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4.
Eur J Prev Cardiol ; 2024 Apr 18.
Artículo en Inglés | MEDLINE | ID: mdl-38636093

RESUMEN

AIMS: To develop and validate equations predicting heart rate (HR) at the first and second ventilatory thresholds (VTs) and an optimized range-adjusted prescription for patients with cardiometabolic disease (CMD). To compare their performance against guideline-based exercise intensity domains. METHODS: Cross-sectional study involving 2,868 CMD patients from nine countries. HR predictive equations for first and second VTs (VT1, VT2) were developed using multivariate linear regression with 975 cycle-ergometer cardiopulmonary exercise tests (CPET). 'Adjusted' percentages of peak HR (%HRpeak) and HR reserve (%HRR) were derived from this group. External validation with 1,893 CPET (cycle-ergometer or treadmill) assessed accuracy, agreement, and reliability against guideline-based %HRpeak and %HRR prescriptions using mean absolute percentage error (MAPE), Bland-Altman analyses, intraclass correlation coefficients (ICC). RESULTS: HR predictive equations (R²: 0.77 VT1, 0.88 VT2) and adjusted %HRR (VT1: 42%, VT2: 77%) were developed. External validation demonstrated superiority over widely used guideline-directed intensity domains for %HRpeak and %HRR. The new methods showed consistent performance across both VTs with lower MAPE (VT1: 7.1%, VT2: 5.0%), 'good' ICC for VT1 (0.81, 0.82) and 'excellent' for VT2 (0.93). Guideline-based exercise intensity domains had higher MAPE (VT1: 6.8%-21.3%, VT2: 5.1%-16.7%), 'poor' to 'good' ICC for VT1, and 'poor' to 'excellent' for VT2, indicating inconsistencies related to specific VTs across guidelines. CONCLUSION: Developed and validated HR predictive equations and the optimized %HRR for CMD patients for determining VT1 and VT2 outperformed the guideline-based exercise intensity domains and showed ergometer interchangeability. They offer a superior alternative for prescribing moderate intensity exercise when CPET is unavailable.


Equations to predict heart rate at ventilatory thresholds were developed and externally validated, offering a new perspective when a cardiopulmonary exercise test is unavailable to accurately determine the aerobic exercise intensity domains. Additionally, an adjusted range for exercise intensity prescription based on the percentage of heart rate reserve (%HRR) was provided, utilizing a large sample from eight countries. The proposed equations and the range-adjusted %HRR significantly outperformed the guideline-directed methods for determining exercise intensity, exhibiting higher accuracy, agreement, and reliability. Exercise intensity prescription based on the percentage of heart rate peak showed higher errors, raising concerns about its clinical applicability. Our study may enhance the efficacy of exercise training and physical activity advice when gas exchange analysis is unavailable, potentially leading to improved clinical outcomes, even in low-resource settings. Employing these approaches in research could facilitate more tailored and consistent interventions, introducing a contemporary perspective for studies comparing exercise intensity prescriptions.

5.
Br J Sports Med ; 58(11): 598-605, 2024 May 28.
Artículo en Inglés | MEDLINE | ID: mdl-38621858

RESUMEN

OBJECTIVES: To evaluate the prevalence of abnormal ECG findings and their association with imaging results in male Brazilian football players. METHODS: The 'B-Pro Foot ECG' is a multicentre observational study conducted in 82 Brazilian professional clubs. It analysed 6125 players aged 15-35 years (2496 white, 2004 mixed-race and 1625 black individuals) who underwent cardiovascular screening from 2002 to 2023. All ECGs were reviewed by two experienced cardiologists in the athlete's care. Those with abnormal findings underwent further investigations, including a transthoracic echocardiogram (TTE). Cardiac magnetic resonance (CMR) was subsequently performed based on TTE findings or clinical suspicion. RESULTS: In total, 180 (3%) players had abnormal ECGs and 176 (98%) showed normal TTE results. Athletes aged 26-35 years had a higher prevalence of abnormal ECGs than younger athletes (15-25 years). Black players had a higher prevalence of T-wave inversion (TWI) in the inferior leads than white players (2.6% vs 1.4%; p=0.005), as well as in V5 (2.9%) and V6 (2.1%) compared with white (1.2% and 1.0%; p<0.001) and mixed-race (1.5% and 1.2%; p<0.05) players, respectively. TTE parameters were similar across ethnicities. However, four out of 75 players with inferolateral TWI showed abnormal TTEs and CMR findings consistent with cardiomyopathies. CMR also showed cardiomyopathies or myocarditis in four players with inferolateral TWI and normal TTEs. In total, nine (0.1%) athletes were diagnosed with cardiac diseases and were followed for 40±30 months, with no cardiac events documented. CONCLUSION: This study found a 3% prevalence of abnormal ECGs in male Brazilian football players. Inferolateral TWI was associated with cardiac pathologies confirmed by CMR, even in athletes with a normal TTE.


Asunto(s)
Ecocardiografía , Electrocardiografía , Fútbol , Humanos , Masculino , Brasil/epidemiología , Adolescente , Adulto Joven , Adulto , Prevalencia , Imagen por Resonancia Magnética
6.
Arq Bras Cardiol ; 121(2): e20230524, 2024.
Artículo en Portugués, Inglés | MEDLINE | ID: mdl-38597535

RESUMEN

BACKGROUND: Disparities in health outcomes among racial groups warrant investigation, even among elite athletes. Therefore, understanding the impact of race upon post-medal survival in Brazilian Olympians becomes essential. OBJECTIVE: To compare post-medal survival between white and non-white Brazilian Olympic medalists from 1920 to 1992. METHODS: This study used publicly available data for a retrospective cohort study on all Brazilian Olympic medalists from 1920 to 1992 (males only). Athletes were classified into white and non-white groups using structured ethnicity determination. Kaplan-Meier analyses computed the restricted mean survival time (RMST) for each ethnic group. A Cox proportional hazards analysis assessed ethnicity-based survival differences, adjusting for medal-winning age and birth year (p<0.05). RESULTS: Among 123 athletes (73.9% white), the mean age of medal achievement was 25.03±4.8 years. During the study, 18.7% of white and 37.5% of non-white athletes died (p=0.031). White athletes had a mean age at death of 75.10±18.01 years, while non-white athletes had an age of 67.13±14.90 years (p=0.109). The RMST for white athletes was 51.59 (95% CI 49.79-53.39) years, while for non-white athletes, it was 45.026 (95% CI 41.31-48.74) years, resulting in a ΔRMST of 6.56 (95% CI 2.43-10.70; p=0.0018). Multivariate analysis showed that non-white athletes had a higher mortality risk than did white athletes (HR 5.58; 95% CI, 2.18-14.31). CONCLUSION: Following their first medal, white Brazilian Olympians typically enjoy a six-year longer lifespan than their non-white counterparts, illustrating a marked mortality gap and health disparities among healthy individuals in Brazil.


FUNDAMENTO: As disparidades nos resultados de saúde entre grupos raciais merecem investigação, mesmo em atletas de elite. Portanto, compreender o impacto da raça na sobrevida pós-medalha em atletas olímpicos brasileiros torna-se essencial. OBJETIVO: Comparar a sobrevida pós-medalha entre medalhistas olímpicos brasileiros brancos e não brancos de 1920 a 1992. MÉTODOS: Utilizamos dados disponíveis publicamente para um estudo de coorte retrospectivo de todos os medalhistas olímpicos brasileiros de 1920 a 1992 (somente homens). Os atletas foram classificados nos grupos brancos e não brancos usando determinação estruturada de etnia. As análises de Kaplan-Meier calcularam o tempo médio de sobrevida restrito (TMSR) para cada grupo étnico. Uma análise de riscos proporcionais de Cox avaliou as diferenças de sobrevida baseadas na etnia, ajustando para a idade da conquista da medalha e ano de nascimento (p<0,05). RESULTADOS: Entre 123 atletas (73,9% brancos), a idade média da conquista de medalhas foi de 25,03 ± 4,8 anos. Durante o estudo, 18,7% dos atletas brancos e 37,5% dos atletas não brancos morreram (p=0,031). Os atletas brancos tiveram média de idade ao óbito de 75,10 ± 18,01 anos, enquanto os atletas não brancos tiveram idade média de 67,13 ± 14,90 anos (p=0,109). O TMSR para atletas brancos foi de 51,59 (IC 95%, 49,79 - 53,39) anos, e para atletas não brancos foi de 45,026 (IC 95%, 41,31 - 48,74) anos, resultando em um ΔTMSR de 6,56 (IC 95%, 2,43 - 10,70; p=0,0018). A análise multivariada mostrou que atletas não brancos apresentavam maior risco de mortalidade do que atletas brancos (RC 5,58; IC 95%, 2,18 - 14,31). CONCLUSÃO: Após a primeira medalha, os atletas olímpicos brasileiros brancos normalmente desfrutam de uma expectativa de vida seis anos mais longa do que seus colegas não brancos, ilustrando uma acentuada diferença de mortalidade e disparidades de saúde entre indivíduos saudáveis no Brasil.


Asunto(s)
Deportes , Masculino , Humanos , Adulto Joven , Adulto , Persona de Mediana Edad , Anciano , Anciano de 80 o más Años , Estudios de Cohortes , Brasil , Estudios Retrospectivos , Atletas
7.
Eur Geriatr Med ; 2024 Feb 29.
Artículo en Inglés | MEDLINE | ID: mdl-38421586

RESUMEN

PURPOSE: Peak oxygen uptake (VO2peak) is a crucial health marker, extensively studied in adults for its prognostic value. However, its significance in the older persons, especially octogenarians, remains underexplored due to limited representation in research. This study aims to assess the predictive power of VO2peak for survival in individuals aged 80 and above. METHODS: We included individuals aged 80 or older who underwent cardiopulmonary exercise tests at a single center. Mortality rates were compared based on VO2peak relative to 80% of predicted values (%VO2peak). We employed three multivariate Cox regression models: Model 1 (unadjusted), Model 2 (adjusted for age) and Model 3 (adjusted for age and stroke). RESULTS: Among 188 participants (mean age 83.3 ± 3 years, 68.9% male), 22 (11.7%) passed away during a median follow-up of 494 days. Non-survivors tended to be older with lower VO2peak and %VO2peak. All models demonstrated associations between %VO2peak ≤ 80% and mortality: HR = 3.19 (95% CI: 1.30-7.86, p = 0.011) for M1; HR = 3.12 (95% CI: 1.26-7.74, p = 0.013) for M2 and HR = 2.80 (95% CI: 1.11-7.06, p = 0.028) for M3. CONCLUSION: In the context of an aging population, this study underscores the enduring significance of VO2peak as a survival predictor among the older person, including octogenarians. These findings carry profound implications for tailoring healthcare strategies to address the evolving demographic landscape.

8.
Top Companion Anim Med ; 58: 100828, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-37890579

RESUMEN

Dioctophyme renale (D. renale) is a nematode that parasitizes the kidney of mammals. Treatment is often surgical, with removal of the affected organ. This retrospective study aims to evaluate the epidemiological, clinical, and surgical aspects, the interval between diagnosis and treatment, the occurrence of pre- and intraoperative complications, and the postoperative survival time of dogs parasitized by D. renale undergoing therapeutic nephrectomy. Records of fifty-two dogs treated in a single hospital service were analyzed. We collected epidemiological data, laboratory results, diagnostic method, anesthetic protocol, surgical technique and time, type of antimicrobial prophylaxis, pre- and intraoperative complications, location and number of parasites, and postoperative survival time. Of the 52 dogs undergoing right nephrectomy by laparotomy, 61.5 % were female and 63.4 % were adults. Although the most common clinical sign was hematuria (25 %), 61.5 % of the patients were asymptomatic. Eosinophilia and increased serum urea were the only laboratory changes found. The interval between diagnosis and surgery was 27.4 ± 23 days and no patient showed changes suggestive of surgical emergency. The most common surgical approach was the right paracostal (61.5 %), and a continuous suture pattern was predominant. Intraoperative complications occurred in 9.6 % of the procedures, varying from mild to severe hemorrhage. Mean postoperative survival was 835.5 ± 428 days. Dioctophymosis was effectively controlled by nephrectomy of the affected kidney, allowing a mean survival of more than 830 days. No serious complications caused by intervals between diagnosis and treatment have been reported. This is the largest retrospective study evaluating dogs infected with D. renale that were surgically treated.


Asunto(s)
Dioctophymatoidea , Enfermedades de los Perros , Infecciones por Enoplida , Humanos , Perros , Femenino , Animales , Masculino , Estudios Retrospectivos , Nefrectomía/veterinaria , Infecciones por Enoplida/cirugía , Infecciones por Enoplida/veterinaria , Infecciones por Enoplida/parasitología , Complicaciones Intraoperatorias/cirugía , Complicaciones Intraoperatorias/veterinaria , Mamíferos
9.
Arq. bras. cardiol ; 121(2): e20230524, 2024. tab, graf
Artículo en Portugués | LILACS-Express | LILACS | ID: biblio-1557001

RESUMEN

Resumo Fundamento: As disparidades nos resultados de saúde entre grupos raciais merecem investigação, mesmo em atletas de elite. Portanto, compreender o impacto da raça na sobrevida pós-medalha em atletas olímpicos brasileiros torna-se essencial. Objetivo: Comparar a sobrevida pós-medalha entre medalhistas olímpicos brasileiros brancos e não brancos de 1920 a 1992. Métodos: Utilizamos dados disponíveis publicamente para um estudo de coorte retrospectivo de todos os medalhistas olímpicos brasileiros de 1920 a 1992 (somente homens). Os atletas foram classificados nos grupos brancos e não brancos usando determinação estruturada de etnia. As análises de Kaplan-Meier calcularam o tempo médio de sobrevida restrito (TMSR) para cada grupo étnico. Uma análise de riscos proporcionais de Cox avaliou as diferenças de sobrevida baseadas na etnia, ajustando para a idade da conquista da medalha e ano de nascimento (p<0,05). Resultados: Entre 123 atletas (73,9% brancos), a idade média da conquista de medalhas foi de 25,03 ± 4,8 anos. Durante o estudo, 18,7% dos atletas brancos e 37,5% dos atletas não brancos morreram (p=0,031). Os atletas brancos tiveram média de idade ao óbito de 75,10 ± 18,01 anos, enquanto os atletas não brancos tiveram idade média de 67,13 ± 14,90 anos (p=0,109). O TMSR para atletas brancos foi de 51,59 (IC 95%, 49,79 - 53,39) anos, e para atletas não brancos foi de 45,026 (IC 95%, 41,31 - 48,74) anos, resultando em um ΔTMSR de 6,56 (IC 95%, 2,43 - 10,70; p=0,0018). A análise multivariada mostrou que atletas não brancos apresentavam maior risco de mortalidade do que atletas brancos (RC 5,58; IC 95%, 2,18 - 14,31). Conclusão: Após a primeira medalha, os atletas olímpicos brasileiros brancos normalmente desfrutam de uma expectativa de vida seis anos mais longa do que seus colegas não brancos, ilustrando uma acentuada diferença de mortalidade e disparidades de saúde entre indivíduos saudáveis no Brasil.


Abstract Background: Disparities in health outcomes among racial groups warrant investigation, even among elite athletes. Therefore, understanding the impact of race upon post-medal survival in Brazilian Olympians becomes essential. Objective: To compare post-medal survival between white and non-white Brazilian Olympic medalists from 1920 to 1992. Methods: This study used publicly available data for a retrospective cohort study on all Brazilian Olympic medalists from 1920 to 1992 (males only). Athletes were classified into white and non-white groups using structured ethnicity determination. Kaplan-Meier analyses computed the restricted mean survival time (RMST) for each ethnic group. A Cox proportional hazards analysis assessed ethnicity-based survival differences, adjusting for medal-winning age and birth year (p<0.05) Results: Among 123 athletes (73.9% white), the mean age of medal achievement was 25.03±4.8 years. During the study, 18.7% of white and 37.5% of non-white athletes died (p=0.031). White athletes had a mean age at death of 75.10±18.01 years, while non-white athletes had an age of 67.13±14.90 years (p=0.109). The RMST for white athletes was 51.59 (95% CI 49.79-53.39) years, while for non-white athletes, it was 45.026 (95% CI 41.31-48.74) years, resulting in a ΔRMST of 6.56 (95% CI 2.43-10.70; p=0.0018). Multivariate analysis showed that non-white athletes had a higher mortality risk than did white athletes (HR 5.58; 95% CI, 2.18-14.31). Conclusion: Following their first medal, white Brazilian Olympians typically enjoy a six-year longer lifespan than their non-white counterparts, illustrating a marked mortality gap and health disparities among healthy individuals in Brazil.

11.
Eur J Sport Sci ; 23(5): 829-839, 2023 May.
Artículo en Inglés | MEDLINE | ID: mdl-35306969

RESUMEN

The multisystem impairment promoted by COVID-19 may be associated with a reduction in exercise capacity. Cardiopulmonary abnormalities can change across the acute disease severity spectrum. We aimed to verify exercise physiology differences between COVID-19 survivors and SARS-CoV-2-naïve controls and how illness severity influences exercise limitation. A single-centre cross-sectional analysis of prospectively collected data from COVID-19 survivors who underwent cardiopulmonary exercise testing (CPET) in their recovery phase (x = 50[36;72] days). Patients with COVID-19 were stratified according to severity as mild [M-Cov (outpatient)] vs severe/critical [SC-Cov(inpatients)] and were compared with SARS-CoV-2-naïve controls (N-Cov). Collected information included demographics, anthropometrics, previous physical exercise, comorbidities, lung function test and CPET parameters. A multivariate logistic regression analysis was performed to identify low aerobic capacity (LAC) predictors post COVID-19. Of the 702 included patients, 310 (44.2%), 305 (43.4%) and 87 (12.4%) were N-Cov, M-Cov and SC-Cov, respectively. LAC was identified in 115 (37.1%), 102 (33.4%), and 66 (75.9%) of N-CoV, M-CoV and SC-CoV, respectively (p < 0.001). SC-Cov were older, heavier with higher body fat, more sedentary lifestyle, more hypertension and diabetes, lower forced vital capacity, higher prevalence of early anaerobiosis, ventilatory inefficiency and exercise-induced hypoxia than N-Cov. M-Cov had lower weight, fat mass, and coronary disease prevalence and did not demonstrate more CEPT abnormalities than N-Cov. After adjustment for covariates, SC-Cov was an independent predictor of LAC (OR = 2.7; 95% CI, 1.3-5.6). Almost two months after disease onset, SC-CoV presented several exercise abnormalities of oxygen uptake, ventilatory adaptation and gas exchange, including a high prevalence of LAC.Highlights Weeks after the acute disease phase, one-third of mild and three-quarters of severe and critical patients with COVID-19 presented a reduced aerobic capacity. Previous studies including SARS-CoV-1 survivors observed much lower values.A severe or critical COVID-19 case was an independent predictor for low aerobic capacity.In our sample, pre-COVID-19 exercise significantly reduced the odds of post-COVID-19 low aerobic capacity. Even severe or critical patients who exercised regularly had a prevalence of low aerobic capacity 2.5 times lower than those who did not have this routine before sickening.


Asunto(s)
COVID-19 , Humanos , COVID-19/epidemiología , SARS-CoV-2 , Estudios Transversales , Prueba de Esfuerzo , Sobrevivientes
12.
Eur J Sport Sci ; 23(6): 925-935, 2023 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-35418276

RESUMEN

Since the beginning of the SARS-CoV-2 pandemic, the community use of facemasks has been widely recommended. However, their use during exercise has raised safety concerns. Thus, we compared the physiological differences between exercising wearing a surgical (SM) or a double-layer-cotton (DLC) facemask and not wearing a mask (NM). Sixteen volunteers underwent 4 bouts of cycling-based exercise, which consisted of two different intensities: light-to-moderate and moderate-to-high. Facemasks were used as follows: bout-1 and 4: NM; bout-2: SM or DLC and bout-3: DLC or SM. Ventilatory, metabolic, pulmonary gas exchange (PGE) and perceptual variables were collected. At both exercise intensities compared to NM, both facemasks induced similar ventilatory adaptations, increasing inspiratory time and tidal volume and decreasing breathing frequency. Effect sizes (ES) were larger for DLC than for SM. At moderate-to-high, both facemasks reduced the minute ventilation, whereas at light-to-moderate, it was only seen with DLC. End tidal and mixed CO2 pressures, as well as the difference between them, increased with both facemasks. Again, ES was larger for DLC than SM. No relevant oxygen saturation drop was observed with both facemaks and exercise intensities. A small ES increament in VO2 and VCO2 were seen with both facemasks. Effort perception increased at moderate-to-high for both exercise intensities, buth larger EF were with DLC than SM . DLC increased facial temperature during both exercise intensities. In conclusion, ventilatory adjustments imposed during facemask exercise influenced PGE and metabolic and perceptual changes. Larger ES were mostly seen for DLC than SM.Abbreviations: Bf: Breathing frequency.; CPET: Cardiopulmonary exercise test.; CI: Confidence interval.; DLC: Double-layer cotton.; ETCO2: End tidal CO2 pressure.; ES: Effect size.; ΔET-PECO2: Difference between ETCO2 and PECO2.; FMMT: Facemask microclimate temperature.; HR: Heart rate.; IQR: Interquartile range.; NM: No mask.; PECO2: Mixed-expired CO2 pressure.; RER: Respiratory exchange ratio.; RPE: Rate of perceived effort.; SD: Standard deviation.; SM: Surgical Mask.; SpO2: Oxygen saturation.; STP: Subjective thermal perception.; Ti/TTOT: Duty cycle.; VE: Minute ventilation.; VCO2: Carbon dioxide output.; VO2: Oxygen uptake.; VT: Tidal volume.; VT: Ventilatory threshold.HighlightsFacemasks affect the breathing pattern by changing the frequency and amplitude of pulmonary ventilation.The augmented ventilatory work increases VO2, VCO2, and RPE and promotes nonconcerning drops in SpO2 and CO2 retention.Increased inspiratory and expiratory pressure can account for the reduction in pulmonary physiological dead space.


Asunto(s)
COVID-19 , Dióxido de Carbono , Humanos , Dióxido de Carbono/metabolismo , Máscaras , SARS-CoV-2/metabolismo , Respiración , Prueba de Esfuerzo
13.
Rev. enferm. UFSM ; 13: e8, 2023.
Artículo en Inglés, Español, Portugués | LILACS, BDENF | ID: biblio-1418604

RESUMEN

Objetivo: cartografar o cuidado em saúde mental à criança e ao adolescente, seus fluxos, linhas e conexões a partir da articulação do Centro de Atenção Psicossocial Infantojuvenil (CAPSi) e Atenção Básica (AB). Método: pesquisa qualitativa e cartográfica, realizada em município do Rio Grande do Sul, de agosto a dezembro de 2017. Participaram do estudo profissionais do CAPSi e AB. Resultados: a experiência cartográfica com a rede rizoma permitiu acompanhar a articulação do CAPSi com serviços da AB; o planejamento e compartilhamento do cuidado segundo o agir coletivo dos trabalhadores, e também os "nós" e desafios da rede de saúde mental infantojuvenil. A insegurança para lidar com a demanda, com a falta de conhecimento e a necessidade de capacitação como forma de apoio são desafios mencionados pelos profissionais da AB para uma assistência em rede. Conclusão: arranjos assistenciais podem articular/compartilhar cuidados, evocando uma "rede rizomática" de conexões, fluxos e variadas linhas.


Objective: to map mental health care for children and adolescents, its flows, lines and connections based on the articulation of the Psychosocial Care Centers for Children and Adolescents (Centros de Atenção Psicossocial Infantojuvenil, CAPSi) and Primary Health Care (PHC). Method: a qualitative and cartographic research study conducted between August and December 2017 in a municipality from Rio Grande do Sul. The study participants were CAPSi and PHC professionals. Results: the cartographic experience with the rhizomatic network made it possible to monitor CAPSi's articulation with PHC services; planning and sharing care according to workers' collective action, and also the "knots" and challenges of the child and youth mental health network. Insecurity to deal with the demand, lack of knowledge and the need for training as a support modality are challenges mentioned by PHC professionals for networked assistance. Conclusion: care-related arrangements can articulate/share the assistance provided, evoking a "rhizomatic network" of connections, flows and varied lines.


Objetivo: cartografiar la atención en salud mental para niños y adolescentes, sus flujos, líneas y conexiones a partir de la articulación de los Centros de Atención Psicosocial Infantojuvenil (CAPSi) y la Atención Primaria (AP). Método: investigación cualitativa y cartográfica realizada en un municipio de Rio Grande do Sul entre agosto y diciembre de 2017. Los participantes del estudio fueron profesionales del CAPSi y de AP. Resultados: la experiencia cartográfica con la red rizomática permitió monitorear la articulación del CAPSi con servicios de AP, la planificación y cooperación en la atención conforme a la acción colectiva de los trabajadores, y también los "nodos" y desafíos de la red de salud mental infanto-juvenil. La inseguridad para lidiar con la demanda, añadida a la falta de conocimiento y a la necesidad de capacitación como forma de apoyo, son desafíos mencionados por los profesionales de AP para brindar asistencia en red. Conclusión: implementar disposiciones asistenciales específicas puede ser útil para articular/compartir la atención provista, evocando una "red rizomática" de conexiones, flujos y líneas variadas.


Asunto(s)
Humanos , Atención Primaria de Salud , Niño , Salud Mental , Adolescente , Política de Salud
15.
J Vet Med Sci ; 84(4): 618-623, 2022 Apr 15.
Artículo en Inglés | MEDLINE | ID: mdl-35264495

RESUMEN

This paper reports on two cases of laparoscopic nephrotomy employed in the treatment of canine dioctophymosis, which is considered a unusual procedure and a new treatment proposal heretofore not performed in veterinary medicine. Two patients were treated, one with a history of hematuria and the other with incidental finding of the parasite in the abdominal cavity during elective ovariohysterectomy. Both dogs were subjected to abdominal ultrasound, which produced images indicating the presence of the parasite in the right side kidney, but with partial parenchymal preservation. The patients were therefore subjected to laparoscopic nephrotomy. The surgical procedure was effective in treating dioctophymosis and enabled minimum tissue invasion during surgery, in addition to preservation of the kidney.


Asunto(s)
Enfermedades de los Perros , Infecciones por Enoplida , Neoplasias Renales , Laparoscopía , Animales , Enfermedades de los Perros/diagnóstico por imagen , Enfermedades de los Perros/cirugía , Perros , Infecciones por Enoplida/veterinaria , Femenino , Neoplasias Renales/veterinaria , Laparoscopía/veterinaria , Masculino , Nefrectomía/métodos , Nefrectomía/veterinaria , Nefronas/cirugía
18.
Zoo Biol ; 40(3): 227-237, 2021 May.
Artículo en Inglés | MEDLINE | ID: mdl-33739560

RESUMEN

The giant anteater (Myrmecophaga tridactyla) is being threatened by natural habitat destruction and fragmentation, illegal hunting and road kills. In this context, the generation of basic information on the reproductive parameters of this species is vital, aiming to improve reproductive management via, amongst others, assisted reproductive technologies. This study aimed to describe the morphological and functional features of semen collected from captive giant anteaters. Electroejaculation was performed in 13 animals housed in zoos located in São Paulo state, Brazil. Semen samples were collected from 13 animals in 16 procedures. Samples were evaluated for volume, motility, vigor, pH, concentration, sperm morphology, and functional tests. The following mean values were obtained: volume 1.28 ± 0.27 mL; motility 28.3 ± 6.2%; vigor 2.4 ± 0.25; concentration 129.4 ± 36.1 × 106 sperm/mL; pH 7.4 ± 0.2. Total acrosome, head, midpiece, and tail sperm abnormalities were 3.2 ± 0.8%, 25.4 ± 3.6%, 20.7 ± 3.2%, and 14.7 ± 2.6%, respectively. Intact acrosome was found in 83.7 ± 3.1% and intact membrane in 81.1 ± 4.0% of all samples collected. Mitochondrial activity was 66.4 ± 6.0% (Class I), 18.7 ± 2.9% (Class II), 8.0 ± 2.0% (Class III), 3.9 ± 1.0% (Class IV), and 3.0 ± 0.9% (Class V). Sperm DNA fragmentation rate was 13.2 ± 3.7%. These results indicated that electroejaculation is a feasible method for semen collection in giant anteaters, allowing a more detailed description of the semen in this species.


Asunto(s)
Animales de Zoológico , Euterios/fisiología , Análisis de Semen/veterinaria , Animales , Brasil , Conservación de los Recursos Naturales
19.
Rev. bras. oftalmol ; 80(5): e0039, 2021. tab, graf
Artículo en Portugués | LILACS | ID: biblio-1347255

RESUMEN

RESUMO Objetivo Verificar a prevalência e as principais causas de baixa acuidade visual encontradas em estudantes; resolver as alterações refracionais por meio de correção óptica e estabelecer uma relação entre visão e desempenho escolar. Métodos Estudo transversal, quantitativo, de ação social realizada em uma escola pública de ensino fundamental e médio de Araçatuba (SP). A avaliação especializada foi indicada aos estudantes que, em triagem visual, apresentaram acuidade visual ≤0,7 em um ou em ambos os olhos, com ou sem correção óptica prévia. Foram entregues óculos a todos que necessitavam, para melhorar visão. Foi realizada análise pela ficha de atendimento e pela nota escolar dos alunos, pelos programas Excel e BioEstat. Resultados Dos 503 alunos triados, 75 (15%) apresentaram baixa de acuidade visual. Compareceram à consulta agendada 66 (88%), e 50 (80,65%) receberam óculos prontos. A média de idade foi de 152 anos, e houve predominância do sexo feminino (64,5%). As alterações refracionais foram a principal causa da baixa visual (90,3%), e miopia, associada ou não a astigmatismo, foi a mais prevalente (63%). Dentre os casos, 13 (21%) tinham anisometropia. Não houve diferença estatisticamente significativa (p=0,5479) entre as médias anuais dos alunos com baixa de acuidade visual e aqueles com visão normal. Conclusão Projetos sociais de triagem visual são facilmente executáveis, têm baixo custo e alta resolutividade, uma vez que os transtornos refracionais são a principal causa e facilmente corrigidos com óculos. A baixa de acuidade visual detectada nos alunos não interferiu no desempenho escolar.


ABSTRACT Objective To verify the prevalence and the main causes of low visual acuity among students, to correct refractive errors with eyewear, and to establish a relation between vision and school performance. Methods This is a cross-sectional, quantitative study of a social action carried out in a public elementary and high school in the city of Araçatuba (SP). Specialized evaluation was indicated to students who presented visual acuity ≤0.7 in one or both eyes, with or without prior optical correction, upon triage. Glasses were delivered to everyone who needed better vision. The analysis was performed based on screening record and student's school grade, using Excel and BioEstat software. Results Out of 503 students screened, 75 (15%) presented low visual acuity. Sixty-six (88%) attended the scheduled visit and 50 (80.65%) received ready-made glasses. The mean age was 15±2 years, and there was a predominance of females (64.5%). Refractive errors were the main cause of visual impairment (90.3%) and myopia, associated or not to astigmatism, was the most prevalent condition (63%). Thirteen (21%) students had anisometropia. There was no statistically significant difference (p=0.5479) in annual average grade of students with low visual acuity and those with normal vision. Conclusion Social projects for visual triage are carried out without effort, have a low cost and high problem-solving capacity, since refractive errors are the most frequent diagnoses and easily corrected with glasses. The low visual acuity detected in students did not interfere in their school performance.


Asunto(s)
Humanos , Masculino , Femenino , Niño , Adolescente , Errores de Refracción/complicaciones , Errores de Refracción/diagnóstico , Servicios de Salud Escolar , Trastornos de la Visión/diagnóstico , Agudeza Visual , Salud Ocular , Trastornos de la Visión/rehabilitación , Pruebas de Visión , Selección Visual , Salud del Estudiante , Estudios Transversales , Diagnóstico Precoz , Anteojos , Estudio Observacional
20.
Rev Bras Parasitol Vet ; 29(4): e011820, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-33111844

RESUMEN

Dioctophymosis is caused by Dioctophyme renale, a nematode that usually affects the right kidney of carnivores. The aim of this study was to report on a case of a dog with progressive weight loss and swollen abdomen that was diagnosed as presenting dioctophymosis. The patient underwent surgical treatment through which 34 nematodes were found, of which 18 were female and 16 were male, with a maximum length of 74 centimeters. The parasites were free in the abdominal cavity and inside the right kidney, and had caused peritonitis, free fluid, severe adherences between the abdominal organs and renal perforation. Parasitic diseases with a high number of specimens of this species are uncommon in dogs. The disease progresses with an inflammatory reaction and consequent formation of adherences and granulomatous tissue. This surrounds the eggs that were eliminated in the abdominal cavity by the free parasites. This disease occurs frequently in the city of Pelotas, Rio Grande do Sul, Brazil, where the patient of this report was living. To the best of authors' knowledge, this is the case with the largest number of specimens of D. renale removed from a single dog in vivo.


Asunto(s)
Dioctophymatoidea , Enfermedades de los Perros , Infecciones por Enoplida , Animales , Brasil , Enfermedades de los Perros/diagnóstico , Enfermedades de los Perros/parasitología , Perros/parasitología , Infecciones por Enoplida/diagnóstico , Infecciones por Enoplida/veterinaria , Femenino , Riñón/parasitología , Masculino
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