DUPLO PRODUTO EM EXERCÍCIO AGACHAMENTO EXECUTADO COM DIFERENTES APARELHOS

As respostas cardiovasculares agudas durante o treinamento resistido compõem perspectivas imprescindíveis à confiabilidade do exercício. O objetivo do presente estudo foi analisar o desempenho do duplo produto durante uma série de repetições máximas até a falha muscular a 85% de 1RM em exercícios de agachamento com barra livre, máquina Smith e máquina Hack. Participaram 23 homens voluntários, saudáveis e experientes no treinamento resistido. O duplo produto foi obtido multiplicando-se pressão arterial sistólica (PAS) pela frequência cardíaca (FC) no dado instante utilizando-se um esfigmomanômetro aneroide, estetoscópio e monitor cardíaco. As mensurações ocorreram antes do exercício (repouso), no final de cada série e na recuperação que foi composto de duas verificações: a) aos 30 segundos do fim das séries somente a FC; b) a um minuto do término dos exercícios a FC, PAS e Pressão Arterial Diastólica. Para comparação das medidas obtidas nas diversas situações uma GLM (General Linear Models) foi realizada como inferência estatística. Identificamos valores significativamente menores na máquina Smith do que na máquina Hack e Agachamento livre. Esses resultados indicam que a máquina Smith provoca menor trabalho cardiovascular, o que deve ser considerado para uma prescrição segura de treinamento resistido em pacientes que necessitem de atenção aumentada

PERFIL NUTRICIONAL E PREVALÊNCIA DE HIPERTENSÃO EM IDOSOS PARTICIPANTES DE UM PROGRAMA DE EXERCÍCIO FÍSICO / NUTRITIONAL PROFILE AND PREVALENCE OF HYPERTENSION IN ELDERLY ENGAGED IN A PHYSICAL EXERCISE PROGRAM

Introdução: A avaliação do Índice de Massa Corporal (IMC) é uma das estratégias mais acessíveis e baratas para identificar se uma pessoa está no peso ideal. Valores acima da normalidade podem contribuir para o aparecimento de diversas doenças crônicas, entre elas a hipertensão arterial, a qual uma simples avaliação pode sugerir que medidas de prevenção sejam tomadas. Objetivo: Verificar o perfil nutricional e a prevalência de hipertensão em um grupo de idosos participantes de um programa de exercícios físicos. Métodos: Foram incluídos 52 idosos de ambos os sexos e todos com pelo menos seis meses de participação no programa. O perfil nutricional foi determinado através do IMC, obtido pela divisão da massa corporal (kg) pelo quadrado da estatura (m), e a presença de hipertensão foi considerada por atestado médico. Uma estatística descritiva foi realizada para apresentação dos dados em média e desvio padrão. Resultados: Nesta pesquisa 55,8% dos idosos foram considerados hipertensos e apresentaram IMC médio de 32,0 kg/m2, o qual os classificou como obesidade grau 1. Já os 44,2% que não foram diagnosticados com hipertensão, apresentaram IMC médio de 26,8 kg/m2 o qual representa sobrepeso. Conclusão: Observando os resultados, sugere-se que estratégias adicionais sejam adotadas pelo grupo analisado, inclusive pelos idosos normotensos, já que apresentaram IMC elevado o qual pode acelerar um possível aparecimento da doença.Palavras-chave: Estado nutricional. Índice de Massa Corporal. Hipertensão.AbstractIntroduction: The evaluation of the Body Mass Index (BMI) is one of the most accessible and affordable techniques to identify whether a person is in the ideal weight. Values above the normality may contribute to the onset of several chronic diseases, including arterial hypertension, in which a simple assessment may suggest that prevention measures should be taken. Objective: To assess the nutritional status and the prevalence of hypertension in a group of elderly participants of an exercise program. Methods: Were included 52 elderly from both sexes, all with at least six months of participation in the program. The nutritional profile was determined by BMI, obtained by dividing body mass (kg) by the square of height (m), and the presence of hypertension was determined by medical certificate. A descriptive analysis was performed to present the data as mean and standard deviation. Results: In this study, 55.8% of the elderly were considered hypertensive and had a mean BMI of 32.0 kg/m2, which classified them as grade 1 obese. As for the 44.2% who were not diagnosed with hypertension, they showed a mean BMI of 26.8 kg/m2, which represents overweight. Conclusion: Observing the results, it is suggested that additional strategies should be adopted by the analyzed group, including the normotensive elderly, since they presented high BMI, which can accelerate a possible onset of the disease.Keywords: Nutritional status. Body Mass Index. Hypertension

The control and prevention of COVID-19 transmission in children : a protocol for systematic review and meta-analysis

Background: The pandemic following the rapid spread of the new SARS-CoV-2 virus has hit all continents and caused thousands of deaths worldwide. Evidence has been published on epidemiological and clinical characteristics of population groups considered at risk; however, information for the other population groups, especially for the child population, is needed. In this context, this protocol describes a systematic review that will aim to identify the evidence on control and prevention of COVID-19 transmission among children and adolescents, as well as to describe the epidemiological profile and clinical and immunological characteristics of COVID-19 in this population. Methods: This protocol will be developed in accordance with PRISMA-P. The searches will be conducted in PubMed, Web of Science, ScienceDirect, EMBASE, and Scopus, seeking clinical trials. Observational studies and case reports with Children and adolescents (≤19 years) infected with SARS-CoV-2 will be included whether they report information on the control of prevention and COVID-19 transmission. Two independent researchers will perform the selection of articles, removal of duplication, and screening by Rayyan QCRI application. Cochrane's RoB 2.0, ROBINS-I, and CASP tools will be used to assess the risk of bias. Meta-analysis, subgroup analyses, and/or descriptive analyses will be carried out based on the data conditions included. Results: A high-quality synthesis of the available evidences on the epidemiological profile, the clinical and immunological characteristics involved in children, and adolescents diagnosed with COVID-19, as well as the participation of this population in the transmission dynamics of SARS-CoV-2 will be provided. Conclusion: This systematic review has an important relevance in the current context because it has a great potential to help the development of new control and prevention strategies in the pediatric population

DESINFORMAÇÃO, SAÚDE PÚBLICA E IMUNIZAÇÃO NO BRASIL: OS EFEITOS DA EDUCAÇÃO POPULAR EM SAÚDE

Vaccine immunization is considered a true milestone in public health by contributing to the reduction, protection and prevention of numerous communicable diseases and in the context of the COVID-19 pandemic it is no different. Therefore, the present study aimed to present the educational actions that have popular health education as a reference, which were used in favor of adherence to vaccination in Brazil, and that are cited in the scientific literature. For this, a systematic review of scientific literature was carried out, using descriptors and search strategies: "Health Education AND COVID-19 Vaccines" and "Health Education AND Immunization", in the online databases Virtual Health Library (VHL) and Scientific Electronic Library Online (SciELO) - with the filters "Brazil", and publications from 2020, until December 2021, in the languages "Portuguese", "English" and "Spanish" and "article". The results point to different strategies of popular health education (HPS), such as: (i) conversation wheels in public health services; (ii) messages and electronic journals forwarded to SUS users by Primary Health Care; (iii) explanatory videos forwarded by public schools; and (iv) posters made available in public buildings in different municipalities. It is concluded that dialogical HPS contributes to the intellectual emancipation of citizens, making them able to decide about themselves, safely, when facing health situations.La inmunización contra la vacunación se considera un verdadero hito en la salud pública al contribuir a la reducción, protección y prevención de numerosas enfermedades transmisibles y, en el contexto de la pandemia de COVID-19, no es diferente. Por lo tanto, el presente estudio tuvo como objetivo presentar las acciones educativas que tienen como referencia a la educación popular en salud, que se utilizaron a favor de la adhesión a la vacunación en Brasil, y que se mencionan en la literatura científica. Para ello, se realizó una revisión sistemática de la literatura científica, utilizando descriptores y estrategias de búsqueda: "Educación en Salud Y Vacunas contra el COVID-19" y "Educación en Salud E Inmunización", en las bases de datos en línea Biblioteca Virtual en Salud (BVS) y Biblioteca Científica Electrónica en Línea (SciELO) - con los filtros "Brasil", y publicaciones de 2020, para diciembre de 2021, en los idiomas "portugués", "inglés" y "español" y "artículo". Los resultados apuntan a diferentes estrategias de educación popular en salud (PHE), tales como: (i) ruedas de conversación en los servicios públicos de salud; (ii) mensajes electrónicos y periódicos enviados a los usuarios del SUS por atención primaria de salud; iii) vídeos explicativos remitidos por las escuelas públicas; y (iv) carteles disponibles en edificios públicos de diferentes municipios. Se concluye que la PHE dialógica contribuye a la emancipación intelectual del ciudadano, haciéndolo capaz de decidir sobre sí mismo, con seguridad, frente a situaciones de salud.A imunização vacinal é considerada um verdadeiro marco na saúde pública ao contribuir para a redução, proteção e prevenção de inúmeras doenças transmissíveis e no contexto da pandemia de COVID-19 não é diferente. Por isso, o presente trabalho objetivou apresentar as ações educativas que têm por referência a educação popular em saúde, que foram utilizadas a favor da adesão à vacinação, no Brasil, e que estão citadas na literatura científica. Para isso, foi feita revisão sistemática da literatura científica, com a utilização de descritores e estratégias de busca: “Educação em Saúde AND Vacinas contra COVID-19" e “Educação em Saúde AND Imunização", nas bases de dados on-line Biblioteca Virtual em Saúde (BVS) e Scientific Electronic Library Online (SciELO) - com os filtros “Brasil”, e publicações a partir de 2020, até dezembro de 2021, nos idiomas “português”, “inglês” e “espanhol” e “artigo”. Os resultados apontam para diferentes estratégias de educação popular em saúde (EPS), tais como: (i) rodas de conversa em serviços de saúde públicos; (ii) mensagens e jornais eletrônicos encaminhados aos usuários do SUS pela Atenção Primária à Saúde; (iii) vídeos explicativos encaminhados pelas escolas públicas; e (iv) cartazes disponibilizados em prédios públicos em diferentes municípios. Conclui-se que a EPS dialógica contribui para a emancipação intelectual do cidadão, tornando-o capaz de decidir sobre si mesmo, com segurança, diante das situações de saúde.A imunização vacinal é considerada um verdadeiro marco na saúde pública ao contribuir para a redução, proteção e prevenção de inúmeras doenças transmissíveis e no contexto da pandemia de COVID-19 não é diferente. Por isso, o presente trabalho objetivou apresentar as ações educativas que têm por referência a educação popular em saúde, que foram utilizadas a favor da adesão à vacinação, no Brasil, e que estão citadas na literatura científica. Para isso, foi feita revisão sistemática da literatura científica, com a utilização de descritores e estratégias de busca: “Educação em Saúde AND Vacinas contra COVID-19" e “Educação em Saúde AND Imunização", nas bases de dados on-line Biblioteca Virtual em Saúde (BVS) e Scientific Electronic Library Online (SciELO) - com os filtros “Brasil”, e publicações a partir de 2020, até dezembro de 2021, nos idiomas “português”, “inglês” e “espanhol” e “artigo”. Os resultados apontam para diferentes estratégias de educação popular em saúde (EPS), tais como: (i) rodas de conversa em serviços de saúde públicos; (ii) mensagens e jornais eletrônicos encaminhados aos usuários do SUS pela Atenção Primária à Saúde; (iii) vídeos explicativos encaminhados pelas escolas públicas; e (iv) cartazes disponibilizados em prédios públicos em diferentes municípios. Conclui-se que a EPS dialógica contribui para a emancipação intelectual do cidadão, tornando-o capaz de decidir sobre si mesmo, com segurança, diante das situações de saúde

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

Mortality from gastrointestinal congenital anomalies at 264 hospitals in 74 low-income, middle-income, and high-income countries: a multicentre, international, prospective cohort study

Summary Background Congenital anomalies are the fifth leading cause of mortality in children younger than 5 years globally. Many gastrointestinal congenital anomalies are fatal without timely access to neonatal surgical care, but few studies have been done on these conditions in low-income and middle-income countries (LMICs). We compared outcomes of the seven most common gastrointestinal congenital anomalies in low-income, middle-income, and high-income countries globally, and identified factors associated with mortality. Methods We did a multicentre, international prospective cohort study of patients younger than 16 years, presenting to hospital for the first time with oesophageal atresia, congenital diaphragmatic hernia, intestinal atresia, gastroschisis, exomphalos, anorectal malformation, and Hirschsprung’s disease. Recruitment was of consecutive patients for a minimum of 1 month between October, 2018, and April, 2019. We collected data on patient demographics, clinical status, interventions, and outcomes using the REDCap platform. Patients were followed up for 30 days after primary intervention, or 30 days after admission if they did not receive an intervention. The primary outcome was all-cause, in-hospital mortality for all conditions combined and each condition individually, stratified by country income status. We did a complete case analysis. Findings We included 3849 patients with 3975 study conditions (560 with oesophageal atresia, 448 with congenital diaphragmatic hernia, 681 with intestinal atresia, 453 with gastroschisis, 325 with exomphalos, 991 with anorectal malformation, and 517 with Hirschsprung’s disease) from 264 hospitals (89 in high-income countries, 166 in middleincome countries, and nine in low-income countries) in 74 countries. Of the 3849 patients, 2231 (58·0%) were male. Median gestational age at birth was 38 weeks (IQR 36–39) and median bodyweight at presentation was 2·8 kg (2·3–3·3). Mortality among all patients was 37 (39·8%) of 93 in low-income countries, 583 (20·4%) of 2860 in middle-income countries, and 50 (5·6%) of 896 in high-income countries (p<0·0001 between all country income groups). Gastroschisis had the greatest difference in mortality between country income strata (nine [90·0%] of ten in lowincome countries, 97 [31·9%] of 304 in middle-income countries, and two [1·4%] of 139 in high-income countries; p≤0·0001 between all country income groups). Factors significantly associated with higher mortality for all patients combined included country income status (low-income vs high-income countries, risk ratio 2·78 [95% CI 1·88–4·11], p<0·0001; middle-income vs high-income countries, 2·11 [1·59–2·79], p<0·0001), sepsis at presentation (1·20 [1·04–1·40], p=0·016), higher American Society of Anesthesiologists (ASA) score at primary intervention (ASA 4–5 vs ASA 1–2, 1·82 [1·40–2·35], p<0·0001; ASA 3 vs ASA 1–2, 1·58, [1·30–1·92], p<0·0001]), surgical safety checklist not used (1·39 [1·02–1·90], p=0·035), and ventilation or parenteral nutrition unavailable when needed (ventilation 1·96, [1·41–2·71], p=0·0001; parenteral nutrition 1·35, [1·05–1·74], p=0·018). Administration of parenteral nutrition (0·61, [0·47–0·79], p=0·0002) and use of a peripherally inserted central catheter (0·65 [0·50–0·86], p=0·0024) or percutaneous central line (0·69 [0·48–1·00], p=0·049) were associated with lower mortality. Interpretation Unacceptable differences in mortality exist for gastrointestinal congenital anomalies between lowincome, middle-income, and high-income countries. Improving access to quality neonatal surgical care in LMICs will be vital to achieve Sustainable Development Goal 3.2 of ending preventable deaths in neonates and children younger than 5 years by 2030

Preliminary pilot search strategy in MEDLINE/PubMed.

Preliminary pilot search strategy in MEDLINE/PubMed.</p

Article selection flowchart.

BackgroundThere is evidence in the literature suggesting that high time spent in sedentary behavior (SB) can reduce the Brain-Derived Neurotrophic Factor (BDNF) levels, an important neurotrophin that plays a role in modulating cognition, learning and memory. Children and adolescents usually spend many hours a day on SB, either sitting for a long time and/or using screen equipment.ObjectiveThe aim of this study is to describe a systematic review and meta-analysis protocol on the associations between SB and BDNF levels in children and adolescents.MethodsThis protocol is guided by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Protocols and was published in the International Prospective Register of Systematic Reviews database (PROSPERO: CRD42023392246). The databases that will be searched are EMBASE, Scopus, ScienceDirect, Web of Science, SPORTDiscus, CINAHL, and PubMed. Cross-sectional and cohort studies conducted with children and adolescents (5 to 19 yr) that analyzed the association between SB and BDNF will be included in the systematic review. The characteristics of the studies, methodological aspects, and main results will be described. Then, the risk of bias (assessed by STROBE and Newcastle-Ottawa scales) and the level of evidence (assessed by the GRADE tool) from included studies will be evaluated. Sub-group analysis will also be performed. Two experienced reviewers will perform the studies selection, data extraction, and methodological quality assessment.ConclusionThis systematic review and meta-analysis will analyze the association between SB and BDNF in children and adolescents. The results will provide subsidies to better understand this relationship and will strengthen evidence-based practice for both health professionals and future researches.</div

PRISMA-P 2015 checklist.

BackgroundThere is evidence in the literature suggesting that high time spent in sedentary behavior (SB) can reduce the Brain-Derived Neurotrophic Factor (BDNF) levels, an important neurotrophin that plays a role in modulating cognition, learning and memory. Children and adolescents usually spend many hours a day on SB, either sitting for a long time and/or using screen equipment.ObjectiveThe aim of this study is to describe a systematic review and meta-analysis protocol on the associations between SB and BDNF levels in children and adolescents.MethodsThis protocol is guided by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Protocols and was published in the International Prospective Register of Systematic Reviews database (PROSPERO: CRD42023392246). The databases that will be searched are EMBASE, Scopus, ScienceDirect, Web of Science, SPORTDiscus, CINAHL, and PubMed. Cross-sectional and cohort studies conducted with children and adolescents (5 to 19 yr) that analyzed the association between SB and BDNF will be included in the systematic review. The characteristics of the studies, methodological aspects, and main results will be described. Then, the risk of bias (assessed by STROBE and Newcastle-Ottawa scales) and the level of evidence (assessed by the GRADE tool) from included studies will be evaluated. Sub-group analysis will also be performed. Two experienced reviewers will perform the studies selection, data extraction, and methodological quality assessment.ConclusionThis systematic review and meta-analysis will analyze the association between SB and BDNF in children and adolescents. The results will provide subsidies to better understand this relationship and will strengthen evidence-based practice for both health professionals and future researches.</div

Teste de uma repetição máxima: análise de duas metodologias / Test of a maximum repeat: two analysis methodologies

RESUMO: Nos últimos anos, ouve um crescente aumento da procura do treinamento resistido, tanto para melhoria das valências físicas relacionadas à saúde, como para melhoria das valências físicas relacionadas ao alto desempenho e para fins estéticos. avaliar duas metodologias do teste de 1RM na carga máxima atingida. Nosso trabalho é caracterizado como descritivo com delineamento transversal, foi composto por 24 indivíduos, do sexo masculino, com media de idade 25 ± 6,3; peso 58,4 ± 8,6; estatura 171,0 ± 3,6; IMC 27 ± 4,4 e tempo de treinamento em meses 10,9 ± 3,2. Foi proposto o teste de carga submáxima, para identificar a carga estimada de 1 RM, em seguida foi realizado o teste de 1 RM nos protocolos crescente e decrescente. o resultado do nosso estudo no exercicio Supino Reto apresentou-se com media de 82,8 ± 27,3 para os protocolos crescente e decrescente. não existe diferença significativa entre o teste de 1 RM com o protocolo crescente e o protocolo decrescente