Mortalidade neonatal em unidades de cuidados intensivos no Brasil Central

OBJETIVO: Identificar fatores prognósticos de mortalidade neonatal em unidades de cuidados intensivos. MÉTODOS: Realizou-se estudo de coorte de nascidos vivos do município de Goiânia, no período de novembro de 1999 a outubro de 2000. Procedeu-se à vinculação das bases de dados das declarações de nascidos vivos e de óbitos, das quais as variáveis de exposição foram extraídas. Adicionalmente, foi implementado um sistema ativo de vigilância de mortalidade neonatal. A variável de efeito foi constituída dos recém-nascidos admitidos nas unidades de cuidados intensivos que sobreviveram (n=713) e dos que morreram (n=162). Utilizou-se o modelo de regressão de Cox para identificar fatores associados à mortalidade neonatal e a curva Receiver Operating Characteristic para avaliar a acurácia de variáveis estatisticamente significantes em modelo multivariado. Taxas de mortalidade ajustadas por peso de nascimento e Apgar do quinto minuto foram calculadas para cada unidade de cuidados intensivos. RESULTADOS: Baixo peso ao nascer e Apgar do quinto minuto permaneceram associados ao óbito neonatal, de forma independente. Peso ao nascer igual a 2.500 g apresentou acurácia de 0,71 (IC 95%: 0,65-0,77) na predição de óbito neonatal (sensibilidade =72,2%). Observou-se ampla variação nas taxas de mortalidade entre as unidades de cuidados intensivos (9,5%-48,1%) sendo que duas delas permaneceram com taxas significantemente mais altas após o ajuste da mortalidade pelo peso de nascimento e Apgar. CONCLUSÕES: Os resultados mostraram que o peso de nascimento é uma variável sensível para uso em triagens em programas de vigilância de óbito neonatal e pode identificar as unidades de cuidados intensivos com altas taxas de mortalidade para implementação de ações preventivas e para intervenções no período intra-parto.OBJECTIVE: To identify potential prognostic factors for neonatal mortality among newborns referred to intensive care units. METHODS: A live-birth cohort study was carried out in Goiânia, Central Brazil, from November 1999 to October 2000. Linked birth and infant death certificates were used to ascertain the cohort of live born infants. An additional active surveillance system of neonatal-based mortality was implemented. Exposure variables were collected from birth and death certificates. The outcome was survivors (n=713) and deaths (n=162) in all intensive care units in the study period. Cox's proportional hazards model was applied and a Receiver Operating Characteristic curve was used to compare the performance of statistically significant variables in the multivariable model. Adjusted mortality rates by birth weight and 5-min Apgar score were calculated for each intensive care unit. RESULTS: Low birth weight and 5-min Apgar score remained independently associated to death. Birth weight equal to 2,500g had 0.71 accuracy (95% CI: 0.65-0.77) for predicting neonatal death (sensitivity =72.2%). A wide variation in the mortality rates was found among intensive care units (9.5-48.1%) and two of them remained with significant high mortality rates even after adjusting for birth weight and 5-min Apgar score. CONCLUSIONS: This study corroborates birth weight as a sensitive screening variable in surveillance programs for neonatal death and also to target intensive care units with high mortality rates for implementing preventive actions and interventions during the delivery period

The Performance, Physiology and Morphology of Female and Male Olympic-Distance Triathletes

Sex differences in triathlon performance have been decreasing in recent decades and little information is available to explain it. Thirty-nine male and eighteen female amateur triathletes were evaluated for fat mass, lean mass, maximal oxygen uptake (VO2 max), ventilatory threshold (VT), respiratory compensation point (RCP), and performance in a national Olympic triathlon race. Female athletes presented higher fat mass (p = 0.02, d = 0.84, power = 0.78) and lower lean mass (p < 0.01, d = 3.11, power = 0.99). VO2 max (p < 0.01, d = 1.46, power = 0.99), maximal aerobic velocity (MAV) (p < 0.01, d = 2.05, power = 0.99), velocities in VT (p < 0.01, d = 1.26, power = 0.97), and RCP (p < 0.01, d = 1.53, power = 0.99) were significantly worse in the female group. VT (%VO2 max) (p = 0.012, d = 0.73, power = 0.58) and RCP (%VO2 max) (p = 0.005, d = 0.85, power = 0.89) were higher in the female group. Female athletes presented lower VO2 max value, lower lean mass, and higher fat mass. However, females presented higher values of aerobic endurance (%VO2 max), which can attenuate sex differences in triathlon performance. Coaches and athletes should consider that female athletes can maintain a higher percentage of MAV values than males during the running split to prescribe individual training. Keywords: VO2 max; female athlete; sports medicine; sports physiology; triathlo

Effects of Biological Age on Athletic Adaptations to Combined Plyometric and Sprint with Change of Direction with Ball Training in Youth Soccer Players

There is evidence for the effectiveness of youth combined plyometric and sprint with change of direction (COD) training. However, the evidence is not well-known regarding the in-season effects of biological age (peak height velocity—PHV) on the motor adaptive processes following combined plyometric and COD with ball training (P-CODBT) in youth soccer players. This study aimed to examine the in-season effects of P-CODBT (8 weeks and twice a week) on the athletic performances of male youth soccer players, circa- and post-PHV. In a randomized controlled training study with pre-to-post measurements, forty-eight male players were assigned into two experimental (performing P-CODBT; n = 12 × circa-PHV and n = 12 × post-PHV) and two control groups (CONG; n = 12 × circa-PHV and n = 12 × post-PHV). The pre- and post-training participants were assessed for their anthropometric, linear sprinting with and without a ball, COD speed with and without a ball, vertical jump, dynamic balance, and endurance-intensive performances. After the intervention, the experimental condition induced significant (all p < 0.0001) and small to large effect size (ES = 0.263–3.471) additional gains only on explosive measures compared to CONG. Both the experimental (all p < 0.0001; ES = 0.338–1.908) and control (p = 0.011–0.0001; ES = 0.2–1.8) groups improved their athletic performances over the training period. The improvements generated by p-CODBT were not affected by biological age. In-season short-term P-CODBT (twice a week) could be safe way to generate benefits in explosive performances in youth soccer players, which are relevant components of match-winning actions in soccer

Effects of Four Weeks of Plyometric Training Performed in Different Training Surfaces on Physical Performances in School Children: Age and Sex Comparisons

Short- to middle-term plyometric training has been shown to be an effective method to promote youth fitness and health. However, there is no knowledge of previous studies that investigated the sex and age effects on physical fitness following different PT surfaces (i.e., firm vs. sand) in schoolchildren. This study examined the effects of age and sex on explosive and high-intensity responses following plyometric training (4 weeks, twice/week) performed on firm vs. sand surfaces in untrained schoolchildren. Ninety girls and ninety boys (under 8: age = 7.1 ± 0.5 and 7.1 ± 0.4 years; under 10: age = 9.0 ± 0.4 and 9.0 ± 0.5 years; under 12: age = 11.0 ± 0.5 and 11.0 ± 0.5 years, respectively) participated in a randomized and parallel training design with pre-to-post testing. Participants were allocated (i.e., 30 boys and 30 girls for each group) into either two experimental groups (firm group: performing plyometrics on a clay surface and sand group: performing plyometrics on a dry surface of 20 cm deep sand) or a control group (CG, habitual physical education classes) within their corresponding age groups. Children were tested for sprint, jumping and change of direction speed performances before and after 4 weeks of plyometric training. Both experimental groups induced more significant improvements in all assessed variables than CG (p 0.80), whereas both surfaces induced similar improvements (p > 0.05). Older boys achieved better performances than their younger counterparts (p < 0.05) and older girls (p < 0.0001), respectively. This finding showed that age and sex could affect explosive and high-intensity performances during childhood after a short-term plyometric training. In contrast, the training-induced fitness changes were not influenced by the type of surface

Return to classes impact on mental health of university students during the COVID-19 pandemic

BACKGROUND The Coronavirus Disease 2019 (COVID-19) pandemic and the necessary social isolation and distancing measures - that were adopted to prevent spreading the virus, including the suspension of university classes - negatively impacted the mental health of young adults. The aim of the current study was to investigate whether returning to online classes, even not presential, during the social isolation of the COVID-19 pandemic, affected the mental health of university students. METHODS Forty students (10 men and 30 women) (age, 22.3±3.8 years; body mass, 62.5±17.8 kg; height, 165.6±8.7cm) from undergraduate health courses participated in the study. The students answered a self-administered questionnaire designed to gather personal and quarantine information as well as information about the frequency of depression (PHQ-9) and anxiety (GAD-7) symptoms. The questionnaire was answered before and after the return to online classes. RESULTS There was a significantly lower frequency of depression symptoms after the return to online classes (Z = -2.27; p = 0.02). However, there was no difference in anxiety symptoms before and after returning to online classes (Z = -0.51; p = 0.61). CONCLUSIONS Return to online classes positively impacted the mental health (decrease of frequency of depression symptoms) of university students. Future studies are needed to observe whether the changes observed after returning to school are maintained over time

Comparison of physiological and psychobiological acute responses between high intensity functional training and high intensity continuous training

Little is known about the physiological and psychobiological responses that occur during and after high intensity functional training (HIFT). We compared physiological and psychobiological responses during and after a HIFT session with a high intensity continuous training (HICT) session. Twenty-one trained and healthy men were submitted to 20-min session of HIFT and HICT on separate days. The heart rate, blood lactate concentration [Lac], levels of state anxiety, rates of perceived exertion (RPE) and perceived discomfort (RPE-D), and affective valence were measured. Exercise intensity of the HICT was adjusted to the mean heart rate obtained in the HIFT session. The highest heart rate in the training sessions was significantly higher in HIFT (mean ​± ​standard deviation [SD]: [187 ​± ​9] bpm) than in HICT (mean ​± ​SD: [178 ​± ​8] bpm, p ​< ​0.001). The [Lac] was significantly higher immediately after the HIFT (median [interquartile range (IQR)]: 6.8 [4.4] mmol/L) than the HICT (median [IQR]: 3.2 [1.9], p ​= ​0.021) and 10 ​min after (median [IQR]: HIFT ​= ​6.8 [4.9] mmol/L, HICT ​= ​2.9 [2.4] mmol/L, p ​= ​0.003). The RPE was also significantly higher in the HIFT (median [IQR]: HIFT ​= ​20 [2], HICT ​= ​15 [5], p ​= ​0.009). The physiological and psychobiological responses compared between HIFT and HICT sessions are similar, except for the higher heart rate obtained during the sessions, [Lac] and RPE. Probably, the results found for the higher heart rate obtained during the sessions, [Lac] and RPE may be explained by the higher participation of the anaerobic glycolytic metabolism during the HIFT session

Amateur Female Athletes Perform the Running Split of a Triathlon Race at Higher Relative Intensity than the Male Athletes: A Cross-Sectional Study

Maximal oxygen uptake (V˙O2max), ventilatory threshold (VT) and respiratory compensation point (RCP) can be used to monitor the training intensity and the race strategy, and the elucidation of the specificities existing between the sexes can be interesting for coaches and athletes. The aim of the study was to compare ventilatory threshold (VT), respiratory compensation point (RCP), and the percentage of the maximal aerobic speed (MAS) that can be maintained in a triathlon race between sexes. Forty-one triathletes (22 men and 19 women), 42.1 ± 8.4 (26 to 60) years old, that raced the same Olympic triathlon underwent a cardiorespiratory maximal treadmill test to assess their VT, RPC, and MAS, and race speed. The maximal oxygen uptake (V˙O2max) (54.0 ± 5.1 vs. 49.8 ± 7.7 mL/kg/min, p < 0.001) and MAS (17 ± 2 vs. 15 ± 2 km/h, p = 0.001) were significantly higher in male than in female athletes. Conversely, there were no sex differences according to the percentage of V˙O2max reached at VT (74.4 ± 4.9 vs. 76.1 ± 5.4%, p = 0.298) and RCP (89.9 ± 3.6 vs. 90.6 ± 4.0%, p = 0.560). The mean speed during the race did not differ between sexes (12.1 ± 1.7 km/h and 11.7 ± 1.8 km/h, p = 0.506, respectively). Finally, men performed the running split at a lower percentage of speed at RCP than women (84.0 ± 8.7 vs. 91.2 ± 7.0%, respectively, p = 0.005). Therefore, male and female athletes accomplished the running split in an Olympic triathlon distance at distinct relative intensities, as female athletes run at a higher RCP percentage

Antimicrobial activity of per acetic acid for trans-operative disinfection of endodontic files

Reducing the accumulation of microorganisms on an endodontic file during endodontic treatment is important to limit recontamination of the root canal and increase likelihood of successful treatment outcome. Objective: To compare the antimicrobial activity of peracetic acid (PA), isopropyl alcohol and acetone against a range of bacteria and also for disinfection of contaminated endodontic K-files. Material and Methods: Antimicrobial activities of PA, isopropyl alcohol and acetone were compared against Staphylococcus aureus, Enterococcus faecalis, Escherichia coli, Pseudomonas aeruginosa, vancomycin resistant E. faecalis (VRE) and meticillin resistant S. aureus (MRSA), using minimum bactericidal concentration (MBC) and time-kill assays. Test solutions at different exposure times (15 s and 30 s) were assessed for treatment of endodontic files acting as carriers of E. faecalis-contaminated dental debris. Results: All bacteria were susceptible to PA (MBC range 0.25-1%), acetone (MBC range 50-60%) and isopropyl alcohol (30-40%). Using a time-kill assay of the antimicrobials at the determined MBC, all test microorganisms, with the exception of E. faecalis (VRE) 7766 were killed after 15 s exposure. In the case of E. faecalis 7766, viable cells remained detectable after 120 s exposure to acetone. Testing disinfection of endodontic K-files, previously coated with dental debris containing E. faecalis, it was found that PA (2%) completely killed E. faecalis after 15 s exposure. However, even after 30 s exposure, isopropyl alcohol (80%) and acetone (80%) had limited disinfecting activity. Conclusion: Extrapolation of these results to clinical practice would suggest that PA would be the most effective agent for trans-operative disinfection of endodontic K-files during treatment of a single patient