Experience of spouses of women with breast cancer: an integrative literature review

Objective: To gather, to characterize, to analyze, to synthesize and to integrate primary studies that addressed the experiences of spouses / husbands / partners of women with breast cancer, presenting the current state of knowledge. Method: Integrative literature review carried out in the databases of VHL, PubMed, CINHAL e SciELO. Results: The sample consisted of eight studies published between 2000-2012, which pointed to the experiences of the involvement and the care of the husbands towards their ill wives. Conclusion: This study highlights the need for attention and assistance to those spouses, as well as guidance and education to exercise the care the same way as the health staff has done with women. Furthermore, it emphasizes the importance of further studies in order to deepen the knowledge on this topic, and thus, improve the care with better scientific basis

Genetic variation and exercise-induced muscle damage: implications for athletic performance, injury and ageing.

Prolonged unaccustomed exercise involving muscle lengthening (eccentric) actions can result in ultrastructural muscle disruption, impaired excitation-contraction coupling, inflammation and muscle protein degradation. This process is associated with delayed onset muscle soreness and is referred to as exercise-induced muscle damage. Although a certain amount of muscle damage may be necessary for adaptation to occur, excessive damage or inadequate recovery from exercise-induced muscle damage can increase injury risk, particularly in older individuals, who experience more damage and require longer to recover from muscle damaging exercise than younger adults. Furthermore, it is apparent that inter-individual variation exists in the response to exercise-induced muscle damage, and there is evidence that genetic variability may play a key role. Although this area of research is in its infancy, certain gene variations, or polymorphisms have been associated with exercise-induced muscle damage (i.e. individuals with certain genotypes experience greater muscle damage, and require longer recovery, following strenuous exercise). These polymorphisms include ACTN3 (R577X, rs1815739), TNF (-308 G>A, rs1800629), IL6 (-174 G>C, rs1800795), and IGF2 (ApaI, 17200 G>A, rs680). Knowing how someone is likely to respond to a particular type of exercise could help coaches/practitioners individualise the exercise training of their athletes/patients, thus maximising recovery and adaptation, while reducing overload-associated injury risk. The purpose of this review is to provide a critical analysis of the literature concerning gene polymorphisms associated with exercise-induced muscle damage, both in young and older individuals, and to highlight the potential mechanisms underpinning these associations, thus providing a better understanding of exercise-induced muscle damage

Inflammatory status in older women with and without metabolic syndrome: is there a correlation with risk factors?

Alessandro de Oliveira Silva,1,2 Ramires Alsamir Tibana,1 Margo Gomes Oliveira Karnikowski,3 Silvana Schwerz Funghetto,3 Jonato Prestes1 1Graduation Program in Physical Education and Health, Catholic University of Brasilia, 2Physical Education Department, Universitary Center of Brasilia, 3Ceilandia Faculty, University of Brasilia, Brasilia, Brazil Purpose: To compare the inflammatory status in older women with and without metabolic syndrome (MetS) and to correlate inflammatory parameters, anthropometric measures, metabolic profile, and blood pressure with MetS Z-score. Methods: This cohort transversal study included 129 older women assigned into two groups: with MetS (n = 48; 66.4 ± 4.4 years; 68.1 ± 8.3 kg; 1.51 ± 0.06 m; 29.8 ± 3.9 kg/m2) and without MetS (n = 81; 68.0 ± 5.8 years; 61.0 ± 9.4 kg; 1.53 ± 0.06 m; 26.0 ± 3.9 kg/m2). Body composition was evaluated by dual-energy X-ray absorptiometry (General Electric-GE model 8548 BX1L, year 2005, Lunar DPX type, software Encore 2005; Rommelsdorf, Germany) and cytokines by enzyme-linked immunosorbent assay. Results: There was no difference between the groups regarding age, height, fat mass, glycosylated hemoglobin, total cholesterol, and low-density lipoprotein cholesterol. However, older women with MetS presented higher body mass, body mass index, waist and hip circumference, waist–hip and waist–height ratio, systolic, diastolic, and mean blood pressure, glucose, insulin, homeostasis model assessment of insulin resistance, MetS Z-score, tumor necrosis factor-α, interferon-γ, and lower lean body mass values compared to women without MetS. Moreover, there were correlations between MetS Z-score and body mass (r = 0.20), waist circumference (r = 0.26), waist–hip (r = 0.32) and waist–height ratio (r = 0.24), blood glucose (r = 0.24), insulin (r = 0.24), homeostasis model assessment of insulin resistance (r = 0.32), triglycerides (r = 0.39), tumor necrosis factor-α (r = 0.28), interferon-γ (r = 0.22), and inverse correlation with high-density lipoprotein cholesterol (r = −0.32). MetS Z-score was positively associated with systolic (r = 0.92), diastolic (r = 0.94), and mean blood pressure (r = 0.98). Conclusion: Older women with MetS have higher cytokine levels, anthropometric measures, metabolic profile, and blood pressure. Inflammatory cytokines may help to improve the understanding of the progression status of MetS in older persons. Keywords: metabolic syndrome, cytokines, agin

Effects of blood flow restriction exercise on hemostasis: a systematic review of randomized and non-randomized trials

Dahan da Cunha Nascimento,1,2 Bernardo Petriz,2 Samuel da Cunha Oliveira,1 Denis Cesar Leite Vieira,2,3 Silvana Schwerz Funghetto,4 Alessandro Oliveira Silva,5,6 Jonato Prestes1 1Graduate Program in Physical Education, Catholic University of Brasilia (UCB), Brasilia, Brazil; 2Department of Physical Education, University Center of the Federal District (UDF), Brasilia, Brazil; 3Department of Physical Education, University of Brasilia (UNB), Brasilia, Brazil; 4Department of Nursing, University of Brasilia (UNB), Brasilia, Brazil; 5Department of Medicine and Physical Education, University Center of Brasilia (UniCEUB), Brasilia, Brazil; 6Department of Medicine and Physical Education, Integrated Colleges of the Central Plateau Educational Union (FACIPLAC), Brasilia, Brazil Background: Blood flow restriction (BFR) exercise has shown to induce a positive influence on bone metabolism and attenuate muscle strength loss and atrophy in subjects suffering from musculoskeletal weakness. Despite the known benefits of BFR exercise, it remains unclear whether or not the pressurization of blood vessels damages the endothelial cells or increases risk for formation of thrombi. Thus, the effects of BFR exercise on coagulation, fibrinolysis, or hemostasis, remains speculative.Objective: The aim of the present study was to perform a systematic review of the short and long- term effects of BFR exercise on blood hemostasis in healthy individuals and patients with known disease (ie, hypertension, diabetes, obesity, and ischemic heart disease).Data Sources: A systematic review of English and non-English articles was conducted across PubMed, Science Direct, and Google Scholar databases, including reference lists of relevant papers. Study quality assessment was evaluated using the modified version of Downs and Black checklist. Search results were limited to exercise training studies investigating the effects of BFR exercise on blood hemostasis in healthy individuals and patients with disease. Level of evidence was determined according to the criteria described by Oxford Center for Evidence-Based Medicine. Study selection: Only randomized controlled trials (RCTs) and non-randomized controlled trials (NRCTs) that examined the effects of exercise with BFR exercise vs exercises without BFR on blood hemostasis in healthy individuals and patients were included.Data extraction: Nine studies were eligible (RCT =4; NRCT =5).Results: The average score on the Downs and Black checklist was 11.22. All studies were classified as having poor methodological quality wherein the level of evidence provided in all reviewed studies was level IIb only (ie, poor quality RCTs).Conclusion: Considering the limitations in the available evidence, firm recommendations cannot be provided. Keywords: exercise, hemostasis, vascular occlusion, blood flow restriction, coagulation system, Kaatsu trainin

Predictive Models of Muscle Strength in Older People with Type 2 Diabetes Mellitus

Mateus Medeiros Leite,1 Ivo Vieira de Sousa Neto,2 Maurílio Tiradentes Dutra,3 Silvana Schwerz Funghetto,1 Alessandro de Oliveira Silva,4 Izabel Cristina Rodrigues da Silva,1 Luciano Ramos de Lima,5 Marina Morato Stival1 1Graduate Program in Health Sciences and Technologies, University of Brasilia, Faculty of Ceilândia, Brasilia, Brazil; 2School of Physical Education and Sport of Ribeirão Preto, University of São Paulo (USP), São Paulo, Brazil; 3Federal Institute of Education, Science and Technology of Brasília, Brasilia, Brazil; 4Physical Education Department, University Center of Brasilia - UniCEUB, Brasilia, Brazil; 5Nursing Course, University of Brasilia, Faculty of Ceilândia, Brasilia, BrazilCorrespondence: Mateus Medeiros Leite, University of Brasilia, Graduate Program in Health Sciences and Technologies, Faculty of Ceilândia, Brasilia, Brasilia, Federal District, Brazil – Campus Universitario, s/n, Centro Metropolitano, Brasília, 72220-275, Brazil, Tel + 55 61 998541966, Email [email protected]: To propose predictive models for absolute muscle strength (AMS) of elderly people with type 2 Diabetes Mellitus (DM2) in primary health care.Patients and Methods: The cross-sectional study was conducted with 138 elderly diabetics. The AMS was measured by a JAMAR® hydraulic handgrip dynamometer, determined by the sum of both hands. The following indices were evaluated: waist-to-height ratio (WHtR), body mass index (BMI), Lipid Accumulation Product (LAP), Triglyceride/High Density Lipoprotein (TG/HDL) ratio and platelet/lymphocyte ratio (PLR). Multiple linear regression was used in the statistical analysis.Results: The final regression model indicated 66.4% (R²=0.66) of the variation in AMS. WHtR decreased AMS by 41.1% (β = − 0.19; t = − 3.70; p < 0.001), while PLR by 11.3% (β = − 0.12; t = − 2.36; p = 0.020). Male sex increased AMS by 10.6% (β = 0.32; t = 4.16; p < 0.001), and lean mass (LM) by 0.89% (β = 0.46; t = 6.03; p < 0.001).Conclusion: WHtR and PLR predicted a decrease, while male sex and LM predicted an increase in AMS. It is suggested that these markers be used as screening measures for variation in AMS in older adults with DM2. These results have relevant practical application in primary health care since the markers are easy to use.Keywords: handgrip strength, obesity, diabetes mellitus, inflammation, primary health car

Resistance training-induced gains in muscle strength, body composition, and functional capacity are attenuated in elderly women with sarcopenic obesity

Alessandro de Oliveira Silva,1,2 Maur&iacute;lio Tiradentes Dutra,3 Wilson Max Almeida Monteiro de Moraes,4 Silvana Schwerz Funghetto,3 Darlan Lopes de Farias,1 Paulo Henrique Fernandes dos Santos,3 Denis Cesar Leite Vieira,5 Dahan da Cunha Nascimento,4,5 V&acirc;nia Silva Macedo Orsano,4 Brad J Schoenfeld,6 Jonato Prestes4 1University Center of Brasilia (UniCEUB), Bras&iacute;lia, Brazil; 2Integrated Colleges of the Central Plateau Educational Union (FACIPLAC), Bras&iacute;lia, Brazil; 3University of Brasilia (UnB), Bras&iacute;lia, Brazil; 4Catholic University of Brasilia (UCB), Bras&iacute;lia, Brazil; 5University Center of the Federal District (UDF), Bras&iacute;lia, Brazil; 6Department of Health Sciences, CUNY Lehman College, Bronx, NY,&nbsp;United States Objectives: The purpose of this study was to compare the effects of resistance training (RT) on body composition, muscle strength, and functional capacity in elderly women with and without sarcopenic obesity (SO).Methods: A total of 49 women (aged &ge;60&nbsp;years) were divided in two groups: without SO (non-SO, n=41) and with SO (n=8). Both groups performed a periodized RT program consisting of two weekly sessions for 16 weeks. All measures were assessed at baseline and postintervention, including anthropometry and body composition (dual-energy X-ray absorptiometry), muscle strength (one repetition maximum) for chest press and 45&deg; leg press, and functional capacity (stand up, elbow flexion, timed &ldquo;up and go&rdquo;).Results: After the intervention, only the non-SO group presented significant reductions in percentage body fat (-2.2%; P=0.006), waist circumference (-2.7%; P=0.01), waist-to-hip ratio (-2.3; P=0.02), and neck circumference (-1.8%; P=0.03) as compared with baseline. Muscle strength in the chest press and biceps curl increased in non-SO only (12.9% and 11.3%, respectively), while 45&deg; leg press strength increased in non-SO (50.3%) and SO (40.5%) as compared with baseline. Performance in the chair stand up and timed &ldquo;up and go&rdquo; improved in non-SO only (21.4% and -8.4%, respectively), whereas elbow flexion performance increased in non-SO (23.8%) and SO (21.4%). Effect sizes for motor tests were of higher magnitude in the non-SO group, and in general, considered &ldquo;moderate&rdquo; compared to &ldquo;trivial&rdquo; in the SO group.Conclusion: Results suggest that adaptations induced by 16 weeks of RT are attenuated in elderly woman with SO, compromising improvements in adiposity indices and gains in muscle strength and functional capacity. Keywords: aging, obesity, resistance training, sarcopeni

Comparison of percentage body fat and body mass index for the prediction of inflammatory and&nbsp;atherogenic lipid risk profiles in elderly women

Silvana Schwerz Funghetto,1 Alessandro de Oliveira Silva,2 Nuno Manuel Frade de Sousa,3 Marina Morato Stival,1 Ramires Alsamir Tibana,4 Leonardo Costa Pereira,1 Marja Let&iacute;cia Chaves Antunes,1&nbsp;Luciano Ramos de Lima,1 Jonato Prestes,4 Ricardo Jac&oacute; Oliveira,1 Maur&iacute;lio Tiradentes Dutra,2 Vin&iacute;cius Carolino Souza,1,4 Dahan da Cunha Nascimento,4 Marg&ocirc; Gomes de Oliveira Karnikowski1 1University of Bras&iacute;lia (UnB), Bras&iacute;lia, DF, Brazil; 2Center University of Brasilia (UNICEUB), Brasilia, DF, Brazil; 3Laboratory of Exercise Physiology, Faculty Est&aacute;cio de S&aacute; of Vit&oacute;ria, ES, Brazil; 4Catholic University of Bras&iacute;lia, Bras&iacute;lia, DF, Brazil Objective: To compare the clinical classification of the body mass index (BMI) and percentage body fat (PBF) for the prediction of inflammatory and atherogenic lipid profile risk in older women.Method: Cross-sectional analytical study with 277 elderly women from a local community in the Federal District, Brazil. PBF and fat-free mass (FFM) were determined by dual energy X-ray absorptiometry. The investigated inflammatory parameters were interleukin 6 and C-reactive protein.Results: Twenty-five percent of the elderly women were classified as normal weight, 50% overweight, and 25% obese by the BMI. The obese group had higher levels of triglycerides and very low-density lipoproteins than did the normal weight group (P&le;0.05) and lower levels of high-density lipoproteins (HDL) than did the overweight group (P&le;0.05). According to the PBF, 49% of the elderly women were classified as eutrophic, 28% overweight, and 23% obese. In the binomial logistic regression analyses including age, FFM, and lipid profile, only FFM (odds ratio [OR]=0.809, 95% confidence interval [CI]: 0.739&ndash;0.886; P&lt;0.0005) proved to be a predictor of reaching the eutrophic state by the BMI. When the cutoff points of PBF were used for the classification, FFM (OR=0.903, CI=0.884&ndash;0.965; P=0.003) and the total cholesterol/HDL ratio (OR=0.113, CI=0.023&ndash;0.546; P=0.007) proved to be predictors of reaching the eutrophic state.Conclusion: Accurate identification of obesity, systemic inflammation, and atherogenic lipid profile is key to assessing the risk of cardiometabolic diseases. Classification based on dual energy X-ray absorptiometry measures, along with biochemical and inflammatory parameters, seems to have a great clinical importance, since it allows the lipid profile eutrophic distinction in elderly overweight women. Keywords: lipids, aging, body fat, women, body mass index, health profil

Decreased functional capacity and muscle strength in elderly women with metabolic syndrome

Denis Cesar Leite Vieira,1 Ramires Alsamir Tibana,1 Vitor Tajra,1 Dahan da Cunha Nascimento,1 Darlan Lopes de Farias,1 Alessandro de Oliveira Silva,1 Tatiane Gomes Teixeira,1 Romulo Maia Carlos Fonseca,2 Ricardo Jac&oacute; de Oliveira,2 Felipe Augusto dos Santos Mendes,2 Wagner Rodrigues Martins,2 Silvana Schwerz Funghetto,2 Margo Gomes de Oliveira Karnikowski,2 James Wilfred Navalta,3 Jonato Prestes11Graduate Program on Physical Education, Catholic University of Brasilia, Brasilia, Brazil; 2University of Brasilia, UnB, Brasilia, Brazil; 3Department of Kinesiology and Nutrition Sciences of the University of Nevada, Las Vegas, NV, USAPurpose: To compare the metabolic parameters, flexibility, muscle strength, functional capacity, and lower limb muscle power of elderly women with and without the metabolic syndrome (MetS).Methods: This cross-sectional study included 28 older women divided into two groups: with the MetS (n = 14; 67.3 &plusmn; 5.5 years; 67.5 &plusmn; 16.7 kg; 1.45 &plusmn; 0.35 m; 28.0 &plusmn; 7.6 kg/m2), and without the MetS (n = 14; 68.7 &plusmn; 5.3 years; 58.2 &plusmn; 9.9 kg; 1.55 &plusmn; 0.10 m; 24.3 &plusmn; 3.8 kg/m2). Body composition was evaluated by dual-energy X-ray absorptiometry and dynamic muscle strength was assessed by one-maximum repetition (1RM) tests in leg press, bench press and biceps curl exercises. Six-minute walk test, Timed Up and Go (TUG); 30-second sitting-rising; arm curl using a 2-kg dumbbell, sit-and-reach (flexibility), and vertical jump tests were performed.Results: There was no difference between groups regarding age (P = 0.49), height (P = 0.46), body fat (%) (P = 0.19), systolic (P = 0.64), diastolic (P = 0.41) and mean blood pressure (P = 0.86), 30-second sitting-rising (P = 0.57), 30-s arm curl (P = 0.73), leg press 1RM (P = 0.51), bench press 1RM (P = 0.77), and biceps curl 1RM (P = 0.85). However, women without the MetS presented lower body mass (P = 0.001), body mass index (BMI) (P = 0.0001), waist circumference (P = 0.02), waist-to-height ratio (P = 0.02), fat body mass (kg) (P = 0.05), lean body mass (kg) (P = 0.02), blood glucose (P = 0.05), triglycerides (P = 0.03), Z-score for the MetS (P = 0.05), higher high-density lipoprotein-cholesterol (HDL-C) (P = 0.002), better performance on TUG (P = 0.01), flexibility (P = 0.03), six-minute walk test (P = 0.04), vertical jump (P = 0.05) and relative muscle strength for leg press (P = 0.03), bench press (P = 0.04) and biceps curl (P = 0.002) exercises as compared to women with the MetS.Conclusion: Elderly women with the MetS have higher metabolic risk profile and lower functional capacity, muscle strength, lower limb power and flexibility as compared to women without the MetS. The evaluation of functional capacity may help to determine the degree of physical decline in older persons with the MetS, while exercise interventions should be encouraged.Keywords: metabolic syndrome, functional capacity, muscle performance, agin