Perfil lipídico e uso de anti-TNF-α

AbstractThe use of anti-TNF-α has been associated with several changes in lipid profile, although some study results are conflicting. The knowledge of this fact is of great importance when one observes at the association between rheumatic diseases and accelerated atherogenesis. The aim of this analysis was search for changes in lipid profile in anti TNF-α users in the population of Southern Brazil and its association with duration of use, indications, patient gender and type of anti-TNF. For this purpose, we studied the profiles of total cholesterol (TC), HDL cholesterol (HDLc), LDL cholesterol (LDLc), atherogenic index (ATI) and triglycerides (TGs) of 58 patients (42 with rheumatoid arthritis and 16 with spondyloarthritis) before and after using this drug for a median of 16.0 months. There were no changes in the levels of TC, HDLc, LDLc and ATI (P=NS). However, there was a significant increase in TG levels (P=0.03). The median difference between first and second TG measurements was 16mg/dL and this increase was not associated with gender, time of use, use indication or type of anti TNF-α (P=NS). It was concluded that the use of anti TNF-α is associated with increased values of TG

Occupational Exposure to Solar Radiation and the Eye: A Call to Implement Health Surveillance of Outdoor Workers

Globally, hundreds of millions of outdoor workers are exposed to solar radiation (SR) for most of their work. Such occupational exposure is known to induce various adverse health effects on the eyes, mainly related to its ultraviolet (UV) component. The present work is a call to action to raise awareness of the need for health surveillance to prevent chronic ocular diseases in outdoor workers. Photo-chemical chronic damage can induce pterygium at the eye's outer layer and cataracts in the lens. Considering carcinogenic effects, rare squamous-cell tumors of the cornea and/or the conjunctiva and ocular melanomas are associated with UV radiation exposure. Solar UV-related eye diseases should be considered "occupational diseases" when workers have sufficient exposure. Still, they are often not recognized and/ or frequently not reported to the national compensation authorities. Therefore, to prevent the burden of these work -related eye pathologies, an adequate risk assessment with identification of appropriate preventive measures and a provision of periodic health surveillance to the exposed workers, particularly those at higher risk of exposure or with individual susceptibility, should be urgently implemented

Treatment of orgasmic urinary incontinence with physical therapy and weight loss

Importância do problema: Incontinência urinária orgásmica (IUO) é um tipo incomum dentre os tipos de perda urinária. O tratamento para esta condição ainda não está estabelecido. Objetivo: Descreve o caso de uma paciente que apresentou IUO e foi submetida ao tratamento multidisciplinar. Metodologia: Paciente obesa, 50 anos, relatando, durante a a consulta, IUO com dois parceiros sexuais. Tratamento farmacológico com imipramina e anticolinérgicos foram realizados sem sucesso. Resultados: Paciente apresentou importante melhora subjetiva após a realização de uma combinação de tratamento de biofeedback, eletroestimulação, treinamento muscular do assoalho pélvico e medidas comportamentais, como perda de peso, incrementada após a cirurgia bariátrica. Comentários: IUO é uma doença complexa, sem tratamentos padrão e precisa ser mais bem investigada com amostras prospectivas maiores. Abordagens fisioterapêuticas combinadas devem ser consideradas quando se discute o tratamento.Importance of the problem: Orgasmic urinary incontinence (OUI) is an uncommon finding among other types of urinary leakage. Treatment of this condition is not established. Aims: To describe the case of a patient who presented OUI and had a multidisciplinary treatment. Methods: An obese, 50-year patient complained of OUI with two sexual partners during her consultation. Pharmacological treatment with imipramine and anticholinergics were undertaken, without success. Results: Patient had an important subjective improvement after performing a treatment combination of biofeedback, electrostimulation, pelvic floor muscle training and behavioral measurements such as weight loss, improved after bariatric surgery. Comments: OUI is a complex disorder, without standard treatments and needs to be further investigated with larger, prospective samples. Combined physical therapy approaches should be considered when discussing treatment

Factors associated with thrombocytopenia in severe leptospirosis (Weil's disease)

OBJECTIVE: This study was conducted to investigate factors associated with thrombocytopenia in a large cohort of patients with leptospirosis in an endemic area. METHODS: This retrospective study included 374 consecutive patients with leptospirosis who were admitted to tertiary hospitals in Fortaleza, Brazil. All patients had a diagnosis of severe leptospirosis (Weil's disease). Acute kidney injury was defined according to the RIFLE criteria. Thrombocytopenia was defined as a platelet coun

Profile of Self-Care Capacity and Alcohol Use in Elderly Brazilians during the COVID-19 Outbreak: An Online Study

Background: Preventive and positive online coping strategies are essential for harm reduction associated with alcohol abuse among older adults in pandemic and social isolation scenarios. The objectives were to examine the relationship between alcohol use/abuse and physical capacity/self-care to perform the physical activities of daily living or impairment of the functional capacity of the elderly in the COVID-19 pandemic. Methods: An online cross-sectional survey was carried out. One hundred and one elderly people in the city of São Paulo, Brazil, participated in a community program. Results: Most participants (52.5%) showed excellent self-care skills. Approximately 12% of participants reported problems related to alcohol use/abuse. There was no association between self-care ability and abuse and probable alcohol dependence. Conclusions: Although most participants have excellent self-care and functional capacity and have not evidenced alcohol use/abuse, health professionals need to systematically provide information to prevent alcohol abuse, especially in scenarios of great emotional distress, such as in a pandemic. In addition, the online meetings held by the UAPI program were shown to be opportunities for social interaction and were essential to minimize the negative effects of the possible presence of alcohol use/abuse and the deteriorating performance of physical activities of daily living during a pandemic outbreak for the elderly

The effects of Pilates vs. aerobic training on cardiorespiratory fitness, isokinetic muscular strength, body composition, and functional tasks outcomes for individuals who are overweight/obese: a clinical trial

Background Some studies have been conducted to verify the effects of Pilates for individuals who are obese, but conclusive results are not yet available due to methodological concerns. The present study aims to verify and compare the effects of Pilates and aerobic training on cardiorespiratory fitness, isokinetic muscular strength, body composition, and functional task outcomes for individuals who are overweight/obese. Methods Of the sixty participants, seventeen were allocated to the control group, since the intervention protocol (Pilates or walking sessions) was during their working hours. The remaining 44 participants were randomly allocated to one of two experimental groups (Pilates (n = 22)) or aerobic groups (n = 21).The Pilates and aerobic groups attended 60-min exercise sessions, three times per week for 8 weeks. The aerobic group performed walking training at a heart rate corresponding to the ventilatory threshold. The Pilates group performed exercises on the floor, resistance apparatus, and 1-kg dumbbells. The control group received no intervention. All volunteers were evaluated at the beginning and end of the intervention. The following assessments were conducted: food intake, cardiorespiratory maximal treadmill test, isokinetic strength testing, body composition and anthropometry, abdominal endurance test, trunk extensor endurance test, flexibility test and functional (stair and chair) tests. Results There was no significant difference pre- and post-intervention in calorie intake [F(2, 57) = 0.02744, p = 0.97)]. A significant improvement in oxygen uptake at ventilatory threshold (p = 0.001; d = 0.60), respiratory compensation point (p = 0.01; d = 0.48), and maximum effort (p = 0.01; d = 0.33) was observed only in the Pilates group. Isokinetic peak torque for knee flexor and extensor muscles did not change for any groups. Lean mass (p = 0.0005; d = 0.19) and fat mass (p = 0.0001; d = 0.19) improved only in the Pilates group. Waist and hip circumference measurements decreased similarly in both experimental groups. Abdominal test performance improved more in the Pilates group (p = 0.0001; d = 1.69) than in the aerobic group (p = 0.003; d = 0.95). Trunk extensor endurance and flexibility improved only in the Pilates group (p = 0.0003; d = 0.80 and p = 0.0001; d = 0.41, respectively). The Pilates group showed greater improvement on the chair and stair tests (p = 0.0001; d = 1.48 and p = 0.003; d = 0.78, respectively) than the aerobic group (p = 0.005; d = 0.75 and p = 0.05; d = 0.41, respectively). Conclusion Pilates can be used as an alternative physical training method for individuals who are overweight or obese since it promotes significant effects in cardiorespiratory fitness, body composition, and performance on functional tests