Prevalência de sobrecarga em cuidadores de idosos assistidos na Atenção Primária à Saúde / Prevalence of burden in elderly caregivers assisted in Primary Health Care

Objetivo: avaliar a sobrecarga dos cuidadores de idosos assistidos na atenção primária à saúde. Método: trata-se de um estudo transversal realizado com cuidadores de idosos adstritos da Estratégia de Saúde a Família, Marau, Rio Grande do Sul. Para a coleta de dados utilizou-se um questionário sociodemográfico, Escala de Katz e Escala de Zarit Burden Interview. Os dados foram duplamente digitados e posteriormente analisados no software PSPP versão 1.2.0-1. A distribuição do desfecho de acordo com as variáveis independentes foi verificada por meio do teste de Qui-quadrado, usando-se significância estatística de 5%. Resultados: o estudo demonstrou a predominância de cuidadores do sexo feminino (83,8%), adultos e com cônjuge (78,4%). Considerando o grau de parentesco, 64,9% eram filhos e 35,1% eram outros, como, esposo(a), genro, nora, sobrinho(a)s e observou-se que 16,2% utilizavam ansiolíticos e 43,2%, antidepressivos. Os cuidadores que compuseram a amostra atuavam na função há mais de 5 anos (59,5%), trabalhando 10 horas ou mais diariamente (54,1%) e não sobrando tempo para lazer (56,8%). Verificou-se a prevalência de sobrecarga entre os cuidadores equivalente a 56,8%, sendo que 76,2% dos cuidadores que não exerciam nenhuma atividade de lazer, apresentaram sobrecarga (p=0,01). Considerações finais: verificou-se que a maior parte da população apresentou níveis preocupantes de sobrecarga.

Mapping Research in the Obesity, Adipose Tissue, and MicroRNA Field: A Bibliometric Analysis.

Recent studies have investigated the control of adipose tissue expansion and inflammatory process by microRNAs (miRNAs). These two processes are of great interest because both are associated with obesity and metabolic syndrome. However, despite the great relevance of the role of miRNAs in obesity and adipose tissue, no qualitative and quantitative analysis on the subject has been performed. Thus, we aimed to examine global research activity and current trends with respect to the interaction between obesity, adipose tissue and miRNAs through a bibliometric analysis. This research was performed on the Scopus database for publications containing miRNA, obesity, and adipose tissue keyword combinations. In total, 898 articles were analyzed and the most frequently occurring keywords were selected and clustered into three well-defined groups. As a result, first group of keywords pointed to the research area on miRNAs expressed in obesity-associated diseases. The second group demonstrated the regulation of the adipogenesis process by miRNAs, while the third group highlighted brown adipose tissue and thermogenesis as one of the latest global research trends related to the theme. The studies selected in this paper describe the expression and performance of different miRNAs in obesity and comorbidities. Most studies have focused on identifying miRNAs and signaling pathways associated with obesity, type 2 diabetes mellitus, and cardiovascular disease. Thus, the miRNA profile for these diseases may be used as biomarkers and therapeutic targets in the prevention and treatment of obesity-associated diseases.

NO Signaling in the Cardiovascular System and Exercise.

Nitric oxide (NO) is a small molecule implicated in multiple signal transduction pathways thus contributing to the regulation of many cellular functions. The identification of NO synthase (NOS) isoforms and the subsequent characterization of the mechanisms of cell activation of the enzymes permitted the partial understanding of both the physiological and pathological processes. NO bioavailability plays an important role in the pathophysiology of cardiovascular disease and its reduction in endothelial cells is strictly associated to endothelial dysfunction which, in turn, correlates with cardiovascular mortality. Indeed, endothelial NO synthase (eNOS) has a key role in limiting cardiac dysfunction and remodeling in heart diseases, in part by decreasing myocyte hypertrophy. Conversely, exercise training is recommended to prevent and treat cardiovascular diseases-associated disorders at least by enhanced NO synthase activity and expression, and increased production of antioxidants, which prevents premature breakdown of NO. Exercise training may cause an improvement in endothelial function for both experimental animals and humans; Studies in both healthy subjects and patients with impaired NO-related vasorelaxation remarked exercise training ability to improve vascular structure and function and endothelial homeostasis. This chapter will briefly consider the importance of NO signaling in the maintenance of cardiovascular physiology, and discuss recent insights into the effect of exercise training on the signaling pathways that modulate NO synthesis and degradation in health and cardiovascular disease. In addition, we will highlight the molecular mechanisms via which microRNAs (miRs) target NO signaling in the cardiovascular system, and NO as a candidate molecule for development of new therapies.

Physical training improves visceral adipose tissue health by remodelling extracellular matrix in rats with estrogen absence: a gene expression analysis.

Adipose tissue development is associated with modifications involving extracellular matrix remodelling, and metalloproteinases play a significant role in this process. Reduced circulating sexual hormones cause impacts on the size, morphology and functions of the adipose tissue, increasing susceptibility to diseases. This study investigated whether exercise training may be an alternative strategy to combat the effects promoted by estrogen decay through modulation in gene expression patterns in the extracellular matrix (ECM) of visceral adipose tissue of ovariectomized rats. Nulliparous rats (n = 40) were randomly distributed into four groups (n = 10/group): sham sedentary (Sh-S), sham resistance training (Sh-Rt), ovariectomized sedentary (Ovx-S) and ovariectomized resistance training (Ovx-Rt). The Sh-S animals did not have any type of training. The body mass and food intake, ECM gene expression, gelatinase MMP-2 activity and adipocyte area were measured. A lack of estrogen promoted an increase in body mass, food intake and the visceral, parametrial and subcutaneous adipocyte areas. The ovariectomy upregulated the expression of MMP-2, MMP-9, TGF-ß, CTGF, VEGF-A and MMP-2 activity. On the other hand, resistance training decreased the body mass, food intake and the adipocyte area of the three fat depots analysed; upregulated TIMP-1, VEGF-A and MMP-2 gene expression; downregulated MMP-9, TGF-ß and CTGF gene expression; and decreased the MMP-2 activity. We speculate that resistance training on a vertical ladder could play an important role in maintaining and remodelling ECM by modulation in the ECM gene expression and MMP-2 activity, avoiding its destabilization which is impaired by the lack of estrogen.

Critical load: a novel approach to determining a sustainable intensity during resistance exercise.

BACKGROUND: A hyperbolic function as well as a linear relationship between power output and time to exhaustion (Tlim) has been consistently observed during dynamic non-resistive exercises. However, little is known about its concept to resistance exercises (RE), which could be defined as critical load (CL). This study aimed to verify the existence of CL during dynamic RE and to verify the number of workbouts necessary to determine the optimal modeling to achieve it. METHODS: Fifteen healthy men (23±2.5 yrs) completed 1 repetition maximum test (1RM) on a leg press and 3 (60%, 75% and 90% of 1RM) or 4 (+ 30% of 1RM) workbouts protocols to obtain the CL by hyperbolic and linear regression models between Tlim and load performed. Blood lactate and leg fatigue were also measured. RESULTS: CL was obtained during RE and 3 workbouts protocol estimate it at 53% while 4 tests at 38% of 1 RM. However, based on coefficients of determination, 3 protocols provided a better fit than the 4-parameter model, respectively (R2>0.95 vs. >0.77). Moreover, all intensities increased blood lactate and leg fatigue, however, when corrected by Tlim, were significantly lower at CL. CONCLUSIONS: It was possible to determinate CL during dynamic lower limbs RE and that 3 exhaustive workbouts can be used to better estimate the CL, constituting a new concept of determining this threshold during dynamic RE and reducing the physically demanding nature of the protocol. These findings may have important applications for functional performance evaluation and prescription of RE programs.

Estrogen deficiency in ovariectomized rats: can resistance training re-establish angiogenesis in visceral adipose tissue?

OBJECTIVE: The purpose of this study was to investigate the effects of resistance training on angiogenesis markers of visceral adipose tissue in ovariectomized rats. METHOD: Adult Sprague-Dawley female rats were divided into four groups (n=6 per group): sham-sedentary, ovariectomized sedentary, sham-resistance training and ovariectomized resistance training. The rats were allowed to climb a 1.1-m vertical ladder with weights attached to their tails and the weights were progressively increased. Sessions were performed three times per week for 10 weeks. Visceral adipose tissue angiogenesis and morphology were analyzed by histology. VEGF-A mRNA and protein levels were analyzed by real-time PCR and ELISA, respectively. RESULTS: Ovariectomy resulted in higher body mass (p=0.0003), adipocyte hypertrophy (p=0.0003), decreased VEGF-A mRNA (p=0.0004) and protein levels (p=0.0009), and decreased micro-vascular density (p=0.0181) in the visceral adipose tissue of the rats. Resistance training for 10 weeks was not able to attenuate the reduced angiogenesis in the visceral adipose tissue of the ovariectomized rats. CONCLUSION: Our findings indicate that the resistance training program used in this study could not ameliorate low angiogenesis in the visceral adipose tissue of ovariectomized rats.

Estrogen deficiency in ovariectomized rats: can resistance training re-establish angiogenesis in visceral adipose tissue?

OBJECTIVE: The purpose of this study was to investigate the effects of resistance training on angiogenesis markers of visceral adipose tissue in ovariectomized rats. METHOD: Adult Sprague-Dawley female rats were divided into four groups (n=6 per group): sham-sedentary, ovariectomized sedentary, sham-resistance training and ovariectomized resistance training. The rats were allowed to climb a 1.1-m vertical ladder with weights attached to their tails and the weights were progressively increased. Sessions were performed three times per week for 10 weeks. Visceral adipose tissue angiogenesis and morphology were analyzed by histology. VEGF-A mRNA and protein levels were analyzed by real-time PCR and ELISA, respectively. RESULTS: Ovariectomy resulted in higher body mass (p=0.0003), adipocyte hypertrophy (p=0.0003), decreased VEGF-A mRNA (p=0.0004) and protein levels (p=0.0009), and decreased micro-vascular density (p=0.0181) in the visceral adipose tissue of the rats. Resistance training for 10 weeks was not able to attenuate the reduced angiogenesis in the visceral adipose tissue of the ovariectomized rats. CONCLUSION: Our findings indicate that the resistance training program used in this study could not ameliorate low angiogenesis in the visceral adipose tissue of ovariectomized rats.

Resistance training restores the gene expression of molecules related to fat oxidation and lipogenesis in the liver of ovariectomized rats.

Decreased levels of estrogen are associated with hepatic steatosis (HS), through changes in gene expression of molecules related to fat oxidation and lipogenesis. Both resistance training (RT) and endurance training (ET) prevent HS in ovariectomized (Ovx) rats. However, the molecular events associated with this process were only investigated for ET, but not for RT. Thus, the aim of this study was to investigate the effects of Ovx and RT on the gene expression of molecules related to fat oxidation and lipogenesis in the liver of rats. Sprague-Dawley adult female rats were grouped into four (n = 6 per group): sham-operated sedentary (Sham-Sed); Ovx sedentary (Ovx-Sed); sham-Rt and Ovx-Rt. A 10-week RT period, during which the animals climbed a 1.1-m vertical ladder with weights attached to their tails, was used. The sessions were performed three times a week, with 4-9 climbs and 8-12 dynamic movements per climb. Gene expression was analyzed by RT-PCR by the ∆∆Ct method. The estrogen deficiency associated with ovariectomy decreased the gene expression of molecules related to fat oxidation, carnitine palmitoyltransferase I (53%) and ß-hydroxyacyl-CoA dehydrogenase (27%), and increased molecules related to lipogenesis, sterol regulatory element-binding protein-1c (106%), acetyl-CoA carboxylase (ACC) (72%) and stearoyl CoA desaturase-1 (109%). With the exception of ACC, the ovariectomy-induced changes in the expression of these molecules were restored by RT. The present results indicate that RT has important effects on the prevention of HS in Ovx animals, through changes in gene expression of molecules related to hepatic lipid metabolism.