Método para establecer la reserva funcional de la velocidad de marcha en una muestra de adultas mayores autosuficientes chilenas: la relevancia del estímulo / Method to establish the functional reserve of gait speed in a sample of self-reliant older Chilean women: The relevance of the stimulus

Antecedentes y objetivo: El envejecimiento como proceso complejo y multifactorial involucra cambios multisistémicos asociados al rendimiento físico con pérdida de funcionalidad, tal como la velocidad de marcha y su reserva. El estudio estableció el método que mejor evidencia la reserva funcional de velocidad de marcha (RFVM) según la incorporación de estímulos en mujeres adultas mayores (AM). Material y método: Estudio observacional analítico con muestra conformada por 30AM de entre 65-69años, autosuficientes sin riesgo, normopeso y sin sospecha de depresión, controladas en Centro Comunitario de Salud Familiar y Centro de Salud Familiar de Talca. La velocidad de marcha (VM) fue medida a través de tres métodos: M1 (marcha habitual), M2 (marcha máxima) y M3 (marcha máxima con estímulos), para posteriormente calcular la RFVM en las AM. El ejercicio se ejecutó en una pista de 10m que incluía 2m de aceleración, 2m de desaceleración y 6m centrales para medir el tiempo en segundos que demoraba en recorrerlos. Resultados: Las medias de velocidades de la muestra en los métodos habitual, máxima y máxima con estímulo fueron de 1,17, 1,38 y 1,57m/s, respectivamente; las reservas funcionales (RF) resultantes entre las diferencias de los métodos fueron: RF-A (M2−M1) 0,26m/s; RF-B (M3−M1) 0,45m/s y RF-C (M2−M3) 0,19m/s; para la mayoría de los casos y según orden correspondiente, las diferencias estadísticas fueron significativas. Conclusión: El método que mejor evidenció la RFVM fue a través de las diferencias de medias entre M3 y M1, siendo una forma objetiva de verificar esta dimensión del movimiento humano como expresión de funcionalidad de las AM. (AU)

Background and objective: Aging as a complex and multifactorial process involves multisystemic changes associated with physical performance with loss of functionality such as walking speed and reserve. The study established the method that best evidences the functional reserve (FR) of walking speed (FRWS) according to the incorporation of stimuli in older adults (OAs). Material and method: Analytical observational study with a sample made up of 30OAs between 65 and 69years, self-administered without risk, normal weight and without suspicion of depression, controlled in Centro Comunitario de Salud Familiar and Centro de Salud Familiar of Talca. The walking speed (WS) was measured by three methods: M1 (usual gait), M2 (maximum gait) and M3 (maximum gait with stimuli); to later calculate the FRWS in the AO, executed on a 10m track that included 2m acceleration, 2m deceleration and 6m centrals to measure the time in seconds it took to travel them. Results: The mean velocities of the sample in the usual, maximum and maximum stimulated methods were 1.17, 1.38 and 1.57m/s respectively; the resulting FRs between the method differences: FR-A (M2−M1) 0.26m/s; FR-B (M3−M1) 0.45m/s and FR-C (M2−M3) 0.19m/s, for most of the cases and according to the corresponding order, the statistical differences were significant. Conclusion: The method that best evidenced the FRWS was through the differences in means between M3 and M1, being an objective way to verify this dimension of human movement as an expression of OA functionality. (AU)

Práctica basada en evidencia en la rehabilitación post-COVID-19: una mirada desde la Fisioterapia / Evidence-based practice in post-COVID-19 rehabilitation: A physical therapy point of view

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Impact of Social Isolation Due to COVID-19 on Health in Older People: Mental and Physical Effects and Recommendations.

OBJECTIVES: To review the impact of social isolation during COVID-19 pandemic on mental and physical health of older people and the recommendations for patients, caregivers and health professionals. DESIGN: Narrative review. SETTING: Non-institutionalized community-living people. PARTICIPANTS: 20.069 individuals from ten descriptive cross-sectional papers. MEASUREMENTS: Articles since 2019 to 2020 published on Pubmed, Scielo and Google Scholar databases with the following MeSh terms ('COVID-19', 'coronavirus', 'aging', 'older people', 'elderly', 'social isolation' and 'quarantine') in English, Spanish or Portuguese were included. The studies not including people over 60 were excluded. Guidelines, recommendations, and update documents from different international organizations related to mental and physical activity were also analysed. RESULTS: 41 documents have been included in this narrative review, involving a total of 20.069 individuals (58% women), from Asia, Europe and America. 31 articles included recommendations and 10 addressed the impact of social distancing on mental or physical health. The main outcomes reported were anxiety, depression, poor sleep quality and physical inactivity during the isolation period. Cognitive strategies and increasing physical activity levels using apps, online videos, telehealth, are the main international recommendations. CONCLUSION: Mental and physical health in older people are negatively affected during the social distancing for COVID-19. Therefore, a multicomponent program with exercise and psychological strategies are highly recommended for this population during the confinement. Future investigations are necessary in this field.

Comparación entre simple y doble tarea, capacidad cognitiva y equilibrio postural en adultos mayores que participan de 3 modalidades de ejercicio físico / Comparison between simple and dual tasks, cognitive capacity, and postural balance in older people who participated in 3 types of exercise

Antecedentes y objetivo: Los programas de ejercicio físico grupales para el adulto mayor son ofrecidos usualmente por los servicios de salud comunitaria, los cuales pueden generar diferentes estímulos en la capacidad física y cognitiva de la población. El objetivo del estudio fue comparar el desempeño en actividades de simple y de doble tarea, equilibrio postural y funciones cognitivas en adultas mayores que participan de diferentes modalidades de ejercicios grupales. Materiales y métodos: Fueron evaluadas 41 adultas mayores pertenecientes a 3 programas de ejercicio (G1=grupo de caminata, G2=grupo de entrenamiento funcional y G3=grupo de danza). Para determinar el nivel de actividad física fue utilizado el International Physical Activity Questionnaire adaptado, para el equilibrio se utilizó el test de apoyo unipodal, para evaluación cognitiva el miniexamen del estado mental y para la evaluación del desempeño en actividades de tarea simple y doble fue contabilizado el número de repeticiones realizando actividades motoras y cognitivas durante 30seg. Para el análisis estadístico, ANOVA de un factor y Kruskal-Wallis fueron utilizadas para la comparación de las variables. El coeficiente de Spearman se utilizó para evaluar la correlación entre las variables. Resultados: Los grupos no fueron diferentes en edad ni índice de masa corporal (IMC), G1 (n=13; edad=62,5±2,9 años; IMC=28,49±6,4kg/m2), G2 (n=13; edad: 64,2±5,9 años; IMC=26,6±4,2kg/m2) y G3 (n=15; edad=66,6±6,05 años; IMC=29,4±8,4kg/m2); p>0,05. El G2 presentó un mayor número de repeticiones de la tarea simple, doble motora y doble motora-cognitiva comparado con el G1 y G3 (p<0,004). Fueron encontradas correlaciones entre la tarea simple, doble motora y doble motora-cognitiva (0,56>r<0,80; p<0,05). Conclusión: Las adultas mayores que practican entrenamiento funcional tienen mejor rendimiento en tareas motoras-cognitivas en comparación con a aquellas que practican danza y caminata

Background and objective: Physical exercise programmes for groups of older people are usually offered by community health services, which can generate different stimulus in the physical and cognitive capacity in this population. The objective of this study was to compare the performance of simple and dual task activities, postural balance and cognitive functions in older adults who took part in different types of group exercises. Materials and methods: A total of 41 older women took part in 3 exercise programmes were evaluated (G1=walking group, G2=functional training group, and G3=dancing group). To determine the level of physical activity the International Physical Activity Questionnaire. Balance was assessed using the unipedal stance test, the cognitive capacity was tested using the mini mental status examination, and the performing of the simple/dual tasks was assessed according to the number of repetitions made during cognitive and motor activities for 30seconds For the statistical analysis, One-way ANOVA and Kruskal-Wallis were used to compare the variables. The Spearman coefficient was used to evaluate the correlation between the variables. Results: There were no differences in age and body mass index (BMI) between the groups, G1 (n=13; age=62.5±2.9 years; BMI=28.49±6.4Kg/m2), G2 (n=13; age: 64.2±5 years; BMI=26.6±4.2Kg/m2), and G3 (n=15; age=66.6±6.05 years; BMI=29.4±8.4Kg/m2), P>.05. G2 showed a better performance in simple, dual motor, and dual motor-cognitive tasks compared to G1 and G3 (P>.004). Correlations were observed between simple, dual motor, and dual motor-cognitive tasks (0.56>r<0.80; P>.05). Conclusion: Older women who practice functional training have better performance in cognitive-motor tasks compared to those who dance and walk

Is oxidative stress associated with disease severity, pulmonary function and metabolic syndrome in chronic obstructive pulmonary disease? / ¿Está el estrés oxidativo asociado a la gravedad de la enfermedad, a la función pulmonar y al síndrome metabólico en la enfermedad pulmonar obstructiva crónica?

OBJECTIVE: To investigate associations between oxidant/antioxidant biomarkers with the disease severity, pulmonary function and diagnosis of metabolic syndrome (MetS) in patients with COPD. METHODS: Seventy-four subjects were included, 39 with COPD (age 69±7 years; female 41%) and 35 for control group (age 69±7 years; female 43%). They were diagnosed with MetS and allocated in one of 4 subgroups: COPD and control, with and without MetS, respectively. Advanced oxidation protein products (AOPP), paraoxonase-1, catalase activity, sulfhydryl group and total lipid hydroperoxide were assayed. Pulmonary function was performed with a plethysmograph. RESULTS: COPD severity (GOLD≥3) and pulmonary function were associated with sulfhydryl group and AOPP (P≤.03 for all). The prevalence of MetS was associated with AOPP in COPD (P=.04). Individuals with COPD and MetS showed higher AOPP compared to COPD without MetS (P<.0001). CONCLUSION: COPD severity, worse pulmonary function and presence of metabolic syndrome are associated with oxidative stress in individuals with COPD.

Transferência passiva de soro hiperimune anti-Streptococcus agalactiae e seu efeito profilático em tilápias-do-nilo infectadas experimentalmente: sobrevivência e títulos de anticorpos / Passive transfer of hyperimmune serum anti Streptococcus agalactiae and its prophylactic effect on Nile tilapia experimentally infected

A bactéria Streptococcus agalactiae é um potente agente causador de surtos por doenças bacterianas em peixes. O estresse provocado pelo manejo zootécnico e pela má qualidade ambiental torna a tilápia susceptível às infecções por essa bactéria. O objetivo do presente trabalho foi avaliar a resistência de tilápias-do-nilo imunizadas com soro hiperimune anti-S. agalactiae, posteriormente desafiadas com cepa homóloga da mesma bactéria. Após determinação da DL 50 de S. agalactiae, 36 tilápias foram distribuídas em quatro aquários, dois para o grupo controle e dois para inoculação celomática para produção de anticorpos anti-S. agalactiae. No 21° e 28° dias, foi coletado sangue para obtenção de soro hiperimune utilizado na transferência passiva. Em seguida, 30 tilápias foram distribuídas em três aquários e submetidas a três tratamentos: GI: controle; GII: imunizadas com o soro inativado; GIII: imunizadas com soro ativo...

The Streptococcus agalactiae bacteria is a potent agent which causes outbreaks of bacterial diseases in fish. The stress caused by management and poor environmental quality makes tilapia susceptible to infections, including by bacterium. The aim of this study was to evaluate the resistance of the Nile tilapia immunized with hyperimmune serum against S. agalactiae subsequently challenged with homologous strain of the same bacteria. After determining the DL 50 of S. agalactiae, 36 tilapias were distributed in 4 aquariums, 2 for the control group and 2 for the group via coelomic, inoculated with the DL 50 for anti-S. agalactiae antibodies production. On the 21st and 28th day blood was collected for the obtainment of hiperimmune serum used in passive transference. Then, 30 tilapias were distributed in 3 aquariums submitted to 3 treatments (GI: control; GII: immunized with inactivated-serum; GIII: immunized with non-inactivated serum)...

Low dose of Concanavalin-A enhances innate immune response and prevents liver injury in mice infected with Candida albicans.

The mechanisms through which Candida albicans is recognized by immune cells and how it triggers host defence are not completely understood. In this study, we evaluated the effect of Concanavalin-A on the clearance of C. albicans by infected mice and their production of proinflammatory cytokine tumor necrosis factor-alpha (TNF-alpha). Subgroups of 5 animals were pretreated with Con-A (250 mug mL(-1) PBS) and after 96 h were infected intraperitoneally with 10(7) cells of C. albicans CR15 (an isolate from a HIV+ person); 30 min, 2, 6, 24 or 72 h after infection the mice were sacrificed. Phagocytosis of C. albicans by peritoneal macrophages increased 30 min after infection in mice pretreated with Con-A. The liver presented the greatest number of CFUs, and this number was reduced by pretreatment with Con-A. Control animals infected with C. albicans presented a significant increase in plasmatic alanine aminotransferase, which was not observed in mice treated with Con-A. Two hours after infection the production of TNF-alpha in the liver of mice pretreated with Con-A was significantly increased. These results suggest that a single dose of Con-A caused a beneficial modulating action of the inflammatory response during infection with C. albicans.

Phagocytosis of enteropathogenic Escherichia coli and Candida albicans by lectin-like receptors.

1. Ingestion of enteropathogenic Escherichia coli or Candida albicans by thioglycollate-elicited macrophages and polymorphonuclear leukocytes was investigated in vitro, 2. Goat antiserum against mannose receptors caused about 50% inhibition of E. coli phagocytosis and about 90% inhibition of C. albicans phagocytosis. 3. E. coli and C. albicans uptake was inhibited by about 60% and 98%, respectively, by plating the macrophages onto substrates coated with poly-L-lysine-mannan. Further addition of 50 mM mannose to the medium significantly increased the inhibition of phagocytosis of E. coli by macrophages from 60.7 +/- 1.5 to 79.8 +/- 13.1 and by polymorphonuclear cells from 58.9 +/- 3.7 to 88.7 +/- 4.9. 4. Preincubation of phagocytic cells with antiserum against substance A of human erythrocytes reduced E. coli ingestion by 95%, but this inhibition was not observed when the antiserum was incubated with N-acetylgalactosamine (50 mM) before being added to the phagocytes. The phagocytosis of C. albicans was not inhibited by anti-substance A antiserum. 5. The phagocytosis of E. coli was inhibited by about 25% by the addition of 7.8 micrograms/ml soluble mannan to the medium, and by about 50% by the addition of 50 mMN-acetylgalactosamine; when both substances were added to the medium, an additive inhibition of about 75% was observed. 6. These results indicate that mannose receptors on the surface of phagocytic cells mediate E. coli or Candida albicans uptake and that the binding of bacteria to N-acetylgalactosamine residues from the membrane of phagocytes is also involved in the phagocytosis of E. coli.

Phagocytosis of enteropathogenic Escherichia coli and Candida albicans by lectin-like receptors

1. Ingestion of enteropathogenic Escherichia coli or Candida albicans by thioglycollate-elicited macrophages and polymorphonuclear leukocytes was investigated in vitro, 2. Goat antiserum against mannose receptors caused about 50% inhibition of E. coli phagocytosis and about 90% inhibition of C. albicans phagocytosis. 3. E. coli and C. albicans uptake was inhibited by about 60% and 98%, respectively, by plating the macrophages onto substrates coated with poly-L-lysine-mannan. Further addition of 50 mM mannose to the medium significantly increased the inhibition of phagocytosis of E. coli by macrophages from 60.7 +/- 1.5 to 79.8 +/- 13.1 and by polymorphonuclear cells from 58.9 +/- 3.7 to 88.7 +/- 4.9. 4. Preincubation of phagocytic cells with antiserum against substance A of human erythrocytes reduced E. coli ingestion by 95%, but this inhibition was not observed when the antiserum was incubated with N-acetylgalactosamine (50 mM) before being added to the phagocytes. The phagocytosis of C. albicans was not inhibited by anti-substance A antiserum. 5. The phagocytosis of E. coli was inhibited by about 25% by the addition of 7.8 micrograms/ml soluble mannan to the medium, and by about 50% by the addition of 50 mMN-acetylgalactosamine; when both substances were added to the medium, an additive inhibition of about 75% was observed. 6. These results indicate that mannose receptors on the surface of phagocytic cells mediate E. coli or Candida albicans uptake and that the binding of bacteria to N-acetylgalactosamine residues from the membrane of phagocytes is also involved in the phagocytosis of E. coli

Participation of mannose receptors on the surface of stimulated macrophages in the phagocytosis of glutaraldehyde-fixed Candida albicans, in vitro.

We have evaluated the participation of mannose receptors on the surface of stimulated macrophages in the phagocytosis of Candida albicans in vitro. A dose-dependent 8.6 to 88.3% reduction of phagocytosis was observed in the presence of 0.5 to 5.0 mg/ml of the mannose-rich glycoprotein invertase (either native or denatured) in the incubation medium. Macrophages plated onto substrates coated with poly-L-lysine-mannan also showed a 99% reduction of phagocytic activity toward Candida albicans, but phagocytosis of IgG-coated erythrocytes was not inhibited under the same conditions. These results indicate that mannose receptors are involved in one of the initial steps of phagocytosis of Candida albicans by macrophages.

Participation of mannose receptors on the surface of stimulated macrophages in the phagocytosis of glutaraldehyde-fixed Candida albicans, in vitro

We have evaluated the participation of mannose receptors on the surface of stimulated macrophages in the phagocytosis of Candida albicans in vitro. A dose-dependent 8.6 to 88.3% reduction of phagocytosis was observed in the presence of 0.5 to 5.0 mg/ml of the mannose-rich glycoprotein invertase (either native or denatured) in the incubation medium. Macrophages plated onto substrates coated with poly-L-lysine-mannan also showed a 99% reduction of phagocytic activity toward Candida albicans, but phagocytosis of IgG-coated erytrocytes was not inhibited under the same conditions. These results indicate that mannose receptors are involved in one of the initial steps of phagocytosis of Candida albicans by macrophages

Civilian gunshot wounds: the limits of salvageability.

Patients who have suffered gunshot wounds in civilian settings, who present with posturing and in whom the bullet has passed through the geographical centre of the brain have generally not been felt to be salvageable. However, surprisingly favourable outcomes in two such patients have led us to believe that some such patients may deserve aggressive treatment.