Higuchi fractal dimension applied to RR intervals in children with Attention Defi cit Hyperactivity Disorder

Background: Attention defi cit hyperactivity disorder (ADHD) is categorized by a lowered attention span, recklessness, and hyperactivity. Autonomic nervous system inequality has previously been studied using the same data by chaotic global techniques. We aim to compare the autonomic function of children with ADHD and controls by analyzing heart rate variability (HRV). Methods: 28 children with ADHD (22 boys, mean age 10.0 years ± 1.9 years) and 28 controls (15 boys, mean age 9.9 years ± 1.8 years) rested in supine position with spontaneous breathing for 20 minutes. Heart rate was recorded beat by beat. HRV analysis was performed by Higuchi Fractal Dimension technique. Results: ADHD promoted an increase in the Higuchi Fractal Dimension. The optimum value of Kmax was 10. Conclusion: ADHD signifi cantly altered cardiac autonomic modulation as measured by the Higuchi fractal dimension of HRV. It can therefore be stated that ADHD has increased the complexity of the HRV  signal through cardiac autonomic modulation

Metabolic syndrome in elderly from a northeastern brazilian city

Introduction: Population aging is a global reality. In Brazil, it is so expressive and in 2050 is estimated that the number of men and women over 80 years old can overcome the 20-24 years old population and also children under 14 years old. Metabolic syndrome is defined as a set of cardiovascular risk factors, detection and intervention in this age group may decrease cardiovascular mortality. We aimed to estimate the prevalence of metabolic syndrome (MS) in elderly patients in a northeastern Brazilian city. Method: This is a quantitative, observational, cross-sectional and population-based study. The population consisted of non-institutionalized individuals aged> 60 years old, attended in the Family Health Strategy (FHS) and residents in Cajazeiras, PB, Brazil. For the diagnosis of metabolic syndrome we considered the criteria recommended by the International Federation of Diabetes. Results: We studied 351 elderly patients with 72.4+8.7 years old and 66.1% were female. The prevalence of MS was 69.8% and the most frequent criterion was increased waist circumference (82.6%), followed by high triglycerides (81.5%) and low HDL-cholesterol (80.6%). We observed a statistically significant positive association between MS and women [OR: 1.38 (95% CI: 1.18 to 1.63)] and housing in urban areas [OR: 1.23 (1.02 to 1.48)]. Conclusion: There is a high prevalence of MS among the elderly mainly in women and those living in urban areas

MEDICINES WASTE POLICIES AND THE POPULATION KNOWLEDGE IN BRAZIL

Objective: To investigate the degree of knowledge of the patients enrolled in the Unified Health System of the Medicine School of ABC (Faculdade de Medicina do ABC) regarding the proper use and disposal of medicaments. Methods: Participants were recruited for convenience, during their medical appointments at the clinic of the Medical School of ABC (Santo André, Sao Paulo, Brazil) in the period from 04 August to 30 September 2014. Data collection was conducted through a self-administered poll designed specifically for the purpose of this study, which consisted of 25 questions multiple choice about socioeconomic issues and the subject disposal of drugs, consumption and environmental pollution. Results: We selected the 140 patients’ polls. Most of them is of white ethnicity (58%) and female (58%). Level of education: 31% have completed secondary education (31%) or incomplete graduation (19%). Most of the participants (76%) buy drugs without a prescription, and most families (76%) seek understanding by reading the labels. 71.43% reported knowing that incorrect disposal of drugs could contaminate the environment, but 78% reported never having seen or received information about these. After using, 22.15% maintains the medication at home for future use, 55% of subjects reported improper disposal sites and 13% are delivered in health care institutions. Conclusion: Our study has showed that most participants inappropriately use and dispose of drugs, even though they know they can contaminate the environment

Os efeitos do exercício aeróbico sobre os parâmetros bioquímicos em indivíduos com DRC em hemodiálise: Um estudo longitudinal

Background: Chronic kidney disease is directly related to cardiovascular disorders. Guided physical exercises significantly improve the adverse effects of dialytic treatment. Objective: To analyze changes in biochemical parameters of subjects with chronic kidney disease undergoing moderate exercise during hemodialysis. Methods: This is an experimental study composed of 54 subjects submitted to hemodialysis, split into a control group and a group with intervention. The experimental group underwent three weekly sessions of aerobic exercise, performed during hemodialysis sessions, with a duration of 30 minutes, for 12 weeks. The blood parameters of both groups were compared. Results: Statistically significant differences were observed between pre (p=0.001) and post-exercise protocol for urea (p=0.006), calcium (p=0.001), alanine aminotransferase (p=0.020) and sodium (p=<0.001). In the control group, we observed significant differences for the calcium variable (p<0.001), alanine aminotransferase (p=0.024), hematocrit (p=0.015), calcium vs phosphorus (p=0.018), and sodium (p=0.023), before and after the period. Conclusion: Aerobic training during hemodialysis was able to maintain blood level stability in patients with chronic kidney disease, both during and at the end of the protocol, even considering increased blood flow. This trial is registered in the Brazilian registry of clinical Trials - number RBR-7354r6. Registration date: July 5, 2018 at 12:59 PM. Last Update: July 24, 2018 at 10:24 AM. Identification of the test - UTN Number: U1111-1216-8272.Introdução: A doença renal crônica está diretamente relacionada a distúrbios cardiovasculares. Exercícios físicos guiados melhoram significativamente os efeitos adversos do tratamento dialítico. Objetivo: Analisar as alterações nos parâmetros bioquímicos de indivíduos com doença renal crônica submetidos a exercícios moderados durante a hemodiálise. Método: Este é um estudo experimental composto por 54 indivíduos submetidos à hemodiálise, divididos em um grupo controle e um grupo com intervenção. O grupo experimental passou por três sessões semanais de exercício aeróbico, realizadas durante as sessões de hemodiálise, com duração   de 30 minutos, por 12 semanas. Os parâmetros sanguíneos de ambos os grupos foram comparados. Resultados: Diferenças estatisticamente significativas foram observadas entre o protocolo pré (p=0,001) e pós-exercício para urea (p=0,006), cálcio (p=0,001), alanina aminotransferase (p=0,020) e sódio (p=&0.001). No grupo controle, observamos diferenças significativas para a variável cálcio (p<0.001), alanina aminotransferase (p=0,024), hematócrito (p=0,015), cálcio vs fósforo (p=0,018) e sódio (p=0,023), antes e depois do período. Conclusão: O treinamento aeróbico durante a hemodiálise foi capaz de manter a estabilidade do nível sanguíneo em pacientes com doença renal crônica, tanto durante quanto no final do protocolo, considerando mesmo o aumento do fluxo sanguíneo. Este ensaio está registrado no registro brasileiro de Ensaios Clínicos - número RBR-7354r6. Data de inscrição: 5 de julho de 2018 às 12h59. Última atualização: 24 de julho de 2018 às 10h24. Identificação do teste - UTN Número: U1111-1216-8272

Long-term cardiac changes in patients with systemic lupus erythematosus

Abstract\ud \ud \ud \ud Background\ud \ud The aim of this study was evaluate the late-onset repercussions of heart alterations of patients with systemic lupus erythematosus (SLE) after a 13-year follow up.\ud \ud \ud \ud Methods\ud \ud A historical prospective study was carried out involving the analysis of data from the charts of patients with a confirmed diagnosis of lupus in follow up since 1998. The 13-year evolution was systematically reviewed and tabulated to facilitate the interpretation of the data.\ud \ud \ud \ud Results\ud \ud Forty-eight patient charts were analyzed. Mean patient age was 34.5 ± 10.8 years at the time of diagnosis and 41.0 ± 10.3 years at the time of the study (45 women and 3 men). Eight deaths occurred in the follow-up period (two due to heart problems). Among the alterations found on the complementary exams, 46.2% of cases demonstrated worsening at reevaluation and four patients required a heart catheterization. In these cases, coronary angioplasty was performed due to the severity of the obstructions and one case required a further catheterization, culminating in the need for surgical myocardial revascularization.\ud \ud \ud \ud Conclusion\ud \ud The analysis demonstrated progressive heart impairment, with high rates of alterations on conventional complementary exams, including the need for angioplasty or revascularization surgery in four patients. These findings indicate the need for rigorous cardiac follow up in patients with systemic lupus erythematosus.The study was performed at the School of Medicine of Sao Jose do Rio Preto

Heart Rate Variability During Hemodialysis in Patients with Chronic Renal Disease

Background: Few studies evaluated cardiac autonomic responses induced by hemodialysis. We aimed to evaluate cardiac autonomic regulation during hemodialysis in haemodynamically stable patients with chronic renal disease. Method: Heart rate variability (HRV) was analyzed in the time and frequency domains in the following periods: Pre-dialysis (10 minutes before); Hemodialysis (240 minutes). Results: The standard deviation of all normal RR intervals (SDNN) increased 60-90min after hemodialysis compared to pre-hemodialysis (29.77 ± 12ms vs. 51.70 ± 41.6ms - p<0.05). The percentage of adjacent RR intervals with a difference of duration greater than 50ms (pNN50) also raised 180-210 min after hemodialysis compared to 0-30 min after hemodialysis (1.29 ± 3.5 vs. 4.37 ± 7.8 - p<0.05). Low frequency (LF) (ms2) increased 150-180 min after hemodialysis compared to pre-hemodialysis (168.2±179.8 ms2 vs. 562.6±455.7 ms2: p<0.05) and high frequency (HF) (ms2) band raised 150-180min and 180-210 after hemodialysis compared to pre-hemodialysis (59.3 ± 70.78ms2 vs. 212.5 ± 304.9 ms2 vs. 186.3 ± 335.1 ms2: p<0.05). Conclusion: Hemodialysis acutely increased HRV, raising the parasympathetic component of  HRV

Cardiovascular responses induced by acute video game boxing performance in healthy women

BACKGROUND: Previous studies suggested that some interactive video games induce cardiovascular responses. However, some different styles of video games have not been investigated. OBJECTIVE: We aimed to evaluate cardiovascular responses induced by video game boxing performance in healthy women. METHOD: We evaluated ten female sedentary volunteers, aged 20.9 ± 1.4 years, weight 58.7 ± 8.0 kg, height 163.2 ± 5.4cm. All subjects were weighed and measured. Their heart rate, blood pressure and lactate levels were recorded before and after video game performance. The volunteers played a Sony video game (Nintendo® Wii) by using the boxing method, in which all volunteers played for 10 minutes without interruption. At the end of the game the volunteers were reassessed using the same parameters mentioned above. RESULTS: At the end of the video game boxing performance we observed highly significant increases of lactate production (p < 0.0035) and the double product (heart rate vs. systolic blood pressure) was also higher (p < 0.0001). Both parameters indicate that the performance increased demands of the cardiovascular system. CONCLUSION: We conclude that a ten-minute video game boxing performance induces cardiovascular responses similar to aerobic exercise. This may be a practical form of exercise, but care should be exercised concerning subjects with cardiovascular disorders.BACKGROUND: Estudos anteriores sugerem que certos jogos de vídeo interativos induzem respostas cardiovasculares. No entanto, alguns estilos diferentes de jogos de vídeo nao foram investigados. OBJETIVO: Nosso objetivo foi avaliar as respostas cardiovasculares induzidas pelo video game desempenho boxe em mulheres saudáveis. MÉTODO: Foram avaliadas dez voluntárias sedentárias do sexo feminino, com idades de 20,9 ± 1,4 anos, peso 58,7 ± 8,0 kg, estatura 163,2 ± 5,4 cm. Todas foram pesadas e medidas. Suas frequências cardíacas, pressões arteriais e níveis de lactato foram registrados antes e depois de um jogo em vídeo game. As voluntárias jogaram um jogo de vídeo Sony (Nintendo ® Wii) usando a modalidade boxe, na qual todas jogaram por 10minutos ininterruptos. No final do jogo, as voluntárias foram reavaliadas utilizando os mesmos parâmetros mencionados acima. RESULTADOS: Ao final da performance de vídeo game boxe observamos aumentos altamente significativos de produção de lactato (p < 0.0035) e do duplo produto (frequência cardíaca versus pressão arterial sistólica) também foi maior (p < 0.0001). Ambos os parâmetros indicam que o desempenho aumentou a demanda de trabalho do sistema cardiovascular. CONCLUSÃO: Concluímos que uma performance de jogo de vídeo de boxe de dez minutos induz respostas cardiovasculares similares aos exercícios aeróbicos. Esta pode ser uma forma prática de exercício, mas cuidado deve ser exercido em relação a indivíduos com doenças cardiovasculares

Indicators of Eating Disorders in Sexually Abused Brazilian Adolescents: Family and School Contexts

Eating disorders, characterized by abnormal eating behaviors, are among a wide variety of psychiatric conditions that mainly affect children and adolescents. These disorders have a multifactorial origin and can be associated with restrictive diets, negative feelings, harmful family relationships, and post-traumatic stress. Thus, this study’s objective was to evaluate the association between indicators of eating disorders and family and school contexts in Brazilian adolescents who previously experienced sexual abuse and examine the findings based on sex. National School Health Survey data were utilized. Among 102,301 students between 11 and 19 years of age, 4124 reported having experienced sexual abuse and were included in this study. Self-report questionnaires were used to assess participants’ health status and the presence of risk behaviors, which were examined through multivariate analysis using a Poisson regression model. The results indicated positive relationships between self-induced vomiting, laxative misuse, and other purgative methods and infrequent meals with family, hunger, and the presence of violence in students’ daily lives, regardless of sex (p p p < 0.05). In conclusion, body dissatisfaction, negative feelings about one’s body, laxative misuse, self-induced vomiting, and purgative methods were found to be associated with factors in family and school contexts such as hunger, infrequent meals with family, family violence, distant relationships with parents, and bullying at school in adolescents who have previously experienced sexual abuse