Bone mineral density in juvenile systemic lupus erythematosus

We evaluated spine bone mineral density (BMD) in Brazilian children with juvenile systemic lupus erythematosus (JSLE) in order to detect potential predictors of reduction in bone mass. A cross-sectional study of BMD at the lumbar spine level (L2-L4) was conducted on 16 female JSLE patients aged 6-17 years. Thirty-two age-matched healthy girls were used as control. BMD at the lumbar spine was measured by dual-energy X-ray absorptiometry. Weight, height and pubertal Tanner stage were determined in patients and controls. Disease duration, mean daily steroid doses, mean cumulative steroid doses and JSLE activity measured by the systemic lupus erythematosus disease activity index (SLEDAI) were determined for all JSLE patients based on their medical charts. All parameters were used as potential determinant factors for bone loss. Lumbar BMD tended to be lower in the JSLE patients, however, this difference was not statistically significant (P = 0.10). No significant correlation was observed in JSLE girls between BMD and age, height, Tanner stage, disease duration, corticosteroid use or disease activity. We found a weak correlation between BMD and weight (r = 0.672). In the JSLE group we found no significant parameters to correlate with reduced bone mass. Disease activity and mean cumulative steroid doses were not related to BMD values. We did not observe reduced bone mass in female JSLE.Universidade Federal de São Paulo (UNIFESP) Escola Paulista de Medicina Departamento de PediatriaUniversidade Federal de São Paulo (UNIFESP) Escola Paulista de Medicina Departamento de MedicinaUNIFESP, EPM, Depto. de PediatriaUNIFESP, EPM, Depto. de MedicinaSciEL

Ação da auriculoacupuntura em pessoas com dor crônica na coluna vertebral: ensaio clínico randomizado

Objetivos: evaluar la acción de la auriculoacupuntura en la incapacidad y en la temperatura del tejido de personas con dolor crónico en la columna vertebral. Método: ensayo clínico con muestra de 110 personas, asignadas aleatoriamente en tres grupos: Tratado, Placebo y Control. Los instrumentos de evaluación fueron el Cuestionario de Incapacidad de Rollad Morris y una cámara termográfica, aplicados antes de la primera sesión de tratamiento, una semana después y quince días después (follow up) de la quinta sesión de auriculoacupuntura. En el análisis de los datos se aplicaron las pruebas Kruskal-Wallis, Student-Newman Keuls y Wilcoxon. Resultados: hubo reducción significativa de la incapacidad en los grupos Tratado y Placebo, entre las evaluaciones inicial y final (p<0,05) y entre las evaluaciones inicial y follow up (p<0,05). En la evaluación final, el grupo Tratado presentó mejoría de la incapacidad si comparado al Placebo y al Control (p<0,05). Hubo aumento en la temperatura media del tejido de la región dorsal entre las evaluaciones inicial y follow up en el Tratado y Control (p<0,05), y entre las evaluaciones final y follow up en el Tratado y Placebo (p<0,05). Conclusión: la auriculoacupuntura fue eficaz en reducir la incapacidad y en aumentar la temperatura del tejido en personas con dolor crónico en la columna vertebral. Registro Brasileño de Ensayos Clínicos (RBR-5X69X2).Objetivos: avaliar a ação da auriculoacupuntura na incapacidade e na temperatura tissular de pessoas com dor crônica na coluna vertebral. Método: ensaio clínico com amostra de 110 pessoas, randomizadas em três grupos: Tratado, Placebo e Controle. Os instrumentos de avaliação foram o Questionário de Incapacidade de Rolland Morris e uma câmera termográfica, aplicados antes da primeira sessão de tratamento, uma semana após e 15 dias após (follow up) à quinta sessão de auriculoacupuntura. Na análise dos dados, aplicaram-se os testes Kruskal-Wallis, StudentNewman-Keuls e Wilcoxon. Resultados: houve redução significativa da incapacidade nos grupos Tratado e Placebo entre as avaliações inicial e final (p<0,05) e entre as avaliações inicial e follow up (p<0,05). Na avaliação final, o grupo Tratado apresentou melhora da incapacidade se comparado ao Placebo e ao Controle (p<0,05). Houve aumento na temperatura média tissular da região dorsal entre as avaliações inicial e follow up no Tratado e Controle (p<0,05). Entre as avaliações final e follow up no Tratado e Placebo (p<0,05). Conclusão: a auriculoacupuntura foi eficaz para reduzir a incapacidade e aumentar a temperatura tissular em pessoas com dor crônica na coluna vertebral. Registro Brasileiro de Ensaios Clínicos (RBR-5X69X2).Objectives: to assess the action of ear acupuncture on disability and tissue temperature in people with chronic pain in the spinal column. Method: a clinical trial with a sample of 110 people, randomized into three groups: Treatment, Placebo and Control. The assessment instruments were the Rolland Morris Disability Questionnaire (RMDQ) and a thermographic camera, administered before the first treatment session, one week after and 15 days after (follow-up) the fifth session of ear acupuncture. In the analysis of the data, the Kruskal Wallis, Student-Newman Keuls and Wilcoxon tests were applied. Results: there was a significant reduction in disability in the Treatment and Placebo groups between the initial and final assessments (p<0.05) and between the initial assessments and follow-up (p<0.05). In the final assessment, the Treatment group presented improvement of disability when compared with the Placebo and Control groups (p<0.05). There was an increase in mean tissue temperature of the dorsal region between the initial and follow-up assessments in Treatment and Control groups (p<0.05), and between the final assessments and follow-up in the Treatment and Placebo groups (p<0.05). Conclusion: ear acupuncture was efficacious in reducing disability and increasing tissue temperature in people with chronic pain in the spinal column. Brazilian Register of Clinical Trials (RBR-5X69X2)

Efectos de la auriculoacupuntura en el dolor crónico en personas con disturbios musculoesqueléticos en la espalda: ensayo clínico randomizado

Objective: To evaluate the effects of auricular acupuncture on pain intensity, its impact on daily activities, the relief provided by the intervention, and the pain threshold in people with back musculoskeletal disorders. Methods: Randomized clinical trial carried out with people randomly allocated into three groups: treatment, placebo, and control. Evaluations were performed using the Brief Pain Inventory and a digital algometer before (initial) and after (final) the treatment and after a 15-day follow-up period. Results: The sample was 110 people. There was a decrease in pain intensity in the treatment and placebo groups as revealed by the comparison between the initial and final evaluations (p<0.05), and in the treatment group in the comparison between the initial and followup evaluations (p<0.05). A decreased impact of pain on daily activities in the treatment and placebo groups over time was found (p<0.05). At the final evaluation, the impact of pain was lower in the treatment group (p<0.05). Auricular acupuncture did not increase the pain threshold. Conclusion: Auricular acupuncture presented positive effects by reducing the chronic pain intensity and its impact on daily activities in people with back musculoskeletal disorders. Brazilian Clinical Trials Registry: RBR-5X69X

Educación Financiera: Un estudio envolvendo los alumnos de una institución de enseñanza superior de la ciudad Divinópolis en Minas Gerais

A educação financeira é um processo em que as pessoas conseguem aprimorar e desenvolver conhecimentos necessários, que irão contribuir para melhores tomadas de decisões. Este estudo analisa se o nível de conhecimento adquirido pelos estudantes de graduação ao longo do curso faz com que eles tomem melhores decisões de investimentos financeiros e se os alunos dos cursos de Ciências Contábeis e Administração são mais assertivos em suas escolhas, além de testar algumas variáveis como sexo, idade, remuneração e estado civil. Para testar as hipóteses levantadas é aplicado um questionário em uma amostra de 50% da população de uma faculdade de Divinópolis, correspondendo a 395 alunos. Os resultados são categorizados e demonstram que o fato dos alunos estarem nos primeiros ou últimos períodos, a faculdade e as variáveis escolhidas não tem nenhuma influência no nível de conhecimento financeiro ou na assertividade das escolhas de investimento.Financial education is a process in which people can improve and develop necessary knowledge that will contribute to better decision making. This study analyzes if the level of knowledge acquired by the undergraduate students, throughout the course, make them better decisions-makers, concerning financial investments. Also, if the students of Accounting and Business are more assertive in their choices, besides testing variable such as gender, age, income and marital status. To test the hypothesis raised, a questionnaire was applied in a sample of 50% of the population of a faculty of Divinopolis, corresponding to 395 students. The results are categorized and demonstrate that the fact that the students are in the first or last terms, the faculty and the variables chosen have no influence on the level of financial knowledge or the assertiveness of the investment choices.La educación financiera es un proceso en el que las personas pueden perfeccionar y desarrollar los conocimientos necesarios, que contribuir a una mejor toma de decisiones. Este estudio analiza si el nivel de conocimiento adquirido por los estudiantes de graduación a lo largo del curso hace que ellos tomen mejores decisiones de inversiones financieras y si los alumnos de los cursos de Ciencias Contables y Administración son más asertivos en sus elecciones, además de probar algunas variables como sexo, edad, remuneración y estado civil. Para probar las hipótesis planteadas se aplica un cuestionario en una muestra del 50% de la población de una facultad de Divinópolis, correspondiendo a 395 alumnos. Los resultados se clasifican y demuestran que el hecho de que los alumnos estén en los primeros o últimos períodos, la facultad y las variables elegidas no tienen ninguna influencia en el nivel de conocimiento financiero o en la asertividad de las elecciones de inversión

What is the role of cardiorespiratory fitness and sedentary behavior in relationship between the genetic predisposition to obesity and cardiometabolic risk score?

Background: Genetic factors along with inadequate lifestyle habits are associated with the development of cardiometabolic alterations. Thus, the present study aimed to examine the role of sedentary behavior on the relationship between rs9939609 polymorphism (fat mass and obesity-associated gene-FTO) and cardiometabolic risk score according to cardiorespiratory ftness (CRF) levels in children and adolescents. Methods: A cross-sectional study with 1215 children and adolescents (692 girls), aged between 6 and 17 years. Screen time as a marker of sedentary behavior was evaluated through a self-reported questionnaire and CRF was estimated using the 6-min walking and running test. The genotyping of the FTO rs9939609 polymorphism was performed using a real-time polymerase chain reaction. Clustered cardiometabolic risk score (cMetS) was calculated by summing z-scores of total cholesterol/high-density lipoprotein cholesterol ratio, triglycerides, glucose, systolic blood pressure, and waist circumference, and dividing it by fve. Moderation analyses were tested using multiple linear regression models. Results: The coefcient of the interaction term of FTO (rs9939609) and screen time indicated that screen time was a signifcant moderator on the relationship between FTO rs9939609 polymorphism and cMetS (p=0.047) in children and adolescents classifed with low CRF (β=0.001; 95% CI=0.001; 0.002). It was observed a signifcant association between genotype risk (AA) of FTO polymorphism and cMetS, in participants that spent more than 378 min a day in front of screen-based devices (β=0.203; 95% CI=0.000; 0.405). No interaction term was found for those with high CRF. Conclusions: High sedentary behavior seems to infuence the relationship between genetic predisposition to obesity and cardiometabolic risk factors in children and adolescents with low CRF

EFFECTS OF BRACHYTHERAPY ON QUALITY OF LIFE AND FUNCTIONALITY IN THE TREATMENT OF CERVIX CANCER

Objective: to assess the effect of brachytherapy on functionality and quality of life of women with cervix cancer.Method: a descriptive and cross-sectional study carried out between December 2019 and February 2020 with 33 women with uterine neoplasia undergoing brachytherapy, followed up at Centro Oncológico do Nordeste - Brazil. The Funtional Assessment of Cancer Therapy – Cervix Cancer instrument was applied. The means of the subscales were compared and their mutual correlation was analyzed by applying the ANOVA and Student’s t tests.Results: requirements focused on self-image, sexuality and urinary complaints were evidenced. The mean of additional concerns was lower in the age group from 50 to 59 years old, when compared to the mean values in the age groups from31 to 49 years old (p=0.004) and from 60 to 75 years old (p=0.002).Conclusion: addressing issues related to sexuality and urinary complaints contribute to early identification of the symptoms caused by brachytherapy, as well as the implementation of measures, providing quality of life for the patient

Physical fitness attenuates the genetic predisposition to obesity in children and adolescents

Obesity is an important risk factor associated with non-communicable cardiometabolic diseases. Previous studies have indicated that children and adolescents with a predisposed genetic risk for obesity could benefit from an active lifestyle, but there are no studies investigating whether physical fitness moderates the association of genetics and obesity. The aim of this study was to verify the moderating role of physical fitness in the relationship between genetic risk score (GRS) and body mass index (BMI) in children and adolescents. This cross-sectional study was carried out with 1471 children and adolescents, aged between 6 and 17 years from Santa Cruz do Sul, Brazil. Weight and height were assessed to determine BMI. Physical fitness components (cardiorespiratory fitness [CRF], lower limb strength [LLS], upper limb strength, and abdominal strength) were evaluated. The GRS was based on previously associated obesity single-nucleotide polymorphism rs9939609 (FTO), rs6548238 (TMEM18), and rs16835198 (FNDC5). Moderation analyses were tested using linear regression models, and the interactions were represented by physical fitness components X GRS (categorical variable). All analyses were adjusted for skin color/ethnicity, sex, and sexual maturation. Significant interactions for CRF (P = 0.041), LLS (P = 0.041), and abdominal strength (P = 0.046) X 5 and 6 risk alleles with BMI were found only in adolescents. In addition, there was evidence that fitness components attenuated the high genetic predisposition to high BMI. Physical fitness components are moderators in the relationship between GRS and BMI in adolescents. These findings highlight the need for interventions targeting to improve this aspect, which is an important health indicator in all ages

Effect of auricular acupuncture on cancer pain: a systematic review

Aims: To analyze the scientific evidence available in the literature about the effect of auricular acupuncture on cancer pain. Method: Systematic review of the literature guided by the criteria of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA Statement); whose research question was “What are the effects of auriculotherapy/auricular acupuncture on cancer pain in adults?”. EndNote and Rayyan platforms were used to manage references and manage the stages of article selection, respectively. The Jadad scale was used to assess the methodological quality of the studies. The data collected from the articles were grouped into tables and analyzed descriptively. Results: A total of 3484 articles were found, of which 11 made up the sample of this study, in which the majority showed excellent methodological quality (54.54%). 533 adults complaining of cancer pain were treated, using auricular acupuncture as the only intervention or as a complement to another treatment and, in all studies, it proved to be effective both for painful symptoms and for relieving other secondary signs, such as anxiety and insomnia. Conclusions: Auricular acupuncture is effective in relieving cancer pain when administered either through needles or seeds and at specific pain points (aché point), in addition to the shemman, sympathetic, subcortex, and kidney points

Ação da acupuntura no sintoma de fogachos em mulheres após câncer de mama: revisão integrativa

Objetivo: Investigar evidências, na literatura, acerca da ação da acupuntura no sintoma de fogachos em mulheres, após câncer de mama e estabelecer um protocolo para o tratamento dessa condição. Método: Revisão integrativa, conduzida em agosto de 2019. Utilizaram-se bases de dados nacionais e internacionais. Resultados: Foram encontradas 288 pesquisas e 11 foram incluídas no estudo. A acupuntura demonstrou resultados positivos sobre os sintomas de fogachos. Não há padronização no tratamento, porém um possível protocolo foi proposto: realização da acupuntura sistêmica ou eletroacupuntura nos acupontos Baço 6, Fígado 3, Rim 3, Circulação sexo 6, Vaso concepção 4, Bexiga 23 e Vaso Governador 20, agulhas sistêmicas que devem ser manipuladas até obter a sensação De qi, 10 sessões, uma ou duas vezes por semana, com retenção das agulhas nos acupontos em aproximadamente 25 minutos. Conclusão: a acupuntura parece ser uma intervenção efetiva para o tratamento e controle dos fogachos em mulheres, após câncer de mama e consiste em uma opção terapêutica a qual o enfermeiro pode executar de maneira autônoma e independente em todos os níveis de atenção. Torna-se necessária a realização de ensaios clínicos randomizados com a utilização do protocolo proposto a fim de validá-lo

Role of Auriculotherapy in the Treatment of Temporomandibular Disorders with Anxiety in University Students

Introduction. The aim of this study was to evaluate the role of auriculotherapy with mustard seeds in the treatment of temporomandibular disorders (TMDs), anxiety, and electromyographic (EMG) activity in university students. Methodology. The State Trait Anxiety Inventory (STAI), Research Diagnostic Criteria (RDC) for TMDs (RDC/TMDs), and electromyography were used in this study of 44 college students with high levels of anxiety and TMDs. The subjects were divided into two groups: an auriculotherapy (AA) group (n=31) and an AA sham group (n=13). The mustard seeds were applied to the shenmen, rim, sympathetic, brain stem, and temporomandibular joint (TMJ) points in the AA group and to sham points in the external ear and wrist in the AA sham group. The treatment protocol was 10 sessions (two treatments per week). Results. Anxiety (p<0.01) was significantly reduced in the AA group. This group also showed a decrease in tender points in the mandibular posterior region (p=0.04) and in the right side of the submandibular region (p=0.02). Complaints of bilateral pain were reduced in the temporal tendon (p≤0.01) and in the left side of the ATM (p<0.01). In addition, electromyographic (EMG) activity was reduced during temporal muscle contraction (p=0.03).  Conclusion. Auriculotherapy was effective in the treatment of students with anxiety and TMDs