Efeitos do método pilates sobre a capacidade funcional, fatores antropométricos, marcadores inflamatórios e qualidade de vida em idosas sedentárias / Effects of the pilates method on functional capacity, anthropometric factors, inflammatory markers and quality of life in sedentary elderly women

O objetivo do presente estudo foi investigar os efeitos de exercícios físicos baseados no método Pilates solo sobre a capacidade funcional, fatores antropométricos, níveis de marcadores inflamatórios circulantes e a qualidade de vida em idosas sedentárias. Trata­se de um delineamento quase experimental com pré e pós teste. A amostra foi constituída por 33 mulheres idosas com idade igual ou superior a 60 anos. Para avaliar a capacidade funcional (CF) foram utilizados os testes de velocidade de caminhada (VC) e de força de preensão manual (FPM). Para avaliar a presença de marcadores inflamatórios foram realizados exames laboratoriais a fim de quantificar os níveis séricos de proteína C reativa ultrassensível (PCR-us) e fibrinogênio. E para avaliar a qualidade de vida (QV) foi utilizado o questionário SF ­ 36. Na análise estatística utilizou-se o teste de normalidade Shapiro Wilk. Para os dados paramétricos teste t pareado e ANOVA one Way e, para os dados não paramétricos, o teste Wilcoxon e Kruskal-Wallis. O teste Qui-Quadrado foi utilizado para analises de associações. Os dados foram analisados pelo no programa SPSS-IBM, versão 22.0 devidamente registrado. O nível de significância adotado foi de p≤0,05. O grupo Pilates não apresentou alterações estatisticamente significativas em relação à CF (p>0,05), porém as demais variáveis apresentaram diferença significativa. Para variáveis antropométricas, PCR e fibrinogênio (p < 0,05); e QV, dois domínios apresentaram alterações significativas: limitações por aspectos físicos (p=0,045) e dor (p=0,011). Conclui-se que a prática do método Pilates solo promoveu redução significativa sobre a composição corporal, sobre os níveis séricos de marcadores inflamatórios, sobre a qualidade de vida e manutenção da capacidade funcional de idosas sedentárias. (AU)

The aim of the present study was investigate the effects of exercises based on the Pilates method on functional capacity, anthropometric factors, levels of circulating inflammatory markers and quality of life in sedentary elderly women. It is an almost experimental design with pre and post-test. The sample considered of 33 elderly individuals, aged 60 years and female. In order to evaluate the functional capacity (FC), the tests of walking speed (WS) and manual grip strength (MGS) were used; to evaluate the presence of inflammatory markers, laboratory tests were performed to quantify the serum levels of C-reactive protein and fibrinogen, and the SF-36 questionnaire was used to evaluate the quality of life. For statistical analysis, Shapiro Wilk normality test was used. For parametric data, paired t- test and one-way ANOVA were used, and for nonparametric data, the Wilcoxon and Kruskal -Wallis test. Chi-square test was used for association analysis. All data were analyzed by SPSS-IBM, version 22.0 duly registered and the significance level of p ≤0.05 was stipulated. The Pilates group did not present significant alterations in relation to CF (p> 0.05), but the other variables presented. Anthropometric variables (total body mass, BMI, waist and hip circumference), C-reactive protein and fibrinogen (p< 0,05); and in relation to QV, two domains presented significant changes: limitations by physical aspects (p = 0.045) and pain (p = 0.011). It was concluded that the Pilates solo practice promoted a significant reduction in body composition, serum levels of inflammatory markers, quality of life and maintenance of functional capacity

A lung image reconstruction from computed radiography images as a tool to tuberculosis treatment control

Background: Tuberculosis (TB) is an infectious lung disease with high worldwide incidence that severely compromises the quality of life in affected individuals. Clinical tests are currently employed to monitor pulmonary status and treatment progression. The present study aimed to apply a three-dimensional (3D) reconstruction method based on chest radiography to quantify lung-involvement volume of TB acute-phase patients before and after treatment. In addition, these results were compared with indices from conventional clinical exams to show the coincidence level. Methods: A 3D lung reconstruction method using patient chest radiography was applied to quantify lung-involvement volume using retrospective examinations of 50 patients who were diagnosed with pulmonary TB and treated with two different drugs schemes. Twenty-five patients were treated with Scheme I (rifampicin, isoniazid, and pyrazinamide), whereas twenty-five patients were treated with Scheme II (rifampicin, isoniazid, pyrazinamide, and ethambutol). Acute-phase reaction: Serum exams included C-reactive protein levels, erythrocyte sedimentation rate, and albumin levels. Pulmonary function was tested posttreatment. Results: We found strong agreement between lung involvement and serum indices pre- and posttreatment. Comparison of the functional severity degree with lung involvement based on 3D image quantification for both treatment schemes found a high correlation. Conclusions: The present 3D reconstruction method produced a satisfactory agreement with the acute-phase reaction, most notably a higher significance level with the C-reactive protein. We also found a quite reasonable coincidence between the 3D reconstruction method and the degree of functional lung impairment posttreatment. The performance of the quantification method was satisfactory when comparing the two treatment schemes. Thus, the 3D reconstruction quantification method may be useful tools for monitoring TB treatment. The association with serum indices are not only inexpensive and sensitive but also may be incorporated into the assessment of patients during TB treatment.(AU)

Evaluation of smoking as an additional risk factor for cardiovascular diseases among hemodialysis patients by increased levels of II-6, TNFα, hs-CRP and Endothelin-1 / Evaluación del tabaquismo como factor de riesgo adicional de enfermedades cardiovasculares en pacientes en hemodiálisis según niveles elevados de II-6, TNFα, hs-CRP y Endotelina-1

INTRODUCTION: Cardiovascular diseases (CVD) are one of the most common causes of mortality in chronic kidney disease. Smoking is a well defined risk factor for atherosclerotic cardiovascular disease. Interleukin-6 (IL-6), tumor necrosis factor-alpha (TNF-α), high sensitive C-reactive protein (hsCRP) and endothelin-1 (Et-1) have found elevated in chronic inflammatory process. OBJECTIVE: We aimed to evaluate if IL-6, TNF-alpha, hsCRP and ET-1 are increased in smoker hemodialysis (HD) patient compared to non-smoker HD individuals to potentially refer us cardiovascular diseases noninvasively. MATERIAL AND METHODS: 80 smoker and 50 non-smoker maintenance hemodialysis male patients with similar demographic characters, dialysis and support treatment and metabolic profile. In addition to routine tests, we took samples for evaluating IL-6, TNF-α, hsCRP and endothelin-1. P values were In smoker HD patients, IL-6, TNF-alpha, hsCRP and endothelin-1 levels were found increased level statistically significant compared to non-smoker indiviuals. CONCLUSION: This study may refer us that smoking is an additional risk factor among HD individuals by increased levels of IL-6, TNF-α, hsCRP and Et-1

INTRODUCCIÓN: Las enfermedades cardiovasculares (EC) constituyen una de las causas más frecuentes de mortalidad en los casos de enfermedad renal crónica. El tabaquismo es un factor de riesgo bien definido para la enfermedad cardiovascular aterosclerótica. Se encontraron valores elevados de Interleucina-6 (IL-6), factor de necrosis tumoral alfa (TNFα), proteína C-reactiva de alta sensibilidad (hs-CRP) y Endotelina-1 (Et-1) en el proceso inflamatorio crónico. OBJETIVO: El objetivo fue analizar si los valores de IL-6, TNFα, hs CRP y Et-1 son más elevados en los pacientes fumadores en hemodiálisis que en los no fumadores para predecir una posible enfermedad cardiovascular de forma no invasiva. MATERIAL Y MÉTODOS: Se incluyeron pacientes masculinos en hemodiálisis de mantenimiento, 80 fumadores y 50 no fumadores, similares en cuanto a sus características demográficas, tratamiento de diálisis y de mantenimiento, y perfil metabólico. Además de los análisis de rutina, se tomaron muestras para evaluar los valores de IL-6, TNFα, hs CRP y Endotelina-1. Se midieron los valores de p. RESULTADOS: Se halló una diferencia estadísticamente significativa en los niveles de IL-6, TNFα, hs CRP y Endotelina-1: fueron más elevados en los pacientes sometidos a hemodiálisis que eran fumadores en comparación con los no fumadores.CONCLUSIÓN: Este estudio podría demostrar que el tabaquismo es un factor de riesgo adicional para los pacientes que se tratan con hemodiálisis según muestran los valores elevados de IL-6, TNFα, hs CRP y Et-1

Efeito da suplementação com ômega-3 associado à hidrocinesioterapia em idosos com osteoartrite de joelho: ensaio clínico randomizado / Effect of supplementation with omega-3 associated with hydrotherapy in elderly with osteoarthritis of the knee: randomized controlled trial

Introdução: A osteoartrite (OA) é causada por fatores mecânicos e inflamatórios que reduz a qualidade de vida (QV) de idosos. Objetivos: Avaliar os efeitos da suplementação com ômega-3 associado à hidrocinesioterapia sobre a QV e o perfil inflamatório em idosos com OA de joelho. Metodologia: Dezesseis idosos com idade média 65±3,5 anos divididos em 2 grupos. Oito pacientes no Grupo Ômega-3 (GO) suplementado com 2g de ômega-3 por dia durante 30 dias e oito pacientes no Grupo Ômega-3 associado à hidrocinesioterapia (GOH). Foram avaliadas a proteína C reativa de alta sensibilidade (PCR-AS), velocidade de sedimentação globular (VSG) e questionário de QV (SF-36). Resultados: A associação do ômega-3 com a hidrocinesioterapia promoveu redução significativa (p=0,02) da PCR-AS e da VSG (p<0,05) comparado aos valores pré-intervenção. Houve melhora significativa (p<0,05) na QV no GOH. Conclusão: A associação da hidrocinesioterapia com ômega-3 promoveu melhora no perfil inflamatório e na QV em idosos com OA de joelho.

Introduction: Osteoarthritis (OA) is caused by mechanical and inflammatory factors that reduce the quality of life (QOL) in elderly. Objectives: To evaluate the effects of supplementation with omega-3 associated with hydrotherapy on the quality of life and inflammatory profile in elderly suffering from knee osteoarthritis (OA). Methods: Sixteen elderly patients, average age 65±3.5 years old divided into 2 groups. Eight patients allocated in the Omega-3 Group (OG) supplemented with 2g of omega-3 per day for 30 days and eight patients in the Omega-3 Group associated with Hydrotherapy (OGH). High-sensitivity C-reactive protein (hs-CRP), erythrocyte sedimentation rate (ESR) and the QOL questionnaire (SF-36) were evaluated. Results: The association of Omega-3 with hydrotherapy promoted a significant reduction (p=0.02) of hs-CRP and ESR (p<0.05) compared to before intervention. There was significant improvement (p<0.05) on QOL in GOH. Conclusion: The association of hydrotherapy with omega-3 promoted improvement in inflammatory profile and QOL in elderly with knee OA.

C-reactive protein serum level in patients with psoriasis before and after treatment with narrow-band ultraviolet B

Abstract: Background: C-reactive protein is an inflammatory biomarker and its level increases in the serum of psoriatic patients. Its level is also associated with Psoriasis Area and Severity Index score. Objective: The aim of this study was to assess the decrement of serum C-reactive protein level with narrow-band ultraviolet B (NB-UVB) therapy. Methods: C-reactive protein serum levels in psoriasis patients were measured before and after treatment with NB-UVB and the data were analyzed in relation to the Psoriasis Area and Severity Index score improvement. Results: Baseline C-reactive protein levels among psoriatic patients were higher than normal. These levels decreased significantly after treatment (P<0.001). At the beginning of the study, patients with higher levels of C-reactive protein also had more extensive and severe skin involvement. The highest decrease in C-reactive protein was observed in patients who responded better to the treatment and achieved a higher Psoriasis Area and Severity Index 75%. There was an association between baseline Psoriasis Area and Severity Index scores and C-reactive protein levels. Conclusion: Patients with moderate to severe plaque-type psoriasis had active systemic inflammation, which was demonstrated by increased levels of C-reactive protein. Furthermore, skin disease severity was correlated with C-reactive protein levels. Phototherapy healed the psoriatic skin lesions and reduced inflammation, while decreasing C-reactive protein levels.

Proteína C ultrasensible como factor independiente de riesgo en población con y sin antecedentes cardiovasculares / High sensitivity C protein as an independent risk factor in people with and without history of cardiovascular disease

Entre los nuevos biomarcadores del riesgo de eventos cardiovasculares (ECV), la proteína C reactiva detectada mediante técnicas de alta sensibilidad (PCRus) ha sido uno de los más evaluados. En esta revisión se exploró la evidencia existente sobre la utilidad de la PCRus como factor independiente del riesgo de eventos en sujetos sin antecedentes cardiovasculares, y como marcador pronóstico en sujetos con enfermedad cardiovascular crónica o aguda. Se realizó un overview (revisión de revisiones) con búsqueda en las principales bases bibliográficas suplementada por buscadores genéricos de Internet. En una primera etapa se detectaron revisiones sistemáticas, guías de práctica clínica, evaluaciones de tecnologías sanitarias y políticas de cobertura, y en una segunda etapa se identificaron estudios primarios publicados posteriormente a las fechas de búsqueda de las revisiones sistemáticas. Fueron recuperadas 774 citas, de las cuales se incluyeron 36 publicaciones que evaluaron el papel de la PCRus en poblaciones sanas o con antecedentes coronarios. Se encontró evidencia de alta calidad señalando a la PCRus, tanto como factor de riesgo en población general, como pronóstico en aquellos con ECV en todas las poblaciones evaluadas. Su mayor utilidad residió en sujetos sin historia de ECV y riesgo intermedio de eventos a 10 años, en donde la adición de la PCRus a modelos clásicos de estimación del riesgo de eventos mejora la estratificación del riesgo. No se identificó, en cambio, consenso sobre su utilidad clínica como marcador pronóstico en sujetos con enfermedad coronaria crónica o aguda.

Among the new cardiovascular event (CVE) risk biomarkers, C-reactive protein detected using high sensitive techniques (hs-CRP) has been one of the most commonly evaluated. In this review, the available evidence on the usefulness of hs-CRP was explored as an independent risk event factor in subjects with no cardiovascular history and as prognosis in case of chronic or acute cardiovascular condition. An overview (revision of revisions) was carried out searching in the main bibliographic databases and in other general Internet search engines. During the first stage, systematic reviews, clinical practice guidelines, health technology assessments and coverage policies were found and, during the second stage primary studies published after the systematic review search dates were added. Seven hundred and seventy four quotes were found, including 36 papers assessing the role of hs-CRP in healthy populations or with cardiovascular history. High quality evidence was found pointing out hs-CRP, both as risk factor in the general population and as prognostic factor in those with CVE, in all the populations assessed. It was most useful in subjects with a history of CVE and intermediate risk of events at 10 years; where adding hs-CRP to the classical models for event risk estimation improves risk staging. There was no consensus on its clinical usefulness as a prognostic marker in subjects with chronic or acute disease.

Influência da periodontite apical nos níveis séricos de marcadores de Proteína C-reativa: revisão da literatura / Influence of apical periodontitis on serum levels of C-reactive protein: literature reviewd

A periodontite apical é uma doença de origem bacteriana que ativa a liberação local de mediadores pró-inflamatórios capazes de induzir a produção hepática de proteínas de fase aguda, como a proteína C-reativa (CRP). Mesmo pequenos aumentos nos níveis séricos de CRP já estão associados com o aumento do risco cardiovascular. Há na literatura vários estudos avaliando a correlação entre doença periodontal, marcadores inflamatórios (como CRP e IL6) e doenças cardiovasculares, entretanto poucos estudos têm estudado uma possível associação entre a periodontite apical crônica ou história de tratamento endodôntico e doença cardiovascular. O objetivo desta revisão foi investigar as evidências atuais em relação à possível associação entre periodontite apical crônica e o aumento dos níveis séricos de CRP.

Apical periodontitis is a bacteria-induced disease that activates the localized release of pro-inflammatory mediators capable of inducing the production of acute-phase proteins (like C-reactive protein) by the liver. Even mild elevations of serum levels of CRP are associated with higher cardiovascular risk. Literature shows many studies that evaluates the correlation between periodontal disease, inflammatory markers (like CRP and IL6) and cardiovascular diseases. However, few studies have assessed the possible association between chronic apical periodontitis or history of endodontic treatment and cardiovascular diseases. The aim of the present review was to assess the current evidence regarding the possible association between chronic apical periodontitis and elevation of serum CRP.

Influencia de la enfermedad periodontal sobre las células sanguíneas y los niveles de proteína c reactiva / Periodontal disease influence on the blood cells and the levels of c-reactive protein

Periodontitis is a chronic inflammatory disease that is related with some systemic alterations. The severity of the inflammation in the periodontal tissues has been associated with a low-grade measurable systemic inflammation, and some studies have suggested an increase in the C-reactive protein levels and in number of white blood cells in patients with periodontal diseases. The red blood cells also could be affected by periodontitis with trends toward anemia. There are still controversies in relation to the direct influence of periodontal diseases in the occurrence of systemic inflammations. Thus, the aim of this study was to accomplish a literature review in order to verify the possible influence of the periodontal disease on blood cells and C-reactive protein levels

La Periodontitis es una enfermedad inflamatoria crónica que está relacionada con algunas alteraciones sistémicas. La gravedad de la inflamación de los tejidos periodontales ha sido asociada a una inflamación sistémica considerada de bajo grado y, algunos estudios han sugerido que hay un aumento en los niveles de proteína C-reactiva y en el número de leucocitos de la sangre en pacientes periodontalmente comprometidos. Las células de la serie roja de la sangre también podrían verse afectadas por la presencia de periodontitis, influyendo asi en la aparición de anemias. A pesar de eso, aún hay controversias en hasta qué punto las enfermedades periodontales podrían influenciar de forma directa en la aparición de las inflamaciones sistémicas. De esa forma, el objetivo de este trabajo fue realizar una revisión de literatura para verificar la posible influencia de la enfermedad periodontal sobre las células sanguíneas y los niveles de proteína C-reactiva