Consequências da rápida redução de peso corporal em atletas de esportes de combate e a importância da nutrição: uma revisão

Os esportes de combate geralmente são divididos por categorias de peso. Com o intuito de obter vantagem lutando com adversários mais leves e fracos, muitos atletas costumam reduzir seu peso corporal de forma rápida através de estratégias potencialmente perigosas à saúde. O objetivo dessa revisão foi sistematizar os principais achados da literatura a respeito das consequências da prática de redução rápida de peso sobre os sistemas fisiológicos e desempenho, bem como verificar a importância da nutrição nesse contexto. A revisão de literatura englobou publicações nacionais e internacionais, com datas compreendidas entre janeiro de 1970 e maio de 2017, nas bases de dados eletrônicas: Elsevier, Medline, Pubmed, Scopus, Sportdiscus e Web of Science. As palavras chaves utilizadas na busca estavam incluídas na Thesaurus Medical Subject Headings (MeSH) desenvolvido pela U.S. National Library of Medicine. A literatura científica se mostrou unânime em demonstrar os efeitos sobre os sistemas fisiológicos, como: redução da densidade óssea; aumento do desenvolvimento de transtornos alimentares; depressão do sistema imune; disfunções do sistema cardiovascular e hipertermia. Quanto ao desempenho, há consenso na literatura de que a rápida redução de peso diminui o desempenho aeróbio. No entanto, os efeitos sobre o desempenho anaeróbio ainda são divergentes, pois dependem do período existente entre a pesagem e os combates. Diversos estudos mostraram que os hábitos alimentares afetam decisivamente a saúde, o peso, a composição corporal e o desempenho esportivo, sendo as intervenções nutricionais eficazes na redução de peso de forma gradual através da redução da quantidade calórica total. ABSTRACT Consequences of body weight rapid reduction in athletes of combat sports and the importance of nutrition: a reviewThe combat sports are usually divided by weight categories. In order to gain an advantage by struggling with lighter and weaker opponents, many athletes often reduce their body weight quickly through potentially dangerous strategies. The objective of this review was to systematize the main findings of the literature regarding the consequences of the practice of rapid weight reduction on physiological systems and performance, as well as to verify the importance of nutrition in this context. The literature review included national and international publications, with dates between January 1970 and May 2017, in the electronic databases: Elsevier, Medline, Pubmed, Scopus, Sportdiscus and Web of Science. Key words used in the search were included in the Thesaurus Medical Subject Headings (MeSH) developed by the U.S. National Library of Medicine. The scientific literature was unanimous in demonstrating the effects on the physiological systems, such as: reduction of bone density; Increased development of eating disorders; Depression of the immune system; Dysfunctions of the cardiovascular system and hyperthermia. Regarding performance, there is consensus in the literature that rapid weight reduction decreases aerobic performance. However, the effects on anaerobic performance are still divergent as they depend on the time between weighing and fighting. Several studies have shown that eating habits decisively affect health, weight, body composition and sports performance, and nutritional interventions are effective in reducing weight gradually by reducing total caloric intake

Situação epidemiológica da meningite em Belém-PA, segundo sistema de informação, no período de 2015 a 2018 / Epidemiological situation of meningitis in Belman-PA, according to the information system, in the period from 2015 to 2018

A meningite é caracterizada por uma inflamação nas meninges, que afeta principalmente, o espaço aracnoide e em alguns casos chegando a atingir o segmento medular ou o craniano. Tem como agentes etiológicos virais o Enterovírus e bacterianosNeisseria meningitidis, o Haemophilus influenzae e o Streptococcus pneumoniae, e até mesmo fungos e parasitas, ocorrendo de uma maneira menos frequente (SILVA, 2018). A transmissão ocorre através do contato direto pessoa a pessoa, por meio de secreções respiratórias de pessoas infectadas, assintomáticas ou doentes. Os principais sintomas são: Febre, vômitos/náuseas, cefaleia, rigidez na nuca e convulsões (BRASIL, 2017). Para o tratamento é necessário de forma precoce a antibioticoterapia associado a outros tipos de tratamento de suporte, como reposição de líquidos e cuidados na assistência, de preferência (SILVA, 2018). Ademais, estudos mostram que para se evitar etiologias bacterianas, torna-se necessário o uso de vacina meningocócica conjugada, que é realizada aos 3, 5 e um reforço aos 12 meses. O Sistema de Informação de Agravos de Notificação - SINAN é um instrumento fundamental para pesquisa epidemiológica, pois tem como responsabilidade o desenvolvimento de um sistema de informação eficaz, capazes de auxiliar no planejamento da saúde, definir prioridades e avaliar o impacto das intervenções. Trata-se de um estudo transversal de abordagem quantitativa, para avaliarcasos confirmados demeningite no município de Belém-PA entre os anos 2015 e 2018, levando em conta as faixas etárias entre <1 ano a 80 e + anos, sendo divididas em categorias: crianças, pré-adolescentes e adolescentes, adultos e idosos, considerando o maior e menor índice de ocorrência de casos notificados no Município de Belém-PA. A partir deste estudo, pôde-se observar o déficit nas ações em saúde destinadas à população, e principalmente nas faixas etárias de maior ocorrência dos casos de meningite, sendo estas em adultos de 20 a 59 anos. Desta forma, há a necessidade de planejamento de intervenções, a busca de soluções e maiores investigações dessa patologia no município de Belém-PA. 

Pervasive gaps in Amazonian ecological research

Biodiversity loss is one of the main challenges of our time,1,2 and attempts to address it require a clear un derstanding of how ecological communities respond to environmental change across time and space.3,4 While the increasing availability of global databases on ecological communities has advanced our knowledge of biodiversity sensitivity to environmental changes,5–7 vast areas of the tropics remain understudied.8–11 In the American tropics, Amazonia stands out as the world’s most diverse rainforest and the primary source of Neotropical biodiversity,12 but it remains among the least known forests in America and is often underrepre sented in biodiversity databases.13–15 To worsen this situation, human-induced modifications16,17 may elim inate pieces of the Amazon’s biodiversity puzzle before we can use them to understand how ecological com munities are responding. To increase generalization and applicability of biodiversity knowledge,18,19 it is thus crucial to reduce biases in ecological research, particularly in regions projected to face the most pronounced environmental changes. We integrate ecological community metadata of 7,694 sampling sites for multiple or ganism groups in a machine learning model framework to map the research probability across the Brazilian Amazonia, while identifying the region’s vulnerability to environmental change. 15%–18% of the most ne glected areas in ecological research are expected to experience severe climate or land use changes by 2050. This means that unless we take immediate action, we will not be able to establish their current status, much less monitor how it is changing and what is being lostinfo:eu-repo/semantics/publishedVersio

Diretriz sobre Diagnóstico e Tratamento da Cardiomiopatia Hipertrófica – 2024

Hypertrophic cardiomyopathy (HCM) is a form of genetically caused heart muscle disease, characterized by the thickening of the ventricular walls. Diagnosis requires detection through imaging methods (Echocardiogram or Cardiac Magnetic Resonance) showing any segment of the left ventricular wall with a thickness > 15 mm, without any other probable cause. Genetic analysis allows the identification of mutations in genes encoding different structures of the sarcomere responsible for the development of HCM in about 60% of cases, enabling screening of family members and genetic counseling, as an important part of patient and family management. Several concepts about HCM have recently been reviewed, including its prevalence of 1 in 250 individuals, hence not a rare but rather underdiagnosed disease. The vast majority of patients are asymptomatic. In symptomatic cases, obstruction of the left ventricular outflow tract (LVOT) is the primary disorder responsible for symptoms, and its presence should be investigated in all cases. In those where resting echocardiogram or Valsalva maneuver does not detect significant intraventricular gradient (> 30 mmHg), they should undergo stress echocardiography to detect LVOT obstruction. Patients with limiting symptoms and severe LVOT obstruction, refractory to beta-blockers and verapamil, should receive septal reduction therapies or use new drugs inhibiting cardiac myosin. Finally, appropriately identified patients at increased risk of sudden death may receive prophylactic measure with implantable cardioverter-defibrillator (ICD) implantation.La miocardiopatía hipertrófica (MCH) es una forma de enfermedad cardíaca de origen genético, caracterizada por el engrosamiento de las paredes ventriculares. El diagnóstico requiere la detección mediante métodos de imagen (Ecocardiograma o Resonancia Magnética Cardíaca) que muestren algún segmento de la pared ventricular izquierda con un grosor > 15 mm, sin otra causa probable. El análisis genético permite identificar mutaciones en genes que codifican diferentes estructuras del sarcómero responsables del desarrollo de la MCH en aproximadamente el 60% de los casos, lo que permite el tamizaje de familiares y el asesoramiento genético, como parte importante del manejo de pacientes y familiares. Varios conceptos sobre la MCH han sido revisados recientemente, incluida su prevalencia de 1 entre 250 individuos, por lo tanto, no es una enfermedad rara, sino subdiagnosticada. La gran mayoría de los pacientes son asintomáticos. En los casos sintomáticos, la obstrucción del tracto de salida ventricular izquierdo (TSVI) es el trastorno principal responsable de los síntomas, y su presencia debe investigarse en todos los casos. En aquellos en los que el ecocardiograma en reposo o la maniobra de Valsalva no detecta un gradiente intraventricular significativo (> 30 mmHg), deben someterse a ecocardiografía de esfuerzo para detectar la obstrucción del TSVI. Los pacientes con síntomas limitantes y obstrucción grave del TSVI, refractarios al uso de betabloqueantes y verapamilo, deben recibir terapias de reducción septal o usar nuevos medicamentos inhibidores de la miosina cardíaca. Finalmente, los pacientes adecuadamente identificados con un riesgo aumentado de muerte súbita pueden recibir medidas profilácticas con el implante de un cardioversor-desfibrilador implantable (CDI).A cardiomiopatia hipertrófica (CMH) é uma forma de doença do músculo cardíaco de causa genética, caracterizada pela hipertrofia das paredes ventriculares. O diagnóstico requer detecção por métodos de imagem (Ecocardiograma ou Ressonância Magnética Cardíaca) de qualquer segmento da parede do ventrículo esquerdo com espessura > 15 mm, sem outra causa provável. A análise genética permite identificar mutações de genes codificantes de diferentes estruturas do sarcômero responsáveis pelo desenvolvimento da CMH em cerca de 60% dos casos, permitindo o rastreio de familiares e aconselhamento genético, como parte importante do manejo dos pacientes e familiares. Vários conceitos sobre a CMH foram recentemente revistos, incluindo sua prevalência de 1 em 250 indivíduos, não sendo, portanto, uma doença rara, mas subdiagnosticada. A vasta maioria dos pacientes é assintomática. Naqueles sintomáticos, a obstrução do trato de saída do ventrículo esquerdo (OTSVE) é o principal distúrbio responsável pelos sintomas, devendo-se investigar a sua presença em todos os casos. Naqueles em que o ecocardiograma em repouso ou com Manobra de Valsalva não detecta gradiente intraventricular significativo (> 30 mmHg), devem ser submetidos à ecocardiografia com esforço físico para detecção da OTSVE.   Pacientes com sintomas limitantes e grave OTSVE, refratários ao uso de betabloqueadores e verapamil, devem receber terapias de redução septal ou uso de novas drogas inibidoras da miosina cardíaca. Por fim, os pacientes adequadamente identificados com risco aumentado de morta súbita podem receber medida profilática com implante de cardiodesfibrilador implantável (CDI)

Pervasive gaps in Amazonian ecological research

Biodiversity loss is one of the main challenges of our time,1,2 and attempts to address it require a clear understanding of how ecological communities respond to environmental change across time and space.3,4 While the increasing availability of global databases on ecological communities has advanced our knowledge of biodiversity sensitivity to environmental changes,5,6,7 vast areas of the tropics remain understudied.8,9,10,11 In the American tropics, Amazonia stands out as the world's most diverse rainforest and the primary source of Neotropical biodiversity,12 but it remains among the least known forests in America and is often underrepresented in biodiversity databases.13,14,15 To worsen this situation, human-induced modifications16,17 may eliminate pieces of the Amazon's biodiversity puzzle before we can use them to understand how ecological communities are responding. To increase generalization and applicability of biodiversity knowledge,18,19 it is thus crucial to reduce biases in ecological research, particularly in regions projected to face the most pronounced environmental changes. We integrate ecological community metadata of 7,694 sampling sites for multiple organism groups in a machine learning model framework to map the research probability across the Brazilian Amazonia, while identifying the region's vulnerability to environmental change. 15%–18% of the most neglected areas in ecological research are expected to experience severe climate or land use changes by 2050. This means that unless we take immediate action, we will not be able to establish their current status, much less monitor how it is changing and what is being lost

Pervasive gaps in Amazonian ecological research

Biodiversity loss is one of the main challenges of our time,1,2 and attempts to address it require a clear understanding of how ecological communities respond to environmental change across time and space.3,4 While the increasing availability of global databases on ecological communities has advanced our knowledge of biodiversity sensitivity to environmental changes,5,6,7 vast areas of the tropics remain understudied.8,9,10,11 In the American tropics, Amazonia stands out as the world's most diverse rainforest and the primary source of Neotropical biodiversity,12 but it remains among the least known forests in America and is often underrepresented in biodiversity databases.13,14,15 To worsen this situation, human-induced modifications16,17 may eliminate pieces of the Amazon's biodiversity puzzle before we can use them to understand how ecological communities are responding. To increase generalization and applicability of biodiversity knowledge,18,19 it is thus crucial to reduce biases in ecological research, particularly in regions projected to face the most pronounced environmental changes. We integrate ecological community metadata of 7,694 sampling sites for multiple organism groups in a machine learning model framework to map the research probability across the Brazilian Amazonia, while identifying the region's vulnerability to environmental change. 15%–18% of the most neglected areas in ecological research are expected to experience severe climate or land use changes by 2050. This means that unless we take immediate action, we will not be able to establish their current status, much less monitor how it is changing and what is being lost

Impact of COVID-19 on cardiovascular testing in the United States versus the rest of the world

Objectives: This study sought to quantify and compare the decline in volumes of cardiovascular procedures between the United States and non-US institutions during the early phase of the coronavirus disease-2019 (COVID-19) pandemic. Background: The COVID-19 pandemic has disrupted the care of many non-COVID-19 illnesses. Reductions in diagnostic cardiovascular testing around the world have led to concerns over the implications of reduced testing for cardiovascular disease (CVD) morbidity and mortality. Methods: Data were submitted to the INCAPS-COVID (International Atomic Energy Agency Non-Invasive Cardiology Protocols Study of COVID-19), a multinational registry comprising 909 institutions in 108 countries (including 155 facilities in 40 U.S. states), assessing the impact of the COVID-19 pandemic on volumes of diagnostic cardiovascular procedures. Data were obtained for April 2020 and compared with volumes of baseline procedures from March 2019. We compared laboratory characteristics, practices, and procedure volumes between U.S. and non-U.S. facilities and between U.S. geographic regions and identified factors associated with volume reduction in the United States. Results: Reductions in the volumes of procedures in the United States were similar to those in non-U.S. facilities (68% vs. 63%, respectively; p = 0.237), although U.S. facilities reported greater reductions in invasive coronary angiography (69% vs. 53%, respectively; p < 0.001). Significantly more U.S. facilities reported increased use of telehealth and patient screening measures than non-U.S. facilities, such as temperature checks, symptom screenings, and COVID-19 testing. Reductions in volumes of procedures differed between U.S. regions, with larger declines observed in the Northeast (76%) and Midwest (74%) than in the South (62%) and West (44%). Prevalence of COVID-19, staff redeployments, outpatient centers, and urban centers were associated with greater reductions in volume in U.S. facilities in a multivariable analysis. Conclusions: We observed marked reductions in U.S. cardiovascular testing in the early phase of the pandemic and significant variability between U.S. regions. The association between reductions of volumes and COVID-19 prevalence in the United States highlighted the need for proactive efforts to maintain access to cardiovascular testing in areas most affected by outbreaks of COVID-19 infection

Differential cross section measurements for the production of a W boson in association with jets in proton–proton collisions at √s = 7 TeV

Measurements are reported of differential cross sections for the production of a W boson, which decays into a muon and a neutrino, in association with jets, as a function of several variables, including the transverse momenta (pT) and pseudorapidities of the four leading jets, the scalar sum of jet transverse momenta (HT), and the difference in azimuthal angle between the directions of each jet and the muon. The data sample of pp collisions at a centre-of-mass energy of 7 TeV was collected with the CMS detector at the LHC and corresponds to an integrated luminosity of 5.0 fb[superscript −1]. The measured cross sections are compared to predictions from Monte Carlo generators, MadGraph + pythia and sherpa, and to next-to-leading-order calculations from BlackHat + sherpa. The differential cross sections are found to be in agreement with the predictions, apart from the pT distributions of the leading jets at high pT values, the distributions of the HT at high-HT and low jet multiplicity, and the distribution of the difference in azimuthal angle between the leading jet and the muon at low values.United States. Dept. of EnergyNational Science Foundation (U.S.)Alfred P. Sloan Foundatio

Penilaian Kinerja Keuangan Koperasi di Kabupaten Pelalawan

This paper describe development and financial performance of cooperative in District Pelalawan among 2007 - 2008. Studies on primary and secondary cooperative in 12 sub-districts. Method in this stady use performance measuring of productivity, efficiency, growth, liquidity, and solvability of cooperative. Productivity of cooperative in Pelalawan was highly but efficiency still low. Profit and income were highly, even liquidity of cooperative very high, and solvability was good