Profile of pharmaceutical interventions of a pharmacotherapeutic follow-up model for diabetic patients in a community pharmacy

Abstract The insertion of Pharmaceutical Care in Primary Health Care (PHC) improves patients' clinical outcomes and quality of life. Pharmacotherapeutic follow-up can contribute to the management of chronic diseases such as diabetes, promoting better glycemic control and adherence to therapy. This study aimed to assess the Drug-therapy Problems (DTPs) and Pharmacist Interventions (PIs) on the pharmacotherapeutic management in patients with type 2 diabetes mellitus (T2DM) in a community pharmacy. A quantitative, retrospective, and cross-sectional study was conducted in a Pharmaceutical Care Program within the PHC in Juiz de Fora (Minas Gerais, Brazil). Inclusion criteria were patients with T2DM above 18, who attended at least three pharmaceutical consultations between July 2016 and October 2018 and presented two or more glycated hemoglobin tests. The study group (n = 17) was largely composed of women (65%), elderly (76%), sedentary (72%), and obese people (52%). The resolution was achieved in 79% of the DTPs identified (n = 115). Most of DTPs were related to administration and adherence to pharmacotherapy (46%). 60% of the 437 PIs involved the provision of information and counseling. In other words, accessible interventions lead to high resolvability. Therefore, clinical actuation of pharmacists could improve the prognosis in diabetes treatment

Caracterização molecular de Staphylococcus aureus isolados de queijos artesanais da Serra da Canastra / Molecular characterization of Staphylococcus aureus isolated from artisanal cheeses from Serra da Canastra

O queijo Minas Artesanal da Canastra é produzido na Serra da Canastra (MG), utilizando leite cru, coalho e pingo, que é uma cultura endógena natural de cada queijaria. Devido ao uso de leite cru, o produto pode veicular microrganismos causadores de doenças veiculadas por alimentos, como Staphylococcus aureus. A caracterização molecular é uma ferramenta importante para avaliar a população microbiana do alimento e direcionar a aplicação de medidas de controle na produção. Este estudo caracterizou a diversidade genética, o potencial de virulência e determinou o perfil de susceptibilidade a antimicrobianos de S. aureus isolados de queijos produzidos na Serra da Canastra. Para o estudo transversal foram analisados 248 isolados de queijos que tinham um tempo de maturação de 22 dias, provenientes de 83 propriedades. Por outro lado, no estudo longitudinal foram analisados outros 197 isolados coletados ao longo do processo de maturação, provenientes de três propriedades. Os isolados foram submetidos a testes bioquímicos para confirmação do gênero e para a confirmação da espécie de S. aureus, foi identificado o gene nuc por meio da técnica de PCR. Além disso, foi pesquisado o gene mecA para a detecção de S. aureus Resistente a Meticilina (MRSA). Após os testes de confirmação, 144 isolados do estudo transversal e 159 do estudo longitudinal foram positivos para o gene nuc, específico para S. aureus. Posteriormente, o perfil clonal foi determinado por Eletroforese de Campo Pulsado (PFGE) utilizando a enzima SmaI e tipagem do locus agr por PCR multiplex. A análise por PFGE foi realizada no programa BioNumerics. A técnica PCR foi realizada para identificar a presença de genes que codificam a produção de hemolisinas, toxina TSST-1, enterotoxinas SEs (SEA, SEB, SEC, SED, SEE, SEG, SEH, SEI, SEJ, SEO, SEM), formação de biofilme e Componentes Microbianos de Superfície que Reconhecem a Matriz de Moléculas Adesivas (MSCRAMMs). Os isolados foram submetidos ao teste de susceptibilidade a antimicrobianos por disco de difusão. Por último, a formação de biofilme em microplaca de 96 poços, em caldo TSB a 37°C, foi verificada pela metodologia de Cristal Violeta. O gene mecA foi detectado em 1,9% dos 445 isolados. A tipagem agrrevelou que 83 (27,4%) dos isolados são do tipo agr-I, 95 (31,4%) agr-II e 43 (14,2%) agr-III, sendo que não foram detectados isolados classificados como agr-IV. A tipagem por PFGE revelou um total de 54 perfis. Assim, um isolado representativo de cada perfil foi utilizado nos demais testes que mostraram a presença dos genótipos spa mais frequentes t127 e t605 (20,58%); t002 (14,70%), seguidos pelos tipos t267 (8,82%); t1234 e t693 (5,8%) e t021, t177, t306, t321, t359, t442, t521, t693 e t5493 (2,9%). Além disso, encontramos a presença dos genes do grupo SEs, sea 1 (1,8%), seh 11 (20,3%), sei 10 (18,5%), sej 7 (12,9%), seg e seo 14 (25,9%), sem 8 (14,8%), e os genes seb, sec, sed, see e tst não foram detectados. Para os genes das hemolisinas, hla foi positivo em todos os isolados e hlb foi positivo em 53 (98,1%) isolados. Os genes positivos para MSCRAMMS foram fnbA, fnbB 18 (33,3%), clfA, clfB e eno 53 (98,1%), fib 44 (81,4%), bbp 4 (7,4%), cna 17 (31,4%) e ebps 10 (18,5%). Por último, os genes de formação de biofilme icaA e icaD estiveram presentes em 38 (70,3%) e 25 (46,2%) dos isolados, respectivamente. Na avaliação de susceptibilidade a antibióticos dos 54 isolados escolhidos, 25 (46,3%) apresentaram maior resistência a penicilina e 13 (24,0%) a tetraciclina. Em menor porcentagem (1,8%), 1 isolado cada foi resistente a eritromicina, cefoxitina, clindamicina, gentamicina, cotrimazol, azitromicina e trimetropim. Além disso, 8 isolados (14,8%) apresentaram resistência intermediaria a tetraciclina, 3 (5,5%) a gentamicina e 1 (1,8%) a tobramicina. No teste para a determinação da formação de biofilme por cristal violeta, 13,7%, foram classificados em isolados não formadores, 60,8% em fracamente formadores, 25,5% moderadamente formadores e nenhum como fortemente formador. A alta diversidade de cepas de S. aureus observada neste estudo mostrou que existem vários tipos de linhagens circulando na região da Canastra. A caracterização revelou uma elevada frequência de genes de virulência e que mais estudos são necessários para avaliar o potencial de produção de enterotoxinas nos queijos artesanais. A melhora dos procedimentos de higienização durante todas as etapas de produção pode ser uma solução para a redução dos níveis de contaminação por S. aureus

Canastra Minas Artesanal cheese is produced in Serra da Canastra (MG), using raw milk, rennet and a natural endogenous culture called pingo. Due to the use of raw milk, the product can carry microorganisms that cause foodborne diseases, such as Staphylococcus aureus. Molecular characterization is an important tool to assess the microbial population of food and guide the application of control measures in production. This study characterized the genetic diversity, virulence potential and determined the antimicrobial susceptibility profile of S. aureus isolated from cheeses produced in Serra da Canastra. A total of 248 isolates from 22 days ripened cheeses were obtained from 83 properties (cross sectional study). Another 197 isolates were collected during maturation (longitudinal study), in three properties. The isolates were submitted to biochemical tests to confirm the genus and to confirm the S. aureus species, the nuc gene was identified by PCR. In addition, the detection of mecA gene was performed for the detection of Methicillin Resistant S. aureus (MRSA). After confirmation tests, 144 isolates from the cross-sectional study and 159 from the longitudinal study were positive for the nuc gene, specific for S. aureus. Subsequently, the clonal profile of the isolates was determined by Pulsed Field Gel Electrophoresis (PFGE) using the SmaI enzyme and typing of the agr locus by multiplex PCR. PFGE analysis was performed using the BioNumerics program. PCR was performed to identify the presence of genes encoding the production of hemolysins, TSST-1 toxin, enterotoxins SEs (SEA, SEB, SEC, SED, SEE, SEG, SEH, SEI, SEJ, SEO, SEM), biofilm formation and microbial surface components recognizing adhesive matrix molecules (MSCRAMMs). The isolates were submitted to the antimicrobial susceptibility test by disc diffusion. Finally, biofilm formation in a 96-well microplate in TSB broth at 37°C was verified by the Cristal Violeta method. The mecA gene was detected in 1.9% of the 445 isolates. Agr typing revealed that 83 (27.4%) of the isolates are agr-I, 95 (31.4%) agr-II and 43 (14.2%) agr-III, and no isolate was classified as agr-IV. PFGE typing revealed a total of 54 profiles. Thus, a representative isolate of each profile was used in the other tests that showed the presence of the most frequent spagenotypes t127, t605 (20.58%); t002 (14.70%), followed by types t267 (8.82%); t1234, t693 (5.8%) e t021, t177, t306, t321, t359, t442, t521, t693 and t5493 (2.9%). In addition, we found the presence of the genes of the SEs group: sea 1 (1.8%), seh 11 (20.3%), sei 10 (18.5%), sej 7 (12.9%), seg and seo 14 (25.9%), sem 8 (14.8%), while seb, sec, sed, see and tst genes were not detected. For hemolysin genes, hla was positive in all isolates and hlb was positive in 53 (98.1%) isolates. The positive genes for MSCRAMMS were: fnbA, fnbB 18 (33.3%), clfA, clfB e eno 53 (98.1%), fib 44 (81.4%), bbp 4 (7.4%), cna 17 (31.4%) and ebps 10 (18.5%). Finally, the biofilm formation genes icaA and icaD were present in 38 (70.3%) and 25 (46.2%) of the isolates, respectively. In the evaluation of antibiotic susceptibility of the 54 isolates, 25 (46.3%) showed greater resistance to penicillin and 13 (24.0%) to tetracycline. In a lower percentage (1.8%), 1 isolate each was resistant to erythromycin, cefoxitin, clindamycin, gentamicin, contrimazole, azithromycin and trimethoprim. In addition, 8 isolates (14.8%) showed intermediate resistance to tetracycline, 3 (5.5%) to gentamicin and 1 (1.8%) to tobramycin. In the test for the determination of biofilm formation by crystal violet, 13.7% were classified as non-forming isolates, 60.8% as weakly forming, 25.5% moderately forming and none as strongly forming. The high diversity of S. aureus strains observed in this study showed that there are several types of strains circulating in the Canastra region. The characterization revealed a high frequency of virulence genes and that further studies are needed to assess the potential for enterotoxin production in artisanal cheeses. The improvement of hygiene procedures during all stages of production can be a solution for reducing the levels of contamination by S. aureus

Prevalence, impact, and management perception of dysmenorrhea among university students: A cross-sectional study

Abstract Dysmenorrhea is a common condition among females that is characterized by painful cramps before or during menstruation. It is considered as a common gynecological complaint that affects the quality of women's life. The study evaluated prevalence of dysmenorrhea, its impact, associated risk factors, and the management strategies adopted by female university students in Taif city, Saudi Arabia. A cross-sectional study was conducted among 562 female students aged 18-30 years at the university level. The results showed a high prevalence rate of dysmenorrhea (79.4%) among the students. The most common risk factors were family history (87.4%) and length of menstruation (79%). Half (50.2%) of the respondents were absent at the university at least 1 day every month. The most widely used medications by the respondents were ibuprofen (42%) and paracetamol (40%), whereas only 3% used mefenamic acid, despite that they experienced complete pain relief with mefenamic acid. High prevalence rate of dysmenorrhea associated with risk factors such as family history and length of menstruation, was found among university students. However, pain and associated symptoms affect the quality of life.

Comparison between ActiGraph GT3X and ActivPAL to assess sedentary behavior during the school period

Abstract Aims: This study aimed to compare the sedentary time measured using the ActiGraph GT3X accelerometer with the measurement of sitting and standing time obtained by ActivPAL inclinometers. Methods: This was a cross-sectional study conducted with a sample of 60 schoolchildren (34 males) of one elementary public school in Brazil. The students used both an ActiGraph GT3X accelerometer and an ActivPAL inclinometer, concurrently, positioned at the beginning and removed at the end of the school shift, for four days. For analysis, paired Student's t-tests, Pearson's correlation coefficients, intraclass correlation coefficients, and Bland-Altman plots were used. Results: When comparing sedentary time with sitting time, although correlated (r = 0.53; p < 0.001), the mean minutes were different (134.2 min/day in ActiGraph GT3X vs 120.3 min/day in ActivPAL; p < 0.001), with a bias of 13.9 min/day. When comparing the measurement of sedentary time with the sum of the sitting time plus standing time, different mean minutes were also observed (134.2 min/day in ActiGraph GT3X vs 177.0 min/day in ActivPAL; p < 0.001), and although the correlation was stronger (r = 0.75; p < 0.001), the bias was higher (−42.8 min/day). Conclusion: Sedentary time derived from the ActiGraph GT3X device should be used with caution to evaluate sedentary behavior in a school setting and may be interpreted only as non-moving activities (stationary behavior).

Anthropometric indicators as predictors of dynapenia in postmenopausal women

Abstract Aim: Anthropometry represents an alternative to the evaluation of nutritional status and screening of events related to muscle fitness. Therefore, this study aimed to compare anthropometric indicators of postmenopausal women with and without dynapenia and to identify the predictive capacity of these indicators to screen the respective outcome in this population. Methods: Cross-sectional epidemiological study, conducted with postmenopausal women. Dynapenia was diagnosed by handgrip strength < 20 kgf. Arm (AC), abdominal (AbC), hip (HC) and calf circumferences (CC), triceps, biceps, subscapular, supraspinatus and thigh skinfolds were analyzed. Body Mass Index, Conicity Index (CI), Body Adiposity Index (BAI), Waist to Hip and Waist to Height Ratio (WHtR), Corrected Arm Muscle Area (CAMA) and Arm Muscle Circumference (AMC) were calculated. Results: A total of 273 women participated in the study. The BAI, WHtR, and CI did not present significant differences between the groups. For the other indicators, the dynapenic group obtained significantly lower values compared to the non-dynapenic. AC was the indicator with the highest sensitivity to screen for postmenopausal dynapenia (79.8%). While CAMA and AMC were the indicators with the best specificity (86.2%). However, CC showed the best balance between sensitivity (67.5%) and specificity (63.0%). Conclusion: The indicators AC, CAMA, and/or the AMC can be used together, or CC alone, to predict postmenopausal women with dynapenia. Therefore, these indicators can be used as important epidemiological tools to improve women's health surveillance actions.

Manipulative skills and games performed by children ranging from 4 to 6 years of age while exploring sensorial cubes

Abstract Aim: To identify and describe the manipulative actions of typical children ages between 4 and 6 years, and the games performed while exploring cubes with different sensorial stimuli. Methods: Cross-sectional, descriptive, and exploratory study. Sixteen typical children aged 4 to 6 years (mean age: 5.78 ± 1.04 years) were filmed, from different angles, during the exploration of six cubes with different sensorial stimuli (transparent, black, tactile, auditory, luminous, and high-contrast). The cubes were delivered in random order and the children explored the cubes for 40 s each. At the end of the explorations, they were asked about what kind of game they could play with that object. The images were observed by the BS Player Profile. Results: Seventeen different types of interactions with the cubes were registered, such as: pushing, shaking, reaching for (bimanual and unimanual), bringing closer to the eyes, knocking, touching with the fingers/hand, throwing upwards, and others. The tactile cube was the favorite among the children (9 children), followed by the luminous cube (6 children). They proposed games with all of the cubes, standing out playing dice (all cubes), building towers, and castles. Conclusion: In the observed group of children, 17 manipulative skills were identified. The games performed during the exploration of the cubes were based on association with other similar objects previously known, related to the visual stimuli provided by the cubes, verbal description of actions that could be performed with that cube, imagination related games using figurative images, and sports-related activities/games.

Postural control in football players with vision impairment: Effect of sports adaptation or visual input restriction?

Abstract Aim: To assess the postural control performance of football 5-a-side (FFS) players, comparing them with sighted players. Methods: Eight FFS players and 7 sighted futsal players were included. Postural control tests included feet together stance (FTS) and single-leg stance (SLS) tasks, performed on rigid and foam surfaces. Sighted players performed the tests with open (EO) and closed (EC) eyes. Area of displacement (Area) and average velocity (Vavg) were calculated from the center of pressure time-series coordinates. Results: On both surfaces conditions, a significant difference between visually impaired football 5-a-side players and sighted EO players was observed during FTS (higher Vavg for visually impaired football 5-a-side players; p < 0.04) and SLS (higher Area and Vavg for visually impaired football 5-a-side players; p < 0.01). No differences between visually impaired football 5-a-side players and sighted EC players were found. Differences between sighted EO vs. sighted EC were observed during FTS on the foam surface, and in SLS on both surface conditions (p < 0.03). Conclusion: FFS players' postural control performance is similar to sighted players with EC but worse than sighted players with EO, suggesting their postural control performance can be simply explained in terms of visual restriction.

Is fatigue associated with balance in Parkinson's disease?

Abstract Background: Fatigue is a disabling symptom in the spectrum of Parkinson's disease (PD), affecting from 30% to 70% of the persons. Even though it is a common symptom, with negative repercussions for PD individuals, its correlation with balance is not established. Aim: The aims of this study were to verify the correlation between fatigue and balance in individuals with PD and to compare balance in individuals with PD that presents low fatigue or high fatigue. Methods: This study included 37 individuals with PD, who were divided into two groups: low fatigue (n = 25) and high fatigue (n = 12). Fatigue was evaluated using the Parkinson's disease Fatigue Scale and a force platform was used to assess four balance tasks: bipedal, tandem with eyes open/closed, and tandem with the dual-task, in three parameters: (1) 95% confidence ellipse area of the center of pressure (COP) (2) mean velocity (3) root mean square of COP. To verify the correlation between fatigue and balance, the Spearman rank-order correlation coefficient was assessed. Comparison of medians between the groups was analyzed using the Mann-Whitney test. Results: There was no significant correlation between fatigue and balance. There was no difference between the groups with low and high fatigue. Conclusion: This study's findings, together with those reported in the literature, suggest there is no correlation between fatigue and balance, and even though individuals with PD report fatigue or experience situations of fatigue, they do not present greater posture instability than individuals with PD who do not report fatigue. Fatigue is a disabling symptom in the spectrum of Parkinson's disease (PD), affecting from

Impact of increasing age on high-performance Olympic triathletes in male and female: a case report

Abstract Aim: Increasing age is associated with significant changes in athletes' performance; however, it is not yet known how increasing age could influence the performance of triathletes. In this sense, the present study aimed to investigate how the performance of two elite triathletes (HCK and AD), who participated and finished the Olympic Games in Sydney, Athens, Beijing, and London, could change over the years. Methods: This study reports two cases (male and female) with cross-sectional and retrospective characteristics that describe how the increasing age changes the performance of two elite triathletes who participated in four consecutive Olympics (2000, 2004, 2008, and 2012). Pearson correlation test was used to verify the correlation between the performance and age of the triathletes. A value of p < 0.05 was assumed to show statistical significance. Results: The results suggest that both triathletes showed impaired performance at the Summer Games in Athens in 2004. When the two athletes were analyzed together, positive correlations were observed between age and transition 1 (T1; swim-to-cycle) and transition 2 (T2; cycle-to-run). Also, a high correlation was found between T2 and age for HCK but not for AD. The results showed a significant correlation between increasing age and a reduction in running performance for HCK. Conclusion: Although the two triathletes improved overall time throughout the Olympic Games, this improvement did not correlate with age. Thus, the increasing age does not seem to impact these two athletes during the four Olympic events.

Características de idosos traumatizados hospitalizados em uma unidade de terapia intensiva / Characteristics of traumatized elderly people hospitalized in an intensive care unit

Introdução: o trauma é uma doença significativa em perda de anos de vida, contribuindo para alta morbidade e mortalidade. Seu evento em idosos pode ocasionar desfechos indesejáveis devido às condições fisiológicas do idoso. Objetivo: analisar as características e associação com o óbito de idosos traumatizados hospitalizados em uma unidade de terapia intensiva. Material e métodos: estudo transversal, com dados de prontuários de idosos hospitalizados por trauma em uma unidade de terapia intensiva geral. Foram incluídos pacientes com 60 anos ou mais de idade e admitidos por lesões. As variáveis coletadas relacionam-se às características sociodemográficas, da internação, de saúde, do trauma e do tratamento intensivo. Para identificação das principais características foi realizada análise descritiva, e para associação com o óbito foi realizado o teste de associação qui-quadrado. Resultados: observou-se predominância masculina (62,5%); idosos entre 60 e 79 anos (70,2%); com comorbidades (60,4%); politraumatizados (58,3%); trauma contuso (95,8%) tendo como principal causa externa as quedas (56,3%). A região do corpo mais afetada foi cabeça e pescoço (39,6%); e a gravidade do trauma foi leve (52,1%). Foram associados ao óbito a disfunção pulmonar (p=0,005), uso de nutrição enteral (p=0,027), drogas vasoativas (p=0,003) e ventilação mecânica (p<0,001). Conclusão: as informações sobre idosos hospitalizados por trauma em tratamento intensivo, sobretudo a observação de fatores associados ao óbito, são úteis para a composição de um perfil clínico capaz de direcionar para a assistência intensiva capaz de prevenir esse e demais desfechos indesejados durante a hospitalização.(AU)

Introduction: trauma is a significant disease in terms of loss of years of life, contributing to high morbidity and mortality. Its occurrence in the elderly can cause undesirable outcomes due to the physiological conditions of such a population. Objective: to analyze the characteristics and association with the death of traumatized elderly people hospitalized in an intensive care unit. Material and methods: cross-sectional study, with data collected from medical records of elderly hospitalized for trauma in a general intensive care unit. Patients aged 60 years' old and over, having been admitted for injuries, were included. The variables collected are related to sociodemographic, hospitalization, health, trauma, and intensive care characteristics. In order to identify the main characteristics, a descriptive analysis was performed. The chi-square association test was applied for the association with death. Results: the study presented predominance of male patients (62.5%); age ranging between 60 and 79 years' old (70.2%); with comorbidities (60.4%); polytrauma (58.3%); blunt trauma (95.8%) with falls being considered the main external cause (56.3%). The head and neck were the regions most frequently affected (39.6%), and the severity of the trauma being mild (52.1%). Lung dysfunction (p = 0.005), use of enteral nutrition (p = 0.027), vasoactive drugs (p = 0.003), and mechanical ventilation (p <0.001) were associated with death. Conclusion: information on elderly hospitalized for trauma in intensive care, especially the observation of factors associated with death, are useful for the composition of a clinical profile capable of guiding the patient to intensive care capable of preventing this and other undesirable outcomes during hospitalization.(AU)

Expression of Vitamin D Receptor and Vitamin D Receptor Gene Polymorphisms (BsmI, FokI, and TaqI) in Patients with Pterygium / Expressão do gene do receptor da vitamina D e de seus polimorfismos (BsmI, FokI e TaqI) em pacientes com pterígio

ABSTRACT Purpose: This study aimed to determine the role of vitamin D receptor in the pathogenesis of pterygium. The vitamin D receptor eexpression levels in pterygium tissue, blood vitamin D levels, and frequency of selected vitamin D receptor gene polymorphisms (BsmI, FokI, and TaqI) were compared between patients with pterygium and healthy participants. Methods: The study included patients with pterygiumeee (n=50) and healthy volunteers (n=50). The serum vitamin D levels were measured for both groups. Immunohistochemical staining for vitamin D receptor ewas performed on sections obtained from the pterygium and adjacent healthy conjunctival tissues of the same individuals. The genomic existence of vitamin D receptor epolymorphisms (BsmI, FokI, and TaqI) were analyzed in DNA obtained from venous blood of participants using polymerase chain reaction and restriction fragment length polymorphism methods. Results: There was no difference found between the serum vitamin D levels of patients with pterygium and healthy controls. However, tissue expression of vitamin D receptor was higher in the pterygium endothelial cells of micro-vessels (p=0.002), subepithelial stromal (p=0.04), and intravascular inflammatory cells (p=0.0001), in comparison with the adjacent healthy conjunctival tissue. Moreover, while the BBtt haplotype was 2-fold higher, the bbTt haplotype was 2.5-fold lower, and the BbTT haplotype was 2.25-fold lower in the control group than in the pterygium group (p<0.001). Conclusions: Vitamin D serum levels did not differ between the healthy and pterygium groups. Vitamin D receptor expression was increased in the pterygium tissue versus the adjacent healthy tissue. However, vitamin D receptor polymorphism analysis in patients with pterygium did not reveal any significant difference in BsmI, FokI, or TaqI polymorphisms in comparison with the healthy volunteers.(AU)

RESUMO Objetivo: Determinar o papel do receptor da vitamina D na patogênese do pterígio. Os níveis de expressão do receptor da vitamina D no tecido do pterígio, os níveis sanguíneos de vitamina D e a frequência de alguns polimorfismos do gene do receptor da vitamina D (BsmI, FokI e TaqI) foram comparados entre pacientes com pterígio e participantes saudáveis. Métodos: Foram incluídos pacientes com pterígio (n=50) e voluntários saudáveis (n=50). Os níveis séricos de vitamina D foram medidos em ambos os grupos. Foi feita uma coloração imuno-histoquímica para o receptor da vitamina D em cortes obtidos do pterígio e dos tecidos conjuntivais saudáveis adjacentes dos mesmos indivíduos. A existência de polimorfismos do receptor da vitamina D (BsmI, FokI e TaqI) no genoma foi analisada em DNA obtido do sangue venoso dos participantes, usando métodos de Polymerase chain reaction (PCR) e RFLP. Resultados: Não foi observada nenhuma diferença entre os níveis séricos de vitamina D dos pacientes com pterígio e os dos controles saudáveis. Entretanto, a expressão tissular do receptor da vitamina D foi maior nas células endoteliais dos microvasos do pterígio (p=0,002), nas células estromais sub-epiteliais (p=0,04) e nas células inflamatórias intravasculares (p=0,0001), quando comparada à expressão no tecido conjuntival saudável adjacente. Além disso, embora o haplótipo BBtt tenha sido duas vezes mais frequente, o haplótipo bbTt foi 2,5 vezes menos frequente e o haplótipo BbTT foi 2,25 vezes menos frequente no grupo de controle do que no grupo com pterígio (p<0,001). Conclusões: Os níveis séricos de vitamina D não apresentaram diferenças entre o grupo de pessoas saudáveis e o com pterígio. A expressão do receptor da vitamina D mostrou-se maior no grupo com pterígio do que no tecido saudável adjacente. Entretanto, a análise dos polimorfismos do receptor da vitamina D nos pacientes com pterígio não revelou qualquer diferença significativa nos polimorfismos BsmI, FokI ou TaqI em comparação com os voluntários saudáveis.(AU)

The effects of functionally monocular patients' emotional reactions during phacoemulsification under topical anesthesia / A influência das reações emocionais durante a facoemulsificação com anestesia tópica em pacientes de olho único

ABSTRACT Purpose: To evaluate the relationship between the incidence of complications and functionally monocular patients' emotional reactions during phacoemulsification under topical anesthesia. Methods: We enrolled 22 functionally monocular patients (11 males and 11 females; group 1) and 19 age- and sex-matched controls (6 males and 13 females; group 2) in this prospective, interventional, cross-sectional, case control study. Demographics data, including age, sex, and educational background, were collected. Surgeries were performed by the same surgeon, and during surgery, the patients' vital signs (blood pressure and heart rate) and surgical events (duration, body movements, signs of increased vitreous cavity pressure, difficulty in performing capsulorhexis, and complications) were noted. Pre- and postoperative visual acuity was also analyzed. Results: The mean age of group 1 was 73.05 ± 13.31 years and of group 1 was 69.74 ± 16.81 years. There was no significant between-group difference in systolic and diastolic blood pressures. The average heart rate was similar in both groups, too. During surgery, the surgeon's perception of excessive eye, eyelid, or head movements in both groups was similar, in addition to signs of increased vitreous cavity pressure. Conclusion: It is safe to perform phacoemulsification under topical anesthesia in functionally monocular patients, who apparently behave similarly to binocular patients.(AU)

RESUMO Objetivo: Avaliar a relação entre a incidência de complicações e reações emocionais durante a cirurgia de catarata sob anestesia tópica em pacientes funcionalmente monoculares. Métodos: Estudo prospectivo, transversal, caso-controle de vinte e dois pacientes monoculares e dezenove controles pareados por idade e sexo . Dados demográficos foram analisados: idade, sexo e escolaridade. As cirurgias foram realizadas pelo mesmo cirurgião e durante o procedimento os sinais vitais dos pacientes (como pressão arterial sistêmica e frequência cardíaca) e eventos cirúrgicos (duração da cirurgia, movimentos corporais, sinais de aumento da pressão vítrea, dificuldade de realização da capsulorrexis e complicações) foram coletados. A acuidade visual pré e pós foi analisada. A distribuição normal dos dados foi confirmada com o teste de Shapiro-Wilk. Os dados foram expressos como média ± DP e porcentagem. A comparação dos diferentes testes clínicos entre os grupos foi realizada utilizando Student's t-test e ANOVA com correção de Bonferroni. O qui-quadrado foi usado para comparar dados demográficos. Valor de p<0,05 foi considerado estatisticamente significante. Resultados: Este estudo incluiu vinte e dois olhos de 22 pacientes funcionalmente monoculares (6 homens e 13 mulheres) e dezenove olhos de 19 controles (11 homens e 11 mulheres). A média de idade foi de 73,05 ± 13,31 anos nos indivíduos monoculares e 69,74 ± 16,81 no controle. Considerando-se os sinais vitais não houve diferença significativa entre os grupos (p>0,05). Durante o procedimento, a percepção do cirurgião em relação aos movimentos excessivos de olho, pálpebra ou cabeça em ambos os grupos foi semelhante, assim como sinais de aumento da pressão vítrea (p=0,2 e p=0,1, respectivamente). Conclusão: Este estudo sugere que é seguro realizar a extração de catarata com anestesia tópica em pacientes funcionalmente monoculares. Esses pacientes aparentemente se comportam de maneira semelhante aos pacientes binoculares.(AU)

Relationship between Sprint, lower limb power, and change of direction speed in adolescents

Abstract Aim: The purpose of this study is to verify the association between sprint, lower limb power, and change of direction speed in schoolchildren. Method: This is a cross-sectional school-based study with a probabilistic sample (n=1455) of adolescents aged 10-17 years. The variables were: sex, chronological age, body mass, height, skinfold sum, maturity offset, lower limb power, change of direction speed, and sprint. For the data analyses, we used a t-test for independent samples, Pearson correlation, and multiple linear regression. A statistical significance level of 5% was considered for all analyses. Results: The three variables of physical fitness presented moderate and significant correlations between them (r = {0.39-0.61}). Three models were tested with sprint (model 1), change of direction sprint (model 2) and lower limb power (model 3) as an outcome. Predictors tested explain 47% of model 1, 49% of model 2, and 54% of model 3. The individual predictor's contribution in both models varied between 0.1% to 38%. Conclusions: The evidence suggests that change of direction speed and sprint, together with sex, body mass, and skinfold sum account for approximately 54% of the variance of lower limb power in adolescents aged 10-17 years.

Functional outcomes and oncological fatigue among older cancer patients: a cross-sectional study

Abstract Aim: To characterize functional outcomes and oncological fatigue in older cancer patients, and verify the relation of these outcomes with age, number of hospitalizations, and falls within 12-months. Methods: Cross-sectional study involving 116 older adults with cancer undergoing treatment in a hospital in Santiago de Chile. Participants were assessed for independence on the activity of daily living (Barthel index), functional mobility with "timed up and go" (TUG) test, handgrip strength with a Baseline® Hydraulic Hand Dynamometer, and fatigue with Brief Fatigue Inventory. Information about the number of falls and hospitalizations from the previous 12-months was also collected. Results: 21.6% had experienced at least one fall during the previous 12-months, and 52% had been hospitalized over the same period. Handgrip strength was below the cut-off thresholds for older adults and 78.4% were classified with the risk of falls according to the TUG test. Forty-nine percent of participants experienced moderate fatigue, and 58% were dependent to perform activities of daily living. There was a correlation of TUG results with age (r = 0.204; p = 0.028). Conclusions: Older adults with cancer in our study experienced moderate fatigue, a high dependence to perform activities of daily living, especially those associated with mobility, dressing, and bladder or bowel function. Older adults with cancer are more likely to develop functional decline which leads to increased dependency or death. The data suggests they present functional impairment. Physical activity interventions would benefit this population.

Physical activity, TV viewing, and human development index in Brazilian adolescents: Results from the National School Health Survey

Abstract Aim: This study aimed to examine the association between physical activity (PA) indicators and TV viewing as a function of the Human Development Index (HDI). Method: This cross-sectional study was based on data from the National School Health Survey, which was composed of 102,072 students (14.28±1.03; 51.3% girls). Total PA, active commuting to school (ACS) and TV viewing were assessed by questionnaires and classified through a gradual scale ranging from "F" (low) to "A+" (high). The correlation between total PA, ACS, TV viewing and HDI was verified by Spearman's Correlation and presented in rs. Results: HDI was positively associated with total PA [girls: rs = 0.572 (p < 0.001); boys: rs = 0.843 (p < 0.001)] and ACS [girls: rs = 0.433 (p < 0.001); boys: rs = 0.554 (p < 0.001)]; while a negative correlation was found between HDI and TV viewing [girls: rs = -0.330 (p < 0.001); boys: rs = -0.348 (p < 0.001)]. Conclusions: Brazilian adolescents from states with higher HDI were more active and spent more time watching TV than their counterparts from states with lower HDI.

Increased modifiable cardiovascular risk factors in patients with Takayasu arteritis: a multicenter cross-sectional study

Abstract Background: Modifiable cardiovascular risk factors (MCRFs), such as those related to aerobic capacity, muscle strength, physical activity, and body composition, have been poorly studied in Takayasu arteritis (TAK). Therefore, the aim of the study was to investigate MCRFs and their relationships with disease status and comorbidities among patients with TAK. Methods: A multicenter cross-sectional study was conducted between 2019 and 2020, in which 20 adult women with TAK were compared with 16 healthy controls matched by gender, age, and body mass index. The following parameters were analyzed: aerobic capacity by cardiopulmonary test; muscle function by timed-stands test, timed up-and-go test, and handgrip test; muscle strength by one-repetition maximum test and handgrip test; body composition by densitometry; physical activity and metabolic equivalent by IPAQ, quality of life by HAQ and SF-36; disease activity by ITAS2010 and NIH score; and presence of comorbidities. Results: Patients with TAK had a mean age of 41.5 (38.0-46.3) years, disease duration of 16.0 (9.5-20.0) years, and a mean BMI of 27.7±4.5 kg/m2. Three out of the 20 patients with TAK had active disease. Regarding comorbidities, 16 patients had systemic arterial hypertension, 11 had dyslipidemia, and two had type 2 diabetes mellitus, while the control group had no comorbidities. TAK had a significant reduction in aerobic capacity (absolute and relative VO2 peak), muscle strength in the lower limbs, increased visceral adipose tissue, waist-to-hip ratio, reduced walking capacity, decreased weekly metabolic equivalent, and quality of life (P< 0.05) as compared to controls. However, there were no correlations between these MCRFs parameters and disease activity. Conclusions: TAK show impairment in MCRFs; therefore, strategies able to improve MCRF should be considered in this disease.(AU)

Chronic osteo-articular changes in patients with sickle cell disease

Abstract Background: Sickle cell disease (SCD) is an autosomal recessive genetic disease in which a mutation occurs in the β-globin chain gene, resulting in abnormal hemoglobin levels. In an environment with reduced oxygen concentration, red blood cells change their conformation, resulting in chronic hemolysis and consequent anemia and vaso-occlusive crises with injuries to several organs, with a significant impairment of the osteoarticular system. This study aimed to verify the chronic osteoarticular alterations and their association with clinical and laboratory characteristics of patients with SCD with a more severe phenotype (SS and Sβ0), on a steady-state fasis. Methods: Fifty-five patients were referred to a medical consultation with a specialized assessment of the locomotor system, followed by laboratory tests and radiographic examinations. Results: In total, 74.5% patients had hemoglobinopathy SS; 67.3% were female; and 78.2% were non-whites. The mean patient age was 30.5 years. Most patients (61.8%) reported up to three crises per year, with a predominance of high-intensity pain (65.5%). Radiographic alterations were present in 80% patients. A total of 140 lesions were identified, most which were located in the spine, femur, and shoulders. Most lesions were osteonecrosis and osteoarthritis and were statistically associated with the non-use of hydroxyurea. Conclusions: There was a high prevalence of chronic osteoarticular alterations, which was statistically associated only with the non-regular use of hydroxyurea.(AU)

Light-intensity physical activity patterns and associated factors in adolescents

Abstract Aims: This study aimed to measure light-intensity physical activity (LPA) patterns in adolescents according to weekdays and school period and investigated associations between LPA patterns and associated factors. Methods: This is a cross-sectional study with 388 students of both genders, selected from public schools from Londrina city, Parana state. LPA was measured using accelerometry for seven consecutive days and was analyzed by the time spent in very short (15 to 30 s), short (30 to 60 s), intermediate (1 to 3 min), and long bouts (≥ 3 min). Results: Approximately 22% of the total daily time was spent in LPA. The time in LPA accumulated in short or intermediate bouts was higher than the time accumulated in very short or long bouts (P < 0.05). Gender was associated with short (β= 2.180; 95% confidence interval [CI], 0.357 to 4.003) and intermediate bouts (β = 2.822; 95% CI, 0.681 to 4.964), girls presented higher daily time. Age was inversely associated with very short (β = −0.925; 95% CI, −1.676 to −0.175) and intermediate bouts (β = −1.985; 95% CI, −3.579 to −0.390). The total time in LPA and time accumulated in very short, short, and intermediate bouts was higher in the school period when compared to the non-school period (P < 0.05). Conclusion: It could be concluded that the LPA patterns are predominantly composed of time spent in bouts between 30 seconds and three minutes. Gender, age, and school period appear to influence the LPA pattern in adolescents.

The effects of active vs. passive recovery on riding performance during a simulated motocross race

Abstract Aims: Motocross consists of two races of 30 min with a break in between. Recovery between races is paramount to performance, this study aimed to compare the effects of active and passive recovery between motocross races on riding performance. Methods: Thirteen elite and non-elite racers performed two races of 30 min with 1 h break, twice with two-week interval. Between the races active (20 min ergometer cycling at 60% of HRmax) or passive recovery (no activity) were executed in a randomized order. Lap times, heart rate during riding, blood lactate, reaction time, handgrip strength, upper back pull strength, counter movement jump height, and medicine ball throw distance were measured before and after both races. Serum creatine kinase enzyme activity and strength tests were assessed also 24 h after the races. Results: No statistically significant differences were observed in any variables between protocols. A significant drop in handgrip strength was found post-race values (p < 0.001). Post-racing creatine kinase values were above resting levels. Conclusion: These results do not support the use of active recovery in between motocross races for restoration of neuromuscular or riding performance. Motocross seems to cause some exercise-induced muscle damage; thus, some rest is required to recover homeostasis.

Validity of the Polar V800 heart rate monitor for assessing cardiac autonomic control in individuals with spinal cord injury

Abstract Aim: Spinal cord injury (SCI) is associated with changes in cardiac autonomic control, that can be evaluated by heart rate variability (HRV), for which the electrocardiogram (ECG) is the gold standard. However, the use of ECG is limited to laboratory environments, and new tools are needed for this purpose and that can be applied in the routine monitoring of individuals with SCI. The present study aimed to investigate the validity of the Polar V800 heart rate monitor in assessing the cardiac autonomic control of individuals with SCI. Methods: Nineteen adult men with SCI (paraplegia n = 10; 44.5 ± 8.5 years and tetraplegia n = 9; 34.4 ± 7.5 years) participated in this cross-sectional study. The participants remained in the sitting position at rest for 10 min for the acquisition of the ECG and Polar V800 signals. The last 5-min window was used to count the beat-by-beat R-R interval series and then calculate the HRV indices (linear methods in the time and frequency domains). The study subgroups were compared, and the validity of the measurements generated with a heart rate monitor was determined using the intraclass correlation coefficient (ICC2,1) and Bland-Altman graphs. Results: Agreement analyses for the R-R intervals, SDNN, rMSSD, PNN50, SD1, LF, HF, and LF: HF ratio tended to show reliability ranging from acceptable to excellent (ICC = 0.579-0.990; P = 0.043-0.001) and acceptably narrow limits of agreement within both the group with tetraplegia and the group with paraplegia. Conclusion: The Polar V800 heart rate monitor is a valid instrument for assessing HRV in individuals with paraplegia and tetraplegia.