Nível de flexibilidade do quadril de idosas praticantes e não praticantes de hidroginástica

Introduction: Frequent water aerobics have certain advantages in old age, through body changes that are part of the normal course of aging, thus strengthening the systems involved in improving body flexibility, autonomy, and quality of life of the elderly. Objective: To analyze the hip flexibility level of the elderly women who attend and those who do not attend the water gymnastics at the Elderly Living Center. Results and discussion: There were a noticeable difference between the groups; More specifically, older women who do water aerobics have greater flexibility than older women who do not water aerobics, but this difference was not so great. This fact may be justified because of what is seen in practice, older women usually seek water aerobics when they have functional restrictions in some joint, pain, decreased flexibility or the presence of rheumatic disease such as osteoporosis, because this modality of Exercise promotes low impact on the body's joints to the physical properties of water, which reduces body weight, making walking easier without affecting the joints. Conclusion: water aerobics can promote functional benefits, such as the development of the level of joint flexibility, contributing to autonomy and assisting in the practice of daily activities, enabling the improvement of posture and coordination of body segments, and also the reduction of joint tensions.Introdução: A hidroginástica frequente possui determinadas vantagens na terceira idade, através das alterações corporais que fazem parte do curso normal do envelhecimento, assim fortalecendo os sistemas envolvidos na melhoria da flexibilidade corporal, da autonomia e da qualidade de vida dos idosos. Objetivo: Analisar o nível de flexibilidade do quadril das idosas que frequentam e as que não frequentam a hidroginástica nos Centro Convivência do Idoso. Materiais e métodos: Tratou-se de uma pesquisa descritiva exploratória com caráter qualitativo e quantitativo, desenvolvida com 50 idosas praticantes e não praticantes de hidroginástica dos Centro de convivência dos idosos. Resultados e discussão: Houve uma diferença notória entre os grupos; mais especificamente, as idosas que praticam hidroginástica têm uma flexibilidade maior do que as idosas que não praticam hidroginástica, mas essa diferença não foi tão grande. Este fato pode ser justificado por causa do que é visto na prática, as mulheres com maior idade geralmente procuram a hidroginástica quando têm restrições funcionais em alguma articulação, dor, diminuição da flexibilidade ou a presença de enfermidade reumática, como osteoporose, pois essa modalidade de exercício promove baixo impacto nas articulações do corpo às propriedades físicas da água, que reduz o peso corporal, tornando mais fácil a locomoção sem afetar as articulações. Conclusão: A hidroginástica, pode promover benefícios funcionais, como o desenvolvimento do nível de flexibilidade das articulações, contribuindo para a autonomia e auxiliando na prática das atividades no dia-a-dia, possibilitando a melhora da postura e da coordenação dos segmentos do corpo, e ainda a redução das tensões articulares

Long-term safety and efficacy of patisiran for hereditary transthyretin-mediated amyloidosis with polyneuropathy: 12-month results of an open-label extension study

Background: Hereditary transthyretin-mediated amyloidosis is a rare, inherited, progressive disease caused by mutations in the transthyretin (TTR) gene. We assessed the safety and efficacy of long-term treatment with patisiran, an RNA interference therapeutic that inhibits TTR production, in patients with hereditary transthyretin-mediated amyloidosis with polyneuropathy. Methods: This multicentre, open-label extension (OLE) trial enrolled patients at 43 hospitals or clinical centres in 19 countries as of Sept 24, 2018. Patients were eligible if they had completed the phase 3 APOLLO or phase 2 OLE parent studies and tolerated the study drug. Eligible patients from APOLLO (patisiran and placebo groups) and the phase 2 OLE (patisiran group) studies enrolled in this global OLE trial and received patisiran 0·3 mg/kg by intravenous infusion every 3 weeks with plans to continue to do so for up to 5 years. Efficacy assessments included measures of polyneuropathy (modified Neuropathy Impairment Score +7 [mNIS+7]), quality of life, autonomic symptoms, nutritional status, disability, ambulation status, motor function, and cardiac stress, with analysis by study groups (APOLLO-placebo, APOLLO-patisiran, phase 2 OLE patisiran) based on allocation in the parent trial. The global OLE is ongoing with no new enrolment, and current findings are based on the interim analysis of the patients who had completed 12-month efficacy assessments as of the data cutoff. Safety analyses included all patients who received one or more dose of patisiran up to the data cutoff. This study is registered with ClinicalTrials.gov, NCT02510261. Findings: Between July 13, 2015, and Aug 21, 2017, of 212 eligible patients, 211 were enrolled: 137 patients from the APOLLO-patisiran group, 49 from the APOLLO-placebo group, and 25 from the phase 2 OLE patisiran group. At the data cutoff on Sept 24, 2018, 126 (92%) of 137 patients from the APOLLO-patisiran group, 38 (78%) of 49 from the APOLLO-placebo group, and 25 (100%) of 25 from the phase 2 OLE patisiran group had completed 12-month assessments. At 12 months, improvements in mNIS+7 with patisiran were sustained from parent study baseline with treatment in the global OLE (APOLLO-patisiran mean change –4·0, 95 % CI –7·7 to −0·3; phase 2 OLE patisiran –4·7, –11·9 to 2·4). Mean mNIS+7 score improved from global OLE enrolment in the APOLLO-placebo group (mean change from global OLE enrolment −1·4, 95% CI –6·2 to 3·5). Overall, 204 (97%) of 211 patients reported adverse events, 82 (39%) reported serious adverse events, and there were 23 (11%) deaths. Serious adverse events were more frequent in the APOLLO-placebo group (28 [57%] of 49) than in the APOLLO-patisiran (48 [35%] of 137) or phase 2 OLE patisiran (six [24%] of 25) groups. The most common treatment-related adverse event was mild or moderate infusion-related reactions. The frequency of deaths in the global OLE was higher in the APOLLO-placebo group (13 [27%] of 49), who had a higher disease burden than the APOLLO-patisiran (ten [7%] of 137) and phase 2 OLE patisiran (0 of 25) groups. Interpretation: In this interim 12-month analysis of the ongoing global OLE study, patisiran appeared to maintain efficacy with an acceptable safety profile in patients with hereditary transthyretin-mediated amyloidosis with polyneuropathy. Continued long-term follow-up will be important for the overall assessment of safety and efficacy with patisiran. Funding: Alnylam Pharmaceuticals

COVID-19 symptoms at hospital admission vary with age and sex: results from the ISARIC prospective multinational observational study

Background: The ISARIC prospective multinational observational study is the largest cohort of hospitalized patients with COVID-19. We present relationships of age, sex, and nationality to presenting symptoms. Methods: International, prospective observational study of 60 109 hospitalized symptomatic patients with laboratory-confirmed COVID-19 recruited from 43 countries between 30 January and 3 August 2020. Logistic regression was performed to evaluate relationships of age and sex to published COVID-19 case definitions and the most commonly reported symptoms. Results: ‘Typical’ symptoms of fever (69%), cough (68%) and shortness of breath (66%) were the most commonly reported. 92% of patients experienced at least one of these. Prevalence of typical symptoms was greatest in 30- to 60-year-olds (respectively 80, 79, 69%; at least one 95%). They were reported less frequently in children (≤ 18 years: 69, 48, 23; 85%), older adults (≥ 70 years: 61, 62, 65; 90%), and women (66, 66, 64; 90%; vs. men 71, 70, 67; 93%, each P < 0.001). The most common atypical presentations under 60 years of age were nausea and vomiting and abdominal pain, and over 60 years was confusion. Regression models showed significant differences in symptoms with sex, age and country. Interpretation: This international collaboration has allowed us to report reliable symptom data from the largest cohort of patients admitted to hospital with COVID-19. Adults over 60 and children admitted to hospital with COVID-19 are less likely to present with typical symptoms. Nausea and vomiting are common atypical presentations under 30 years. Confusion is a frequent atypical presentation of COVID-19 in adults over 60 years. Women are less likely to experience typical symptoms than men