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1.
Sci Rep ; 10(1): 11399, 2020 Jul 09.
Artigo em Inglês | MEDLINE | ID: mdl-32647148

RESUMO

Heart rate variability (HRV) is a valid and non-invasive indicator of cardiac autonomic nervous system functioning. Short-term HRV recordings (e.g., 10 min long) produce data that usually is manually processed. Researcher subjective decision-making on data processing could produce inter- or intra-researcher differences whose magnitude has not been previously quantified in three independent human cohorts. This study examines the inter- and intra-researcher reproducibility of HRV parameters (i.e., the influence of R-R interval selection by different researchers and by the same researcher in different moments on the quantification of HRV parameters, respectively) derived from short-term recordings in a cohort of children with overweight/obesity, young adults and middle-age adults. Participants were recruited from 3 different studies: 107 children (10.03 ± 1.13 years, 58% male), 132 young adults (22.22 ± 2.20 years, 33% males) and 73 middle-aged adults (53.62 ± 5.18 years, 48% males). HRV was measured using a Polar RS800CX heart rate monitor. The intraclass correlation coefficient (ICC) ranged from 0.703 to 0.989 and from 0.950 to 0.998 for inter-and intra-researcher reproducibility, respectively. Limits of agreement for HRV parameters were higher for the inter-researcher processing compared with the intra-researcher processing. On average, the intra-researcher differences were 31%, 62%, and 80% smaller than the inter-researchers differences based on Coefficient of Variation in children, young and middle-aged adults, respectively. Our study provides the quantification of the inter-researcher and intra-researcher differences in three independent human cohorts, which could elicit some clinical relevant differences for HRV parameters. Based on our findings, we recommend the HRV data signal processing to be performed always by the same trained researcher and we postulate a development of algorithms for an automatic ECG selection.

2.
Sci Rep ; 10(1): 12469, 2020 Jul 27.
Artigo em Inglês | MEDLINE | ID: mdl-32719329

RESUMO

Recent studies investigated the association of cardiorespiratory fitness with white matter microstructure in children, yet little work has explored to what extent other components of physical fitness (i.e., muscular or motor fitness) are associated with white matter microstructure. Indeed, this association has not been previously explored in children with overweight/obesity who present a different white matter development. Therefore, we aimed to examine associations between physical fitness components and white matter microstructure in children with overweight/obesity. In total, 104 (10.04 ± 1.15 years old; 43 girls) children were included in this cross-sectional study. Physical fitness was assessed using the ALPHA-fitness test battery. Fractional anisotropy (FA) and mean diffusivity were derived from diffusion tensor imaging (DTI). No association was found between physical fitness and global DTI metrics (all P > 0.082). Within individual tracts, all associations became non-significant when analyses were adjusted for multiple comparisons. Using the voxel-wise approach, we identified a small cluster in the left lateral frontal lobe where children with greater upper-body muscular fitness showed higher FA (PFWE-corrected = 0.042). Although our results cannot conclude physical fitness is related to white matter microstructure in children with overweight/obesity; those findings indicate that the association of muscular fitness with white matter microstructure might be more focal on frontal areas of the brain, as opposed to global differences.

3.
Sci Rep ; 10(1): 6638, 2020 04 20.
Artigo em Inglês | MEDLINE | ID: mdl-32313018

RESUMO

Sauropods were among the most diverse lineages of dinosaurs, with an ample geographic distribution throughout the Mesozoic. This evolutionary success is largely attributed to neck elongation and its impact on feeding efficiency. However, how neck elongation influenced exactly on feeding strategies is subject of debate. The process of mounting a nearly complete virtual skeleton of Spinophorosaurus nigerensis, from the Middle (?) Jurassic of Niger, has revealed several previously unknown osteological adaptations in this taxon. Wedged sacral and posterior dorsal vertebrae cause the presacral column to deflect antero-dorsally. This, together with elongated scapulae and humeri make the anterior region of the skeleton vertically lengthened. Also, elongated prezygapophyseal facets on the cervical vertebrae and a specialized first dorsal vertebra greatly increase the vertical range of motion of the neck. These characters support this early eusauropod as a more capable high browser than more basally branching sauropods. While limb proportions and zygapophyseal facets vary among Eusauropoda, the sacrum retained more than 10° of wedging in all Eusauropoda. This implied a functional constraint for sauropod species which evolved lower browsing feeding strategies: the antero-dorsal sloping caused by the sacrum had to be counteracted with further skeletal modifications, e.g. a ventrally curved mid to anterior presacral spine to hinder the dorsal slope of the whole presacral series caused by the wedged sacrum. This suggests that at least the last common ancestor of Eusauropoda developed high browsing capabilities, partially due to the modified wedged sacrum, likely a potential synapomorphy of the clade and key in the evolutionary history of the group.

4.
Rev. esp. patol. torac ; 31(4): 240-248, dic. 2019. ilus, graf, tab
Artigo em Espanhol | IBECS | ID: ibc-187184

RESUMO

Objetivo: el objetivo del estudio fue evaluar la función muscular periférica de pacientes con EPOC moderadasevera, mediante la medición de la fuerza muscular isométrica e isotónica del cuádriceps y la masa muscular mediante ecografía. Método: fueron incluidos pacientes con EPOC moderada-severa estables, remitidos a Rehabilitación Respiratoria. En la extremidad dominante, se midió la fuerza isométrica (dinamómetro hidráulico), test 1RM y se realizó una ecografía para obtener el área transversal y dimensiones de diversas secciones musculares. Resultados: participaron 34 pacientes con EPOC estable: GOLD 2 (n = 11), GOLD 3 (n = 12) y GOLD 4 (n = 11) Los GOLD 4 tenían un IMC P50 (P25 - P75) 25,3 (22,5 - 28,8), significativamente menor que los GOLD 3: 32,0 (27,5 - 34,0); p = 0,025. Se evidenció debilidad del cuádriceps (1RM/peso <0,60 1RM/IMC <120%), de forma global: 0,33 (0,22 - 0,41) y 93% (61 - 112) respectivamente, y en cada grupo, sin diferencias significativas entre ellos. Tampoco hubo diferencias significativas entre los grupos en las mediciones de ecografía muscular. La fuerza isotónica (1RM) se correlacionó con el grosor del cuádriceps QT (r = 0,529; p = 0,003) y el grosor del músculo vasto intermedio Q1(r = 0,514; p = 0,004) La fuerza isométrica se correlacionó con el QT (0,621; p <0,001), Q1 (0,441; p = 0,009) y el área transversal AQ (r = 0,587; p <0,001) Para cada grupo, el QT y la fuerza isométrica se correlacionaron significativamente. Conclusión: en nuestra serie de pacientes se demuestra la existencia de debilidad muscular del cuádriceps, independientemente del grado de severidad de la enfermedad y en estrecha relación con la masa muscular de dicho músculo. Palabras clave: disfunción muscular, fuerza isotónica, 1RM, fuerza isométrica, ecografía muscular


Objective: The objective of this study was to evaluate peripheral muscle function in patients with moderate-severe COPD by measuring isometric and isotonic muscular strength of the quadriceps and muscle mass through ultrasound. Method: This study included stable patients with moderate-severe COPD who were referred to pulmonary rehabilitation. In the dominant extremity, isometric strength (hydraulic dynamometer) and the 1RM test were measured and an ultrasound was done to determine the transversal area and dimensions of different sections of muscle. Results: 34 stable patients with COPD participated: GOLD 2 (n = 11), GOLD 3 (n = 12) and GOLD 4 (n = 11). GOLD 4 patients had a BMI P50 (P25 - P75) 25.3 (22.5 - 28.8), which was significantly lower than GOLD 3 patients: 32.0 (27.5 - 34.0); p = 0.025. Weakness in the quadriceps was observed (1 RM/weight <0.60; 1 RM/BMI <120%) overall: 0.33 (0.22 - 0.41) and 93% (61 - 112), respectively, and in each group, without significant differences between groups. There were also no significant differences between groups for ultrasound muscle measurements. Isotonic strength (1 RM) correlated to quadricep thickness QT (r = 0.529; p = 0.003) and vastus intermedius muscle thickness Q1(r = 0.514; p = 0.004). Isometric strength correlated to QT (0.621; p <0.001), Q1 (0.441; p = 0.009) and transversal area AQ (r = 0.587; p <0.001). QT and isometric strength were significantly correlated in each group. Conclusion: In our study, patients showed muscular weakness in the quadriceps, regardless of the degree of disease severity and this weakness was closely related to the mass of said muscle


Assuntos
Humanos , Músculo Quadríceps/fisiologia , Doença Pulmonar Obstrutiva Crônica/diagnóstico , Força Muscular/fisiologia , Músculo Quadríceps/diagnóstico por imagem , Músculo Quadríceps/patologia , Ultrassonografia , Contração Isotônica/fisiologia , Contração Isométrica/fisiologia , Espirometria , Análise de Variância , Debilidade Muscular/diagnóstico por imagem
5.
Rev. otorrinolaringol. cir. cabeza cuello ; 79(4): 482-492, dic. 2019. tab, graf
Artigo em Espanhol | LILACS-Express | LILACS | ID: biblio-1058726

RESUMO

RESUMEN En la práctica clínica es habitual el estudio de linfonodos cervicales. La anamnesis y el examen físico orientan la etiología, pero ocasionalmente debemos recurrir a estudios imagenológicos. Esto es muy relevante en contexto de un linfonodo metastásico por un carcinoma escamoso de cabeza y cuello. Para esto podemos utilizar diversas herramientas imagenológicas. El ultrasonido se utiliza para el estudio inicial de una masa cervical en donde clínicamente no queda claro el origen. La tomografía computarizada permite la evaluación de manera global del cuello. Se utiliza ante sospechas o diagnósticos confirmados de carcinoma escamoso de cabeza y cuello. La resonancia magnética tiene utilidad en casos que requieren evaluación de un primario y el cuello, como cánceres de glándulas salivales, base de lengua, lengua oral o piso de boca. El PET-TC es un buen examen a la hora de evaluar un cáncer de cabeza y cuello de primario desconocido y posibles metástasis a distancia, como también cuando se quiere evaluar adenopatías persistentes postratamiento con radioquimioterapia. Tener una evaluación ordenada en el estudio de un linfonodo, por sobre todo con un uso adecuado del recurso imagenológico ayuda a no enlentecer el proceso diagnóstico y dar un diagnóstico y tratamiento más certero.


ABSTRACT In clinical practice, the study of cervical lymph nodes is common. The anamnesis and the physical examination often guide the etiology, however sometimes we have to use images studies. This is very relevant when we are assessing a metastatic lymph node due to head and neck squamous cell carcinoma. Ultrasound is usually used for the initial study of a cervical mass where the physician cannot determine its origin. The computed tomography allows a global evaluation of the neck. It is most often used when there is suspicion or confirmed diagnoses of head and neck squamous cell carcinoma. Magnetic resonance imaging is useful in cases that require evaluation of a primary neoplasm and the neck, such in salivary gland cancers, tongue base cancers, oral tongue or mouth floor tumors. PET-CT is a good test to evaluate head and neck cancers of unknown primary site and possible distant metastases, as well as evaluation of persistent adenopathies after treatment with radiochemotherapy. Having an organized evaluation in the study of a lymph node, with an adequate use of the imaging resource, helps not to hinder the diagnostic process and give an accurate diagnosis and treatment.

6.
Rev Clin Esp ; 2019 Nov 24.
Artigo em Inglês, Espanhol | MEDLINE | ID: mdl-31776005

RESUMO

BACKGROUND AND OBJECTIVE: Heart failure (HF) is a frequent condition that deteriorates quality of life and results in high morbidity and mortality. A considerable number of studies have been implemented in recent years to determine the factors that affect the prognosis of HF; however, few studies have assessed the prognosis of patients hospitalised for their first episode of HF. The aim of our study was to analyse the prognostic impact of renal function on patients hospitalised for a first episode of HF. MATERIAL AND METHODS: We recruited 600 patients hospitalised for a first episode of HF in 3 tertiary Spanish hospitals. We analysed the mortality risk during the first year of follow-up according to renal function at the time of admission. RESULTS: The patients with the highest degree of kidney failure at admission were older (P<.001), were more often women (p=.01) and presented a higher degree of dependence (P<.05), as well as a higher prevalence of arterial hypertension (P<.001), chronic renal failure (P<.001) and anaemia (P<.001). In the multivariate analysis, the degree of kidney failure at admission remained an independent predictor of increased mortality risk during the first year of follow-up. CONCLUSIONS: The presence of kidney failure at admission was a marker of poor prognosis in our cohort of patients hospitalised for a first episode of HF.

7.
Braz J Med Biol Res ; 52(9): e8402, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31482976

RESUMO

Cardiopulmonary fitness assessment is a valuable resource to obtain quantitative indicators of an individual's physical performance. The cardiopulmonary exercise test (CPX), considered the gold standard test for this evaluation, is costly and difficult to be accessed by the general population. In order to make this evaluation more accessible, and to better reflect the performance of daily life activities, alternative tests were proposed. Morbidly obese patients present limitations that impair physical performance assessment and could benefit from a test of shorter duration, provided it is validated. This observational study aimed to validate the two-minute step test (2MST) as a tool to evaluate functional capacity (FC) in obese with comorbidities and morbidly obese patients, compared the 2MST with CPX as a measure of physical performance, and developed a predictive equation to estimate peak oxygen uptake (VO2) in the 2MST. The CPX and the 2MST were performed and metabolic and ventilatory parameters were recorded in 31 obese individuals (BMI>35 kg/m2). Pearson correlation and multiple linear regression analyses were performed to evaluate the peak VO2 best predictors. Bland-Altman analysis was performed to assess the agreement between the two methods. Peak VO2 measured by CPX and 2MST showed a strong correlation (r=0.70, P<0.001) and there was a moderate correlation between peak VO2 of the 2MST and the number of up-and-down step cycles (UDS) (r=0.55; P=0.01). The reference equation obtained was: VO2 (mL·kg-1·min-1) = 13.341 + 0.138 × total UDS - (0.183 × BMI), with an estimated standard error of 1.3 mL·kg-1·min-1. The 2MST is a viable, practical, and easily accessible test for FC. UDS and BMI can predict peak VO2 satisfactorily.


Assuntos
Aptidão Cardiorrespiratória/fisiologia , Tolerância ao Exercício/fisiologia , Frequência Cardíaca/fisiologia , Obesidade/fisiopatologia , Consumo de Oxigênio/fisiologia , Teste de Caminhada/métodos , Adolescente , Adulto , Comorbidade , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Obesidade Mórbida/fisiopatologia , Fatores de Tempo , Adulto Jovem
8.
Rev. int. med. cienc. act. fis. deporte ; 19(75): 505-520, sept. 2019. graf, tab
Artigo em Espanhol | IBECS | ID: ibc-187228

RESUMO

La presente investigación pretende definir y contrastar un modelo explicativo del consumo de alcohol y tabaco, y la práctica de actividad física en función de las cinco dimensiones del autoconcepto en una muestra de 2.134 adolescentes de la provincia de Granada (España). Los instrumentos empleados fueron el Cuestionario de Autoconcepto Forma-5, Test para la Identificación de Trastornos en el Uso de Alcohol-AUDIT, Test para la Dependencia a la Nicotina-FTND y un cuestionario ad-hoc para controlar la práctica de actividad física. En esta investigación se planteó un modelo de ecuaciones estructurales que se ajustó de forma adecuada (χ2 = 79,476; gl = 8; p = 0,000; CFI = 0,968; NFI = 0,964; IFI = 0,968; RMSEA = 0,065). Los resultados obtenidos muestran una relación positiva entre el consumo de alcohol y el consumo de tabaco, y relaciones negativas entre el autoconcepto familiar, emocional y académico con el consumo de alcohol


The present research aims to define and contrast an explanatory model of alcohol and tobacco consumption, and the practice of physical activity according to the five dimensions of self-concept in a sample of 2.134 adolescents from the province of Granada (Spain). The instruments used were the Self-concept Questionnaire Form-5, Test for the Identification of Disorders in the Use of Alcohol-AUDIT, Test for the Nicotine-FTND Unit and an ad-hoc questionnaire to control the practice of physical activity. In this research, a model of structural equations was presented that was adjusted appropriately (χ2 = 79.476, gl = 8, p = 0,000, CFI = 0,968, NFI = 0,964, IFI = 0,968, RMSEA = 0,065). The results obtained show a positive relationship between alcohol consumption and tobacco consumption, and negative relationships between family, emotional and academic self-concept with alcohol consumption


Assuntos
Humanos , Masculino , Feminino , Adolescente , Autoimagem , Atividade Motora/fisiologia , Noxas/toxicidade , Alcoolismo/psicologia , Tabagismo/psicologia , Comportamento do Adolescente/psicologia , Modelos Estruturais , Psicologia do Adolescente , Estudos Transversais , Espanha
9.
Eur J Cancer ; 117: 48-59, 2019 08.
Artigo em Inglês | MEDLINE | ID: mdl-31229949

RESUMO

BACKGROUND: The DREAMtherapy (Dual REctal Angiogenesis MEK inhibition radiotherapy) trial is a novel intertwined design whereby two tyrosine kinase inhibitors (cediranib and selumetinib) were independently evaluated with rectal chemoradiotherapy (CRT) in an efficient manner to limit the extended follow-up period often required for radiotherapy studies. PATIENTS AND METHODS: Cediranib or selumetinib was commenced 10 days before and then continued with RT (45 Gy/25#/5 wks) and capecitabine (825 mg/m2 twice a day (BID)). When three patients in the cediranib 15-mg once daily (OD) cohort were in the surveillance period, recruitment to the selumetinib cohort commenced. This alternating schedule was followed throughout. Three cediranib (15, 20 and 30 mg OD) and two selumetinib cohorts (50 and 75 mg BID) were planned. Circulating and imaging biomarkers of inflammation/angiogenesis were evaluated. RESULTS: In case of cediranib, dose-limiting diarrhoea, fatigue and skin reactions were seen in the 30-mg OD cohort, and therefore, 20 mg OD was defined as the maximum tolerated dose. Forty-one percent patients achieved a clinical or pathological complete response (7/17), and 53% (9/17) had an excellent clinical or pathological response (ECPR). Significantly lower level of pre-treatment plasma tumour necrosis factor alpha (TNFα) was found in patients who had an ECPR. In case of selumetinib, the 50-mg BID cohort was poorly tolerated (fatigue and diarrhoea); a reduced dose cohort of 75-mg OD was opened which was also poorly tolerated, and further recruitment was abandoned. Of the 12 patients treated, two attained an ECPR (17%). CONCLUSIONS: This novel intertwined trial design is an effective way to independently investigate multiple agents with radiotherapy. The combination of cediranib with CRT was well tolerated with encouraging efficacy. TNFα emerged as a potential predictive biomarker of response and warrants further evaluation.

10.
Rev. esp. patol. torac ; 31(2): 113-123, jun. 2019. graf, tab
Artigo em Espanhol | IBECS | ID: ibc-183652

RESUMO

Objetivo: comprobar el efecto beneficioso sobre la capacidad de esfuerzo de un programa de entrenamiento al ejercicio combinado (RR) con tratamiento de ventilación mecánica no invasiva (VMNI), frente a cada uno de ellos de forma aislada, en pacientes con síndrome overlap EPOC-SAHS. Método: estudio analítico experimental en el que los pacientes se incluyeron de forma prospectiva y con asignación aleatoria a seguir la terapia habitual con VMNI o formar parte del grupo en programa RR. Un tercer grupo tuvo las dos intervenciones; RR y VMNI. Se estudió la repercusión sobre el tiempo de resistencia (test de ejercicio submáximo) y la distancia recorrida (prueba de paseo de los 6 minutos). Se midió también repercusión sobre síntomas medidos con mMRC y CRDQ así como el intercambio gaseoso. Se analizaron parámetros inflamatorios como IL6, IL8, PCR y TNF. Resultados: se analizaron un total de 30 pacientes distribuidos de forma homogénea en los 3 brazos del estudio. Los pacientes sometidos a RR, tanto de forma aislada como combinada con VMNI obtuvieron una mejoría en el tiempo de endurance (grupo RR 8,89 min pre, 25,9 min post, p = 0,008; grupo RRVMNI 6,8 min pre, 12,2 min post, p= 0,03) mientras que sólo el grupo sometido a VMNI-RR obtuvo mejoría estadísticamente significativa en el T6MM (282 m pre, 323 m post, p = 0,017). Los tres grupos obtuvieron mejoría en los cuestionarios de calidad de vida medidos por el CRDQ mientras que sólo el grupo sometido a VNI y el grupo mixto obtuvieron mejoría en la mMRC. En cuanto a parámetros gasométricos, sólo el grupo mixto obtuvo mejoría en los niveles de pCO2 (56 mmHg pre, 48 mmHg post, p = 0,02). No hubo mejorías estadísticamente significativas en cuanto a la evolución de parámetros inflamatorios. Conclusiones: este trabajo demuestra el efecto beneficioso sobre la capacidad de esfuerzo de un programa de entrenamiento al ejercicio combinado con tratamiento de VMNI, frente a cada uno de ellos de forma aislada, en pacientes con síndrome overlap


Objective: To compare the beneficial effect of an exercise training program (RR) combined with non-invasive mechanical ventilation (NIMV) on effort capacity, compared to each treatment separately, in patients with COPD-SAHS overlap syndrome. Methods: An experimental analytical study in which patients were prospectively included and randomly assigned to receive habitual NIMV therapy or form a part of the RR program group. A third group underwent both RR and NIMV treatments. The effects on endurance time (submaximal exercise test) and distance covered (6-minute walk test) were studied. The effect on symptoms measured with mMRC and CRDQ as well as gas exchange were also studied. Inflammatory parameters like IL6, IL8, CRP and TNF were analyzed. Results: A total of 30 patients homogeneously distributed between the three arms of the study were analyzed. Patients who underwent RR, both alone and in combination with NIMV, showed an improvement in endurance time (RR group: 8.89 min pre, 25.9 min post, p = 0.008; RR-NIMV group: 6.8 min pre, 12.2 min post, p = 0.03) while only the group undergoing RR-NIMV showed statistically significant improvement in the 6MWT (282 m pre, 323 m post, p = 0.017). All three groups showed improvement with regard to quality of life measured by the CRDQ while only the group undergoing NIMV and the mixed group showed improvement in the mMRC. With regard to gasometric parameters, only the mixed group showed improvement in pCO2 levels (56 mmHg pre, 48 mmHg post, p = 0.02). There were no statistically significant improvements with regard to the evolution of inflammatory parameters. Conclusions: This study shows the beneficial effect of an exercise training program combined with NIMV treatment on effort capacity, compared to each treatment separately, in patients with COPD-SAHS overlap syndrome


Assuntos
Humanos , Masculino , Feminino , Pessoa de Meia-Idade , Idoso , Doença Pulmonar Obstrutiva Crônica/terapia , Terapia por Exercício/métodos , Síndromes da Apneia do Sono/terapia , Respiração Artificial/métodos , Estudos Prospectivos , Inquéritos e Questionários , Qualidade de Vida
11.
Rev. int. med. cienc. act. fis. deporte ; 19(74): 243-258, jun. 2019. tab
Artigo em Espanhol | IBECS | ID: ibc-183690

RESUMO

El presente estudio tiene como objetivo determinar y analizar las relaciones y diferencias existentes entre el clima motivacional, en base al nivel competitivo en judocas no profesionales. Participaron un total de 121 judocas chilenos no profesionales (70 hombres y 51 mujeres) con edades comprendidas entre los 18 y 40 años, provenientes de siete clubes de judo. Completaron una hoja de autoregistro de variables sociodemográficas y un cuestionario de clima motivacional (PMCSQ-2). Los resultados indican que en los judocas aficionados predomina el clima tarea y a medida que se asciende en el nivel, en deportistas amateurs cobra una mayor importancia el clima ego. Como principal conclusión destaca que los judocas amateurs distinguen en mayor proporción la diferencia entre la superación personal y el esfuerzo (clima tarea) y demuestran mayor habilidad física que los demás. Al contrario que sucede en los aficionados, donde la correlación entre ambos es inferior, aunque sigue siendo negativa


The aim of this study is to determine and analyse the relationships and differences in the motivational climate, based on the competitive level in non-professional judokas. A sample of 121 non-professional Chilean judokas (70 men and 51 women) aged between 18 and 40, coming from seven different judo clubs took part. They completed a self-registration sheet of sociodemographic variables and a motivational climate questionnaire (PMCSQ-2). The results indicate that the task goal orientation prevails in non-professional judokas and as the level rises, in amateur athletes the ego goal orientation takes on greater importance. The main deduction is that amateur judokas distinguish in a greater proportion between personal improvement and effort (task goal orientation) and show a greater physical ability than others.This is opposed to what happens with non-professionals, where the correlation between both is lower, although still negative


Assuntos
Humanos , Masculino , Feminino , Adolescente , Adulto Jovem , Adulto , Artes Marciais/psicologia , Atletas/psicologia , Motivação/fisiologia , Destreza Motora/fisiologia , Estudos Transversais , Ego , Análise de Dados , Inquéritos e Questionários
12.
Braz. j. med. biol. res ; 52(9): e8402, 2019. tab, graf
Artigo em Inglês | LILACS-Express | LILACS | ID: biblio-1019567

RESUMO

Cardiopulmonary fitness assessment is a valuable resource to obtain quantitative indicators of an individual's physical performance. The cardiopulmonary exercise test (CPX), considered the gold standard test for this evaluation, is costly and difficult to be accessed by the general population. In order to make this evaluation more accessible, and to better reflect the performance of daily life activities, alternative tests were proposed. Morbidly obese patients present limitations that impair physical performance assessment and could benefit from a test of shorter duration, provided it is validated. This observational study aimed to validate the two-minute step test (2MST) as a tool to evaluate functional capacity (FC) in obese with comorbidities and morbidly obese patients, compared the 2MST with CPX as a measure of physical performance, and developed a predictive equation to estimate peak oxygen uptake (VO2) in the 2MST. The CPX and the 2MST were performed and metabolic and ventilatory parameters were recorded in 31 obese individuals (BMI>35 kg/m2). Pearson correlation and multiple linear regression analyses were performed to evaluate the peak VO2 best predictors. Bland-Altman analysis was performed to assess the agreement between the two methods. Peak VO2 measured by CPX and 2MST showed a strong correlation (r=0.70, P<0.001) and there was a moderate correlation between peak VO2 of the 2MST and the number of up-and-down step cycles (UDS) (r=0.55; P=0.01). The reference equation obtained was: VO2 (mL·kg-1·min-1) = 13.341 + 0.138 × total UDS - (0.183 × BMI), with an estimated standard error of 1.3 mL·kg-1·min-1. The 2MST is a viable, practical, and easily accessible test for FC. UDS and BMI can predict peak VO2 satisfactorily.

13.
ACS Appl Mater Interfaces ; 10(35): 29367-29377, 2018 Sep 05.
Artigo em Inglês | MEDLINE | ID: mdl-30088905

RESUMO

Some biological microorganisms can crawl or swim due to coordinated motions of their cytoskeleton or the flagella located inside their bodies, which push the cells forward through intracellular forces. To date, there is no demonstration of synthetic systems propelling at low Reynolds number via the precise actuation of the material confined within an enclosing lipid membrane. Here, we report lipid vesicles and other more complex self-assembled biohybrid structures able to propel due to the advection flows generated by the actuated rotation of the superparamagnetic particles they contain. The proposed swimming and release strategies, based on cooperative hydrodynamic mechanisms and near-infrared laser pulse-triggered destabilization of the phospholipid membranes, open new possibilities for the on-command transport of minute quantities of drugs, fluid or nano-objects. The lipid membranes protect the confined substances from the outside environment during transportation, thus enabling them to work in physiological conditions.


Assuntos
Hidrodinâmica , Lipídeos , Magnetismo , Modelos Biológicos , Rotação , Vesículas Transportadoras/metabolismo
14.
Eur Arch Otorhinolaryngol ; 275(9): 2265-2272, 2018 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-30043077

RESUMO

INTRODUCTION: Nasoseptal perforations (NSP) are becoming common in the modern world, and can cause a wide variety of symptoms, including a sensation of nasal obstruction, epistaxis, crusting, dryness, headache, nasal pain and a whistling sound. There is an extensive range of surgical treatment techniques, but reported results were rarely statistically significant. The lack of consistent surgical results may be related to the lack of knowledge about the pathophysiology of NSP and how they affect the nasal flow. Computational fluid dynamics (CFD) has proved to be a very useful tool to study nasal function. METHODS: We have used CFD software (the program MECOMLAND® and the Digbody® tool for virtual surgery) to investigate the behaviour of the parameters R-[Formula: see text] based on CFD results, when four subjects underwent virtual surgery to induce a septal perforation: two subjects with healthy noses and two patients suffering from nasal airway obstruction. For each case a CFD study was performed, before and after creating an anterior (close to nostrils) or a posterior (close to choanae) NSP. RESULTS: In all cases analyzed, a posterior septal perforation did not result in a significant volumetric flow rate [Formula: see text] through the perforation between nasal passages. However, for anterior defects only in those nasal cavities considered diseased or unhealthy, high values of [Formula: see text] were found. CONCLUSION: The induced NSP only rendered significant flow alterations in noses with preexisting nasal airway obstruction alterations, whereas in nasal cavities considered as normal the creation of a NSP did not produce significant differences between both sides. We strongly suggest that this finding can explain the variety of symptoms and the number of asymptomatic patients bearing NSP.


Assuntos
Simulação por Computador , Hidrodinâmica , Obstrução Nasal/fisiopatologia , Perfuração do Septo Nasal/fisiopatologia , Software , Adulto , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Cavidade Nasal/fisiopatologia , Obstrução Nasal/etiologia , Perfuração do Septo Nasal/etiologia , Perfuração do Septo Nasal/cirurgia
15.
Radiología (Madr., Ed. impr.) ; 60(3): 217-222, mayo-jun. 2018. ilus, tab
Artigo em Espanhol | IBECS | ID: ibc-175243

RESUMO

Objetivo: Relacionar, en sujetos con parálisis cerebral no deambulantes, el porcentaje de migración de Reimers con medidas radiológicas estandarizadas, incluyendo el ángulo acetábulo-epifisario. Método: Estudio descriptivo, observacional y transversal de 15 individuos, de edades comprendidas entre 3 y 9 años, con parálisis cerebral, pertenecientes a los niveles IV y V del Gross Motor Function Classification System. Se realizaron medidas radiológicas del índice acetabular, el ángulo epifisario de Hilgenreiner, el ángulo acetábulo-epifisario, el ángulo cérvico-diafisario y el porcentaje de migración de Reimers de cada una de las caderas. Resultados: Se obtuvieron correlaciones entre el índice acetabular, el ángulo epifisario y el ángulo acetábulo-epifisario respecto al porcentaje de migración de Reimers. Para las caderas con un porcentaje de migración igual o menor del 15% se observó correlación positiva entre los ángulos acetabular y epifisario. Conclusiones: En nuestra población, la medida entre la inclinación acetabular y epifisaria es la que mayor asociación presenta con el porcentaje de migración de la cadera


Objective: To relate, in non-ambulatory subjects with palsy, Reimers' migration percentage with standardized radiological measurements, including the acetabular-epiphyseal angle. Method: Descriptive, observational and transversal study of 15 individuals with cerebral palsy at levels IV and V of the Gross Motor Function Classification System, aged between 3 and 9 years. Radiological measurements of the acetabular index, Hilgenreiner's epiphyseal angle, acetabular-epiphyseal angle, neck-shaft angle and Reimers’ migration percentage of each of the hips were performed. Results: Correlations between acetabular index, epiphyseal angle and acetabular-epiphyseal angle were obtained with respect to the Reimers migration percentage. For hips with a migration rate of 15% or less, a positive correlation was observed between acetabular and epiphyseal angles. Conclusions: In our population, the measurement between acetabular and epiphyseal inclination represents the highest association with the hip migration percentage


Assuntos
Humanos , Masculino , Feminino , Pré-Escolar , Criança , Luxação do Quadril/diagnóstico por imagem , Paralisia Cerebral/complicações , Articulação do Quadril/diagnóstico por imagem , Acetábulo/diagnóstico por imagem , Sensibilidade e Especificidade , Epífises/diagnóstico por imagem , Colo do Fêmur/diagnóstico por imagem , Diáfises/diagnóstico por imagem
16.
Rev. esp. patol. torac ; 30(2): 108-114, jun. 2018. tab, graf
Artigo em Espanhol | IBECS | ID: ibc-180246

RESUMO

OBJETIVO: evaluar la persistencia en el tiempo de los criterios clínicos de bronquitis crónica (BC) en pacientes con enfermedad pulmonar obstructiva crónica (EPOC), así como evaluar los determinantes clínicos potencialmente asociados a su presentación clínica y persistencia en el tiempo. MÉTODO: el estudio "Registro y análisis en el tiempo de resultados clínicos en EPOC" (Proyecto TRACE) es una cohorte de pacientes prospectiva que tiene por objetivo la descripción de la evolución clínica de los pacientes con EPOC con las herramientas básicas del clínico, en la que se recoge sistemáticamente la presencia de BC. Durante 4 años se recogió la presencia de BC en visitas anuales y se estudió su relación con la presentación clínica mediante un análisis multivariante expresando los resultados como odds ratio (OR) y su intervalo de confianza (IC) al 95%. RESULTADOS: la cohorte inicial estaba compuesta por 391 pacientes en la visita basal. La prevalencia de BC fue del 53,5% con 122 (31,2%) casos que mantenían criterios clínicos de bronquitis crónica en todas las visitas, mientras que 106 (27,1%) casos nunca presentaron criterios clínicos en ninguna de las visitas registradas. El análisis multivariante mostró una asociación entre tabaquismo activo y el grado de disnea con la persistencia de la BC en el tiempo. CONCLUSIONES: la presencia de BC es un hallazgo clínico frecuente en los pacientes con EPOC, pero variable en el tiempo. El tabaquismo activo y la intensidad de los síntomas parecen ser los principales factores asociados a su presentación. Estas conclusiones refuerzan la importancia de la intervención sobre el tabaquismo en pacientes diagnosticados de EPOC


OBJECTIVE: to evaluate the persistence of the clinical criteria for chronic bronchitis over the years in patients with chronic obstructive pulmonary disease (COPD), as well as to evaluate the clinical determiners potentially associated with the clinical presentation of the disease and their persistence over time. METHOD: the "Time-based Register and Analysis of COPD" (TRACE Project) is a prospective patient cohort whose objective is to describe the clinical evolution of patients with COPD using the clinical criteria which systematically reflect the presence of chronic bronchitis as the basic tools. The presence of chronic bronchitis over 4 years of annual visits was recorded and its relationship with clinical presentation was studied using a multivariate analysis expressing the results as an odds ratio (OR) and confidence interval (CI) of 95%. RESULTS: the initial cohort consisted of 391 patients at the baseline visit. The prevalence of chronic bronchitis was 53.5% with 122 (31.2%) cases maintaining the clinical criteria of chronic bronchitis across all visits, while 106 (27.1%) cases never showed clinical criteria in any of the recorded visits. The multivariate analysis showed an association between active tobacco use and the level of dyspnea with the persistence of chronic bronchitis over time. CONCLUSIONS: the presence of chronic bronchitis is a frequent clinical finding in patients with COPD but can vary over time. Active tobacco use and symptom intensity appear to be the main factors associated with its presentation. These conclusions reinforce the importance of tobacco use intervention in patients diagnosed with COPD


Assuntos
Humanos , Masculino , Idoso , Feminino , Pessoa de Meia-Idade , Bronquite Crônica/epidemiologia , Doença Pulmonar Obstrutiva Crônica/diagnóstico , Tabagismo/complicações , Estudos Longitudinais , Estudos de Coortes , Razão de Chances , Estudos Prospectivos , Análise Estatística
17.
Comput Biol Med ; 98: 118-125, 2018 07 01.
Artigo em Inglês | MEDLINE | ID: mdl-29787939

RESUMO

BACKGROUND AND PURPOSE: Recent studies have demonstrated that a significant number of surgical procedures for nasal airway obstruction (NAO) have a high rate of surgical failure. In part, this problem is due to the lack of reliable objective clinical parameters to aid surgeons during preoperative planning. Modeling tools that allow virtual surgery to be performed do exist, but all require direct manipulation of computed tomography (CT) or magnetic resonance imaging (MRI) data. Specialists in Rhinology have criticized these tools for their complex user interface, and have requested more intuitive, user-friendly and powerful software to make virtual surgery more accessible and realistic. In this paper we present a new virtual surgery software tool, DigBody®. METHODS: This new surgery module is integrated into the computational fluid dynamics (CFD) program MeComLand®, which was developed exclusively to analyze nasal airflow. DigBody® works directly with a 3D nasal model that mimics real surgery. Furthermore, this surgery module permits direct assessment of the operated cavity following virtual surgery by CFD simulation. RESULTS: The effectiveness of DigBody® has been demonstrated by real surgery on two patients based on prior virtual operation results. Both subjects experienced excellent surgical outcomes with no residual nasal obstruction. CONCLUSIONS: This tool has great potential to aid surgeons in modeling potential surgical maneuvers, minimizing complications, and being confident that patients will receive optimal postoperative outcomes, validated by personalized CFD testing.


Assuntos
Imageamento Tridimensional/métodos , Modelos Anatômicos , Cavidade Nasal/diagnóstico por imagem , Software , Adulto , Simulação por Computador , Feminino , Humanos , Masculino , Tomografia Computadorizada por Raios X , Interface Usuário-Computador
18.
Radiologia ; 60(3): 217-222, 2018.
Artigo em Inglês, Espanhol | MEDLINE | ID: mdl-29523346

RESUMO

OBJECTIVE: To relate, in non-ambulatory subjects with palsy, Reimers' migration percentage with standardized radiological measurements, including the acetabular-epiphyseal angle. METHOD: Descriptive, observational and transversal study of 15 individuals with cerebral palsy at levels IV and V of the Gross Motor Function Classification System, aged between 3 and 9 years. Radiological measurements of the acetabular index, Hilgenreiner's epiphyseal angle, acetabular-epiphyseal angle, neck-shaft angle and Reimers' migration percentage of each of the hips were performed. RESULTS: Correlations between acetabular index, epiphyseal angle and acetabular-epiphyseal angle were obtained with respect to the Reimers migration percentage. For hips with a migration rate of 15% or less, a positive correlation was observed between acetabular and epiphyseal angles. CONCLUSIONS: In our population, the measurement between acetabular and epiphyseal inclination represents the highest association with the hip migration percentage.


Assuntos
Acetábulo/diagnóstico por imagem , Paralisia Cerebral/complicações , Luxação do Quadril/diagnóstico por imagem , Luxação do Quadril/etiologia , Acetábulo/anatomia & histologia , Criança , Pré-Escolar , Estudos Transversais , Epífises/anatomia & histologia , Epífises/diagnóstico por imagem , Feminino , Cabeça do Fêmur/anatomia & histologia , Cabeça do Fêmur/diagnóstico por imagem , Humanos , Masculino , Radiografia
19.
Rev. chil. radiol ; 24(1): 12-17, mar. 2018. tab, ilus
Artigo em Espanhol | LILACS | ID: biblio-959568

RESUMO

Para determinar la existencia de compromiso parenquimatoso renal en infección del tracto urinario en niños, la tendencia actual es utilizar métodos de imágenes lo menos invasivos posibles, disminuyendo al máximo la exposición a radiación ionizante. La resonancia magnética ha demostrado utilidad en la pesquisa de pielonefritis aguda. Desarrollamos por esto un protocolo de resonancia magnética (PieloRM), que permite de manera rápida, segura y no invasiva detectar compromiso inflamatorio parenquimatoso renal, eventuales complicaciones y alteraciones anatómicas preexistentes. Se utilizan secuencias anatómicas potenciadas en T2 y difusión en los planos axial y coronal en el eje largo de los riñones, sin contraste endovenoso ni anestesia, con técnica de privación de sueño, abrigar y alimentar en lactantes y niños más pequeños. La duración total del examen no sobrepasa los 15 minutos.


Current trend to determine kidney involvement in urinary tract infection in children consider less invasive and lower radiation exposure. Magnetic resonance has been reported has a useful tool in acute pyelonephritis suspicion. We developed a fast, safety, non-contrast magnetic resonance protocol to detect renal parenchymal inflammatory changes in children. Complications and anatomical alterations were also possible to be evaluated. Axial and coronal T2-weighted images for anatomical characterization and diffusion weighted images were obtain for kidney representation. Feed and wrap technique and sleep deprivation, with non-additional sedation or anesthesia was used in a 15 minutes total examination protocol.


Assuntos
Humanos , Feminino , Criança , Pielonefrite/diagnóstico por imagem , Imagem por Ressonância Magnética/métodos , Doença Aguda
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