The Association between Physical Activity and Anxiety in Aging: A Comparative Analysis.

(1) Background: As the worldwide aging population is growing, there is a need to embrace the role of physical activity in the anxiety of older people. Objectives: To analyze anxiety in older people practitioners and non-practitioners of physical activity; (2) Methods: ample composed of 690 older people of both genders, unselected volunteers, residing in Brazil, present (as participants or observers) in selected street races in the state of Rio de Janeiro, Brazil, between 30 October 2019, and 12 March 2020. An instrument composed of the sociodemographic questionnaire and questions from the Beck Anxiety Inventory, BAI, and the Physical Activity Inventory for older people, Baecke-Old. Design: Ex-post-facto observational analytical descriptive research; (3) Results: The average age of the sample was in the range of 65 to 69y, 74% female, 94% completed high school, 69% living with the family, 84% practicing physical activity. Anxiety levels were 26% (without), 35% (mild), 21% (moderate), and 18% (severe). The comparison of anxiety showed a difference between the groups of active and sedentary elderly. Logistic regression analysis considering anxiety (yes or no; dichotomous variable) and physical activity (yes or no; dichotomous variable) and Odds Ratio were performed to identify possible influences of the independent variables PA, gender, marital status, and education on anxiety. Only physical activity was associated with anxiety. (4) Conclusions: The sample data of this research point to the conclusion that physical activity influences anxiety levels with 98% certainty, and it is suggested that it be enriched in the future with different studies with different designs. The older people practitioners of physical activity with a high level of education presented as 26% without, 35% mild, 21% moderate, and 18% severe anxiety. More active individuals are less likely to develop anxiety.

Is there a link between heart rate variability and cognitive decline? A cross-sectional study on patients with mild cognitive impairment and cognitively healthy controls.

BACKGROUND: Given that, up to date, there is no effective strategy to treat dementia, a timely start of interventions in a prodromal stage such as mild cognitive impairment (MCI) is considered an important option to lower the overall societal burden. Although autonomic functions have been related to cognitive performance, both aspects have rarely been studied simultaneously in MCI. OBJECTIVE: The aim of the present study was to investigate cardiac autonomic control in older adults with and without MCI. METHODS: Cardiac autonomic control was assessed by means of heart rate variability (HRV) at resting state and during cognitive tasks in 22 older adults with MCI and 29 healthy controls (HCs). Resting HRV measurement was performed for 5 minutes during a sitting position. Afterwards, participants performed three PC-based tasks to probe performance in executive functions and language abilities (i.e., Stroop, N-back, and a verbal fluency task). RESULTS: Participants with MCI showed a significant reduction of HRV in the frequency-domain (high frequency power) and nonlinear indices (SD2, D2, and DFA1) during resting state compared to HCs. Older individuals with MCI exhibited decreases in RMSSD and increases in DFA1 from resting state to Stroop and N-back tasks, reflecting strong vagal withdrawal, while this parameter remained stable in HCs. CONCLUSION: The results support the presence of autonomic dysfunction at the early stage of cognitive impairment. Heart rate variability could help in the prediction of cognitive decline as a noninvasive biomarker or as a tool to monitor the effectiveness of therapy and prevention of neurodegenerative diseases.

ANTECEDENTES: Como não existe até o momento uma estratégia eficaz para tratar a demência de comprometimento cognitivo leve (MCI, na sigla em inglês), as intervenções em um estágio prodrômico são consideradas uma opção. Embora as funções autonômicas tenham sido relacionadas ao desempenho cognitivo, ambos os aspectos raramente foram estudados simultaneamente no MCI. OBJETIVO: Investigar o controle autonômico cardíaco em idosos com e sem MCI. MéTODOS: O controle autonômico cardíaco foi avaliado por meio da variabilidade da frequência cardíaca (HRV, na sigla em inglês) em repouso e durante tarefas cognitivas, em 22 idosos com MCI e 29 controles saudáveis (HCs, na sigla em inglês). A medida da HRV de repouso foi realizada por 5 minutos na posição sentada. Os participantes realizaram três tarefas executadas em computador para testar o desempenho em funções executivas e habilidades de linguagem (o teste de cores e palavras - Stroop, Tarefa N-back auditiva e uma tarefa de fluência verbal). RESULTADOS: Em pacientes com MCI, observou-se uma redução significativa da HRV no domínio da frequência (potência de alta frequência) e índices não lineares (SD2, D2 e DFA1) durante o estado de repouso em comparação com os HCs. Indivíduos mais velhos com MCI exibiram diminuições em RMSSD e aumentos em DFA1 do estado de repouso para Stroop e tarefas N-back, refletindo forte recessão vagal, enquanto este parâmetro permaneceu estável em HC. CONCLUSãO: Observou-se disfunção autonômica na fase inicial da neurodegeneração. A HRV pode ajudar na previsão do declínio cognitivo, como um biomarcador não invasivo, ou como uma ferramenta para monitorar a eficácia da terapia e prevenção de doenças neurodegenerativas.

Impact of Physical Activity on Anxiety, Depression, Stress and Quality of Life of the Older People in Brazil.

BACKGROUND: Population aging all over the world invites older people to be active, considering physical activity (PA) as associated with reduced anxiety, depression and stress and a high quality of life (QOL) in older people. OBJECTIVE: To analyze anxiety, depression, stress and QOL as a function of PA in older people. METHODOLOGY: Descriptive analytical research. Six hundred and ninety older people answered the instrument composed of sociodemographic questions, followed by questions from the WHOQOL-Old, Baecke-Old, WHOQOL-SRPB, Stress Perception Scale, Beck Anxiety Inventory and Beck Depression Inventory. RESULTS: The beneficial effect of PA on the elderly is evident in this sample with such a high QoL (73%) and such a high level of physical activity (84%), and even with an advanced level of education (75%) and high spirituality (99.6%). The influence of PA on the anxiety and stress cluster showed Pearson's chi-square = 9.9, DF = 4, p = 0.04239, critical value = 9.5. The influence of PA on the anxiety, depression and stress cluster showed Pearson's chi-square = 6.8; DF = 5; p-value = 0.24; critical value = 11.1. CONCLUSION: In the elderly, PA has a significant relationship with anxiety, stress and QOL. In addition, the high level of QOL of the elderly in the sample demonstrates the capacity for PA, educational level and spirituality for personal satisfaction.

Is there a link between heart rate variability and cognitive decline? A cross-sectional study on patients with mild cognitive impairment and cognitively healthy controls / Existe uma ligação entre a variabilidade da frequência cardíaca e o declínio cognitivo? Um estudo transversal em pacientes com deficiência cognitiva leve e controles cognitivos saudáveis

Abstract Background Given that, up to date, there is no effective strategy to treat dementia, a timely start of interventions in a prodromal stage such as mild cognitive impairment (MCI) is considered an important option to lower the overall societal burden. Although autonomic functions have been related to cognitive performance, both aspects have rarely been studied simultaneously in MCI. Objective The aim of the present study was to investigate cardiac autonomic control in older adults with and without MCI. Methods Cardiac autonomic control was assessed by means of heart rate variability (HRV) at resting state and during cognitive tasks in 22 older adults with MCI and 29 healthy controls (HCs). Resting HRV measurement was performed for 5 minutes during a sitting position. Afterwards, participants performed three PC-based tasks to probe performance in executive functions and language abilities (i.e., Stroop, N-back, and a verbal fluency task). Results Participants with MCI showed a significant reduction of HRV in the frequency-domain (high frequency power) and nonlinear indices (SD2, D2, and DFA1) during resting state compared to HCs. Older individuals with MCI exhibited decreases in RMSSD and increases in DFA1 from resting state to Stroop and N-back tasks, reflecting strong vagal withdrawal, while this parameter remained stable in HCs. Conclusion The results support the presence of autonomic dysfunction at the early stage of cognitive impairment. Heart rate variability could help in the prediction of cognitive decline as a noninvasive biomarker or as a tool to monitor the effectiveness of therapy and prevention of neurodegenerative diseases.

Resumo Antecedentes Como não existe até o momento uma estratégia eficaz para tratar a demência de comprometimento cognitivo leve (MCI, na sigla em inglês), as intervenções em um estágio prodrômico são consideradas uma opção. Embora as funções autonômicas tenham sido relacionadas ao desempenho cognitivo, ambos os aspectos raramente foram estudados simultaneamente no MCI. Objetivo Investigar o controle autonômico cardíaco em idosos com e sem MCI. Métodos O controle autonômico cardíaco foi avaliado por meio da variabilidade da frequência cardíaca (HRV, na sigla em inglês) em repouso e durante tarefas cognitivas, em 22 idosos com MCI e 29 controles saudáveis (HCs, na sigla em inglês). A medida da HRV de repouso foi realizada por 5 minutos na posição sentada. Os participantes realizaram três tarefas executadas em computador para testar o desempenho em funções executivas e habilidades de linguagem (o teste de cores e palavras - Stroop, Tarefa N-back auditiva e uma tarefa de fluência verbal). Resultados Em pacientes com MCI, observou-se uma redução significativa da HRV no domínio da frequência (potência de alta frequência) e índices não lineares (SD2, D2 e DFA1) durante o estado de repouso em comparação com os HCs. Indivíduos mais velhos com MCI exibiram diminuições em RMSSD e aumentos em DFA1 do estado de repouso para Stroop e tarefas N-back, refletindo forte recessão vagal, enquanto este parâmetro permaneceu estável em HC. Conclusão Observou-se disfunção autonômica na fase inicial da neurodegeneração. A HRV pode ajudar na previsão do declínio cognitivo, como um biomarcador não invasivo, ou como uma ferramenta para monitorar a eficácia da terapia e prevenção de doenças neurodegenerativas.

3D Mitochondrial Structure in Aging Human Skeletal Muscle: Insights into MFN-2 Mediated Changes.

Sarcopenia is an age-related loss of skeletal muscle, characterized by loss of mass, strength, endurance, and oxidative capacity during aging. Notably, bioenergetics and protein turnover studies have shown that mitochondria mediate this decline in function. Although mitochondrial aging is associated with decreased mitochondrial capacity, the three-dimensional (3D) mitochondrial structure associated with morphological changes in skeletal muscle during aging still requires further elucidation. Although exercise has been the only therapy to mitigate sarcopenia, the mechanisms that govern these changes remain unclear. We hypothesized that aging causes structural remodeling of mitochondrial 3D architecture representative of dysfunction, and this effect is mitigated by exercise. We used serial block-face scanning electron microscopy to image human skeletal tissue samples, followed by manual contour tracing using Amira software for 3D reconstruction and subsequent analysis of mitochondria. We then applied a rigorous in vitro and in vivo exercise regimen during aging. We found that mitochondria became less complex with age. Specifically, mitochondria lost surface area, complexity, and perimeter, indicating age-related declines in ATP synthesis and interaction capacity. Concomitantly, muscle area, exercise capacity, and mitochondrial dynamic proteins showed age-related losses. Exercise stimulation restored mitofusin 2 (MFN2), which we show is required for mitochondrial structure. Furthermore, we show that this pathway is evolutionarily conserved with Marf, the MFN2 ortholog in Drosophila, as Marf knockdown alters mitochondrial morphology and leads to the downregulation of genes regulating mitochondrial processes. Our results define age-related structural changes in mitochondria and further suggest that exercise may mitigate age-related structural decline through modulation of mitofusins.

Higher Muscle Damage Triggered by Shorter Inter-Set Rest Periods in Volume-Equated Resistance Exercise.

Objectives: The aim of the manuscript was to analyze the effects of two rest periods between volume-equated resistance exercise (RE) on inflammatory responses (cytokines and leukocyte) and muscle damage. Methods: Ten trained men (26.40 ± 4.73 years, 80.71 ± 8.95 kg, and 176.03 ± 6.11 cm) voluntarily participated in training sessions consisting of five sets of 10 reps performed at 10-RM on (1) the barbell bench press followed by (2) leg press, with either 1- or 3-min rest between sets and exercises. Circulating concentrations of different biomarkers was measured before (Pre), and after 3 h (excepted for cytokines), 6, 12, and 24 h from exercise. The rate of perceived exertion (RPE) was recorded after each set on both planned visits. Results: We found greater increases triggered by the 1-min rest period in Creatine Kinase (CK), occurring from 12 to 24 h post-exercise compared to the 3-min rest condition. A significant increase in the 1-min rest condition was also observed in the total number of leukocytes, neutrophils, and monocytes. The 1-min rest period also triggered increases compared to baseline in pro-inflammatory cytokines [Interleukin 1 beta (IL-1ß), p = 0.004; tumor necrosis factor α (TNF-α), p = 0.01; and granulocyte-macrophage colony-stimulating factor (GM-CSF), p = 0.01], which were more evident after 6 and 12 h post-exercise. Similarly, increases in anti-inflammatory cytokines [Interleukin 5 (IL-5), p = 0.01; Interleukin 6 (IL-6), p = 0.01; and Interleukin 10 (IL-10), p = 0.01] at all time-points were observed. Conclusion: Our results indicate that a 1-min rest condition in volume-equated RE promoted greater overall muscle tissue damage with a longer duration of the inflammatory processes compared to a 3-min rest.

Chronic Effects of Different Types of Neuromuscular Training on Hemodynamic Responses Estimated VO2max, and Walking Performance in Older People.

This paper investigated the effects over time of different forms of neuromuscular training on hemodynamic responses, the estimated VO2max, and walking performance. 105 older adults were randomly organized into three groups: RGA, RGB, and the Control Group (CG). RGA and RGB did 4 weeks of adaptation phase training and 12 weeks of intervention with different loads: moderate loads for RGB. and higher loads for RGA. A pre- and post-evaluation of the resting heart rate (HR), systolic blood pressure (SBP), diastolic blood pressure (DBP), double product (DP), estimated VO2max, and walking performance were assessed. Significant differences were observed for SBP, DBP, HR, and DP. For SBP, a post-evaluation reduction was observed only in RGA (p = 0.007) and when comparing RGA with the Control Group (p < 0.000). For the absolute VO2max, a significant improvement was seen in RGB compared to RGA (p = 0.037) and CG (p < 0.000). For the relative VO2max, RGB scored significantly higher than RGA (p < 0.000) and CG (p < 0.000), post-intervention. For the walk test, a significant reduction in completion times was observed for RGA (p = 0.027) and RGB (p < 0.000), and for RGB compared to RGA (p = 0.000) and CG (p < 0.000). Resistance training can be an excellent strategy for hemodynamic and cardiorespiratory improvement in the elderly.

Born to move: a review on the impact of physical exercise on brain health and the evidence from human controlled trials.

BACKGROUND: Physical exercise has been found to impact neurophysiological and structural aspects of the human brain. However, most research has used animal models, which yields much confusion regarding the real effects of exercise on the human brain, as well as the underlying mechanisms. OBJECTIVE: To present an update on the impact of physical exercise on brain health; and to review and analyze the evidence exclusively from human randomized controlled studies from the last six years. METHODS: A search of the literature search was conducted using the MEDLINE (via PubMed), EMBASE, Web of Science and PsycINFO databases for all randomized controlled trials published between January 2014 and January 2020. RESULTS: Twenty-four human controlled trials that observed the relationship between exercise and structural or neurochemical changes were reviewed. CONCLUSIONS: Even though this review found that physical exercise improves brain plasticity in humans, particularly through changes in brain-derived neurotrophic factor (BDNF), functional connectivity, basal ganglia and the hippocampus, many unanswered questions remain. Given the recent advances on this subject and its therapeutic potential for the general population, it is hoped that this review and future research correlating molecular, psychological and image data may help elucidate the mechanisms through which physical exercise improves brain health.

Born to move: a review on the impact of physical exercise on brain health and the evidence from human controlled trials / Nascidos para o movimento: uma revisão sobre o impacto do exercício físico na saúde do cérebro e as evidências de estudos controlados em humanos

Abstract Background: Physical exercise has been found to impact neurophysiological and structural aspects of the human brain. However, most research has used animal models, which yields much confusion regarding the real effects of exercise on the human brain, as well as the underlying mechanisms. Objective: To present an update on the impact of physical exercise on brain health; and to review and analyze the evidence exclusively from human randomized controlled studies from the last six years. Methods: A search of the literature search was conducted using the MEDLINE (via PubMed), EMBASE, Web of Science and PsycINFO databases for all randomized controlled trials published between January 2014 and January 2020. Results: Twenty-four human controlled trials that observed the relationship between exercise and structural or neurochemical changes were reviewed. Conclusions: Even though this review found that physical exercise improves brain plasticity in humans, particularly through changes in brain-derived neurotrophic factor (BDNF), functional connectivity, basal ganglia and the hippocampus, many unanswered questions remain. Given the recent advances on this subject and its therapeutic potential for the general population, it is hoped that this review and future research correlating molecular, psychological and image data may help elucidate the mechanisms through which physical exercise improves brain health.

RESUMO Introdução: Evidências das últimas décadas têm mostrado que o exercício físico impacta de forma significativa aspectos neurofisiológicos e estruturais do cérebro humano. No entanto, a maioria das pesquisas emprega modelos animais, o que gera confusão no que diz respeito aos efeitos reais do exercício no cérebro humano, assim como os mecanismos adjacentes. Objetivo: Apresentar uma atualização sobre o impacto do exercício no cérebro; revisar e analisar sistematicamente as evidências provenientes exclusivamente de estudos randomizados controlados em humanos, dos últimos seis anos. Métodos: Foi conduzida uma busca na literatura usando as bases de dados MEDLINE (via PubMed), EMBASE, Web of Science e PsycINFO, para todos os estudos randomizados e controlados publicados entre janeiro de 2014 e janeiro de 2020. Resultados: Foram revisados 24 estudos randomizados controlados em humanos, que observavam a relação entre exercício físico e alterações neuroquímicas e estruturais no cérebro. Conclusões: Ainda que esta revisão tenha observado que o exercício físico melhora a plasticidade cerebral em humanos, particularmente por meio de alterações no fator neurotrófico derivado do cérebro (BDNF), conectividade funcional, núcleos da base e hipocampo, muitas questões ainda precisam ser respondidas. Dados os avanços recentes nessa temática e seu potencial terapêutico para a população em geral, espera-se que este manuscrito e pesquisas futuras que correlacionem estudos moleculares e variáveis psicológicas e de imagem possam ajudar na elucidação dos mecanismos pelos quais o exercício físico melhora a saúde cerebral.

Estresse ocupacional e fatores associados: um estudo em professores / Occupational stress and associated factors: a study on professors

O objetivo deste trabalho é estimar a frequência de estresse entre professores e verificar sua associação com variáveis sociodemográficas, características de trabalho e estado nutricional. Trata-se de estudo transversal com 84 professores da área de Ciências Humanas e Naturais, através dos instrumentos: IPAQ abreviado, escala demanda-controle de Karasek e Theorel e Job Stress Scale. O estado nutricional foi definido pelo Índice de Massa Corporal (IMC), o estado de saúde e as características de trabalho foram autorreferidas. Observou-se que 64,3% dos docentes apresentaram baixos níveis de estresse. Embora a prevalência encontrada seja menor do que em outros estudos, 35,7% mostraram alto estresse e trabalho passivo (n = 30). Dentre os estressores, destacam-se os deveres administrativos (p = 0,012) e o tempo exercendo o cargo administrativo (p = 0,024). O excesso de peso predominou na amostra. Diante disso, é fundamental repensar o modelo de gestão dessas instituições de modo a não prejudicar a saúde e atuação do profissional do ensino superior.

To estimate the frequency of stress among professors and to check its association with sociodemographic variables, work characteristics and nutritional status. Cross-sectional study with 84 professors from the Human and Natural Sciences area, using the instruments: abbreviated IPAQ, Karasek and Theorell and Job Stress Scale demand-control scales. Nutritional status was defined by Body Mass Index (BMI), health status and work characteristics were selfreported. It was observed that 64.3% professors had low stress levels. Although the prevalence found is lower than in other studies, 35.7% showed high stress and passive work (n = 30). Among the stressors, we highlight the administrative duties (p = 0.012) and the time exercising the administrative position (p = 0.024). Overweight predominated in the sample. It is essential to rethink the management model of these institutions so as not to damage the health and performance of higher education professionals.

Analysis of pain symptoms, flexibility and hydroxyproline concentration in individuals with low back pain submitted to Global Postural Re-education and stretching.

Aim: To evaluate pain, flexibility and hydroxyproline (HP) urinary levels in patients with nonspecific low back pain submitted to Global Postural Re-education (GPR) and stretching. Materials & methods: 39 individuals who reported low back pain were randomly assigned to a group submitted to GPR (GPRG) or stretching exercises (SG) for 8 weeks. Pain and flexibility were assessed using the Borg CR10 scale and goniometry, respectively. Results: The GPR group showed a significant reduction in the HP levels and significant improvements in flexibility after the intervention when compared with SG. Both groups presented a significant reduction in HP and pain after the intervention. Conclusion: Both interventions were effective in the treatment of low back pain. However, the GPR method presented better responses than stretching.

Multimodal HIIT is more efficient than moderate continuous training for management of body composition, lipid profile and glucose metabolism in the diabetic elderly / El entrenamiento multimodal es más eficiente que el entrenamiento continuo moderado para el manejo de la composición corporal, el perfil de lípidos y el metabolismo de la glucosa en adultos mayores diabéticos

The exercise could play a central role to the fat management and glucose metabolism what can be a critical role in the health status of diabetic people, but the high intense exercise remains with controversial data about their effects. To identify the effect of the multimodal high-intensity interval training on body composition, lipid profile, and glucose metabolism in elderly diabetics. Methods: Elderly diabetic individuals (n = 48) were randomly divided in a Sedentary Control (SC) group, a Moderate-Intensity Continuous Training (MICT) group, and a High-Intensity Interval Training (HIIT) group. MICT and HITT were conducted over 60 days, 3x per week, with 40 minutes of exercise. Blood was collected prior to intervention, at four, and at eight weeks subsequently to assess glucose metabolism and lipid profiles. Body composition was determined before and after the intervention period. To verify the normality Kolmogorov-Smirnov statistical test was performed, followed by student "t" test or two-way ANOVA with Bonferroni's post hoc test with significance of 5 % the Cohen's f test to indicate the magnitude of the differences. HIIT significantly lowered cholesterol and triglyceride levels, and significantly lowered blood glucose and glycosylated haemoglobin levels (p<0.05). MICT and HIIT significantly increased levels of high-density lipoprotein, decreased total body mass and body mass index. HIIT resulted in significantly smaller waist circumferences, waist-to-hip ratios, and weight-to-height ratios over 60 days of training. HIIT is more effective than MICT for improving lipid and glycaemic profiles, decreasing body fat, and improving fat distribution elderly diabetics.

El ejercicio podría desempeñar un papel central en el manejo de la grasa y el metabolismo de la glucosa, lo que puede ser un papel crítico en el estado de salud de las personas diabéticas, pero el ejercicio intenso intenso sigue teniendo datos controvertidos sobre sus efectos. El objetivo del estudio fue identificar el efecto del entrenamiento multimodal de intervalos de alta intensidad sobre la composición corporal, el perfil lipídico y el metabolismo de la glucosa en diabéticos de edad avanzada. Los individuos diabéticos de edad avanzada (n = 48) se dividieron aleatoriamente en un grupo de control sedentario (SC), un grupo de entrenamiento continuo de intensidad moderada (MICT) y un grupo de entrenamiento de intervalos de alta intensidad (HIIT). MICT y HITT se realizaron durante 60 días, 3 veces por semana, con 40 minutos de ejercicio. Se recogió sangre antes de la intervención, a las cuatro y a las ocho semanas posteriormente para evaluar el metabolismo de la glucosa y los perfiles de lípidos. La composición corporal se determinó antes y después del período de intervención. Para verificar la normalidad se realizó la prueba estadística de Kolmogorov-Smirnov, seguida de la prueba "t" de Student o ANOVA de dos vías con la prueba post hoc de Bonferroni con una significancia del 5 % de la prueba f de Cohen, indicando las diferencias. HIIT redujo significativamente los niveles de colesterol y triglicéridos, además de reducir de manera importante los niveles de glucosa en la sangre y la hemoglobina glicosilada (p <0.05). MICT y HIIT aumentaron significativamente los niveles de lipoproteína de alta densidad, disminuyeron la masa corporal total y el índice de masa corporal. HIIT resultó en circunferencias de cintura significativamente más pequeñas, relaciones cintura-cadera y relaciones peso-altura durante 60 días de entrenamiento. HIIT es más efectivo que MICT para mejorar los perfiles de lípidos y glucémicos, disminuir la grasa corporal y mejorar la distribución de grasa en los diabéticos de edad avanzada.

Aspectos epidemiológicos, clínicos e terapêuticos da COVID-19 / Epidemiological, clinical and therapeutic aspects of COVID-19

Objetivo: apresentar os aspectos epidemiológicos, clínicos e terapêuticos da COVID-19. Método: trata-se de uma revisão narrativa da literatura, realizada por meio da busca por publicações científicas indexadas nas bases de dados: PubMed, Europe PMC, ScienceDirect e SciELO. Os seguintes descritores foram utilizados: "COVID-19", "diagnosis", "drug therapy", "pandemics" e "SARS-CoV-2". Ao final, foram selecionadas 32 publicações. Resultados: a análise dos estudos evidenciou que a rápida disseminação da COVID-19 pode estar relacionada à forma de transmissão, bem como à capacidade de o vírus permanecer estável em aerossóis e superfícies contaminadas. O diagnóstico de COVID-19 tem sido realizado mediante observação dos sintomas, e por um método de biologia molecular. Ainda não há medicamentos específicos e uma vacina contra a doença. No entanto, alguns medicamentos existentes no mercado, indicados para tratar outras patologias, estão sendo considerados como promissoras terapêuticas para a doença. Conclusão: a pandemia de COVID-19 já se configura como o maior desafio para saúde pública do século XXI, com elevadas taxas de morbidade e mortalidade em todo o mundo, principalmente devido à alta infectividade, e à severidade das manifestações clínicas em populações de risco, sendo mais letal. A falta de evidências científicas conclusivas quanto à eficácia e à segurança dos medicamentos off label no tratamento da doença tem gerado incertezas nos procedimentos de decisão clínica, sendo primordial a realização de ensaios clínicos randomizados, envolvendo um maior número de pacientes.

Objective: to present the epidemiological, clinical and therapeutic aspects of COVID-19. Method: this is a narrative review of the literature, performed through the search of scientific publications indexed in the databases: PubMed, Europe PMC, ScienceDirect and SciELO. The following descriptors were used: "COVID-19", "diagnosis", "drug therapy", "pandemics" and "SARS-CoV-2". At the end, 32 publications were selected. Results: the analysis of the studies showed that the rapid spread of COVID-19 may be related to the form of transmission, as well as to the ability of the virus to remain stable in aerosols and contaminated surfaces. The diagnosis of COVID-19 has been made through observation of symptoms, and by a molecular biology method. There are still no specific drugs and a vaccine against the disease. However, some drugs on the market, indicated to treat other pathologies, are being considered as promising therapeutics for the disease. Conclusion: the COVID-19 pandemic is already configured as the greatest public health challenge of the 21st century, with high morbidity and mortality rates worldwide, mainly due to high infectivity, and severity of clinical manifestations in populations at risk, being more lethal. The lack of conclusive scientific evidence regarding the efficacy and safety of off-label medications in the treatment of the disease, has generated uncertainties in clinical decision-making procedures, and it is essential to carry out randomized clinical trials, involving a greater number of patients.

Dermatoglyphic traits of brazilian golfers / Traços dermatoglíficos dos golfistas brasileiros

ABSTRACT Played all over the world, golf has gained popularity, for it is a sport that depends on individual abilities. For this reason the search for tools that aim to seek and guide its respective talented players has become very important. Therefore, this study had the objective of comparing the distribution of the dermatoglyphic indicators of high performance golfers and of a group control of non-athletes. The sample was composed of 46 individuals with paired age and gender, divided into two groups: the Group Golf (GG), composed of 23 golfers, and the Group Control (GC), composed of 23 individuals control randomly selected. The golfers, part of the Project Golf Brazil of the Brazilian Golf Confederation, were between 11 and 21 years old. The results demonstrated that the number of lines in the pattern was of six possible variables of fingerprint (MESQL1, MESQL2, MESQL4, MESQL5, SQTLE, SQTL) is significantly higher in the golfers (GG) when compared to the group control (GC). When observed the qualitative variables, i. e., the pattern type, significant diferences where observed between the groups, since the golfers (GG) presented more Radial Loops (RL) in MDT5 when compared to the group control (GC). The results found in this study demonstrated that the dermatoglyphic profile of high performance golfers differ from the non-athlete population.

RESUMO Jogado em todo o mundo, o golfe está ganhando popularidade, sendo um esporte que depende das habilidades individuais, tornando-se importante a busca por ferramentas que visem buscar e orientar seus respectivos talentos. O presente estudo teve por objetivo comparar a distribuição dos indicadores dermatoglíficos de golfistas de alto rendimento e de um grupo controle de não atletas. A amostra foi composta por 46 indivíduos com idade e sexo pareados, divididos em dois grupos: o Grupo Golf (GG), composto por 23 golfistas e o Grupo Controle (GC), composto por 23 indivíduos controle aleatoriamente selecionados. Os golfistas, parte do Projeto Golf Brasil da Confederação Brasileira de Golfe, tinham idade entre 11 e 21 anos. Os resultados demonstram que o número de linhas no padrão de seis possíveis variáveis de impressão digital (MESQL1, MESQL2, MESQL4, MESQL5, SQTLE, SQTL) é maior nos golfistas (GG) quando comparado ao grupo controle (GC). Quando observadas as variáveis qualitativas, ou seja, o tipo de figura, observaram-se diferenças significativas entre os grupos, visto que os Golfistas (GG) apresentaram maior quantidade de Presilha Radial (LR) no MDT5 quando comparados ao grupo controle (GC). Os resultados encontrados neste estudo demonstraram que o perfil dermatoglífico de golfistas de alto rendimento difere da população não atleta.

Sensibilidade, especificidade e eficiência dos indicadores do estado nutricional de idosos atendidos pela Estratégia de Saúde da Família / Sensitivity, specificity and efficiency of indicators of the nutritional status of the elderly attended by the Family Health Strategy

Objetivo: Averiguar a sensibilidade, especificidade e eficiência dos indicadores do estado nutricional de idosos. Métodos: Trata-se de uma pesquisa descritiva, transversal, com uma abordagem quantitativa. Foram avaliados 252 idosos assistidos por equipe da Estratégia Saúde da Família. O estado nutricional dos idosos foi avaliado a partir dos indicadores antropométricos Índice de Massa Corporal (IMC), Circunferência da Panturrilha (CP), Dobra Cutânea Tricipital (DCT), Área Muscular do Braço (AMB) e Circunferência Muscular do Braço (CMB) e da Mini Avaliação do Estado Nutricional (MAN). O índice kappa foi utilizado para avaliar a concordância entre os métodos de avaliação do estado nutricional de idosos, com nível de significância estabelecido em p < 0,05. Resultados: Em relação ao estado de desnutrição, destacou-se a comparação do IMC vs. CMB (sensibilidade S =100%, valor preditivo negativo VPN = 100%, p = 0,001). O estado de eutrofia foi determinado utilizando os indicadores IMC vs. MAN (S = 84,4%, VPN = 71,1%, p = 0,04), bem como a do IMC vs. CMB (especificidade = 95,8%, VPN = 56%, p = 0,02). O intuito foi diagnosticar o estado de obesidade entre idosos, em relação aos indicadores IMC vs DCT, (especificidade = 82,8%, VPN= 70,2%, p= 0.06). Conclusão: Existe uma boa associação entre os indicadores, para determinar o estado nutricional de idosos atendidos pela Estratégia Saúde da Família, quanto a sensibilidade e especificidade dos métodos de avaliação. (AU)

Objective: To determine the sensitivity, specificity and efficiency indicators of the nutritional status of the elderly. Methods: This is a descriptive, cross-sectional research with a quantitative approach. We evaluated 252 elderly assisted by the Family Health Strategy team. The nutritional status of the elderly was evaluated based on anthropometric indicators: Body Mass Index (BMI), Circumference Calf (CP), Triceps Skin Fold (TSF), Arm Muscle Area (AMA) and Circumference Muscular Arm (CMA) and Mini nutritional assessment (MNA). The kappa index was used to evaluate the correlation between the methods of evaluating the nutritional status of the elderly, with a significance level set at p < 0.05. Results: In relation to the state of malnutrition we highlighted the comparison of BMI vs. CMA (S = 100% sensitivity, negative predictive value NPV = 100%, p = 0.001). We evaluated the state of normal weight using BMI vs. MNA indicators (S = 84.4% NPV = 71.1%, p = 0.04), as well as BMI vs. CMA (Specificity = 95.8% NPV = 56%, p = 0.02). The aim was to diagnose the state of obesity among the elderly in relation to BMI indicators vs. TSF (Specificity = 82.8%, NPV = 70.2%, p = 0.06). Conclusion: There is a good association between the indicators to determine the nutritional status of the elderly assisted by the Family Health Strategy, regarding the sensitivity and specificity of the evaluation methods. (AU)

Cardiovascular and strength adaptations in concurrent training in hypertensive women / Adaptações cardiovasculares e de força no treinamento concorrente em mulheres hipertensas / Adaptaciones cardiovasculares y de fuerza en el entrenamiento concurrente en mujeres hipertensas

ABSTRACT Introduction Physical exercise has been recommended as a non-pharmacological strategy for preventing and controlling hypertension. Objective To verify chronic cardiovascular and muscle strength adaptations in hypertensive women who underwent 12 weeks of concurrent training (CT) in different orders. Methods Twenty hypertensive women were randomly assigned into 2 groups: resistance exercise-endurance group (REE; 56.00 ± 5.20 years; 78.95 ± 8.28 kg; 155.10 ± 5.30 cm; 33.00 ± 5.30 kg.m-2) and endurance-resistance exercise group (ERE; 57.10 ± 13.38 years; 76.56 ± 18.87 kg; 155.50 ± 8.18 cm; 31.41 ± 5.84 kg.m-2). The endurance exercise was composed of 3 sets of 4 exercises, with 8-RM loads with a 90-second break between sets and exercises. The resistance exercise lasted for 25 minutes and was of progressive intensity. Muscle strength (8-RM), systolic and diastolic blood pressure, heart rate, and double product were assessed pre- and post-exercise. Results The ANOVA showed significant increases in strength for all exercises (p <0.0001) regardless of the order of the concurrent training (bench press, p = 0.680; leg press, p = 0.244; seated row, p = 0.668; and leg extension, p = 0.257). No significant differences in systolic (p = 0.074) and diastolic blood pressures (p = 0.064) were observed for different CT conditions. However, significant reductions in systolic (p = 0.0001) and diastolic blood pressures (p = 0.006) and double product (p = 0.006) only occurred in the REE group. Conclusion Endurance training and resistance exercise promote significant muscle strength gains after 12 weeks of training regardless of CT order in hypertensive women. Beneficial cardiovascular responses (SBP, DBP, and RPP) were also observed when endurance training was initiated. Level of evidence I; Therapeutic Studies - Investigating Treatment Outcomes.

RESUMO Introdução O exercício físico tem sido recomendado como estratégia não farmacológica para prevenção e controle da hipertensão. Objetivo Verificar as adaptações crônicas cardiovasculares e de força muscular em mulheres hipertensas submetidas a 12 semanas de treinamento concorrente (TC) em diferentes ordens. Métodos Foram distribuídas aleatoriamente em dois grupos 20 mulheres hipertensas: grupo de treinamento de força-resistência (REE; 56,00 ± 5,20 anos; 78,95 ± 8,28 kg; 155,10 ± 5,30 cm; 33,00 ± 5,30 kg.m-2) e grupo de exercícios de resistência-treinamento de força (ERE; 57,10 ± 13,38 anos; 76,56 ± 18,87 kg; 155,50 ± 8,18 cm; 31,41 ± 5,84 kg.m-2). O treinamento de força foi composto por quatro exercícios, três séries, com cargas de 8-RM com 90 segundos de intervalo entre as séries e os exercícios. O exercício de resistência teve duração de 25 minutos com intensidade progressiva. Força muscular (8-RM), pressão arterial sistólica e diastólica, frequência cardíaca e duplo produto foram avaliados pré e pós-exercício. Resultado ANOVA mostrou aumentos significativos de força para todos os exercícios (p < 0,0001), independente da ordem do treinamento concorrente (supino horizontal: p = 0,680; leg press: p = 0,244; remada sentada: p = 0,668; e cadeira extensora: p = 0,257). Para a pressão arterial sistólica (p = 0,074) e diastólica (p = 0,064), não foram verificadas diferenças significativas para diferentes condições de TC. No entanto, apenas em REE, houve redução significativa na pressão arterial sistólica (p = 0,0001), diastólica (p = 0,006) e duplo produto (p = 0,006). Conclusão O treinamento de força e exercício de resistência promove ganhos de força muscular significativos em 12 semanas de treinamento, independentemente da ordem de realização, em mulheres hipertensas. Também foram observadas respostas benéficas cardiovasculares (SBP, DBP e RPP) quando iniciado pelo treinamento de força. Nível de evidência I; Estudos terapêuticos − investigando os resultados do tratamento.

RESUMEN Introducción El ejercicio físico ha sido recomendado como estrategia no farmacológica para prevención y control de la hipertensión. Objetivo Verificar las adaptaciones crónicas cardiovasculares y de fuerza muscular en mujeres hipertensas sometidas a 12 semanas de entrenamiento concurrente (EC) en diferentes órdenes. Método Fueron distribuidas aleatoriamente en dos grupos veinte mujeres hipertensas: grupo de entrenamiento de fuerza-resistencia (REE, 56,00 ± 5,20 años; 78,95 ± 8,28 kg; 155,10 ± 5,30 cm; 33,00 ± 5,30 kg.m-2) y grupo de ejercicios de resistencia-entrenamiento de fuerza (ERE, 57,10 ± 13,38 años; 76,56 ± 18,87 kg; 155,50 ± 8,18 cm; 31,41 ± 5,84 kg.m-2). El entrenamiento de fuerza fue compuesto por cuatro ejercicios, tres series, con cargas de 8-RM con 90 segundos de intervalo entre las series y ejercicios. El ejercicio de resistencia tuvo duración de 25 minutos con intensidad progresiva. La fuerza muscular (8-RM), la presión arterial sistólica y diastólica, la frecuencia cardíaca y el doble producto se evaluaron pre y post-ejercicio. Resultados ANOVA mostró aumentos significativos de fuerza para todos los ejercicios (p < 0,0001), independiente del orden del entrenamiento concurrente (press de banca, p = 0,680; leg press, p = 0,244; remada sentada, p = 0,668; y silla extensora, p = 0,257). Para la presión arterial sistólica (p = 0,074) y diastólica (p = 0,064), no se verificaron diferencias significativas para diferentes condiciones de EC. Sin embargo, sólo en REE, hubo una reducción significativa en la presión arterial sistólica (p = 0,0001), diastólica (p = 0,006) y doble producto (p = 0,006). Conclusión El entrenamiento de fuerza y ejercicio de resistencia promueve aumentos de fuerza muscular significativos en 12 semanas de entrenamiento, independiente del orden de realización, en mujeres hipertensas. También fueron observadas respuestas benéficas cardiovasculares (SBP, DBP y RPP) cuando se inicia por el entrenamiento de fuerza. Nivel de evidencia I; Estudios terapéuticos - investigación de los resultados del tratamiento.

Reprodutibilidade, objetividade e validade do instrumento de avaliação do nível de atividade física de idosos ­ Curitibativa (INAFI) / Reproducibility, objectivity and validity of the instrument measuring the level of physical activity in the elderly - Curitibativa (INAFI)

O estudo propôs verificar a autenticidade científica do Instrumento de Avaliação do Nível de Atividade Física de Idosos (INAFI). Participaram 64 idosos, com 69,37 ± 6,70 anos (mulheres) e 70,5 ± 3,54 anos (homens). O instrumento adotado foi o acelerômetro GT3X, Actigraph (USA). Na análise geral do instrumento, comparação entre os grupos A e B (reprodutibilidade, mesmo entrevistador), o INAFI apresentou bom desempenho, p = 0,6956, grupos B e C (objetividade, entrevistadores diferentes), o instrumento foi razoável, p = 0,5047. No diagrama de dispersão observou-se que o viés A e B (= 0,5), B e C (= 6,61), é muito próximo de Zero, demonstrando que há concordância na maneira de aplicar as entrevistas. Na comparação, INAFI X acelerômetro foi necessário homogeneizar a diferença no tamanho das escalas, dividindo as variáveis pelas suas respectivas médias. Os resultados das análises: total/INAFI (MET/min/sem) X counts/min eixo1; total/INAFI (MET/min/sem) X counts/min vetor magnitude; total/atividade leve/INAFI, (< 3 METs) X total/light e lifestyle/acelerômetro (1,5-2,9 METs); total/atividade moderada/INAFI (> 3 METs) X total/atividade moderada/acelerômetro (3-5,9 METs) obteve-se um viés (= zero), portanto existe uma forte concordância entre as medidas dos dois instrumentos. Podemos afirmar que o INAFI se mostrou eficiente ao propósito para qual foi construído, portanto possui autenticidade científica. (AU)

The study proposed to verify the scientific authenticity of the Instrument Measuring the Level of Physical Activity in the Elderly (INAFI). Sixty-four elderly individuals participated, with 69.37 ± 6.70 years (women) and 70.5 ± 3.54 years (men). The instrument adopted was the GT3X accelerometer, Actigraph (USA). In the general analysis of the instrument, comparison between groups A and B (reproducibility, same interviewer), INAFI presented good performance, p = 0.6956, groups B and C (objectivity, different interviewers), the instrument was reasonable, p = 0.5047. In the dispersion diagram it was observed that the bias A and B (= 0.5), B and C (= 6.61), is very close to Zero, demonstrating that there is agreement in the way of applying the interviews. In the comparison, INAFI X accelerometer was necessary to homogenize the difference in the size of the scales, dividing the variables by their respective means. The results of the analyzes: total / INAFI (MET / min / without) X counts / min axis1; total / INAFI (MET / min / without) X counts / min vector magnitude; total / light activity / INAFI, (<3 METs) X total / light and lifestyle / accelerometer (1.5-2.9 METs); total / moderate activity / INAFI (> 3 METs) total X / moderate activity / accelerometer (3-5.9 METs) was obtained a bias (= zero), therefore there is a strong agreement between the measurements of the two instruments. We can say that INAFI was efficient for the purpose for which it was built, so it has scientific authenticity. (AU)