The Distance Covered in Field Tests is more Explained by Walking Capacity than by Cardiorespiratory Fitness after Stroke.

OBJECTIVES: To investigate if the distance covered in the Six-Minute Walk Test (6MWT) and in the Incremental Shuttle Walk Test (ISWT) is most strongly explained by walking capacity or cardiorespiratory fitness (CRF) measures in individuals after chronic stroke. MATERIALS AND METHODS: This is a cross-sectional study. Individuals after chronic stroke aged at least 20 years old and able to walk at least 10 minutes independently were included. The distance covered (meters) in the 6 MWT and ISWT (dependent variables), comfortable and fast gait speed obtained by the 10 m walk test (10 mWT) (walking capacity measures; independent variables) and peak oxygen consumption (VO2peak; CRF measure; independent variable) (ml.kg-1.min-1) obtained by the cardiopulmonary exercise test (CPET) were obtained. Linear regression analyses were performed (α = 5%). RESULTS: Fifty individuals (mean age of 55±12 years and mean time after stroke of 67±74 months) were included. Comfortable and fast gait speeds were the variables that most strongly explained the distance covered in the field tests: 6MWT (R² = 0.614, ß = 0.784, p < 0.001 and R² = 0.615, ß = 0.778, p < 0.001, respectively) and ISWT (R² = 0.450, ß = 0.671, p < 0.001 and R² = 0.456, ß = 0.746, p < 0.001, respectively). On the other hand, for the VO2peak, the following models were generated: 6MWT (R² = 0.280, ß = 0.530, p < 0.001) and ISWT (R² = 0.154, ß = 0.393, p = 0.005). CONCLUSIONS: The distance covered in the field tests (6MWT and ISWT) is more suitable to support inferences about the walking capacity than about the CRF of individuals after chronic stroke.

Aerobic Training Efficacy in Inflammation, Neurotrophins, and Function in Chronic Stroke Persons: A Randomized Controlled Trial Protocol.

BACKGROUND: Neuroinflammation is an important part of stroke pathophysiology and has both detrimental and beneficial effects after stroke. Besides that the enhancement of neurotrophins seems to be related to improvements in stroke recovery. Evidences suggest that exercise plays a role in modulating anti-inflammatory and neurotrophic effects. However, little is known about its impact in stroke survivors, mainly in chronic stroke. The purpose of this study is to investigate the efficacy of moderate-intensity treadmill exercise in changing inflammatory mediators, interleukin-6 (IL-6), soluble tumor necrosis factor receptors I and II (sTNFRI, sTNFRII), interleukin-10 (IL-10), and brain-derived neurotrophic factor (BDNF) levels in chronic stroke patients. The secondary objective is to investigate the effects of training in improve mobility and exercise capacity. METHODS: This is a randomized controlled trial. Chronic stroke patients will be randomized to an experimental or control group, and will receive group interventions three times per week, over 12 weeks. The experimental group will receive moderate-intensity (60%-80% of maximum heart rate reserve) treadmill exercise. Control group will perform walking training on the ground (<40% of maximum heart rate reserve). Primary outcomes include IL-6, sTNFRI, sTNFRII, IL-10, and BDNF levels. Secondary outcomes include mobility and exercise capacity. Outcomes will be measured at baseline, postintervention, and at the 4-week follow-up. DISCUSSION: The findings of this trial have the potential to provide important insights regarding the effects of an aerobic physical program in the inflammatory process and in the neuronal plasticity in stroke persons and its impact on mobility and exercise capacity.

Perfil de atenção ao parto em um hospital público: contribuições da enfermagem / Profile of attention to the delivery in a public hospital: nursing assistance / Perfil de atención al parto en un hospital público: contribuciones de la enfermería

Objetivo:realizar diagnóstico situacional da atenção ao parto em uma maternidade pública da baixada litorânea do Estado do Rio de Janeiro.Método: estudo descritivo com abordagem quantitativa. Foram aplicados dois instrumentos para coleta de dados, do tipo checklist,no primeiro semestre de 2014, tendo como recorte temporal os 9 anos de funcionamento de uma maternidade. Para a análise dos dados, foram utilizados os referenciais teóricos do Inquérito Nacional sobre Parto e Nascimento/Nascer no Brasil, Ministério da Saúde e as Recomendações da Organização Mundial de Saúde. Resultados: foi prescrita dieta zero para 69,4% das parturientes durante todo trabalho de parto. A infusão de ocitocina contínua foi prescrita na admissão para 38,9% parturientes. Conclusão:constatou-se alto índice de partos cirúrgicos em detrimento dos partosvia vaginal. Evidenciando também a realização de intervenções obstétricas, tais como jejum, ocitocina, litotomia e episiotomia sendo efetuadas de modo rotineiro e sem indicação adequada.(AU)

Objective: to perform situational diagnosis of delivery care at a public maternity of the coast of the State of Rio de Janeiro. Method: descriptive study with a quantitative approach, applying two instruments for data collection, checklist type in the first half of 2014 with time cutting of nine years running of a a maternity hospital. For data analysis the theoretical reference of the National Survey on Labor and Delivery/Childbirth in Brazil, Ministry of Health and the Recommendations of the World Health Organization. Results: zero diet was prescribed for 69.4% of pregnant women throughout labor. The continuous infusion of oxytocin was prescribed at admission to 38.9% pregnant women. Conclusion: it was found a high rate of surgical deliveries than vaginal births. It was also observed the performance of obstetric interventions such as fasting, oxytocin, lithotomy and episiotomy carried out routinely and without proper indication.(AU)

Objetivo: realizar diagnóstico situacional de la atención al parto en una maternidad pública del litoral del Estado de Rio de Janeiro. Método: estudio descriptivo con enfoque cuantitativo, habiendo aplicado dos instrumentos para recolección de datos, del tipo checklist, en el primer semestre de 2014 con recorte temporal de 9 años de funcionamiento de una maternidad. Para el análisis de los datos, los referenciales teóricos de la Encuesta Nacional sobre Parto y Nacimiento/Nacer en Brasil, Ministerio de la Salud y las Recomendaciones de la Organización Mundial de la Salud. Resultados: fue prescrita dieta cero para 69,4% de las parturientes durante todo trabajo de parto. La infusión de oxitocina continua fue prescrita en la admisión para 38,9% parturientes. Conclusión: se constató alto índice de partos quirúrgicos en comparación con los partos vaginales. Se evidenció también la realización de intervenciones obstétricas, tales como ayuno, oxitocina, litotomía y episiotomía siendo realizadas de modo rutinero y sin indicación adecuada.(AU)

Perfil reprodutivo das mulheres assistidas no evento Outubro Rosa ­ dia d / Reproductive profile of women cared for during the 'Pink October d-day event

Objetivo: descrever o perfil reprodutivo das mulheres participantes da Campanha Outubro Rosa. Método: estudo descritivo, tipo informativo, realizado de outubro a dezembro de 2013, no município de Rio das Ostras/RJ, por discentes do Curso de Enfermagem da Universidade Federal Fluminense - Campus Rio das Ostras. Resultados: destacam-se entre as usuárias: a multiparidade em 64,3%; a nuliparidade em 10,5%; taxa de abortamentos, excluindo nulíparas, de 19%; e incidência de parto cesárea de 47%. Conclusão: evidencia-se a necessidade de que o município de Rio das Ostras (RJ) amplie o acesso e a adesão das usuárias aos serviços de saúde. A vivência foi extremamente rica na formação profissional dos acadêmicos de enfermagem participantes, por proporcionar o contato e a interação com as usuárias, fundamental para a caracterização e ampliação do conhecimento sobre a saúde reprodutiva da população feminina.(AU)

Interleukin-6 plasma levels and socioeconomic status in Brazilian elderly community-dwelling women.

Aging is related to a chronic increase in inflammatory cytokines. Adverse socioeconomic conditions are associated with increased plasma levels of these molecules, especially interleukin (IL)-6. Considering the differential profile of elderly Brazilians regarding their socioeconomic and cultural aspects, the objectives of this study were: to assess the correlation and differences between levels of IL-6 and socioeconomic status (education and income) in elderly women. IL-6 levels were measured using ELISA. The Spearman test was used to determine the correlation between IL-6 and socioeconomic status, and the Kruskal-Wallis and Mann-Whitney tests for cytokine level differences across education and income. IL-6 showed a significant inverse correlation with education (r = -0.205, p = 0.014) and income (r = -0.185, p = 0.028). Differences in IL-6 levels were registered across the education variables. The results corroborate evidence that low socioeconomic status is related to higher IL-6 plasma levels in elderly women.

Correlation between manual muscle strength and interleukin-6 (IL-6) plasma levels in elderly community-dwelling women.

Sarcopenia is a loss of muscle mass related to aging and leads to muscle performance decline. An increase in inflammatory mediator levels, especially of IL-6, has been associated to reduced muscle strength in the elderly. The aim of the present cross-sectional study was to correlate IL-6 plasma levels with manual muscle strength (MMS) in 63 community-dwelling elderly women. (71.2+/-7.4years). IL-6 was measured using enzyme-linked immunosorbent assay (ELISA) and MMS was measured using the JAMAR dynamometer. Pearson's test was used to explore the relationship between the outcomes at the significance level of alpha=0.05. IL-6 levels (2.56+/-3.44pg/ml) and MMS (22.86+/-4.62kgf) exhibited an inverse correlation (r=-0.2673 and p=0.0373). The increase in IL-6 plasma levels possibly contributed toward the reduction in manual muscle strength among the elderly women studied.

A influência do fortalecimento muscular no desempenho motor do membro superior parético de indivíduos acometidos por acidente vascular encefálico / The influence of muscle strengthening on upper limb motor performance in stroke subjects

Após o acidente vascular encefálico, mais de 80% dos sobreviventes apresentam hemiparesia e a fraqueza muscular é citada como uma importante deficiência responsável pela redução do uso funcional do membro superior parético. Nesse contexto, evidências científicas sugerem o treinamento resistido como um importante componente dos programas de reabilitação. Estudos relacionados à recuperação destes indivíduos apresentam fundamentação que apóia a utilização do treinamento resistido para a recuperação da função do membro superior parético. Entretanto, esta modalidade de treinamento pode não resultar em benefícios para todos os indivíduos hemiparéticos e seus efeitos estariam condicionados ao nível de acometimento inicial do indivíduo. Ainda não há resultados conclusivos sobre a influência do fortalecimento muscular no desempenho motor do membro superior parético, o que sugere a aplicação do treinamento resistido como intervenção terapêutica complementar à reabilitação funcional. O objetivo deste estudo foi analisar, por meio de revisão bibliográfica, a influência do fortalecimento muscular no desempenho motor dos membros superiores de indivíduos.