Short-term aerobic training improves heart rate variability in men living with HIV: a pre-post pilot study.

BACKGROUND: Heart rate variability (HRV) a feasible predictor of prognosis in cardiovascular outcomes shown to be reduced in people living with HIV (PLWH). OBJECTIVE: This study sought to understand the effects of short-term aerobic training (AT) on the resting HRV and endothelial function in this population. METHODS: PLWH performed 24 sessions of AT protocol. The protocol consists of 40 min of treadmill (60 to 80% of the VO2max), 3 times per week, for 8 weeks. HRV (standard deviation of all normal RR intervals - SDNN; root mean square of the successive differences - rMSSD; low frequency - LF; high frequency - HF; LF:HF ratio) and endothelial function parameters were evaluated by EndoPAT system pre and post intervention. RESULTS: 7 men, the median age of the sample was 49 years (range, 38-68 years), completed the protocol. AT improved resting HRV parameters: SDNN (p = 0.02, power analysis (PA) 0.54), rMSSD (p = 0.02, PA = 0.99), LF (p = 0.02, PA = 0.85). HF, LF:HF ratio and endothelial function parameters showed no changes. CONCLUSIONS: The results suggest the short-term AT may improve HRV in men living with HIV.

Breathing at Extremes: The Restrictive Consequences of Super- and Super-Super Obesity in Men and Women.

BACKGROUND: Massively obese subjects frequently undergo pulmonary function tests nowadays. Obesity-associated decreases in key operating lung volumes (reduced inspiratory capacity and reduced vital capacity) are particularly concerning because they may shorten the "room" for tidal volume expansion with negative physiologic and sensory consequences. RESEARCH QUESTION: Is massive obesity associated with reduced operating lung volumes? If so, is this effect more pronounced in men than women? STUDY DESIGN AND METHODS: We performed an observational, retrospective study in a tertiary, hospital-based laboratory. Pulmonary function test results from 248 super-obese (SO; BMI, 50 to 59.9 kg/m2) and 83 super-super obese (SSO; BMI, ≥60 kg/m2) men and women were analyzed. Electronic medical records were screened to ensure that subjects were free of any disease that potentially could interfere with lung volumes. RESULTS: The prevalence of a low total lung capacity (restriction) was 26.9%, which increased to 38.6% in SSO. Despite the absence of between-sex differences in BMI and spirometric variables derived from the forced maneuver in both SO and SSO, men presented with higher prevalence of restriction (46.7%) than women (19.4%) (P < .05). Between-sex differences in residual volume differed according to the BMI group; SO men presented with higher values than SO women; the opposite was found in the SSO group. The prevalence of restriction with low operating lung volumes was approximately twice (SSO) and approximately thrice (SSO) as high in men compared with women (P < .01). Linear prediction equations as a function of sex, demographic, and anthropometric attributes markedly reduced the prevalence of these abnormalities across the population. INTERPRETATION: Obesity-related restriction leading to low operating lung volumes is highly prevalent in the massively obese subject, particularly in men. These alterations that are associated with massive obesity should be taken into consideration for an accurate interpretation of pulmonary function tests in this growing population.

Is the Slow Vital Capacity Clinically Useful to Uncover Airflow Limitation in Subjects With Preserved FEV1/FVC Ratio?

BACKGROUND: FVC may underestimate the slow vital capacity (SVC) due to early closure of the small airways at low lung volumes in the forced maneuver. It remains unclear whether using SVC instead of FVC in the FEV1/vital capacity (VC) ratio increases the yield of spirometry in detecting airflow limitation or, alternatively, leads to a false-positive finding for obstruction. METHODS: This study included 13,893 adult outpatients with FEV1/FVC and total lung capacity at or above the lower limit of normal. A cluster of clinical and physiological variables defined the probability of airway disease and dysfunction, respectively. RESULTS: The prevalence of "discordance" (preserved FEV1/FVC but low FEV1/SVC) was 20.4%: discordant subjects had lower mid-expiratory flows, higher airway resistance, worse gas trapping, and ventilation distribution abnormalities than "concordant" subjects (both ratios preserved) (P < .05). Regardless of sex, age < 60 years, BMI > 30 kg/m2, and FEV1 > 70% predicted were associated with discordance (P < .001). Discordant subjects with preserved FEV1/FVC but low FEV1/SVC were four times more likely to be diagnosed with an obstructive airway disease by a respirologist compared with those with preserved FEV1/SVC and FEV1/FVC. The only exception was in the elderly subgroup with discordance (age > 70 years): only 10% of these subjects were subsequently diagnosed with an airway disease (P > .05). CONCLUSIONS: Using SVC instead of FVC in the FEV1/VC ratio enhances the yield of spirometry in detecting mild airflow obstruction in younger and obese subjects. The FEV1/SVC ratio, however, should be used with caution in elderly subjects with preserved FEV1/FVC because a low value may represent a false-positive finding for airflow limitation.

Qualidade de Vida de cuidadores de praticantes de equoterapia no Distrito Federal / Quality of Life of caregivers of equine therapy practitioners in the Federal District

RESUMO O cuidador oferece atendimento individualizado, e a qualidade de sua atuação influencia na Qualidade de Vida (QV) da pessoa com deficiência. A sobrecarga de trabalho ou a falta de orientação quanto à melhor forma de sua atuação pode influenciar negativamente em sua saúde. Este artigo teve como objetivo avaliar a QV dos cuidadores dos praticantes de centros de equoterapia do Distrito Federal. Foi realizado um estudo de corte transversal em oito centros de equoterapia do Distrito Federal vinculados a Ande-Brasil, utilizando como instrumento de avaliação o questionário WHOQOL-bref para avaliar a QV dos cuidadores dos praticantes de equoterapia. Foram estudados 389 cuidadores, dos quais 71,72% correspondem ao gênero feminino e 28, 27% correspondem ao gênero masculino. Na análise dos resultados dos questionários, o domínio Relações Sociais obteve maior satisfação com escore de 66,13; o domínio Psicológico obteve escore de 64,52; o domínio Ambiente obteve escore de 60,8; e o domínio Físico apresentou o menor escore, obtendo 56,46. A média dos escores obtidos foi de 61,89. Os resultados demonstraram que a tarefa de cuidador pode provocar alterações físicas e mentais de forma negativa, e isso pode influenciar na qualidade de atendimento e no bem-estar do praticante.

ABSTRACT The caregiver offers individualized care, and the quality of his/her performance influences the Quality of Life (QoL) of disabled individuals. Overworking or lack of guidance can affect the caregiver's health either positively or negatively. This article aimed at evaluating the QoL of caregivers of equine therapy practitioners in the Federal District. A cross-sectional study was carried out in eight equine therapy centers of the Federal District, linked to Ande-Brasil, using the WHOQOL-bref questionnaire, to evaluate the QoL of caregivers of equine therapy practitioners. A total of 389 caregivers were studied, 71.72% of which were females and 28.27% were males. The analysis of answers to the questionnaires showed that the Social Relations domain obtained the highest satisfaction score (66.13); the Psychological domain scored 64.52; the Environment domain scored 60.8; and the Physical domain presented the lowest score, 56.46. Scores average was 61.89. The results showed that the work the caregiver performs may cause negative physical and mental changes, and these changes can influence the quality of care and her/his own well-being.