Temporal response of post-activation performance enhancement induced by a plyometric conditioning activity

IntroductionTo better understand the post-activation performance enhancement (PAPE) effect promoted by a plyometric conditioning activity (CA), the aim of this study was to investigate the temporal response of PAPE after a plyometric CA.MethodsFourteen healthy and active adults visited the laboratory 3 times, with an interval of 7 days between each visit. On the first day they were familiarized with the countermovement jump (CMJ) test and plyometric CA. In the second and third visits, participants performed either plyometric CA or control (remaining seated) in a crossover design. The CMJ test was performed pre and 1-, 3-, 6-, and 9-min post the plyometric CA or control. The comparisons were performed using the repeated measure two-factor ANOVA and Bonferroni adjustment (significance level adopted P ≤ 0.05).ResultsTime (P < 0.01), condition (P < 0.01), and interaction (P < 0.01) effects were reported for CMJ comparisons. For the control condition, CMJ increased at 3 min compared to pre (P = 0.03) and at 3 min compared to 1 min (P = 0.03). For the plyometric CA, CMJ increased at 1- (P < 0.01), 3- (P < 0.01), and 6-min (P = 0.02) compared to pre. For condition comparisons, CMJ was different at 1- (P < 0.01), 3- (P < 0.01), 6- (P < 0.01), and 9-min (P = 0.02). The Effect size of the comparisons of all moments compared to pre was null (d < 0.20) for control and small (d < 0.50) for plyometric CA.DiscussionIt is possible to conclude that the plyometric CA promoted a PAPE effect for up to 9-min. Strength and conditioning coaches and practitioners may consider multiple sets of plyometric CA to produce immediate enhancement of power in the lower limbs

Coagulopatia induzida pela Covid-19: Uma revisão de literatura / Coagulopathy induced by Covid-19: A literature review

Objetivo: O vírus da Covid-19 surgiu na China em 2019. Conhecido como um beta vírus de RNA, já matou milhares de pessoas ao redor do mundo. O presente trabalho tem por objetivo realizar um estudo acerca da associação entre a coagulopatia e a infecção pela Covid-19. Metodologia: Trata-se de um estudo de revisão, de natureza descritiva e exploratória. Este tipo de estudo é evidenciado por analisar informações de assunto por meio da síntese dos resultados anteriores. Resultados e Discussão: A patogênese das complicações trombóticas em pacientes com Covid-19 permanece. Os resultados do estudo mostram que a infecção pelo SARS-CoV-2 está intimamente relacionada a manifestações pulmonares graves como a síndrome de angústia respiratória grave (SDRA) por sua inflamação difusa pulmonar ou extrapulmonar, ao tromboembolismo pulmonar (TEP) devido a localização errática de um trombo nas artérias pulmonares, e principalmente a coagulopatias por se tratar de um prognóstico negativo significante no quadro do paciente na maioria dos casos. Conclusão: De acordo com a literatura, embora os mecanismos específicos ainda não estejam claros, a infecção pelo SARS-CoV-2 envolve processos potencialmente danosos na coagulação e inflamação. Entretanto, a Covid-19 pode ter um comportamento grave, caracterizado por uma resposta imunológica com hiperinflamação e hipercoagulabilidade evoluindo para trombose e Coagulação Intravascular Disseminada (CIVD)

Rationale, study design, and analysis plan of the Alveolar Recruitment for ARDS Trial (ART): Study protocol for a randomized controlled trial

Background: Acute respiratory distress syndrome (ARDS) is associated with high in-hospital mortality. Alveolar recruitment followed by ventilation at optimal titrated PEEP may reduce ventilator-induced lung injury and improve oxygenation in patients with ARDS, but the effects on mortality and other clinical outcomes remain unknown. This article reports the rationale, study design, and analysis plan of the Alveolar Recruitment for ARDS Trial (ART). Methods/Design: ART is a pragmatic, multicenter, randomized (concealed), controlled trial, which aims to determine if maximum stepwise alveolar recruitment associated with PEEP titration is able to increase 28-day survival in patients with ARDS compared to conventional treatment (ARDSNet strategy). We will enroll adult patients with ARDS of less than 72 h duration. The intervention group will receive an alveolar recruitment maneuver, with stepwise increases of PEEP achieving 45 cmH(2)O and peak pressure of 60 cmH2O, followed by ventilation with optimal PEEP titrated according to the static compliance of the respiratory system. In the control group, mechanical ventilation will follow a conventional protocol (ARDSNet). In both groups, we will use controlled volume mode with low tidal volumes (4 to 6 mL/kg of predicted body weight) and targeting plateau pressure <= 30 cmH2O. The primary outcome is 28-day survival, and the secondary outcomes are: length of ICU stay; length of hospital stay; pneumothorax requiring chest tube during first 7 days; barotrauma during first 7 days; mechanical ventilation-free days from days 1 to 28; ICU, in-hospital, and 6-month survival. ART is an event-guided trial planned to last until 520 events (deaths within 28 days) are observed. These events allow detection of a hazard ratio of 0.75, with 90% power and two-tailed type I error of 5%. All analysis will follow the intention-to-treat principle. Discussion: If the ART strategy with maximum recruitment and PEEP titration improves 28-day survival, this will represent a notable advance to the care of ARDS patients. Conversely, if the ART strategy is similar or inferior to the current evidence-based strategy (ARDSNet), this should also change current practice as many institutions routinely employ recruitment maneuvers and set PEEP levels according to some titration method.Hospital do Coracao (HCor) as part of the Program 'Hospitais de Excelencia a Servico do SUS (PROADI-SUS)'Brazilian Ministry of Healt

Vitamin D status and prevalence of hypovitaminosis D in different genders throughout life stages: A Brazilian cross-sectional study

OBJECTIVES: To evaluate the mean concentration of 25-hydroxivitamin D [25(OH) D] and prevalence of hypovitaminosis D in individuals residing in Rio de Janeiro, Brazil. METHODS: The data of 80,000 consecutive individuals who had 25(OH) D measurements performed by electrochemiluminescence between 1/2/2018 and 2/5/2018 were selected. Patients who reported the use of therapies/ supplements were excluded. Levels of 25(OH) D X20 ng/mL (ages o60 years) and X30 ng/mL (ages X60 years) were considered adequate. RESULTS: We analyzed the data of 24,074 individuals (1–95 years old, 64.7% female). Descriptive curves showed that, in both sexes, the mean values of 25(OH) D decreased from the first years of life until adolescence, then slightly increased, and then tended to stabilize during adulthood. Levels of 25(OH) D o20 ng/mL were observed in 6% of girls versus 3.6% of boys and in 13.6% of adolescent girls versus 12.6% of adolescent boys and 11% of adults. The percentage of seniors with serum levels of 25(OH) D o20 ng/mL was 13.6% in women and 12.7% in men; 53.2% of women and 50.6% of men had levels o30 ng/mL. CONCLUSIONS: Mean 25(OH) D values were higher in children and lower in adolescents and women. Approximately 90% of non-seniors and presumably healthy residents of the urban metropolitan region of Rio de Janeiro presented satisfactory levels of 25(OH) D during the summer months; however, in over half of the elderly, the serum concentrations of 25(OH) D were inadequate. Therefore, strategies for the prevention of hypovitaminosis D should be considered in the senior population

Avaliação de elementos inorgânicos em água e uma população humana exposta a rejeitos de minério

Introduction: Manganese exploration in Amapá and inadequate ore tailing storage in the Santana port area have generated environmental and social impacts for residents. Objective: Assess the presence of inorganic elements in Elesbão neighborhood inhabitants exposed to ore tailings. Methods: Metals were quantifed in the water used by the population and in urine by Flame Atomic Absorption Spectrophotometry (F-AAS), and in hair Inductively Coupled Plasma Mass Spectrometry (ICP-MS). Blood was obtained from 67 exposed and 99 unexposed women, totaling 65 urine and 18 hair samples. Hematological, biochemical and blood clotting analyses were performed in all participants, who also answered a socio-economic questionnaire. Results: Regarding age group, 60.0% of exposed residents ranged between 18 and 42 years old and lived in the area from 10 to 34 years. High concentrations of As, Cd, Cu, Fe, Mn and Pb were detected in the analyzed water. In urine, signifcance was observed for Mn and in hair, for Pb and Mn. Hb, Ht, VCM, HCM, monocytes, morphological changes in red cells and platelets were among the signifcant hematological parameters. Regarding the biochemical evaluations, alterations in the enzymes Alkaline Phosphatase, Bilirubins and Creatinine were observed. Conclusions: Environmental contamination by elements that can compromise the health of the exposed population was observed. However, more in-depth studies aimed at women’s health are required, including hormones and genetic marker analyses, thus contributing to the action of competent authorities to improve the health of the exposed population.Introdução: A exploração do manganês no Amapá e o armazenamento inadequado dos rejeitos de minério na área portuária de Santana geraram impactos ambientais e sociais aos moradores locais. Objetivo: Avaliar a presença de elementos inorgânicos nas moradoras do bairro Elesbão expostas aos rejeitos de minérios. Método: Por meio da Espectrofotometria de Absorção Atômica de Chama (F-AAS), quantifcaram-se metais na água utilizada pela população e na matriz biológica urina, enquanto no cabelo utilizou-se Espectrometria de Massas com Plasma Indutivamente Acoplado (ICP-MS). Coletou-se o sangue de 67 mulheres expostas e de 99 não expostas, destas, coletou-se 65 amostras de urina e 18 de cabelo. Foram realizadas análises hematológica, bioquímica e de coagulação no sangue de todas as participantes que também responderam a um questionário socioeconômico. Resultados: Quanto à faixa etária, 60,0% das moradoras expostas estavam entre 18 e 42 anos e moravam na localidade entre 10 e 34 anos. Na água analisada, encontrou-se concentrações elevadas dos metais As, Cd, Cu, Fe, Mn e Pb. Na matriz urina, observou-se signifcância para o Mn e, no cabelo, para Pb e Mn. Dentre os parâmetros hematológicos signifcativos estavam Hb, Ht, VCM, HCM, monócitos, alterações morfológicas nas hemácias e plaquetas. Na avaliação bioquímica, observaram-se alterações nas enzimas fosfatase alcalina, bilirrubinas e creatinina. Conclusões: Há contaminação ambiental por elementos que podem comprometer a saúde da população exposta, quando em contato por tempo prolongado. Estudos mais aprofundados e direcionados à saúde da mulher precisam ser realizados, incluindo parâmetros como a análise de hormônios e marcadores genéticos, visando contribuir, assim, para uma ação das autoridades competentes em melhorar a saúde da população exposta.    

A cidadania sob o signo do desvio: Para uma crítica da "tese de excepcionalidade brasileira"

O propósito central do artigo consiste em realizar uma consideração crítica do que denominamos de "tese da excepcionalidade normativa brasileira". As duas principais questões orientadoras são: em primeiro lugar, haveria alguma desvantagem, do ponto de vista analítico, em manter-se orientado pela noção conforme a qual a experiência da cidadania no Brasil é algo particular em relação ao "centro da modernidade"? Em segundo lugar, é possível vislumbrar outra maneira profícua de refletir a respeito da experiência da cidadania no Brasil para além da "tese da excepcionalidade normativa"?<br>This article aims at carrying out a critique of the so-called "thesis of the Brazilian normative exceptionality". The two driving questions are: first and foremost, is there any disadvantage, from an analytical point of view, in remaining oriented by the notion according to which the experience of citizenship in Brazil is something peculiar as compared to the "nucleus of modernity"? Secondly, is it possible to envisage another fruitful way of framing such an experience which goes beyond the "exceptionality thesis"

Rationale, study design, and analysis plan of the Alveolar Recruitment for ARDS Trial (ART): Study protocol for a randomized controlled trial

Background: Acute respiratory distress syndrome (ARDS) is associated with high in-hospital mortality. Alveolar recruitment followed by ventilation at optimal titrated PEEP may reduce ventilator-induced lung injury and improve oxygenation in patients with ARDS, but the effects on mortality and other clinical outcomes remain unknown. This article reports the rationale, study design, and analysis plan of the Alveolar Recruitment for ARDS Trial (ART). Methods/Design: ART is a pragmatic, multicenter, randomized (concealed), controlled trial, which aims to determine if maximum stepwise alveolar recruitment associated with PEEP titration is able to increase 28-day survival in patients with ARDS compared to conventional treatment (ARDSNet strategy). We will enroll adult patients with ARDS of less than 72 h duration. The intervention group will receive an alveolar recruitment maneuver, with stepwise increases of PEEP achieving 45 cmH(2)O and peak pressure of 60 cmH2O, followed by ventilation with optimal PEEP titrated according to the static compliance of the respiratory system. In the control group, mechanical ventilation will follow a conventional protocol (ARDSNet). In both groups, we will use controlled volume mode with low tidal volumes (4 to 6 mL/kg of predicted body weight) and targeting plateau pressure <= 30 cmH2O. The primary outcome is 28-day survival, and the secondary outcomes are: length of ICU stay; length of hospital stay; pneumothorax requiring chest tube during first 7 days; barotrauma during first 7 days; mechanical ventilation-free days from days 1 to 28; ICU, in-hospital, and 6-month survival. ART is an event-guided trial planned to last until 520 events (deaths within 28 days) are observed. These events allow detection of a hazard ratio of 0.75, with 90% power and two-tailed type I error of 5%. All analysis will follow the intention-to-treat principle. Discussion: If the ART strategy with maximum recruitment and PEEP titration improves 28-day survival, this will represent a notable advance to the care of ARDS patients. Conversely, if the ART strategy is similar or inferior to the current evidence-based strategy (ARDSNet), this should also change current practice as many institutions routinely employ recruitment maneuvers and set PEEP levels according to some titration method.13Hospital do Coracao (HCor) as part of the Program 'Hospitais de Excelencia a Servico do SUS (PROADI-SUS)'Brazilian Ministry of Healt