Effect of Combined Training on Body Image, Body Composition and Functional Capacity in Patients with Breast Cancer: Controlled Clinical Trial.

OBJECTIVE: Evaluate the effect of combined training on body image (BI), body composition and functional capacity in patients with breast cancer. As also the relationship of BI with body composition and functional capacity. METHODS: This was a Controlled Clinical Trial study, this study including 26 patients with breast cancer (30 to 59 years). The training group (n = 13) underwent 12 weeks of training, including three 60-min sessions of aerobic exercise and resistance training, and two sessions of flexibility training per week; each flexibility exercise lasted 20s. The Control Group (n = 13) received only the standard hospital treatment. Participants were evaluated at baseline and after 12 weeks. BI (primary outcomes) was assessed using the Body Image After Breast Cancer Questionnaire; Body composition was estimated with the indicators: Body mass index; Weight, Waist hip Ratio; Waist height ratio; Conicity index; Reciprocal ponderal index; Percentage of fat; Circumference of the abdomen and waist; Functional capacity by cardiorespiratory fitness (cycle ergometer) and strength (manual dynamometer). The statistic was performed in the Biostatistics and Stata 14.0 (α = 5%). RESULTS: The patients in the training group showed a reduction in the limitation dimension (p = 0.036) on BI, However, an increase in waist circumference was observed in both groups. In addition an increase in VO2max (p < 0.001) and strength in the right (p = 0.005) and left arms (p = 0.033). CONCLUSION: Combined training demonstrates to be an effective and non-pharmacological strategy to patients with breast cancer, with improvement on BI and functional capacity, changing related variables negatively when there is no physical training.

OBJETIVO: Avaliar o efeito do treinamento combinado na imagem corporal (IB), composição corporal e capacidade funcional em pacientes com câncer de mama. Assim como a relação do IB com a composição corporal e capacidade funcional. MéTODOS:: Este foi um estudo de Ensaio Clínico Controlado, este estudo incluiu 26 pacientes com câncer de mama (30 a 59 anos). O grupo de treinamento (n = 13) foi submetido a 12 semanas de treinamento, incluindo três sessões de 60 min de exercício aeróbio e treinamento de resistência, e duas sessões de treinamento de flexibilidade por semana; cada exercício de flexibilidade durou 20s. O Grupo Controle (n = 13) recebeu apenas o tratamento hospitalar padrão. Os participantes foram avaliados no início e após 12 semanas. O IB (desfechos primários) foi avaliado por meio do Body Image After Breast Cancer Questionnaire; A composição corporal foi estimada com os indicadores: índice de massa corporal; Peso, relação cintura-quadril; Relação da altura da cintura; Índice de conicidade; Índice ponderal recíproco; Porcentagem de gordura; Circunferência do abdômen e cintura; Capacidade funcional por aptidão cardiorrespiratória (cicloergômetro) e força (dinamômetro manual). A estatística foi realizada na Bioestatística e no Stata 14.0 (α = 5%). RESULTADOS: Os pacientes do grupo de treinamento apresentaram redução da dimensão da limitação (p = 0,036) no IB, porém, foi observado aumento da circunferência da cintura em ambos os grupos. Além disso, um aumento do VO2máx (p <0,001) e da força nos braços direito (p = 0,005) e esquerdo (p = 0,033). CONCLUSãO:: O treinamento combinado demonstra ser uma estratégia eficaz e não farmacológica para pacientes com câncer de mama, com melhora do IB e da capacidade funcional, alterando variáveis relacionadas negativamente quando não há treinamento físico.

Effect of Combined Training on Body Image, Body Composition and Functional Capacity in Patients with Breast Cancer: Controlled Clinical Trial / Efeito do treinamento combinado na imagem corporal, composição corporal e capacidade funcional em pacientes com câncer de mama: ensaio clínico controlado

Abstract Objective Evaluate the effect of combined training on body image (BI), body composition and functional capacity in patients with breast cancer. As also the relationship of BI with body composition and functional capacity. Methods This was a Controlled Clinical Trial study, this study including 26 patients with breast cancer (30 to 59 years). The training group (n = 13) underwent 12 weeks of training, including three 60-min sessions of aerobic exercise and resistance training, and two sessions of flexibility training per week; each flexibility exercise lasted 20s. The Control Group (n = 13) received only the standard hospital treatment. Participants were evaluated at baseline and after 12 weeks. BI (primary outcomes) was assessed using the Body Image After Breast Cancer Questionnaire; Body composition was estimated with the indicators: Body mass index; Weight, Waist hip Ratio; Waist height ratio; Conicity index; Reciprocal ponderal index; Percentage of fat; Circumference of the abdomen and waist; Functional capacity by cardiorespiratory fitness (cycle ergometer) and strength (manual dynamometer). The statistic was performed in the Biostatistics and Stata 14.0 (α = 5%). Results The patients in the training group showed a reduction in the limitation dimension (p = 0.036) on BI, However, an increase in waist circumference was observed in both groups. In addition an increase in VO2max (p < 0.001) and strength in the right (p = 0.005) and left arms (p = 0.033). Conclusion Combined training demonstrates to be an effective and non-pharmacological strategy to patients with breast cancer, with improvement on BI and functional capacity, changing related variables negatively when there is no physical training.

Resumo Objetivo Avaliar o efeito do treinamento combinado na imagem corporal (IB), composição corporal e capacidade funcional em pacientes com câncer de mama. Assim como a relação do IB com a composição corporal e capacidade funcional. Métodos Este foi um estudo de Ensaio Clínico Controlado, este estudo incluiu 26 pacientes com câncer de mama (30 a 59 anos). O grupo de treinamento (n = 13) foi submetido a 12 semanas de treinamento, incluindo três sessões de 60 min de exercício aeróbio e treinamento de resistência, e duas sessões de treinamento de flexibilidade por semana; cada exercício de flexibilidade durou 20s. O Grupo Controle (n = 13) recebeu apenas o tratamento hospitalar padrão. Os participantes foram avaliados no início e após 12 semanas. O IB (desfechos primários) foi avaliado por meio do Body Image After Breast Cancer Questionnaire; A composição corporal foi estimada com os indicadores: índice de massa corporal; Peso, relação cintura-quadril; Relação da altura da cintura; Índice de conicidade; Índice ponderal recíproco; Porcentagem de gordura; Circunferência do abdômen e cintura; Capacidade funcional por aptidão cardiorrespiratória (cicloergômetro) e força (dinamômetro manual). A estatística foi realizada na Bioestatística e no Stata 14.0 (α = 5%). Resultados Os pacientes do grupo de treinamento apresentaram redução da dimensão da limitação (p = 0,036) no IB, porém, foi observado aumento da circunferência da cintura em ambos os grupos. Além disso, um aumento do VO2máx (p <0,001) e da força nos braços direito (p = 0,005) e esquerdo (p = 0,033). Conclusão O treinamento combinado demonstra ser uma estratégia eficaz e não farmacológica para pacientes com câncer de mama, com melhora do IB e da capacidade funcional, alterando variáveis relacionadas negativamente quando não há treinamento físico.

Estado nutricional e consumo alimentar de vegetarianos estritos e não estritos / Nutritional status and food consumption of strict and non-strict vegetarians

Introdução: O número de adeptos ao vegetarianismo tem crescido consideravelmente. Observa-se que, entre as vantagens de se adotar uma dieta vegetariana, está o menor risco de desenvolver sobrepeso e obesidade, o que pode estar relacionado com o alto consumo de vegetais e práticas importantes de estilo de vida. Objetivos: Avaliar o estado nutricional e a frequência do consumo alimentar de vegetarianos não estritos e estritos. Métodos: Estudo transversal descritivo, realizado com participantes do grupo "Vegans SLZ", de ambos os sexos e com idade a partir de 18 anos. A coleta de dados ocorreu de janeiro a março de 2020. Foi realizada aplicação de questionários sobre dados de frequência do consumo alimentar, socioeconômico e de estilo de vida e a aferição de medidas de peso corporal, estatura e de percentuais de gordura corporal e massa muscular. Os dados foram tabulados no Excel 2010® e analisados no programa estatístico R Studio versão 3.6.1. Resultados: Dos 43 vegetarianos avaliados, a maioria seguia a dieta vegetariana estrita (55,81%) e era eutrófica (62,79%), 32,56% apresentaram alto percentual de gordura corporal e 53,49% percentual de massa magra corporal normal. Foi frequente o consumo de pães, cereais, tubérculos, leguminosas, oleaginosas, frutas e verduras, e 41% consumiam alimentos industrializados de 4 a 7 vezes por semana. Conclusões: A maioria da amostra tinha estado nutricional eutrófico e consumo regular de todos os grupos alimentares, porém com importante consumo de alimentos industrializados.

Introduction: The number of adherents to vegetarianism has grown considerably. It is observed that, among the advantages of adopting a vegetarian diet, there is a lower risk of developing overweight and obesity, which may be related to the high consumption of vegetables and important lifestyle practices. Objectives: To assess the nutritional status and frequency of food consumption of non-strict and strict vegetarians. Methods: Descriptive cross-sectional study carried out with participants of the "Vegans SLZ" group, of both sexes and aged 18 years and over. Data collection took place from January to March 2020. Questionnaires were applied to data on frequency of food, socioeconomic and lifestyle consumption and measurements of body weight, height and percentages of body fat and muscle mass were measured. Data were tabulated in Excel 2010® and analyzed in the statistical program R Studio version 3.6.1. Results: Of the 43 vegetarians evaluated, the majority followed the strict vegetarian diet (55.81%) and were eutrophic (62.79%), 32.56% had a high percentage of body fat and 53.49% percentage of lean body mass normal. The consumption of breads, cereals, tubers, legumes, oilseeds, fruits and vegetables was frequent, and 41% consumed processed foods 4 to 7 times a week. Conclusions: Most of the sample had a eutrophic nutritional status and regular consumption of all food groups, but with a significant consumption of industrialized foods.

Effect of concurrent training (aerobic+resistance) more static stretching on flexibility in women with breast cancer / Efeito do treinamento concorrente (aeróbio + resistência) mais alongamento estático na flexibilidade em mulheres com câncer de mama

Objective. was to assess flexibility in women with breast cancer who underwent concurrent training (aerobic+resistance) (CT) more static stretching. Methods. This was a controlled pilot study, with 31 women (age 30 to 59) under breast cancer treatment, 14 women were allocated to a training group (TG) who underwent CT more static stretching, concomitant to hospital treatment and 17 women for the control group (CG) who only underwent hospital treatment. The CT more static stretching was performed in 12 weeks with 5 sessions per week, three sessions (aerobic+resistance) and two sessions (stretching exercises) on alternate days. The flexibility of the shoulder was measured by means of the 360º Sanny pendulum goniometer and the flexibility of the lower limbs was assessed through the sit-and-reach test. Data were analyzed using repeated measures ANOVA Test and Bonferroni Post-hoc using SPSS 21 software, with α of 5%. Results. The TG presented increased flexibility in the horizontal abduction of the right shoulder (p=0.001) and in the lower limbs (p<0.001), but the CG showed a reduction in the horizontal abduction of the right shoulder (p=0.003). The effect size for horizontal abduction of the right shoulder was medium (p=0.508) and for the lower limbs was large (p=0.839). Conclusion. CT more static stretching may be a therapeutic intervention to increase flexibility of upper and lower limbs in women with breast cancer. (AU)

Objetivo. Avaliar a flexibilidade em mulheres com câncer de mama que realizaram treinamento concorrente (aeróbio + resistência) (TC) mais alongamento estático. Métodos. Este foi um estudo piloto controlado, com 31 mulheres (de 30 a 59 anos) em tratamento para câncer de mama, 14 mulheres foram alocadas em um grupo de treinamento (GT) que realizaram TC mais alongamento estático, concomitante a tratamento hospitalar e 17 mulheres para o grupo de controle (GC) que somente realizaram tratamento hospitalar. O TC mais alongamento estático foram realizados em 12 semanas com 5 sessões semanais, três sessões (aeróbia + resistência) e duas sessões (exercícios de alongamento) em dias alternados. A flexibilidade do ombro foi medida por meio do goniômetro de pêndulo 360º Sanny e a flexibilidade de membros inferiores foi avaliada por meio do teste de sentar e alcançar. Os dados foram analisados usando o Teste ANOVA de medidas repetidas e Post-hoc de Bonferroni no software SPSS 21, com α de 5%. Resultados. O GT apresentou aumento da flexibilidade na abdução horizontal do ombro direito (p=0,001) e nos membros inferiores (p<0,001), mas o GC apresentou redução da abdução horizontal do ombro direito (p=0,003). O tamanho do efeito para abdução horizontal do ombro direito foi médio (p=0,508) e para membros inferiores foi grande (p=0,839). Conclusão. O TC mais alongamento estático podem ser uma intervenção terapêutica para aumentar a flexibilidade de membros superiores e inferiores em mulheres com câncer de mama. (AU)

Ansiedade, Depressão, Dor e Fadiga em Pacientes com Câncer de Mama que Realizaram Treinamento Combinado / Anxiety, Depression, Pain and Fatigue in Patients with Breast Cancer who Submitted to Combined Training / Ansiedad, Depresión, Dolor y Fatiga en Pacientes con Cáncer de Mama con Entrenamiento Combinado

Introdução: Apesar do aumento na sobrevida de pacientes com neoplasias de mama, muitas persistem com ansiedade, depressão, fadiga e dor mesmo após o tratamento anticancerígeno, fatores associados a uma pior qualidade de vida. Objetivo: Avaliar a influência do treinamento combinado na ansiedade, depressão, dor e fadiga em pacientes com câncer de mama. Método: Ensaio controlado randomizado com 26 pacientes em quimioterapia, radioterapia ou acompanhamento clínico em um centro de referência em tratamento de câncer, com idade 30 a 59 anos, não praticantes de treinamento físico nos últimos três meses. O grupo experimental (GE) (n=13) foi submetido a três sessões por semana de treinamento aeróbico e resistido em 12 semanas, com duração de 60 minutos, e duas sessões de treinamento de flexibilidade por semana com duração de 20 segundos em três séries. O grupo controle (GC) (n=13) realizou somente o tratamento hospitalar convencional. Todas as avaliações foram realizadas no tempo basal e após 12 semanas. Resultados: As pacientes do GE apresentaram redução significativa da ansiedade (p=0,0242), intensidade da dor (p=0,0290) e dimensão comportamental da fadiga (0,0033). Não foram observadas diferenças na depressão (p=0,0803), interferência da dor nas atividades habituais (p=0,0933) e dimensões afetiva (p=0,0583) e sensorial/cognitiva/emocional (p=0,5525) da fadiga. O GC permaneceu inalterado em todas as variáveis. Conclusão: O treinamento combinado, envolvendo exercícios aeróbios, de resistência e de flexibilidade durante 12 semanas, apresenta efeitos benéficos na ansiedade, fadiga e dor em pacientes com câncer de mama

Introduction: Despite the increase of the survival of patients with breast cancer, many persist with anxiety, depression, fatigue, and pain even after anticancer treatment, factors associated with a worse quality-oflife. Objective: Evaluate the influence of combined training on anxiety, depression, pain and fatigue in breast cancer patients. Method: Randomized controlled trial with 26 patients undergoing chemotherapy, radiotherapy, or clinical follow-up at a referral centre for cancer treatment, aged 30 to 59 years, not practicing physical training in the last three months. The experimental group (EG) (n=13) was submitted to 3 sessions per week of aerobic and resistance training, for 12 weeks, lasting 60 minutes, and 2 sessions per week of flexibility training lasting 20 seconds in 3 sets. The control group (CG) (n=13) submitted only to conventional hospital treatment. All assessments were performed at baseline and after 12 weeks. Results: EG patients showed a significant reduction in anxiety (p=0.0242), pain intensity (p=0.0290) and the behavioral dimension of fatigue (0.0033). No differences were observed in depression (p=0.0803), interference of pain in usual activities (p=0.0933) and affective (p=0.0583) and sensory/ cognitive/emotional (p=0.5525) dimensions of fatigue. The GC remained unchanged in all variables. Conclusion: Combined training involving aerobic, resistance and flexibility exercises for 12 weeks has beneficial effects on anxiety, fatigue and pain in breast cancer patients

Introducción: A pesar del aumento de la supervivencia de las pacientes con cáncer de mama, muchas persisten con ansiedad, depresión, fatiga y dolor incluso después del tratamiento anticanceroso, factores asociados a una peor calidad de vida. Objetivo: evaluar la influencia del entrenamiento combinado sobre la ansiedad, la depresión, el dolor y la fatiga en pacientes con cáncer de mama. Método: Ensayo controlado aleatorio con 26 pacientes bajo quimioterapia, radioterapia o seguimiento clínico en un centro de referencia para el tratamiento del cáncer, con edades comprendidas entre los 30 y los 59 años, que no han practicado entrenamiento físico en los últimos tres meses. El grupo experimental (GE) (n=13) fue sometido a tres sesiones semanales de entrenamiento aeróbico y de resistencia en 12 semanas, de 60 minutos de duración, y a dos sesiones semanales de entrenamiento de flexibilidad de 20 segundos en tres series. El grupo de control (GC) (n=13) sólo realizó el tratamiento hospitalario convencional. Todas las evaluaciones se realizaron al inicio y después de 12 semanas. Resultados: Los pacientes del GE mostraron una reducción significativa de la ansiedad (p=0,0242), la intensidad del dolor (p=0,0290) y la dimensión conductual de la fatiga (0,0033). No se observaron diferencias en la depresión (p=0,0803), la interferencia del dolor en las actividades habituales (p=0,0933) y las dimensiones afectivas (p=0,0583) y sensoriales/cognitivas/emocionales (p=0,5525) de la fatiga. El GC se mantuvo sin cambios en todas las variables. Conclusión: El entrenamiento combinado de ejercicios aeróbicos, de resistencia y de flexibilidad durante 12 semanas presenta efectos beneficiosos sobre la ansiedad, la fatiga y el dolor en pacientes con cáncer de mama

End-of-life experience and its toll on quality of life and spirituality: a cross-sectional study.

BACKGROUND: Breast and cervical/uterine cancer affect body parts that have symbolic meaning for women. Women with this diagnosis at the end-of-life often experience anxiety and depression that severely impacts their quality of life (QoL). AIMS: This study aims to determine how the end-of-life experience impacts on the QoL and spirituality of women with advanced cancer. METHODS: End-of-life patients and their caregivers were evaluated regarding religious and spiritual coping, depression and self-efficacy. Caregivers were interviewed regarding patients' QoL at the end-of-life. A spearman correlation test was used to evaluate correlation between variables. FINDINGS: Several dimensions of positive religious and spiritual coping stood out for patients at the end of life. However, patients often experienced a negative revaluation of God. Patients reported experiencing low self-efficacy, depression and high levels of stress. The length of hospital stay, time spent in intensive care units and depression also correlated to the amount of worry and stress a patient experienced. CONCLUSIONS: The end-of-life patients had a poor quality of life, and experienced depression, but also used spiritual beliefs and religion as a means of coping with their end-of-life experience.

Impact of home-based aerobic training combined with food orientation on food consumption, daily physical activity and cardiorespiratory fitness among breast cancer survivors: six-month clinical trial

ABSTRACT BACKGROUND: Anticancer treatment gives rise to adverse effects such as increased pain and changes to body weight and menstrual cycles, with negative effects on activities of daily living. OBJECTIVE: To analyze the effect of food orientation combined with supervised (face-to-face, FF) versus home-based (HB) aerobic training on lifestyle (food consumption and daily physical activity (PA) levels), body composition, metabolic profile and cardiorespiratory fitness, among breast cancer survivors. DESIGN AND SETTING: Clinical trial study (six months) conducted at a public university in Presidente Prudente, Brazil. METHODS: Twenty-three female breast cancer survivors (40-75 years old) were allocated to aerobic training groups, either FF or HB. Both groups were trained and received food orientation. They were evaluated through a dietary record, ergometric treadmill test and blood test and the Baecke questionnaire. RESULTS: After six months, both groups had reduced their lipid levels, total energy consumption and polyunsaturated fat intake, and had increased their PA levels and treadmill test durations. However, only the HB showed reduced carbohydrate percentage and increased folic acid; and only the FF showed reduced lipid, saturated fat and sodium levels, along with increased carbohydrate and protein levels. No differences in body composition or metabolic profile were found. CONCLUSIONS: These results demonstrated the feasibility of HB aerobic training. In isolation, HB showed greater regulation of carbohydrate percentage and increased folic acid levels. Moreover, these breast cancer survivors presented improvements in food consumption, PA levels and cardiorespiratory fitness, while also maintaining their body composition and metabolic profile after the intervention, independent of the group.

Impact of home-based aerobic training combined with food orientation on food consumption, daily physical activity and cardiorespiratory fitness among breast cancer survivors: six-month clinical trial.

BACKGROUND: Anticancer treatment gives rise to adverse effects such as increased pain and changes to body weight and menstrual cycles, with negative effects on activities of daily living. OBJECTIVE: To analyze the effect of food orientation combined with supervised (face-to-face, FF) versus home-based (HB) aerobic training on lifestyle (food consumption and daily physical activity (PA) levels), body composition, metabolic profile and cardiorespiratory fitness, among breast cancer survivors. DESIGN AND SETTING: Clinical trial study (six months) conducted at a public university in Presidente Prudente, Brazil. METHODS: Twenty-three female breast cancer survivors (40-75 years old) were allocated to aerobic training groups, either FF or HB. Both groups were trained and received food orientation. They were evaluated through a dietary record, ergometric treadmill test and blood test and the Baecke questionnaire. RESULTS: After six months, both groups had reduced their lipid levels, total energy consumption and polyunsaturated fat intake, and had increased their PA levels and treadmill test durations. However, only the HB showed reduced carbohydrate percentage and increased folic acid; and only the FF showed reduced lipid, saturated fat and sodium levels, along with increased carbohydrate and protein levels. No differences in body composition or metabolic profile were found. CONCLUSIONS: These results demonstrated the feasibility of HB aerobic training. In isolation, HB showed greater regulation of carbohydrate percentage and increased folic acid levels. Moreover, these breast cancer survivors presented improvements in food consumption, PA levels and cardiorespiratory fitness, while also maintaining their body composition and metabolic profile after the intervention, independent of the group.

QUALITY OF LIFE OF MOTHERS OF CHILDREN WITH CONGENITAL SYNDROME AFFECTED BY ZIKA VIRUS.

OBJECTIVE: To investigate how mothers of children with congenital syndrome (microcephaly) associated with Zika virus perceive their quality of life. METHODS: This is a qualitative study carried out in two stages: at the Maternal and Child University Hospital and at Casa de Apoio Ninar through semi-structured interviews with mothers of children with congenital syndrome associated with Zika virus. Ten women comprised the sample. RESULTS: In line with the critical discourse analysis, four categories emerged based on Fairclough's 2008 assumptions: Quality of Life and Health - quality of life perception associated with the broad meaning of the term health; Quality of Life and Health Care Systems - characterized by care instability and fragmentation; Quality of Life and Free Time - lack of free time for activities of daily living and leisure; Quality of Life and Future Perspectives - lack of future perspective, considering that most participants had to stop working and studying to take care of their children. CONCLUSIONS: Mothers of children with congenital syndrome associated with Zika virus are devoted to their children's care. Their lack of prospects was considered a consequence of the lack of time for activities of daily living and leisure.

Quality of life of mothers of children with congenital syndrome affected by zika virus / Qualidade de vida de mães de crianças com síndrome congênita afetadas pelo zika vírus

ABSTRACT Objective: To investigate how mothers of children with congenital syndrome (microcephaly) associated with Zika virus perceive their quality of life. Methods: This is a qualitative study carried out in two stages: at the Maternal and Child University Hospital and at Casa de Apoio Ninar through semi-structured interviews with mothers of children with congenital syndrome associated with Zika virus. Ten women comprised the sample. Results: In line with the critical discourse analysis, four categories emerged based on Fairclough's 2008 assumptions: Quality of Life and Health - quality of life perception associated with the broad meaning of the term health; Quality of Life and Health Care Systems - characterized by care instability and fragmentation; Quality of Life and Free Time - lack of free time for activities of daily living and leisure; Quality of Life and Future Perspectives - lack of future perspective, considering that most participants had to stop working and studying to take care of their children. Conclusions: Mothers of children with congenital syndrome associated with Zika virus are devoted to their children's care. Their lack of prospects was considered a consequence of the lack of time for activities of daily living and leisure.

RESUMO Objetivo: Investigar a percepção da qualidade de vida das mães de crianças portadoras de síndrome congênita (microcefalia) associada ao Zika vírus. Métodos: Trata-se de um estudo qualitativo realizado em duas etapas. A primeira foi conduzida no Hospital Universitário Materno-Infantil e a segunda na Casa de Apoio Ninar, por meio de entrevista semiestruturada com mães de crianças que apresentam a síndrome congênita associada ao Zika vírus. A amostra foi composta por 10 mulheres. Resultados: Em consonância com a análise crítica do discurso, segundo os pressupostos de Fairclough, de 2008, quatro categorias emergiram: Qualidade de Vida e Saúde - a percepção da qualidade de vida está vinculada ao significado amplo do termo saúde; Redes de Qualidade de Vida e Atenção à Saúde - caracterizadas por precariedade e fragmentação do cuidado; Qualidade de Vida e Tempo Livre - falta de tempo livre para realizar atividades da vida diária e lazer; Qualidade de Vida e Perspectivas Futuras - foi abordada a falta de perspectiva futura, uma vez que a maioria das participantes teve que parar de trabalhar e estudar para cuidar dos filhos. Conclusões: Mães de crianças com síndrome congênita associada ao vírus Zika são totalmente dedicadas ao cuidado de seus filhos. A falta de perspectivas para o futuro foi considerada em decorrência da falta de tempo para lazer e atividade da vida diária.

Fatores associados ao elevado percentual de gordura corporal em indivíduos fisicamente ativos / Factors associated with the high body fat percentage in physically active individuals

Introdução: O exercício físico é praticado com diversos objetivos, destacando-se a promoção na mudança da composição corporal, com a redução de gordura e aumento de massa magra. Assim, compreender os fatores que podem estar associados nesta modificação se torna relevante. Objetivo: Analisar os fatores demográficos, estilo de vida, bioquímico, alimentares e de treinamento associados ao percentual de gordura corporal em praticantes de exercício físico em academias. Materiais e Métodos: Estudo transversal com 143 praticantes de exercícios físicos saudáveis, de ambos os sexos. Características sociodemográficas e estilo de vida foram obtidas através da aplicação de questionário. O consumo alimentar foi obtido através de registros alimentares de 24h, considerando as médias de três dias. A composição corporal foi avaliada por meio de avaliação antropométrica e pelo teste de bioimpedância elétrica. A análise estatística contemplou o teste de Shapiro Wilk para verificação da normalidade; o qui-quadrado e exato de Fisher foram usados para avaliar a associação entre as variáveis categóricas e a variável resposta e os testes de Mann-Whitney e t de Student para as contínuas. A regressão de Poisson com variância robusta foi usada para determinar as associações entre variáveis estudadas. O software Stata versão 14.0 foi usado para análise estatística, tendo sido adotado o valor de p <0,05. Resultados: A prevalência de gordura corporal elevada foi de 49,3% nos homens e 79,2% nas mulheres. Os fatores associados foram o maior consumo de proteína e fibras nas mulheres e a concentração de monócitos nos homens. Conclusão: Apesar de se tratar de público fisicamente ativo, observou-se elevado percentual de gordura entre os participantes do estudo e os fatores associados reforçam o caráter multietiológico deste indicador. (AU)

Introduction: Physical exercise is practiced with several objectives, especially the promotion of changes in body composition, with fat reduction and increase in lean mass. Thus, understanding the factors that may be associated with this modification becomes relevant. Objective: To analyze demographic, lifestyle, biochemical, dietary, and training factors associated with the percentage of body fat in practitioners of physical exercise in gyms. Materials and Methods: Cross-sectional study with 143 healthy physical exercise practitioners, of both sexes. Sociodemographic characteristics and lifestyle were obtained through the application of a questionnaire. Food consumption was obtained through 24-hour food records, considering the averages of three days. Body composition was assessed using anthropometric assessment and the electrical bioimpedance test. The statistical analysis included the Shapiro Wilk test to verify normality, the chi-square and Fisher's exact test were used to assess the association between categorical variables and the response variable and the Mann-Whitney and Student t tests for the continuous variables. Poisson regression with robust variance was used to determine the associations between studied variables. Stata software version 14.0 was used for statistical analysis and a value of p <0.05 was adopted. Results: The prevalence of high body fat was 49.3% in men and 79.2% in women. The associated factors were the higher consumption of protein and fibers in women and the concentration of monocytes in men. Conclusion: Despite being a physically active public, a high percentage of fat was observed among the study participants and the associated factors reinforce the multi-etiological character of this indicator. (AU)

Análise epidemiológica da tuberculose em São Luís - MA / Epidemiological analysis of tuberculosis in São Luís ­ MA

RESUMO: Objetivo: Analisar as ocorrências de Tuberculose registradas em São Luís. Método: Trata-se de um estudo epidemiológico descritivo, com dados obtidos do Sistema de Informação de Agravos de Notificação (SINAN/Tuberculose) de 2014 a 2016. Aplicou-se estatística descritiva com cálculo de frequência absoluta e relativa para variáveis categóricas e medidas de posição e de dispersão para variáveis métricas. Resultados: Foram encontrados 2.306 casos em 378 bairros residenciais. Em 2014, o Distrito mais afetado foi a Vila Cidade Olímpica com 50 casos; em 2015, houve 39 casos e em 2016 ficou com 25 casos. Conclusão: O estudo avança no conhecimento na medida em que apresenta o perfil epidemiológico dos casos de tuberculose em São Luís. Observou-se que a maioria era do sexo masculino, em idade economicamente ativa, da raça/cor parda e com ensino médio completo. (AU)

ABSTRACT: Objective: Analyzing the occurrence of Tuberculosis registered in São Luís. Method: This is a descriptive epidemiological study, with data obtained from the Notifiable Diseases Information System (SINAN/Tuberculosis) from 2014 to 2016. Descriptive statistics with the calculation of absolute and relative frequency was applied for categorical variables and position and dispersion measures for metric variables. Results: 2,306 cases were found in 378 residential neighborhoods. In 2014, the most affected District was the Vila Cidade Olímpica with 50 cases; in 2015, it had 39 cases, and in 2016 it had 25 cases. Conclusion: The study broadens the knowledge since it presents the epidemiological profile of Tuberculosis cases in São Luís. It was observed that the majority of cases were male, with economically active age, brown ethnic group, and complete secondary education. (AU)

Efeito do contraceptivo hormonal na depressão, ansiedade e qualidade de vida: estudo controlado / Effect of hormonal contraception on depression, anxiety and quality of life: a controlled study / xxx

RESUMO: Objetivo: Identificar o efeito do uso de contraceptivos hormonais orais na depressão, ansiedade e qualidade de vida. Métodos: Neste estudo, utiliza-se o método transversal e a amostra foi 113 mulheres em idade reprodutiva. Para avaliação de depressão, ansiedade e qualidade de vida foram utilizados o Inventário de BECK, IDATE Traço--Estado e o SF-36, respectivamente. Para análise estatística utilizou-se o programa STATA 14.0. O nível de significância adotado foi de 5%. Resultados: Mulheres que utilizam contraceptivos tiveram idade 24,02±5,30 anos, menarca 12,23±1,40 anos e peso 58,90±10,20 kg. O não consumo de álcool e tabaco foi de 73 (64,60%) e 111(98,23%), respectivamente. Nas usuárias de contraceptivos hormonais orais combinados e não usuárias de contraceptivos hormonais orais combinados em relação ao tipo de ansiedade e nível de depressão, não houve diferença estatisticamente significante. Prevaleceram as mulheres assintomáticas em relação a depressão (não usuárias de contraceptivos hormonais orais combinados 61/82,43%) e presença de ansiedade/traço e ansiedade/estado, em ambos os grupos. A qualidade de vida não foi prejudicada pelo uso ou não dos contraceptivos hormonais orais combinados. Conclusão: O uso do Contraceptivo não está relacionado á presença de ansiedade, depressão e alteração de qualidade de vida. (AU)

ABSTRACT: Objective: Identify the effect of oral hormonal contraceptive use on depression, anxiety, and quality of life.Methods: A cross-sectional study method was used and the sample was 113 women on reproductive age. Depression,anxiety, and QoL were assessed by the BECK Inventory, the State-Trait IDATE, and the SF-36, respectively. For the statistical analysis, the STATA 14.0 program was used. The level of significance was 5%. Results: Women who use oral contraceptives have age 24,02 ± 5,30 years, menarche 12,23±1,40 years, and weight 58.9 kg. Nonconsumption of alcohol and tobacco prevailed, respectively, with 73 (64.60%) and 111 (98.23%). Concerning the use of combined oral hormonal contraceptives and without the use of COHC in relation to the type of anxiety and level of depression, there was no statistically significant difference between them. Asymptomatic women prevailedin relation to depression (without the use of combined oral hormonal contraceptives 61/82.43%) and presence of anxiety/trait and anxiety/status in both groups. QoL was not impaired by the use of combined oral hormonal contraceptives or not. Conclusion: Contraceptive use is not related to the presence of anxiety, depression, and quality of life alteration. (AU)

Atividade física na prevenção de doenças crônicas não transmissíveis em homens / Physical activity in the prevention of chronic noncommunicable diseases in men

RESUMO: Introdução: A promoção da atividade física (AF) é uma das prioridades das políticas públicas de atenção básica à saúde, especialmente para o público masculino. Objetivo: Avaliar a associação da prática de atividade física com o estilo de vida e presença doenças crônicas não transmissíveis (DCNTs) em usuários do sexo masculino de Unidade Básica de Saúde (UBS). Métodos: Participaram do estudo 119 homens na faixa etária de 20 a 59 anos. A associação entre a prática de atividade física com variáveis sociodemográficas, etilismo, tabagismo, uso de medicamento, presença de doenças crônicas não transmissíveis e conhecimento da política de saúde do homem foi realizada por Regressão Logística com um α=5%. Resultados: A prevalência de atividade física foi de 58,8%, entretanto 36,7% dos participantes faziam uso de medicações diariamente e 70,6% não conhecem a Política Nacional de Atenção Integral à Saúde do Homem. Além disso, fazer atividade física demonstrou como um fator de proteção contra as doenças crônicas não transmissíveis (OR = 2,97; IC 95% 1,03 ­ 8,55; p = 0,043). Conclusão: A prática de atividade física em homens, independentemente da idade, tabagismo e etilismo foi associada à prevenção de doenças crônicas não transmissíveis.(AU)

ABSTRACT: Introduction: The promotion of physical activity (PA) is one of the priorities of public policies for primary health care, especially for the male audience. Objective: To evaluate the association between physical activity and life-style and presence of chronic noncommunicable diseases (NCDs) in male users of the Basic Health Unit (BHU). Methods: 119 men, aged between 20 and 59 years, participated in the study. The association between the practice of physical activity with sociodemographic variables, alcoholism, smoking, use of medication, presence of chronic noncommunicable diseases and knowledge of men's health policy was carried out by Logistic Regression with an α= 5%. Results: The prevalence of physical activity was 58.8%, however 36.7% of the participants used medica-tions daily and 70.6% did not know the National Policy for Comprehensive Attention to Men's Health. In addition, physical activity proved to be a protective factor against chronic non-communicable diseases (OR= 2,97; IC 95% 1,03 ­ 8,55; p = 0,043). Conclusion: The practice of physical activity in men, regardless of age, smoking and alcohol consumption was associated with the prevention of chronic noncommunicable diseases. (AU)

Relationship of different intensities of physical activity and quality of life in postmenopausal women.

BACKGROUND: It is known that the elderly population remains most of the time in light activity. Physical activity plays a key role in the primary prevention of chronic diseases to mitigate various deleterious effects of aging and improve quality of life. The objective of the present study was to evaluate whether the time that postmenopausal women remain in light activities during the day are related to better quality of life and compare these results with the quality of life of those who remain longer in moderate intensity and vigorous activity. METHODS: This is a cross sectional study there were evaluated 102 women, aged 50 to 79 years, all postmenopausal. Physical activity was measured by triaxial accelerometers. The quality of life was assessed using a Brazilian validated version of the SF-36 questionnaire. The sample was divided in three groups (G1, G2 and G3) according to tercile of time spent per week on light, moderate and moderate+vigorous physical activity. The comparisons between groups were made by ANOVA One Way, and the relationship between variables were made through the Spearman's correlation coefficient, and the significance was set at 5%. RESULTS: We found that the amount of time of light physical activity shows a higher correlation values compared to the moderate and moderate+vigorous physical activity (p < 0,05) and presented significant correlation in all domains of quality of life. Vigorous physical activity did not presented significant correlation in all domains of quality of life. CONCLUSION: Our data suggests that light intensity physical activity presented influence on the quality of life of postmenopausal women. TRIAL REGISTRATION: (NCT02804308). Registered on 17 june 2016 (retrospectively registred).

Relação entre o estresse e a autoestima de gestantes durante o pré-natal / Relationship between stress and self-esteem of pregnant women during prenatal care

RESUMO: Objetivo: analisar os componentes do perfil psicossocial de gestantes durante o pré-natal. Métodos: estudo quantitativo, analítico, realizado com 160 gestantes, entre 14 e 47 anos de idade, atendidas num Hospital de referência do Maranhão, em 2017. Resultados: a maioria das gestantes tinha entre 19 a 35 anos de idade (48,75%); realizaram de 0 a 5 consultas de pré-natal (40,65%) e eram nulíparas (43,13%). A análise de regressão linear evidenciou a influência do estresse devido a problemas financeiros e relacionados à família, os itens que mais explicaram o constructo autoestima foram sentir que não é um fracasso e sentir-se satisfeita consigo mesma; A correlação de Pearson do estresse e autoestima foi negativa e com influência significativamente forte. Conclusão: o estresse dentre os fatores psicossociais é o que mais influencia para alterações no pré-natal provavelmente na autoestima, pois quando relacionado com estresse evidenciou relação negativa. (AU)

ABSTRACT: Objective: Analyzing the components of the psychosocial profile of pregnant women during prenatal care. Methods: a quantitative and analytical study performed with 160 pregnant women between the ages of 14 and 47 assisted at a reference hospital in Maranhão, in 2017. Results:the majority of pregnant women were between 19 and 35 years of age (48.75%); attended to 0-5 prenatal appointments (40.65%), and were nulliparous (43.13%).The linear regression analysis evidenced the influence of stress due to financial and family-related problems; the items that most explained the construct of self-esteem were feeling that they are not a failure and feeling satisfied with themselves; Pearson's correlation of stress and self-esteem was negative and had a significantly stronginfluence. Conclusion: the stress among the psychosocial factors is the one that most influences prenatal changesprobably in self-esteem because when related to stress it showed a negative relation. (AU)

Perfil Clínico e Bioquímico de Pacientes em Hemodiálise com Hiperparatireoidismo Secundário / Clinical and Biochemical Profile of Patients on Hemodialysis with Secondary Hyperparathyroidism

Objetivo: Avaliar o perfil clínico e bioquímico de pacientes com e sem HPTS. Metodologia:Estudo transversal e analítico realizado com 93 pacientes com DRC em HD. Os pacientes foram alocados em dois grupos: sem HPTS (Paratormônio: < 300pg/mL) e com HPTS (Paratormônio: ≥ 300pg/mL). Foram verificados os dados socioeconômicos por meio de questioná-rio semiestruturado. Os dados bioquímicos e antropométricos foram obtidos por meio do prontuário de cada paciente. Tam-bém foram coletadas informações quanto ao tempo de HD, tabagismo, diabetes mellitus, hipertensão arterial sistêmica, cardiopatias, atividade física e a razão triglicerídeo/HDL-Coles-terol. Resultados:O gênero feminino apresentou-se prevalente no grupo com HPTS (59,09%, p=0,017). Nos pacientes que não apresentavam HPTS foi detectado maior presença de diabetes mellitus (77,27%, p=0,021). Os pacientes com HPTS diferiram dos pacientes sem HPTS para o hematócrito (p=0,0457), crea-tinina (p=0,0303) e a fosfatase alcalina (p=0,0011). Conclusão:Encontramos diferença ao comparar os grupos quanto aos níveis de hematócrito, creatinina, fósforo e fosfatase alcalina, resultados que podem implicar no estado clínico de indivíduos com HPTS. Essas análises poderão direcionar condutas e estratégias específicas para o acompanhamento da doença e proposta adequada de tratamento, buscando a melhora do quadro clínico e qualidade de vida. (AU)

Objective: To evaluate the clinical and biochemical profile of patients with and without secondary hyperparathyroidism. Methodology: Cross-sectional and analytical study conducted with 93 patients with CKD in HD. The patients were allocated into two groups: without HPTS (Parathyroid hormone: <300pg / mL) and with HPTS (Parathyroid hormone: ≥ 300pg / mL). Socioeconomic data were verified through a semi-structured questionnaire. Biochemical and anthropometric data were obtained from each patient's medical record. Information was also collected regarding HD time, smoking, diabetes mellitus, systemic arterial hypertension, heart disease, physical activity and the triglyceride / HDL-cholesterol ratio. Results: The female gender was prevalent in the group with HPTS (59.09%, p = 0.017). In patients without HPTS, a higher presence of diabetes mellitus was detected (77.27%, p = 0.021). Patients with HPTS differed from patients without HPTS for hematocrit (p = 0.0457), creatinine (p = 0.0303) and alkaline phosphatase (p = 0.0011). Conclusion: We found a difference when comparing the groups regarding hematocrit, creatinine, phosphorus and alkaline phosphatase levels. Results that may imply the clinical status of individuals with HPTS. These analysis may direct specific conducts and strategies for the follow-up of the disease and appropriate treatment proposal, seeking to improve the clinical condition and quality of life. (AU)

Quality of life of elderly quilombolas in the Brazilian northeast / Qualidade de vida em idosos quilombolas no nordeste brasileiro

Abstract Objective: To evaluate the quality of life (QoL) of elderly quilombolas (residents of quilombo settlements first established by escaped slaves) in mixed urban and rural residential developments (agrovilas) in Alcântara, Maranhão, Brazil. Method: An observational, cross-sectional and descriptive study was performed. The sample consisted of 129 elderly people of both genders, aged 60 years or older and living in northeastern Brazil. The sample was allocated into three groups, distributed according to geographic space. Quality of life was assessed using the WHOQoL-Bref instrument and a sociodemographic questionnaire was applied. The comparison between groups was carried out using the Anova test (one-way) and subsequently the Bonferroni Post-Hoc test. The correlation was obtained by the Pearson test, p<0.05. Results: Elderly quilombolas had a mean age of 69.7 years (±7.9) and were predominantly men with low income and schooling. Quality of life had higher scores in the social domain (values) and lower in the environmental domain (values). Quality of life as measured by the psychological domain was higher in group I than in groups II (p=0.012) and III (p=0.002). The facets of QoL correlated with facets of health for group I (r=0.357; p=0.032) and III (r=0.461; p<0.001). Conclusion: The situation of the quilombola population surveyed is considered vulnerable and psychological factors influence QoL.

Resumo Objetivo: Avaliar a qualidade de vida (QV) dos idosos quilombolas das agrovilas de Alcântara, Maranhão, Brasil. Método: Estudo observacional, transversal e descritivo. A amostra foi composta por 129 idosos, de ambos os sexos, com idade igual ou maior a 60 anos e residentes na região nordeste do Brasil. A amostra foi alocada em três grupos, distribuídos conforme o espaço geográfico. A QV foi avaliada por meio do instrumento WHOQOL-Bref e também foi aplicado um questionário sociodemográfico. A comparação entre grupos foi obtida pelo teste de Anova (one-way) e em seguida foi aplicado o teste de Post-Hoc de Bonferroni. A correlação foi obtida pelo teste de Pearson, p<0,05. Resultados: Os idosos quilombolas tiveram média de idade de 69,7 (±7,9) anos, sendo predominantemente homens com baixa renda e escolaridade. A QV teve maior pontuação para o domínio social (valores) e menor para o domínio meio ambiente (valores). A QV, quando verificado o domínio psicológico, houve destaque do Grupo I, o qual apresentou diferença com o Grupo II (p=0,012) e III (p=0,002). As facetas da QV tiveram correlação com as facetas de saúde para o Grupo I (r=0,357; p=0,032) e III (r=0,461; p<0,001). Conclusão: Considera-se que a situação da população quilombola pesquisada é vulnerável e fatores psicológicos influenciam a QV.

Atividade física nos programas de promoção à saúde do homem / Physical activity in men's health promotion programs

Objetivo: buscou-se analisar os programas que incluem a atividade física como ferramenta para a promoção à saúde do homem. Método: trata-se de uma revisão de literatura, tipo revisão integrativa, realizada a partir de buscas nas bases de dados Cochrane Library, MEDLINE via PubMed, Web of Knowledge, LILACS, SPORTDiscus e Biblioteca Virtual em Saúde. Apresentaram-se os resultados em forma de tabelas e figuras. Resultados: encontrou-se um total de 720 estudos, entretanto somente 15 corresponderam aos critérios de inclusão e exclusão. Verifica-se que esses estudos compreenderam amostras de pessoas com idades entre 18 e 59 anos e que a abordagem mais predominante foi a qualitativa, analisando a baixa adesão do sexo masculino aos serviços de saúde; todavia, a atividade física foi considerada uma estratégia de promoção à saúde dos homens. Conclusão: conclui-se que, embora existam estratégias de promoção à saúde do homem, a adesão da população masculina continua desafiadora, fazendo-se, portanto, necessária a inclusão de atividades físicas nos programas de saúde do homem.(AU)

Objective: it was sought to analyze programs that include physical activity as a tool for the promotion of human health. Method: This is an integrative literature review based on searches in the following databases: Cochrane Library, MEDLINE via PubMed, Web of Knowledge, LILACS, SPORTDiscus, and Virtual Health Library. Tables and figures are presented. Results: a total of 720 studies were found, but only 15 met the inclusion criteria. It was verified that these studies comprised samples of people between the ages of 18 and 59 years and that the most predominant approach was qualitative, and the articles analyzed the low adherence of men to health services. However, physical activity was considered a strategy for promotion of men's health. Conclusion: it is concluded that, although there are strategies to promote the health of men, the adherence of the male population remains challenging, making it necessary to include physical activities in programs aimed at men's health.(AU)

Objetivo: analizar los programas que incluyen la actividad física como herramienta para la promoción de la salud del hombre. Método: se trata de una revisión de la literatura, clasificada como revisión integradora, conducida mediante búsquedas en las bases de datos Cochrane Library, MEDLINE vía PubMed, Web of Knowledge, LILACS, SPORTDiscus y Biblioteca Virtual en Salud. Los resultados se presentaron en forma de tablas y figuras. Resultados: se encontró un total de 720 estudios; sin embargo, solo 15 correspondían a los criterios de inclusión y exclusión. Se comprueba que estos estudios abarcaron muestras de personas de entre 18 y 59 años y que el enfoque más prevalente era cualitativo, analizando la baja adhesión del sexo masculino a los servicios de salud; sin embargo, la actividad física se consideró una estrategia de promoción de la salud de los hombres. Conclusión: se concluye que, aunque existen estrategias para promover la salud del hombre, la adhesión de la población masculina sigue siendo desafiante, por lo que es necesario incluir las actividades físicas en los programas de salud del hombre.(AU)

Dietary supplements and fatigue in patients with breast cancer: a systematic review.

PURPOSE: Cancer-related fatigue (CRF) is defined as a distressing, persistent, and subjective sense of physical or emotional and/or cognitive exhaustion. The treatment of CRF includes pharmacological and non-pharmacological therapies; dietary strategies with promising results have also been used. This study aimed to identify dietary supplements that improve fatigue in patients with breast cancer. METHODS: A systematic review of the literature was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement. Data were obtained from PubMed, Scopus, MEDLINE, CENTRAL, and CINAHL databases using the following MeSH terms: breast neoplasms, dietary supplements, diet, and fatigue. In addition, the Google and Google Scholar search engines were used to find grey literature. Methodological quality was evaluated using the risk of bias in randomised clinical trials in the systematic Cochrane reviews, and the quality of the evidence was also analysed using the GRADE system. RESULTS: A total of 893 studies were assessed, of which eight were included in the review, with 932 women diagnosed with breast cancer. The most commonly used supplements that improve fatigue were guarana, acetyl-L-carnitine, and co-enzyme Q10. Two studies had a low risk of bias in all categories and three had high-quality evidence. CONCLUSIONS: Dietary supplements or diet patterns are seldom used to treat fatigue in patients with breast cancer. The results of this review showed that guarana extract and a diet rich in whole foods, omega-3 fatty acids, fruits, and vegetables could be used to treat CRF in patients with breast cancer. The studies had a low risk of bias with high-quality evidence on the efficacy of the interventions in treating fatigue in the study population.