Quantitative relationship between physical activity and antihypertensives in elderly women / Relación cuantitativa entre actividad física y antihipertensivos en ancianas / Relação quantitativa entre atividade física e anti-hipertensivos em idosas

ABSTRACT Introduction: Physical activity is an important tool to manage systemic arterial hypertension. However, less is known about the relationship of physical activity with the number of antihypertensive drugs used by older adults. Objective: The aim of this study was to compare the number of antihypertensive drugs used by older female adults (aged ≥ 60 years) with a low level of physical activity with the number used by those with a high level of physical activity, and to verify how many participants used more than two antihypertensive drugs. Methods: Twenty-eight physically active older women with systemic arterial hypertension who participated in a physical activity program for community-dwelling older female adults were divided into two groups: participants who presented lower habitual physical activity levels were placed in group 1 and participants that presented higher habitual physical activity levels were placed in group 2, according to the Baecke questionnaire. In addition, the number of antihypertensive drugs used by participants was collected. Results: The number of prescribed antihypertensive drugs was 2.0 (median) for both groups investigated. There was no significant difference between groups regarding the number of antihypertensive tablets prescribed (p>0.05). Although there was no statistical difference, a higher proportion of participants from the lower physical activity group used more than two antihypertensive drugs. Conclusion: The level of habitual physical activity did not affect the number of antihypertensive tablets used by hypertensive elderly women. Level of evidence II; Therapeutic studies - investigation of treatment results.

RESUMEN Introducción: La actividad física es una herramienta importante para el manejo de la hipertensión arterial sistémica. Sin embargo, se sabe poco sobre la relación de la actividad física con la cantidad de medicamentos antihipertensivos utilizados por las ancianas. Objetivo: El objetivo de este estudio fue hacer una comparación entre el número de medicamentos antihipertensivos utilizados por mujeres adultas mayores (≥ 60 años) y bajo nivel de actividad física con el número utilizado por aquellas con alto nivel de actividad física, y verificar cuántas de las participantes usaron más de dos medicamentos antihipertensivos. Métodos: Veintiocho ancianas físicamente activas con hipertensión arterial sistémica que participaron en un programa de actividad física para mujeres adultas mayores residentes en la comunidad fueran divididas en dos grupos: las participantes que presentaron niveles más bajos de actividad física habitual se ubicaron en el grupo 1 y las participantes que presentaron los mayores niveles de actividad física se ubicaron en el grupo 2, según el cuestionario de Baecke. Además, se recogió el número de medicamentos antihipertensivos utilizados por las participantes. Resultados: El número de comprimidos antihipertensivos prescritos fue de 2,0 (mediana) para ambos grupos investigados. No hubo diferencia significativa entre los grupos en cuanto al número de medicamentos antihipertensivos prescritos (p>0,05). Aunque no hubo diferencia estadística, una mayor proporción de participantes del grupo de menor actividad física usó más de dos medicamentos antihipertensivos. Conclusión: El nivel de actividad física habitual no afectó el número de comprimidos antihipertensivos utilizados por las ancianas hipertensas. Nivel de evidencia II; Estudios terapéuticos: investigación de los resultados del tratamiento.

RESUMO Introdução: A atividade física é uma importante ferramenta no manejo da hipertensão arterial sistêmica. No entanto, pouco se sabe sobre a relação entre a atividade física e a quantidade de anti-hipertensivos usados por idosos. Objetivo: O objetivo deste estudo foi realizar uma comparação entre o número de anti-hipertensivos usados por idosas (≥ 60 anos) com baixo nível de atividade física com o número usado por aquelas com alto nível de atividade física, verificando quantas participantes usaram mais de dois anti-hipertensivos. Métodos: Vinte e oito idosas fisicamente ativas com hipertensão arterial sistêmica que participavam de um programa de atividade física para idosas da comunidade foram divididas em dois grupos: as participantes que apresentaram níveis mais baixos de atividade física habitual foram colocadas no grupo 1 e as participantes que apresentaram maiores níveis de atividade física foram colocados no grupo 2, de acordo com o questionário de Baecke. Ademais, coletou-se o número de medicamentos anti-hipertensivos utilizados pelas participantes. Resultados: O número de fármacos anti-hipertensivos prescritos foi de 2,0 (mediana) para ambos os grupos investigados. Não houve diferença significativa entre os grupos quanto ao número de comprimidos anti-hipertensivos prescritos (p>0,05). Embora não tenha havido diferença estatística, uma maior proporção de participantes entre o grupo de menor atividade física utilizava mais de dois anti-hipertensivos. Conclusão: O nível de atividade física habitual não afetou a quantidade de comprimidos anti-hipertensivos utilizados pelas idosas hipertensas. Nível de evidência II; Estudos terapêuticos - Investigação dos resultados do tratamento.

Smartphone e folder podem ser uma alternativa para reduzir o comportamento sedentário? Estudo piloto / Can smartphone and folder be an alternative to reduce sedentary behavior? Pilot study

O objetivo do estudo foi investigar se a exposição a informações sobre vida saudável, via aplicativo de mensagem de smartphone ou folder impresso, reduz o comportamento sedentário (CS) de universitários. Este estudo é um piloto prospectivo quase experimental, constituído por 69 participantes, randomizados por turma, em dois grupos de intervenção via mensagem de texto Whatsapp (grupo MSG)e folder impresso (grupo FOLDER). As intervenções apresentaram orientações semelhantes com foco geral de promover um perfil de vida saudável, reduzindo o CS. As mensagens foram encaminhadas às segundas-feiras por um período de quatro semanas consecutivas. O tempo exposto ao CS foi avaliado a partir do Questionário Internacional de Atividade Física na Baseline e após quatro semanas de intervenção. Para avaliar o efeito do tempo, da intervenção e a interação (tempo*intervenção) no CS, foram utilizados modelos mistos generalizados para medidas repetidas, utilizando uma matriz de covariância autorregressiva de primeira ordem (AR1) e foi utilizado o teste post hoc de Bonferroni. Foi adotado o nível de significância de 5%. Foram observados efeitos significantes das intervenções (F = 5,30; p = 0,024), FOLDER (519,71 ± 28,01) e MSG (430,37 ± 26,82), e dos tempos (F = 19,05; p < 0,001) baseline (522,07 ± 22,18) e após 4 semanas (428,00 ± 22,18) mas não foi observado interação entre o tempo e a intervenção (F = 0,430; p = 0,514). Foram observadas diferenças significantes entre os grupos no momento pós intervenção (p = 0,022). Ambas as intervenções parecem ser úteis para a redução do tempo exposto ao CS em uma população de adultos jovens durante o período de quatro semanas

The objective of the study was investigate whether exposure to information about healthy living, via smart-phone message application or printed folder, reduces the sedentary behavior (SB) of university students. This study is an almost experimental prospective pilot, consisting of 69 participants, randomized by class, in two intervention groups via Whatsapp text message (MSG group) and printed folder (FOLDER group). The interventions presented similar guidelines with a general focus on promoting a healthy life profile, reducing SB. The messages were forwarded on Mondays for a period of four consecutive weeks. The time exposed to the SB was evaluated using the International Physical Activity Questionnaire on the baseline and after four weeks of intervention. To evaluate the effect of time, intervention and interaction (time * intervention) in the SB, generalized mixed models for repeated measures were used, using a first order autoregressive covariance matrix (AR1) and Bonferroni post hoc test was used. The significance level of 5% was adopted. Significant effects of the interventions (F = 5.30; p = 0.024), FOLDER (519.71 ± 28.01) and MSG (430.37 ± 26.82), and of the times (F = 19.05; p < 0.001) baseline (522.07 ± 22.18) and after 4 weeks (428.00 ± 22.18) but no interaction was observed between time and intervention (F = 0.430; p = 0.514). Significant differences were observed between the groups at the time after the intervention (p = 0.022). Both interventions appear to useful for reducing the time exposed to SC in a population of young adults over the four-week period

Mood state, motivation and impulsiveness among students participating in youth school games / Estado de humor, motivação e impulsividade de estudantes participantes dos jogos escolares da juventude

ABSTRACT The objective of the present study was to describe the mood state, motivation and impulsiveness of students participating in youth school games and to compare these variables between sexes. The research was cross-sectional, and the sample was composed of 147 students aged 12 to 17 years old (14.53±1.51 years; 51.70% of male participants). The following scales were used: 1) Brunel Mood Scale; 2) Motives for Physical Activity Measure - Revised, and 3) Impulsive Behavior Scale. For comparison between groups, the Mann-Whitney U test was used, and the effect size was calculated by means of Cohen's d. The results showed that female students presented higher scores for anxiety, anger, confusion, depression, fatigue, lack of perseverance and premeditation. On the other hand, male students presented higher scores for appearance and health, seeming to be more motivated by extrinsic factors compared to females. Therefore, it is suggested that training strategies should be adapted by sex, in view of the respective characteristics.

RESUMO O objetivo do presente estudo foi descrever o estado de humor, motivação e impulsividade dos estudantes participantes dos Jogos Escolares da Juventude e comparar estas variáveis entre os sexos. A pesquisa teve caráter transversal e a amostra foi composta por 147 escolares de 12 a 17 anos (14,53±1,51 anos; 51,70% participantes do sexo masculino). As seguintes escalas foram utilizadas: 1) Brunel Mood Scale; 2) Motivação para Atividade Física Medida Revisada e 3) Escala de Comportamento Impulsivo. Para a comparação entre os grupos, utilizou-se o teste de U de Mann-Whitney e calculou-se o tamanho do efeito por meio do d de Cohen. Os resultados mostraram que escolares do sexo feminino apresentaram maiores escores de ansiedade, raiva, confusão, depressão, fadiga, falta de perseverança e premeditação. Por outro lado, escolares do sexo masculino apresentaram maiores escores na aparência e saúde, mostrando-se mais motivados por fatores extrínsecos, em relação ao sexo feminino. Portanto, sugere-se que as estratégias de treinamento sejam adaptadas conforme o sexo, tendo em vista as respectivas características.

Frequency and intensity of gastrointestinal symptoms in exercisers individuals at rest and during physical exercise: an internet-based survey.

BACKGROUND/AIMS: Despite the evidence of a modest to high prevalence of gastrointestinal (GI) symptoms in recreational runners and endurance athletes, the frequency and intensity of GI symptoms in exercisers, but nonathletes, individuals from different modalities have been less investigated. Therefore, the present study aimed to assess the prevalence of GI symptoms in individuals that practice moderate or vigorous physical exercise, at rest and during physical exercise training session. METHODS: The sample consisted of 142 exercisers individuals (64 women and 78 men with mean age of 32.9 ± 10.7 years). Out of the 142 participants, 71 reported to perform moderate physical exercise and 71 reported to perform vigorous physical exercise. Participants were assessed by an internet-based questionnaire designed to assess the frequency and intensity (at rest and during physical exercise training session) of 18 GI symptoms. RESULTS: The GI symptoms most frequently reported by the respondents (during rest and physical exercise training session, respectively) were flatulence (90.8% and 69.7%), abdominal noise (77.5% and 41.5%), and eructation (73.9% and 52.1%). Overall, the frequency and intensity of symptoms were higher (P< 0.050) during rest than physical exercise training session for who perform moderate and vigorous physical exercise. CONCLUSIONS: It can be concluded that GI symptoms in exercisers, but nonathletes, individuals are more prevalent during rest than during physical exercise training session, suggesting that moderate and vigorous physical exercise may act as a regulator of the GI tract.

Prevention of Sudden Death Related to Sport: The Science of Basic Life Support-from Theory to Practice.

The sudden cardiac arrest (CA) and death of athletes are dramatic and emotionally impacting events for health professionals, family, and society. Although the practice of sport participation improves general health, physical fitness, and quality of life, intense physical exercise can be a trigger for CA and sudden death occasionally in the presence of known or unknown cardiac disorders (mainly hypertrophic cardiomyopathy) and risk factors (environment, health style, family, and genetic). The present review found that sudden death associated with CA was not such a common event in competitive athletes, but it might be an underestimated event in recreational athletes. Thus, considering the exponential increase in sport participation, both in a recreational or competitive way, and the rate of sudden CA, knowledge of implementing prevention and treatment strategies is crucial. This includes preparation of health professionals and lay people in basic life support (BLS); screening and pre-participation assessment in sport programs and health education; and promotion for the recognition of CA and early completion of BLS and rapid access to automatic external defibrillator to improve the victim survival/prognosis. Thus, the purpose of this review is to provide for health professionals and lay people the most updated information, based on current guidelines, of how to proceed in an emergency situation associated with sudden CA of young adult athletes.

Do isometric, isotonic and/or isokinetic strength trainings produce different strength outcomes?

INTRODUCTION: Several studies have been developed to determine which type of muscular action (isometric, isotonic and isokinetic) elicits more gains in functional strength and muscle mass. The comparisons between training outcomes are inconclusive due to lack of exercise standardization. OBJECTIVE: To compare muscle strength, mass, and functional performance in response to isometric, isotonic, and isokinetic contractions, when training loads (volume and intensity) are equated. METHOD: Data were derived from a university community-recruited sample (n = 31 men). INTERVENTIONS: Untrained men were assigned to isotonic (IT), isometric (IM), or isokinetic (IK) group, and trained their dominant quadriceps muscle 3 sessions/week for 8 weeks with a dynamometer. Muscle strength was assessed using Cybex 6000 dynamometer; the triple-hop-distance test was used to assess functional performance, and dual energy x-ray absorptiometry to assess lean muscle mass. RESULTS: After training, muscle lean muscle mass increased in isometric (+3.1%, p < 0.01) and isotonic groups (+3.9%, p < 0.01); only the isokinetic group showed a significant improvement in the triple-hop-distance test (4.84%, p < 0.01). CONCLUSION: Clinicians should consider isometric training as an alternative for isotonic training to gain muscle mass, and isokinetic training to improve functional performance of daily activities and/or sports.

Pilates and aerobic training improve levels of depression, anxiety and quality of life in overweight and obese individuals.

OBJECTIVE: To compare the effects of Pilates and walking on quality of life, depression, and anxiety levels. METHODS: Sixty-three overweight/obese participants were randomly divided into: control (n = 20), walking (n = 21), and Pilates (n = 22) groups. Pilates and walking groups attended eight weeks of 60-minute exercise sessions three times per week. Quality of life, depression, and state- and trait-anxiety levels were evaluated before and after eight weeks of training. RESULTS: Scores of quality of life, depression, and trait-anxiety improved in the Pilates and walking groups. State-anxiety levels improved only in the walking group. CONCLUSION: Pilates and walking positively impact quality of life, depression and anxiety. The Pilates method could be used as an alternative to improve mood disorders in overweight/obese individuals.

Pilates and aerobic training improve levels of depression, anxiety and quality of life in overweight and obese individuals / O treinamento de Pilates e aeróbio melhoram os níveis de depressão, ansiedade e qualidade de vida em indivíduos com sobrepeso e obesidade

ABSTRACT Objective: To compare the effects of Pilates and walking on quality of life, depression, and anxiety levels. Methods: Sixty-three overweight/obese participants were randomly divided into: control (n = 20), walking (n = 21), and Pilates (n = 22) groups. Pilates and walking groups attended eight weeks of 60-minute exercise sessions three times per week. Quality of life, depression, and state- and trait-anxiety levels were evaluated before and after eight weeks of training. Results: Scores of quality of life, depression, and trait-anxiety improved in the Pilates and walking groups. State-anxiety levels improved only in the walking group. Conclusion: Pilates and walking positively impact quality of life, depression and anxiety. The Pilates method could be used as an alternative to improve mood disorders in overweight/obese individuals.

RESUMO Objetivo: Comparar os efeitos do treinamento com Pilates e caminhada sobre os níveis de qualidade de vida, depressão e ansiedade. Métodos: Sessenta e três participantes com sobrepeso/obesidade foram divididos aleatoriamente em grupos: Controle (n = 20), Caminhada (n = 21) e Pilates (n = 22). Os grupos Pilates e caminhada realizaram oito semanas de sessões de exercício de 60 minutos 3 vezes/semana. Os níveis de qualidade de vida, depressão e ansiedade traço e estado foram avaliados antes e após oito semanas de treinamento. Resultados: Os escores de qualidade de vida, depressão e ansiedade-traço melhoraram nos grupos Pilates e caminhada. Os níveis de ansiedade-estado melhoraram apenas no grupo caminhada. Conclusão: O Pilates e a caminhada impactam positivamente os níveis de qualidade de vida, depressão e ansiedade. O método Pilates pode ser usado como um método alternativo para distúrbios do humor em indivíduos com sobrepeso e obesidade.

Benefícios da prática da espiritualidade e religiosidade para pessoas com epilepsia / Benefits of spiritual and religious practices for people with epilepsy

A epilepsia é considerada uma doença neurológica enigmática pela forma de manifestação de seus sinais e sintomas. É importante notar que a prática da espiritualidade/religiosidade pode impactar positivamente na qualidade de vida de pacientes com doenças neurológicas, em particular a epilepsia, sendo considerada uma forma de enfrentamento e tratamento complementar da doença. Dessa forma, o objetivo deste trabalho foi apresentar informações referentes aos possíveis benefícios da prática da espiritualidade/religiosidade como forma de tratamento alternativo de pacientes com essa condição. Esta pesquisa consistiu de ampla revisão de literatura realizada na base de dados PubMed. Para a seleção dos artigos, dentro da temática de interesse (27 no total), foram utilizados os descritores "epilepsy", "spirituality", "religiosity", "quality of life" e "religion" bem como seus cruzamentos. Além disso, foram utilizados outros artigos que apontavam as definições, a classificação, os aspectos históricos e epidemiológicos e as diretrizes do manejo da epilepsia. Foi possível concluir que a prática da espiritualidade/religiosidade somada ao tratamento convencional pode ser uma alternativa a ser recomendada pelos profissionais da saúde, pois impacta positivamente na qualidade de vida de pacientes com epilepsia.

Epilepsy is an enigmatic neurological disease, due to the manner its signs and symptoms are manifested. The practice of spirituality/religiosity can positively impact the quality of life of patients with neurological diseases, particularly epilepsy, and it is considered a form of coping and complementary treatment of the disease. Thus, the aim of this study was to present information regarding the possible benefits of the spirituality/ religiosity practices as alternative treatments for patients with epilepsy. This article consisted of a broad literature review carried out in the database PubMed. For the selection of articles within the theme of interest (27 in total), the descriptors used were "epilepsy", "spirituality", "religiosity", "quality of life", and "religion" as well as their intersections. In addition, other articles that pointed definitions, classifications, historical and epidemiological aspects, and the guidelines of epilepsy management were used. It was possible to conclude that the spirituality/religiosity practice in addition to conventional treatment may be an alternative to be recommended by health professionals, since it positively impacts epilepsy patients' quality of life.

Ressuscitação cardiopulmonar na gestação: uma revisão integrativa / Cardiopulmonary resuscitation in pregnancy: an integrative review

O objetivo deste estudo foi identificar dados sobre atendimento à parada cardiorrespiratória na gestação. Foi realizada uma revisão integrativa de artigos publicados entre 2010 e 2015, em português, inglês e espanhol com a utilização dos seguintes descritores: "Parada Cardíaca"; "Ressuscitação Cardiopulmonar"; "Gestante" e "Gestação", nas seguintes bases de dados: MEDLINE, LILACS, IBECS e CUMED. A idade gestacional variou de 10 a 41 semanas, as etiologias mais comuns da parada cardiorrespiratória foram embolia pulmonar e trauma, os ritmos foram fibrilação ventricular e atividade elétrica sem pulso e o tempo em parada cardiorrespiratória variou de 15 a 60 minutos. O tratamento foi ressuscitação cardiopulmonar, intubação, administração de epinefrina e cesárea de emergência. Os desfechos mais observados nas mães e recém-nascidos foram alta e bom estado neurológico. Conclui-se que protocolos de atendimento específicos podem respaldar e auxiliar a tomada de decisão da equipe durante a ressuscitação cardiopulmonar, aumentando a sobrevida e diminuindo o dano neurológico nestas pacientes.

The objective of this study was to identify data of compliance in cardiac arrest during pregnancy. An integrative review of articles published between 2010 and 2015 in Portuguese, English and Spanish using the following descriptors: "Cardiac Arrest"; "Cardiopulmonary Resuscitation"; "Pregnant" and "Pregnancy" was perfeormed in the following databases: MEDLINE, LILACS, IBECS and CUMED. The gestational age ranged from 10 to 41 weeks, the most common etiologies of cardiopulmonary arrest were pulmonary embolism and trauma, the rhythms were ventricular fibrillation and pulseless electrical activity and the time in cardiac arrest ranged from 15 to 60 minutes. Treatment was cardiopulmonary resuscitation, intubation, administration of epinephrine and emergency cesarean section. The outcomes observed in more mothers and newborns were hospital discharge and good neurological status. In conclusion, specific care protocols can endorse and assist the team's decision-making during cardiopulmonary resuscitation, increasing survival and decreasing neurological damage in these patients.

The Spiritism as therapy in the health care in the epilepsy.

OBJECTIVE: to present a brief history of Spiritism, the vision of epilepsy by Spiritism, and the potential of spirituality and religiosity care as complementary and coadjutants treatments in epilepsy. METHOD: this is a brief review about the impact of faith, spirituality, and religiosity, particularly the Spiritism philosophy as complementary treatment to neurological disorders (particularly focusing on epilepsy) and mental health. We conduct a review of published articles (about religion/spirituality and epilepsy) in the Pubmed and SciELO databases. CONCLUSION: the exercise of spirituality and religiosity can be a positive coping strategy to support the traditional therapy of patients with epilepsy and other neurological disorders. However, it is necessary to demystify myths and beliefs about the epilepsy and improve knowledge about this important health dimension among professionals, patients, and caregivers to explore their full treatment and supportive potential.

The Spiritism as therapy in the health care in the epilepsy / O Espiritismo como terapia no cuidado em saúde na epilepsia / Espiritismo como terapia en el cuidado de la salud en la epilepsia

ABSTRACT Objective: to present a brief history of Spiritism, the vision of epilepsy by Spiritism, and the potential of spirituality and religiosity care as complementary and coadjutants treatments in epilepsy. Method: this is a brief review about the impact of faith, spirituality, and religiosity, particularly the Spiritism philosophy as complementary treatment to neurological disorders (particularly focusing on epilepsy) and mental health. We conduct a review of published articles (about religion/spirituality and epilepsy) in the Pubmed and SciELO databases. Conclusion: the exercise of spirituality and religiosity can be a positive coping strategy to support the traditional therapy of patients with epilepsy and other neurological disorders. However, it is necessary to demystify myths and beliefs about the epilepsy and improve knowledge about this important health dimension among professionals, patients, and caregivers to explore their full treatment and supportive potential.

RESUMO Objetivo: apresentar uma breve história do Espiritismo, a visão da epilepsia pelo Espiritismo e o potencial dos cuidados de espiritualidade e religiosidade como tratamentos complementares e coadjuvantes na epilepsia. Método: trata-se de uma breve revisão sobre o impacto da fé, da espiritualidade, da religiosidade, particularmente da filosofia espírita, como tratamento complementar dos distúrbios neurológicos (particularmente com foco na epilepsia) e da saúde mental. Para isso, fizemos uma revisão, sobre religiosidade/espiritualidade e epilepsia, na base de dados do Pubmed e SciELO. Conclusão: o exercício da espiritualidade e da religiosidade pode ser uma estratégia de enfrentamento positiva para apoiar a terapia tradicional no tratamento de pacientes com epilepsia. No entanto, é preciso desmistificar mitos e crenças sobre a epilepsia e melhorar o conhecimento deste aspecto importante da dimensão da saúde entre profissionais, pacientes e cuidadores para explorar todo o potencial de tratamento e suporte.

RESUMEN Objetivo: presentar una breve historia del Espiritismo, la visión de la epilepsia por el Espiritismo, y el potencial de la espiritualidade y religiosidad como tratamientos complementarios y coadyuvantes de la epilepsia. Método: esta es una breve revisión del impacto de la fe, la espiritualidad y religiosidad, en particular la filosofía espiritual como tratamiento complementario de los trastornos neurológicos (centrada especialmente en la epilepsia) y la salud mental. Para esto, se realizó una revisión de la religiosidad/espiritualidad y la epilepsia en la base de datos PubMed y SciELO. Conclusión: el ejercicio de la espiritualidad y la religiosidad puede ser una estrategia de afrontamiento y tratamiento positivo para apoyar la terapia tradicional de los pacientes con epilepsia y otros trastornos neurológicos. Sin embargo, es necesario desmitificar muchas creencias sobre la epilepsia así como mejorar el conocimiento sobre este importante aspecto de la dimensión de salud entre profesionales, cuidadores y pacientes para explorar su potencial para el tratamiento y el apoyo.

Cohort study on the factors associated with survival post-cardiac arrest / Estudo de coorte dos fatores associados à sobrevivência pós-parada cardiorrespiratória

CONTEXT AND OBJECTIVE: Cardiac arrest is a common occurrence, and even with efficient emergency treatment, it is associated with a poor prognosis. Identification of predictors of survival after cardiopulmonary resuscitation may provide important information for the healthcare team and family. The aim of this study was to identify factors associated with the survival of patients treated for cardiac arrest, after a one-year follow-up period. DESIGN AND SETTING: Prospective cohort study conducted in the emergency department of a Brazilian university hospital. METHODS: The inclusion criterion was that the patients presented cardiac arrest that was treated in the emergency department (n = 285). Data were collected using the In-hospital Utstein Style template. Cox regression was used to determine which variables were associated with the survival rate (with 95% significance level). RESULTS: After one year, the survival rate was low. Among the patients treated, 39.6% experienced a return of spontaneous circulation; 18.6% survived for 24 hours and of these, 5.6% were discharged and 4.5% were alive after one year of follow-up. Patients with pulseless electrical activity were half as likely to survive as patients with ventricular fibrillation. For patients with asystole, the survival rate was 3.5 times lower than that of patients with pulseless electrical activity. CONCLUSIONS: The initial cardiac rhythm was the best predictor of patient survival. Compared with ventricular fibrillation, pulseless electrical activity was associated with shorter survival times. In turn, compared with pulseless electrical activity, asystole was associated with an even lower survival rate.

CONTEXTO E OBJETIVO: A parada cardiorrespiratória é comum e, mesmo com tratamentos de emergência eficientes, associa-se a prognósticos ruins. A identificação de fatores preditores de sobrevivência após ressuscitação cardiopulmonar pode fornecer informações importantes para equipe de saúde e familiares. O objetivo deste estudo foi identificar fatores associados à sobrevivência, após um ano de seguimento, de pacientes atendidos em parada cardiorrespiratória. DESENHO E LOCAL: Estudo de coorte prospectivo realizado no serviço de emergência de um hospital universitário. MÉTODOS: O critério de inclusão foi o atendimento de paciente em parada cardiorrespiratória no serviço de emergência (n = 285). Os dados foram coletados por meio do modelo In-hospital Utstein Style. Para verificar quais variáveis associaram-se à sobrevida, utilizou-se regressão de Cox (nível de significância 95%). RESULTADOS: Após um ano, a sobrevida foi baixa. Dos pacientes atendidos, 39,6% tiveram retorno da circulação espontânea, 18,6% sobreviveram até as primeiras 24 horas, sendo que, destes, 5,6% obtiveram alta hospitalar e 4,5% permaneceram vivos após um ano de seguimento. Pacientes com atividade elétrica sem pulso apresentaram duas vezes menos chances de sobreviver que aqueles com fibrilação ventricular. Nos pacientes com assistolia, as taxas de sobrevida foram 3,5 menores quando comparados aos com atividade elétrica sem pulso. CONCLUSÕES: O ritmo cardíaco inicial foi o fator preditor que melhor explicou a sobrevida. O ritmo de atividade elétrica sem pulso associou-se a menor sobrevida quando comparado a fibrilação ventricular, enquanto o ritmo de assistolia relacionou-se a ainda menor sobrevivência em relação à atividade elétrica sem pulso.

One-year follow-up of neurological status of patients after cardiac arrest seen at the emergency room of a teaching hospital / Um ano de seguimento da condição neurológica de pacientes pós-parada cardiorrespiratória atendidos no pronto-socorro de um hospital universitário

ABSTRACT Objective: To describe neurological status and associated factors of survivors after cardiac arrest, upon discharge, and at 6 and 12 month follow-up. Methods: A cohort, prospective, descriptive study conducted in an emergency room. Patients who suffered cardiac arrest and survived were included. A one-year consecutive sample, comprising 285 patients and survivors (n=16) followed up for one year after discharge. Neurological status was assessed by the Cerebral Performance Category before the cardiac arrest, upon discharge, and at 6 and 12 months after discharge. The following factors were investigated: comorbidities, presence of consciousness upon admission, previous cardiac arrest, witnessed cardiac arrest, location, cause and initial rhythm of cardiac arrest, number of cardiac arrests, interval between collapse and start of cardiopulmonary resuscitation, and between collapse and end of cardiopulmonary resuscitation, and duration of cardiopulmonary resuscitation. Results: Of the patients treated, 4.5% (n=13) survived after 6 and 12 months follow-up. Upon discharge, 50% of patients remained with previous Cerebral Performance Category of the cardiac arrest and 50% had worsening of Cerebral Performance Category. After 6 months, 53.8% remained in the same Cerebral Performance Category and 46.2% improved as compared to discharge. After 12 months, all patients remained in the same Cerebral Performance Category of the previous 6 months. There was no statistically significant association between neurological outcome during follow-up and the variables assessed. Conclusion: There was neurological worsening at discharge but improvement or stabilization in the course of a year. There was no association between Cerebral Performance Category and the variables assessed. .

RESUMO Objetivo: Identificar a condição neurológica e os fatores associados de sobreviventes pós-parada cardiorrespiratória na alta hospitalar, após 6 e 12 meses de seguimento. Métodos: Estudo de coorte, prospectivo e descritivo, realizado em um pronto-socorro. Foram incluídos pacientes em parada cardiorrespiratória que sobreviveram à alta. A amostra foi consecutiva por um ano, sendo composta por 285 pacientes, e os sobreviventes (n=16) foram acompanhados por um ano após alta. O estado neurológico foi avaliado pela Categoria de Performance Cerebral antes da parada, na alta, 6 e 12 meses após alta. Foram investigados os seguintes fatores: comorbidades, presença de consciência na admissão, parada cardiorrespiratória prévia, parada cardiorrespiratória testemunhada, local, causa e ritmo inicial da parada, número de paradas, intervalo entre colapso e início da ressuscitação cardiopulmonar, e entre colapso e término da ressuscitação, e duração da ressuscitação. Resultados: Dos pacientes atendidos, 4,5% (n=13) sobreviveram após 6 e 12 meses de seguimento. Na alta, 50% dos pacientes permaneceram com Categoria de Performance Cerebral prévia à parada, e 50% tiveram piora da mesma. Após 6 meses, 53,8% permaneceram com mesma Categoria de Performance Cerebral, e 46,2% tiveram melhora em relação à alta. Após 12 meses, a totalidade dos pacientes permaneceu com mesma Categoria de Performance Cerebral em relação aos 6 meses anteriores. Não houve associação estatisticamente significativa entre evolução neurológica durante o seguimento e variáveis de interesse. Conclusão: Observou-se piora neurológica na alta, mas houve melhora ou estabilização no decorrer de 1 ano. Não foi encontrada associação entre Categoria de Performance Cerebral e variáveis de interesse. .

Low levels of maximal aerobic power impair the profile of mood state in individuals with temporal lobe epilepsy.

OBJECTIVE: To investigate the correlation between cardiorespiratory fitness and mood state in individuals with temporal lobe epilepsy (TLE). METHOD: Individuals with TLE (n = 20) and healthy control subjects (C, n = 20) were evaluated. Self-rating questionnaires were used to assess mood (POMS) and habitual physical activity (BAECKE). Cardiorespiratory fitness was evaluated by a maximal incremental test. RESULTS: People with TLE presented lower cardiorespiratory fitness; higher levels of mood disorders; and lower levels of vigor when compared to control health subjects. A significant negative correlation was observed between the levels of tension-anxiety and maximal aerobic power. CONCLUSION: Low levels of cardiorespiratory fitness may modify the health status of individuals with TLE and it may be considered a risk factor for the development of mood disorders.

Low levels of maximal aerobic power impair the profile of mood state in individuals with temporal lobe epilepsy / Os baixos níveis de potência aeróbia máxima prejudicam o perfil do estado de humor em indivíduos com epilepsia do lobo temporal

Objective To investigate the correlation between cardiorespiratory fitness and mood state in individuals with temporal lobe epilepsy (TLE). Method Individuals with TLE (n = 20) and healthy control subjects (C, n = 20) were evaluated. Self-rating questionnaires were used to assess mood (POMS) and habitual physical activity (BAECKE). Cardiorespiratory fitness was evaluated by a maximal incremental test. Results People with TLE presented lower cardiorespiratory fitness; higher levels of mood disorders; and lower levels of vigor when compared to control health subjects. A significant negative correlation was observed between the levels of tension-anxiety and maximal aerobic power. Conclusion Low levels of cardiorespiratory fitness may modify the health status of individuals with TLE and it may be considered a risk factor for the development of mood disorders. .

Objetivo Investigar a correlação entre aptidão cardiorrespiratória e variáveis de estado de humor em indivíduos com epilepsia do lobo temporal (ELT). Método Indivíduos com ELT (n = 20) e controles saudáveis (C, n = 20) foram avaliados. Administraram-se questionários para avaliar o estado de humor (POMS) e nível de atividade física habitual (BAECKE). Avaliou-se a aptidão cardiorrespiratória por teste incremental máximo. Resultados Pessoas com ELT apresentaram menor aptidão cardiorrespiratória; elevados níveis de transtornos do humor; e menor nível de vigor, quando comparadas ao grupo C. Observou-se correlação negativa significativa entre os níveis de tensão-ansiedade e a potência aeróbica máxima. Conclusão O baixo nível de aptidão cardiorrespiratória pode modificar o estado de saúde de indivíduos com ELT e pode ser considerado fator de risco para o desenvolvimento de transtornos de humor. .

Cohort study on the factors associated with survival post-cardiac arrest.

CONTEXT AND OBJECTIVE: Cardiac arrest is a common occurrence, and even with efficient emergency treatment, it is associated with a poor prognosis. Identification of predictors of survival after cardiopulmonary resuscitation may provide important information for the healthcare team and family. The aim of this study was to identify factors associated with the survival of patients treated for cardiac arrest, after a one-year follow-up period. DESIGN AND SETTING: Prospective cohort study conducted in the emergency department of a Brazilian university hospital. METHODS: The inclusion criterion was that the patients presented cardiac arrest that was treated in the emergency department (n = 285). Data were collected using the In-hospital Utstein Style template. Cox regression was used to determine which variables were associated with the survival rate (with 95% significance level). RESULTS: After one year, the survival rate was low. Among the patients treated, 39.6% experienced a return of spontaneous circulation; 18.6% survived for 24 hours and of these, 5.6% were discharged and 4.5% were alive after one year of follow-up. Patients with pulseless electrical activity were half as likely to survive as patients with ventricular fibrillation. For patients with asystole, the survival rate was 3.5 times lower than that of patients with pulseless electrical activity. CONCLUSIONS: The initial cardiac rhythm was the best predictor of patient survival. Compared with ventricular fibrillation, pulseless electrical activity was associated with shorter survival times. In turn, compared with pulseless electrical activity, asystole was associated with an even lower survival rate.