Functional training improves peak oxygen consumption and quality of life of individuals with heart failure: a randomized clinical trial.

BACKGROUND: Functional training may be an effective non-pharmacological therapy for heart failure (HF). This study aimed to compare the effects of functional training with strength training on peak VO2 and quality of life in individuals with HF. METHODS: A randomized, parallel-design and examiner-blinded controlled clinical trial with concealed allocation, intention-to-treat and per-protocol analyses. Twenty-seven participants with chronic HF were randomly allocated to functional or strength training group, to perform a 12-week physical training, three times per week, totalizing 36 sessions. Primary outcomes were the difference on peak VO2 and quality of life assessed by cardiopulmonary exercise testing and Minnesota Living with Heart Failure Questionnaire, respectively. Secondary outcomes included functionality assessed by the Duke Activity Status Index and gait speed test, peripheral and inspiratory muscular strength, assessed by hand grip and manovacuometry testing, respectively, endothelial function by brachial artery flow-mediated dilation, and lean body mass by arm muscle circumference. RESULTS: Participants were aged 60 ± 7 years, with left ventricular ejection fraction 29 ± 8.5%. The functional and strength training groups showed the following results, respectively: peak VO2 increased by 1.4 ± 3.2 (16.9 ± 2.9 to 18.6 ± 4.8 mL.kg-1.min-1; p time = 0.011) and 1.5 ± 2.5 mL.kg-1.min-1 (16.8 ± 4.0 to 18.6 ± 5.5 mL.kg-1.min-1; p time = 0.011), and quality of life score decreased by 14 ± 15 (25.8 ± 14.8 to 10.3 ± 7.8 points; p time = 0.001) and 12 ± 28 points (33.8 ± 23.8 to 19.0 ± 15.1 points; p time = 0.001), but no difference was observed between groups (peak VO2: p interaction = 0.921 and quality of life: p interaction = 0.921). The functional and strength training increased the activity status index by 6.5 ± 12 and 5.2 ± 13 points (p time = 0.001), respectively, and gait speed by 0.2 ± 0.3 m/s (p time = 0.002) in both groups. CONCLUSIONS: Functional and strength training are equally effective in improving peak VO2, quality of life, and functionality in individuals with HF. These findings suggest that functional training may be a promising and innovative exercise-based strategy to treat HF. TRIAL REGISTRATION: NCT03321682. Registered date: 26/10/2017.

Cardiopulmonary exercise capacity and quality of life of patients with heart failure undergoing a functional training program: study protocol for a randomized clinical trial.

BACKGROUND: Exercise intolerance is a common finding in heart failure that generates a vicious cycle in which the individual starts to limit his activities even more due to progressive fatigue. Regular physical exercise can increase the cardiopulmonary exercise capacity of these individuals. A new approach to physical exercise, known as functional training, could improve the oxygen consumption and quality of life of patients with heart failure; however, there is no information about the effect of this modality of exercise in this patient population. This randomized trial will compare the effects of 36 sessions of functional training versus strength training in heart failure patients. METHODS: This randomized parallel-design examiner-blinded clinical trial includes individuals of both sexes aged ≥40 years receiving regular follow-up at a single academic hospital. Subjects will be randomly allocated to an intervention group (for 12-week functional training) or an active comparator group (for 12-week strength training). The primary outcomes will be the difference from baseline to the 3-month time point in peak oxygen consumption on cardiopulmonary exercise testing and quality of life assessed by the Minnesota Living with Heart Failure Questionnaire. Secondary outcome measures will include functionality assessed by the Duke Activity Status Index and gait speed test; peripheral and inspiratory muscular strength, assessed by hand grip and manovacuometry testing, respectively; endothelial function by brachial artery flow-mediated dilation; lean body mass by arm muscle circumference; and participant adherence to the exercise programs classified as a percentage of the prescribed exercise dose. DISCUSSION: The functional training program aims to improve the functional capacity of the individual using exercises that relate to his specific physical activity transferring gains effectively to one's daily life. In this context, we believe that that functional training can increase the cardiopulmonary exercise capacity and quality of life of patients with heart failure. The trial has been recruiting patients since October 2017. TRIAL REGISTRATION: NCT03321682. Registered on October 26, 2017.

Differential HLA class I and class II associations in pemphigus foliaceus and pemphigus vulgaris patients from a prevalent Southeastern Brazilian region.

Genetic factors, particularly those concerning HLA class II, have been associated with the pathogenesis of pemphigus. Taking advantage of an area where pemphigus foliaceus (PF) and pemphigus vulgaris (PV) are prevalent in the northeastern region of the state of São Paulo, Southeastern Brazil, we have studied the HLA class I (A, B and C) and class II (DRB1 and DQA1/DQB1) profiles in 86 and 83 patients with PF and PV, respectively, as compared with 1592 controls from the same region. Among all the HLA alleles described herein, the more prevalent susceptibility alleles for PF were HLA-A*11, 33, -B*14; -DRB1*01:01, *01:02; -DQA1*01:02; and -DQB1*05:01. In PV patients, the HLA-B*38; -C*12; -DRB1*04:02, *08:04, *14:01, *14:04; -DQA1*03:01; and -DQB1*03:02 and *05:03 alleles were associated with susceptibility. The HLA-DRB1*01:02 allele and the HLA-DRB1*01-DQA1*01-DQB1*05 haplotype in PF patients and the HLA-DRB1*04:02 and *14:01 alleles and the HLA-DRB1*14-DQA1*01-DQB1*05 haplotype in PV patients were related with the highest etiologic fraction values. Distinct genetic patterns and not yet described HLA susceptibility/protection alleles/haplotypes profiles have been observed in this series. Our findings corroborate the differential genetic markers in PF and PV in an area where pemphigus is prevalent but not yet reported.

Nitric oxide-induced regulatory T cells inhibit Th17 but not Th1 cell differentiation and function.

NO is a free radical with pleiotropic functions. We have shown earlier that NO induces a population of CD4(+)CD25(+)Foxp3(-) regulatory T cells (NO-Tregs) that suppress the functions of CD4(+)CD25(-) effector T cells in vitro and in vivo. We report in this study an unexpected finding that NO-Tregs suppressed Th17 but not Th1 cell differentiation and function. In contrast, natural Tregs (nTregs), which suppressed Th1 cells, failed to suppress Th17 cells. Consistent with this observation, NO-Tregs inhibited the expression of retinoic acid-related orphan receptor γt but not T-bet, whereas nTregs suppressed T-bet but not retinoic acid-related orphan receptor γt expression. The NO-Treg-mediated suppression of Th17 was partially cell contact-dependent and was associated with IL-10. In vivo, adoptively transferred NO-Tregs potently attenuated experimental autoimmune encephalomyelitis. The disease suppression was accompanied by a reduction of Th17, but not Th1 cells in the draining lymph nodes, and a decrease in the production of IL-17, but an increase in IL-10 synthesis. Our results therefore demonstrate the differential suppressive function between NO-Tregs and nTregs and indicate specialization of the regulatory mechanism of the immune system.

Context affects nestmate recognition errors in honey bees and stingless bees.

Nestmate recognition studies, where a discriminator first recognises and then behaviourally discriminates (accepts/rejects) another individual, have used a variety of methodologies and contexts. This is potentially problematic because recognition errors in discrimination behaviour are predicted to be context-dependent. Here we compare the recognition decisions (accept/reject) of discriminators in two eusocial bees, Apis mellifera and Tetragonisca angustula, under different contexts. These contexts include natural guards at the hive entrance (control); natural guards held in plastic test arenas away from the hive entrance that vary either in the presence or absence of colony odour or the presence or absence of an additional nestmate discriminator; and, for the honey bee, the inside of the nest. For both honey bee and stingless bee guards, total recognition errors of behavioural discrimination made by guards (% nestmates rejected + % non-nestmates accepted) are much lower at the colony entrance (honey bee: 30.9%; stingless bee: 33.3%) than in the test arenas (honey bee: 60-86%; stingless bee: 61-81%; P<0.001 for both). Within the test arenas, the presence of colony odour specifically reduced the total recognition errors in honey bees, although this reduction still fell short of bringing error levels down to what was found at the colony entrance. Lastly, in honey bees, the data show that the in-nest collective behavioural discrimination by ca. 30 workers that contact an intruder is insufficient to achieve error-free recognition and is not as effective as the discrimination by guards at the entrance. Overall, these data demonstrate that context is a significant factor in a discriminators' ability to make appropriate recognition decisions, and should be considered when designing recognition study methodologies.

Morphofunctional parameters, physical fitness and musculoskeletal symptoms in cooperative recyclers.

Introduction: Members of solid waste recycling cooperatives are exposed to serious conditions and complications in their everyday life, which makes them likely to present poor quality of life and unfavorable health conditions in their work environment. Objectives: To evaluate morphofunctional parameters, physical fitness, and musculoskeletal symptoms of workers at solid waste recycling cooperatives in Maringá, state of Paraná, Brazil. Methods: This was a quantitative, cross-sectional, descriptive study. Data were collected from 60 cooperative members of both sexes linked to the Popular and Solidarity Recycling Association of Maringá. Participants underwent a medical screening at the cooperative, involving anamnesis, pulmonary and cardiac auscultation, and blood pressure measurement. In a second moment, they underwent physical assessment in the laboratory, using instruments for physical tests and questionnaires. Results: There was a predominance of females in the sample (54%), with a mean age of 41.82±12.03 years, and most participants did not practice physical activity (70%). With regard to body composition, women had the highest body mass index (28.29±6.61 kg/m2); as for the variables physical and aerobic fitness, men showed better scores than women (p < 0.05). In relation to musculoskeletal symptoms, most participants complained of lower back pain (56.66%). Conclusions: Although the results for anthropometric variables are within normal standards in most cooperative members, most of them present with musculoskeletal symptoms and do not practice physical activity, which can have negative implications in their health conditions in the medium and long term.

Introdução: Os cooperados de reciclagem de resíduos sólidos são expostos a gravidades e complicações no seu dia a dia. Diante disso, é possível que apresentem uma má qualidade de vida e condições de saúde não favoráveis em seu âmbito de trabalho. Objetivos: Avaliar os parâmetros morfofuncionais, a aptidão física e os sintomas osteomusculares dos trabalhadores das cooperativas de reciclagem de resíduos sólidos de Maringá, no estado do Paraná. Métodos: Tratou-se de estudo quantitativo do tipo transversal descritivo. Foram coletados dados de 60 cooperados, de ambos os sexos, vinculados à Associação de Reciclagem Popular e Solidária de Maringá. Os participantes foram submetidos a uma triagem médica na cooperativa, envolvendo anamnese, ausculta pulmonar e cardíaca e mensuração da pressão arterial. Em um segundo momento, foram submetidos à avaliação física em laboratório, com a utilização de instrumentos para testes físicos e preenchimento de questionários. Resultados: Na amostra, houve predomínio do sexo feminino (54%), com média de idade de 41,82±12,03, e a maioria não praticava exercícios físicos (70%). Quanto à composição corporal, o sexo feminino apresentou maior índice de massa corporal (28,29±6,61 kg/m2); para as variáveis de aptidão física e aeróbia, o sexo masculino apresentou melhores escores em relação ao sexo feminino (p < 0,05). Em relação aos sintomas osteomusculares, a maioria relatou sintomas de dor na parte inferior das costas (56,66%). Conclusões: Apesar de os resultados das variáveis antropométricas da maioria dos cooperados encontrarem-se dentro dos padrões de normalidade, a maioria apresenta sintomas osteomusculares e não pratica atividades físicas, o que pode ter implicações negativas nas suas condições de saúde a médio e longo prazo.

First molecular detection of Leishmania (Leishmania) infantum chagasi in a domestic cat (Felis catus) from an urban area in eastern Amazon.

Background: Domestic cats have been implicated as accidental hosts of Leishmania sp. However, in recent years, the recurrent description of new cases in endemic and nonendemic areas draw attention to the potential epidemiological role of cats as reservoir hosts. Although dogs are considered urban reservoirs, cats could act as a secondary natural reservoirs in these areas. Thus, feline leishmaniasis has become an emerging disease in several countries worldwide. Case presentation: This study aimed to describe the first case of feline leishmaniasis in a stray animal that presented lesions compatible with the disease in Belém, Pará, Brazil, an important urban area in eastern Amazon. Serological tests for Leishmania infantum (ELISA and IFA) were nonreactive, whereas histopathological examination indicated infectious dermatitis caused by Leishmania spp. or Toxoplasma gondii. Cytopathological study of lesion aspirate confirmed the presence of Leishmania sp. amastigotes within macrophages. Finally, molecular analyses revealed that the feline infection was caused by Leishmania (Leishmania) infantum chagasi. Conclusion: To the best of the authors' knowledge, this study reports the first case of natural infection by Leishmania (Leishmania) infantum chagasi in a feline from eastern Amazon. These findings suggest domestic cats as potential secondary reservoir hosts of Leishmania spp. in Belém, which reinforces the importance of further epidemiological investigation of feline leishmaniasis, especially in urban areas with human cases.

Meta-Analysis of Physical Training on Natriuretic Peptides and Inflammation in Heart Failure.

Physical training has been reported to attenuate myocardial stress and inflammation in heart failure (HF). We aimed to assess the impact of physical training on B-type natriuretic peptide and N-terminal pro-B-type natriuretic peptide (NT-proBNP), as well as biomarkers of inflammation-C-reactive protein, tumor necrosis factor α (TNF-α), and interleukins (ILs). A systematic electronic literature search was conducted up to May 2021 in PubMed, Cochrane Library, CINAHL, Embase, and SPORTDiscus to identify randomized clinical trials reporting associations between any formal physical training intervention and biomarker levels in patients with HF. Random-effects meta-analyses was used to calculate pooled correlations between physical training and blood biomarkers. Biomarker outcomes were expressed as mean difference or ratio of means and 95% confidence interval between the intervention and control groups, according to the normality of the data. A total of 38 trials were included in the final meta-analysis (2,652 randomized patients). Physical training was associated with decreased B-type natriuretic peptide (p = 0.02), NT-proBNP (p <0.01), C-reactive protein (p <0.00001), TNF-α (p = 0.03), IL-6 (p = 0.04), and IL-1ß (p = 0.001). Aerobic continuous training was associated with a 35% reduction in NT-proBNP (p = 0.01); ≥150 min/week of exercise was associated with a greater reduction in TNF-α levels (p = 0.0004), and aerobic interval training was associated with lower IL-6 levels (p = 0.01). In conclusion, physical training in patients with HF is associated with beneficial effects on natriuretic peptides and biomarkers of inflammation because they were all reduced by the intervention.

Association Between Physical Exercise Interventions Participation and Functional Capacity in Individuals with Type 2 Diabetes: A Systematic Review and Meta-Analysis of Controlled Trials.

BACKGROUND: The prevalence of type 2 diabetes mellitus increases with age, and people with type 2 diabetes are more affected by reductions in functional performance. Although exercise interventions are recommended for people with diabetes, it is relevant to assess the effects of different training modes on the available functional outcomes. Therefore, our purpose was to systematically assess the effect of different physical exercise modalities in patients with type 2 diabetes with an average age of 45 years or older on outcomes used to measure functional capacity. METHODS: A systematic review and meta-analysis of controlled trials was conducted. Seven databases were searched from January 1987 to December 2021 (PubMed, Physiotherapy Evidence Database, Cochrane Library, SPORTDiscus, and in grey literature: Open Grey and Google Scholar). Eligible studies should last 8 weeks or longer, comparing structured exercise training and non-exercise control for one out of six pre-specified functional capacity outcomes (Timed Up and Go test, chair stands, walking performance, upper-limb muscle strength, lower-limb muscle strength, physical fitness parameter), in patients with type 2 diabetes, aged ≥ 45 years. The risk of bias was assessed with the Downs & Black checklist. Pooled mean differences were calculated using a random-effects model, followed by sensitivity and meta-regression analyses. RESULTS: Of 18,112 references retrieved, 29 trials (1557 patients) were included. Among these, 13 studies used aerobic training, 6 studies used combined training, 4 studies used resistance training, 3 studies had multiple intervention arms and 3 studies used other types of training. Exercise training was associated with an increase in functional capacity outcomes, as reflected by changes in 6-min walk test (n = 8) [51.6 m; 95% CI 7.6% to 95.6%; I2 92%], one-repetition maximum leg-press (n = 3) [18.0 kg; 95% CI 4.0% to 31.9%; I2 0%], and maximum oxygen consumption (VO2max) (n = 20) [2.41 mL/kg·min; 95% CI 1.89% to 2.92%; I2 100%] compared with control groups. In sensitivity and subgroup analyses using VO2max as outcome and stratified by type of study (randomized and non-randomized controlled clinical trials), duration of diabetes diagnosis, and sex, we observed overlapping confidence intervals. Meta-regression showed no association between glycated hemoglobin (HbA1C) levels and VO2max [p = 0.34; I2 99.6%; R2 = 2.6%]. In addition, the quality of the included studies was mostly low. CONCLUSION: The results indicate that structured physical exercise programs might improve functional capacity in patients with type 2 diabetes, except for the upper-limb muscle strength. However, we could not identify potential effect predictors associated with directional summary estimates. Trial registration This systematic review was registered in the PROSPERO international prospective register of systematic reviews (CRD42020162467); date of registration: 12/15/2019. The review protocol is hosted at the Open Science Framework (OSF) (Preprint https://doi.org/10.31219/osf.io/kpg2m ).

First highly sensitive and specific competitive ELISA for detection of bovine besnoitiosis with potential as a multi-species test.

Serological cross-reactions represent a serious problem in some currently available tests to diagnose Besnoitia infections in many species including cattle, caribou and donkeys. False-positive results are due to the low positive-predictive value of these serological tests for besnoitiosis. These tests therefore have clear limitations if large herds are screened in areas with low prevalence, since increased numbers of false-positive reactions require confirmatory testing by alternative serological methods, e.g. immunoblotting, which are time-consuming and create extra costs. To overcome this problem, we aimed to develop a highly sensitive and specific competitive ELISA (cELISA) using a panel of 12 monoclonal antibodies raised against the tachyzoite stage of Besnoitia besnoiti. A cELISA set up with one of these antibodies (Bb-cELISA1) was screened with a large panel of B. besnoiti-positive bovine sera to estimate the diagnostic sensitivity of the test. Sera from herds with Neospora caninum- or Sarcocystis spp.-infected cattle were used to estimate its diagnostic specificity. Relative to a reference standard, which combined the results obtained in a previously established highly sensitive and specific ELISA, in the immunofluorescence antibody test and in B. besnoiti tachyzoite and bradyzoite immunoblots, the new Bb-cELISA1 revealed a diagnostic sensitivity of 99.2% (95% confidence interval: 97.1-99.9%) and a diagnostic specificity of 99.9% (95% confidence interval: 97.7-100%). This novel assay was tested on a variety of proven Besnoitia-positive sera from other species, including B. besnoiti-infected cats, rabbits or Besnoitia bennetti-infected donkeys or Besnoitia tarandi-infected caribou. The results obtained with the new Besnoitia-cELISA for these animal species also corresponded almost perfectly with those of the reference tests, which included immunoblot and immunofluorescence antibody tests. In conclusion, the novel Besnoitia-cELISA represents a valuable tool for the diagnosis and control of bovine besnoitiosis and for studies on the epidemiology of Besnoitia infections in a variety of host species, including naturally exposed wildlife and experimental hosts.

Colletotrichum species causing cassava (Manihot esculenta Crantz) anthracnose in different eco-zones within the Recôncavo Region of Bahia, Brazil.

A survey to investigate the occurrence of cassava anthracnose disease (CAD) and distribution of Colletotrichum spp. in cassava plantations in different eco-zones of the Reconcavo Region in Bahia, Brazil, investigated during the rainy season of 2014. A total of 50 cassava fields distributed among 18 municipalities were visited and intensity of anthracnose evaluated. The highest disease incidence (DI) (83.3%) was in samples collected in São Félix, and the lowest (34.4%), in Varzedo. Municipalities that presented the highest values for DI were located within the 'Af' Köppen-Geiger eco-zone, also presenting the highest values for the estimated McKinney disease index. Based on previous studies of multilocus phylogeny, seven different species of Colletotrichum were identified (Colletotrichum fructicola, Colletotrichum tropicale, Colletotrichum gloeosporioides s.s, Colletotrichum theobromicola, Colletotrichum siamense, Colletotrichum brevisporum and Colletotrichum plurivorum) and a new approach based on ERIC-PCR was used aiming to group the 82 isolates according to these findings. The highest percentage of genetic variance (> 78%) was among isolates within fields. Based on the survey and genetic analysis, C. fructicola is probably the main causal agent of cassava anthracnose in the Recôncavo Region, since this species was present with highest incidence in all eco-zones, 47.61, 42.86 and 57.14% for Af (tropical rainforest climate), As (tropical dry savanna climate) and Aw (tropical wet savanna climate), respectively. This study is the first report of C. fructicola lineages as the most likely pathogen causing anthracnose disease of cassava in Brazil, and these findings may be used to guide the selection of resistant varieties.

Is Frailty Syndrome a Predictor of Morbimortality in Postoperative Cardiac Surgery? - A Retrospective Cohort Study

Abstract Background Frailty is a biological syndrome suggested as a better predictor of morbimortality than chronological age. Objective To assess associations between frailty and morbimortality outcomes in postoperative cardiac surgery. Methods A retrospective cohort study was conducted with cardiac surgery patients. Frailty and maximal inspiratory pressure (MIP) were assessed before surgery. Postoperative outcomes were: extracorporeal circulation time; use of vasopressor; mean arterial pressure (MAP); red blood cell (RBC) transfusion; cardiac arrhythmia and/or heart arrest; presence of intra-aortic balloon pump; antibiotic use; extubation time; length of stay in the intensive care unit (ICU); length of postoperative stay; mortality. One-way ANOVA was used to compare postoperative variables between frailty categories; Spearman was used to evaluate the correlations between frailty and postoperative variables. Age, sex, and MIP were introduced into multiple regression models to find the independent association between postoperative variables and frailty. A significance level of p < 0.05 was adopted. Results The medical records of 200 patients were analyzed (65.7±7.2 years; 68.5% men; 63.5% non-frail, 22.5% pre-frail, 14% frail). Frailty was not a predictor of postoperative outcomes. Age was an independent predictor for alterations in MAP (PR: 1.028, 95% CI: 1.003-1.053, p=0.025), need for RBC transfusion (PR: 1.034, 95% CI: 1.007-1.062, p=0.014), longer extubation time (PR: 1.052, 95% CI: 1.023-1.083, p<0.001), length of stay in the ICU (ß: 0.031, 95% CI: 0.010-0.053, p=0.005), length of postoperative stay (ß: 0.017, 95% CI: 0.003-0.031, p=0.015). Conclusions Frailty was not a predictor of morbimortality following cardiac surgery in middle-aged and older adults; however, age did predict morbidities in this setting.

Data on HLA class I/II profile in Brazilian pemphigus patients.

Pemphigus are blistering autoimmune diseases related with genetic and environmental factors. Here we describe HLA genotyping in pemphigus patients. First, we review the HLA class I/II data on pemphigus reported in Brazilian samples and then present the HLA class I (-A, -B, -C) and class II (-DRB1, -DQA1, -DQB1) alleles related to susceptibility/resistance to pemphigus by comparing 86 patients with pemphigus foliaceus, 83 patients with pemphigus vulgaris, and 1592 controls from the northeastern region of the state of São Paulo, Southeastern Brazil. The data presented here are related to the manuscript "Differential HLA class I and class II associations in Pemphigus Foliaceus and Pemphigus Vulgaris patients from a prevalent Southeastern Brazilian region" Brochado et al. (2016) [1].

Foliar Substrate Affects Cuticular Hydrocarbon Profiles and Intraspecific Aggression in the Leafcutter Ant Atta sexdens.

Cuticular hydrocarbons (CHCs) are traditionally considered to be one of the most important chemical cues used in the nestmate recognition process of social hymenopterans. However, it has been suggested that in the leafcutter ant genus Atta, it is not the CHCs, but the alarm pheromone that is involved in the nestmate recognition process. In this study we used a laboratory population of Atta sexdens to explore the association between their CHC profile variation and intraspecific aggression. In the first part of the experiment, four colonies were divided into two groups with distinct diets to stimulate differentiation of their CHC profiles. In the second part of the experiment, all colonies received the same diet to examine resemblance of chemical profiles. At the end of each part of the experiment we extracted the CHCs from workers. The results demonstrated that colonies that shared the same food resource had similar cuticular hydrocarbon profiles. Furthermore, colonies were significantly more aggressive towards conspecifics that used a different foliar substrate and consequently had greater differences in their cuticular chemical composition. This study suggests that the CHC profiles of A. sexdens can be affected by the foliar substrates used, and that the CHCs are used in the nestmate recognition process of this species.

Reasoning, Affectivity and School Performance at the end of Portuguese Elementary Education: Which Variables To Consider? / Raciocínio, Afetividade e Rendimento Escolar no Final do Ensino Básico Português: Que Variáveis Considerar? / Razonamiento, Afectividad y Rendimiento Escolar al Final de la Educación Básica Portuguesa: ¿Qué Variables a que Tener en Cuenta?

Abstract Elementary education is a stage in which children and adolescents develop reasoning and affectivity, variables often associated with school performance. This study aims to analyze the relationship between reasoning, affectivity and school performance in Portuguese and Mathematics, considering sociodemographic, relational and academic characteristics. In a non-probabilistic sample of 226 ninth graders from three different Portuguese basic schools, we collected sociodemographic, relational and academic data, and applied instruments to assess reasoning and affectivity. The results show correlation between reasoning, affectivity, school performance, parental education and quality of relationships with parents, teachers and classmates. We found differences in reasoning, affectivity and school performance based on gender, retention history, liking for school and study activities; however, there was no verification of difference regarding variables such as having separated parents, having siblings or practicing leisure activities in spare time. These results should be considered as to develop interventions to promote academic success in students who are in their final year of elementary education.

Resumo O ensino básico é uma etapa na qual crianças e adolescentes desenvolvem o raciocínio e a afetividade, variáveis associadas ao rendimento escolar. Este estudo tem como objetivo estudar a relação entre raciocínio, afetividade e rendimento escolar em Português e Matemática, tendo em consideração caraterísticas sociodemográficas, relacionais e escolares. Numa amostra não-probabilística de 226 alunos do 9º ano de três escolas básicas portuguesas, foram recolhidas medidas sociodemográficas, relacionais e escolares, e aplicados instrumentos para avaliar o raciocínio e a afetividade. Os resultados evidenciam correlações entre raciocínio, afetividade, rendimento escolar, escolaridade dos pais e qualidade dos relacionamentos com pais, professores e pares. Foram encontradas diferenças no raciocínio, afetividade e rendimento escolar, mediante o gênero, histórias de retenção, gosto pela escola e pelo estudo, não se verificando diferenças mediante variáveis como ter pais separados, ter irmãos, ou praticar atividades nos tempos livres. Estes resultados devem ser tidos em consideração em intervenções para a promoção do sucesso escolar em alunos que estejam no último ano do ensino básico.

Resumen La enseñanza básica es una etapa en la que niños y adolescentes desarrollan el razonamiento y los afectos, variables asociadas al rendimiento escolar. Este estudio tiene como objetivo estudiar la relación entre razonamiento, afectividad y rendimiento escolar en Lengua Portuguesa y Matemáticas, teniendo en cuenta las características demográficas, relacionales y escolares. De una muestra no probabilística de 226 estudiantes en el 9.º grado de la secundaria en tres escuelas portuguesas, se tomaron medidas sociodemográficas, educativas y relacionales, y se aplicaron instrumentos para evaluar el razonamiento y la afectividad. Los resultados evidencian correlaciones entre raciocinio, afectividad, rendimiento escolar, escolaridad de los padres y calidad de las relaciones con padres, profesores y pares. Se encontraron diferencias en el razonamiento, afectividad y rendimiento escolar, mediante el género, historias de retención, gusto por la escuela y por los estudios, no verificándose diferencias mediante variables como tener padres separados, tener hermanos, o practicar actividades en el tiempo libre. Estos resultados deben tenerse en cuenta en las intervenciones para promover el éxito escolar en los alumnos que se encuentren en el último grado de la educación básica.

Depressão e ansiedade na enfermagem em unidade de terapia intensiva / Depression and anxiety in nursing in an intensive care unit / Delecion y anxiety en la enfermedad en una unidad de cuidado intensivo

Introdução:A depressão é definida como uma síndrome, composta de diversos sintomas físicos e emocionais, com implicações sobre as capacidades comportamentais dos indivíduos. Numa Unidade de Terapia Intensiva, é quesito que o profissional possua agilidade na tomada de decisões, um cuidado livre de danos, conhecimentoclínicoe controle emocional. Esses elementos, agregados aos hábitos de vida, conflitos e estresse no ambiente laboral podem desencadear nesses profissionais transtornos como depressão e ansiedade. Objetivo:Identificar a prevalência de depressão e ansiedade em profissionais de enfermagem que atuam em Unidade de terapia intensiva adulto.Metodologia:Pesquisa descritiva, transversal com abordagem quantitativa. Por tratar-se de um censo, a população foi composta por toda equipe de enfermagem que atua emnessa unidade adultode dois hospitais de grande porte da rede pública de saúde do município de Caruaru, estado de Pernambucoeque atendiam aos critérios de elegibilidade. Para a coleta de dados utilizou-se um questionário sociodemográfico e os inventários de depressãoe ansiedade de Beck. Adotou-se estatística descritiva para a análise dos dados. Resultados:Amédia de idade dos profissionais foi de 35 anos, onde 86% são do gênero feminino e sua maioria são casados (46%). Observou-se que 77% da amostra não apresenta sintomas depressivos. Já no que se refere aos sintomas ansiosos, 85% apresentaram grau mínimo de ansiedade. Conclusões:Os resultados desse estudo evidenciaram uma baixa prevalência de depressão e ansiedade. Tais resultados trazem aos gestores de saúde a possibilidade de atentar-se e rever as práticas adotadas nas instituições hospitalares. Recomenda-se que outros estudos, com análises mais robustas, sejam realizados no intuito de se ampliar o conhecimento sobre a temática (AU).

Introduction:Depression is defined as a syndrome, composed of several physical and emotional symptoms, with implications for the behavioral capacities of individuals. In anIntensive Care Unit, it is a fact that the professional has agility in decision making, a carefree of damage, clinical knowledge and emotional control. These elements, added to life habits, conflicts and stress in the work environment can trigger disorders such as depression and anxiety in these professionals.Objective:To identify the prevalence of depression and anxiety in nursing professionals working in the adult intensive care unit.Methodology:Descriptive, cross-sectional research with quantitative approach. Because it is a census, the population was composed of a nursing team working in an Adult of two large hospitals in the public health networkof the municipality of Caruaru, state of the Pernambucoand that met the eligibility criteria. For data collection, a sociodemographic questionnaire and Beck's depression and anxiety inventories were used. Descriptive statistics were adopted for data analysis.Results:The mean age of professionals was 35 years, where 86% are female and most are married (46%). It was observed that 77% of the sample did not present depressive symptoms. Regarding anxious symptoms, 85% had a minimum degree of anxiety. Conclusions:The results of this study showed a low prevalence of depression and anxiety. These results bring health managers the possibility of paying attention and reviewing the practices adopted in hospital institutions. It is recommended that other studies, with more robustanalyses, be carried out in order to expand knowledge on the subject (AU).

Introducción: La depresión se define como un síndrome, compuesto por varios síntomas físicos y emocionales, con implicaciones para las capacidades conductuales de las personas. En una Unidad de Cuidados Intensivos, es un hecho que el profesional tiene agilidad en la toma de decisiones, una atención libre de daños, conocimiento clínico y control emocional. Estos elementos, añadidos a los hábitos de vida, conflictos y estrés en el entorno de trabajo pueden desencadenar trastornos como la depresión y la ansiedad en estos profesionales.Objetivo:Identificar la prevalencia de depresión y ansiedad en los profesionales de enfermería que trabajan en la unidad de cuidados intensivos para adultos. Metodología: Investigación descriptiva y transversal con enfoque cuantitativo. Debido a que se trata de un censo, la población estaba compuesta por un equipo de enfermería que trabajaba en una unidadadulta de dos grandes hospitales de la red de salud pública del municipio de Caruaru-Pernambucoy que cumplía con los criterios de elegibilidad. Para la recopilación de datos, se utilizó un cuestionario sociodemográfico y los inventarios de depresión y ansiedad de Beck. Se adoptaron estadísticas descriptivas para el análisis de datos.Resultados: La edad media de los profesionales fue de 35 años, donde el 86% son mujeres y la mayoría están casados (46%). Se observó que el 77% de la muestra no presentó síntomas depresivos. En cuanto a los síntomas ansiosos, el 85% tenía un grado mínimo de ansiedad. Conclusiones: Los resultados de este estudio mostraron una baja prevalencia de depresión y ansiedad. Estos resultados traen a los gerentes de salud la posibilidad de prestar atención y revisar las prácticas adoptadas en las instituciones hospitalarias. Se recomienda que se lleven a cabo otros estudios, con análisis más sólidos, con el fin de ampliar el conocimiento sobre el tema (AU).

Hemodynamic changes and autonomic nervous system after acute myocardial infarction in rats submitted to left coronary artery ligation

Introduction: Heart failure is a clinical syndrome characterized by sympathetic/ renin-angiotensin system activation, besides parasympathetic activity attenuation. In the initial phase of HF, following a myocardial infarction, there is impairment of the ventricular function and this can be influenced by the myocardium ischemia area in addition to alteration in the autonomic control of the heart. The aim of this study is to evaluate the hemodynamic responses and autonomic nervous system and its associations in infarcted rats by left coronary artery ligation. Methods: Forty male rats were submitted to left coronary artery ligation: infarcted animals with fifteen days from cardiac surgery (I15), infarcted animals with thirty days from cardiac surgery (I30) and sham-operated groups (S15 and S30), with 10 animals in each group. Basal hemodynamic data and heart rate variability (spectral analysis) were evaluated. Results: Compared to control groups, the infarcted rats demonstrated the following complications: a) cardiac hypertrophy (I30); b) pulmonary congestion (I30); c) mean arterial pressure (MAP), systolic arterial pressure (SAP) and diastolic arterial pressure (DAP) reduction; d) left ventricular systolic pressure (LVSP) reduction and left ventricular end-diastolic pressure (LVEDP) rise; e) contractile (+dP/dt) and relaxation derivatives (-dP/dt) reduction; f) sympathetic cardiac activity increase, and parasympathetic cardiac activity reduction (I30). Conclusion: Our study shows that the infarcted animals presented left ventricular dysfunction, which was influenced by the infarct size. In addition, impairment of autonomic control was present only in the animals belonging to the I30 group, probably due to the degree of cardiac decompensation and disease progression. (AU)

Avaliação da Força de Preensão Palmar e Qualidade de Vida de Crianças com Câncer Submetidas à Quimioterapia com Vincristina / Evaluation of Handgrip Strength and Children's Quality of Life with Cancer Submitted to Chemotherapy with Vincristine / Evaluación de la fuerza de Asimiento Palmar y Calidad de Vida de Niños con Cáncer Sometidos a la quimioterapia con Vincristina

Introdução: com a quimioterapia, os pacientes podem apresentar diversas alterações; entre elas, polineuropatia e mudança na qualidade de vida, tanto à criança como aos familiares. Objetivo: avaliar a força de preensão palmar e a qualidade de vida de crianças e adolescentes com câncer submetidos à quimioterapia com vincristina. Método:trata-se de um estudo, no qual os pacientes responderam aos questionários de anamnese e PedsQLTM 3.0 Câncer Module, em três momentos diferentes do tratamento. um dos seus responsáveis foi convidado a responder ao mesmo questionário. a força de preensão palmar foi aferida por meio de um dinamômetro, nos mesmos momentos. Resultados: a amostra foi composta por sete pacientes com mediana 7 (5-15 anos); com predomínio de meninas, residentes em Porto alegre, rs, e diagnóstico prevalente de leucemia linfoide aguda, internados na primeira semana após o diagnóstico de câncer. a força de preensão palmar apresentou redução significativa para ambos os membros (p=0,018, membro superior direito; p=0,030, membro superior esquerdo). apesar de não apresentar resultado significativo, na maioria dos domínios do questionário de qualidade de vida, ocorreu declínio nas respostas, principalmente nas dos pais. Conclusão: a quimioterapia com vincristina reduz a força muscular periférica em pacientes com câncer, nos 30 primeiros dias. em relação à qualidade de vida, não foi apresentada diferença significativa. Porém, dentro dos domínios, pôde-se perceber algumas alterações. sendo assim, fica clara a importância do acompanhamento contínuo da fisioterapia junto a uma equipe preparada para esses pacientes e seus familiares

Introduction: With chemotherapy, patients may have several changes. among them: polyneuropathy and change in the quality of life, both the children and the family. Objective: to evaluate the handgrip's power and the life quality in these children and teens with cancer undergoing to chemotherapy with vincristine. Method: This is a study in which patients responded the questionaries of anamnsis and PedsQLTM 3.0 Cancer Modulein three different moments of the treatment. one of your responsible was invited to answer separately the same questionarie. The handgrip's power was measured by dynamometer, in the same moments. Results: The sample was composed for seven patients with average 7 (5-15 years); The most of them were girls, residing in Porto alegre-rs, with a prevalent diagnostic of acute lymphoid leukemia and who were hospitalized in the first week after the diagnosis of cancer. The handgrip's strength show significant reduction for all of the limbs (p=0,0018, right upper limb; p=0,0030, left upper limb). although of not show significant results, in most areas of the questionnaire of quality of life ocurred decline in the answers, mainly in the parents awnsers. Conclusion: The chemotherapy with vincristine, decrease in the peripheral muscle strength in the patients with cancer, in the first 30 days. in relationship of quality of life, there was no significant diference, however we could perceive some trends. Therefore, it is clear the importance of the continuous monitoring of physiotherapy with a team prepared for these patients and their families

Introducción: con la quimioterapia, los pacientes pueden presentar varias modificaciones. entre ellas: polineuropatía y cambio en la calidad de vida, tanto del niño y de los familiares. Objetivo: evaluar la fuerza de asimiento palmar y la calidad de vida de niños y adolescentes con cáncer sometidos a la quimioterapia con vincristina. Método: se trata de un estudio, en el cual los pacientes respondieron a los cuestionarios de anamnesis y PedsQltM 3.0 cáncer Module, en tres momentos diferentes del tratamiento. uno de sus responsables fue invitado a responder el mismo cuestionario. la fuerza de asimiento palmar fue evaluada por medio de un dinamómetro, en los mismos momentos. Resultados: la muestra fue compuesta por siete pacientes con mediana 7 (5-15 años); teniendo más niñas, residentes en Porto alegre-rs, con diagnóstico prevalente de leucemia linfoide aguda y que estaban internadas en la primera semana después del diagnóstico de câncer. la fuerza de asimiento palmar presentó una reducción significativa para ambos miembros (p=0,018, miembro superior derecho, p=0,030, miembro superior izquierdo). a pesar de no presentar resultados significativos, en la mayoría de los dominios del cuestionario de calidad de vida ocurrió declinación en las respuestas, principalmente en la respuesta de los padres. Conclusión: la quimioterapia con vincristina reduce la fuerza muscular periférica en pacientes con cáncer, en los 30 primeros días. en cuanto a la calidad de vida, no se presentó una diferencia significativa. sin embargo, dentro de los dominios se pode percibir algunos cambios. Por lo tanto, queda claro la importancia del acompañamiento continuo de la fisioterapia junto a un equipo preparado para esos pacientes y sus familiares

Evaluation of acute radiation effects on mandibular movements of patients with head and neck cancer.

OBJECTIVES: To evaluate radiotherapy effects (RT) on mandibular movements of patients with head and neck cancer (H&NC) and associate them to the variables: functional capacity, radiation field, disease staging, type of feeding, concomitant chemotherapy and total dose of RT. METHODS: Twenty-six patients with H&NC were followed up at the RT service. Physical examination was performed in 3 follow up time points: before the beginning of RT (T0), between 14th and 17th session of RT (T1) and after the last session of RT (T2). The physical examination consisted of the assessment of the following variables: mouth opening without pain (MO), maximum mouth opening (MMO), right lateral excursion (RLE), left lateral excursion (LLE) and protrusion (PR) of the jaw. The feeding type and the Karnofsky Performance Status Scale (KPS) were evaluated in each follow up time point. Data with regards to the tumor lesion and the RT were collected from the patient's clinical notes. RESULTS: There was a statistical significant reduction in the values of MO (p=0.006), MMO (p=0.001), LLE (p=0.006) and KPS (p=0.001). There was significant a statistical association among the reduction in KPS and decreased measure of MO (r=0.390, p=0.048) and MMO (r=0.435, p=0.026). The mouth and oropharynx radiation fields when combined showed a significant reduction for both the measure of MO (p=0.005) and for MMO (p=0.004). Patients who used nasoenteric tube feeding (NTF) had greater reduction in the measurement of MMO (p=0.031). The remaining variables showed no statistically significant difference. CONCLUSION: Patients with H&NC present reduction of the measures of MO and MMO during the RT, especially if they present reduced functional capacity, have radiation in the mouth and oropharynx fields and used NTF.

Effects of inspiratory muscle training in hemodialysis patients.

INTRODUCTION: Chronic kidney disease associated with hemodialysis can have a variety of musculoskeletal complications, in addition to repercussions in pulmonary function. OBJECTIVE: To evaluate the effects of inspiratory muscle training on inspiratory muscle strength, pulmonary function, and functional capacity in patients with chronic kidney failure undergoing hemodialysis. METHOD: Non-controlled clinical trial, comprising 15 individuals diagnosed with chronic kidney failure and undergoing hemodialysis. Maximum inspiratory (PImax) and expiratory (PEmax) pressures were assessed by use of pressure vacuum meter reading. Pulmonary function was assessed by use of spirometry. Functional capacity was assessed by use of walked distance and oxygen consumption obtained in the six-minute walk test (6MWT). For eight weeks, the inspiratory muscle training (IMT) protocol was applied during hemodialysis sessions, with load set to 40% of PImax and weekly frequency of three alternate days. RESULTS: A significant increase in the walked distance was observed after training (455.5 ± 98 versus 557.8 ± 121.0; p = 0.003). No statistically significant difference was observed in the other variables when comparing their pre- and posttraining values. CONCLUSION: The study showed no statistically significant difference in respiratory muscle strength, pulmonary function, and oxygen consumption. An increase in the walked distance was observed in the 6MWT.