Impact of physical exercise in cardiovascular and metabolic parameters in post-menopausal women / Impacto do exercício físico nos parâmetros cardiovasculares e metabólicos em mulheres na pós-menopausa

Backgound: understanding how physical exercise changes vascular and metabolic health of women with hormonal changes resulting from the menopausal period is essential for better discernment of therapeutic anti-sedentary indications. Besides that, the effects of physical exercise in post-menopause women is not entirely understood.Objectives: the aim of the present study was to investigate the effect of physical exercise on specific parameters in post-menopause women’s cardiovascular and metabolic health.Design: a total of 31 participants, assisted in a primary health care were included. Twenty (20) women from a program promoted by the health service were assigned to the physically active group (AG), in which they performed many types of exercise, including stretching, aerobic and resistance training of varying intensities. Eleven (11) women on the control group (CG) were recruited at the same service and attended the institution for other ends related to their health.Results: arterial pressure had a significant diference between AG adn CG: mean systolic blood pressure (SBP) in the AG was 111±6mmHg versus 118mmHg in the CG; mean diastolic blood pressure (DBP) was 71mmHg in the AG versus 82mmHg in the CG. The fact that the majority of women in the AG (60%) had more than 8 years of formal education versus 37% in the CG drew attention. In both groups, most women had less than 3 children. Most women in the CG reported formal work while domestic work prevailed in the AG. Despite this, per capita income showed no difference.Conclusion: blood pressure, an important cardiovascular risk factor, is significantly lower in post-menopause women that practised regular physical exercises; in addition, socioeconomic factors is very close influencer in physical exercise engagement. Other studies are necessary to evaluate more cardiovascular variables.Backgound: understanding how physical exercise changes vascular and metabolic health of women with hormonal changes resulting from the menopausal period is essential for better discernment of therapeutic anti-sedentary indications. Besides that, the effects of physical exercise in post-menopause women is not entirely understood.Objectives: the aim of the present study was to investigate the effect of physical exercise on specific parameters in post-menopause women’s cardiovascular and metabolic health.Design: a total of 31 participants, assisted in a primary health care were included. Twenty (20) women from a program promoted by the health service were assigned to the physically active group (AG), in which they performed many types of exercise, including stretching, aerobic and resistance training of varying intensities. Eleven (11) women on the control group (CG) were recruited at the same service and attended the institution for other ends related to their health.Results: arterial pressure had a significant diference between AG adn CG: mean systolic blood pressure (SBP) in the AG was 111±6mmHg versus 118mmHg in the CG; mean diastolic blood pressure (DBP) was 71mmHg in the AG versus 82mmHg in the CG. The fact that the majority of women in the AG (60%) had more than 8 years of formal education versus 37% in the CG drew attention. In both groups, most women had less than 3 children. Most women in the CG reported formal work while domestic work prevailed in the AG. Despite this, per capita income showed no difference.Conclusion: blood pressure, an important cardiovascular risk factor, is significantly lower in post-menopause women that practised regular physical exercises; in addition, socioeconomic factors is very close influencer in physical exercise engagement. Other studies are necessary to evaluate more cardiovascular variables

Cirurgias durante a gravidez: artigo de revisão: Surgeries during pregnancy: review article

As abordagens cirúrgicas que ocorrem no período da gravidez, trazem aos cirurgiões, obstetras, anestesiologistas e neonatologistas, um misto de grandes preocupações, angústia e expectativa de sucesso em ralação à saúde materna e fetal. Entretanto, a oportuna tomada de decisão muito e quase sempre tem efeito alentador. Objetivo: Buscar na literatura apanhados escritos sobre as cirurgias no ciclo gravídico, incluindo relatos históricos que nos eleva ao conhecimento hodierno. Revisão da literatura: Na varredura literária médica realizada para este trabalho, verificou-se predominância de vantagens nas abordagens cirúrgicas. Técnicas variando de acordo com a ocorrência, mostrando configurações e métodos seguros e, muitas vezes, minimamente invasivos, podendo ser realizadas em qualquer trimestre da gestação. Conclusão: Faz-se cuidar no esmero do cotidiano, de algumas complicações esperadas, tais como: lesão do útero, diminuição do fluxo sanguíneo comprometendo a higidez do concepto, e também eventos tromboembólicos na gestante. Observou-se menor tempo de hospitalização, infecções, trabalho de parto pré-termo, hemorragias e íleo paralítico

The inventory of geological heritage of the state of São Paulo, Brazil: Methodological basis, results and perspectives

An inventory of geological sites based on solid and clear criteria is a first step for any geoconservation strategy. This paper describes the method used in the geoheritage inventory of the State of São Paulo, Brazil, and presents its main results. This inventory developed by the geoscientific community aimed to identify geosites with scientific value in the whole state, using a systematic approach. All 142 geosites representative of 11 geological frameworks were characterised and quantitatively evaluated according to their scientific value and risk of degradation, in order to establish priorities for their future management. An online database of the inventory is under construction, which will be available to be easily consulted and updated by the geoscientific community. All data were made available to the State Geological Institute as the backbone for the implementation of a future state geoconservation strategy.The authors acknowledge the Science Without Borders Programme, Process 075/2012, which supported this study and the São Paulo Research Foundation (FAPESP), Process 2011/17261-6. We also thanks C. Mazoca for his help with maps and figures.info:eu-repo/semantics/acceptedVersio

Statement of Second Brazilian Congress of Mechanical Ventilarion : part I

Resumo não disponíve

Aplicabilidade dos marcadores de rigidez arterial na doença arterial periférica

Resumo A análise de rigidez arterial tem sido feita em vários grupos populacionais com o objetivo de identificar precocemente o risco cardiovascular e realizar medidas terapêuticas específicas. O aumento da rigidez arterial leva à perda de capacidade de adaptação da aorta e das artérias elásticas às variações de pressão durante o ciclo cardíaco. Os principais marcadores de rigidez arterial são a velocidade de onda de pulso (VOP), o índice de aumentação (AIx) e a pressão aórtica central. Esses índices podem ser obtidos de maneira não invasiva. Ocorre aumento da mortalidade em pacientes com doença coronariana ou em hemodiálise que apresentam aumento da VOP ou do AIx. A associação com a doença arterial periférica é pouco estudada. O objetivo desta revisão é mostrar a aplicabilidade e a utilidade de realizar medidas de rigidez arterial em pacientes com doença arterial periférica

Association between critical limb ischemia and arterial stiffness measured by brachial artery oscillometry

Abstract Background Elevated arterial stiffness is associated with increased cardiovascular mortality. The relationship between arterial stiffness and critical limb ischemia (CLI) is not well established. Objectives The objective of this study is to analyze the relationship between arterial stiffness indices and the degree of limb ischemia measured by the ankle-brachial index (ABI). Methods A cross-sectional study comparing patients with CLI and controls. Arterial stiffness was measured using brachial artery oscillometry. The arterial stiffness indices pulse wave velocity (PWV) and augmentation index normalized to 75 beats/min (AIx@75) were determined. Multiple linear regression was applied to identify predictors of arterial stiffness indices. Results Patients in the CLI group had higher PWV (12.1±1.9 m/s vs. 10.1±1.9 m/s, p < 0.01) and AIx@75 (31.8±7.8% vs. 17.5±10.8%, p < 0.01) than controls. Central systolic pressure was higher in the CLI group (129.2±18.4 mmHg vs. 115.2±13.1 mmHg, p < 0.01). There was an inverse relationship between AIx@75 and ABI (Pearson coefficient = 0.24, p = 0.048), but there was no relationship between ABI and PWV (Pearson coefficient = 0.19, p = 0.12). In multiple regression analysis, reduced ABI was a predictor of elevated levels of AIx@75 (β = -25.02, p < 0.01). Conclusions Patients with CLI have high arterial stiffness measured by brachial artery oscillometry. The degree of limb ischemia, as measured by the ABI, is a predictor of increased AIx@75. The increased AIx@75 observed in CLI may have implications for the prognosis of this group of patients with advanced atherosclerosis

Predictors and reference equations for augmentation index, an arterial stiffness marker, in healthy children and adolescents

OBJECTIVES: To investigate predictors and propose reference equations for the augmentation index normalized to 75 bpm heart rate (AIx@75) in healthy children and adolescents. METHODS: This was a cross-sectional, observational study involving 134 healthy children and adolescents aged 9 to 19 years old. Participants were categorized into child (n=53) and adolescent (n=81) groups, as well as into male (n=69) and female (n=65) groups. We evaluated AIx@75, vascular and hemodynamic parameters, anthropometric data, physical activity profile, and quality of life (Peds-QL4.0; physical, emotional, social and school domains). RESULTS: The predictors of AIx@75 in the whole sample were age, peripheral diastolic blood pressure (pDBP), mean arterial pressure, pulse pressure amplification (PPA), systolic volume (SV), cardiac index (CI), and pulse wave velocity (PWV; R2=80.47%). In the male group, the predictors of AIx@75 were SV, CI, total vascular resistence (TVR), and PWV (R2=78.56%), while in the female group, they were pDBP, PPA, SV, and PWV (R2=82.45%). In the children, they were pDBP, PPA, SV, and PWV (R2=79.17%), while in the adolescents, they were body mass index, pDBP, PPA, SV, TVR, and PWV (R2=81.57%). CONCLUSION: In the present study, we used a representative sample from Belo Horizonte to establish normality values of AIx@75. We also identified, for the first time, independent predictors of AIx@75 in healthy children and adolescents categorized by sex and age. Determining AIx@75 reference equations may facilitate the early diagnosis of preclinical atherosclerosis and allow an objective measure of the vascular effects of therapeutic interventions aimed at modifying cardiovascular risk factors

ACE2 a double-edged sword?

Angiotensin-converting enzyme 2 (ACE2) is the binding protein/receptor used by the new SARS-CoV-2, which causes 2019 coronavirus disease (COVID-19), to enter host cells [1,2]. In 2003, Li and colleagues [3] at the Harvard Medical School, USA had previously described that a protein (spike proteins - S1 domain) da família do coronavirus binds efficiently to ACE2 [3,4]. From binding to ACE2, the virus envelope fuses into the host cell membrane allowing its genetic material entering the cell and replicate, triggering severe respiratory disease, including acute respiratory distress syndrome (ARDS), a devastating lung disease with high mortality rates (3060%).Sociedad Argentina de Fisiologí

A influência de duas frações inspiradas de oxigênio no padrão respiratório de pacientes sob desmame ventilatório

INTRODUÇÃO E OBJETIVOS: Frações inspiradas de oxigênio (FiO2) < 40% são recomendadas durante o desmame ventilatório se pressão arterial de oxigênio (PaO2)/FiO2 >150-200 mmHg, O objetivo desse estudo foi comparar as variáveis respiratórias e os dados vitais coletados durante a utilização de uma FiO2 suficiente para manter a saturação periférica de oxigênio em 92% (ideal) com aquelas coletadas durante uma FiO2 rotineiramente ajustada em 40% (basal) em pacientes sob desmame ventilatório. MÉTODOS: Estudo prospectivo cruzado. As variáveis freqüência respiratória, volume corrente, pressão de oclusão, relação tempo inspiratório/tempo total, pressão arterial e freqüência cardíaca foram coletados, seqüencialmente, aos 30 e 60 minutos sob FiO2 basal (40%) e, em seguida sob FiO2 ideal. Essas foram comparadas pelo modelo linear generalizado para medidas repetidas. Para comparar os valores basal e ideal da FiO2 e da PaO2 foram utilizados os testes t Student ou Wilcoxon. RESULTADOS: Em 30 pacientes adultos a mediana da FiO2 ideal foi 25% (IQ25%-75% 23-28), significativamente menor que a basal (40%) (p< 0,001). A relação PaO2/FiO2 não apresentou diferença significativa entre a FiO2 basal (269±53) e a FiO2 ideal (268±47). O volume corrente foi significativamente menor durante a utilização da FiO2 ideal (p=0,003) e a pressão arterial foi significativamente maior durante a utilização da FiO2 ideal (p=0,041), mas sem significância clínica. A FiO2 ideal não influenciou as demais variáveis. CONCLUSÃO: Esses resultados sugerem que níveis de FiO2 suficientes para manter uma SpO2>92% não alteraram o padrão respiratório ou provocaram alterações clínicas em pacientes sob desmame ventilatório