Influence of diabetes on autonomic function in children: analysis through the geometr ic indices

Introduction: Diabetes mellitus type 1 has been established as one of the most common noncommunicable diseases among children, diabetic autonomic dysfunction presenting as one of its most frequent complications, however, few studies have evaluated autonomic modulation through heart rate variability in diabetic children. Objective: To analyze the autonomic modulation in children with diabetes mellitus type 1. Methods: Data from 36 children of both sexes were analyzed, who were divided into two groups: Diabetes mellitus type 1, n = 13 (11.62 ± 2.18) with a diagnosis of Diabetes mellitus type 1 and control, n = 23 (11.04 ± 1.02) without the disease. Initially personal data, weight, height, heart rate and blood pressure were collected. Subsequently, for the analysis of autonomic modulation, the heart rate beatto-beat was captured using a heart rate monitor in the supine position for 30 minutes. The geometric indices (RRtri, TINN, Poincaré plot) were calculated to analyze autonomic modulation. The Student t test for parametric data or the Mann-Whitney test for nonparametric data, with a 5% signifi cance level, were used for comparison between groups. Results: The results demonstrated a reduction in RRtri, TINN, SD1 and SD2 in diabetic children. The SD1/SD2 ratio was similar between groups. In the qualitative analysis of the Poincaré plot, the children with Diabetes mellitus type 1 presented a fi gure with less dispersion of the points when compared to the control children. Conclusion: Children with diabetes mellitus type 1 have reduced overall variability and parasympathetic modulation

AVALIAÇÃO DA EFETIVIDADE DO “PROJETO HIPERTENSÃO DO SETOR DE REABILITAÇÃO CARDÍACA” DA FCT/UNESP

A Hipertensão Arterial Sistêmica (HAS) apresenta alta prevalência na população mundial, sendo assim programas preventivos e de acompanhamento necessitam ser aplicados na população. O objetivo foi avaliar a efetividade do “Projeto Hipertensão” analisando fatores que agravam a HAS. Coletou-se dados de 29 participantes hipertensos, para avaliar altura e peso e calcular o índice de massa corpórea, pressão arterial(PA), glicemia, pelo exame de punção da polpa digital com 2hs de jejum, utilizando o aparelho Biochek relação cintura quadril, medindo-se as circunferências abdominal e do quadril e nível de atividade física, através do IPAQ.Utilizou-se estatística descritiva. Observou-se que 55% da amostra apresentou glicemia normal, 83% tem PA abaixo de 140/90 mmHg, 86% estão na faixa de Sobrepeso/obesidade, 68% sedentários, 65% risco alto/muito alto para desenvolver doenças cardiovasculares. Concluímos que acompanhar hipertensos do projeto possibilitou resultados satisfatórios com relação à diminuição da PA, contudo faz-se necessária campanhas preventivas paralelamente às mensurações de PA, devido a significativa presença de fatores de riscos na população

OBESIDADE E RISCO CORONARIANO EM HOMENS E MULHERES PARTICIPANTES DE UM PROJETO DE EXTENSÃO UNIVERSITÁRIA

Caracterizada pelo acúmulo excessivo de gordura corporal a obesidade se torna um problema de saúde pública com o avanço da idade podendo ser avaliada por meio do índice de massa corpórea (IMC) e o Índice de conicidade (IC). Objetivo: Determinar a prevalência de obesidade e comparar risco coronariano em homens e mulheres participantes do programa de prevenção primária e secundária de doenças cardiovasculares de um centro de reabilitação. Metodologia: Os voluntários foram identificados e tiveram avaliadas medidas antropométricas e de circunferência da cintura para o cálculo do IMC e IC. O método estatístico utilizado foi Shapiro-wilk para normalidade e posterior teste t de Student e Man-Withney (

Relationship of the Aggregation of Cardiovascular Risk Factors in the Parasympathetic Modulation of Young People with Type 1 Diabetes

Background and objectives: In healthy individuals, autonomic alterations are associated with the aggregation of cardiovascular risk factors. However, in individuals with type 1 diabetes, who are known to present autonomic alterations, mainly characterized by a reduction in parasympathetic modulation, these associations have not yet been investigated. We assess whether the aggregation of cardiovascular risk factors influences parasympathetic indices of heart rate variability in young people with type 1 diabetes. Materials and methods: This cross-sectional study included 39 individuals with type 1 diabetes (22.54 ± 4.31), evaluated in relation to the risk factors: blood pressure, fat percentage, and resting heart rate. For heart rate variability analysis, heart rate was recorded beat-to-beat using a cardio frequency meter (PolarS810i) for 30 min with the volunteers in dorsal decubitus. The parasympathetic heart rate variability indices were calculated: rMSSD, pNN50, high frequency (HF) n.u (normalized units), SD1, 2LV, and 2ULV. Data collection was carried out in 2014 and analyzed in 2017. Results: Individuals with two aggregate risk factors present a reduction in the values of the indices that reflect parasympathetic autonomic modulation compared to individuals without the risk factors analyzed, regardless of sex and age. Conclusion: In young people with type 1 diabetes, the aggregation of cardiovascular risk factors is associated with parasympathetic autonomic impairment

Dinâmica linear e não linear da variabilidade da frequência cardíaca: sensibilidade, especificidade, valor preditivo e correlação de características físicas e clínicas no Diabetes Mellitus tipo 1

Type 1 diabetes mellitus (T1DM) can promote autonomic alterations, and this can be assessed by heart rate variability (HRV). However the power diagnosis of this tool and the association between clinics and physics characteristics and HRV index in T1DM is unknowledge for us. Objective: to evaluate the HRV prognostic value on literature and in T1DM by sensibility, specificity and predict values. And assess the association existence between HRV index and physic activity levels, corporal composition and metabolic and cardiovascular parameters in this population. Methods: we perform a search at electronics bases of older records to April 2014 searching on literature what they have about the theme. After this, we evaluated 43 young people‟s health and 39 T1DM people which had measured their cardiovascular parameters, corporal composition, physical activity level, and their casual glycemic, followed by an autonomic evaluation by HRV that was obtained with a heart rate monitor to have the HRV index. The data were analyzed as normality (Shapiro-wilk) to determinate the HRV diagnosis accuracy, cutoff point was obtained for Receiver Operating characteristic (ROC) curve...O Diabetes Mellitus tipo 1 (DM Tipo 1) pode promover alterações autonômicas que podem ser avaliadas pela variabilidade da frequência cardíaca (VFC), entretanto não são do nosso conhecimento o poder diagnóstico dessa ferramenta e a associação de características clínicas e físicas com os índices da VFC no DM tipo 1. OBJETIVO: 1) Verificar o uso da VFC como ferramenta para avaliação diagnóstica em diabéticos, assim como se existem pontos de corte gerados a partir da utilização dessa ferramenta nesses indivíduos; 2) Comparar os índices da VFC e avaliar o valor prognóstico destes índices por meio da sensibilidade, especificidade e valores preditivos em jovens com DM tipo 1 e saudáveis; 3) Avaliar a existência de associações entre índices de VFC e níveis de atividade física, composição corporal, parâmetros metabólicos e cardiovasculares em indivíduos com DM tipo 1. MÉTODOS: Para atingir o primeiro objetivo, realizou-se busca em bases eletrônicas partindo dos registros mais antigos até abril de 2014 para buscar na literatura o que havia sobre o tema. Posteriormente, para atingir os objetivos 2 e 3, foram avaliados 39 jovens com DM tipo 1 e 43 jovens saudáveis, os quais tiveram seus parâmetros cardiovasculares, composição corporal, nível de atividade física e glicemia casual mensurados, seguido da captação da frequência cardíaca batimento a batimento com os voluntários em decúbito dorsal, para posterior análise da VFC...Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP

Effects of osteopathic manipulative treatment associated with pain education and clinical hypnosis in individuals with chronic low back pain: study protocol for a randomized sham-controlled clinical trial

Abstract Background Patients with chronic low back pain (CLBP) suffer with functional, social, and psychological aspects. There is a growing number of studies with multimodal approaches in the management of these patients, combining physical and behavioral therapies such as osteopathic manipulative treatment, associating pain education and clinical hypnosis. The aim of the present study will be to evaluate the effects of osteopathic manipulative treatment (OMT) associated with pain neuroscience education (PNE) and clinical hypnosis (CH) on pain and disability in participants with CLBP compared to PNE, CH, and sham therapy. Methods A randomized controlled clinical trial will be conducted in participants aged 20–60 years with CLBP who will be divided into two groups. Group 1 will receive PNE and CH associated with OMT, and G2 will receive PNE, CH, and sham therapy. In both groups, 4 interventions of a maximum of 50 min and with an interval of 7 days will be performed. As primary outcomes, pain (numerical pain scale), pressure pain threshold (pressure algometer), and disability (Oswestry Disability Questionnaire) will be evaluated and, as a secondary outcome, global impression of improvement (Percent of Improvement Scale), central sensitization (Central Sensitization Questionnaire), biopsychosocial aspects (Start Beck Toll Questionnaire), and behavior of the autonomic nervous system (heart rate variability) will be assessed. Participants will be evaluated in the pre-intervention moments, immediately after the end of the protocol and 4 weeks after the procedures. Randomization will be created through a simple randomized sequence and the evaluator will be blinded to the allocation of intervention groups. Discussion The guidelines have been encouraging multimodal, biopsychosocial approaches for patients with CLBP; in this sense, the results of this study can help clinicians and researchers in the implementation of a model of treatment strategy for these patients. In addition, patients may benefit from approaches with minimal risk of deleterious effects and low cost. In addition, it will enable the addition of relevant elements to the literature, with approaches that interact and do not segment the body and brain of patients with CLBP, allowing new studies in this scenario. Trials registration Date: September 4, 2021/Number: NCT05042115

Cardiac risk stratification in cardiac rehabilitation programs: a review of protocols

Objective: Gather and describe general characteristics of different protocols of risk stratification for cardiac patients undergoing exercise. Methods: We conducted searches in LILACS, IBECS, MEDLINE, Cochrane Library, and SciELO electronic databases, using the following descriptors: Cardiovascular Disease, Rehabilitation Centers, Practice Guideline, Exercise and Risk Stratification in the past 20 years. Results: Were selected eight studies addressing methods of risk stratification in patients undergoing exercise. Conclusion: None of the methods described could cover every situation the patient can be subjected to; however, they are essential to exercise prescription