Baixos Níveis de Atividade Física e suas Associações com o Estado de Humor, Sonolência Diurna e Consumo Alimentar em Universitários / Low Levels of Physical Activity and its Associations with Mood State, Daytime Sleepiness and Food Consumption in University Students

O ingresso em um curso universitário leva a mudanças significativas no estilo de vida e na rotina do estudante, com impacto na prática de atividade física, saúde mental, hábitos de sono e hábitos alimentares. O objetivo do estudo foi verificar o nível de atividade física dos jovens universitários e suas associações com estado de humor, qualidade do sono e consumo alimentar. Trata-se de uma pesquisa de corte transversal, realizada com estudantes universitários do curso de Medicina de uma Instituição de Ensino Superior Pública. Realizou-se avaliação de medidas antropométricas, do nível de atividade física (NAF) por meio do acelerômetro GT3x (Actigraph), do consumo alimentar (inventário de 24h), e utilizando os questionários de BECK e BRUMs / POMS avaliou-se os distúrbios de sono e estado de humor. Utilizando o software SPSS realizou análise comparativa com teste t Student para grupos independentes, análise inferencial de correlação de Pearson e Regressão logística binária. Dos universitários analisados (n=75), 54,7% (n=41) eram do sexo masculino e, quando comparado com as mulheres, apresentaram maior nível de atividade física (NAF). Aproximadamente 1/3 de toda a amostra do estudo realizou menos de 300min de atividade física moderada/vigorosa. O perfil alimentar dos universitários não foi satisfatório. Verificou-se para ambos os sexos o Escore Total de POMS (Profile of Mood States) se associou com universitários que realizam menos de 300min de atividade física por semana. As mulheres têm 65% mais chances de apresentar Escala de Tensão (POMS) quando são menos ativas, e nos homens, a razão de chances é de aproximadamente três vezes maior de apresentar Confusão (BRUMS - Escala de Humor de Brunel). Conclui-se que os estudantes universitários do curso estudado, em sua maioria, foram insuficientemente ativos fisicamente e apresentam algumas alterações no estado de humor, sonolência diurna e um consumo alimentar insatisfatório.

Starting a university course leads to significant changes in the student's lifestyle and routine, with an impact on physical activity, mental health, sleeping habits and eating habits. The objective of the study was to verify the level of physical activity of young university students and its associations with mood, sleep quality and food consumption. This is a cross-sectional survey, carried out with university students studying Medicine at a Public Higher Education Institution. Anthropometric measurements, physical activity level (PAL) were assessed using the GT3x accelerometer (Actigraph), food consumption (24-hour inventory), and using the BECK and BRUMs / POMS questionnaires, health disorders were assessed. sleep and mood. Using SPSS software, comparative analysis was carried out with Student's t test for independent groups, Pearson correlation inferential analysis and binary logistic regression. Of the university students analyzed (n=75), 54.7% (n=41) were male and, when compared to women, they had a higher physical activity level (PAL). Approximately 1/3 of the entire study sample performed less than 300 minutes of moderate/vigorous physical activity. The dietary profile of university students was not satisfactory. For both sexes, the POMS Total Score (Profile of Mood States) was found to be associated with university students who perform less than 300 minutes of physical activity per week. Women are 65% more likely to present with Tension Scale (POMS) when they are less active, and in men, the odds ratio is approximately three times greater for presenting Confusion (BRUMS - Brunel Mood Scale). It is concluded that the majority of university students on the course studied were insufficiently physically active and presented some changes in mood, daytime drowsiness and unsatisfactory food consumption.

Proposition of Cutoff Points for Anthropometric Indicators to Identify High Blood Pressure in Adolescents.

Aim: To propose cutoff points for anthropometric indicators for high blood pressure (HBP) screening in adolescents and to identify, among these indicators, those more accurately for boys and girls. Methods: This cross-sectional study was carried out in the city of São José, SC, Brazil with 634 adolescents aged 14 to 19 years. Blood pressure levels were measured using a digital oscillometric sphygmomanometer and adolescents were classified as having HBP or not. Anthropometric indicators were calculated based on anthropometric measurements such as body mass (BM), height, waist circumference (WC), hip circumference (HC) and triceps, subscapularis, suprailiac, and midcalf skinfold thickness (SF). The Receiver Operating Characteristic Curve (ROC) was used to analyze the predictive capacity of anthropometric indicators in the identification of HBP. Results: Higher values of Area Under the Curve (AUC) were for the anthropometric indicators BM (0.67; 95%CI: 0.62-0.72), body mass index (BMI) (0.67; 95%CI: 0.62-0.72), and WC (0.67; 95%CI: 0.62-0.71) for males. For females, no anthropometric indicator had discriminatory power for HBP screening. The cutoff points for the anthropometric indicators with discriminatory power for HBP screening in males were BM > 64.80 Kg, BMI > 21.76 Kg/m2, fat percentage (FP) > 15.75, waist height to ratio (WHtR) > 0.41, WC > 73.00 cm, and HC > 92.25 cm. Conclusion: Anthropometric indicators of body adiposity had greater discriminatory power of HBP screening in males. For females, caution is suggested because the anthropometric indicators showed AUC values (95%CI) below 0.60.

Author Correction: Handrail support interference in cardiac autonomic modulation adjustments in young adults during maximal exercise testing.

An amendment to this paper has been published and can be accessed via a link at the top of the paper.

O tempo sentado está associado aos fatores de risco cardiometabólicos em adolescentes? / Is sitting time associated with cardiometabolic risk factors in adolescents?

O presente estudo teve como objetivo verificar a associação entre o tempo sentado e fatores de risco cardiometabólicos em adolescentes. A amostra foi composta por 454 adolescentes (50,6% masculino) com idades entre 12 a 18 anos. O tempo diário despendido sentado e a prática de atividade física moderada-vigorosa foram avaliados por meio do recordatório de três dias de Bouchard. Os fatores de risco cardiometabólicos analisados foram: circunferência de cintura; glicose; HDL-C; triglicerídeos; e pressão arterial. Foi utilizada a análise de variância com dois fatores (sexo e quartis) para comparar os fatores de risco cardiometabólicos entre os quartis de tempo sentado. Para verificar a associação entre o tempo sentado e os fatores de risco cardiometabólicos foi empregado a regressão linear múltipla. Foi observado que os meninos pertencentes ao 4º quartil (maior tempo sentado) apresentaram valores mais elevados de glicose e triglicerídeos em comparação com seus pares com menos tempo. No sexo feminino, verificou-se que as pertencentes ao 3º e 4º quartil apresentaram maiores valores de triglicerídeos e glicose em comparação ao 1º quartil. Associações positivas e significativas foram observadas entre o tempo sentado e os valores de circunferência da cintura (ß = 0,093; p < 0,05), glicose (ß = 0,111; p < 0,05) e pressão arterial diastólica (ß = -0,115; p < 0,05) mesmo após o ajuste para a prática de atividade física moderada-vigorosa. De acordo com os achados do presente estudo, conclui-se que os adolescentes que permaneceram maior tempo sentado apresentaram maiores valores de glicose, triglicerídeos e escore de risco cardiometabólico em comparação aos que despenderam menos tempo

This study aimed to verify if there is an association between sitting time and cardiometabolic risk factors in adolescents. The sample was composed of 454 adolescents (50.6% male) aged between 12 and 18 years. The time spent in sitting and physical activity were assessed through a record of three days by Bouchard. The following cardiometabolic risk factors were analyzed: waist circumference, glucose, HDL ­ cholesterol, tri-glycerides, and blood pressure. It was used the Two-way Analysis of Variance (sex and quartiles) to compare the cardiometabolic risk factors between the quartiles of sitting time. To verify the association between sitting time and cardiometabolic risk factors it was used the multivariate linear regression. Boys of the 4th quartile (higher sitting time) presented higher values of glucose and triglycerides compared to their peers with less time. Girls of the 3rd and 4th quartile presented higher triglycerides and glucose values, compared to the 1st quartile. Significant associations (p < 0.05) were observed between sitting time with waist circumference (ß = 0.093; p < 0.05), glucose (ß = 0.111; p < 0.05) and diastolic blood pressure (ß = 0.115; p < 0.05) even after the adjustment for the moderate to vigorous physical activity. According to the findings of this study, we concluded that adolescents who spent more sitting time had higher values of glucose, triglycerides and cardiometabolic risk score compared with who has less sitting time

Handrail support interference in cardiac autonomic modulation adjustments in young adults during maximal exercise testing.

The aim of this study was to investigate whether the use of handrail support during maximal exercise treadmill testing (ETT) would interfere in cardiac autonomic modulation kinetics when compared to not using handrail support. The hypothesis of overestimation in cardiac autonomic dynamics when the ETT is performed using handrail was tested. Thirty-five undergraduates (21.08 ± 2.98 years old) of both sexes, volunteered to undertake two ETT under the Ellestad protocol, in non-consecutive days. The first test (T1) was performed with handrail support and, after 7 days, the second test was performed (T2) without the support. Autonomic function was measured by heart rate variability (HRV) during both tests and resting. Estimated value of peak oxygen uptake (VO2) was 22.4% (p < 0.0001) higher in T1 when compared to T2. Overall, parasympathetic pathway was deactivated earlier in T2 than in T1, with NNxx measures variating in T1 from 10.74 ± 14.59 (ms) and in T2 from 3.48 ± 3.79 (ms). In stage two, mean values of HF in T2 corresponded to 32% of values in T1. Stage three presented a difference of 60% (p < 0.014) in LF between means reached in T1 and T2. Lastly, the association of LF and VO2 persisted longer in T1 stages than in T2 and was verified in early stages (S2 and S3) of both ETTs. Our findings suggest that parasympathetic influences on HR were slightly prolonged during ETT when subjects hold onto the treadmill.

Metabolic syndrome and its components in adult hypopituitary patients.

PURPOSE: To evaluate the prevalence of metabolic syndrome (MetS) and its components in adult hypopituitary patients. PATIENTS AND METHODS: Retrospective, cross-sectional analysis of a cohort of hypopituitary adult patients followed in a single reference center for pituitary diseases. MetS was defined by the National Cholesterol Education Program Adult Treatment Panel III (NCEP-ATP III) criteria. Patients with 18 years or older, presenting two or more anterior pituitary deficiencies associated or not with diabetes insipidus (DI), were included, while patients with hypopituitarism due to Acromegaly or Cushing's disease were excluded. RESULTS: We studied 99 hypopituitary patients (52 males, mean age 50.1 ± 16.3 years, mean age at diagnosis 33.7 ± 17.6 years) who have been followed for a mean time of 15.9 ± 10.1 years. Hypothalamic-pituitary tumors and non-tumoral etiologies were observed in 53.4% and 46.6% of the cases, respectively. FSH/LH, GH, TSH, ACTH deficiency and DI was present in 99%, 98.6%, 96%, 81.8%, and 23.2%, respectively. The prevalence of MetS was 39.4% and was significantly higher in patients older than 50 years (p = 0.02), overweight/obese (p < 0.001), with hypopituitarism diagnosed in adult life (p = 0.02), who did not replace GH (p = 0.004) and in smokers (p = 0.007). In the logistic regression model, body mass index (BMI) and GH replacement were significantly associated with the presence of MetS. Reduced HDL cholesterol was the most prevalent component of MetS in hypopituitary patients. CONCLUSIONS: MetS is a common finding in adult hypopituitary patients, which is mainly influenced by increased BMI and untreated GH deficiency. Trial Registration number (Plataforma Brasil): CAAE 51008815.2.0000.0096 (May 31, 2017) .

Efeito agudo do exercício físico aeróbio de diferentes intensidades na proliferação linfocitária de adultos / Acute effect of aerobic exercise training of different intensities on lymphocyte proliferation in adults

O exercício físico gera um desvio da homeostase e a reorganização das respostas de diversos sistemas, entre eles o sistema imune. A resposta aguda do sistema imune pode estar sujeita a mudanças de acordo com a intensidade do exercício praticado. O objetivo do estudo é observar a resposta da proliferação linfocitária à prática de sessões de exercício físico aeróbio de diferentes intensidades. Para tal, foram avaliados dez voluntários (23,50 ± 3,43 anos), que realizaram sessões de exercício aeróbio em bicicleta indoor nas intensidades moderada (40-59% da frequência cardíaca de reserva - FCr) e vigo-rosa (60-89% da FCr). Houve coleta de sangue venoso para análise da proliferação linfocitária antes (baseline) e após cada uma das sessões. A proliferação linfocitária foi estimulada através de Concanavalina A e mensurada através do ensaio de Alamar Blue® por análise fluorimétrica após 24h, 48h e 72h de cultivo. A análise estatística compreendeu comparações repetidas entre as diferentes sessões e o baseline por ANOVA two-way, considerando um p < 0,05. A sessão de exercício de intensidade vigorosa apresentou diminuição significativa da proliferação linfocitária basal de 21,96% (p = 0,011) em 24h, 37,46% (p = 0,001) em 48h e 27,61% (p = 0,005) em 72h quando comparada com o baseline. A sessão de exercício de intensidade moderada mostrou um aumento de 42,17% (p = 0,001), 36,89% (p = 0,011) e 30,84% (p = 0,001) para os mesmos tempos. Houve diferença significativa no delta de variação na comparação entre as intensidades (p < 0,005). A prática aguda de exercício físico aeróbio em intensidades moderada e vigorosa foi associada ao aumento e diminuição, respectivamente, da proliferação linfocitária de adultos.

Physical exercise causes a deviation in homeostasis and the reorganization of various systems responses, including the immune system. The acute response of the immune system may differ according to the intensity of physical exercise. The objective of this study is to analyze the lymphocyte proliferative response to the practice of aerobic physical exercise sessions of varying intensities. Ten volunteers (23.50 ± 3.43 years) were evaluated performing aerobic exercise sessions on an indoor bicycle at a moderate intensity (40-59% of heart rate reserve - HRR) and at a vigorous intensity (60-89% of HRR). Venous blood was collected for the analysis of lymphocyte proliferation before (baseline) and after each session. Concanavalin A (ConA) was utilized as stimulator and Alamar Blue® assay as measurement. The results were obtained by means of fluorimetric analysis after 24, 48 and 72 hours of cell culture after the exercise sessions. Statistical analysis comprised of repeated comparisons between the different sessions and the baseline by two-way ANOVA, considering p < 0.05. The vigorous exercise session reported a significant decrease in lymphocyte proliferative response of 21.96% (p = 0.011) in 24h, 37.46% (p = 0.001) in 48h and 27.61% (p = 0.005) in 72h, compared to the baseline. The moderate intensity exercise session reported a significant increase of 42.17% (p = 0.001) in 24h, 36.89% (p = 0.011) in 48h and 30.84% (p = 0.001) in 72h, compared to the baseline. There was a significant difference in delta variation between the two intensities (p < 0.005). Acute aerobic physical exercise at moderate and vigorous intensities caused a decrease and increase, respectively, in the lymphocyte proliferation of young adults.

Prevalência de doença arterial periférica e fatores de risco associado em uma população rural brasileira: estudo Corações de Baependi / Prevalence of peripheral artery disease and associated risk factors in a brazilian rural population: the Baependi heart study

A identificação da doença arterial periférica (DAP) pode atenuar a progressão e suas complicações adicionais, uma vez que a DAP é um fator de risco para mortalidade geral e cardiovascular. Avaliar a prevalência de DAP na população do Estudo Corações de Baependi e investigar fatores de risco associados em diferentes grupos etários. Foram selecionados 1.627 indivíduos (ambos os sexos e idade entre 18 e 102 anos) residentes no município de Baependi (Minas Gerais, Brasil). Os parâmetros antropométricos e bioquímicos foram avaliados por meio de protocolos padrões. O nível de atividade física foi determinado pelo Questionário Internacional de Atividade Física - Versão Curta (IPAQ-SF). A triagem da DAP foi realizada pelo índice tornozelo-braço (ITB). O nível de significância estatística adotado nas análises foi de 5%. Na população total, a prevalência de DAP foi de 1,05% e atingiu 5,2% após os 70 anos de idade. A frequência e intensidade do tabagismo foram maiores nos indivíduos com DAP. Uma história prévia de infarto do miocárdio e maior prevalência de hipertensão, diabetes, obesidade e sedentarismo também estiveram associados à DAP. Além disso, a DAP foi mais frequente em negros que em brancos. Após análise multivariada, a idade, diabetes, tabagismo e inatividade física permaneceram independentemente associados à DAP. A prevalência de DAP foi baixa e claramente aumentou com a idade em nossa amostra de uma população rural brasileira. Além disso, os principais fatores de risco para DAP foram tabagismo, sedentarismo, diabetes e idade

The identification of peripheral artery disease (PAD) can help prevent further progression of the disease and additional complications, considering that this condition is a risk factor for all-cause mortality and cardiovascular death. To assess the prevalence of PAD in the Baependi Heart Study and investigate associated risk factors in different age groups. A total of 1,627 individuals (of both genders and aged 18 - 102 years) residing in the municipality of Baependi (Minas Gerais, Brazil) were selected for this study. Anthropometric and biochemical parameters were evaluated by standard techniques. Physical activity level was determined by the International Physical Activity Questionnaire - Short Form (IPAQ-SF). The screening of PAD was performed by determination of the ankle-brachial index (ABI). The level of statistical significance was set at 5%. In the overall sample, the prevalence of PAD was 1.05%, and reached 5.2% after the age of 70 years. The frequency and intensity of smoking were higher in individuals with PAD. A prior history of myocardial infarction and a higher prevalence of hypertension, diabetes, obesity, and sedentary lifestyle were also associated with PAD. In addition, PAD was more frequent in blacks than whites. In multivariable analysis, age, diabetes, smoking, and physical inactivity remained independently associated with PAD. The prevalence of PAD was low and increased clearly with age in our sample from a Brazilian rural population. Furthermore, the main risk factors for PAD in the investigated sample were smoking, sedentary lifestyle, diabetes mellitus, and age

Influence of exercise on oxidative stress in patients with heart failure.

Reactive oxygen species play an important role in the pathophysiology of heart failure (HF). In contrast, regular physical exercise can promote adaptations to reactive oxygen species that are beneficial for patients with HF. We completed a systematic review of randomized controlled trials that evaluate the influence of exercise on oxidative stress in patients with HF. Articles were searched in the PubMed, Cochrane, SciELO, and LILACS databases. The search was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. The quality of the included studies was assessed using the Physiotherapy Evidence Database scale. We selected 12 studies with a total of 353 participants. The included patients had a left ventricle ejection fraction of < 52% and New York Heart Association functional class II or III disease. A significant increase was observed in peak oxygen consumption (between 10 and 46%) in the group that underwent training (TG). There was an improvement in the oxidative capacity of skeletal muscles in the TG, related to the positive activity of mitochondrial cytochrome c oxidase (between 27 and 41%). An increase in the expression of the enzymes glutathione peroxidase (41%), catalase (between 14 and 42%), and superoxide dismutase (74.5%), and a decrease in lipid peroxidation (between 28.8 and 58.5%) were observed in the TG. Physical training positively influenced the cardiorespiratory capacity and enhanced the benefits of oxidant and antioxidant biomarkers in patients with HF. High-intensity training promoted a 15% increase in the plasma total antioxidant capacity, whereas moderate training had no effect.

Association between anthropometric indicators of adiposity and hypertension in a Brazilian population: Baependi Heart Study.

BACKGROUND: Recently, some studies have evaluated the role of adiposity measures in the prediction of hypertension risk, but the results are conflicting. Thus, the aim of this study was to compare which of the four indicators of adiposity (waist circumference-WC, body mass index-BMI, body adiposity index-BAI, and visceral adiposity index-VAI) were better associated with hypertension in a Brazilian population. METHODS AND FINDINGS: For this study, were selected 1627 individuals (both genders, and aged over 18 years) resident in the municipality of Baependi, a city located in the Southeast of Brazil. WC, BMI, BAI and VAI were determined according to a standard protocol. Hypertension was defined as mean systolic blood pressure ≥ 140 mmHg and/or diastolic blood pressure ≥ 90 mmHg, and/or antihypertensive drug use. The indicators of adiposity WC, BMI, BAI, and VAI were higher in hypertensive when compared to non-hypertensive individuals. In addition, WC and BMI were most strongly associated with hypertension in men and women, respectively. The area under the curve (AUC) of WC was significantly higher than VAI in men. In women, both AUC of BMI and WC showed higher discriminatory power to predict hypertension than BAI and VAI. CONCLUSIONS: The indicators of adiposity WC and BMI were better associated with hypertension than BAI and VAI, in both genders, and it could be a useful tools for the screening of hypertensive patients.

Sobrepeso e obesidade: associação com o nível socioeconômico de universitários / Overweight and obesity: association with the socioeconomic level of university students

Objetivo: avaliar a prevalência de sobrepeso e obesidade e a associação com o nível socioeconômico de universitários. Método: estudo quantitativo, transversal, realizado em uma universidade pública, com 550universitários de ambos os sexos e idade entre os 18 e 51 anos. O estado nutricional foi estimado por meio do Índice de Massa Corporal e o nível socioeconômico, por meio de um questionário padronizado. Os dados foram analisados no software SPSS 20.0 e apresentados em uma figura e tabelas. Resultados: a maioria dos universitários era mulheres (66,2%). A prevalência de excesso de peso foi de 20,4%. Os universitários classificados no nível socioeconômico médio e alto apresentaram 2,86 e 3,46 mais chances de desenvolver excesso de peso, respectivamente. Conclusão: os universitários apresentaram considerável prevalência de excesso de peso e os indivíduos, nos níveis socioeconômicos mais elevados, tinham maiores chances de sobrepeso e obesidade.

Insuficiência cardíaca, exercício físico e sistema inflamatório / Heart failure, exercise training and systemic inflammatory

Fundamentação: No contexto do tratamento da insuficiência cardíaca (IC) se torna relevante a melhor compreensão das repercussões da interação entre exercício físico e inflamação, tendo em vista a forte influência de ambos na evolução clínica dos portadores da síndrome. Objetivo: Busca de informações sobre as repercussões do exercício físico no perfil inflamatório de pacientes com IC. Métodos: Busca por periódicos nas bases de dados, CONCHRANE, PUBMED, LILACS. Os seguintes termos MeSH foram utilizados: heart failure, inflammatory mediators e exercise. Os estudos foram selecionados por dois avaliadores, segundo critérios do instrumento Delphi List. Resultados: Dezenove ensaios clínicos controlados foram selecionados. Os estudos foram semelhantes quanto à modalidade e protocolos de exercícios físicos utilizados na investigação dos efeitos no comportamento dos mediadores inflamatórios, havendo, entretanto, predominância no uso da atividade aeróbica de moderada intensidade. Os desfechos dos estudos mostram redução crônica de citocinas pró-inflamatória de ação sistêmica e cardíaca, como também de ação endotelial e de apoptose celular em decorrência do exercício físico. Nenhum estudo avaliou a influência do exercício de alta intensidade sobre os marcadores inflamatórios. Conclusões: Tem sido demonstrado que o exercício físico utilizado predominantemente de forma aeróbica com intensidade moderada proporciona estabilização e diminuição dos marcadores pró-inflamatórios, algo desejável no tratamento da IC. Não foram encontrados estudos evidenciando o efeito isolado do exercício resistido, assim como o efeito do exercício de alta intensidade sobre os marcadores inflamatórios em pacientes com insuficiência cardíaca.

Preditores de transtornos na excitação sexual de participantes de reabilitação cardiopulmonar / Predictors of sexual aurousal disorders in participants of cardiopulmonary rehabilitation program

Objetivo do estudo foi verificar o perfil da função sexual e quais fatores melhor predizem os transtornos na resposta de excitação sexual de participantes de programa de reabilitação cardiopulmonar e metabólica. Participaram 61 homens e 53 mulheres. Para investigar a função sexual foi aplicado Índice Internacional de Função Erétil e Female Sexual Function Índex. Utilizou-se estatística descritiva, teste t student, Quiquadrado e regressão linear, considerando p<0,05. 71,9% dos homens apresentaram disfunção erétil, sendo 28,1% de grau leve, 15,6% moderadamente leve, 9,4% moderada e 18,8% grave. Transtornos de excitação sexual foram preditos para os homens pelos domínios: satisfação sexual (ß:0,445), satisfação geral (ß:0,229) e função orgásmica (ß:0,309). Para as mulheres: orgasmo (ß: 0,440), dor (ß:0,312) e excitação (ß:0,338). Porcentagem significativa da amostra apresentou disfunção sexual e os preditores para transtornos de excitação masculina foram satisfação sexual, satisfação geral e função orgásmica e para as mulheres orgasmo, dor e excitação.

Exercício intenso e suplementação de testosterona em portadores de insuficiência cardíaca / High-intese exercise and testosterone supplementation in individuals with heart failure / Ejercicio intenso y suplementación de testosterona em portadores de insuficiência cardiaca

INTRODUÇÃO: O sono é um estado natural e recorrente, no qual acontecem processos neurobiológicos importantes. A má qualidade do sono está diretamente A insuficiência cardíaca (IC) é uma síndrome com alterações neuroendócrinas, limitações funcionais associadas à baixa qualidade de vida. Há pouco conhecimento dos efeitos do exercício físico de alta intensidade e terapia de suplementação de testosterona (TST) em portadores de IC e hipotestosteronemia. OBJETIVO: Avaliar os efeitos do exercício de alta intensidade associado a TST na qualidade de vida e potência aeróbia destes pacientes. MÉTODOS: Dezenove pacientes portadores de IC (idade media, 58 ± 10 anos; fração de ejeção, 34 ± 8%) foram randomizados para o grupo exercício de alta intensidade (controle; n=9) e exercício de alta intensidade com suplementação hormonal (intervenção; n=10). Os Pacientes exercitaram-se (40 minutos, 90% do consumo máximo de oxigênio) três vezes semanalmente durante 12 semanas. O grupo intervenção recebeu testosterona na primeira e sexta semanas. Antes e após o período de estudo foram obtidas medidas da capacidade funcional e escores do Minnesota Living with Heart Failure Questionnaire. RESULTADOS: No intragrupo controle e intervenção, respectivamente, houve aumento do pico de consumo de oxigênio (12% vs. 15%; p CONCLUSÃO: Exercício de alta intensidade melhora a capacidade funcional e escores da QV após 12 semanas de tratamento. .

INTRODUCTION: Heart failure is a syndrome related to neuroendocrine alterations and limitations on daily activities associated with poor quality of life. Little is known about the effects of high-intensity exercise and testosterone supplementation therapy (TST) on heart failure patients with hypotestosteronemia. OBJECTIVE: To evaluate the effects of high-intensity exercise and testosterone supplementation on quality of life and aerobic power in these patients. METHODS: Nineteen heart failure patients (age=58 ± 10 years; ejection fraction= 34 ± 8%) were randomized to either a high-intensity exercise group (control; n=9) or high-intensity exercise group with hormonal supplementation (intervention; n=10). Patients exercised (40 minutes, 90% peak oxygen consumption) for 12 weeks, three times weekly and intervention group received testosterone in the first and sixth weeks. Functional capacity measurements and Minnesota Living With Heart Failure Questionnaire (MLWHFQ) scores were obtained before and after the study period. RESULTS: Within control and intervention group respectively there was an increase in peak oxygen uptake (12% vs. 15%; p CONCLUSION: High-intensity exercise improves functional capacity and quality of life scores after 12 weeks of treatment. .

INTRODUCCIÓN: La insuficiencia cardiaca (IC) es un síndrome con alteraciones neuroendocrinas, limitaciones funcionales asociadas a la baja calidad de vida. Hay poco conocimiento de los efectos del ejercicio físico de alta intensidad y terapia de suplementación de testosterona (TST) en portadores de IC e hipotestosteronemia. OBJETIVO: Evaluar los efectos del ejercicio de alta intensidad asociado a TST en la calidad de vida y potencia aeróbica de estos pacientes. MÉTODOS: Diecinueve pacientes portadores de IC (promedio de edad= 58 ± 10 años; fracción de eyección= 34 ± 8%) fueron randomizados para el grupo ejercicio de alta intensidad (control; n=9) y ejercicio de alta intensidad con suplementación hormonal (intervención; n=10). Los pacientes se ejercitaron (40 minutos, 90% del consumo máximo de oxígeno) tres veces semanalmente por 12 semanas, el grupo intervención recibió testosterona en la primera y sexta semanas. Antes y después del período de estudio fueron obtenidas medidas de la capacidad funcional y escores del Minnesota Living with Heart Failure Questionnaire. RESULTADOS: Intragrupo control e intervención respectivamente hubo aumento del pico de consumo de oxígeno (12% vs. 15%; p CONCLUSIONES: El ejercicio de alta intensidad mejora la capacidad funcional y escores de la CV después de 12 semanas de tratamiento. .

Capacidade funcional como preditor de qualidade de vida na insuficiência cardíaca / Functional capacity as a predictor of quality of life in heart failure

INTRODUÇÃO: A insuficiência cardíaca (IC) prejudica a qualidade de vida (QV), enquanto a reabilitação cardiopulmonar e metabólica (RCPM) de pacientes com a síndrome proporciona melhora da capacidade funcional (CF) e da qualidade de vida. OBJETIVOS: Determinar a relação dos domínios da QV com a CF de pacientes com IC, assim como propor pontos de corte dos domínios da QV por meio da CF. MATERIAIS E MÉTODOS: Avaliou-se 57 pacientes com IC, classe funcional II e III, sendo 37 ingressantes (GI) no programa de RCPM e 20 participantes (GP) com mais de três meses de programa. A QV foi avaliada pelo questionário de Minnesota por meio dos domínios físicos, emocionais e dimensões gerais. A CF foi determinada por meio do teste de caminhada de seis minutos (TC6'), tendo pontos de corte definidos conforme proposto na literatura. Utilizou-se teste t de Student, correlação de Pearson e análise da curva ROC para responder aos objetivos da pesquisa, considerando significância de 5%. RESULTADOS: Participantes da RCPM apresentaram melhores escores da QV quando comparados aos ingressantes. Correlações significativas foram observadas entre o domínio emocional e TC6' para ambos os grupos. Verificou-se pontos de corte significativos dos domínios da QV advindos da CF, com destaque ao domínio emocional (sensibilidade/especificidade) para ambos os grupos. CONCLUSÃO: Os portadores de IC com mais de três meses de RCPM apresentaram melhor QV e capacidade funcional do que os iniciantes. O domínio emocional do questionário de Minnesota se mostrou um bom preditor de ponto de corte da capacidade funcional.

INTRODUCTION: Heart failure (HF) affects the quality of life (QoL), while metabolic and cardiopulmonary rehabilitation program (MCRP) of patients with the syndrome provides improved functional capacity (FC) and QoL. Objectives: To determine the relationship of the QoL domains with CF in patients with HF and propose cutoff points of the QoL domains by CF. MATERIALS AND METHODS: We evaluated 57 patients with HF functional, class II and III, with 37 beginners (GI) in MCRP and 20 participants (GP) with more than three-month program. QoL was evaluated by the Minnesota through the physical, emotional, and general dimension domains. The CF was determined by testing the six-minute walk (6MWT), with cutoffs defined as proposed in the literature. We used the Student t test, Pearson correlation and ROC curve analysis to answer the research objectives, considering a 5% significance. RESULTS: Participants of RCPM showed better QoL scores when compared to beginners. Significant correlations were observed between the Emotional Domain and 6MWT for both groups. There were significant cutoffs of domains of QoL arising from CF, highlighting the emotional domain (sensitivity/ specificity) for both groups. CONCLUSION: Patients with HF with more than three months MCRP showed better QoL and functional capacity than beginners. The emotional domain of Minnesota questionnaire proved to be a good predictor of cutoff point of functional capacity.

Effects of creatine supplementation on biomarkers of hepatic and renal function in young trained rats.

Creatine supplementation has been widely used by athletes and young physical exercise practioneers in order of increasing muscle mass and enhancing athletic performance, but their use/overuse may represent a health risk on hepatic and renal impaired function. In this study, we evaluated the effects of 40 days of oral creatine supplementation on hepatic and renal function biomarkers in a young animal model. Wistar rats (5 weeks old) were divided in five groups (n = 7): control (CONTR), oral creatine supplementation (CREAT), moderate exercise training (EXERC), moderate exercise training plus oral creatine supplementation (EXERC + CREAT) and pathological group (positive control for liver and kidney injury) by the administration of rifampicin (RIFAMPICIN). Exercise groups were submitted to 60 min/day of swimming exercise session with a 4% of body weight workload for six weeks. The EXERC + CREAT showed the higher body weight at the end of the training protocol. The CREAT and EXERC + CREAT group showed an increase in hepatic (Aspartate transaminase and gamma-glutamyl transpeptidase) and renal (urea and creatinine) biomarkers levels (p < 0.05). Our study showed that the oral creatine supplementation promoted hepatic and renal function challenge in young rats submitted to moderate exercise training.

Validação do Índice Internacional de Função Erétil (IIFE) para uso no Brasil / Validation of the International Index of Erectile Function (IIFE) for use in Brazil

FUNDAMENTO: O Índice Internacional de Função Erétil tem sido proposto como método de avaliação da função sexual, auxiliando no diagnóstico e na classificação da disfunção erétil. No entanto, não foi realizada a validação do IIFE para a língua portuguesa. OBJETIVO: Validar o Índice Internacional de Função Erétil em pacientes portadores de doenças cardiopulmonares e metabólicas. MÉTODOS: A amostra foi composta por 108 participantes portadores de doenças cardiopulmonares e metabólicas de dois programas de reabilitação cardiopulmonar e metabólica (RCPM) do sul do Brasil. A avaliação da clareza do instrumento foi realizada por meio de escala com variação de 0-10, a validação de construto foi realizada pela análise fatorial confirmatória (KMO = 0,85, Barllet p < 0,001), a consistência interna foi analisada pelo alfa de Cronbach. Foram analisados, ainda, os preceitos de reprodutibilidade e confiabilidade interavaliadores por meio do teste reteste. RESULTADOS: Os itens foram julgados muito claros, com médias superiores a 9. A consistência interna resultou em 0,89. A maioria das questões relacionou-se corretamente com seus respectivos domínios, com exceção das três questões do domínio satisfação sexual e uma questão relacionada à função erétil. Os itens apresentaram excelente estabilidade de medida e concordância substancial quase perfeita. CONCLUSÃO: Demonstrou-se que o IIFE é válido e bem compreendido por pacientes que participam de programa de reabilitação cardiopulmonar e metabólica.

BACKGROUND: The International Index of Erectile Function has been proposed as a method for assessing sexual function assisting the diagnosis and classification of erectile dysfunction. However, IIEF was not validated for the Portuguese language. OBJECTIVE: Validate the International Index of Erectile Function in patients with cardiopulmonary and metabolic diseases. METHODS: The sample consisted of 108 participants of to Cardiopulmonary and Metabolic program Rehabilitation (CPMR) in southern Brazil. The clarity assessment of the instrument was performed using a scale ranging from zero to 10. The construct validity was carried out by confirmatory factor analysis (KMO = 0.85; Barllet p < 0.001), internal consistency by Cronbach's alpha and reproducibility and interrater reliability via the test retest method. RESULTS: The items were considered very clear with averages superior to 9. The internal consistency resulted in 0.89. The majority of items related correctly with their domains, with exception of three questions from sexual satisfaction domain, and one from erectile function. All items showed excellent stability of measure and substantial to almost perfect agreement. CONCLUSION: The present study showed that the IIEF is valid and reliable for use in participants of a cardiopulmonary and metabolic rehabilitation program.

Validation of the International Index of Erectile Function (IIFE) for use in Brazil.

BACKGROUND: The International Index of Erectile Function has been proposed as a method for assessing sexual function assisting the diagnosis and classification of erectile dysfunction. However, IIEF was not validated for the Portuguese language. OBJECTIVE: Validate the International Index of Erectile Function in patients with cardiopulmonary and metabolic diseases. METHODS: The sample consisted of 108 participants of to Cardiopulmonary and Metabolic program Rehabilitation (CPMR) in southern Brazil. The clarity assessment of the instrument was performed using a scale ranging from zero to 10. The construct validity was carried out by confirmatory factor analysis (KMO = 0.85; Barllet p < 0.001), internal consistency by Cronbach's alpha and reproducibility and interrater reliability via the test retest method. RESULTS: The items were considered very clear with averages superior to 9. The internal consistency resulted in 0.89. The majority of items related correctly with their domains, with exception of three questions from sexual satisfaction domain, and one from erectile function. All items showed excellent stability of measure and substantial to almost perfect agreement. CONCLUSION: The present study showed that the IIEF is valid and reliable for use in participants of a cardiopulmonary and metabolic rehabilitation program.

Questionário nutricional simplificado de apetite (QNSA) para uso em programas de reabilitação cardiopulmonar e metabólica / Simplified nutritional appetite questionnaire (SNAQ) for cardiopulmonary and metabolic rehabilitation program

O presente estudo teve por objetivo traduzir e validar para a língua portuguesa o Questionário Nutricional Simplificado de Apetite (QNSA), verificando sua clareza e validade para participantes de programa de Reabilitação Cardiopulmonar e Metabólica (RCPM). Cento e quarenta e seis indivíduos foram entrevistados, sendo 79 homens, com média de idade de 63 anos (± 10) e 67 mulheres, com média de 66 anos (± 11). A análise descritiva foi apresentada em média, desvio padrão e frequência. A consistência interna da escala foi avaliada por meio do coeficiente alfa de Cronbach e a análise fatorial pelo método de extração de análise dos componentes principais utilizando os critérios de Kaiser (autovalores > 1). Todas as questões do instrumento apresentaram resultados positivos em relação à clareza. Os itens do questionário apresentaram carga fatorial superior a 0,40, com variação de 0,40 a 0,81. Com exceção da questão relacionada com a quantidade de refeições diárias, todas as demais apresentaram alta correlação com o escore total da versão brasileira do instrumento. No que se refere à análise de consistência interna, obteve-se resultado de 0,61. A versão brasileira do QNSA demonstrou ser válida para aplicação em participantes de programa de RCPM, constituindo-se em uma importante ferramenta na avaliação do apetite nessa população.

This study aimed to translate and validate a Brazilian version of the Simplified Nutritional Appetite Questionnaire (SNAQ), checking its clarity and validity for the participants of the Cardiopulmonary and Metabolic Rehabilitation Program (CPMR). One hundred and forty-six subjects were interviewed: 79 males, mean age of 63 years (±10) and 67 women, mean age of 66 years (±11). Descriptive analysis was presented as mean, standard deviation and frequency. The internal consistency of the scale was assessed using Cronbach's alpha coefficient and factor analysis by the method of extraction of principal components analysis using Kaiser's criteria (eigenvalues > 1). All questions of the instrument showed positive results regarding clarity. The questionnaire items presented factor loadings above 0.40, (ranging from 0.40 to 0.81). Except for the issue related to the amount of daily meals, all others showed high correlation with the total score of the Brazilian version. Regarding the analysis of internal consistency, the result of 0.61 was reached. In conclusion, the Brazilian Version of SNAQ proved to be valid for use in CPMR program participants, thus becoming an important tool in assessing the appetite of the Brazilian population.

[Probability of arterial hypertension from anthropometric measures in adults]. / Probabilidade de hipertensão arterial a partir de indicadores antropométricos em adultos.

OBJECTIVE: To associate anthropometric measures with arterial hypertension and develop a mathematical model to estimate this probability. SUBJECTS AND METHODS: A cross-sectional study was carried out with 3,445 adults of both sexes, between 18 and 60 years of age. Body mass index (BMI), waist-to-height ratio (WHR), waist circumference (HC), in addition age and sex were assessed. Blood pressure (BP) was measured and classified according to World Health Organization (WHO) and Brazilian Society of Hypertension (SBH) recommendations, using frequency analyses, correlation and logistic regression between variables, with p < 0.05. RESULTS: Males were twice as likely as woman to have hypertension, and for each year of life, the chance of hypertension increased 1.04 times. Odds ratio of hypertension in overweight individual increased two times, and in obese subjects, four times. CONCLUSION: Changes in body composition with advancing age, especially in men, were associated with hypertension, and assessment of these changes was relevant in the identification of this disease.