Factors Associated With Mortality and Hospice Use Among Medicare Beneficiaries With Heart Failure Who Received Home Health Services.

BACKGROUND: Although many Medicare beneficiaries with heart failure (HF) are discharged with home health services, little is known about mortality rates and hospice use in this group. OBJECTIVES: To identify risk factors for 6-month mortality and hospice use among patients hospitalized due to HF who receive home health care, which could inform efforts to improve palliative and hospice use for these patients. METHODS: A retrospective cohort analysis was conducted in a 100% national sample of Medicare fee-for-service beneficiaries with HF who were discharged to home health care between 2017 and 2018. Multivariable Cox regression models examined factors associated with 6-month mortality, and multivariable logistic regression models examined factors associated with hospice use at the time of death. RESULTS: A total of 285,359 Medicare beneficiaries were hospitalized with HF and discharged with home health care; 15.5% (44,174) died within 6 months. Variables most strongly associated with mortality included: age > 85 years (hazard ratio [HR] 1.66, 95% CI 1.61-1.71), urgent/emergency hospital admission (HR 1.68, 1.61-1.76), and "serious" condition compared to "stable" condition (HR 1.64, CI 1.52-1.78). Among 44,174 decedents, 48.2% (21,284) received hospice care at the time of death. Those with lower odds of hospice use at death included patients who were: < 65 years (odds ratio [OR] 0.65, CI 0.59-0.72); of Black (OR 0.64, CI 0.59-0.68) or Hispanic race/ethnicity (OR 0.79, CI 0.72-0.88); and Medicaid-eligible (OR 0.80, CI 0.76-0.85). CONCLUSIONS: Although many patients hospitalized for HF are at risk of 6-month mortality and may benefit from palliative and/or hospice services, our findings indicate under-use of hospice care and important disparities in hospice use by race/ethnicity and socioeconomic status.

Sports participation plays a relevant role in the relationship between birth weight and bone mineral content in adolescents.

The Developmental Origins of Health and Disease hypothesis (DOHaD) proposes that growth during the prenatal period might play a critical role in health, affecting the development of diseases, such as osteoporosis. Bone health is particularly affected by human behaviors when sports participation constitutes the main manifestation of physical exercise. The aim of this study is to analyze the relationship between birth weight (BW) and bone mineral content (BMC) among adolescents, as well as to identify if sports participation and maturity can affect this relationship. The sample was composed of adolescents with ages ranging from 11 to 18 years, stratified according to normal birth weight (n = 331), low birth weight (n = 36), and macrosomia (n = 47), extracted from a wider cross-sectional study (ABCD Growth Study). BW was self-reported by the adolescent's parent. Sports participation was assessed by face-to-face interview. BMC was assessed using dual-energy X-ray absorptiometry. In the multivariate models, the relationships between BW and BMC remained non-significant, while sports participation was significantly related to BMC on lower limbs among boys (r = 0.154; p value = .001) and BMC of upper limbs among girls (r = 0.124; p value = .044). APHV was related to BMC of upper limbs among boys (r = 0.137; p value = .001). In conclusion, BMC was not affected by BW, while this phenomenon seems to be significantly affected by the positive impact of sports participation and maturation on it.

Relationship between vigorous physical activity and health care costs among adolescents: ABCD Growth Study.

BACKGROUND: The relationship between physical activity and health care costs among adolescents is not yet clear in the literature. OBJECTIVE: To analyze the relationship between physical activity and annual health care costs among adolescents. METHODS: The present sample was composed of 85 adolescents of both sexes with ages ranging from 11 to 18 years (mean age 15.6 ± 2.1). Health care costs were self-reported every month for 12 months, and information on health care values was verified with local pharmacies, private health care plans, and the National Health Service. The time spent in different physical activity intensities was objectively measured by accelerometers. Confounding variables were: sex, age, somatic maturation, body fatness, blood pressure, and components of dyslipidemia and insulin resistance. Multivariate models were generated using generalized linear models with gamma distribution and a log-link function. RESULTS: The overall annual health care cost was US$ 733.60/ R$ 2,342.38 (medication: US$ 400.46 / R$ 1,278.66; primary and secondary care: US$ 333.14 / R$ 1,063.70). The time spent in vigorous physical activity (minutes/day) was negatively related to health care costs (r = -0.342 [95% CI: -0.537,-0.139]; ß = -0.06 cents (95% CI: -0.089, -0.031). CONCLUSION: Vigorous physical activity seems to be associated with lower health care costs among adolescents.

Relationship of Objectively Measured Physical Activity, Sedentary Behavior and Sleep Time with Cardiovascular and Mtabolic Outcomes in Adolescents (A Pilot Study): ABCD Growth Study.

STUDY OBJECTIVE: Different behaviors are considered important factors that may influence a healthy lifestyle. Given this fact, we aim to analyze the relationship between moderate-vigorous physical activity (MVPA), sleep time, and sedentary time, with cardiometabolic outcomes in adolescents. METHODS: Cross-sectional study, with 152 eutrophic and healthy adolescents. The behavioral variables were collected objectively and the arterial thickness was measured through ultrasound. Blood variables (LDL, TG, HDL, glucose, and insulin) were collected in a private laboratory. To analyze the data, the Student t test and Kruskal-Wallis test were used to compare the groups. All analyses adopted p < 0.05. RESULTS: Girls who demonstrated better combined behaviors, presented significant results for TG (p = 0.045), BP (p = 0.016), and cardiovascular score (p = 0.049) when compared to their peers. Furthermore, the practice of physical activity combined with sufficient sleep time was associated with lower values of arterial thickening (p = 0.017). CONCLUSIONS: In view of the results presented, it is possible to state that the aggregation of behaviors was more consistent in females and that the practice of physical activity and adequate sleep time can reflect on cardiovascular health.

Sports participation improves metabolic profile in adolescents: ABCD growth study.

To analyze the impact of participation in sports with different cardiorespiratory fitness (CRF) demands on changes in metabolic and cardiovascular markers in adolescents. Longitudinal study with 12 months of follow-up (Analysis of Behaviors of Children During Growth [ABCD Growth Study]). Overall, 184 adolescents (age 15.6 ± 2.1) were classified according to sports participation: non-sport (control), low CRF sports, and high CRF sports. Metabolic outcomes were total cholesterol (TC) and its fractions, triacylglycerol (TG), glucose, insulin levels, and the insulin resistance index. Cardiovascular outcomes were arterial thickness (carotid and femoral [ultrasound]), blood pressure, and resting heart rate. Adolescents engaged in sports classified as high CRF demand presented a significant increase in HDL-c (1.2 mg/dL [95%CI: -0.5 to 3.0]) when compared to the non-sport group (-2.4 mg/dL [95%CI: -4.4 to -0.5]). Regular engagement in high CRF sports was significantly related to changes in TC (ß = -0.027 [95%CI: -0.048 to -0.005]), HDL-c (ß = 0.009 [95%CI: 0.001 to 0.019]), LDL-c (ß = -0.032 [95%CI: -0.049 to -0.016]), and glucose (ß = -0.017 [95%CI: -0.025 to -0.008]), while engagement in low CRF sports was related to changes in TG (ß = -0.065 [95%CI: -0.112 to -0.019]). No significant relationships for cardiovascular parameters were observed in the low CRF group, but one significant relationship was found between high CRF sports and changes in SBP (ß = -0.063 [95%CI: -0.117 to -0.009]). In conclusion, engagement in sports seems to be beneficial for improvements in metabolic and cardiovascular parameters in adolescents, mainly sports with higher CRF demand.

Participation in Non-professional Sports and Cardiovascular Outcomes Among Adolescents: ABCD Growth Study.

OBJECTIVES: Sports are an important way to improve health during adolescence. However, it is still unclear whether the association between sports, blood pressure, and metabolic profile could be affected by sex, biological maturation, and trunk fatness. The aim of this study was to analyze the association between sports participation and the cluster of cardiovascular markers among adolescents of both sexes. METHODS: A cross-sectional study involving 285 adolescents aged from 11 to 17 years of age (202 boys and 83 girls). Cardiovascular variables were composed of systolic blood pressure (SBP), diastolic blood pressure (DBP), resting heart rate (RHR), and carotid (CIMT) and femoral (FIMT) intima-media thickness, which were used to calculate the CardiovascularZ score. Sports participation was assessed through a face-to-face interview. Age of peak height velocity (APHV) was used as a covariate. RESULTS: Among girls, the group engaged in sports presented lower values of RHR (sport: - 0.344 [95% CI - 0.650 to - 0.037] versus non-sport: 0.540 [95% CI 0.125 to 0.954]) and CardiovascularZ score (sport: - 0.585 [95% CI - 1.329 to 0.159] versus non-sport: 0.879 [95% CI - 0.127 to 1.884]), explaining 12.2% and 6.1% of all variance, respectively. Among boys, the group engaged in sports presented lower values of DBP (sport: - 0.158 [95% CI - 0.335 to 0.018] versus non-sport: 0.160 [95% CI - 0.091 to 0.412]) and FIMT (sport: - 0.128 [95% CI - 0.300 to - 0.044] versus non-sport: 0.211 [95% CI - 0.032 to 0.454]), explaining 2.2% and 2.6% of all variance, respectively. CONCLUSIONS FOR PRACTICE: Adolescents engaged in sports presented healthier cardiovascular parameters, and sports participation seems to affect cardiovascular health differently in boys and girls.

Sports participation is inversely associated with C-reactive protein levels in adolescents: ABCD Growth Study.

OBJECTIVE: To analyze the relationship between sports participation and C-reactive protein (CRP) levels in adolescents and to identify the possible role of mediation developed by trunk fatness (TF). METHODS: Cross-sectional design, part of the longitudinal study entitled "Analysis of Behaviors of Children During Growth" (ABCD Growth Study), Presidente Prudente, SP, Brazil. The sample comprised 259 adolescents (14.7 ± 2.1 [182 boys and 77 girls]) stratified according to sex and engagement in sports in agreement with the inclusion criteria: absence of any known diseases; previous engagement in sports for at least 12 months (≥300 minutes weekly); no regular engagement in sports in the previous 12 months (non-regular sports participation or <300 min/wk); written parental consent and adolescents' assent both signed. Engagement in sports was self-reported. CRP levels were used to assess the inflammatory status. TF was estimated by a densitometer scanner. Age, biological maturation, HOMA-IR, and blood pressure were treated as covariates. RESULTS: There was no mediation effect of TF in the association of any indicators of sports practice and CRP. However, a direct effect of sports was observed on CRP levels when considering previous months of engagement, frequency, and volume of sports for boys and also previous months of engagement in sports for girls. CONCLUSION: Previous sports participation and the amount of engagement in sports per week (≥300 min/wk) presented an inverse relationship with CRP levels; however, trunk fatness did not mediate this process.

Sports participation and adiposity do not mediate the relationship between birth weight and arterial thickness in adolescents: ABCD Growth Study.

OBJECTIVE: To analyse the relationship of altered birth weight with metabolic and cardiovascular outcomes among adolescents, as well as to identify if sports participation is able to attenuate or even eliminate the impact of birth weight on health outcomes. METHODS: Cross-sectional study (Analysis of Behaviours of Children During Growth [ABCD Growth Study]). Adolescents with age ranging from 11 to 18 years old (14.7±2.1) stratified according to normal (n = 230) and altered (n = 35) birth weight composed the sample. Birth weight was self-reported by adolescent's parents. Sports participation was assessed by face-to-face interview. Carotid intima-media thickness (CIMT) and femoral intima-media thickness (FIMT) were measured using an ultrasound device. C-reactive protein levels were used to assess the inflammatory status. Blood pressure, Z score of metabolic risk (dyslipidemia and glucose), adiposity, and insulin resistance were covariates. RESULTS: In the crude model, FIMT (p value = 0.037) and C-reactive protein (p value = 0.029) were affected by altered birth weight. In the adjusted models, altered birth weight affected FIMT (p value = 0.048; small effect size of 1.7%), independently of sports participation. For C-reactive protein, previous time of engagement in sports (p value = 0.001; small effect size of 4.8%) affected C-reactive protein, independently of birth weight. CONCLUSION: Vascular structure seems to be affected by birth weight in adolescents, while its impact on inflammation seems to be attenuated by the regular engagement in sports.

Physical Activity and Skipping Breakfast Have Independent Effects on Body Fatness Among Adolescents.

OBJECTIVE: We analyzed the longitudinal relationship between breakfast intake and adiposity among adolescents, and the possible mediation role of physical activity on this phenomenon. METHODS: We conducted the longitudinal study composed of 86 adolescents (11-14 years old), absence of any known chronic diseases and no regular medicine use that returned the formal consent and assent both signed. Breakfast intake was reported through face-to-face interviews. Adiposity was assessed using a densitometry scanner. Physical activity was estimated through step counts performed using pedometers. Biological maturation was estimated through the maturity level. Student t test for independent samples was used to compare adolescents who were "nonskipping breakfast" and "skipping breakfast," whereas the relationship between adiposity, physical activity, and skipping breakfast was assessed using Pearson correlation. Structural equation model was created to identify the mediation role of physical activity on the relationship between nonskipping breakfast and adiposity. RESULTS: After 12 months, adolescents who had consumed breakfast regularly presented decreased trunk fatness (-3.5% [95% confidence interval (CI): -6.9 to -0.2]) and body fatness (-2.3% [95% CI: -3.9 to -0.7]) compared with their counterparts. Physical activity had an inverse relationship with trunk fatness (r = -0.270 [95% CI: -0.457 to -0.060]). Nonskipping breakfast was, however, not significantly related to trunk fatness; however, physical activity seems to reduce trunk fatness in our sample (r = -0.281; 95% CI: -0.479 to -0.083). CONCLUSIONS: Adolescents who ate breakfast regularly presented lower body fatness independent of physical activity, whereas trunk fatness decreased in adolescents who improved physical activity.

Association between Cluster of Lifestyle Behaviors and HOMA-IR among Adolescents: ABCD Growth Study.

Objective: To analyze the association of potential risk factors to health with body fatness and insulin resistance. Baseline measures of the ongoing longitudinal Analysis of Behaviors of Children During (ABCD) Growth Study. Materials and Methods: The sample was composed of 280 adolescents of both sexes (198 boys and 82 girls) aged from 10 to 18 years. Four risk factors were considered, as follows: no sports practice, skipping breakfast, poor sleep quality, and TV viewing. The outcomes considered were insulin resistance (HOMA-IR) and body fatness (densitometer scanner). Age, sex, maturity offset, and ethnicity were treated as covariates. Results: No sports practice and skipping breakfast were associated with higher body fatness (Sports practice: Wald: 8.786; p = 0.003. Breakfast: Wald: 9.364; p = 0.002). Poor sleep quality was related to a greater HOMA-IR index (Wald: 6.013; p = 0.014). Adolescents with ≥3 risk factors presented a higher risk of high HOMA-IR (OR = 4.89 (95%CI: 1.61 to 14.84)) than their counterparts with no risk factors. Conclusion: Lifestyle risk factors seem relevant to affect obesity and insulin resistance, while the aggregation of these risk factors affects insulin resistance, independent of adiposity.

Effect of Resistance Training on Body Composition of Adolescents: ABCD Growth Study.

OBJECTIVE: To analyze the relationship between resistance training and body composition in adolescents. METHODS: A longitudinal 12-month follow up of 190 adolescents of both sexes categorized into three groups according to resistance training practice, as non-engagement (n=121), irregular engagement (n=44), and frequent engagement (n=25). The outcomes adopted were bone mineral density (BMD), lean soft tissue (LST), and body fatness (BF). RESULTS: Adolescents frequently engaged in resistance training presented higher gains in mean (95 CI) LST [6.1 (3.7 to 8.5) kg vs 2.4 (1.4 to 3.4) kg; P= 0.027] and BMD-upper limbs [0.096 (0.072 to 0.121) g/cm2 vs 0.046 (0.036 to 0.056) g/cm2; P=0.002] than adolescents who were not engaged in resistance training, respectively. Findings were more consistent for boys than girls (models were not significant among girls: LST P= 0.721; BMD-upper limbs P= 0.053). CONCLUSION: Regular engagement in resistance training was related to higher gains in muscle mass and bone density, especially among boys.

Why So Salty? Transient Diabetes Insipidus After Discontinuation of Vasopressin.

In recent years, vasopressin has been increasingly used as an early treatment of vasopressor-refractory septic shock. In this article, we describe 2 episodes of transient diabetes insipidus after vasopressin for the treatment of septic shock was discontinued, which adds to a modest number of case studies reporting the same phenomenon. With the anticipated continued use of vasopressin in intensive care units, it can be expected that this adverse effect will occur with some frequency. Awareness and early recognition of this phenomenon can lead to prompt diagnosis and treatment.

Impact of sports participation on cardiovascular health markers of children and adolescents: Systematic review and meta-analysis.

BACKGROUND: Cardiovascular diseases have a high prevalence in adults and their development begins in the first decades of life. On the other hand, sports participation in childhood and adolescence provides benefits which can delay the onset of these diseases. AIM: To synthesize the available literature on the impact of sports participation on cardiovascular outcomes in children and adolescents. METHODS: This systematic review was conducted on studies of children and adolescents (aged 8-18 years) who regularly practiced a sport and had reported cardiovascular outcomes (blood pressure and intima-media thickness) recorded. The Medline/PubMed, SciELO, Reference Citation Analysis (https://www.referencecitationanalysis.com/) and Bireme databases were searched. RESULTS: In total, 3314 publications for blood pressure and 122 publications for intima-media thickness were identified in the databases. After exclusions (e.g., duplicate articles, animal studies and those that did not meet the inclusion criteria), four publications for blood pressure (449 adolescents) and two publications for intima-media thickness were included (402 adolescents). For blood pressure, all publications were longitudinal in design (follow-up ranging from 12 wk to 12 mo) and involved adolescents aged from 8 years to 18 years of age. For intima-media thickness, both publications were longitudinal in design and involved adolescents aged from 11 years to 18 years of age. CONCLUSION: Sports participation seems to promote benefits to cardiovascular structure and function in adolescents. However, studies with adolescents are scarce and further research is needed to understand this phenomenon.

Impact of Moderate-To-Vigorous Sports Participation Combined with Resistance Training on Metabolic and Cardiovascular Outcomes among Lean Adolescents: ABCD Growth Study.

BACKGROUND: To investigate the combined impact of being engaged in resistance training (RT) and meeting the physical activity guidelines through sports participation (SP) on cardiovascular and metabolic parameters in lean adolescents. METHODS: A longitudinal study, part of the ongoing study entitled "ABCD Growth Study" (Analysis of Behaviors of Children During Growth), assessed data from 64 adolescents (23 from the sport group, 11 from the sport + RT group, and 30 from the control group). Metabolic and cardiovascular outcomes were analyzed as dependent variables. For the independent variables, sports participation and resistance training were considered, and for the covariates, sex, chronological age, body weight, height, and somatic maturation. RESULTS: After 12 months of follow-up, the RT + SP presented improvements in triglycerides (TG) and the SP presented a reduction in LDL-c, TG, and glucose when compared to the control group. CONCLUSIONS: Being engaged in RT and SP is a good strategy to improve health in eutrophic adolescents, with a great impact on TG from the lipid profile.

Impact of sports participation on components of metabolic syndrome in adolescents: ABCD growth study.

OBJECTIVES: This study aimed to analyze the impact of sports participation (12 months of practice) on the components of metabolic syndrome (MetS) in both sexes. METHODS: This is an observational longitudinal study, a part of which is entitled "Analysis of Behaviors of Children During Growth" (ABCD Growth Study), Presidente Prudente, São Paulo, Brazil. The sample was composed of 171 adolescents (112 boys and 59 girls), divided into non-sports and sports groups. High-density lipoprotein-cholesterol (HDL-c), triglycerides, and glucose were analyzed by the colorimetric method of dry chemistry and processed biochemically. Systolic blood pressure and diastolic blood pressure were measured using an automatic device. Body fat was estimated using a densitometry scanner. RESULTS: Adolescents who practiced sports were younger (p-value=0.001) and had a lower peak height velocity (p-value=0.001) than the non-sports group. The differences (Δ) after 12 months were of greater magnitude for the sports group when compared to the non-sports group (p-value=0.013), glucose (moderate magnitude in favor of the sports group; p-value=0.001), HDL-c (small magnitude in favor of the sports group; p-value=0.0015), and MetS (moderate magnitude in favor of the sports group; p-value=0.001). CONCLUSIONS: The practice of sports in adolescents had a protective effect on the metabolic components of MetS.

THE INFLUENCE OF PASSIVE TOBACCO EXPOSURE AND PHYSICAL EXERCISE ON BONE TISSUE OF YOUNG RATS.

OBJECTIVE: The objective of this study is to investigate the effect of passive smoking during pregnancy and associated with swimming on bone area growth, bone mineral density (BMD), and bone mineral content (BMC). METHODS: The offspring was grouped by control matrices (G1) and passive smokers (G2). The offspring was regrouped in eight subgroups, with exposure to smoking (2x/day) and physical exercise (1 session/day), respecting the group of matrices in: sedentary control (G1CS and G2CS), swimming control (G1CN and G2CN), sedentary passive smoker (G1FS and G2FS), and passive smoker swimmer (G1FN and G2FN). The area, BMD and BMC were measured by the tibia and femur and analyzed by densitometer. The results were analyzed by One-Way ANOVA test with Tukey post-test, with a significance level of 5%. RESULTS: In the tibia BMC study, a better rate was observed in G2CN group when compared to G1CS, G1CN and G1FN (p ≤ 0.023). When assessing BMD in the femur, a higher density ratio was observed in G1FS group when compared to G2CS, G2CN, G2FS and G2FN (p<0.008). In the tibia study, the animals of the G1FS group had higher rates when compared to G2CS and G2FN groups (p≤0.007). CONCLUSIONS: The model of male offspring exposed to passive smoking during fetal development showed a strong decrease in the analyzed parameters. Level of Evidence I, Randomized High Quality Clinical Trial With or Without Statistically Significant Difference, But Narrow Confidence Intervals.

OBJETIVO: O objetivo desse estudo é investigar o efeito do tabagismo passivo durante a prenhez e associado à natação no crescimento de área óssea, densidade mineral óssea (DMO) e conteúdo mineral ósseo (CMO). MÉTODOS: Os filhotes foram gerados por matrizes controle (G1) e tabagistas (G2). Os filhotes foram reagrupados em oito subgrupos, com exposição ao tabagismo (2x/dia) e realização de exercício físico (1 sessão/dia), respeitando o grupo de matrizes em: controle sedentário (G1CS e G2CS), controle natação (G1CN e G2CN), tabagista passivo sedentário (G1FS e G2FS) e tabagista passivo natação (G1FN e G2FN). A área, a DMO e o CMO foram aferidos pela tíbia e pelo fêmur e analisados pelo densitômetro. Os resultados foram analisados pelo teste de ANOVA One-Way, com pós-teste de Tukey, com nível de significância de 5%. RESULTADOS: No estudo do CMO da tíbia, foi observada taxa melhor no grupo G2CN quando comparada aos filhotes dos grupos G1CS, G1CN e G1FN (p ≤ 0,023). Na averiguação da DMO no fêmur, foi observada maior taxa de densidade no grupo G1FS quando confrontado aos grupos G2CS, G2CN, G2FS e G2FN (p ≤ 0,008). Já no estudo da tíbia, os animais do grupo G1FS apresentaram maiores taxas quando comparados aos grupos G2CS e G2FN (p≤0,007). CONCLUSÕES: O modelo de filhotes machos expostos ao tabagismo passivo durante o desenvolvimento fetal apresentou uma forte diminuição dos parâmetros analisados. Nível de Evidência I, Estudo Clínico Randomizado de Alta Qualidade Com ou Sem Diferença Estatisticamente Significante, Mas Com Intervalos de Confiança Estreitos.

THE INFLUENCE OF PASSIVE TOBACCO EXPOSURE AND PHYSICAL EXERCISE ON BONE TISSUE OF YOUNG RATS / INFLUÊNCIA DO TABAGISMO PASSIVO E DO EXERCÍCIO FÍSICO NO TECIDO ÓSSEO DE RATOS JOVENS

ABSTRACT Objective: The objective of this study is to investigate the effect of passive smoking during pregnancy and associated with swimming on bone area growth, bone mineral density (BMD), and bone mineral content (BMC). Methods: The offspring was grouped by control matrices (G1) and passive smokers (G2). The offspring was regrouped in eight subgroups, with exposure to smoking (2x/day) and physical exercise (1 session/day), respecting the group of matrices in: sedentary control (G1CS and G2CS), swimming control (G1CN and G2CN), sedentary passive smoker (G1FS and G2FS), and passive smoker swimmer (G1FN and G2FN). The area, BMD and BMC were measured by the tibia and femur and analyzed by densitometer. The results were analyzed by One-Way ANOVA test with Tukey post-test, with a significance level of 5%. Results: In the tibia BMC study, a better rate was observed in G2CN group when compared to G1CS, G1CN and G1FN (p ≤ 0.023). When assessing BMD in the femur, a higher density ratio was observed in G1FS group when compared to G2CS, G2CN, G2FS and G2FN (p<0.008). In the tibia study, the animals of the G1FS group had higher rates when compared to G2CS and G2FN groups (p≤0.007). Conclusions: The model of male offspring exposed to passive smoking during fetal development showed a strong decrease in the analyzed parameters. Level of Evidence I, Randomized High Quality Clinical Trial With or Without Statistically Significant Difference, But Narrow Confidence Intervals.

RESUMO Objetivo: O objetivo desse estudo é investigar o efeito do tabagismo passivo durante a prenhez e associado à natação no crescimento de área óssea, densidade mineral óssea (DMO) e conteúdo mineral ósseo (CMO). Métodos: Os filhotes foram gerados por matrizes controle (G1) e tabagistas (G2). Os filhotes foram reagrupados em oito subgrupos, com exposição ao tabagismo (2x/dia) e realização de exercício físico (1 sessão/dia), respeitando o grupo de matrizes em: controle sedentário (G1CS e G2CS), controle natação (G1CN e G2CN), tabagista passivo sedentário (G1FS e G2FS) e tabagista passivo natação (G1FN e G2FN). A área, a DMO e o CMO foram aferidos pela tíbia e pelo fêmur e analisados pelo densitômetro. Os resultados foram analisados pelo teste de ANOVA One-Way, com pós-teste de Tukey, com nível de significância de 5%. Resultados: No estudo do CMO da tíbia, foi observada taxa melhor no grupo G2CN quando comparada aos filhotes dos grupos G1CS, G1CN e G1FN (p ≤ 0,023). Na averiguação da DMO no fêmur, foi observada maior taxa de densidade no grupo G1FS quando confrontado aos grupos G2CS, G2CN, G2FS e G2FN (p ≤ 0,008). Já no estudo da tíbia, os animais do grupo G1FS apresentaram maiores taxas quando comparados aos grupos G2CS e G2FN (p≤0,007). Conclusões: O modelo de filhotes machos expostos ao tabagismo passivo durante o desenvolvimento fetal apresentou uma forte diminuição dos parâmetros analisados. Nível de Evidência I, Estudo Clínico Randomizado de Alta Qualidade Com ou Sem Diferença Estatisticamente Significante, Mas Com Intervalos de Confiança Estreitos.

[Influence of passive smoking associated with exercise performed by rats during pregnancy and lactation on their offspring growth]. / Influência do tabagismo passivo associado ao exercício físico realizado por ratas durante prenhez e lactação, sobre o desenvolvimento dos filhotes.

PURPOSE: the purpose of this study was to evaluate mortality, weight and body length, and the gastrocnemius muscle of the offspring of pregnant rats submitted to a swimming program associated with second-hand smoke. METHODS: twenty-four rats were divided into four groups: GF (exposed to cigarette smoke), GC (control), GFN (submitted to the swimming program and exposed to cigarette smoke), and GN (submitted to the swimming program). The mortality, weight and length of the offspring were measured at four time points. The gastrocnemius muscle of the pups was obtained for evaluation of muscle development. RESULTS: the average number of offspring was lower for GF (10.2) and GFN (10.3) and higher for GN (12.8). At birth, only GFN showed significantly lower weight (p=0.016) and length (p=0.02), whereas during lactation the groups exposed to cigarette smoke showed significantly lower weight. GFN had delayed muscle development compared to GC (p=0.03). CONCLUSIONS: Passive smoking during pregnancy and lactation negatively influenced number, weight and body length of offspring from birth to weaning and muscle development, and the swimming program positively influenced these variables at birth, although it did not provide the same benefits during lactation; and their association negatively affected these measures.

Influência do tabagismo passivo associado ao exercício físico realizado por ratas durante prenhez e lactação, sobre o desenvolvimento dos filhotes / Influence of passive smoking associated with exercise performed by rats during pregnancy and lactation on their offspring growth

OBJETIVOS: o objetivo deste estudo foi avaliar mortalidade, peso e comprimento corporal, e o músculo gastrocnêmio dos filhotes de ratas prenhes submetidas ao programa de natação associado ao tabagismo passivo. MÉTODOS: vinte e quatro ratas foram divididas em quatro grupos: GF (exposto à fumaça de cigarro), GC (Controle), GFN (submetido ao programa de natação e exposto à fumaça de cigarro) e GN (submetido ao programa de natação). A mortalidade e a aferição do peso e comprimento dos filhotes foram realizadas em quatro momentos. O músculo gastrocnêmio dos filhotes foi obtido para avaliação do desenvolvimento muscular. RESULTADOS: a média do nascimento de filhotes foi menor para os grupos GF (10,2) e GFN (10,3) e maior para o GN (12,8). No nascimento, somente o GFN apresentou medidas de peso (p=0,016) e comprimento (p=0,02) significantemente inferiores ao Controle, já na lactação foram os grupos expostos à fumaça de cigarro. O grupo GFN apresentou retardo no desenvolvimento muscular em relação ao GC (p=0,03). CONCLUSÃO: O tabagismo passivo durante a prenhez e lactação exerceu influência negativa sobre o número, peso e comprimento corporal dos filhotes do nascimento ao desmame e sobre o desenvolvimento muscular; o programa de natação influenciou positivamente tais variáveis no momento do nascimento, entretanto, não possibilitou os mesmos benefícios durante a lactação; e a associação destes influenciou negativamente tais medidas.

PURPOSE: the purpose of this study was to evaluate mortality, weight and body length, and the gastrocnemius muscle of the offspring of pregnant rats submitted to a swimming program associated with second-hand smoke. METHODS: twenty-four rats were divided into four groups: GF (exposed to cigarette smoke), GC (control), GFN (submitted to the swimming program and exposed to cigarette smoke), and GN (submitted to the swimming program). The mortality, weight and length of the offspring were measured at four time points. The gastrocnemius muscle of the pups was obtained for evaluation of muscle development. RESULTS: the average number of offspring was lower for GF (10.2) and GFN (10.3) and higher for GN (12.8). At birth, only GFN showed significantly lower weight (p=0.016) and length (p=0.02), whereas during lactation the groups exposed to cigarette smoke showed significantly lower weight. GFN had delayed muscle development compared to GC (p=0.03). CONCLUSIONS: Passive smoking during pregnancy and lactation negatively influenced number, weight and body length of offspring from birth to weaning and muscle development, and the swimming program positively influenced these variables at birth, although it did not provide the same benefits during lactation; and their association negatively affected these measures.