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1.
Pediatr Rev ; 41(6): 265-275, 2020 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-32482689

RESUMO

Pediatric rhabdomyolysis is a common diagnosis that pediatricians need to be able to recognize because prompt treatment can prevent potential complications, such as acute kidney injury. The triggers for rhabdomyolysis are extensive, with viruses being the most common cause in pediatric patients. The pathophysiology behind rhabdomyolysis is complex and still being researched, but having a firm understanding of the cascade that results when muscle injury occurs is essential for proper management. Guidelines for managing pediatric rhabdomyolysis currently do not exist, but this article aims to review the available literature and give clinicians a general approach to aid in history taking, physical examination, diagnosis, acute management, follow-up, and prevention.


Assuntos
Rabdomiólise , Solução Salina/uso terapêutico , Algoritmos , Biomarcadores/sangue , Criança , Creatina Quinase/sangue , Exercício Físico/fisiologia , Humanos , Infecções/complicações , Rabdomiólise/diagnóstico , Rabdomiólise/etiologia , Rabdomiólise/fisiopatologia , Rabdomiólise/terapia
2.
Artigo em Inglês | MEDLINE | ID: mdl-32486380

RESUMO

A global pandemic caused by the novel coronavirus (COVID-19) resulted in restrictions to daily living for Canadians, including social distancing and closure of city and provincial recreation facilities, national parks and playgrounds. The objective of this study was to assess how these preemptive measures impacted physical activity behaviour and well-being of Canadians. An online survey was utilized to measure participant physical activity behavior, nature exposure, well-being and anxiety levels. Results indicate that while 40.5% of inactive individuals became less active, only 22.4% of active individuals became less active. Comparatively, 33% of inactive individuals became more active while 40.3% of active individuals became more active. There were significant differences in well-being outcomes in the inactive population between those who were more active, the same or less active (p < 0.001) but this was not seen in the active population. Inactive participants who spent more time engaged in outdoor physical activity had lower anxiety than those who spent less time in outdoor physical activity. Public health measures differentially affected Canadians who were active and inactive and physical activity was strongly associated with well-being outcomes in inactive individuals. This suggests that health promoting measures directed towards inactive individuals may be essential to improving well-being.


Assuntos
Infecções por Coronavirus/epidemiologia , Exercício Físico/fisiologia , Exercício Físico/psicologia , Pneumonia Viral/epidemiologia , Comportamento Social , Adulto , Fatores Etários , Idoso , Ansiedade/epidemiologia , Betacoronavirus , Canadá/epidemiologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Pandemias , Saúde Pública , Qualidade de Vida , Características de Residência , Fatores Sexuais , Fatores Socioeconômicos
3.
Rev Assoc Med Bras (1992) ; 66(3): 296-299, 2020 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-32520148

RESUMO

OBJECTIVE: The aim of our study is to explore the relationship between physical performance and visual acuity in university students in China. METHODS: tests of standing long jump, 50-meter dash and pull-ups sit-ups were conducted. The visual acuity was measured using a logarithm of the minimum angle of resolution (logMAR) chart. Pearson correlation was used to test the correlation of physical performance with visual acuity in university students. RESULTS: The number of pull-ups was negatively associated with visual acuity in the left eye for male students, while a negative correlation was found between the time of the 50-meter dash and visual acuity in the right eye for female students. CONCLUSIONS: Our study identified that physical exercise might help improve visual acuity. University students should practice strength exercises to improve physical performance.


Assuntos
Exercício Físico/fisiologia , Desempenho Físico Funcional , Acuidade Visual/fisiologia , Adulto , China , Estudos Transversais , Feminino , Humanos , Masculino , Fatores Sexuais , Estudantes , Universidades , Testes Visuais/métodos , Adulto Jovem
4.
Rev Assoc Med Bras (1992) ; 66(3): 314-320, 2020 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-32520151

RESUMO

OBJECTIVE: We investigated the associations between objectively assessed sedentary behavior (SB) and moderate-to-vigorous physical activity (MVPA) and body composition variables among a representative sample of Brazilian adults. METHODS: Using an accelerometer, SB and MVPA were monitored for at least 5 days in 524 participants (261 men; age, 18-65 years). Each minute epoch was classified as sedentary or spent in light, moderate, or vigorous physical activity (LPA, MPA, and VPA, respectively). The measured body composition variables included abdominal perimeter (AP) and neck circumference (NC). RESULTS: Men accumulated significantly more min/day of MPA (37.82 versus 27.28), VPA (1.10 versus 0.31), MVPA (39.02 versus 27.61), and steps/day (14,978 versus 13,443) than women (p<.001). In men, MPA, VPA, MVPA, and steps/day were negatively associated with AP (p<.05) independently of SB. Only VPA was significantly associated with NC (ß= 0.113; p=.002). In women, only SB was significantly associated with AP (ß= 0.003; p=.031). There were no significant associations between physical activity intensities and body composition in women. CONCLUSIONS: Our findings on the unequal association of physical activity with body composition variables between sexes can help inform future intervention strategies in Brasil.


Assuntos
Composição Corporal/fisiologia , Exercício Físico/fisiologia , Comportamento Sedentário , Acelerometria , Adolescente , Adulto , Idoso , Antropometria , Brasil , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Atividade Motora , Fatores Sexuais , Adulto Jovem
5.
Arch Endocrinol Metab ; 64(3): 312-318, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32555999

RESUMO

OBJECTIVE: To identify the level of physical activity and glycemic variability of adolescents with type 1 diabetes mellitus and to compare glycemic variability on days with different amounts of moderate to vigorous physical activity (MVPA). SUBJECTS AND METHODS: A sample of 34 subjects aged 10 to 15 years, 18 (52.94%) female; age: 13.04 ± 1.94; HbA1c: 9.76 ± 1.51. Physical activity was measured by wGT3X accelerometer. The glucose data were obtained using continuous glucose monitoring, and the following glycemic variability measures were calculated: standard deviation (SD), low blood glucose index (LBGI), high blood glucose index (HBGI), mean amplitude of glycemic excursions (MAGE), glycemic risk assessment in diabetes equation (GRADE) and coefficient of variation (CV). The most and least active days (the days with greater and lesser time dedicated to physical activities of moderate to vigorous intensity, respectively) were identified. In addition, based on the whole period of accelerometer use, daily means of time spent in MVPA were identified among participants, who were then divided into three groups: up to 100 minutes; from 101 to 200 minutes and above 201 minutes. Then, the measures of glycemic variability were compared among the most and least active days and among the groups too. RESULTS: The amount of MVPA was significantly different between the days evaluated (237.49 ± 93.29 vs. 125.21 ± 58.10 minutes), but glycemic variability measures did not present a significant difference. CONCLUSION: Despite the significant differences in the amount of MVPA between the two days evaluated, the glycemic variability did not change significantly. Arch Endocrinol Metab. 2020;64(3):312-8.


Assuntos
Glicemia/análise , Diabetes Mellitus Tipo 1/sangue , Exercício Físico/fisiologia , Adolescente , Criança , Estudos Transversais , Diabetes Mellitus Tipo 1/metabolismo , Diabetes Mellitus Tipo 1/fisiopatologia , Feminino , Humanos , Masculino
6.
Cent Eur J Public Health ; 28(2): 120-123, 2020 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-32592556

RESUMO

OBJECTIVE: Cardiorespiratory fitness (CRF) is defined as the capacity of the cardiovascular and pulmonary systems to meet the oxygen demands of the body during physical work. Poor CRF is connected with a higher risk for the development of various noninfectious diseases such as cardiovascular disease or malignancies. The standard test for the assessment of CRF is exercise testing with the measurement of maximal oxygen consumption (VO2 max). Standard VO2 max values for adult men and women in the Czech Republic have been available since the 1970s without being updated. According to experts, these standard values are now unusable for contemporary CRF measurements of the population in the Czech Republic. The Fitness Registry and the Importance of Exercise: a National Database (FRIEND) - 4,494 patients (1,717 men) defined new standard values for bicycle ergometry CRF for the population in the United States of America. The aim of the study was the statistical comparison of VO2 max values (reference standards) in the 1970s population in the Czech Republic with the new reference standards of the FRIEND registry. METHODS: All analyses were performed using IBM SPSS statistics and all tests with a p-value of less than 0.05 were considered statistically significant. RESULTS: VO2 max norms for women in the Czech population were higher in all age categories with statistically significant differences in the categories 30-39, 40-49 and 50-59 (p < 0.001). In the male population aged 20-29 years, VO2 max was significantly higher in the FRIEND registry (p < 0.001) in contrast to the other age categories, 30-39, 40-49 and 50-59, which were significantly higher in the Czech population (p < 0.001). CONCLUSIONS: Czech VO2 max population norms from the 1970s are (with the exception of age category 20-29 years) higher than values from the recent FRIEND registry.


Assuntos
Aptidão Cardiorrespiratória/fisiologia , Teste de Esforço , Exercício Físico/fisiologia , Consumo de Oxigênio/fisiologia , Aptidão Física , Adulto , República Tcheca , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Padrões de Referência , Estados Unidos , Adulto Jovem
7.
Apunts, Med. esport (Internet) ; 55(206): 71-79, abr.-jun. 2020. tab
Artigo em Espanhol | IBECS | ID: ibc-ET2-5894

RESUMO

In order to better understand the possible relationships between the application of training loads and the risk of injury in professional women's basketball, four parameters from a professional women's basketball team (N = 11) were analysed: exposure time, number of injuries, rate of perceived exertion (RPE), and workload (sRPE). A total of 3182h of exposure were registered, 2774 were training hours, and 408 were game hours with a total of 9 time loss injuries. The data obtained from each player was related to the exposure time, injury risk, perception of effort, and workload. Several differences were observed between the injury risk values and the morning RPE (F = 5.0811; p = .032), the sRPE of the morning practices (F = 7.3585; p = .010) and the total time of exposure (F = 3.5055; p=.064). There is also a significant negative relationship between total training time and the number of time-loss (TL) injuries (rho = - .797; p = .003), as well as a possible association between exposure time and a lower risk of TL injury (R2 = .645). These findings suggest that an increase in specific exposure time could be associated with a decrease in the risk of time-loss injuries


Con el objetivo de entender mejor las posibles relaciones entre la aplicación de cargas de entrenamiento y el riesgo de lesión en el baloncesto femenino profesional, se analizaron 4 parámetros de un equipo de baloncesto femenino profesional (N = 11): tiempo de exposición, número de lesiones, percepción del esfuerzo después de las sesiones entrenamiento (RPE) y carga de entrenamiento (sRPE). Se registraron 3.182 horas de exposición totales, de las cuales 2.774 fueron de entrenamiento y 408h de competición con un total de 9 lesiones "time-loss" (TL) que comportaron tiempo de actividad perdido. Se relacionan los datos obtenidos de cada jugadora relativos a tiempo de exposición, lesiones, percepción del esfuerzo y carga de trabajo. Se observan posibles diferencias entre los valores de lesionabilidad y RPE de las sesiones de entrenamiento de la mañana (F = 5,0811; p = 0,032), el sRPE de la mañana (F = 7,3585: p = 0,010) y el tiempo total de exposición (F = 3,5055; p = 0,064). Se observa también una relación significativa negativa entre tiempo total de entrenamiento y el número de lesiones TL (rho = -0,797; p = 0,003), así como una posible asociación entre el tiempo de exposición y una menor incidencia lesional TL (R2 = 0,645). Estos valores sugieren que un aumento del tiempo de exposición de carácter específico podría vincularse a la disminución del riesgo de lesiones "time-loss"


Assuntos
Humanos , Feminino , Basquetebol/fisiologia , Esforço Físico , Fatores de Risco , Exercício Físico/fisiologia , Análise de Variância , Modelos Lineares
9.
Medicine (Baltimore) ; 99(20): e20231, 2020 May.
Artigo em Inglês | MEDLINE | ID: mdl-32443355

RESUMO

BACKGROUND: To systematically evaluate the effects of physical activity on physiological markers in breast cancer survivors. METHODS: A systematic search of the PubMed, Wed of Science, Medline, CNKI and Wanfang Database was performed to identify eligible randomized controlled trials to explore physical activity on physiological markers in breast cancer survivors. STATA version 13.0 (Stata Corp LP, College Station, TX) was used for all statistical analyses. RESULTS: A total of 11 articles with 941 cases were eligible in this meta-analysis. The results of the meta-analysis showed that physical activity could decrease the levels of insulin (SMD = -1.90, 95%CI: -3.2 to -0.60; I = 92.3%, P < .001), insulin-like growth factor 1 (IGF-I) (WMD = -4.67, 95%CI: -23.14 to 13.79; I = 96.2%, P < .001), insulin-like growth factor binding protein-3 (IGFBP-3) (WMD = -20.09, 95%CI: -47.15 to 6.97; I = 93.3%, P < .001). However, compared with the control group, there was not the significant change of insulin-like growth factor 2 (IGF-II), insulin-like growth factor binding protein-1 (IGFBP-1), leptin, adiponectin, glucose, C-reactive protein (CRP), Interleukin-6 (IL-6), Interleukin-10 (IL-10), and tumor necrosis factor alpha (TNF-ɑ) levels after the intervention. CONCLUSIONS: Physical activity could improve the insulin function that might be associated with decreasing the levels of IGF-I, IGFBP-3 and insulin in breast cancer survivors.


Assuntos
Biomarcadores/análise , Neoplasias da Mama/sangue , Exercício Físico/fisiologia , Adulto , Biomarcadores/sangue , Neoplasias da Mama/fisiopatologia , Sobreviventes de Câncer , Feminino , Humanos , Insulina/análise , Insulina/sangue , Proteína 1 de Ligação a Fator de Crescimento Semelhante à Insulina/análise , Proteína 1 de Ligação a Fator de Crescimento Semelhante à Insulina/sangue , Proteína 3 de Ligação a Fator de Crescimento Semelhante à Insulina/análise , Proteína 3 de Ligação a Fator de Crescimento Semelhante à Insulina/sangue
10.
Diabetes Technol Ther ; 22(6): 462-467, 2020 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-32421355

RESUMO

Background: To limit the spread of coronavirus disease 2019 (COVID-19), governments have ordered a series of restrictions that may affect glycemic control in individuals with type 1 diabetes mellitus (T1DM), since physical activity (PA) was not allowed outside home. Methods: We retrospectively evaluated glycemic control of individuals with T1DM using hybrid closed loop (HCL) system in the period before the SARS-CoV-2 outbreak in Italy (February 10-23, 2020-Time 1), when movements were only reduced (February 24-March 8, 2020-Time 2) and during complete lockdown (March 9-22, 2020-Time 3). Information about regular PA (at least 3 h per week) prior and during the quarantine was collected. Results: The study included 13 individuals with a median age of 14.2 years and a good glycemic control at baseline (glucose management indicator of 7%, time in range [TIR] of 68%, time below range [TBR] of 2%). All individuals continued to show good glycemic control throughout the study period. There was an increase in TIR during the study period (+3%) and TIR was significantly higher during Time 3 (72%) than during Time 2 (66%). TBR was significantly lower during Time 3 (1%) both compared with Time 1 and Time 2 (2%). A meaningful variance in TIR at Time 3 between individuals who performed or not PA during quarantine and a significant increase in TIR between Time 2 and Time 3 in individuals both doing PA at baseline and during quarantine was found. At logistic regression, only the presence of PA during quarantine significantly predicted a TIR >70%. Conclusions: Glycemic control of T1DM in adolescents using HCL system did not worsen during the restrictions due to COVID-19 pandemics and further improved in those who continued PA during the quarantine. Maintaining regular PA in a safe home environment is an essential strategy for young individuals with T1DM during the COVID-19 crisis.


Assuntos
Infecções por Coronavirus/prevenção & controle , Diabetes Mellitus Tipo 1/terapia , Exercício Físico/fisiologia , Pandemias/prevenção & controle , Pneumonia Viral/prevenção & controle , Quarentena , Autogestão/métodos , Adolescente , Betacoronavirus , Glicemia/análise , Infecções por Coronavirus/complicações , Diabetes Mellitus Tipo 1/sangue , Diabetes Mellitus Tipo 1/virologia , Feminino , Humanos , Itália/epidemiologia , Masculino , Pneumonia Viral/complicações , Estudos Retrospectivos
11.
Recenti Prog Med ; 111(5): 297-301, 2020 05.
Artigo em Italiano | MEDLINE | ID: mdl-32448880

RESUMO

Regular physical activity grants significant health effects and lowers the risk of premature death for all causes, in particular cardiovascular ones in asymptomatic subjects. Physical activity is useful in the primary and secondary prevention of cardiovascular and lung diseases, metabolic diseases, musculoskeletal diseases, cancer and depression. Recent studies correlate inactivity with chronic low-grade inflammation and obesity, at the origin of chronic non-communicable diseases. The evidence must be taken seriously into consideration in this particular CoViD-19 emergency period and long-term effects of prolonged limitation of sports activity must not be overlooked. Contagion in open places is very difficult and the absolute prohibition of sports activities in open places and the closure of parks are creating discomfort and confusion. Institutions and media are generating the wrong message that active people must be looked at with disapproval. Instead, this habit should be encouraged, in order to protect citizens' and community health, lightening the welfare load for society.


Assuntos
Infecções por Coronavirus/epidemiologia , Exercício Físico/fisiologia , Ginástica , Pneumonia Viral/epidemiologia , Esportes/fisiologia , Infecções por Coronavirus/transmissão , Humanos , Pandemias , Pneumonia Viral/transmissão , Fatores de Tempo
13.
Bull Cancer ; 107(5): 556-564, 2020 May.
Artigo em Francês | MEDLINE | ID: mdl-32414536

RESUMO

As the benefits of physical activity (PA) in oncology field continue to be demonstrated, multiple structures (sports clubs, associations…) develop PA programs and activities to offer cancer patients survivors the opportunity to continue adapted physical activity. Promoted in the 2014-2019 cancer plan as complementary supportive care, the practice of physical activity is legitimized by the 2016 Health Act of the Ministry of Social Affairs and Health, including the amendment 'prescription health sport', by giving it a legislative framework. In this context of development of new PA offers for cancer patients, it seems necessary to determine and evaluate the structures on their capacities to supervise physical activities for this population with specific needs. This article presents the methodological development and validation process of a tool used to characterize the different structures offering physical activity programs for people who have had cancer, and seeks to define the quality criteria that a structure should meet in the current state of knowledge. Ten of these criteria were selected according to a qualitative methodology and the final tool therefore facilitates the identification of quality programs in post-cancer PA, and could be used systematically by both users and professionals as part of the post-cancer care pathway, as well as by the sport-health platforms themselves in the current dynamics of their deployment throughout the national territory.


Assuntos
Sobreviventes de Câncer , Exercício Físico , Promoção da Saúde , Desenvolvimento de Programas , Certificação , Contraindicações , Exercício Físico/fisiologia , França , Promoção da Saúde/legislação & jurisprudência , Promoção da Saúde/métodos , Humanos , Desenvolvimento de Programas/métodos , Esportes
14.
PLoS One ; 15(3): e0230420, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32226052

RESUMO

INTRODUCTION: Physical activity level during pregnancy is unknown in Middle Eastern and North African countries, since no valid tools assessing it exist in Arabic. The aim of this study is to culturally adapt and translate to Arabic an internationally validated instrument, the Pregnancy Physical Activity Questionnaire (PPAQ), and to measure the physical activity of pregnant women using the adapted PPAQ, Arabic version. This tool is time-sparing, self-administered and is the only one taking into account childcare and household chores. METHODS: After following the guidelines for translation and back-translation by certified translators, a committee composed of professionals in the field reviewed each item of the PPAQ, for its comprehensibility. This Arabic version of the PPAQ was tested on a sample of 179 pregnant Lebanese women, from different educational backgrounds, socioeconomic status and gestational ages. RESULTS: Cross-cultural adaptations were applied on the newly translated PPAQ in Arabic version, thus questions referring to some types of outdoor activities were excluded from the final format. Our results reported that 51% and 1.7% of women engage respectively in light and high intensity physical activity, while 18% had a sedentary lifestyle. Occupational type of activities were significantly more performed by women having a higher education (p value 0.001), as opposed to those who attended only high school, who were physically more active in household activities (p value 0.038). Second trimester was a period where pregnant women were active for household, caregiving (p value 0.031), whereas women in their third trimester were physically more active in occupational activities (p value 0.001). Sport-oriented activities were performed by women reporting a good physical status (p value 0.03). Age and crowding index were significantly correlated with occupational, household and caregiving activities (p values 0.004, 0.008 respectively). No significant correlations were observed with pre-gestational body mass index and the physical activity levels. CONCLUSION: A valid tool will help researchers in Arab countries identify physical activity levels of pregnant women and consequently emit specific guidelines relative to the importance and the benefits of a daily active lifestyle throughout gestation.


Assuntos
Exercício Físico/fisiologia , Atividade Motora/fisiologia , Gestantes , Traduções , Adulto , Índice de Massa Corporal , Feminino , Humanos , Idioma , Gravidez , Comportamento Sedentário , Inquéritos e Questionários , Adulto Jovem
15.
Medicine (Baltimore) ; 99(16): e19584, 2020 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-32311926

RESUMO

INTRODUCTION: Healthy dietary patterns and physical activity (PA) represent important lifestyle behaviors with considerable potential to influence on age-related metabolic health. Yet, data on the combined effects of these lifestyle behaviors on metabolic health including low-grade systemic inflammation in aging populations remain scarce. Therefore, this protocol describes a randomized controlled trial aiming to examine the impacts of healthy dietary patterns alone or combined with PA on metabolic health in middle-aged and older men and women. MATERIAL AND METHODS: The ORUDIET study is a 3-arm randomized controlled 16-week trial: Healthy Diet (HD), Healthy diet plus PA (HD-PA), and control (CON). The trial is open label, randomized with allocation concealment, parallel groups with passive controls. Participants without overt disease aged between 55 and 70 years, with BMI below 35, a current intake of a maximum of 1 serving of fruit and vegetable per day, and noncompliance to PA guidelines are eligible for inclusion. Participants in HD are instructed to increase fruit and vegetable intake to 5 servings per day (equivalent to 500 g). Participants in HD-PA receive the same dietary intervention as the HD and are additionally instructed to engage in moderate-to-vigorous physical activities for at least 150 minutes per week. The primary study outcomes are changes in metabolic and inflammatory health biomarkers. Secondary outcomes are changes in body composition and perceived health. ETHICS AND DISSEMINATION: The study protocol has been approved by the ethical review board in Uppsala, Sweden. The results will be published in peer-reviewed journals and disseminated in national and international conferences. TRIAL REGISTRATION NUMBER: NCT04062682 Pre-results.


Assuntos
Dieta Saudável , Exercício Físico/fisiologia , Interleucinas/sangue , Idoso , Alanina Transaminase/sangue , Aspartato Aminotransferases/sangue , Glicemia/metabolismo , Pressão Sanguínea , Composição Corporal , Proteína C-Reativa/metabolismo , HDL-Colesterol/sangue , Feminino , Hemoglobina A Glicada/metabolismo , Nível de Saúde , Humanos , Inflamação/sangue , Insulina/sangue , Masculino , Síndrome Metabólica/sangue , Síndrome Metabólica/diagnóstico , Pessoa de Meia-Idade , Ensaios Clínicos Controlados Aleatórios como Assunto , Triglicerídeos/sangue
16.
Medicine (Baltimore) ; 99(17): e19769, 2020 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-32332617

RESUMO

INTRODUCTION: High blood pressure is the leading modifiable risk factor for cardiovascular disease, and is associated with high morbidity and mortality and with significant health care costs for individuals and society. However, fewer than half of the patients with hypertension receiving pharmacological treatment have adequate blood pressure control. The main reasons for this are therapeutic inertia, lack of adherence to treatment, and unhealthy lifestyle (i.e., excess dietary fat and salt, sedentary lifestyle, and overweight). Cardiovascular risk and mortality are greater in hypertensive patients who are receiving treatment but have suboptimal control of blood pressure. METHODS/DESIGN: This is a multicentre, parallel, 2-arm, single-blind (outcome assessor), controled, cluster-randomized clinical trial. General practitioners and nurses will be randomly allocated to the intervention group (self-management of antihypertensive medication, self-measurement of blood pressure, hypocaloric and low sodium diet, and physical exercise) or the control group (regular clinical practice). A total of 424 patients in primary care centers who use 2 or more antihypertensive drugs and blood pressure of at least 130/80 during 24-hambulatory blood pressure monitoring will be recruited. The primary outcome is systolic blood pressure at 12 months. The secondary outcomes are blood pressure control (<140/90 mm Hg); quality of life (EuroQol 5D); direct health care costs; adherence to use of antihypertensive medication; and cardiovascular risk (REGICOR and SCORE scales). DISCUSSION: This trial will be conducted in the primary care setting and will evaluate the impact of a multifactorial intervention consisting of self-management of blood pressure, antihypertensive medications, and lifestyle modifications (hypocaloric and low sodium diet and physical exercise).


Assuntos
Anti-Hipertensivos/normas , Determinação da Pressão Arterial/normas , Hipertensão/tratamento farmacológico , Adulto , Idoso , Anti-Hipertensivos/uso terapêutico , Pressão Sanguínea/efeitos dos fármacos , Determinação da Pressão Arterial/métodos , Restrição Calórica/métodos , Análise por Conglomerados , Dieta Hipossódica/métodos , Exercício Físico/fisiologia , Feminino , Humanos , Hipertensão/psicologia , Estilo de Vida , Masculino , Pessoa de Meia-Idade , Fatores de Risco , Autogestão/métodos , Autogestão/psicologia , Cooperação e Adesão ao Tratamento/psicologia , Resultado do Tratamento
17.
Int J Sports Med ; 41(7): 427-442, 2020 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-32252102

RESUMO

Exercise is commonly utilized for weight loss, yet research has focused less on specific modifications to adipose tissue metabolism. White adipose tissue (WAT) is the storage form of fat, whereas brown adipose tissue (BAT) is a thermogenic tissue whose uncoupling increases energy expenditure. The most established BAT activator is cold exposure, which also transforms WAT into "beige cells" that express uncoupling protein 1 (UCP1). Preliminary evidence in rodents suggests exercise elicits similar effects. The purpose of this review is to parallel and examine differences between exercise and cold exposure on BAT activation and beige induction. Like cold exposure, exercise stimulates the sympathetic nervous system and activates molecular pathways responsible for BAT/beige activation, including upregulation of BAT activation markers (UCP1, proliferator-activated receptor-gamma coactivator-1α) and stimulation of endocrine activators (fibroblast growth factor-21, irisin, and natriuretic peptides). Further, certain BAT activators are altered exclusively by exercise (interleukin-6, lactate). Markers of BAT activation increase from both cold exposure and exercise, whereas effects in WAT are compartment-specific. Stimulation of endocrine activators depends on numerous factors, including stimulus intensity and duration. Evidence of these analogous, albeit not mirrored, mechanisms is demonstrated by increases in adipose activity in rodents, while effects remain challenging to quantify in humans.


Assuntos
Tecido Adiposo Marrom/metabolismo , Temperatura Baixa , Exercício Físico/fisiologia , Termogênese , Tecido Adiposo Bege/metabolismo , Tecido Adiposo Branco/metabolismo , Animais , Fator Natriurético Atrial/metabolismo , Biomarcadores/metabolismo , Metabolismo Energético , Fatores de Crescimento de Fibroblastos/metabolismo , Fibronectinas/metabolismo , Humanos , Peptídeo Natriurético Encefálico/metabolismo , Coativador 1-alfa do Receptor gama Ativado por Proliferador de Peroxissomo/metabolismo , Proteína Desacopladora 1/metabolismo
18.
J Frailty Aging ; 9(2): 111-117, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32259186

RESUMO

BACKGROUND: No study has performed an exercise intervention that included high-intensity, free-weight, functional resistance training, and assessed frailty status as an inclusion criteria and outcome measure via original, standardized tools, in pre-frail females. OBJECTIVES: Determine if the intervention strategy is not only feasible and safe, but can also improve frailty status, functional task performance, and muscle strength. DESIGN: Pilot, quasi-experimental. SETTING: Community. PARTICIPANTS: 20 older-adults with pre-frailty characteristics. INTERVENTION: 12-weeks (3 days/week, 45-60 minutes/session) of multi-component exercise, inclusive of aerobic, resistance, balance and flexibility exercises. The crux of the program was balance and resistance exercises, the latter utilized high-intensity, free-weight, functional resistance training. The control group maintained their usual care. MEASUREMENTS: 1) Feasibility and safety (dropout, adherence, and adverse event); 2) Frailty (Frailty Phenotype, Clinical Frailty Scale, and gait speed); 3) Functional task performance (grip strength and sit-to-stand time); and 4) Isometric and isotonic strength of the knee extensors and elbow flexors. RESULTS: No participants dropped out of the intervention or experienced an adverse event, and adherence averaged 88.3%. The exercise group became less frail, whereas the control group became more frail. There was a significant within-group improvement in exercise participants gait speed (p ≤ 0.01, +0.24 m/sec), grip strength (p ≤ 0.01, +3.9 kg), and sit-to-stand time (p ≤ 0.01, -5.0 sec). There was a significant within-group improvement in exercise participants knee extension isometric torque (p ≤ 0.05, +7.4 Nm) and isotonic velocity (p = ≤ 0.01, +37.5 ˚/sec). Elbow flexion isotonic velocity significantly declined within the control group (p ≤ 0.01, -20.2 ˚/sec) and demonstrated a significant between-group difference (p ≤ 0.05, 40.73 ˚/sec) post-intervention. CONCLUSIONS: The intervention strategy appears to be feasible and safe, and may also improve frailty status, functional task performance, and muscle strength. These results help calculate effect size for a future randomized controlled trial.


Assuntos
Terapia por Exercício/métodos , Fragilidade/prevenção & controle , Adulto , Idoso , Exercício Físico/fisiologia , Feminino , Humanos , Força Muscular/fisiologia , Projetos Piloto , Treinamento de Resistência , Resultado do Tratamento
20.
Int. j. morphol ; 38(2): 481-491, abr. 2020. graf
Artigo em Espanhol | LILACS | ID: biblio-1056466

RESUMO

La osteoartritis (OA) es una enfermedad crónica, degenerativa, muy invalidante, que destruye en forma gradual y progresiva el cartílago articular en diversas regiones: rodillas, caderas, hombros, manos, tobillos y columna vertebral. En este sentido, el ejercicio ha sido descrito como la intervención no farmacológica más recomendada para pacientes con OA. La práctica regular de ejercicio es considerada un componente integral del estilo de vida saludable; sin embargo, su efecto en el cartílago se mantiene como objeto de debate y especulaciones, así como la relación del ejercicio con el desarrollo de OA. Algunos estudios de modelos animales sugieren que el ejercicio puede ser beneficioso para la salud del cartílago, mientras otros demuestran su efecto nocivo. Una explicación general a estos resultados inconsistentes es que el correr a intensidad moderada tiene efectos beneficiosos, mientras que correr "vigorosamente" o de manera "extenuante" lleva a un efecto nocivo. El objetivo de este trabajo consistió en realizar una revisión de la literatura acerca de los efectos del ejercicio sobre el cartílago artícular, especialmente enfocado a modelos animales experimentales con ratas.


Osteoarthritis (OA) is a chronic, degenerative, and very disabling disease that gradually and progressively destroys articular cartilage in various regions: knees, hips, shoulders, hands, ankles and spine. In this sense, exercise has been described as the most recommended non-pharmacological intervention for patients with OA. Regular exercise is considered an integral component of the healthy lifestyle. However, its effect on cartilage remains the subject of debate and speculation, as well as the relationship between exercise and the development of OA. Some animal model studies suggest that exercise may be beneficial for cartilage health, while others demonstrate its harmful effect. A general explanation for these inconsistent results is that running at moderate intensity has beneficial effects, while running "vigorously" or "strenuously" leads to a harmful effect. The aim of this work was to make a literature review about the effects of exercise on cartilage, especially focused on experimental animal models with rats.


Assuntos
Animais , Ratos , Osteoartrite/patologia , Exercício Físico/fisiologia , Cartilagem Articular/anatomia & histologia , Osteoartrite/fisiopatologia , Modelos Animais de Doenças
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