Evaluation of acute effect of light-emitting diode (LED) phototherapy on muscle deoxygenation and pulmonary oxygen uptake kinetics in patients with diabetes mellitus: study protocol for a randomized controlled trial.

BACKGROUND: Type 2 diabetes mellitus (DM) is responsible for a significant reduction in the quality of life due to its negative impact on functional capacity. Cardiopulmonary fitness impairment in DM patients has been associated with limited tissue oxygenation. Phototherapy is widely utilized to treat several disorders due to expected light-tissue interaction. This type of therapy may help to improve muscular oxygenation, thereby increasing aerobic fitness and functional capacity. METHODS/DESIGN: This study is a randomized, double-blind, placebo-controlled crossover trial approved by the Ethics Committee of the Federal University of São Carlos and registered at ClinicalTrials.gov. Four separate tests will be performed to evaluate the acute effect of phototherapy. All participants will receive both interventions in random order: light-emitting diode therapy (LEDT) and placebo, with a minimum 14-day interval between sessions (washout period). Immediately after the intervention, participants will perform moderate constant workload cycling exercise corresponding to 80 % of the pulmonary oxygen uptake [Formula: see text] during the gas exchange threshold (GET). LEDT will be administered with a multidiode cluster probe (50 GaAIA LEDs, 850 ηm, 75 mW each diode, and 3 J per point) before each exercise session. Pulmonary oxygen uptake, muscle oxygenation, heart rate, and arterial pressure will be measured using a computerized metabolic cart, a near-infrared spectrometer, an electrocardiogram, and a photoplethysmography system, respectively. DISCUSSION: The main objective of this study is to evaluate the acute effects of muscular pre-conditioning using LED phototherapy on pulmonary oxygen uptake, muscle oxygenation, heart rate, and arterial pressure dynamics during dynamic moderate exercise. We hypothesize that phototherapy may be beneficial to optimize aerobic fitness in the DM population. Data will be published after the study is completed. TRIAL REGISTRATION: Registered at ClinicalTrials.gov under trial number NCT01889784 (date of registration 5 June 2013).

Teste das fábulas: estudo em psicossomática / Fables test: study in psychosomatic

Esta pesquisa renova trabalhos de validade relativos ao teste das Fábulas (TF). Sua originalidade consiste em examinar indicadores de somatização (IS), novo problema no TF. São estudados IS em 47 crianças (16 com asma, 21 câncer, 10 sadias), de ambos os sexos, com idades entre quatro e 14 anos. Utiliza-se estatística descritiva e testes de associação. As fábulas do Passarinho e do Elefante, cujas estórias propiciam alusão ao corpo, mostram-se altamente sensíveis a esses indicadores. A análise dos IS, em grupos contrastantes, sugere a validade do TF. O estudo contribui para o conhecimento psicossomático baseado em evidências. Apesar das promissoras evidências empíricas, há necessidade de mais estudos controlados, com amostras maiores e com outras doenças crônicas.(AU)

This research renovates previous works about the validity of the Fables Test (TF). Its originality lies on investigating indicators of somatization (IS) that are a new problem about TF. These indicators were studied in a group of 47 children, aged 4 to 14 years (16 with asthma, 21 with cancer, 10 healthy). Descriptive statistics and association tests were used. Fables of the Bird and the Elephant, whose stories provide an allusion to the body, appeared as highly sensitive to these indicators. The somatization analysis in contrasted groups suggests the validity of the TF. The study contributes to psychosomatic evidence-based knowledge. Despite the promising empirical evidence, there is a need for larger controlled studies with other groups of chronic disease.(AU)

Teste das fábulas: estudo em psicossomática / Fables test: study in psychosomatic

Esta pesquisa renova trabalhos de validade relativos ao teste das Fábulas (TF). Sua originalidade consiste em examinar indicadores de somatização (IS), novo problema no TF. São estudados IS em 47 crianças (16 com asma, 21 câncer, 10 sadias), de ambos os sexos, com idades entre quatro e 14 anos. Utiliza-se estatística descritiva e testes de associação. As fábulas do Passarinho e do Elefante, cujas estórias propiciam alusão ao corpo, mostram-se altamente sensíveis a esses indicadores. A análise dos IS, em grupos contrastantes, sugere a validade do TF. O estudo contribui para o conhecimento psicossomático baseado em evidências. Apesar das promissoras evidências empíricas, há necessidade de mais estudos controlados, com amostras maiores e com outras doenças crônicas...

This research renovates previous works about the validity of the Fables Test (TF). Its originality lies on investigating indicators of somatization (IS) that are a new problem about TF. These indicators were studied in a group of 47 children, aged 4 to 14 years (16 with asthma, 21 with cancer, 10 healthy). Descriptive statistics and association tests were used. Fables of the Bird and the Elephant, whose stories provide an allusion to the body, appeared as highly sensitive to these indicators. The somatization analysis in contrasted groups suggests the validity of the TF. The study contributes to psychosomatic evidence-based knowledge. Despite the promising empirical evidence, there is a need for larger controlled studies with other groups of chronic disease...

[Relationship between climate change and determinant factors of mortality among the elderly in the municipality of São Carlos (São Paulo, Brazil) over a period of ten years]. / Relação entre alterações climáticas e fatores determinantes da mortalidade de idosos no município de São Carlos (SP) em um período de dez anos.

The aim of this study was to identify the correlation between the number of deaths of elderly people and climate change in the district of São Carlos (SP) over a period of 10 years (1997-2006). Records of deaths were obtained from DATASUS for people aged over 60 who died between 1997 and 2006 in São Carlos. The average monthly maximum and minimum temperature data and relative air humidity in São Carlos were provided by the National Institute of Meteorology. The mortality coefficient of the district was calculated by gender and age and the resulting data were analyzed using t test, one-way ANOVA, the Bonferroni test and the Pearson correlation coefficient test. There were 8,304 deaths which predominantly occurred among males aged over 80, and diseases of the circulatory system were the main cause of death. There was a positive correlation between mortality by infectious disease and minimum humidity, and a negative correlation between mortality by infectious diseases and minimum temperatures, between mortality caused by respiratory disease and minimum humidity, between mortality caused by endocrine disease and minimum and maximum temperature. Thereby, it was possible to conclude that there was a correlation between climate change and mortality among elderly individuals in São Carlos.

Relação entre alterações climáticas e fatores determinantes da mortalidade de idosos no município de São Carlos (SP) em um período de dez anos / Relationship between climate change and determinant factors of mortality among the elderly in the municipality of São Carlos (São Paulo, Brazil) over a period of ten years

O objetivo desse estudo foi identificar as correlações existentes entre o número de óbitos de indivíduos idosos e as alterações climáticas no município de São Carlos (SP) em um período de 10 anos (1997-2006). Foram colhidas informações do registro de óbitos por meio do DATASUS, de pessoas com 60 anos ou mais, falecidas entre 1997 e 2006 no município. Os dados mensais da média das Temperaturas Máxima, Média e Mínima e da Umidade Relativa do Ar no município de São Carlos foram fornecidos pelo Instituto Nacional de Meteorologia. Calcularam-se os coeficientes de mortalidade do município, por sexo e faixa etária e os dados foram analisados com teste t, ANOVA de fator único, teste de Bonferroni e teste de Pearson. Ocorreram 8.304 óbitos, com predominância de indivíduos na faixa dos 80 anos ou mais, do sexo masculino. As doenças do aparelho circulatório foram as principais causas de óbito. Houve correlação positiva entre mortalidade por doenças infecciosas e Umidade Mínima e correlação negativa entre mortalidade por doenças infecciosas e Temperatura Mínima Mínima, entre mortalidade por doenças respiratórias e Umidade Mínima, entre mortalidade por doenças endócrinas e Temperatura Mínima Mínima e Temperatura Máxima Máxima. Dessa forma, foi possível concluir que houve relação entre o clima e a mortalidade de idosos em São Carlos.

The aim of this study was to identify the correlation between the number of deaths of elderly people and climate change in the district of São Carlos (SP) over a period of 10 years (1997-2006). Records of deaths were obtained from DATASUS for people aged over 60 who died between 1997 and 2006 in São Carlos. The average monthly maximum and minimum temperature data and relative air humidity in São Carlos were provided by the National Institute of Meteorology. The mortality coefficient of the district was calculated by gender and age and the resulting data were analyzed using t test, one-way ANOVA, the Bonferroni test and the Pearson correlation coefficient test. There were 8,304 deaths which predominantly occurred among males aged over 80, and diseases of the circulatory system were the main cause of death. There was a positive correlation between mortality by infectious disease and minimum humidity, and a negative correlation between mortality by infectious diseases and minimum temperatures, between mortality caused by respiratory disease and minimum humidity, between mortality caused by endocrine disease and minimum and maximum temperature. Thereby, it was possible to conclude that there was a correlation between climate change and mortality among elderly individuals in São Carlos.

Relationship between eccentric hip torque and lower-limb kinematics: gender differences.

The purposes of this study were to compare lower-limb kinematics between genders, and determine the relationships among eccentric hip abductor and lateral rotator torques and lower-limb kinematics. The movements of the pelvis, femur, and knee were calculated for 16 women and 16 men during the single-leg squat. Eccentric hip abductor and lateral rotator torques were measured using an isokinetic dynamometer. The results showed that women had greater contralateral pelvic depression, femur adduction, and knee abduction than men. The eccentric hip abductor and lateral rotator torques were correlated with coronal plane femur and knee movements in the overall sample. When the genders were analyzed separately, it was observed that women with greater eccentric hip abductor torque exhibited less femur adduction and femur medial rotation, and greater knee adduction excursion. No significant relationship was observed between the isokinetic and kinematic variables in the male group. The differences between the genders help to explain the greater rate of knee disorders observed in women. Moreover, the eccentric hip abduction action seemed to be more important in women to control the lower-limb movements.

Variations in dynamic knee valgus and gluteus medius onset timing in non-athletic females related to hormonal changes during the menstrual cycle.

It has been suggested that activities of daily living could contribute to the occurrence of ACL injury in females. Currently, no studies have focused on the lower extremity behavior of a non-athletic population to compare or understand the lower extremity adeptness towards daily movements that mimic athletic tasks. Our hypothesis was that increased knee valgus angles would occur during the late follicular phase of the menstrual cycle accompanied by different onset timing of the gluteus medius muscle. In a controlled laboratory study, 23 non-athletic collegiate females participated and 15 subjects comprised the final sample for statistical analysis. Subjects performed a single leg drop landing maneuver while 3-D knee kinematics and gluteus medius muscle onset timing were assessed throughout three distinct phases of the menstrual cycle, confirmed by blood hormone analysis. In general, knee valgus angles were significantly less in the luteal phase compared to both follicular phases (p<0.005), while differences were not observed for gluteus medius onset timing (p=0.936). As a decreased knee joint valgus angle was observed during the luteal phase, it was hypothesized that the hormone progesterone could significantly influence knee kinematics during a dynamic task. However, such influence was not observed for gluteus medius EMG onset timing as a significant correlation between gluteus medius onset timing and knee valgus angle could not be determined.

Identification of a statistical method as a quality tool: patient's length of stay in the operating room.

OBJECTIVE: To identify a statistical method that may express the patient length of stay in the operating room and build a 'matrix of relationship' for optimizing this time, the real and exact time of the operation. METHODS: The analysis of survival and the Kaplan-Meier estimator allowed to calculate the survival curves for different times and the 'matrix of relationship' with 10 hypothesis to help in choosing the new operation. The study consisted of a simple random sample of 71 patients, from elective operations for adults in Cardiac Surgery/Clinics Hospital/Unicamp, with confidence level of 95% in 2008. RESULTS: On average, the times of the operations over at a range of 140 minutes to 200 minutes and excess from 5 minutes to 90 minutes. In general, on average, one operation was daily performed within 520 minutes, for a time of 720 minutes. CONCLUSION: 1) With the maximum available time of 720 minutes is not possible to perform surgery, unless using the 'matrix of relationship', whereas the maximum time available varies between 660 minutes and 690 minutes, considering the range of cleaning of the room. 2) The time of the patient in the operating room is a time that includes the time of learning by the student in an university hospital school. 3) When optimizing the time, most patients will benefit, causing a decrease from the waiting list for new opeartions. 4) The 'matrix of relationship' allows to view and express opinion on a better decision making in addition to decide upon several assumptions.

Comparação do equilíbrio corporal de mulheres a partir da meia-idade obesas e não-obesas / Body balance comparison betweeen obese and non-obese women from middle-age on

Este é um estudo comparativo do efeito da obesidade no equilíbrio estático e dinâmico de mulheres a partir da meia-idade. A amostra foi composta por mulheres acima de 50 anos (n=80), distribuídas segundo o índice de massa corporal em grupo não-obeso (n=45) e obeso (n=35), com médias de idade equivalentes. Foram avaliadas quanto à gordura corporal por bioimpedância e quanto ao equilíbrio pelos testes de apoio unipodal (TAU) e de velocidade máxima de andar (VMA). Os dados foram tratados estatisticamente. No TAU em ambos os membros inferiores o grupo não-obeso permaneceu por mais tempo na posição – 25,6 segundos (s) no membro direito e 24,9 s no esquerdo – do que o grupo obeso (19,0 s no direito e17,5 s no esquerdo, p<0,01). No VMA o grupo obeso apresentou marcha mais lenta e velocidade média menor quando comparado ao grupo não obeso (p<0,027). No grupo não-obeso, verificaram-se correlações moderadas entre a gordura corporal e o equilíbrio estático e dinâmico; no grupo obeso não foram encontradas correlações entre a gordura corporal e a maioria das variáveis de equilíbrio. Os resultados evidenciam que a obesidade contribui para o pior desempenho no equilíbrio de mulheres de meia-idade e idosas...

This is a comparative study on the effect of obesity on static and dynamic balance in middle-aged and elderly women. The sample was composed by 80 women over 50 years old, distributed according to the body mass index into a non-obese group (n=45) and an obese group (n=35), with similar mean age. Participants were assessed as to body fat by bioimpedance and submitted to the one leg stance (OLS) and maximum walking speed (MWS) tests. Data were statistically analysed. At the OLS on both feet the non-obese group remained longer in position – 25.6 seconds (s) on the right limb and 24,9 s on the left one – than the obese group (19.0 s on the right, 17.5 s on the left limb, p<0.01). At he MWS test the obese group showed slower walking and lower mean speed than the non-obese group (p<0,027).Within non-obese group results, moderate correlations were found between body fat and static and dynamic balance; in the obese group practically no corresponding correlations were found. Results show that obesity contributes to worse balance performance in middle-age and elderly women...

Identificação de um método estatístico como instrumento da qualidade: tempo da presença do doente na sala de operação / Identification of a statistical method as a quality tool: patient's length of stay in the operating room

OBJETIVO: Identificar um método estatístico que expresse o tempo da presença do doente na sala de operação e construir a "matriz de relação" de otimização deste tempo, o tempo exato e real da operação. MÉTODOS: A análise de sobrevivência e o estimador de Kaplan-Meier permitiram calcular as curvas de sobrevivência para os diferentes tempos e a "matriz de relação" com 10 hipóteses para auxiliar na escolha da nova operação. A amostra aleatória simples de 71 indivíduos, das operações eletivas de adultos da Cirurgia Cardíaca/Hospital de Clínicas/UNICAMP, no ano 2008, no nível de confiança de 95 por cento. RESULTADOS: Os tempos das operações em média sobram em um intervalo de 140 a 200 minutos e excedem de 5 a 90 minutos. No geral, realizou-se em média diariamente uma operação dentro de 520 minutos, para um tempo disponível de 720 minutos. CONCLUSÃO: 1) Com o tempo máximo disponível de 720 minutos não é possível realizar operação, a não ser utilizando da "matriz de relação", sendo que o tempo máximo disponível varia entre 660 e 690 minutos, considerando-se intervalo de limpeza da sala. 2) O tempo do doente na sala de operação tem nele incluso o tempo de aprendizado pelo aluno, em um hospital escola, universitário. 3) Ao otimizar o tempo, mais doentes serão beneficiados, acarretando diminuição da fila de espera para novas operações. 4) A "matriz" de relação permite visualizar, opinar e decidir mediante várias hipóteses, resultando em melhor tomada de decisão

OBJECTIVE: To identify a statistical method that may express the patient length of stay in the operating room and build a "matrix of relationship" for optimizing this time, the real and exact time of the operation. METHODS: The analysis of survival and the Kaplan-Meier estimator allowed to calculate the survival curves for different times and the "matrix of relationship" with 10 hypothesis to help in choosing the new operation. The study consisted of a simple random sample of 71 patients, from elective operations for adults in Cardiac Surgery/Clinics Hospital/Unicamp, with confidence level of 95 percent in 2008. RESULTS: On average, the times of the operations over at a range of 140 minutes to 200 minutes and excess from 5 minutes to 90 minutes. In general, on average, one operation was daily performed within 520 minutes, for a time of 720 minutes. CONCLUSION: 1) With the maximum available time of 720 minutes is not possible to perform surgery, unless using the "matrix of relationship", whereas the maximum time available varies between 660 minutes and 690 minutes, considering the range of cleaning of the room. 2) The time of the patient in the operating room is a time that includes the time of learning by the student in an university hospital school. 3) When optimizing the time, most patients will benefit, causing a decrease from the waiting list for new opeartions. 4) The "matrix of relationship" allows to view and express opinion on a better decision making in addition to decide upon several assumptions

Shoulder abduction torque steadiness is preserved in subacromial impingement syndrome.

This study compared peak torque and torque steadiness during isometric abduction in subjects with subacromial impingement syndrome (SIS) and those with no upper limb disorders. The SIS group consisted of 27 subjects (33.48 +/- 9.94 years) with unilateral SIS. The control group consisted of 23 healthy and active subjects (32.26 +/- 9.04 years). Peak torque and torque steadiness were measured during isometric abduction (80 masculine in the scapular plane) of the shoulder. Standard deviation, coefficient of variation, stability time, median frequency, and relative power were measured from the steadiness trials. There were neither significant interactions between group and side (P > 0.05), nor were there significant main effects of group and side (P > 0.05) for all variables analyzed. The results of this study showed that steadiness is preserved by SIS during isometric abduction of the shoulder.

Análise de estimadores das curvas de sobrevivência em estudos de pequena escala, sob dados censurados / Analysis of estimators of the survival curves in small scale, for censored data

Mediante o estudo do viés e erro médio quadrático, foi comparado o desempenho dos estimadores F-N-P de Kaplan e Meier (1958) e de Kitchin (1980) e do estimador bayesiano de Salinas e Pereira (1992), das curvas de sobrevivência sob dados censurados. Além disso, foi pesquisado e comparado outro estimador F-N-P para esse mesmo fim, que foi chamado estimador modificado de Kitchin (pela mudança realizada na taxa de risco acumulada do estimador de Kitchin nos subintervalos formados pelos tempos consecutivos das ocorrências dos eventos de interesse). As estimativas säo calculadas e comparadas primeiramente em um exemplo de dados clínicos reais de transplantes renais humanos e depois em amostras geradas por simulaçäo a partir de modelos teóricos, assumindo distribuiçöes exponencial e de Weibull. As simulaçöes indicaram que o estimador de Kaplan e Meier é melhor que os demais, isto é, tem menor erro quadrático médio em todas as circunstâncias abordadas. Neste mesmo sentido o estimador modificado apresentou-se melhor que o de Kitchin. Com uma priori näo informativa, o estimador de Salinas e Pereira teve melhor desempenho que o modificado de Kitchin. A análise simultânea do desempenho e simplicidade operacional aponta para os estimadores de Kaplan e Meier e Modificado de Kitchin, nessa ordem