Influence of different types of corticosteroids on heart rate variability of individuals with Duchenne Muscular Dystrophy: A pilot cross sectional study

Individuals with Duchenne Muscular Dystrophy (DMD) have an impairment of cardiac autonomic function categorized by parasympathetic reduction and sympathetic predominance. The objective of this study was to assess the cardiac autonomic modulation of individuals with DMD undergoing therapy with Prednisone/Prednisolone and Deflazacort and compare with individuals with DMD without the use of these medications and a typically developed control group. Methods: A cross-sectional study was completed, wherein 40 boys were evaluated. The four treatment groups were: Deflazacort; Prednisone/Prednisolone; no corticoid use; and typical development. Heart Rate Variability (HRV) was investigated via linear indices (Time Domain and Frequency Domain) and non-linear indices Results: The results of this study revealed that individuals with DMD undertaking pharmacotherapies with Prednisolone demonstrated HRV comparable to the Control Typically Developed (CTD) group. In contrast, individuals with DMD undergoing pharmacotherapies with Deflazacort achieved lower HRV, akin to individuals with DMD without any medications, as demonstrated in the metrics: RMSSD; LF (n.u.), HF (n.u.), LF/HF; SD1, α1, and α1/α2, and a significant effect for SD1/SD2; %DET and Ratio; Shannon Entropy, 0 V%, 2 LV% and 2 ULV%. Conclusions: Corticosteroids have the potential to affect the cardiac autonomic modulation in adolescents with DMD. The use of Prednisone/Prednisolone appears to promote improved responses in terms of sympathovagal activity as opposed to Deflazacort

Lesões desportivas na ginástica artística: estudo a partir de morbidade referida

INTRODUÇÃO: Os níveis de exigência biomecânica devidos ao alto grau de dificuldade na realização de gestos fazem da ginástica artística (GA) uma modalidade com elevado risco de lesões. Assim, é necessário que os aspectos a elas relacionados sejam controlados. OBJETIVO: Analisar a ocorrência de lesões na Ginástica Artística, associando-as a fatores de risco específicos da modalidade e do atleta, a partir de inquérito de morbidade referida. MÉTODOS: Foram entrevistados 54 ginastas, recrutados ao acaso, classificados segundo o nível competitivo em duas categorias: regional e nacional. Utilizou-se o inquérito de morbidade referida (IMR) com a finalidade de reunir dados sobre a natureza da lesão, região corporal e aparelho ginástico. Os dados foram organizados e apresentados sob a forma de distribuição de freqüências e as variáveis, analisadas segundo nível de associação a partir do teste de Goodman para contrastes entre populações multinomiais, considerando significante o valor P < 0,05. RESULTADOS: Presença de lesão durante a temporada foi relatada por 39 (71,70%) atletas, sendo 22 (56,41%) mulheres e 17 (43,59%) homens. Nas categorias regional masculino e feminino e nacional feminino, a maior ocorrência de lesões foi de origem articular, correspondendo a 55,56%, 50% e 45,45% do total, respectivamente. Para o sexo feminino nacional, os membros inferiores foram os mais referidos (68,18%) e, em ambas as categorias, as lesões ocorreram nos aparelhos de saltos (79,41%), enquanto que no sexo masculino nacional o maior número de agravos foi verificado nos aparelhos de apoio e suspensão (72%). CONCLUSÕES: Há elevada freqüência de lesões, acometendo principalmente articulações e membros inferiores, sendo os aparelhos de saltos os mais referidos quanto à ocorrência de acometimentos. Foi observado também que, quanto maiores as exigências de desempenho técnico, maior a freqüência de lesões.INTRODUCTION: The levels of biomechanical demands due to the high level of difficulty in the gestures accomplishment make Artistic Gymnastics (AG) a modality with high risk of injuries. Thus, it is necessary that the aspects concerned with them are controlled. OBJECTIVE: To analyze the occurrence of injuries in artistic gymnastics, associating them with specific risk factors of the modality and of the athlete from reported morbidity survey. METHODS: 54 gymnasts randomly recruited have been interviewed and classified according to their competitive level into two categories: regional and national. The reported morbidity questionnaire (RMQ) was used with the purpose to collect data on the injury's nature, body region and gymnastic apparatus. Data were organized and presented under frequency distribution and analyzed variables. The variables were analyzed according to their level of association from the Goodmann's test for contrasts between multinomials populations considering significant value p<0.05. RESULTS: 39 (71.70%) athletes have reported injury during the season, being 22 of them (56.41) women and 17 (43.59%) men. In the regional male and female categories and in the national female, the largest reported occurrence of injuries was articular, corresponding to 55.56%, 50% and 45.45% of the total, respectively. For the national female category, the lower limbs were the most affected (68.18%). In female, the most frequent injuries occurred in the jumps (79.41%), while in national male the highest number of complaints has been reported in the support and suspension moves (72%). CONCLUSIONS: There is high frequency of injuries, especially in the joints and lower limbs, being the jump events the most mentioned concerning occurrence. It has also been observed that the higher the level of demand, the higher the occurrence of injuries

Métodos de recuperação pós-exercício: uma revisão sistemática

A recuperação pós-exercício consiste em restaurar os sistemas do corpo a sua condição basal, proporcionando equilíbrio e prevenindo a instalação de lesões e, nesse sentido, torna-se aspecto importante de todo programa de condicionamento físico, em quaisquer níveis de desempenho, mas, sobretudo nos mais elevados. O objetivo desta revisão foi reunir informações e descrever as respostas proporcionadas por métodos recuperativos pós-exercício, como crioterapia, contraste, massagem e recuperação ativa, constituindo uma fonte de atualização do referido tema. Utilizaram-se os bancos de dados MedLine, Scielo e Lilacs, como lista de periódicos, o SportsDiscus. Foram incluídos no estudo somente ensaios clínicos randomizados controlados e não-controlados, além de artigos de revisão referentes ao tema proposto. Optou-se por procurar os termos: cryotherapy, massage, active recovery, thermotherapy, immersion e exercise, individualmente e em cruzamentos. Como achado, observou-se que alguns estudos relatam que a crioterapia é prejudicial em se tratando de recuperação pós-exercício, pois reduz o desempenho imediatamente após a aplicação da técnica. Por outro lado, estudos apontam como sendo benéfica, pois reduzem o nível de creatinaquinase após alta intensidade de esforço, evitando danos musculares. Para o contraste, embora apresente significância em se tratando de remoção de lactato sanguíneo, sua efetividade necessita ser mais bem discutida. Na massagem e na recuperação ativa, os principais vieses descritos dizem respeito à pressão exercida e à intensidade do exercício, respectivamente. Entre as técnicas, as que parecem ter efeitos semelhantes são o contraste e a recuperação ativa, no que tange à remoção de lactato e diminuição da creatinaquinase. Ressalta-se que o tempo de exposição é de fundamental importância para todos os métodos. Entretanto, diversos estudos não se propõem a identificar os reais efeitos fisiológicos promovidos pelas técnicas, utilizando-as de modo inipiente. Portanto, a inconsistência dos resultados encontrados sugere que a análise das variáveis utilizadas como método de recuperação deve ser mais bem controlada.The post-exercise recovery consists in restoring the body systems to baseline condition, providing balance and preventing injuries installation and, in that sense; it becomes an important aspect of every fitness program, at any levels of performance, but especially in higher levels. The objective of this review was to gather information and to describe the responses provided by post-exercise recovery methods, such as cryotherapy, contrast water immersion, massage and active recovery, providing an update on this issue. MedLine, Scielo and Lilacs databases were used, as well as the SportsDiscus list of journals. Only randomized controlled and non-controlled clinical essays, in addition to review articles concerning the proposed topic were included. Our choice was for the search terms: cryotherapy, massage, active recovery, thermotherapy, immersion and exercise, individually and combined. It was observed that some studies report that cryotherapy is harmful concerning post-exercise recovery, once it reduces performance immediately after the technique application. on the other hand, studies point it as being beneficial due to its reduction in the creatine kinase level after exercise, avoiding hence muscle damage. Concerning contrast water immersion, although it presents significance when it comes to blood lactate removal, its effectiveness needs to be better discussed. Regarding massage and active recovery, the main described biases relate to the pressure and intensity of the exercise, respectively. Among the techniques, contrast water immersion and active recovery seem to have similar effects concerning lactate removal and creatine kinase decrease. It is highlighted that the exposure time is crucial for all methods. However, several studies do not try to identify the real physiological effects promoted by the techniques, having them in limited use. Therefore, the inconsistency of the results found suggests that the assessed variables used as a recovery method should be better controlled

Correlação entre padrão postural em jovens praticantes do atletismo

O estudo objetivou observar o alinhamento corporal de jovens atletas praticantes de atletismo e analisar a associação de tais padrões dentro e entre os grupos de provas desta modalidade. Participaram 63 atletas de ambos os sexos e o protocolo de coleta para análise postural baseou-se na observação e registro fotográfico com marcações nos principais acidentes ósseos visando à verificação do alinhamento dessas estruturas. Os segmentos considerados para análise foram: tronco, pelve, joelho e tornozelo. Foi utilizado para análise dos dados o teste de Goodman para contrastes entre e dentro de proporções binomiais. Os resultados mostraram que saltadores (58,33%) e arremessadores/lançadores (50,00%) apresentam o tronco em posição mais equilibrada que atletas de resistência (5,56%). Na região do quadril, arremessadores/lançadores apresentaram predomínio de pelve com rotação esquerda (66,67%), enquanto nos saltadores foi observada elevada frequência de anteversão pélvica (58,33%). A observação do joelho revelou altas taxas de normalidade e recurvatum em fundistas, valgo nos arremessadores/lançadores (50,00%) e varo para os demais grupos. Para a articulação do tornozelo, nota-se que, exceto os saltadores, os grupos apresentaram predominância de valgismo. Conclui-se que, para atender às características particulares de cada prova, níveis distintos de postura são estabelecidos.The aim of this study was to observe the body alignment of young athletes practicing athletics and analyze the combination of such patterns within and between groups of this modality. The sample was composed of 63 athletes of both sexes and the postural analysis protocol was based on observation and photographic record with markings on bone's accidents to verify the alignment of these structures. The segments considered in the analysis were: trunk, pelvis, knee and ankle. The Goodmann's test for contrasts between and within binomial proportions was used for data analysis. The results showed that jumpers (58.33%) and throwers/launchers (50.00%) presented the trunk in more balanced position than resistance athletes (5.56%). At the hip region, throwers/ launchers presented predominance of pelvis with left rotation (66.67%), while in jumpers was observed high frequencies for pelvic anteversion (58,33%). The knee observation revealed that resistance athletes presented normality and recurvatum, valgus in throwers/ launchers (50,00%) and varus for the other groups. For the ankle, except for jumpers, all groups showed predominance of valgism. It is concluded that to reach the specific characteristics of each population, different levels of posture are established

Recurrence Plots: a New Tool for Quantification of Cardiac Autonomic Nervous System Recovery after Transplant

Abstract Objective: To evaluate a possible evolutionary post-heart transplant return of autonomic function using quantitative and qualitative information from recurrence plots. Methods: Using electrocardiography, 102 RR tachograms of 45 patients (64.4% male) who underwent heart transplantation and that were available in the database were analyzed at different follow-up periods. The RR tachograms were collected from patients in the supine position for about 20 minutes. A time series with 1000 RR intervals was analyzed, a recurrence plot was created, and the following quantitative variables were evaluated: percentage of determinism, percentage of recurrence, average diagonal length, Shannon entropy, and sample entropy, as well as the visual qualitative aspect. Results: Quantitative and qualitative signs of heart rate variability recovery were observed after transplantation. Conclusion: There is evidence that autonomic innervation of the heart begins to happen gradually after transplantation. Quantitative and qualitative analyses of recurrence can be useful tools for monitoring cardiac transplant patients and detecting the gradual return of heart rate variability

Immunoglobulin G N-Glycosylation Signatures in Incident Type 2 Diabetes and Cardiovascular Disease

OBJECTIVE: N-glycosylation is a functional posttranslational modification of immunoglobulins (Igs). We hypothesized that specific IgG N-glycans are associated with incident type 2 diabetes and cardiovascular disease (CVD). RESEARCH DESIGN AND METHODS: We performed case-cohort studies within the population-based European Prospective Investigation into Cancer and Nutrition (EPIC)–Potsdam cohort (2,127 in the type 2 diabetes subcohort [741 incident cases]; 2,175 in the CVD subcohort [417 myocardial infarction and stroke cases]). Relative abundances of 24 IgG N-glycan peaks (IgG-GPs) were measured by ultraperformance liquid chromatography, and eight glycosylation traits were derived based on structural similarity. End point–associated IgG-GPs were preselected with fractional polynomials, and prospective associations were estimated in confounder-adjusted Cox models. Diabetes risk associations were validated in three independent studies. RESULTS: After adjustment for confounders and multiple testing correction, IgG-GP7, IgG-GP8, IgG-GP9, IgG-GP11, and IgG-GP19 were associated with type 2 diabetes risk. A score based on these IgG-GPs was associated with a higher diabetes risk in EPIC-Potsdam and independent validation studies (843 total cases, 3,149 total non-cases, pooled estimate per SD increase 1.50 [95% CI 1.37–1.64]). Associations of IgG-GPs with CVD risk differed between men and women. In women, IgG-GP9 was inversely associated with CVD risk (hazard ratio [HR] per SD 0.80 [95% CI 0.65–0.98]). In men, a weighted score based on IgG-GP19 and IgG-GP23 was associated with higher CVD risk (HR per SD 1.47 [95% CI 1.20–1.80]). In addition, several derived traits were associated with cardiometabolic disease incidence. CONCLUSIONS: Selected IgG N-glycans are associated with cardiometabolic risk beyond classic risk factors, including clinical biomarkers