RESUMO
Heart rate variability (HRV) is an early marker of risk for various health conditions, and its analysis serves as a valuable tool for assessing older adults. This study aimed to describe the reference values of HRV parameters in older adults through a systematic review of the literature. The review included searches in MEDLINE (via PubMed®), EMBASE, Latin American and Caribbean Health Literature, Scopus, and Web of Science (WOS). Studies presenting reference values for at least one HRV linear analysis measure in older adults were considered eligible. Out of 1618 studies identified, only 11 met the inclusion criteria. Sample sizes of older adults ranged from 21 to 6250 subjects. The HRV measures assessed (mean RR intervals, SDNN, RMSSD, PNN50, LF, HF, and LF/HF ratio) varied significantly between studies, with no standardized methods for HRV analysis. We concluded that reference values for HRV measures in older adults vary widely between studies. The scientific literature on HRV reference values in older adults is still limited, and future studies should standardize assessment methods for HRV measures in this population.
RESUMO
Neurocritical patients (NCPs) in the intensive care unit (ICU) rapidly progress to respiratory and peripheral muscle dysfunctions, which significantly impact morbidity and death. Early mobilization in NCPs to decrease the incidence of ICU-acquired weakness has been showing rapid growth, although pertinent literature is still scarce. With this review, we summarize and discuss current concepts in early mobilization of critically ill patients within the context of neurologic pathology in NCPs. A narrative synthesis of literature was undertaken trying to answer the following questions: How do the respiratory and musculoskeletal systems in NCPs behave? Which metabolic biomarkers influence physiological responses in NCPs? Which considerations should be taken when prescribing exercises in neurocritically ill patients? The present review detected safety, feasibility, and beneficial response for early mobilization in NCPs, given successes in other critically ill populations and many smaller intervention trials in neurocritical care. However, precautions should be taken to elect the patient for early care, as well as monitoring signs that indicate interruption for intervention, as worse outcomes were associated with very early mobilization in acute stroke trials.
Assuntos
Estado Terminal , Deambulação Precoce , Humanos , Cuidados Críticos , Doenças do Sistema Nervoso/terapia , Unidades de Terapia IntensivaRESUMO
PURPOSE: To carry out a systematic review to determine the main methods used to study the heart rate variability (HRV) in individuals after the acute phase of COVID-19. METHODS: The study followed the Preferred Items for Reporting for Systematic Reviews and Meta-Analyses (PRISMA) statement. PubMed, Web of Science, Scopus and CINAHAL electronic databases were searched from the inception to November 2022. The studies were included if they used HRV assessment based on linear and non-linear methods in long-term COVID-19 patients. Review studies, theses and dissertations, conference abstracts, longitudinal studies, studies conducted on animals and studies that included individuals in the acute phase of the COVID-19 were excluded. The methodological quality of the studies was analyzed using the Joanna Briggs Institute's critical evaluation checklist for cross-sectional analytical studies. RESULTS: HRV was mainly assessed using 24-h Holter monitoring in 41.6% (5/12) of the studies, and 12lead ECG was used in 33.3% (4/12). Regarding the type of assessment, 66.6% (8/12) of the studies only used linear analysis, where 25% (3/12) used analysis in the time domain, and 41.6% (5/12) used both types. Non-linear methods were combined with the previously cited linear method in 25% (3/12) of the studies. Moreover, 50% (6/12) of the studies demonstrated post-COVID-19 autonomic dysfunction, with an increase in the predominance of cardiac sympathetic modulation. The average score of the evaluation checklist was 6.6, characterized as having reasonable methodological quality. CONCLUSION: 24-h Holter and 12lead ECG are considered effective tools to assess HRV in post-COVID-19 patients. Furthermore, the findings reveal diverse effects of COVID-19 on the autonomic nervous system's sympathovagal balance, which might be influenced by secondary factors such as disease severity, patients' overall health, evaluation timing, post-infection complications, ventilatory functions, and age.
Assuntos
Eletrocardiografia , Frequência Cardíaca , Síndrome de COVID-19 Pós-Aguda , Humanos , Sistema Nervoso Autônomo , COVID-19/complicações , Estudos Transversais , Síndrome de COVID-19 Pós-Aguda/diagnósticoRESUMO
BACKGROUND: To promote optimal neuromuscular and cardiovascular gains in older adults, it seems crucial to investigate the effects of different combined training volumes in this population. Thus, the present study aimed to compare the effects of combined muscle power training (MPT) and endurance training (ET) with different volumes on functional and hemodynamic parameters in previously trained older adults. METHODS: Twenty-five older adults were randomly assigned to either the lower-volume group (LVG; n = 13) or the higher-volume group (HVG; n = 12). In the LVG, participants performed 1 set of 6 repetitions for each exercise, followed by 10 min of walking exercise. In the HVG, participants performed 2 sets of 6 repetitions for each exercise, followed by 20 min of walking exercise. Lift from the ventral decubitus position (LPDV), timed up-and-go (TUG), systolic blood pressure (SBP), and diastolic blood pressure (DBP) were assessed before and after 8 weeks. RESULTS: Significant increases in LPDV test occurred in both groups after 8 weeks (p < 0.05). Additionally, significant improvements in TUG performance occurred in both groups from week 0 to week 8 (p < 0.05). However, no significant changes were observed between groups in functional parameters (p > 0.05). SBP and DBP remain unchanged (p > 0.05) in both groups over the experimental period. CONCLUSIONS: These findings indicate that lower-volume and higher-volume of combined MPT and ET promoted improvements in functional parameters. This study has an important practical application, as it indicates that regardless of the volume (lower or higher), comparable improvements are observed in functional parameters in previously trained older adults.
Assuntos
Treino Aeróbico , Treinamento Resistido , Humanos , Idoso , Exercício Físico/fisiologia , Caminhada/fisiologia , Pressão Sanguínea , Músculos , Força Muscular/fisiologiaRESUMO
The novel coronavirus (SARS-CoV-2) has distinct clinical manifestations that can vary from an asymptomatic condition to severe acute respiratory failure. Phenotypes are attributable to different pathophysiological mechanisms and require different treatment strategies. The assessment and identification of different phenotypes can guide therapy configurations such as oxygen therapy, non-invasive ventilation, airway management, and tracheal intubation. Further studies are essential to provide information on the influence of phenotypes in the decision of rehabilitation strategies. The sequelae left in the respiratory system of COVID-19 survivors and its limitations will be a challenge for rehabilitation services worldwide. Lung injuries are directly related to the phenotypes presented, and depending on the degree of these injuries, rehabilitation strategies can be targeted. We believe that differentiating patients, according to their respective phenotypes, can improve decision-making in treatment and individualized rehabilitation.
Assuntos
COVID-19/epidemiologia , COVID-19/reabilitação , Medicina Física e Reabilitação/métodos , SARS-CoV-2/genética , Manuseio das Vias Aéreas/métodos , COVID-19/terapia , COVID-19/virologia , Tomada de Decisão Clínica , Humanos , Intubação Intratraqueal/métodos , Ventilação não Invasiva/métodos , Oxigênio/uso terapêutico , Fenótipo , Síndrome Respiratória Aguda Grave/complicações , Síndrome Respiratória Aguda Grave/terapia , Síndrome Respiratória Aguda Grave/virologiaRESUMO
BACKGROUND: The recreational use of anabolic-androgenic steroids (AAS) has reached alarming levels among healthy people. However, several complications have been related to consumption of these drugs, including liver disorders. OBJECTIVE: To evaluate the prevalence of liver injuries in young Brazilian recreational AAS users. METHODS: Between February/2007 and May/2012 asymptomatic bodybuilders who were ≥18 years old and reported AAS use for ≥6 months were enrolled. All had clinical evaluations, abdominal ultrasound (AUS), and blood tests. RESULTS: 182 individuals were included in the study. The median age (interquartile range) was 26.0 years (22.0-30.0) and all were male. Elevated liver enzyme levels were observed in 38.5% (n = 70) of AAS users, and creatine phosphokinase was normal in 27.1% (n = 19) of them. Hepatic steatosis was observed by AUS in 12.1% of the sample. One individual had focal nodular hyperplasia and another had hepatocellular adenoma. One case each of hepatitis B and C virus infection was found. A diagnosis of toxic liver injury was suggested in 23 (12.6%) AAS users without a history of alcohol or other medications/drugs consumption, or evidence of other liver diseases. CONCLUSIONS/IMPORTANCE: Young Brazilian recreational AAS users presented a wide spectrum of liver injuries that included hepatotoxicity, fatty liver, and liver neoplasm. They also presented risk factors for liver diseases such as alcohol consumption and hepatitis B and C virus infection. The results suggest that the risk of AAS use for the liver may be greater than the esthetic benefits, and demonstrate the importance of screening AAS users for liver injuries.
Assuntos
Anabolizantes/efeitos adversos , Doença Hepática Induzida por Substâncias e Drogas/epidemiologia , Drogas Ilícitas/efeitos adversos , Fígado/patologia , Adulto , Brasil , Doença Hepática Induzida por Substâncias e Drogas/etiologia , Doença Hepática Induzida por Substâncias e Drogas/patologia , Humanos , Masculino , Prevalência , Fatores de Risco , Adulto JovemRESUMO
Anabolic-androgenic steroids (AAS) are used to enhance physical performance and/or appearance. The aim of this study was to evaluate the influence of the concomitant use of alcohol, tobacco, cocaine, and AAS on blood lipid profiles of 145 asymptomatic male bodybuilders from the Northeast region of Brazil. Interviews, clinical exams, and serological evaluations were performed on all participants between 2007 and 2009. All subjects' self-reported use of testosterone or its derivatives, 118 individuals reported alcohol intake, 27-reported cigarette smoking, and 33 confirmed cocaine use. Four subjects were users of all drugs at the same time. Higher levels of total cholesterol and LDL-cholesterol were observed among concomitant users of alcohol, tobacco, cocaine, and AAS. The study's limitations are noted.
Assuntos
Consumo de Bebidas Alcoólicas , Anabolizantes/administração & dosagem , Cocaína/administração & dosagem , Dopagem Esportivo , Lipídeos/sangue , Nicotiana , Adolescente , Adulto , Brasil , Humanos , Masculino , Levantamento de Peso , Adulto JovemRESUMO
OBJECTIVE: The objective of the present study was to analyze the effects of 10 weeks of resistance training (RT) and subsequent 4 weeks of detraining on physical function, body composition, and biochemical markers in aging adults. METHODS: The study sample was selected by convenience and consisted of 12 women with a mean age of 58 ± 7 years. Physical function [Latin-American Group of Development for Maturity (GDLAM) general index], body composition, total and fractional cholesterol, triglycerides, and glycemia were assessed before and after RT (10 weeks) and detraining (4 weeks). RESULTS: After 10 weeks of RT, there were improvements in fat-free mass (39.1 ± 4.2 vs. 39.9 ± 4.4 kg; p < 0.05 and d = 0.2), fat mass (39.9 ± 6.3% vs. 38.7 ± 6.4%; p < 0.05 and d = -0.2), conicity index (1.47 ± 0.07 vs. 1.43 ± 0.06; p = 0.001 and d = -0.6), and physical function (GDLAM index [27.2 ± 5.5 vs. 25.0 ± 4.7; p = 0.001 and d = -0.4]). Significant improvements were also found in total cholesterol (271.8 ± 75.7 vs. 217.2 ± 52.2 mg/dL; p < 0.01 and d = -0.8), LDL-cholesterol (196.5 ± 61.6 vs. 159.3 ± 38.5 mg/dL; p < 0.01 and d = -0.7), HDL-cholesterol (53.1 ± 7.3 vs. 64.3 ± 23.7 mg/dL; p < 0.05 and d = 0.7), and triglycerides (165.8 ± 32.6 vs. 139.9 ± 46.6 mg/dL; p = 0.001 and d = -0.6). After the detraining period, all benefits in physical function were successfully maintained. CONCLUSION: RT provided benefits in physical function, body composition, and biochemical markers in aging adults. However, 4-week detraining impaired body composition and biochemical markers in the investigated sample.
Assuntos
Treinamento Resistido , Idoso , Feminino , Humanos , Pessoa de Meia-Idade , Envelhecimento , Biomarcadores , Composição Corporal , Colesterol , TriglicerídeosRESUMO
Previous studies have investigated the effects of different combined training programs involving traditional resistance training and aerobic exercise on hemodynamic parameters and arterial stiffness in older adults. However, little is known about the impact of power training combined with endurance training on these variables in hypertensive older adults. Therefore, this study aimed to investigate the effects of dynamic power training with elastic bands combined with endurance training on arterial stiffness and hemodynamic parameters in hypertensive older adults. Twenty-six participants were randomly assigned to the control group (CG; nâ=â13) and the intervention group (nâ=â13). IG participants performed power training with elastic bands combined with endurance training twice a week for 8âweeks. Pulse pressure, central pulse pressure, pulse wave velocity, SBP, DBP, central SBP, and central DBP were assessed before and after 8âweeks using the triple pulse wave velocity method. Pulse pressure, central pulse pressure, pulse wave velocity, SBP, DBP, central SBP, and central DBP significantly improved after 8âweeks of intervention (Pâ<â0.05). These findings indicate that power training with elastic bands combined with endurance training reduces arterial stiffness and significantly improves hemodynamic parameters in older adults diagnosed with grade 1 hypertension. In addition, underscores the potential of this approach as a promising strategy for the management of hypertension in older adults.
Assuntos
Treino Aeróbico , Hipertensão , Treinamento Resistido , Humanos , Idoso , Análise de Onda de Pulso , Hipertensão/terapia , Pressão SanguíneaRESUMO
Background: Ageing is associated with structural changes in brain regions and functional decline in cognitive domains. Noninvasive tools for identifying structural damage in the brains of older adults are relevant for early treatment. Aims: This study aims to evaluate and compare the accuracy of the Mini-Mental State Examination (MMSE) and Montreal Cognitive Assessment (MoCA©) in identifying gray and white matter brain damage in older individuals with varying degrees of cognitive impairment. Methods: Ninety older adults (62 women) with an average age of 69 ± 7 years were enrolled and categorized as having no cognitive impairment (NCI), mild cognitive impairment (MCI), or moderate cognitive impairment (MoCI). Magnetic resonance imaging (MRI) was utilized to assess the number, volume, and distribution of brain damage. The Fazekas and Scheltens scales were applied to the brain MRIs, and inferential statistics were employed to compare variables among the groups. Results: Cognitive impairment was observed in 56.7% of the participants (95% confidence interval (CI): 46.4-66.4%), with thirty-six older adults (40%) classified as MCI and 15 (17%) as MoCI. Cognitive impairment and medial temporal lobe (MTL) atrophy were found to be associated (p=0.001), exhibiting higher mean volume scales of the MTL atrophied area in the MoCI group (p < 0.001). The MMSE accurately revealed MTL atrophy based on the Scheltens (p < 0.05) and Fazekas (p < 0.05) scales. At the same time, the MoCA accurately identified periventricular white matter (PWM) abnormalities according to the Fazekas scale (p < 0.05). Conclusions: The MMSE and MoCA screening tools effectively identified gray and white matter brain damage in older adults with varying degrees of cognitive impairment. Lower MMSE scores are associated with MTL atrophy and lesions, and lower MoCA scores are related to PWM lesions. The concurrent use of MMSE and MoCA is recommended for assessing structural changes in distinct brain regions.
RESUMO
BACKGROUND: Presenteeism, the act of showing up to work when one is ill, is a prevailing global phenomenon, at rates varying from 30% to 90%. Presenteeism results in consequences to the worker's health, like pain, depression, and poor work ability, as well as consequences to the organization like productivity loss, negative feelings and engagement of coworkers, and risk of accidents. Agriculture is an important sector for the global economy, providing employment for 27% of the global workforce. This study aimed to estimate the prevalence of presenteeism and its associated factors among agricultural workers. METHODS: A systematic review was performed through searches at PubMed, Web of Science, LILACS, SciELO, EMBASE, PsycINFO, and Scopus databases. Observational studies (cross-sectional, cohort or case-control) that reported the prevalence of presenteeism in agricultural workers were eligible. FINDINGS: A total of 139 studies were found but only two met the inclusion criteria. The selected studies reported prevalence rates of presenteeism of 5.0% and 58.2%. Poor work safety climate, female workers, workers dissatisfied with management, and sunscreen not available at the workplace were strongly associated with the prevalence of presenteeism. CONCLUSIONS/APPLICATIONS TO PRACTICE: We concluded that the scientific literature about the prevalence of presenteeism among agricultural workers is scarce. Future studies about presenteeism among agricultural workers should measure the prevalence and/or incidence of presenteeism by using the epidemiological approach and, furthermore, should integrate these measures with the work productivity approach.
Assuntos
Fazendeiros , Presenteísmo , Humanos , Feminino , Estudos Transversais , Prevalência , Dor , Local de TrabalhoRESUMO
CONTEXT: Despite the well-known positive effects of exercise in hypertensive patients, the best mode of exercise is still under discussion. OBJECTIVE: A systematic review of the literature, synthesizing data on the effects of high-intensity interval training (HIIT) on peak oxygen consumption (VO2 peak), blood pressure (BP), cardiac autonomic modulation, and resting heart rate (HR) in patients with hypertension. DATA SOURCES: MEDLINE (via PubMed), CENTRAL, PEDro database, and SciELO (from the earliest date available to December 31, 2020). STUDY SELECTION: Randomized controlled trials (RCTs) that evaluated the effects of HIIT in hypertensive patients. STUDY DESIGN: Systematic review and meta-analysis. LEVEL OF EVIDENCE: Level 2. DATA EXTRACTION: Mean differences (MDs) with a 95% CI were calculated, and heterogeneity was assessed using the I2 test. RESULTS: Nine RCTs encompassing 569 patients met the eligibility criteria and were included in the systematic review. Five trials compared supervised HIIT with moderate-intensity continuous training (MICT) and a control; 1 trial compared HIIT with MICT, and 3 compared HIIT with a control. In comparison with MICT, HIIT improved VO2 peak MD (3.3 mL.kg-1.min-1; 95% CI, 1.4-5.3; N = 130). In comparison with controls, HIIT improved VO2 peak MD (4.4 mL.kg-1.min-1; 95% CI, 2.5-6.2; N = 162). CONCLUSION: Despite the low quality of the evidence, HIIT is superior to MICT in improving VO2 peak in patients with hypertension. HIIT effectively improved VO2 peak, BP, and resting HR when compared with controls. HIIT appears to be safe only when performed in a supervised manner for stage 1 hypertension patients without associated risk factors.
Assuntos
Treinamento Intervalado de Alta Intensidade , Hipertensão , Humanos , Pressão Sanguínea/fisiologia , Tolerância ao Exercício , Hipertensão/terapia , Exercício Físico/fisiologiaRESUMO
BACKGROUND: Coronavirus disease 2019 (COVID-19) can damage cardiac tissue by increasing troponin levels and inducing arrhythmias, myocarditis, and acute coronary syndrome. OBJECTIVES: To analyze the impact of COVID-19 on cardiac autonomic control in mechanically ventilated intensive care unit (ICU) patients. DESIGN AND SETTING: This cross-sectional analytical study of ICU patients of both sexes receiving mechanical ventilation was conducted in a tertiary hospital. METHODS: Patients were divided into COVID-19-positive (COVID(+)) and COVID-19-negative (COVID(-)) groups. Clinical data were collected and heart rate variability (HRV) records obtained using a heart rate monitor. RESULTS: The study sample comprised 82 subjects: 36 (44%) in the COVID(-) group (58.3% female; median age, 64.5 years) and 46 (56%) in the COVID(+) group (39.1% females; median age, 57.5 years). The HRV indices were lower than the reference values. An intergroup comparison identified no statistically significant differences in the mean normal-to-normal (NN) interval, standard deviation of the NN interval, or root mean square of successive differences in NN intervals. The COVID(+) group had an increased low frequency (P = 0.05), reduced high frequency (P = 0.045), and increased low frequency/high frequency (LF/HF) ratio (P = 0.048). There was a weak positive correlation between LF/HF and length of stay in the COVID(+) group. CONCLUSION: Patients who received mechanical ventilation had lower overall HRV indices. COVID(+) patients who received mechanical ventilation had lower vagal HRV components. These findings likely indicate clinical applicability, as autonomic control impairments are associated with a greater risk of cardiac death.
Assuntos
COVID-19 , Respiração Artificial , Masculino , Humanos , Feminino , Pessoa de Meia-Idade , Estudos Transversais , Sistema Nervoso Autônomo , Arritmias Cardíacas/etiologia , Frequência Cardíaca/fisiologiaRESUMO
OBJECTIVE: This study aimed to evaluate the acute responses of pulse pressure (PP), SBP, and DBP to dynamic explosive resistance exercise (DERE) with elastic resistance bands in hypertensive older adults. METHODS: Eighteen hypertensive older adults were randomly assigned to participate in DERE and control sessions. PP, SBP, and DBP were measured before (baseline) and after each session (immediately, 10, and 20â min after the session). The DERE protocol has five sets of two consecutive exercises. RESULTS: There was an important clinical decrease in PP (Δ = -7.8â mmHg; dz = 0.7) and in DBP (Δ = -6.3â mmHg; dz = 0.6) favoring the exercise session post-20â min in the intersession comparison. DERE also promoted lowering levels in SBP (140.3â ±â 16.0 vs. 126.2â ±â 14.3â mmHg; Δ = -14.1â mmHg; P â =â 0.04) with a large effect size ( dz = 0.9) post-20â min when compared to the control session. CONCLUSION: Our findings indicate that DERE with elastic resistance bands improved SBP in hypertensive older adults. In addition, our results support the hypothesis that DERE can an important clinical decrease in PP and DBP. According to this, professionals may have additional exercise training possibilities with elastic resistance bands when prescribing resistance exercises for systemic arterial hypertension treatment in this population.
Assuntos
Hipertensão , Treinamento Resistido , Humanos , Idoso , Pressão Sanguínea/fisiologia , Treinamento Resistido/métodos , Estudos Cross-Over , Terapia por ExercícioRESUMO
BACKGROUND: Respiratory failure is the most common cause of death in patients with amyotrophic lateral sclerosis (ALS), and morbidity is related to poor quality of life (QOL). Non-invasive ventilation (NIV) may be associated with prolonged survival and QOL in patients with ALS. OBJECTIVES: To assess whether NIV is effective and safe for patients with ALS in terms of survival and QOL, alerting the health system. DESIGN AND SETTING: Systematic review was conducted in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses reporting standards using population, intervention, comparison, and outcome strategies. METHODS: The Cochrane Library, CENTRAL, MEDLINE, LILACS, EMBASE, and CRD databases were searched based on the eligibility criteria for all types of studies on NIV use in patients with ALS published up to January 2022. Data were extracted from the included studies, and the findings were presented using a narrative synthesis. RESULTS: Of the 120 papers identified, only 14 were related to systematic reviews. After thorough reading, only one meta-analysis was considered eligible. In the second stage, 248 studies were included; however, only one systematic review was included. The results demonstrated that NIV provided relief from the symptoms of chronic hypoventilation, increased survival, and improved QOL compared to standard care. These results varied according to clinical phenotype. CONCLUSIONS: NIV in patients with ALS improves the outcome and can delay the indication for tracheostomy, reducing expenditure on hospitalization and occupancy of intensive care unit beds. SYSTEMATIC REVIEW REGISTRATION: PROSPERO database: CRD42021279910 - https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=279910.
Assuntos
Esclerose Lateral Amiotrófica , Ventilação não Invasiva , Insuficiência Respiratória , Humanos , Esclerose Lateral Amiotrófica/terapia , Esclerose Lateral Amiotrófica/complicações , Ventilação não Invasiva/métodos , Qualidade de Vida , Respiração Artificial/efeitos adversos , Insuficiência Respiratória/terapia , Insuficiência Respiratória/complicaçõesRESUMO
BACKGROUND: Stroke is a major cause of mortality worldwide. Renal dysfunction is an important risk factor for stroke. Brazilian studies on stroke knowledge are generally population based. Studies stratifying stroke knowledge according to comorbidities are rare. Scientific data are essential to guide the awareness of stroke. OBJECTIVE: To assess stroke knowledge in patients with chronic kidney disease (CKD) on hemodialysis. DESIGN AND SETTING: Cross-sectional analytical study of patients with CKD on hemodialysis in north-eastern Brazil. METHODS: A self-administered questionnaire survey on stroke awareness was administered to patients with CKD on hemodialysis between April and November 2022. The chi-square test and other descriptive statistics were used. Univariate and multivariate analyses were performed using logistic regression. RESULTS: A total of 197 patients were included in the analysis. The Brazilian acronym for stroke was used by 53.5% of the participants. Less than 10.0% of the sample showed optimal decision-making ability regarding stroke. Of the participants, 29.9% knew at least one risk factor and one symptom; however, this was considered as having below the minimum capacity because they did not know the emergency service call number. In the analysis adjusted for income and education, females (odds ratio [OR], 0.40%; 95% confidence interval [CI], 0.20-0.82), older patients (OR, 0.24%; 95% CI, 0.09-0.63) and having at most one comorbidity (OR, 0.48%; 95% CI, 0.23-0.98) were factors for lower levels of knowledge or ideal decision-making capacity against stroke. CONCLUSIONS: Patients on hemodialysis, especially women and older people, have little knowledge about stroke.
Assuntos
Insuficiência Renal Crônica , Acidente Vascular Cerebral , Humanos , Feminino , Idoso , Estudos Transversais , Insuficiência Renal Crônica/complicações , Insuficiência Renal Crônica/terapia , Diálise Renal/efeitos adversos , Acidente Vascular Cerebral/complicações , Acidente Vascular Cerebral/epidemiologia , Comorbidade , Fatores de RiscoRESUMO
Background: Knee osteoarthritis (KOA) provokes pain, muscle weakness, and consequent impairment in activities of daily living. On the other hand, adherence to exercise training (ET) is associated with the attenuation of the impairments. The aims of the present study were to a) investigate adherence to ET in older adults with KOA diagnosed attending public service; and b) to analyze the physical function of the older adults with KOA who did not adhere to the ET in public service. Methods: The adherence to ET programs was analyzed retrospectively from each patient's date of KOA diagnosis. After assessing the adherence to ET, the physical function of these older adults diagnosed with KOA (n=19) was analyzed and compared with another group composed of asymptomatic sedentary older adults without evidence of KOA (ASKOA) (n=17). Results: Although all older adults with KOA received guidelines to practice ET, only 58% were able to start a program. Additionally, 100% of the sample could not perform ET uninterruptedly. According to the findings, close to 80% of older adults had difficulties scheduling ET sessions in public places. Subjects with KOA (12.1±3.1; IC95%:10.6-13.6) had worse lower limb functional capacity than ASKOA (8.1±1.0; IC95%:7.6-8.6; p<.001; δ=4.0 sec; d=1.7). Likewise, they had a lower dynamic balance than KOA (12.4±2.7; IC95%:11.1-13.7 vs. 8.0±1.1; IC95%:7.4-8.6; p<.001; δ=4.4 sec; d=2.1). Conclusions: The investigated sample has a lack of ET adherence by difficulties in scheduling ET sessions in public places. In addition, it demonstrated impairment in physical function in older adults with KOA.
RESUMO
BACKGROUND: Although there are studies on blood pressure (BP) and autonomic cardiac control (ACC) impairments caused by ergogenic aids, research has scarcely addressed this analysis during sleep. This study analyzed BP and ACC during sleep and wake periods in three groups of resistance training (RT) practitioners: ergogenic aid non-users, thermogenic supplement (TS) self-users, and anabolic-androgenic steroid (AAS) self-users. METHODS: RT practitioners were selected for the Control Group (CG; n = 15), TS self-users Group (TSG; n = 15), and AAS self-users Group (AASG; n = 15). All individuals underwent cardiovascular Holter monitoring (BP, ACC) during sleep and wake periods. RESULTS: The maximum systolic BP (SBP) during sleep was higher in AASG (p < 0.01) than CG (p < 0.001). CG had lower mean diastolic BP (DBP) than TSG (p < 0.01) and lower mean SBP (p = 0.009) than the other groups. Additionally, CG had higher values (p < 0.01) than TSG and AASG for SDNN and pNN50 during sleep. HF, LF, and LF/HF ratio values during sleep were statistically different in CG (p < 0.001) from the other groups. CONCLUSIONS: Our findings demonstrate that high doses of TS and AAS can impair cardiovascular parameters during sleep in RT practitioners who take ergogenic aids.
RESUMO
Individuals diagnosed with systemic arterial hypertension (SAH) are considered risk groups for COVID-19 severity. This study assessed differences in cardiac autonomic function (CAF) and functional capacity (FC) in SAH individuals without COVID-19 infection compared to SAH individuals post-COVID-19. Participants comprised 40 SAH individuals aged 31 to 80 years old, grouped as SAH with COVID-19 (G1; n = 21) and SAH without COVID-19 (G2; n = 19). CAF was assessed via heart rate variability (HRV), measuring R-R intervals during a 10-min supine period. Four HRV indices were analyzed through symbolic analysis: 0V%, 1V%, 2LV%, and 2UV%. FC assessment was performed by a 6-min walk test (6MWT). G1 and G2 showed no significant differences in terms of age, anthropometric parameters, clinical presentation, and medication use. G2 exhibited superior 6MWT performance, covering more distance (522 ± 78 vs. 465 ± 59 m, p < 0.05). Specifically, G2 demonstrated a moderate positive correlation between 6MWT and the 2LV% index (r = 0.58; p < 0.05). Shorter walking distances were observed during 6MWT in SAH individuals post-COVID-19. However, the study did not find impaired cardiac autonomic function in SAH individuals post-COVID-19 compared to those without. This suggests that while COVID-19 impacted FC, CAF remained relatively stable in this population.
RESUMO
INTRODUCTION: Smartphone and application use can improve communication and monitoring of chronic diseases, including chronic kidney disease, through self-management and increased adherence to treatment. OBJECTIVE: To assess smartphone use in patients with chronic kidney disease on dialysis and their willingness to use mobile applications as a disease self-management strategy. DESIGN AND SETTING: This was a cross-sectional study of chronic kidney disease patients on hemodialysis in the São Francisco Valley in the Northeast Region, Brazil. METHODS: The questionnaire developed by the authors was administered between April and June 2021. Cronbach's alpha coefficient for the construct was 0.69. Associations between the dependent and independent variables were determined using univariate analysis. Multivariate analysis with logistic regression analysis was also performed. RESULTS: A total of 381 patients were included, of whom 64% had a smartphone, although only 3.1% knew of a kidney disease-related application. However, 59.3% believed that using an application could help them manage their disease. Having a smartphone was associated with treatment adherence, higher educational attainment, and higher per capita income. Educational attainment remained an independent factor in multivariate analysis. CONCLUSION: More than 64% of patients had a smartphone, although few knew of applications developed for kidney disease. More than half of the population believed that technology use could benefit chronic kidney disease treatment. Smartphone ownership was more common among the younger population, with higher educational attainment and income, and was associated with greater adherence to hemodialysis sessions.