Feasibility study of arterial pressure measurement by snuff pot artery puncture / 中华危重病急救医学

OBJECTIVE@#To explore the feasibility of snuff pot arterial pressure measurement for patients undergoing routine elective surgery during anesthesia.@*METHODS@#A prospective randomized controlled trial was conducted. Patients undergoing elective surgery admitted to the Handan Hospital of Traditional Chinese Medicine from June 1, 2020 to June 1, 2022 were enrolled. Patients who needed arterial pressure measurement for hemodynamic monitoring were randomly divided into routine radial artery puncture group and snuff pot artery puncture group with their informed consent. The patients in the routine radial artery puncture group were placed a catheter at the styloid process of the patient's radius to measure pressure. In the snuff pot artery puncture group, the snuff pot artery, that was, the radial fossa on the back of the hand (snuff box), was selected to conduct the snuff pot artery puncture and tube placement for pressure measurement. The indwelling time of arterial puncture catheter, arterial blood pressure, and complications of puncture catheterization of patients in the two groups were observed. Multivariate Logistic regression analysis was used to screen the relevant factors that affect the outcome of arterial catheterization.@*RESULTS@#Finally, a total of 252 patients were enrolled, of which 130 patients received routine radial artery puncture and 122 patients received snuff pot artery puncture. There was no statistically significant difference in general information such as gender, age, body mass index (BMI), and surgical type of patients between the two groups. There was no significant difference in the indwelling time of artery puncture catheter between the routine radial artery puncture group and the snuff pot artery puncture group (minutes: 3.4±0.3 vs. 3.6±0.3, P > 0.05). The systolic blood pressure (SBP) and the diastolic blood pressure (DBP) measured in the snuff pot artery puncture group were significantly higher than those in the conventional radial artery puncture group [SBP (mmHg, 1 mmHg ≈ 0.133 kPa): 162.3±14.3 vs. 156.6±12.5, DBP (mmHg): 85.3±12.6 vs. 82.9±11.3, both P < 0.05]. There was no statistically significant difference in the incidence of complications such as arterial spasm, arterial occlusion, and pseudoaneurysm formation between the two groups. However, the incidence of hematoma formation in the snuff pot artery puncture group was significantly lower than that in the conventional radial artery puncture group (2.5% vs. 4.6%, P < 0.05). Based on the difficulty of arterial puncture, multivariate Logistic regression analysis showed that gender [odds ratio (OR) = 0.643, 95% confidence interval (95%CI) was 0.525-0.967], age (OR = 2.481, 95%CI was 1.442-4.268) and BMI (OR = 0.786, 95%CI was 0.570-0.825) were related factors that affect the outcome of arterial catheterization during anesthesia in patients undergoing elective surgery (all P < 0.05).@*CONCLUSIONS@#Catheterization through the snuff pot artery can be a new and feasible alternative to conventional arterial pressure measurement.

Analysis of the impact of different exercise methods on the physical health of obese adolescents / Análise do impacto entre diferentes métodos de exercício na saúde física de adolescentes obesos / Análisis del impacto entre diferentes métodos de ejercicio en la salud física de adolescentes obesos

ABSTRACT Introduction: The unregulated development in the current life pattern has strengthened obesity among adolescents, and this problem is becoming more serious. Objective: Compare the impact of two exercise methods on the physical health of obese adolescents. Methods: 24 obese adolescents (12 females; BMI>30% ± 3%; age concentrated between 10 and 16 years) were selected and divided into group I and group II for a 4-week experimental study, and changes in physical fitness and function were recorded. Results: After four weeks of aerobic exercise control (group I), waist circumference, hip circumference, skinfold thickness, and abdominal fold thickness were significantly reduced in boys (p<0.05), and girls' body shape indicators were significantly altered (p<0.05). After four weeks of aerobic exercise combined with resistance training (group II), the effects of weight, BMI, and body size were significant in boys and girls. Conclusion: Aerobic exercise can effectively improve the physical problems of obese adolescents. Under the same external conditions, the effect of aerobic exercise was shown to be more effective when combined with resistance training in the physical improvement of the analyzed group. Level of evidence II; Therapeutic studies - investigation of treatment outcomes.

RESUMO Introdução: O desenvolvimento desregrado no padrão de vida atual fortaleceu a obesidade entre os adolescentes e esse problema está se tornando cada vez mais grave. Objetivo: Comparar o impacto entre dois métodos de exercício na saúde física de adolescentes obesos. Métodos: Foram selecionados 24 adolescentes obesos (12 mulheres; IMC>30% ± 3%; idade concentrada entre 10 e 16 anos) e divididos no grupo I e no grupo II para um estudo experimental de 4 semanas, sendo registradas as alterações no condicionamento e função física. Resultados: Após 4 semanas de controle de exercício aeróbico (grupo I), a circunferência da cintura, circunferência do quadril, espessura da dobra cutânea e espessura da dobra abdominal foram significativamente reduzidas em meninos (p<0,05), e os indicadores de forma corporal das meninas foram significativamente alterados (p<0,05). Após 4 semanas de exercício aeróbico combinado com treinamento de resistência (grupo II), os efeitos do peso, IMC e tamanho do corpo foram significativos em meninos e meninas. Conclusão: O exercício aeróbico pode melhorar efetivamente os problemas físicos dos adolescentes obesos. Sob as mesmas condições externas, o efeito do exercício aeróbico demonstrou-se mais eficaz quando aliado ao treinamento de resistência na melhoria física do grupo analisado. Nível de evidência II; Estudos terapêuticos - investigação dos resultados do tratamento.

RESUMEN Introducción: El desarrollo desordenado en el patrón de vida actual ha potenciado la obesidad entre los adolescentes y este problema es cada vez más grave. Objetivo: Comparar el impacto de dos métodos de ejercicio en la salud física de adolescentes obesos. Métodos: Se seleccionaron 24 adolescentes obesos (12 mujeres; IMC>30% ± 3%; edad concentrada entre 10 y 16 años) y se dividieron en el grupo I y el grupo II para un estudio experimental de 4 semanas, y se registraron los cambios en la aptitud física y la función. Resultados: Después de 4 semanas de control de ejercicio aeróbico (grupo I), la circunferencia de la cintura, la circunferencia de la cadera, el grosor de los pliegues cutáneos y el grosor de los pliegues abdominales se redujeron significativamente en los niños (p<0,05), y los indicadores de la forma corporal de las niñas se alteraron significativamente (p<0,05). Tras 4 semanas de ejercicio aeróbico combinado con entrenamiento de resistencia (grupo II), los efectos del peso, el IMC y el tamaño corporal fueron significativos en chicos y chicas. Conclusión: El ejercicio aeróbico puede mejorar eficazmente los problemas físicos de los adolescentes obesos. En las mismas condiciones externas, el efecto del ejercicio aeróbico se mostró más eficaz cuando se combinó con el entrenamiento de resistencia en la mejora física del grupo analizado. Nivel de evidencia II; Estudios terapéuticos - investigación de los resultados del tratamiento.

Effect of Physical Training on Nitric Oxide Levels in Patients with Arterial Hypertension: An Integrative Review

Abstract The regular practice of physical exercise as a non-pharmacological treatment of arterial hypertension (AH) has been encouraged due to causing a series of physiological responses in the cardiovascular system, such as the production of vasoactive substances, including nitric oxide (NO). NO is a relaxation factor released by the endothelium, and the decrease in its bioavailability is related to coronary and arterial diseases, such as AH. This study aimed to perform an integrative literature review to elucidate the effect of physical training on NO levels in patients with AH and to establish a relationship between these levels and blood pressure (BP) control. A literature review was was performed by searching PubMed / MEDLINE, Lilacs, Scielo, Cinahl and Embase databases. The search string used was ("arterial hypertension" OR hypertension) AND (exercise OR "physical exercise" OR "aerobic exercise" OR "exercise training" or "physical activity") AND ("nitric oxide"). We included fully available controlled and uncontrolled clinical trials published in English and Portuguese languages in the last 10 years. The review consisted of 16 articles, of which 13 reported an increase in NO production after the physical training intervention, and three studies found no change. In addition, 15 studies observed a reduction in BP after the intervention. In conclusion, regular practice of physical exercises, advocating moderate intensity, can improve NO bioavailability in pre-hypertensive and hypertensive individuals, which seems to be one of the mechanisms responsible for BP reduction.

Is the Wistar Rat a more Suitable Normotensive Control for SHR to Test Blood Pressure and Cardiac Structure and Function?

Abstract Background: There are divergences in the literature regarding the experimental model (Wistar-WIS or Wistar Kyoto-WKY) to be used as a Spontaneously Hypertensive Rat (SHR) control. The characterization of these models in terms of cardiovascular parameters provides researchers with important tools at the time of selection and application in scientific research. Objective: The aim of this study was to evaluate the use of WIS and WKY as a Spontaneously Hypertensive Rat (SHR) control by assessing the long-term behavior of blood pressure and cardiac structure and function in these strains. Methods: To this end, WIS, WKY, and SHR underwent longitudinal experiments. Blood pressure and body mass were measured every two weeks from the 8th to the 72nd. Echocardiographic analysis was performed in all groups with 16, 48, and 72 weeks of life. After having applied the normality test, the Two-Way ANOVA of repeated measures followed by the Tukey post hoc test was used. A significance level of 5% was established. Results: The WIS group showed higher body mass (p<0.05), while the WKY and SHR presented higher body mass variation over time (p<0.05). SHR exhibited increased values of systolic, diastolic, and mean blood pressure when compared to WKY and WIS, whereas the WKY generally showed higher values than WIS (p<0.05). Regarding the cardiac function, SHR showed reduced values, while the WKY presented an early decrease when compared to WIS with aging (p<0.05). Conclusion: WIS is a more suitable normotensive control for SHR than WKY in experiments to test blood pressure and cardiac structure and function.

Adaptation to university studies affects on functional state of freshmen

According to different researches, 30% of university graduates have a low level of health, and studying at university is one of the factors of its deterioration, besides the first year is considered critical. The purpose of research is to study the dynamics of physical development, physical fitness and functional state of young men during the first year of university studies. For the survey we used standard measurements and index calculations for 11 indicators of physical development, 9 indicators of physical fitness and 15 indicators of functional status. We calculated the arithmetic mean (M), the standard error of the mean (m), then evaluated differences by the Student criterion (t) for independent samples and considered them as reliable atр < 0.05. It is shown that during the first year of studies, young men have an increase in the Erismann index, the corpulence (Rohrer's) index, the body mass index and a decrease in the Pignet index. There is also an increase in the coefficient of endurance, adaptive capacity and diastolic pressure, while vital capacity of the lungs, the vital index, time of hanging on the bar and the speed of running 1000 m decrease. The dynamics of physical development is expressed in a change in mass-growth indices and indicates an increase in body weight. The dynamics of physical fitness is expressed in a decrease of the time of hanging on the bar and the speed of running 1000 m. The dynamics of the functional state is expressed in a decrease of vital capacity of the lungs, vital index, increase in the coefficient of endurance, adaptive capacity and diastolic blood pressure.

Effects of different order of combined training on functional capacity, blood pressure, and body composition in women from 53 to 79 years old / Efeitos de diferentes ordens do treinamento combinado sobre a capacidade funcional, pressão arterial e composição corporal em mulheres de 53 a 79 anos

Objective: To assess the effects of order of resistance training (RT) and high-intensity interval training (HIIT) on functional capacity, blood pressure, and body composition in middle-aged and older women. Methods: Twenty-two participants were randomly assigned to one of two groups: RT followed by HIIT (RT-HIIT, n = 10, mean age 64.5 ± 7.9 years) or HIIT followed by RT (HIIT-RT, n = 10, mean age 59.32 ± 4.44 years). Both groups trained twice a week for 8 weeks. RT was composed of 7 exercises for the upper and lower body. HIIT was composed of alternate pairings of high-intensity (> 85% of maximum heart rate [MHR]) and moderate-intensity (60% MHR) running. Results: A time effect was found for upper-body muscle endurance (HIIT-RT = +9.43%; RT-HIIT = +6.16%), agility and dynamic balance (HIIT-RT = -5.96%; RT-HIIT = -8.57%), and cardiorespiratory fitness (HIIT-RT = +5.14%; RT-HIIT = +6.13%), with no difference between groups. Body composition and blood pressure did not change throughout the investigation for either group. Conclusion: Eight weeks of a combined HIIT and RT exercise program improved functional capacity of middle-aged and older women without altering blood pressure and body composition, regardless of the order of exercises.

Objetivo: Avaliar os efeitos da ordem do treinamento resistido (TR) e do treinamento intervalado de alta intensidade (HIIT) sobre a capacidade funcional, pressão arterial e composição corporal em mulheres de meia-idade e idosas. Metodologia: Vinte e duas mulheres foram aleatoriamente designadas em dois grupos: um grupo realizou TR seguido por HIIT (TR-HIIT, n = 10, 64,5 ± 7,94 anos) e outro grupo realizou HIIT seguido por TR (HIIT-TR, n = 10, 59,32 ± 4,44 anos). Ambos os grupos treinaram duas vezes por semana durante oito semanas. O TR foi composto por sete exercícios para a parte superior e inferior do corpo. O HIIT foi composto de pares alternados de corrida de alta intensidade (> 85% da frequência cardíaca máxima [FCM]) e intensidade moderada (60% FCM). Resultados: Foi encontrado um efeito dos programas de exercício para a resistência muscular de membros superiores do corpo (HIIT-TR = +9.43%; TR-HIIT = +6.16%), agilidade e equilíbrio dinâmico (HIIT-TR = -5,96%; TR-HIIT = -8.57%) e aptidão cardiorrespiratória (HIIT-TR = +5.14%; TR-HIIT = +6.13%), sem diferença entre os grupos. A composição corporal e a pressão arterial não se alteraram ao longo da investigação em nenhum dos grupos. Conclusão: Oito semanas de um programa combinado de exercícios de HIIT e de TR proporcionaram melhora na capacidade funcional de mulheres de meia-idade e idosas, sem alterar a pressão arterial e a composição corporal, independente da ordem de execução.

Dinámica no lineal de la regulación autonómica cardiovascular durante la prueba del peso sostenido en pacientes con diabetes mellitus tipo 2 / Nonlinear dynamics of cardiovascular autonomic regulation during the sustained weight test in patients with type 2 diabetes mellitus

Resumen Introducción: La dinámica no lineal de la regulación autonómica cardiovascular a partir de la variabilidad de la frecuencia cardiaca no ha sido previamente estudiada en pacientes con diabetes mellitus tipo 2 mediante la prueba del peso sostenido como inductor de hiperreactividad cardiovascular. Objetivo: Determinar las variaciones en la dinámica no lineal de la regulación autonómica cardiovascular durante la prueba del peso sostenido en pacientes con diabetes mellitus tipo 2. Método: Estudio cuasiexperimental, antes-después, con grupo control, realizado en junio-agosto de 2018 en la Facultad No. 1 de Medicina de Santiago de Cuba. Se trabajó con 15 pacientes que padecían diabetes mellitus tipo 2 sin otra enfermedad asociada y 15 sujetos sanos, a quienes se les aplicó la prueba del peso sostenido. Resultados: En los pacientes con diabetes mellitus, al realizar la prueba del peso sostenido se produjo un aumento significativo en la presión arterial sistólica, diastólica y media, y en la frecuencia cardiaca. En la entropía muestral, parámetro que evalúa la adaptabilidad de los sistemas, se produjo una disminución significativa (2.28 ± 0.33 vs. 1.83 ± 0.47 ms; p = 0.003143). El valor del estadístico C de la entropía muestral en estado basal quedó establecido en 0.973, siendo la variable con mayor capacidad predictiva. Conclusiones: Durante la prueba del peso sostenido en los pacientes con diabetes mellitus tipo 2 se produjo una disminución de la complejidad de la regulación autonómica cardiovascular; la entropía muestral basal constituyó el indicador de mayor eficacia en la identificación de alteraciones autonómicas cardiovasculares.

Abstract Introduction: The analysis of non-linear dynamics of cardiovascular autonomic regulation based on heart rate variability has not been previously studied in patients with type 2 diabetes mellitus using the sustained weight test as an inducer of cardiovascular hyperreactivity. Objective: To determine the variations in the non-linear dynamics of cardiovascular autonomic regulation during the sustained weight test in patients with type 2 diabetes mellitus. Method: A quasi-experimental, before-after study with a control group, from June-August 2018, at the No. 1 School of Medicine in Santiago de Cuba. We worked with 15 patients suffering from type 2 diabetes mellitus without other associated disease and 15 healthy subjects, to whom the sustained weight test was applied. Results: In patients with diabetes mellitus, when performing the sustained weight test, there was a significant increase in the hemodynamic parameters TAS, TAD, TAM and FC. In the sample entropy, a parameter that evaluates the adaptability of the systems, there is a significant decrease (2.28 ± 0.33 vs. 1.83 ± 0.47 ms; p = 0.003143). The value of the C statistic of the sample entropy at baseline was established at 0.973, being the variable with the highest predictive capacity. Conclusions: In patients with type 2 diabetes mellitus during the sustained weight test, there was a decrease in the complexity of cardiovascular autonomic regulation, the basal sample entropy was the indicator of greater efficacy in the identification of cardiovascular autonomic alterations.

Efeito crônico do treinamento resistido sobre a pressão arterial: uma revisão sistemática e metanálise de ensaios clínicos controlados randomizados / Chronic effect of resistance training on blood pressure: a systematic review and metanalysis of randomized controlled clinical trials

Este estudo tem como objetivo comparar e discutir, a partir de estudos científicos publicados, o efeito crônico do treinamento resistido sobre a pressão arterial. Foi realizada uma revisão sistemática de ensaios clínicos controlados randomizados. A busca dos artigos foi realizada nas bases de dados SciELO, PubMed e Biblioteca Virtual da Saúde. Foram selecionados artigos publicados a partir de 2015, com avaliação da pressão arterial antes e após um período de treinamento resistido e com um grupo controle. Nos 18 estudos selecionados, 551 participantes foram identificados, incluindo idosos, obesos, hipertensos, diabéticos, indivíduos com síndrome metabólica e indivíduos saudáveis, com idade média variando entre 15,4 e 87,7 anos. A maioria dos estudos selecionados realizou uma intervenção de treinamento resistido com exercícios dinâmicos tradicionais para membros inferiores e superiores, com duração de 12 semanas e frequência de 3 vezes por semana. O volume de treinamento apresentado nos estudos variou entre 1 e 5 séries de 3 a 20 repetições por exercício. A intensidade foi apresentada em percentual de uma repetição máxima, percentual de 10 repetições máximas, repetições máximas e percepção subjetiva de esforço. O intervalo de descanso entre os exercícios variou entre 30 e 180 segundos. A metanálise indicou que o treinamento resistido reduziu significativamente a pressão arterial sistólica em -3,38 mmHg ([IC 95% = -5,82; -0,95] p < 0,01; I² = 76%) e a pressão arterial diastólica em -1,95 mmHg ([IC 95% = -3,12; -0,78] p < 0,01; I² = 58%). De acordo com os resultados desta revisão, o treinamento resistido sozinho é mais efetivo em reduzir a pressão arterial de repouso do que o não treinamento, principalmente pressão arterial sistólica; com maior redução em idosos, pré-hipertensos e hipertensos. Sendo assim, o treinamento resistido pode ser um método a ser indicado na prevenção e tratamento da hipertensão arterial sistêmica.(AU)

This study aims to compare and discuss, based on published scientific studies, the chronic effect of resistance training on blood pressure. A systematic review of randomized controlled clinical trials was performed. The search for articles was carried out in the SciELO, PubMed and Biblioteca Virtual da Saúde databases. Articles published from 2015 onwards, with blood pressure assessment before and after a period of resistance training and with a control group, were selected. In the 18 selected studies, 551 participants were identified, including the elderly, obese, hypertensive, diabetics, subjects with metabolic syndrome and healthy subjects, with a mean age ranging between 15,4 and 87,7 years. Most of the selected studies carried out a resistance training intervention with traditional dynamic exercises for lower and upper limbs, lasting 12 weeks and frequency of 3 times a week. The volume of training presented in the studies varied between 1 and 5 sets of 3 to 20 repetitions per exercise. The intensity was presented as a percentage of a maximum repetition, a percentage of 10 maximum repetitions, maximum repetitions and perceived exertion. The rest interval between exercises varied between 30 and 180 seconds. The metaanalysis indicated that resistance training significantly reduced systolic blood pressure by -3,38 mmHg ([95% CI = -5,82; -0,95] p <0,01; I² = 76%) and blood pressure diastolic at -1,95 mmHg ([95% CI = -3,12; -0,78] p <0,01; I² = 58%). According to the results of this review, resistance training alone is more effective in reducing resting blood pressure than non-training, especially systolic blood pressure; with greater reduction in elderly, pre-hypertensive and hypertensive subjects. Therefore, resistance training can be a method to be indicated in the prevention and treatment of systemic arterial hypertension.(AU)

Efeitos de diferentes métodos de treinamento na melhora dos indicadores cardiometabólicos em corredores recreacionais: uma revisão sistemática / Effects of different training methods in improving cardiometabolic indicators in recreational runners: a systematic review

: O exercício físico, em especial a corrida de rua tem sido recomendada para prevenção e tratamento de doenças crônicas não transmissíveis. O objetivo desta revisão sistemática foi verificar os efeitos de diferentes métodos de treinamento sobre os indicadores cardiometabólicos de corredores recreacionais. As bases de dados eletrônicas utilizadas na presente pesquisa foram: PUBMED, SCIENCE DIRECT, LILACS e COCHRANE LIBRARY, usando os descritores agrupados segundo o método PICO; População ("adults" OR "young adult" OR "middle aged") AND Intervenção ("endurance training" OR "aerobic training" OR "running") OR Comparação ("recreational runners" OR "jogging") AND Outcome/Desfecho ("cardiovascular risk factors" OR "cardiometabolic risk factors" OR "metabolic syndrome"). Na seleção os artigos foram excluídos por título, resumo e texto. Obteve-se um total de 813 artigos encontrados, no qual nove (9) preencheram os critérios de inclusão e baixo risco de viés de acordo com a Escala Testex. Foram encontrados três métodos de treinamento: Combinado (Contínuo +Intervalado); Contínuo e Intervalado. Considerando a somatória das amostras dos nove estudos, um total de 604 indivíduos (466 homens e 138 mulheres) participaram dos ensaios. Os diferentes métodos de treinamentos resultaram na redução dos níveis de triglicerídeos, insulina e glicose e na redução do colesterol total e LDL, e consequentemente o aumento do HDL. Na composição corporal houve diminuição significativa do peso e da gordura corporal, do IMC, na medida da circunferência da cintura, e no aumento da capacidade aeróbia (VO2). Concluiu-se que os treinamentos combinado, contínuo e intervalado podem ser aplicados para melhora dos indicadores cardiometabólicos, cada um dentro da sua especificidade de frequência, volume e intensidade.(AU)

Physical exercise, especially running, has been recommended for the prevention and treatment of chronic non-communicable diseases. The objective of this systematic review was to verify the effects of different training methods on the cardiometabolic indicators of recreational runners. The electronic databases used in the present research were: PUBMED, SCIENCE DIRECT, LILACS and COCHRANE LIBRARY, using the descriptors grouped according to the PICO method; Population ("adults" OR "young adult" OR "middle aged") AND Intervention ("endurance training" OR "aerobic training" OR "running") OR Comparison ("recreational runners" OR "jogging") AND Outcome / Outcome ("Cardiovascular risk factors" OR "cardiometabolic risk factors" OR "metabolic syndrome"). In the selection, articles were excluded by title, abstract and text. A total of 813 articles were obtained, in which nine (9) met the inclusion criteria and low risk of bias according to the Testex Scale. Three training methods were found: Combined (Continuous + Interval); Continuous and Interval. Considering the sum of the samples from the nine studies, a total of 604 individuals (466 men and 138 women) participated in the trials. The different training methods resulted in a reduction in the levels of triglycerides, insulin and glucose and in the reduction of total cholesterol and LDL, and consequently an increase in HDL. In body composition, there was a significant decrease in weight and body fat, in BMI, as measured by waist circumference, and in increased aerobic capacity (VO2). It is concluded that combined, continuous and interval training can be applied to improve cardiometabolic indicators, each within its specific frequency, volume and intensity.(AU)

Tracking of risk factors for non-communicable diseases in young shooters, Ituiutaba, MG

The aim of this study was to detect early hypertension, diabetes and obesity, as well as their risk factors, in 105 young shooters from Tiro de Guerra 11-002 in the city of Ituiutaba-MG. This is a cross-sectional mixed study. A semi-structured questionnaire that contained questions related to the sociodemographic context, health status, lifestyle, eating habits, and psychosocial variables was applied. Blood pressure, anthropometric indexes, and lipid and glycemic profiles were measured. Descriptive and inferential statistics, including Pearson's correlation test and Spearman's coefficient, considering significative value (p < 0.05). The shooters had an average of 18.9 years old, most educated and brown. Anthropometric indices indicated a mainly eutrophic population, and normotensive and desirable lipid and glycemic profiles. However, overweight, high blood pressure, and self-declaration of family history for chronic diseases were identified. In addition, most shooters affirmed to ingest alcoholics beverages, to have insufficient time of physical activity, and to be aware of their levels of stress, pressure and anxiety and a few hours of sleep. Overall, the shooters showed good anthropometric and biochemical indicatorsof blood. Risk behavior, such as drinking alcoholic beverages and smoking, low level of physical activity and self-perception of stress, anxiety and pressure were also noted.

Función pulmonar: medición continua de la saturación del pulso arterial de oxígeno: propuesta para interpretación / Continuous measurement of oxygen arterial pulse saturation: an interpretation proposal

La medición continua de la saturación de pulso arterial de oxígeno (SpO2) es un método no invasivo, confiable y seguro. El consolidado permite obtener valores promedio de SpO2 y frecuencia cardiaca, gráficos y valores acumulados, rangos de valores de SpO2, que permiten definir si existe o no alguna alteración. Los avances tecnológicos han dado paso a la fabricación de equipos con alta exactitud de las mediciones, mediante algoritmos matemáticos que filtran los artefactos debido a movimientos y/o hipoperfusión. La ventaja, es una mayor precisión para determinar estados de hipoxemia en distintas situaciones clínicas. Las principales indicaciones en pediatría son la determinación de hipoxemia y titulación de oxígeno en niños con enfermedades que comprometen el sistema respiratorio, especialmente displasia broncopulmonar. También se usa como screening para apneas obstructivas del sueño en rango moderado a severo en situaciones en que no es posible realizar poligrafía o polisomnografía, dado la facilidad con la que se puede realizar la medición continua de SpO2 en domicilio u hospitalizado. En este artículo se describen características importantes del procedimiento, y se propone un esquema para ordenar su interpretación.

Continuous measurement of arterial oxygen saturation by pulse oximetry (SpO2) is a non-invasive, reliable, and safe method. The consolidated allows obtaining average values of SpO2 and heart rate, graphs and accumulated values, ranges of SpO2 values, which allow defining whether or not there is any alteration. Technological advances have given way to the manufacture of equipment with high measurement accuracy, using mathematical algorithms that filter artifacts due to movements and/or hypoperfusion. The main indications are the diagnosis of hypoxemia and titration of oxygen requirements in patients with chronic lung damage and other diseases that compromise the respiratory system. Also, it is used as screening of moderate to severe obstructive apneas when other sleep studies, such as polysomnography or polygraphy, are not available. It can be done at home or hospitalized. This article describes important characteristics of the procedure, and a scheme is proposed to order its interpretation.

Can exergames be used as an alternative to conventional exercises?

Abstract Aim: The present study aimed to analyze if the exergaming exercise produces the same acute effects as conventional training. Methods: The Nintendo® Wii was chosen as the stimulus for this study. Participants should conduct a physical training session under Exergames Training (ET) and Conventional Training (CT). Both training conditions use two aerobic exercises and six strength exercises, which were always performed in the same sequence. The study group was composed of 30 young adults (16 men and 14 women, mean age of 23.7 ± 3.7 years). Results: Our findings showed significant results between pre and post-tests: the heart rate (HR) and the double product (DP) were higher in the post-exercise period, while the systolic blood pressure (SBP) was lower. Further analysis revealed that ET and CT conditions had no significant differences. ET condition showed to present similar results as CT condition to women (regarding HR, diastolic blood pressure - DBP, and DP), and to men (HR, SBP, and DBP). Conclusion: The present research showed that exergaming provides the same acute effects in physiological variables as conventional exercises. Thus, this kind of exercise can be a reliable way to improve the lifestyle of young adults.

Effect of combined exercise training on heart rate variability in normotensive and hypertensive postmenopausal women

Abstract Aim: This study aimed to verify and compare the effects of 10 weeks of combined exercise training on the heart rate variability of normotensive (NT) and hypertensive (HT) postmenopausal women. Methods: This is a quasi-experimental controlled clinical trial. Therefore, 14 HT and 12 NT postmenopausal women completed 10 weeks of combined exercise training. The exercise protocol consisted of 45 min of exercise, performed 3 times a week, consisting of 5 min of warm-up, 20 min of resistance exercise, and 20 min of aerobic exercise. Heart rate variability assessments were performed before and after the end of physical training. Results: Heart rate variability was assessed pre- and post-training periods. Mean RR (δNT = 95 ± 88; δHT = 38 ± 127), SDNN (δNT = 9 ± 13; δHT = 3 ± 14), RMSSD (δNT = 10 ± 12; δHT = 2 ± 18), SD1 (δNT = 7 ± 8; δHT = 1 ± 13), and SD2 (δNT = 10 ± 18; δHT = 4 ± 17) showed improvements after the intervention (time effects p < 0.05). No parameters presented group or interaction effects (p ≥ 0.05). Conclusion: In summary, 10 weeks of combined exercise training improved heart rate variability parameters similarly in both NT and HT postmenopausal women. Therefore, combined exercise training may be used to improve autonomic modulation of the heart rate of postmenopausal women, regardless of the presence of hypertension.

Interrelationships between obesity, blood pressure and metabolic profile in climacteric women / Inter-relações entre obesidade, pressão arterial e perfil metabólico em mulheres climatéricas

ABSTRACT Objective This study aimed to evaluate the interrelationships between obesity, blood pressure and metabolic profile in climacteric women. Methods This is a cross-sectional study with a random sample of 874 women, aged 40 to 65 years, assisted in Family Health Strategies units in Montes Claros, Minas Gerais, Brazil. A structural equation model was used to assess the interrelationships between obesity, blood pressure and metabolic profile, adjusted for age. The variables blood pressure, obesity and metabolic profile were treated as constructs, which measurement models were developed using confirmatory factor analysis. Results It was observed that age has a positive and significant effect on blood pressure (β=0.20; p<0.001) and obesity (β=0.10; p=0.004). There was a direct and positive effect of obesity on blood pressure (β=0.26; p<0.001) and on the metabolic profile (β=0.10; p=0.037), adjusted for physical activity. Conclusions The simultaneous analysis of the relationships between age, obesity, blood pressure and metabolic profile in menopausal women suggests that, ageing has an effect on the increase of obesity and blood pressure, just as obesity increases blood pressure and changes the metabolic profile.

RESUMO Objetivo Avaliar as inter-relações entre obesidade, pressão arterial e perfil metabólico em mulheres climatéricas. Métodos Trata-se de estudo transversal com amostra aleatória composta por 874 mulheres com idade entre 40 a 65 anos assistidas em unidades de Estratégias de Saúde da Família em Montes Claros, Minas Gerais, Brasil. Foi utilizado modelo de equação estrutural para avaliar as inter-relações entre obesidade, pressão arterial e perfil metabólico, ajustado pela idade. As variáveis pressão arterial, obesidade e perfil metabólico foram tratadas como construtos, cujos modelos de mensuração foram construídos utilizando-se a análise fatorial confirmatória. Resultados Observou-se que a idade exerce efeito positivo e significativo sobre a pressão arterial (β=0,20; p<0,001) e a obesidade (β=0,10; p=0,004). Houve efeito direto e positivo da obesidade na pressão arterial (β=0,26; p<0,001) e no perfil metabólico (β=0,10; p=0,037), ajustado por atividade física. Conclusão A análise simultânea das relações entre idade, obesidade, pressão arterial e perfil metabólico em mulheres no climatério sugere que o aumento da idade tem efeito sobre o aumento da obesidade e da pressão arterial, assim como a obesidade tem efeito positivo sobre o aumento da pressão arterial e sobre a alteração no perfil metabólico.

Significado clínico da hipertensão durante o sono / Clinical meaning of hypertension during sleep

A anormalidade da pressão arterial durante o período de sono identificada como médias ≥ 120 x 70 mm Hg, por meio de registros da Monitorização Ambulatorial da Pressão Arterial de 24 horas (MAPA), está relacionada a pior prognóstico e maior risco de eventos. Essa alteração pode ser decorrência de vários fatores, mas, geralmente, independentemente da causa está fortemente relacionada a maior probabilidade de eventos e mortalidade cardiovasculares. Ainda restam dúvidas, embora evidências começam a ser oferecidas, se o tratamento medicamentoso desse estado de comportamento peculiar da pressão arterial nas 24 horas deva ser instituído. Nessa revisão esses aspectos são amplamente discutidos com base nas melhores evidências disponíveis

The abnormality of blood pressure during the sleep period identified as means ≥ 120 x 70 mm Hg, through 24-hour Ambulatory Blood Pressure Monitoring (ABPM) records, is related to a worse prognosis and greater risk of events. This change can be due to several factors, but, generally, regardless of the cause, it is strongly related to a higher probability of cardiovascular events and mortality. Doubts remain, although evidence is beginning to be offered, whether drug treatment of this peculiar behavioral state of blood pressure within 24 hours should be instituted. In this review, these aspects are widely discussed based on the best available evidence

Níveis pressóricos de uma comunidade indígena do cerrado brasileiro / Pressorial levels of an indigenous community of the Brazilian closure

Buscou-se analisar os níveis pressóricos dos Haliti-Paresí e sua relação com alguns aspectos sociodemográficos. Trata-se de estudo transversal, descritivo e com abordagem quantitativa, realizado com a comunidade indígena Haliti-Paresí. A coleta de dados foi realizada em dezembro de 2015 com os residentes da terra indígena Utiariti. Realizou-se a análise estatística bivariada da Pressão Arterial (PA), Pressão Arterial Sistólica (PAS) e Pressão Arterial Diastólica (PAD) em função das variáveis independentes, sendo que as variáveis que apresentaram significância estatística com p<0,05 foram utilizadas para construir o modelo de regressão de Poisson robusto. Foi possível identificar o predomínio de jovens e com ensino fundamental incompleto. A hipertensão no estágio 1 apresentou prevalência de PA (21,85%), PAS (14,29%) e PAD (17,65%) (p<0,001). Na análise bivariada foram identificadas significâncias estatísticas para PA e PAS nas variáveis independentes sexo masculino, idade maior que 60 anos e realizar a atividade agrícola, caça, pesca e coleta. No entanto, a PAD apresentou as mesmas significâncias estatísticas supracitadas, porém sem associação com idade. Faz-se necessária a realização de ações de promoção, prevenção e elaboração de planos estratégicos que visam ampliar os hábitos saudáveis e consequente elevação da qualidade de vida desses indígenas.(AU)

The aim was to analyze the pressure levels of the Haliti-Paresí and their relationship with some sociodemographic aspects. It is a cross-sectional, descriptive study with a quantitative approach, carried out with the Haliti-Paresí indigenous community. Data collection was carried out in December 2015 with residents of Utiariti indigenous land. The bivariate statistical analysis of the arterial pressure (BP), systolic arterial pressure (SBP) and diastolic blood pressure (DBP) was performed as a function of the independent variables, and the variables that presented statistical significance with p <0.05, were used to construct the robust Poisson regression model. It was possible to identify the predominance of young people with incomplete primary education. Hypertension in stage 1 presented a prevalence of AP (21.85%), SBP (14.29%) and DBP (17.65%) (p <0.001). In the bivariate analysis, statistical significance was identified for PA and SBP in the independent variables male sex, age > 60 years and to perform the agricultural activity, hunting, fishing and collection. However, PAD presented the same statistical significance as above, but without association with age. It is necessary to carry out actions of promotion, prevention and elaboration of strategic plans that aim to increase the healthy habits and consequent elevation of the quality of life of these natives.(AU)

Pressão arterial sistólica noturna e doença cerebrovascular subclinica: o estudo de anormalidades cardiovasculares e lesões cerebrais / Night-time systolic blood pressure and subclinical cerebrovascular disease: the cardiovascular abnormalities and brain lesions (cabl) study

Introdução: Embora a pressão arterial (PA) ambulatorial seja um melhor preditor de desfechos cardiovasculares do que a pressão arterial de consultório, sua associação com a doença cerebrovascular subclínica não está esclarecida. Assim, esse estudo investigou a associação dos valores da PA de consultório e ambulatorial com a doença cerebrovascular subclínica em uma coorte populacional predominantemente idosa, sem histórico de acidente vascular cerebral prévio. Material e Métodos: 828 participantes foram submetidos à monitorização ambulatorial da PA por 24 horas (MAPA), ecocardiograma, ressonância magnética cerebral no estudo Cardiac Abnormalities and Brain Lesion (CABL). PA de vigília, PA durante o sono e de 24 horas, padrão de descenso noturno, elevação matutina (EM) e variabilidade da PA de 24 horas foram avaliados. A doença cerebrovascular subclínica foi definida como infarto cerebral silencioso (ICS) e volume de hiperintensidade da substância branca (VHSB). A associação das medidas da PA com a presença de ICS e o quartil superior do log-VHSB (log-VHSB 4) também foi analisada. Resultados: ICSs foram detectados em 111 pacientes (13,4%). Na análise multivariável, apenas a PA sistólica (PAS) noturna esteve significantemente associada ao ICS [odds ratio (OR): 1,15 para cada 10mmHg, P = 0,042], independente de fatores de risco cardiovascular e parâmetros ecocardiográficos avaliados. Embora PA na vigília, durante o sono, PA de 24 horas e o padrão não dipper tenham sido significantemente associados ao log-VHSB 4, a PAS noturna apresentou a associação mais forte (OR: 1,21 para cada 10 mmHg, P = 0,003) e foi o único preditor independente comparado aos outros parâmetros da PA. Medidas da PA de consultório, EM e variabilidade da PA não foram associadas à doença cerebrovascular subclínica nas análises ajustadas. Conclusão: A PAS elevada durante o sono apresenta forte associação com a doença cerebrovascular subclínica. O estudo conclui que a PAS noturna avaliada pela MAPA permite identificar indivíduos com maior risco de lesão cerebral hipertensiva

Comentário: Pressão arterial sistólica noturna e doença cerebrovascular subclínica: estudo sobre anormalidades cardiovasculares e lesões cerebrais / Comment: Night-time systolic blood pressure and subclinical cerebrovascular disease: the cardiovascular abnormalities and brain lesions (CABL) study

Introdução: Embora a pressão arterial (PA) ambulatorial seja um melhor preditor de desfechos cardiovasculares do que a pressão arterial de consultório, sua associação com a doença cerebrovascular subclínica não está esclarecida. Assim, esse estudo investigou a associação dos valores da PA de consultório e ambulatorial com a doença cerebrovascular subclínica em uma coorte populacional predominantemente idosa, sem histórico de acidente vascular cerebral prévio. Material e Métodos: 828 participantes foram submetidos à monitorização ambulatorial da PA por 24 horas (MAPA), ecocardiograma, ressonância magnética cerebral no estudo Cardiac Abnormalities and Brain Lesion (CABL). PA de vigília, PA durante o sono e de 24 horas, padrão de descenso noturno, elevação matutina (EM) e variabilidade da PA de 24 horas foram avaliados. A doença cerebrovascular subclínica foi definida como infarto cerebral silencioso (ICS) e volume de hiperintensidade da substância branca (VHSB). A associação das medidas da PA com a presença de ICS e o quartil superior do log-VHSB (log-VHSB 4) também foi analisada. Resultados: ICSs foram detectados em 111 pacientes (13,4%). Na análise multivariável, apenas a PA sistólica (PAS) noturna esteve significantemente associada ao ICS [odds ratio (OR): 1,15 para cada 10mmHg, P = 0,042], independente de fatores de risco cardiovascular e parâmetros ecocardiográficos avaliados. Embora PA na vigília, durante o sono, PA de 24 horas e o padrão não dipper tenham sido significantemente associados ao log-VHSB 4, a PAS noturna apresentou a associação mais forte (OR: 1,21 para cada 10 mmHg, P = 0,003) e foi o único preditor independente comparado aos outros parâmetros da PA. Medidas da PA de consultório, EM e variabilidade da PA não foram associadas à doença cerebrovascular subclínica nas análises ajustadas. Conclusões: A PAS elevada durante o sono apresenta forte associação com a doença cerebrovascular subclínica. O estudo conclui que a PAS noturna avaliada pela MAPA permite identificar indivíduos com maior risco de lesão cerebral hipertensiva

Respostas pressóricas em indivíduos normotensos submetidos a diferentes intensidades em sessões de treinamento de força / Blood pressure responses in normotensive individuals submitted to different intensities in resistance training sessions / Respuestas de la presión arterial en individuos normotensos sometidos a diferentes intensidades en sesiones de entrenamiento de fuerza

OBJETIVO: Investigar o efeito do treinamento de força (TF) com distintas intensidades sobre a cocorrência e magnitude da hipotensão pós-exercício (HPE). MÉTODOS: sete homens normotensos foram submetidos a duas sessões de TF, com intensidades de 60% e 85% de 1RM, respectivamente. A pressão arterial sistólica (PAS) e diastólica (PAD) foram monitoradas em cada sessão nos momentos: antes, imediatamente após, e a cada 10' durante uma hora. RESULTADOS: Após a primeira sessão, houve redução (p=0,001) da PAS a partir de 20' pós-exercício, sem alterações em relação aos níveis basais; a PAD demonstrou redução (p=0,03) em relação ao repouso apenas nos momentos 20' e 30' pós-exercício. Na segunda sessão, a PAS apresentou redução (p=0,01) a partir do momento 30' pós-exercício até a última mensuração; a PAD não apresentou alterações. Não houve alterações entre as sessões com 60 e 85% de 1RM para PAS e PAD. CONCLUSÃO: Apesar de ser observada tendência à redução nos níveis das variáveis em ambas as sessões, não foram observadas significâncias que pudessem caracterizar a HPE. Entretanto, observou-se que a manipulação da intensidade produziu respostas similares entre as sessões para PAS e PAD.

OBJECTIVE: To investigate the effect of strength training (ST) with distinct intensity characteristics, on post exercise hypotension (PEH) occurrence and magnitude. METHODS: Seven normotensive men were submitted to two ST sessions, with intensities of 60% and 85% of 1RM, respectively. Systolic (SBP) and diastolic blood pressure (DBP) were measured at distinct moments of each session: before, immediately after, and each 10' for one hour. RESULTS: After the first session, there was a reduction (p=0.001) on SBP since 20' post-exercise, without changes compared to the basal levels; DBP showed reduction (p=0.03) compared to rest only at 20' post and 30' post-exercise. In the second session, SBP showed reduction (p=0.01) since 30' post-exercise until the last measure; DBP did not show any changes. There were no changes between the session with 60 and 85% of 1RM for SBP or DBP. CONCLUSION: Despite the trend of reduction of the variables at both sessions, there were no significance that could characterize the PEH. However, it was observed that the intensity manipulation has produced similar of SBP and DBP response for both exercise sessions.

OBJETIVO: Investigar el efecto del entrenamiento de fuerza (TF) con distintas intensidades sobre la ocurrencia y magnitud de la hipotensión post-ejercicio (HPE). MÉTODOS: siete hombres normotensos fueron sometidos a dos sesiones de TF, con intensidades de 60% y 85% de 1RM, respectivamente. La presión arterial sistólica (PAS) y diastólica (PAD) fue monitoreada en cada sesión en los momentos: antes, inmediatamente después, y cada 10 'durante una hora. RESULTADOS: Después de la primera sesión, hubo reducción (p = 0,001) de la PAS a partir de 20 'post-ejercicio, sin alteraciones en comparación con los niveles basales; la PAD demostró reducción (p = 0,03) en relación al reposo sólo en los momentos 20 'y 30' post-ejercicio. En la segunda sesión, la PAS presentó reducción (p = 0,01) a partir del momento 30 'post-ejercicio hasta la última medición; la PAD no presentó cambios. No hubo cambios entre las sesiones con 60 y 85% de 1RM para PAS y PAD. CONCLUSIÓN: Aunque se observó tendencia a la reducción en los niveles de las variables en ambas sesiones, no se observaron significaciones que pudieran caracterizar la HPE. Sin embargo, se observó que la manipulación de la intensidad produjo respuestas similares entre las sesiones para PAS y PAD.