Gravidade da apneia obstrutiva do sono e treinamento resistido - efeito em idosos : um ensaio clínico randomizado piloto

Introdução: A prevalência da apneia obstrutiva do sono (AOS) entre pessoas com mais de 70 anos atinge até 95%. As opções de tratamento incluem o uso de pressão positiva nas via aérea, dispositivos intraorais e mudança de estilo de vida. Programa de exercícios aeróbicos ou combinados mostrou reduzir o índice de apneia-hipopneia (IAH) em adultos de meia-idade. No entanto, o efeito do treinamento resistido sobre a gravidade da AOS de pessoas idosas é controverso. O objetivo do presente estudo é avaliar o impacto do treinamento resistido no IAH e identificar possíveis mediadores do efeito do exercício. Métodos: Estudo randomizado, mascarado, controlado, em grupo paralelo. Indivíduos entre 65 e 80 anos, com IAH entre 20 e 50 eventos/hora na poligrafia respiratória foram atribuídos aleatoriamente para 12 semanas de treinamento de força ou grupo controle. IAH foi o principal desfecho. Índice de massa corporal (IMC) e teor de água corporal foram testados como mediadores. Espessura do músculo, força máxima e função física também foram avaliadas. Resultados: A amostra incluiu 23 indivíduos, 57% homens, com média de idade de 71±5 anos, alocados para treinamento (n=12) e grupo controle (n=11). O IAH basal nos grupos de treinamento e controle foi, respectivamente, 30±7/h e 29±9/h. No seguimento, o IAH mostrou significativa interação tempo × grupo. Não foi observada correlação entre Delta IAH e Delta IMC ou Delta teor de água corporal. A interação tempo × grupo permanece significativa após ajustar o modelo GEE para esses possíveis mediadores. Conclusão: Treinamento resistido a curto prazo em pessoas idosas é viável e muda de forma favorável a severidade da AOS e desfechos funcionais. As alterações no IMC e no teor de água corporal não parecem mediar a redução da IAH. Estudos futuros em amostras maiores de pessoas idosas são necessários.Introduction: Obstructive sleep apnea (OSA) prevalence among persons older than 70 years reaches up to 95%. The treatment options include use of positive airway pressure, intraoral devices, and lifestyle changes. Aerobic or combined exercise program has been shown to reduce the apnea-hypopnea index (AHI) in middle-aged adults. However, the effect of resisted training on OSA severity of older persons is controversial. The aim of the present study is to evaluate the impact of resisted training on the AHI and to identify possible mediators of the effect of exercise. Methods: This was a randomized, masked, controlled, parallel group trial. Subjects between 65 and 80 years, with AHI between 20 and 50 events/hour in the respiratory polygraphy were assigned randomly to 12 weeks of strength training or control groups. AHI was the main outcome. Body mass index (BMI) and bodily water content were tested as mediators. Muscle thickness, maximum strength, and physical function were assessed also. Results: The sample included 23 subjects, 57% men, aged 71±5 years, randomized to training (n=12) and control groups (n=11). The baseline AHI in the training and control groups were, respectively, 30±7/h and 29±9/h. At follow-up, the AHI showed significant time × group interaction. No correlation was observed between Delta AHI and delta BMI or delta bodily water content. The time × group interaction remains significant after adjusting the GEE model for these possible mediators. Conclusion: Short-term resisted training in older persons is feasible and changes favorably OSA severity and functional outcomes. Changes in BMI and in bodily water content do not seem to mediate the reduction in AHI. Future studies in larger samples of older persons are necessary

Scores of a web-based version of the seasonal pattern assessment questionnaire in Brazil

Introduction: Seasonal affective disorder (SAD) is a proposed mental disorder still controversial. This condition is prevalent in northern latitudes, but few studies have been conducted at locations in the southern hemisphere. It is usually assessed by the Seasonal Pattern Assessment Questionnaire (SPAQ). This study aimed to evaluate, through on-line questionnaire, the hypothesis that, in the Brazilian population, latitude and longitude influence SPAQ scores.Methods: An advertisement was posted on a sleep medicine website inviting visitors to investigate seasonal patterns of behavior and mood, using a Brazilian Portuguese version of the SPAQ. The geographic coordinates of the place of residence of each respondent were analyzed as a continuous variable or distributed in quartiles of latitude and longitude. The psychometric properties of the SPAQ were assessed by reliability and factor analyses.Results: Answers from 1001 respondents out of 1045 were considered eligible. High SPAQ scores were observed in 287 respondents, equally distributed among all latitude and longitude quartiles. Data collected in different seasons and during daylight saving time did not differ significantly in any of the scores for SPAQ dimensions. No correlations between SPAQ scores and latitude or longitude were observed. Psychometric properties of the SPAQ were preserved in all geographic locations.Conclusion: The finding of similar SPAQ scores at a wide latitude range defies the concept of SAD symptoms as latitude or longitude-dependent phenomena.

Leishmaniose visceral causada por Leishmania (Viannia) braziliensis em paciente infectado com HIV

No presente artigo os autores relatam caso de uma criança de 1 ano e 07 meses proveniente do estado de Minas Gerais com leishmaniose visceral causada por Leishmania (Viannia) braziliensis e co-infecção HIV. A mãe e o pai da criança de 22 e 27 anos de idade respectivamente também HIV positivo. A criança foi internada no Centro Geral de Pediatria em Belo Horizonte com febre alta, fadiga, perda de peso e aumento de fígado e baço. Foi realizado teste de imunofluorescência indireta para Leishmania e detectado título de 1:320. Este resultado foi confirmado com o encontro de amastigotas em aspirado de medula óssea e o crescimento de promastigotas em meios de cultura. Os parasitos foram identificados como Leishmania (Viannia) braziliensis utilizando PCR com primer específico para o complexo L. braziliensis, e primer genérico seguido de hibridização. Terapia específica para leishmaniose (antimonial de Glucantime) foi administrado por via intravenosa.The current article reports the case of a 19-month-old-girl, from the state of Minas Gerais, Brazil, with visceral leishmaniasis, by Leishmania (Viannia) braziliensis, and Human Immunodeficiency Virus (HIV) co-infection. The child's mother and father, aged 22 and 27 years old, respectively, were both HIV positive. The child was admitted to the General Pediatric Center, in Belo Horizonte, presenting high fever, fatigue, weight loss and enlargement of liver and spleen. Indirect immunofluorescent test revealed a titer of 1:320 for Leishmania. Such result was confirmed by the presence of amastigotes in bone marrow aspirate samples and culture of promastigote forms. Parasites were identified as being Leishmania (Viannia) braziliensis through PCR, using a L. braziliensis complex primer and a generic primer, followed by hibridization. Specific leishmaniasis therapy (Glucantime;Ò; antimonial) was intravenously administered

Estructuras Antiguas, Tectónica Reciente: Diferentes Controles en la Evolución del Relieve en la Región de las Altas Crestas Cuartzíticas de la Mantiqueira Meridional

Las altas crestas de la Mantiqueira Meridional figuran como estructuras festoneadas por la red de drenaje que demanda indirectamente el Océano Atlántico, figurando como una unidad morfoestructural cuya geomorfogénesis coaduna retracción erosiva de escarpas a procesos díastróficos morfotectónicos, encerrando un sistema geomorfológico de alta complejidad, donde los efectos neotectónicos se superponen a las expresiones geomorfológicas regionales forjadas en estructuras antiguas reactivadas durante el rifte Sudeste. La investigación aquí divulgada identificó importantes aspectos de la tectónica activa actuando en la evolución del relieve regional, cuya espacialidad es establecida por las superficies de base, por la configuración del drenaje y patrón de lineamientos, por el reconocimiento y mapeo de las características morfotectónicas e interpretación de su significado, así como por la compartimentación del área según su significado morfoestructural y morfotectónicoThe high crests of Southern Mantiqueira appear as structures scalloped by the drainage network that indirectly demands the Atlantic Ocean appearing as a morphostructural unit whose geomorphogenesis combines cliffs erosive retraction to morphothectonic diastrophic processes enclosing a geomorphological system of high complexity where the neotectonic effects are superimposed to the regional geomorphological expressions forged in old structures reactivated during the Continental rift of Southeastern of Brazil . Based on methodological approaches focused on morphostructural and morphothectonic interpretations the research disclosed here identified important aspects of the active tectonics acting on the evolution of the regional relief whose spatiality is established by base surfaces, by drainage configuration and lineaments pattern by the recognition and mapping of morphothectonic features and interpretation of its meaning as well as by the compartmentalization of the area according to its morphostructural  and morphothectonic meaning.As altas cristas da Mantiqueira Meridional figuram como estruturas festonadas pela rede de drenagem que demanda indiretamente o Oceano Atlântico, figurando como uma unidade morfoestrutural cuja geomorfogênese coaduna retração erosiva de escarpas a processos diastróficos morfotectônicos, encerrando um sistema geomorfológico de alta complexidade, onde os efeitos neotectônicos se sobrepõem às expressões geomorfológicas regionais forjadas em estruturas antigas reativadas durante o rifte Continental do Sudeste do Brasil. Com base em abordagens metodológicas voltadas para as interpretações morfoestruturais e morfotectônicas, a pesquisa aqui divulgada identificou importantes aspectos da tectônica ativa atuando na evolução do relevo regional, cuja espacialidade é estabelecida pelas superfícies de base, pela configuração da drenagem e padrão de lineamentos, pelo reconhecimento e mapeamento de feições morfotectônicas e interpretação de seu significado, bem como pela compartimentação da área segundo seu significado morfoestrutural e morfotectônico

Scores of a web-based version of the seasonal pattern assessment questionnaire in Brazil

Introduction: Seasonal affective disorder (SAD) is a proposed mental disorder still controversial. This condition is prevalent in northern latitudes, but few studies have been conducted at locations in the southern hemisphere. It is usually assessed by the Seasonal Pattern Assessment Questionnaire (SPAQ). This study aimed to evaluate, through on-line questionnaire, the hypothesis that, in the Brazilian population, latitude and longitude influence SPAQ scores. Methods: An advertisement was posted on a sleep medicine website inviting visitors to investigate seasonal patterns of behavior and mood, using a Brazilian Portuguese version of the SPAQ. The geographic coordinates of the place of residence of each respondent were analyzed as a continuous variable or distributed in quartiles of latitude and longitude. The psychometric properties of the SPAQ were assessed by reliability and factor analyses. Results: Answers from 1001 respondents out of 1045 were considered eligible. High SPAQ scores were observed in 287 respondents, equally distributed among all latitude and longitude quartiles. Data collected in different seasons and during daylight saving time did not differ significantly in any of the scores for SPAQ dimensions. No correlations between SPAQ scores and latitude or longitude were observed. Psychometric properties of the SPAQ were preserved in all geographic locations. Conclusion: The finding of similar SPAQ scores at a wide latitude range defies the concept of SAD symptoms as latitude or longitude-dependent phenomena

Evaluating steel fiber‐reinforced self‐consolidating concrete performance

The fiber‐reinforced self‐compacting concrete (FR‐SCC) is considered a high‐performance material, clustering characteristics of SCC combined with steel fibers. This paper assessed fresh and hardened state properties of a reference SCC and a FR‐SCC with fibers of three types and three quantities of reinforcement, totalizing 10 mixtures. Fresh state properties of the mixture were evaluated through the tests of slump‐flow, flow rate, filling ability, plastic viscosity by V‐funnel, passing ability by J‐ring and by L‐box; and hardened properties comprised compressive strength, flexural strength, and flexural toughness. Overall, it was observed that increasing the amount and length of fibers hindered the mixture workability. Also, the flexural strength and flexural toughness increased as the length and the amount of fibers increased. Regarding mechanical properties, it was not possible to identify an equivalence between the types of fibers evaluated and the compressive strength of mixtures. The flexural was proportional to the amount of fibers, with increases of up to 30% for concretes with fibers

MONITORAMENTO TECNOLÓGICO COM BASE EM PATENTES: CATALISADORES PARA A OXIDAÇÃO DE GLICEROL

Em resposta a alguns problemas ambientais, a sociedade apresenta um novo comportamento, como a busca de fontes de energias renováveis e menos agressiva a natureza. O uso do biodiesel é uma alternativa para combater os efeitos poluentes proporcionados pelo uso de combustíveis fosseis. Com a produção de biodiesel, aumenta a quantidade de glicerol disponível para o mercado, visto que este é um coproduto do processo de obtenção de biodiesel. O glicerol possui diversas aplicações no mercado, mas com a produção de biodiesel, a tendência é que o mercado fique saturado. Visando o mapeamento de patentes relacionadas a catalisadores utilizados na reação de oxidação de glicerol, foi realizado um monitoramento tecnológico, em bancos de patentes (INPI, Derwent Innovations Index e WIPO), buscando analisar as tendências tecnológicas relativas a esta área

Composted sewage sludge as an alternative substrate for forest seedlings production

The production of forest seedlings with adequate morphological and physiological characteristics is essential for the success of plantations. Substrates and irrigation are the major factors determining seedlings’ growth. Substrates made of urban and agricultural residues are a sustainable alternative to peat-based substrates. In this study, we evaluated how composted sewage sludge substrates affect the growth and gas exchange in seedlings of Cedrela fissilis Vell. Seedlings were produced under daily irrigation depths of 6, 9, and 12 mm, and on different substrates. The substrates were based on sewage sludge composted with Eucalyptus bark or sugarcane bagasse, and a commercial substrate based on peat, involving a double factorial design with 12 treatments (3 irrigation depths × 3 substrates). Both physical and chemical characteristics of substrates were analyzed, and morphological traits and gas exchanges of seedlings were measured. Sewage sludge-based substrates presented different characteristics according to the material it was mixed. Eucalyptus bark provided higher bulk density (0.19 g cm-3) and lower total porosity (75%) to the substrate, while sugarcane bagasse increased macroporosity up to 60%. Seedlings produced in sewage sludge-based substrates presented a height up to 17.8 cm and stem diameters of between 8.39-10.29 mm. Higher shoot and root dry mass was obtained in sewage sludge-based substrates with irrigation depth of 9 mm, which were 3.71 and 2.01 g, respectively. Photosynthetic carbon assimilation varied between 2.26 and 3.23 µmol CO2 m-2 s-1, and water use efficiency varied from 2.058 to 3.395 µmol CO2 (mol H2O)-1, with the highest values being obtained in seedlings produced in sewage sludge-based substrates with irrigation depth of 6 mm. Our results demonstrate that sewage sludge-based substrates are an efficient alternative to commercial peat-based substrates for seedling production

Performance and feed conversion of beef cattle steers on Tanzania guineagrass under two grazing intensities and rotational stocking

O experimento foi realizado para avaliar o valor nutritivo da forragem, o desempenho e a conversão alimentar de novilhos em pastos de Panicum maximum Jacq. cv. Tanzânia submetidos a duas intensidades de pastejo rotativo (resíduos de 25 e 50 cm), associadas a intervalo de pastejo correspondente ao tempo necessário para que o dossel forrageiro interceptasse 95% da luz incidente durante a rebrotação. O delineamento experimental utilizado foi o de blocos completos casualizados, com duas repetições. Foram avaliados a altura do dossel pré-pastejo, os intervalos de pastejo, o ganho de peso individual, a conversão alimentar, a taxa de lotação e o ganho de peso por unidade de área. Pastos manejados com o resíduo 50 cm apresentaram maior número de ciclos de pastejo em relação àqueles manejados com resíduo de 25 cm. O maior ganho de peso médio diário foi registrado nos pastos manejados com 50 cm de resíduo (801 g/dia) em relação àqueles manejados com de 25 cm de resíduo (664 g/dia). Em contrapartida, a taxa de lotação foi mais alta nos pastos manejados com o resíduo 25 cm, fazendo com que os ganhos de peso por unidade de área fossem 601 e 559 kg/ha para os resíduos de 25 e 50 cm, respectivamente. O manejo do pasto visando altura de resíduo de 25 cm proporciona maiores ganhos de peso por unidade de área e maior uniformidade de produção e o resíduo de 50 cm promove maior ganho individual e maior número de ciclos de pastejo.The objective of this experiment was to evaluate the nutritive value, animal performance and feed conversion of beef cattle steers grazing Panicum maximum Jacq. cv. Tanzania pasture subjected to intensities of rotational grazing. Treatments corresponded to two grazing intensities (post-grazing residues of 25 and 50 cm) associated with a grazing interval corresponding to the time necessary for a 95% canopy light interception (LI) condition during regrowth. A randomized complete block design was used, with two replications. The pre-grazing sward height, grazing interval, weight gain, stocking rate and weight gain per unit area were assessed. Pastures managed with 50 cm residue post-grazing condition resulted in a larger number of grazing cycles than the 25 cm residue. The highest daily average weight gain was observed in the pastures managed with 50 cm residue (801 g/.day) compared to those managed with 25cm residue (664 g/day). However, the 25 cm post-grazing condition allowed for higher of stocking rate values, resulting in 601 and 559 kg weight gain/ha for the 25 and 50 cm conditions, respectively. Grazing management with a post-grazing residue of 25 cm result in higher weight gain per unit area and a more stable pattern of animal performance while management with 50 cm residue result in higher individual performance and a larger number of grazing cycles.FundectCNP

Ecocardiografia em pacientes com apneia do sono grave com e sem pressão arterial controlada: Estudo transversal

Introdução: A apneia obstrutiva do sono (AOS) afeta a anatomia e função do coração. Ocorre hipertensão arterial em metade dos casos de AOS, dificultando atribuir a etiologia dessas alterações separadamente à hipertensão arterial ou à apneia do sono. Métodos: Estudo transversal de pacientes com índice de apneia-hipopneia maior que 50 eventos por hora. As variáveis ecocardiográficas comparadas em indivíduos com hipertensão arterial controlada e não controlada foram: 1) fração de ejeção, 2) diâmetro da aorta, 3) diâmetro do átrio esquerdo, 4) diâmetro de ventrículo direito, 5) diâmetros do ventrículo esquerdo diastólico e sistólico, 6) percentagem delta, 7) espessura do septo, 8) espessura da parede posterior. Resultados: Foram incluídos 83 voluntários, 50 com pressão arterial não controlada. Em média, a idade era 47±9,5 anos, o índice de massa corporal 34±5,4 Kg/m2, o índice de apneia-hipopneia 86±18 eventos/hora. Sessenta pacientes apresentaram anormalidade no ecocardiograma. A hipertrofia de ventrículo esquerdo foi o achado mais comum, sem diferença de frequência em controles (39%) e em hipertensos (48%), seguida por disfunção diastólica em controles (27%) e em hipertensos (32%). Conclusões: Indivíduos com apneia do sono grave e pressão arterial controlada apresentam alterações no ecocardiograma de tipo e frequência semelhantes aos com hipertensão não controlada. Isso sugere que a apneia do sono pode causar dano cardíaco independentemente de hipertensão. Quando não explicáveis por hipertensão arterial, achados como hipertrofia de ventrículo esquerdo podem ser provocados por apneia do sono.   Introduction:  Obstructive sleep apnea (OSA) affects the cardiac anatomy and function. Hypertension occurs in half the OSA cases, making it difficult to attribute the cause of these changes separately to arterial hypertension or sleep apnea. Methods: Prospective cross-sectional study of volunteers with apnea-hypopnea index >50 events per hour. The echocardiographic variables were analyzed: 1) ejection fraction, 2) aortic diameter, 3) left atrial diameter, 4) right ventricular diameter, 5) diastolic and systolic diameters of the left ventricle, 6) delta percentage, 7) septum thickness, 8) posterior wall thickness. Results: There were 83 participants, 74 men, 50 with hypertension. The average age was 47±9.5 years, body mass index of 34±5.4 kg/m2, apnea-hypopnea index of 86±18 events/hour, and minimum oxygen saturation of 55±17%. Left ventricular hypertrophy was the most common echocardiographic abnormality in subjects without hypertension (39%) and with hypertension (48%), followed by diastolic dysfunction in subjects with normal blood pressure (27%) and with high blood pressure (32%). There was no statistically significant difference in echocardiographic characteristics between hypertensive subjects with those with normal pressure. Conclusions: Individuals with normal blood pressure and severe sleep apnea show abnormalities in the echocardiogram with frequency similar to that observed in patients with high blood pressure. This suggests that sleep apnea can cause ventricular overload independently of hypertension. When not explained by high blood pressure, left ventricular hypertrophy can be caused by sleep apnea