,9 vs. 31,2±5,1; P=0,001), supino reto em 13% (34,3±8,1 vs. 39,8±9,4; P=0,04), cadeira extensora em 34,1% (26,3±7,1 vs. 37,1±6,6; P=0,01), tríceps em 51% (22,9±4,0 vs. 38,3±4,9; P=0,001), pulley costas em 31,5% (31,7±3,9 vs. 41,7±4,4; P=0,01), cadeira flexora em 37,2% (18,9±3,4 vs. 27,3±3,2; P=0,01) e rosca bíceps em 60% (27,9±6,9 vs. 40,4±4,5; P=0,001). Não foram observadas diferenças (P<0,05) entre os valores basais e finais para o grupo controle. Observou-se aumento significativo (P<0,05) na área muscular do braço isenta de massa óssea, no grupo TR (52,8±14,5 cm²) em relação ao controle (39,5±12,4 cm²). Ademais, o TR resultou em significativa (P<0,05) redução da glicemia sanguínea de jejum (96,5±18,3 vs. 90,5±12,6), pressão arterial sistólica (126,3±14,3 vs. 120,0±10,0) e circunferência de cintura (83,0±12,5 vs. 80,6±10,2). Conclui-se que seis meses de TR resultaram em melhora na força e hipertrofia, ademais, o treinamento aplicado contribuiu para a regulação das variáveis metabólicas dos pacientes. Uma vez que a HAART é inevitável ao HIV-soropositivo, recomenda-se que o exercício físico seja realizado no intuito de dirimir os efeitos colaterais advindos desta terapia.

The aim of this study was to investigate the effect of 24 weeks of resistance training (RT) on the strength and muscle hypertrophy in patients with HIV-seropositive. Participated in the study 45 subjects undergoing highly active antiretroviral therapy (HAART). They were divided into two groups: control (n=22) and RT (n=23). The RT group realized three sessions, with 10 repetitions at 80% of 1MR. The MR tests were performed pre and post 24 weeks according to Kraemer and Fry (1995) and the equations proposed by Frisancho (1984) were adopted to estimate bone-free upper arm muscle area. Compared to baseline, the RT improved the strength of 1MR in the squat exercise at 49% (21.0±4.9 vs. 31.2±5.1; P=0.001), bench press by 13% (34.3±8.1 vs. 39.8±9.4, P=0.04), leg extension in 34.1% (26.3±7.1 vs. 37.1±6.6, P=0.01), triceps in 51% (22.9±4.0 vs. 38.3±4.9, P=0.001), pulley in 31.5% (31.7±3.9 vs. 41.7±4.4, P=0.01), leg curl in 37.2% (18.9±3.4 vs. 27.3±3.2, P=0.01) and biceps in 60% (27.9±6.9 vs. 40.4±4.5, P=0.001); there were no significant differences between baseline and final at control. The Bone-free upper arm muscle area at RT group (52.8±14.5 cm²) was significant increased (P<0.05) comparing to control (39.5±12.4 cm²). Moreover, the RT resulted in significant reduction (P<0.05) in fasting blood glucose (96.5±18.3 vs. 90.5±12.6, P<0.05), systolic blood pressure (126.3±14.3 mmHg vs. 120.0±10.0 mmHg) and waist circumference (83.0±12.5 cm vs. 80.6±10.2 cm). We conclude that six months of RT resulted in improvement in strength and hypertrophy; in addition, this training contributed to regulate the metabolic variables from these patients. Since the HAART is inevitable to HIV-seropositive, It's recommended that physical exercise be realized to minimize the side effects from this therapy.

The effect of aerobic exercise intensity on attenuation of postprandial lipemia is dependent on apolipoprotein E genotype.

OBJECTIVE: To investigate the effect of aerobic exercise intensity on postprandial lipemia according to allelic variants of the apolipoprotein E gene. METHODS: Three groups of 10 healthy men each were formed based genotyping of the APOE gene, rested or performed 500 Kcal tests in a random sequence separated by a minimum 48 h interval, as follows: (a) no exercise (control), (b) intense intermittent exercise, (c) moderate continuous exercise. Each test series was completed 30-min before ingestion of a high-fat meal (1 g fat/kg). Venous blood was collected before and at 1, 2, 3 and 4 h after the high-fat meal. Postprandial lipemia was assessed using the area under the curve approach as well as the kinetic profile of mean lipid variables. Statistical significance was adopted at P ≤ 0.05 level. RESULTS: The main results show that, in the moderate continuous exercise, total postprandial cholesterolemia was higher in ɛ4 than in ɛ2 carriers, whereas under intense intermittent exercise, total and LDL cholesterolemia were higher in ɛ4 than in ɛ2 and ɛ3 carriers. There was no difference in the lipemic profile of the subjects across APOE genotypes at baseline. CONCLUSION: Moderate and intense exercise were effective in attenuating PPL in both ɛ2 and ɛ3 subjects, with ɛ2 subjects being more susceptible to the lipid lowering effect of moderate training than ɛ3 subjects. Carriers of the ɛ4 allele, however, showed no attenuation of postprandial lipemia.

Proposta de modelo matemático para estimativa do número de leucócitos circulantes pós-exercício agudo em ratos Wistar / Propose of a mathematical model to estimate the number of circulating leukocytes after exercise in Wistar rats

Sugere-se que os efeitos do exercício físico sobre o sistema imunitário possam contribuir tanto para o tratamento de doenças crônicas quanto para a prevenção de processos infecciosos oportunistas. Entretanto, para que este propósito seja alcançado, é importante a especificação e a prescrição do protocolo de exercício. Sendo assim, o presente trabalho teve por objetivo investigar os efeitos da intensidade do exercício agudo no número de leucócitos circulantes em ratos Wistar e de erigir modelos matemáticos-estatísticos capazes de predizerem o número celular em função da concentração de lactato sanguíneo (mmol.l-1). Os resultados sugerem que a relação polinomial cúbica foi a que melhor representou a relação entre leucócitos (R2=0,91), linfócitos (R2=0,90), monócitos (R2=0,46), e neutrófilos (R2=0,81). Exceto para os monócitos, sugere-se forte relação entre a concentração de lactato sanguíneo e o número de leucócitos circulantes pós-exercício.

It is suggested that the effects of physical exercise on the immune system may not only significantly contribute in the treatment of chronic diseases, but also in the prevention of opportunist infection processes. For this reason, both the specification and prescription of the exercise protocol are important. Thus, the aim of this work is to investigate the effects of acute exercise intensity on the number of circulating leukocytes in Wistar rats, and to construct mathematical models that are capable of predicting the number of cells in relation to the sanguineous lactate concentration (mmol.L-1). The results suggested that a cubic polynomial relationship best represented the relationship between leukocytes (R2=0.91), lymphocytes (R2=0.90), monocytes (R2=0.46), and neutrophils (R2=0.81). With the exception of monocytes, a strong relationship is suggested between sanguineous lactate concentration and the number of circulating leukocytes post-exercise.