Effects of cardiorespiratory fitness and body mass index on cardiometabolic risk factors in schoolchildren.

INTRODUCTION: High levels of physical fitness established during childhood and adolescence have been associated with positive effects on cardiometabolic risk factors (CMRF), which persist into adulthood. Conversely, a sedentary lifestyle, overweight, and obesity during this period are considered public health problems. These conditions tend to worsen in adulthood, increasing the incidence of chronic diseases, deteriorating CMRF, and consequently leading to higher comorbidity and mortality rates. OBJECTIVE: To investigate the effect of cardiorespiratory fitness (CRF) and body mass index (BMI) on CMRF in children and adolescents. METHODS: The sample consisted of 49 schoolchildren of both sexes aged 10-17 years. Anthropometric assessments, CRF test, muscle strength test, and blood pressure (BP) measurement were conducted. Participants were allocated into groups based on BMI (eutrophic, overweight, obese), and CRF levels (low-fit, normal-fit, and high-fit). RESULTS: Obese individuals had lower CRF values compared to the eutrophic and overweight groups. The cardiometabolic risk profile (CMRP) was significantly higher in the obese group compared to the eutrophic group but showed no significant difference compared to the overweight group. The hight-fit group had lower CMRP values compared to the low-fit group. CONCLUSIONS: Higher BMI and CRF values had negative and positive effects on CMRF and CMRP in schoolchildren, respectively. Overweight or obese schoolchildren with low levels of CRF constitute an unfavourable cardiometabolic risk profile.

Effects of a small-sided soccer program on health parameters in obese children / Efectos de un programa de fútbol reducido en los parámetros de salud de niños obesos / Efeitos de um programa de futebol reduzido sobre os parâmetros de saúde de crianças obesas

ABSTRACT Introduction: Childhood obesity is increasing and, as a consequence, it generates health complications resulting from sedentary behavior and low levels of physical fitness. There are few studies involving children, metabolic and cardiorespiratory profiles, and soccer. Objective: The purpose was to measure the effects of a 12-week recreational small-sided soccer program on cardiometabolic risk and individual responses to cardiometabolic risk factors in overweight or obese boys. Methods: Thirteen boys aged 8-12 years (34.9±11.6% body fat) participated in a 12-week recreational small-sided soccer training program with two 80-minute sessions per week at intensities over 80% of the maximal heart rate. Anthropometric characteristics, cardiorespiratory fitness, metabolic profile, individual responses to peak oxygen uptake (VO2peak), maximal workload (Wmax), fasting blood glucose, insulin, HOMA-IR, LDL-C, HDL-C, TC, and TG were measured both pre- and post-training. Results: Considering the individual responses of the participants, recreational soccer training was effective in improving variations in maximum power and exhaustion time, as well as promoting at least one beneficial change in cardiometabolic risk factors in 84% of the overweight or obese children. There were no differences between pre- and post-program anthropometric characteristics, metabolic profiles, or VO2peak values. Conclusion: Twelve-week recreational small-sided soccer programs were able to improve maximal power and anaerobic capacity and maintain cardiometabolic risk factor levels in overweight and obese boys. Level of evidence I; High-quality prospective study (all patients were enrolled at the same stage of disease, with >80% of patients enrolled) .

RESUMEN Introdução: La obesidad infantil está aumentando y, como consecuencia, genera complicaciones de salud derivadas del comportamiento sedentario y de los bajos niveles de aptitud física. Existen pocos estudios sobre niños, perfiles metabólicos, cardiorrespiratorios y fútbol. Objetivo: El objetivo fue medir los efectos de un programa de fútbol recreativo reducido de 12 semanas sobre el riesgo cardiometabólico y respuestas individuales en niños con sobrepeso u obesos. Métodos: Trece niños de 8 a 12 años (34,9 ± 11,6% de grasa corporal) participaron en un programa de entrenamiento de fútbol recreativo reducido de 12 semanas con dos sesiones de 80 minutos por semana a intensidades superiores al 80% de la frecuencia cardíaca máxima. Se midieron las características antropométricas, la aptitud cardiorrespiratoria, el perfil metabólico y las respuestas individuales del consumo máximo de oxígeno (VO2pico), la carga de trabajo máxima (Wmax), la glucemia y la insulina en ayunas, HOMA-IR, LDL-C, HDL-C, CT y TG antes y después del entrenamiento. Resultados: Teniendo en cuenta las respuestas individuales, el entrenamiento de fútbol recreativo fue eficaz para mejorar las variaciones de potencia máxima y el tiempo hasta el agotamiento, así como para promover al menos un cambio beneficioso en los factores de riesgo cardiometabólico en el 84% de los niños con sobrepeso u obesidad. No hubo diferencias entre las características antropométricas, los perfiles metabólicos o el pico de VO2 antes y después del programa. Conclusões: Doce semanas de programas de fútbol recreativo reducido fueron capaces de mejorar la potencia máxima y la capacidad anaeróbica, así como de mantener los niveles de factores de riesgo cardiometabólicos en niños con sobrepeso y obesidad. Nível de evidência I; Estudo prospectivo de alta qualidade (todos os pacientes foram inscritos no mesmo estágio da doença, com > 80% dos pacientes inscritos) .

RESUMO Introdução: A obesidade infantil está aumentando e, como consequência, gera complicações de saúde decorrentes do comportamento sedentário e baixos níveis de aptidão física. Existem poucos estudos que envolvem crianças, perfis metabólicos e cardiorrespiratórios e futebol. Objetivo: O objetivo foi medir os efeitos de um programa de futebol recreativo reduzido de 12 semanas sobre o risco cardiometabólico e respostas individuais em meninos com sobrepeso ou obesos. Métodos: Treze meninos de 8 a 12 anos (34,9 ± 11,6% de gordura corporal) participaram de um programa de treinamento de futebol recreativo reduzido de 12 semanas com duas sessões de 80 minutos por semana em intensidades acima de 80% da frequência cardíaca máxima. As características antropométricas, a aptidão cardiorrespiratória, o perfil metabólico e as respostas individuais do pico de consumo de oxigênio (VO2pico), carga máxima de trabalho (Wmáx), glicemia e insulina em jejum, HOMA-IR, LDL-C, HDL-C, CT e TG foram medidos pré e pós-treinamento. Resultados: considerando as respostas individuais dos participantes, o treinamento recreativo de futebol foi eficaz para melhorar as variações da potência máxima e do tempo até a exaustão, bem como promover pelo menos uma alteração benéfica nos fatores de risco cardiometabólico em 84% das crianças com sobrepeso ou obesidade. Não houve diferenças entre as características antropométricas pré e pós-programa, perfis metabólicos ou VO2pico. Conclusões: Doze semanas de programas de futebol recreativo reduzido foram capazes de melhorar a potência máxima e a capacidade anaeróbica, bem como manter os níveis de fatores de risco cardiometabólicos em meninos com sobrepeso e obesos. Nível de evidência I; Estudo prospectivo de alta qualidade (todos os pacientes foram inscritos no mesmo estágio da doença, com > 80% dos pacientes inscritos) .

Prevalence and factors associated with depression in people living with HIV/AIDS in a Brazilian metropolitan region.

The frequent association between mental disorders and HIV infection may be related to several risk factors. The present study aims to determine the prevalence of depression and its associated factors in people living with HIV/AIDS (PLWHA) who attended four outpatient clinics in Fortaleza, Brazil, between September 2014 and April 2015. In addition to the Mini International Neuropsychiatric Interview questionnaire, which was used to identify the prevalence of depressive disorder, the researchers applied a sociodemographic questionnaire, and the Hamilton Depression Scale to classify the severity of depression. In all, 257 participants were included in the analyses. The overall lifetime prevalence of depression was identified to be 29.2% (19.5% in men and 44.9% in women). The prevalence of a current depressive episode was 18.7%. Mild, moderate, and severe depression was identified in 2.1%, 12.5%, and 85.4%, respectively. The factors related to depression were: gender, marital status, income, educational level, current employment status, and family history of depression. This study highlights the importance of lifetime depression as a disorder of high prevalence in PLWHA, and associated with risk factors that are difficult or impossible to be modified. Early diagnosis and treatment of depression may improve quality of life in PLWHA.

Competências dos Enfermeiros em Emergência no Serviço de Urgência / Emergency Nurses Competences in the Emergency Department

A prática clínica no Serviço de Urgência (SU) tem como função responder a situações de saúde consideradas urgentes ou emergentes. Num contexto exigente e com elevada complexidade de condições clínicas, a prática de enfermagem requer a apresentação de competências específicas. Contudo, não existe consenso sobre quais aquelas mais relevantes por parte das principais organizações nacionais e internacionais. A manutenção da qualidade e segurança clínica da intervenção dos enfermeiros num SU implica a existência de um quadro de competências claramente definido, e de estratégias e recursos que suportem a formação contínua. A introdução das tecnologias de informação e comunicação (TIC), como recurso pedagógico na formação contínua poderá ser facilitadora do desenvolvimento de competências, viabilizando a gestão do tempo, expetativas e preferências dos enfermeiros do SU. A finalidade do projeto visa contribuir para clarificar o quadro de competências de um enfermeiro a exercer funções num SU, e a predisposição para a utilização de recursos pedagógicos na formação contínua, baseados nas TIC. Numa primeira fase, foram estudadas as orientações relativas às competências dos enfermeiros do SU, através da realização de uma scoping review. Numa segunda fase, para compreender qual o nível de formação, as necessidades formativas e as estratégias pedagógicas suportadas pelas TIC, percecionadas como mais adequadas para a formação dos enfermeiros do SU, foi realizado um estudo exploratório, descrito e transversal, de cariz quantitativo. A scoping review permitiu definir quatro domínios e dezoito categorias de competências, clarificando o quadro de competências e formação dos enfermeiros do SU. O segundo estudo permitiu caraterizar as necessidades formativas e a facilidade, a utilidade e a intenção dos enfermeiros do SU para utilizarem as TIC, como estratégia para a formação contínua. Esta dissertação clarifica o quadro de competências de um enfermeiro no SU a nível nacional e internacional. Permite, ainda, identificar as necessidades formativas e a predisposição dos enfermeiros de um serviço de urgência português para utilizarem as TIC como recurso pedagógico na formação contínua.

Clinical practice in the Emergency Service (ES) aims at responding to health situations considered urgent or emergent. In a demanding context, under highly complex clinical conditions, nursing practice requires specific skills. However, there is no consensus on which are the most relevant skills by most important national and international organizations. Maintaining the quality and clinical safety of nurses' intervention in an ES implies that a clearly defined competence framework is defined, as well as strategies and resources that support continuous education. The introduction of information and communication technologies (ICT) as a pedagogical resource in continuous training can be seen as facilitating the development of skills, enabling the management of time, expectations and preferences of ES nurses. Our aim was to contribute to clarify the framework of competences of a nurse working in an ES, and the predisposition to use pedagogical resources in continuous training based on ICT. In the first stage, the guidelines regarding the competences of nurses in an ES were studied through a scoping review. In the second stage, in order to understand the level of training, the training needs, and the most appropriate pedagogical strategies supported by ICT, and seen as more appropriate for the training of ES nurses, an exploratory, descriptive and transversal study of a quantitative nature was developed. The scoping review made it possible to define four areas and eighteen categories of skills, clarifying the framework of skills and training of ES nurses. The second study served to characterize the training needs and the ease, usefulness and intention of ES nurses to use ICT as a strategy for continuous training. This dissertation serves to clarify the framework of skills for a nurse in an ES at a national and international level. It also serves to identify the training needs and predisposition of nurses in a Portuguese emergency service to use ICT as a pedagogical resource in continuous training

Hepatite B: um alerta aos cirurgiões-dentistas / Hepatitis B: a warning to dentists

Objetivo: Apesar da disponibilidade e orientações acerca da vacinação contra o vírus da hepatite B (VHB), observa-se que a cobertura vacinal e o conhecimento entre os profissionais de Odontologia não são satisfatórios, especialmente nos países em desenvolvimento. Como um alerta aos estudantes e profissionais de Odontologia, o objetivo deste estudo é revisar a literatura acerca da infecção pelo VHB na prática odontológica. Materiais e métodos: Trata-se de uma revisão narrativa. Os artigos incluídos foram pesquisados nas bases de dados Pubmed, Scielo e Lilacs, utilizando os descritores "Hepatitis B virus" e "Dentist", no período de 2000 a 2020. Revisão de literatura: Os conhecimentos acerca do VHB devem ser incentivados durante a graduação, uma vez que os cirurgiões-dentistas desempenham papel importante na prevenção desta doença. A hepatite B é mais prevalente entre os cirurgiões-dentistas do que na população geral. Nesses profissionais, a transmissão acontece principal-mente durante o uso e descarte de instrumentos cortan-tes contaminados com sangue ou saliva infectada. Além disso, como as secreções nasofaríngeas carregam o vírus, embora remota, ainda existe a possibilidade de infecção por aerossol. Discussão: Dentre as formas de prevenção, podemos citar a realização do esquema vacinal completo, as orientações para manejo odontológico de pacientes com hepatite, a adoção às normas de biossegurança e os métodos corretos para limpeza e desinfecção e esterilização dos materiais. Conclusão: Os cirurgiões-dentistas possuem um risco maior de exposição à infecção pelo HBV do que o restante da população. Portanto, esses profissionais devem dispor de atenção especial às estratégias de prevenção contra a hepatite

Aim: Despite the availability and guidance regarding the hepatitis B virus (HBV) vaccination, it is observed that the vaccine coverage and knowledge among dental professionals are not satisfactory, especially in developing countries. As a warning to dental students and professionals, the aim of this study is to review the literature on HBV infection in dental practice. Materials and methods: This is a narrative review. The articles included were searched in the Pubmed, Scielo and Lilacs databases, using the des-criptors "Hepatitis B virus" and "Dentist", from 2000 to 2020. Literature review: Knowledge about HBV should be encouraged during graduation, since dentists play an im-portant role in preventing this disease. Hepatitis B is more prevalent among dentists than in the general population. In these professionals, the transmission occurs mainly due to a percutaneous injury involving the use and disposal of cutting instruments contaminated with the infected patient's blood or saliva. In addition, as nasopharyngeal secretions carry the virus, although remote, there is still the possibility of aerosol infection. Discussion: Among the forms of prevention, we can mention the accomplishment of the complete vaccination schedule, the guidelines for the dental management of patients with hepatitis, the adoption of biosafety standards and the correct methods for cleaning, disinfecting and sterilizing the materials. Conclusion: Dentists have higher risk of exposure to HBV infection than the rest of the population. Therefore, these professionals must pay special attention to strategies for preventing hepatitis.

What is the relevance of research for nursing students?

Introduction and objectives: The Bologna Process led to the reorganization of the education system into three academic degrees: Bachelor's degree, Master's de-gree and Doctorate, differentiated by focusing on the research area only after the Bachelor's degree. The present study aims to understand the relevance of research in Nursing for undergraduate students. Methodology: Through a mixed descriptive-correlative investigation, the data was collected through an online form, sent via social networks. The sample is made up of 250 students, in the 4th year of the Nursing Bachelor's degree, from 17 higher education institutions in Portugal. Results and discussion: All students consider nursing research important, but 35.2% of the respondents are undecided about contributing to this area and 5.6% do not intend to contribute to it. It was also noted that, although 99.6% of the students reported they had a curricular unit associated to research, 53.2% of the students considered their ability to analyse a scientific article as "Sufficient". The relevance attributed to this component of research analysis is mostly evaluated as "Very im-portant" (42%). Conclusions: Most students value nursing research, and are interested in projects that contribute to the subject and to the development of their personal and pro-fessional skills, but there is a lack of incentive for investment in this area. It is also possible to identify gaps in learning regarding the analysis and interpretation of scientific articles. It is possible to conclude that in the educational system there must be structural and content changes to respond to the students' needs

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Glycemic Threshold as an Alternative Method to Identify the Anaerobic Threshold in Patients With Type 2 Diabetes.

Purpose: To analyze the agreement between the velocity, heart rate, and oxygen uptake values corresponding to second ventilatory threshold and glycemic threshold in patients with type 2 diabetes. Methods: Twenty-four untrained patients (55.1 ± 8.9 years) were evaluated. Three different parameters of training intensity corresponding to anaerobic threshold, one mechanical (velocity) and two physiological (heart rate and oxygen uptake) parameters, were identified by a classical method (second ventilatory threshold) and by an alternative method (glycemic threshold). To determine the threshold values, patients performed an incremental treadmill test, with an initial velocity of 3 km.h-1 for 3 min, that was then increased by 1 km.h-1 every 2 min. Comparisons between mean values and the degree of agreement between second ventilatory threshold and glycemic threshold were analyzed using the paired t-test and Bland-Altman test, respectively. Results: All patients performed the tests appropriately, and no adverse effects were recorded. Patients demonstrated similar mean velocity (p = 0.25), heart rate (p = 0.97) and oxygen uptake (p = 0.71) between the ventilatory threshold (6.4 ± 0.6 km.h-1, 130.1 ± 18.7 bpm, 15.2 ± 3.5 ml.kg.min-1) and the glycemic threshold (6.2 ± 0.9 km.h-1, 130.2 ± 12.8 bpm, 15.0 ± 3.8 ml.kg.min-1). Conclusion: The present study indicates an agreement between the glycemic and second ventilatory methods in determination of the anaerobic threshold of patients with type 2 diabetes; and thus, either method may be used for these patients.

Quality of life and sleep quality are similarly improved after aquatic or dry-land aerobic training in patients with type 2 diabetes: A randomized clinical trial.

OBJECTIVES: To compare the effects of two aerobic training models in water and on dry-land on quality of life, depressive symptoms and sleep quality in patients with type 2 diabetes. DESIGN: Randomized clinical trial. METHODS: Thirty-five patients with type 2 diabetes were randomly assigned to aquatic aerobic training group (n=17) or dry-land aerobic training group (n=18). Exercise training length was of 12 weeks, performed in three weekly sessions (45min/session), with intensity progressing from 85% to 100% of heart rate of anaerobic threshold during interventions. All outcomes were evaluated at baseline and 12 weeks later. RESULTS: In per protocol analysis, physical and psychological domains of quality of life improved in both groups (p<0.05) without between-group differences. Overall quality of life and sleep quality improved in both groups (p<0.05), without between-group differences in per protocol and intention to treat analysis. No changes on depressive symptoms were observed in both groups at follow-up. CONCLUSIONS: Aerobic training in an aquatic environment provides similar effects to aerobic training in a dry-land environment on quality of life, depressive symptoms and sleep quality in patients with type 2 diabetes. Clinical trial reg. no. NCT01956357, clinicaltrials.gov.

Efeitos agudos dos exercícios de hidroginástica e minitrampolim sobre os níveis pressóricos e glicêmicos de adolescentes obesos / Acute effects of water based and mini-trampoline exercises on pressoric and glycaemic levels of obese adolescents

O número de crianças com excesso de peso está aumentando na sociedade, implicando no aparecimento precoce de diabetes tipo 2 e hipertensão. Para prevenir isso, o exercício físico de baixo impacto pode ser uma alternativa segura e eficaz, podendo ser realizado tanto em meio aquático como em meio terrestre. Assim, o presente estudo objetivou analisar o efeito do exercício aeróbico de baixo impacto, em diferentes meios (hidroginástica vs mini trampolim), sobre os níveis glicêmicos e pressóricos de adolescentes obesos. Trinta e dois adolescentes obesos (12,4±2,5 anos) foram alocados randomicamente no grupo hidroginástica (GH; n = 16) e no grupo minitrampolim (GMT; n = 16). Ambos os grupos realizaram uma sessão de exercícios com duração de 32 minutos, prescrita de forma intervalada, com intensidade de estímulo em índice de esforço percebido intenso e recuperação em índice de esforço percebido muito leve. Os desfechos de glicemia capilar e pressão arterial foram avaliados pré, pós e 30 minutos pós-exercício. Uma equação de estimativas generalizadas foi usada para analisar os níveis glicêmicos e pressóricos nos diferentes momentos e modalidades, adotando-se um nível de significância de 5%. Ambos os grupos apresentaram redução glicêmica apenas imediatamente após a sessão de exercício (GH: -7,4mg/dL, GMT: -4,5mg/dL; efeito tempo, p = 0,005). A pressão arterial diastólica foi reduzida em ambos os grupos cinco minutos pós-exercício (GH: - 4mmHg, GMT: 0mmHg; efeito tempo, p = 0,017), permanecendo assim 30 minutos pós-exercício (efeito tempo; p = 0,013), enquanto a pressão arterial sistólica foi reduzida somente 30 minutos pós-exercício (GH: -14mmHg, GMT: -1,5mmHg; efeito tempo, p < 0,001). Conclui-se que sessões sob minitrampolim e hidroginástica, de forma intervalada, podem diminuir de forma similar os níveis glicêmicos e pressóricos de adolescentes obesos....(AU)

The number of children that are overweight it has been increasing in society, resulting in early-onset type 2 diabetes and hypertension. To prevent this, the physical low-impact exercise can be a safe and effective alternative and can be performed both aquatic as terrestrial environment. Therefore, this study aimed to analyze the effect of aerobic exercise with low impact in different environment (water vs/ land) on glucose and blood pressure levels in obese adolescents. Thirty-two obese adolescents (12.4 ± 2.5 years; BMI: 33.1 ± 5.3 kg / m2) were randomly allocated in two aerobics group: water group (GH; n = 16) and mini-trampoline training (GMT; n = 16). Both groups performed an exercise session lasting 32 minutes of prescribed intervals and stimulus intensity perceived intense effort index and recovery in very light perceived. The outcomes of blood glucose and blood pressure were analyze before, after and 30 minutes after exercise. An equation of generalized estimates was use to analyze the blood sugar and blood pressure levels at different times and modalities, adopting the significance level of 5%. Both groups had reduced glycemic only immediately after the exercise session (GH: -7,4mg/dL, GMT: -4,5mg/dL; time effect, p = 0,005). The diastolic blood pressure was reduced both the five minutes post-exercise groups (GH: - 4mmHg, GMT: 0mmHg; time effect, p = 0.017) and remained at 30 minutes post-exercise (time effect, p = 0.013), while the systolic blood pressure was reduced just 30 minutes post-exercise (GH: -14mmHg, GMT: -1,5mmHg; time effect; p <0.001). We conclude that interval sessions with low impact exercise can decrease similarly glycemic and blood pressure of obese adolescents....(AU)

Glycemic reductions following water- and land-based exercise in patients with type 2 diabetes mellitus.

PURPOSE: To assess the acute glucose responses to the first sessions of three mesocycles of water- and land-based aerobic exercise. METHODS: The water-based exercise group (WBE, n = 14; 54.1 ± 9.1 years) performed deep water walking and/or running, while the land-based exercise group (LBE, n = 11; 60.1 ± 7.3 years) performed walking and/or running on athletic track. In the first mesocycle, patients trained at 85-90% of their anaerobic threshold (AT) for 35 min, progressing to 90-95% of the AT in the second mesocycle, and 95-100% of the AT in the last mesocycle. Capillary glucose was assessed before and immediately after the first session of each mesocycle. RESULTS: There was glycemic reduction (p < 0.001) in all sessions, with relative reductions of 19%, 29% and 24% for the WBE and 24%, 29% and 27% for the LBE in the mesocycles 1, 2 and 3, respectively. There were no found differences between groups and between mesocycles. CONCLUSIONS: The acute response of blood glucose to aerobic training between 85 and 100% of the heart rate of AT is effective and independent of the environment in which it is performed. Clinical trial reg. no. NCT01956357, clinicaltrials.gov.

Acute glycemic outcomes along the aerobic training in deep water in patients with type 2 diabetes / Respuestas de la glucemia aguda a lo largo del entrenamiento aeróbico en aguas profundas en pacientes con diabetes tipo 2

Aims: The present study aimed to analyze the acute glucose responses in the first and last sessions of four mesocycles along an aquatic aerobic training periodization. Methods: Fourteen patients (6 men and 8 women; 54.3 ± 9.0 years; body mass index of 34.5 ± 3.9 kg/m2) with type 2 diabetes underwent a 12-week training program involving deep-water running. This exercise training was performed by an interval training method, with a frequency of 3 times a week, session duration of 35 minutes and intensity progressing from 85 to 90% to 95 to 100% of the anaerobic threshold heart rate (ATHR) along the periodization. Capillary glucose was assessed before and immediately after the first and last session of each mesocycle. A generalized estimated equation (time x session x mesocycle) was used to assess reductions in glucose levels in different sessions (first and last) along four mesocycles (α = 0.05). Results: All sessions resulted in a reduction in glucose levels (time effect: p <0.001), without differences between the first and last session of each mesocycle (session effect: p = 0.738). With regard to the mesocycles (mesocycle effect: p = 0.003), significant differences were found between mesocycles 2 and 3. In time mesocycle interaction (p = 0.002), in most comparisons, post-session values were lowest that pre-session values, regardless of mesocycle, except for the post-session value of mesocycle 3, which was similar to the pre-values of mesocycles 2 and 4. Conclusion: Aerobic training in deep water with crescent linear periodization over 12 weeks is able to reduce glucose levels in patients with type 2 diabetes

Objetivo: Analizar las respuestas de glucemia aguda en las primeras y últimas sesiones de cuatro mesociclos a lo largo de una periodización de entrenamiento aeróbico acuático. Métodos: Catorce pacientes (6 hombres y 8 mujeres; 54,3 ± 9,0 años; índice de masa corporal de 34,5 ± 3,9 kg/m2) con diabetes tipo 2 fueron sometidos a un programa de entrenamiento de 12 semanas de carrera en aguas profundas. Se realizó un entrenamiento aeróbico de intervalos, realizado 3 veces por semana, con sesiones de 35 minutos y la intensidad progresando a lo largo de la periodización desde 85% - 90% a 95% - 100% de la frecuencia cardiaca del umbral anaeróbico (FCUA). La glucosa capilar fue evaluada antes e inmediatamente después de la primera y la última sesión de cada mesociclo. Se utilizó una ecuación generalizada estimada (tiempo x sesión x mesociclo) para evaluar las reducciones en los niveles de glucosa en las diferentes sesiones (primera y última) a lo largo de cuatro mesociclos (α = 0.05). Resultados: todas las sesiones resultaran en una reducción en los niveles de glucosa (efecto tiempo: p<0,001), sin diferencias entre la primera y la última sesión de cada mesociclo (efecto de sesión: p = 0,738). Con respecto a los mesociclos (efecto mesociclo: p=0,003) se encontraron diferencias significativas entre los mesociclos 2 y 3. En la interacción tiempo mesociclo (p=0,002), en la mayor.a de las comparaciones, los valores post-sesión fueron menores de los valores pre-sesión, independientemente de mesociclo, excepto para el valor después de la sesión del mesociclo 3, que fue similar a los valores antes de la sesión de los mesociclos 2 y 4. Conclusión: Doce semanas de entrenamiento aeróbico en aguas profundas con la periodización linear y creciente es capaz de reducir los niveles de glucosa en pacientes con diabetes tipo 2

Glucose control can be similarly improved after aquatic or dry-land aerobic training in patients with type 2 diabetes: A randomized clinical trial.

OBJECTIVES: To compare the effects of two aerobic training methods in water and on dry-land on glycemic, lipid, inflammatory, hormonal, cardiorespiratory, and functional outcomes in patients with type 2 diabetes. DESIGN: Randomized clinical trial. METHODS: Thirty-five patients with type 2 diabetes were randomly assigned to aquatic aerobic training group (n=17) or dry-land aerobic training group (n=18). Exercise training interventions had duration of 12 weeks, performed in three weekly sessions (45min/session), with intensity progressing from 85% to 100% of heart rate of anaerobic threshold during interventions. All outcomes were evaluated at baseline and 12 weeks later. RESULTS: Patients were 56.7±7.9 years old. Decreases in glycated hemoglobin were observed in both groups (AT: -0.42±0.28%, DLT: -0.35±1.8%). Total cholesterol, high density lipoprotein, low density lipoprotein levels, plasma renin activity, angiotensin II concentrations, C-reactive protein, systolic blood pressure, resting heart rate, and timed up and go test performed at the usual speed also decreased in both groups in response to both interventions (p<0.05), without between-group differences. Both groups increased the ratio between oxygen uptake at the anaerobic threshold and oxygen uptake of peak (p=0.01). CONCLUSIONS: Aerobic training in an aquatic environment provides effects similar to aerobic training in a dry-land environment in patients with type 2 diabetes.

Transtornos mentais em pacientes portadores de HIV: um estudo de prevalência e fatores associados

A associação frequente entre transtornos mentais e infecção pelo Vírus da Imunodeficiência Humana (HIV) pode relacionar-se aos fatores de risco, a saber: maior exposição ao HIV que alguns desses transtornos acarretam; circunstâncias de vida frequentemente associadas ao diagnóstico da infecção; reação ao diagnóstico; a própria infecção pelo HIV. Objetivou-se neste estudo identificar a prevalência de transtornos mentais (depressão, transtorno bipolar, psicose, transtorno de ansiedade generalizada e abuso/dependência de substâncias) e seus fatores associados. Foram avaliados 257 pacientes de quatro ambulatórios especializados no município de Fortaleza entre setembro de 2014 e abril de 2015. Foi utilizado o questionário Mini International Neuropsychiatric Interview (MINI) para identificar a prevalência desses transtornos. Foram identificadas prevalências de 29,2% para depressão, 7,0% para transtorno bipolar tipo II, 4,7% para transtorno bipolar tipo I, 2,3% para transtorno do pânico, 14% para transtorno de ansiedade generalizada, 10,1% para abuso/dependência de álcool, 7,8% para uso de substâncias não alcoólicas, 0,4% para abuso/dependência de substâncias não alcoólicas e10,5% para síndrome psicótica. Os fatores relacionados aos transtornos foram: sexo; estado civil; renda; escolaridade; o fato de estar trabalhando atualmente; a condição de ser morador de rua; a situação de ter sido presidiário; o fato ter sido internado e estar fazendo tratamento para o transtorno mental; a condição de ter sido internado pelo HIV; adesão à terapia antirretroviral (TARV) e CD4. No estudo foram encontradas prevalências de transtornos mentais mais elevadas do que as encontradas na população geral. Observou-se que os transtornos mais leves (ansiedade e depressão) foram sub diagnosticados e subtratados em relação aos transtornos mais graves (transtorno bipolar tipo I e psicose).

The frequent association between mental disorders and infection by the HumanImmunodeficiency Virus (HIV) can be related to risk factors, such as: greater exposure toHIV that some of these disorders lead, life circumstances often associated with the diagnosisof infection, reaction to the diagnosis, and the HIV infection itself. This study aimed todetermine the prevalence of mental disorders (depression, bipolar disorder, psychosis,generalized anxiety disorder, and the abuse of and dependence on substances) and theirassociated factors. From September 2014 to April 2015, 257 patients were evaluated in fourspecialized clinics in Fortaleza city. To obtain the prevalence of these disorders, thequestionnaire Mini International Neuropsychiatric Interview was applied. Depression, bipolardisorder type II, bipolar disorder type I, panic disorder, generalized anxiety disorder, alcoholabuse/ dependence, use of non-alcoholic substances, abuse of/dependence on non-alcoholicsubstances and psychotic syndrome showed prevalences of 29.2%, 7.0%, 4.7%, 2.3%, 14%,10.1%, 7.8%, 0.4%, and 10.5%, respectively. The factors associated with the disorders wereas following: sex, marital status, income, education, being working, being homeless, havingbeen in prison, having been admitted and being under treatment for mental disorder, havingbeen hospitalized owing to HIV, adherence to antiretroviral therapy (ART) and CD4. In thepresent study, the prevalence of mental disorders was greater than in the general population. Less severe disorders (anxiety and depression) were underdiagnosed and undertreated withregard to the most severe disorders (bipolar disorder type I and psychosis).

Punto de desviación de la frecuencia cardíaca es una alternativa de método para identificar el umbral anaeróbico en pacientes con diabetes tipo 2 / Heart rate deflection point as an alternative method to identify the anaerobic threshold in patients with type 2 diabetes

Objetivos: El propósito de este artículo fue evaluar la concordancia entre frecuencia cardíaca (FC) y velocidad en la cinta de correr correspondiente al umbral anaeróbico medido por el segundo umbral ventilatorio (VT2) y por el punto de deflexión de la FC (PDFC) en pacientes con diabetes tipo 2. Métodos: Se evaluaron treinta y dos pacientes sedentarios (56,1 ± 7,7 años) para determinar los valores de los umbrales, los pacientes realizaron una prueba de esfuerzo incremental a una velocidad inicial de 3 km h-1 durante 3 min, con incrementos de 1 km h-1 cada 2 min. Se analizó el grado de concordancia entre VT2 y PDFC mediante el test de Bland-Altman. Resultados: Los pacientes mostraron una FC de 133 ± 16 lpm en VT2 y 133 ± 18 lpm en PDFC. La velocidad media correspondiente a VT2 fue 6,3 ± 0,7 km h-1 y la correspondiente a PDFC fue 6,4 ± 1,1 km h-1. No hubo diferencias significativas entre los métodos evaluados (FC:p = 0,78; velocidad media: p = 0,57). Conclusión: Esta investigación concluye que existe correspondencia entre los métodos VT2 y PDFC en FC y la velocidad media en la cinta de correr, por lo tanto, cualquiera de estos dos métodos puede ser usado en estos pacientes

Aims: The purpose of this study was to evaluate the agreement between heart rate (HR) and treadmill velocity corresponding to the anaerobic threshold measured by second ventilatory threshold (VT2) and the HR deflection point (HRDP) in patients with type 2 diabetes. Materials and methods: Thirty-two sedentary patients (56.1 ± 7.7 years) were evaluated. To determine the threshold values, patients performed an incremental treadmill test, with an initial velocity of 3 km h-1 for 3 min, which was then increased by 1 km h-1 every 2 min. The degree of agreement between VT2 and HRDP was analyzed using the Bland–Altman test. Results: Patients had a HR of 133 ± 16 bpm at VT2 and 133 ± 18 bpm at HRDP. Mean velocity corresponding to VT2 was 6.3 ± 0.7 km h-1, and that corresponding to HRDP was 6.4 ± 1.1 km h-1. There were no significant differences between the methods evaluated (HR: p = 0.78; mean velocity: p = 0.57). Conclusions: The present investigation concludes that there is an agreement between VT2 and HRDP methods for HR and treadmill velocity, and thus, either method may be used for these patients

Comunidades ribeirinhas como forma socioespacial de expressão urbana na Amazônia: uma tipologia para a região do Baixo Tapajós (Pará-Brasil) / Riverine communities as socio-spatial units of the urban process in Amazon: a typology for the lower Tapajós River (State of Pará, Brazil) / Comunidades ribereñas como forma socioespacial de expresión urbana en la Amazonia: una tipología para la región del Baixo Tapajós (Pará-Brasil)

O fenômeno urbano na Amazônia contemporânea se estende pelo território e se estrutura por diversas formas socioespaciais, tais como as comunidades locais, que, ao formarem redes urbanas incipientes, têm características particulares definindo sua importância na estruturação do território regional. Neste artigo, é proposto o uso de técnicas quali-quantitativas para definir uma tipologia para as comunidades ribeirinhas do Baixo Tapajós (Pará): variáveis descritoras, obtidas por questionários de campo aplicados a 62 comunidades, entre Santarém e Itaituba, e submetidas à estatística multivariada. A partir da análise de componentes principais para 30 variáveis e agrupamento hierárquico, cinco grupos de comunidades foram identificados e descritos; resultado considerado consistente com as observações de campo. Variáveis relacionadas principalmente ao uso da terra e à infraestrutura condicionaram esta classificação. Comunidades em unidades de conservação, independente da localização na margem do Rio Tapajós, apresentaram situação distinta das demais, sendo que a presença do Estado, suportando programas governamentais, mostrou-se fundamental para manutenção de todas as comunidades.

The phenomenon of urban growth in the Amazon can be seen throughout the territory today and is structured into many different sociospatial forms. One such form consists of local communities, which, as they develop incipient urban networks, show specific characteristics that define their importance in the structuring of the territory throughout the region. In this paper we propose the use of quali-quantitative techniques for defining a typology for riverine communities along the Lower Tapajos River, in the State of Pará in northern Brazil. Descriptive variables were obtained through field-applied questionnaires in 62 communities between the towns of Santarém and Itaituba. The variables were then submitted to multi-variate statistics. On the basis of the analysis of the main components of 30 variables and hierarchical grouping, five groups of communities were identified and described, and the results were considered consistent with the field-based observations. Variables related mainly to the use of the land and to infrastructure conditioned this classification. Communities located in conservation units, regardless of exactly where they were located along the banks of the Tapajos river, were in a situation different from that of the other communities, since the maintenance of all of them depended on programs of the Pará State Government. The methodology presented can also be applied to other areas in the Amazon, provided that the specific characteristics of each area are taken into consideration. The typology proposed identifies the differences and presence of the communities in the regional space along the Lower Tapajos, and can be used for drawing up public policies addressed to local populations.

El fenómeno urbano en la Amazonia contemporánea se extiende por su territorio y se estructura por diversas formas socioespaciales, tales como las comunidades locales que, al formar redes urbanas incipientes, adquieren características particulares, definiendo su importancia en la estructuración del territorio regional. En este artículo, se propone el uso de técnicas cuali-cuantitativas para definir una tipología para las comunidades ribereñas del Baixo Tapajós (Pará): variables descriptoras, que se obtuvieron por medio de cuestionarios de campo aplicados a 62 comunidades, entre Santarém e Itaituba, y sometidas a la estadística multivariada. A partir del análisis de componentes principales para 30 variables y agrupamiento jerárquico, se identificaron y describieron cinco grupos de comunidades; el resultado fue considerado consistente con las observaciones de campo. Variables relacionadas principalmente al uso de la tierra y a la infraestructura condicionaron dicha clasificación. Comunidades en unidades de conservación, independientemente de la localización en la orilla del río Tapajós, presentaron una situación distinta de las demás; la presencia del Estado, apoyando programas gubernamentales, se mostró fundamental para el mantenimiento de todas las comunidades. La metodología presentada se puede aplicar a otras áreas en la Amazonia, siempre que se consideren las especificidades regionales. La tipología propuesta identifica las diferencias y la inserción de las comunidades del Baixo Tapajós en el espacio regional y se puede utilizar en el diseño de políticas públicas dirigidas a las poblaciones locales.

Odontogenic keratocyst in maxillary sinus with invasive behaviour.

Odontogenic keratocyst is a cystic lesion characterized by a high rate of recurrence. This report describes a rare case of ciliated epithelium-lined odontogenic keratocyst in the maxilla of a 27-year-old female. Panoramic radiography showed a lytic lesion on the right maxilla associated with an impacted molar tooth. Computerized tomography image revealed the involvement of the lesion with the right maxillary sinus, destroying the sinus floor. Histopathologically, the typical keratinized epithelial-lined cyst of odontogenic keratocyst abruptly changed into a ciliated epithelium, suggesting the fusion of both these epithelia rather a metaplastic transformation. The biological behaviour of odontogenic keratocysts is discussed.