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The study aimed to identify whether people diagnosed with depression have endothelial dysfunction, assessed by the technique of flow-mediated dilation (FMD), when compared to controls without depression. In addition, to verify whether people with depressive symptoms have impaired endothelial function when compared to controls without symptoms. Also to explore the potential moderators of the association between depression and endothelial dysfunction. Systematic review and meta-analysis. We searched PubMed, PsycINFO, Embase and Web of Science, from inception to April 16, 2021, for studies in people with depression and controls evaluating endothelial function through FMD. The primary outcome was the percentage of change in FMD. Comparative random effects meta-analysis, calculating the mean difference (MD) of the FMD between depressed and controls was performed. Potential sources of heterogeneity were explored by meta-regressions and subgroup analyses. The study protocol was registered with PROSPERO (CRD42020192070). Nine studies evaluating 1367 participants (379 depressed and 988 controls) (median age = 39.8 years, 44.9% men) were included. People with depression had lower FMD = −1.48% (95%CI = −2.62 to −0.33). High density lipoprotein (HDL) cholesterol levels moderated the effect (beta = −0.408, 95%CI = −0.776 to −0.040). Differences in FMD were found when assessment was done in the first minute after release of the occlusion, when using occlusion position in distal forearm, and when using occlusion pressure between 250 and 300 mmHg. Those with clinical depression (established by diagnostic instruments) presented the greatest dysfunction. Individuals with depression have a more impaired endothelial dysfunction when compared to controls. HDL cholesterol levels and differences in FMD assessment modalities moderate the difference.

In obesity, high levels of TNF-α in the bone marrow microenvironment induce the bone marrow-mesenchymal stem cells (BM-MSCs) towards a pro-adipogenic phenotype. Here, we investigated the effect of obesity on the migratory potential of BM-MSCs and their fate towards the adipose tissues. BM-MSCs were isolated from male C57Bl/06 mice with high-fat diet-induced obesity. The migratory potential of the BM-MSCs, their presence in the subcutaneous (SAT) and the visceral adipose tissues (VAT), and the possible mechanisms involved were investigated. Obesity did not affect MSC content in the bone marrow but increased the frequency of MSCs in blood, SAT, and VAT. In these animals, the SAT adipocytes presented a larger area, without any changes in adipokine production or the Sdf-1α gene expression. In contrast, in VAT, obesity increased leptin and IL-10 levels but did not modify the size of the adipocytes. The BM-MSCs from obese animals presented increased spontaneous migratory activity. Despite the augmented expression of Cxcr4, these cells exhibited decreased migratory response towards SDF-1α, compared to that of BM-MSCs from lean mice. The PI3K-AKT pathway activation seems to mediate the migration of BM-MSCs from lean mice, but not from obese mice. Additionally, we observed an increase in the spontaneous migration of BM-MSCs from lean mice when they were co-cultured with BM-HCs from obese animals, suggesting a paracrine effect. We concluded that obesity increased the migratory potential of the BM-MSCs and induced their accumulation in VAT, which may represent an adaptive mechanism in response to chronic nutrient overload.

Objective: To evaluate idiopathic musculoskeletal pain, musculoskeletal pain syndromes, and use of electronic devices in adolescents with asthma and healthy controls. Methods: Cross-sectional study was conducted on 150 asthmatic adolescents and 300 controls. Adolescents completed a self-administered questionnaire regarding painful symptoms, use of electronic devices, and physical activity. Seven musculoskeletal pain syndromes were evaluated, and Asthma Control Test (ACT) was assessed. Results: Musculoskeletal pain (42% vs. 61%, p = 0.0002) and musculoskeletal pain syndromes (2.7% vs. 15.7%, p = 0.0006) were significantly lower in asthmatic adolescents than in controls. The frequency of pain in the hands and wrists was reduced in asthmatic than in controls (12.6% vs. 31.1%, p = 0.004), in addition to cell phone use (80% vs. 93%, p < 0.0001), simultaneous use of at least two electronic media (47% vs. 91%, p < 0.0001), myofascial syndrome (0% vs. 7.1%, p = 0.043), and tendinitis (0% vs. 9.2%, p = 0.008). Logistic regression analysis, including asthma with musculoskeletal pain as the dependent variable, and female sex, ACT > 20, simultaneous use of at least two electronic devices, cell phone use, and weekends and weekdays of cell phone use, as independent variables, showed that female sex (odds ratio [OR], 2.06; 95% confidence interval [CI], 1.929–6.316; p = 0.0009) and ACT ≥ 20 (OR, 0.194; 95% CI, 0.039–0.967; p = 0.045) were associated with asthma and musculoskeletal pain (Nagelkerke R2 = 0.206). Conclusion: Musculoskeletal pain and musculoskeletal pain syndromes were lower in adolescents with asthma. Female sex was associated with musculoskeletal pain in asthmatic, whereas patients with asthma symptoms and well-controlled disease reported a lower prevalence of musculoskeletal pain.

Purpose To compare the effects of combined training (CT) versus aerobic training (AT) or versus control on VO2 peak and quadriceps muscle strength in patients with heart failure (HF). Materials and methods Major electronic databases were searched, from inception to November 2020, for randomized clinical trials comparing the effects of CT against AT or control on VO2 peak and/or quadriceps muscle strength in patients with HF. Random effects meta-analyses were conducted, calculating the standardized mean difference (SMD). Results Twenty-eight articles were included. An increase on VO2 peak (SMD = 0.77, 95%CI 0.39-1.14, I2=80.1%) and quadriceps muscle strength (SMD = 0.67, 95%CI 0.18-1.16, I2=0%) was found in CT compared to control. CT increased quadriceps muscle strength, versus AT (SMD = 0.44, 95%CI 0.15-0.74, I2=0%). There were no differences between CT and AT on VO2 peak (SMD=-0.01, 95%CI -0.36 to 0.34, I2=65%). Time of session and training duration moderate the effects of CT over control on VO2 peak. Conclusions CT promotes increases on quadriceps muscle strength and aerobic capacity over control and provides additional gains on quadriceps muscle strength, having the same effects on VO2 peak compared to AT. A longer time of session is associated with greater benefits to aerobic capacity.Implications for rehabilitationCombining aerobic and strength training increases the functional capacity and quadriceps muscle strength in heart failure patients.Using longer sessions of training has a greater impact on aerobic capacity.

Ultrasound-assisted extraction (UAE) of antioxidant compounds from Diaporthe schini biomass using ethanol as solvent was performed and the results were compared with heat-assisted extraction (HAE; conventional technique). Ultrasound intensity (17–85 W cm−2) and pulse cycle (0.50–1.00) were evaluated according to a Central Composite Rotatable Design (CCRD) to obtain the highest extraction yield. The HAE was studied at 30 and 50 °C. In the validation condition (85 W cm−2 and 0.93) of the UAE the extraction yield and antioxidant capacity (DPPH) were 22.30 ± 0.47% and 91.35 ± 0.27%, respectively. The best extraction yield (8.34 ± 0.38%) and antioxidant activity (91.32 ± 0.98%) of the HAE were observed at 50 oC. The GC/MS analysis of the UAE extracts showed the presence of methyl 9,12 octadecadienoate (Z, Z)-, ethyl ester of hexadecanoic acid, ethyl octadec-9-enoate, and 1,4-diaza-2,5-dioxo-3-isobutyl bicyclo[4.3.0]nonane, which could be responsible for the antioxidant activity observed. This study was the first attempt to optimize the UAE parameters for the antioxidant compounds extraction from Diaporthe schini. UAE improved the extraction yield and reduced the extraction time in relation to HAE.

Background/aimsA growing body of evidence has demonstrated that early mobilisation is beneficial for patients in the intensive care unit. The aim of this prospective study was to investigate the acute effect of an early passive cycling exercise session on serum interleukin-8 and interleukin-10 levels in critically ill patients.MethodsA total of 11 haemodynamically stable and deeply sedated (Richmond Agitation and Sedation Scale-4) adult patients within the first 48 hours of mechanical ventilation received a single 20-minute session of passive cycle ergometer. Serum interleukin-8 and interleukin-10 levels were measured at baseline, immediately after the intervention and 60 minutes after the intervention.FindingsInterleukin-8 levels decreased significantly 60 minutes after the passive cycle ergometer session compared to baseline (P=0.001). The serum levels of interleukin-10 increased immediately after the end of the 20 minutes and at 60 minutes after the intervention (PConclusionsA single 20-minute session of passive cycle ergometer seems to have a positive effect on the inflammatory response in critically ill patients.

Introduction Resistance exercises (RE) performed at high intensity cause an inflammatory response and electrolyte abnormalities in blood plasma. Objectives To study the plasma electrolyte changes resulting from a high-intensity session of RE in untrained volunteers, and to correlate these with delayed onset muscle soreness (DOMS). Methods Twenty volunteers, aged 26.9 (±4.4) years, underwent an RE session. The workout (leg extension, squat and leg press) consisted of four sets of 10 maximum repetitions. Electrolytes (Na+, K+, Ca2+ e Mg2+) were evaluated before the training (baseline), immediately (0 min), and 30 minutes after the RE. The DOMS was assessed 24 hours after the sessions. Results The Na+ increased immediately after the RE and returned to normal after 30 min (p

Background/Aims The aim of this study was to evaluate the effects of different intensities and waveforms of therapeutic ultrasound on endothelial function in typically healthy participants. Methods A total of 15 participants were evaluated over 2 consecutive days. Different intensities of continuous and pulsed (20% duty cycle) 1-MHz ultrasound were applied to the brachial artery for 5 minutes each. Endothelial function was measured using flow-mediated dilation technique before and immediately after ultrasound was applied. Results Compared to baseline values, endothelium-dependent vasodilation increased with both continuous (2.8%) and pulsed (1.6%) ultrasound at an intensity of 0.4 W/cm2SPTA. At 1.2 W/cm2SPTA, endothelium-dependent vasodilation was 4.1% above baseline for pulsed and 5.3% above baseline for continuous waveforms. There was no additional increase in vasodilation at intensities above 1.2 W/cm2SPTA. The percentage of endothelium-dependent vasodilation was similar for the all of the different waveforms studied. Conclusions Both continuous and pulsed ultrasound waveforms promote endothelium-dependent vasodilation. There was a dose-dependent increase in vasodilation at intensities from 0.4 W/cm2SPTA to 1.2 W/cm2SPTA. Pulsed is more efficient than continuous ultrasound because it produces the same effect on endothelium-dependent vasodilation while employing 20% of the energy applied with continuous ultrasound.

Background The effect of high-intensity interval training (HIIT) protocols according to different work intervals, session volumes and training periods has not been evaluated in patients with type 2 diabetes mellitus (T2DM). Objective This was a systematic review and meta-analysis of the effect of HIIT and its different protocols compared to moderate-intensity continuous training (MICT) and the control group on VO2max and glycated hemoglobin (HbA1c) level in patients with T2DM. Methods The search strategy considered studies published up to September 2020 in the databases MEDLINE (PubMed), EMBASE, Cochrane CENTRAL, Web of Science and SPORTDiscus. Two authors independently searched the selected databases for randomized clinical trials that compared HIIT to MICT or the control in adults with T2DM. A random-effects meta-analysis was performed and the data are presented as the mean difference (95% confidence intervals [95% CIs]) between HIIT, MICT and control groups. Results A total of 20 studies (738 participants) were included. Overall, HIIT increased VO2max by 5.09 mL/kg/min (95% CI 2.99; 7.19, I² = 80.89) versus the control and by 1.9 mL/kg/min (95% CI 0.81; 2.98, I² = 25.62) versus MICT. HIIT promoted a significant reduction in HbA1c level of -0.8% (95% CI -1.06; -0.49, I² = 77.31) versus the control but with no difference versus MICT. Moderate-interval, high-volume and long-term training promoted a greater increase in VO2max. A long interval and moderate volume and period conferred a greater increase in VO2max versus MICT. A short interval and moderate volume and period conferred a greater reduction in HbA1c level versus the control. No publication bias was detected, as evaluated by a funnel chart and Egger's test (p > 0.05). Conclusions As compared with MICT, HIIT had better effect on VO2max and a similar effect on HbA1C level. Interval protocols, moderate to long training period and moderate to high volume may maximize the HIIT effect in patients with T2DM.

Endophytic fungi have been highlight in the production of secondary metabolites with different bioactive properties, such as in the production of the antioxidant compounds. Therefore, the objective of this work was the extraction of the antioxidant compounds from the biomass of Diaporthe schini using supercritical carbon dioxide (CO2) without and with ethanol as cosolvent. The biomass was produced by submerged fermentation and the parameters evaluated in the extraction process were: pressure (150–250 bar), temperature (40–60 oC) and cosolvent [biomass: cosolvent ratio, 1:0, 1:0.75 and 1:1.5 (w/v)]. Extraction yield, antioxidant activity and chemical composition of the extracts were determined. The highest extraction yield (3.24 wt.%) and the best antioxidant activity against the 2,2-diphenyl-1-picrylhydrazyl (DPPH) radical (96.62%) were obtained at 40 oC, 250 bar and biomass:cosolvent ratio of 1:1.5 (w/v). The chemical compounds 1,4-diaza-2,5-dioxo-3-isobutyl bicyclo[4.3.0]nonane and benzeneethanol identified in GC/MS could be responsible for the antioxidant activity found in this study.

Autonomic dysfunction is reported in Human Immunodeficiency Virus (HIV) patients, leading to higher rates of morbity-mortality. However, the relationship of the viral load and antiretroviral therapy (ART) with the cardiovascular autonomic balance requires more clarification. The objective of the study was to evaluate the influence of ART and viral control concerning the autonomic balance and cardiovascular risks in HIV people. This was a cross-sectional study with 60 HIV patients, subdivided in three groups paired up by gender and age: with ART and undetectable viral load (ARTVL-; n=20); ART and detectable viral load (ARTVL+; n=20); and without ART and detectable viral load (noARTVL+; n=20). The cardiovascular autonomic control of heart rate variability (HRV) was evaluated according to time and frequency domain. The Framingham Risk Score was used in order to calculate the risk of cardiovascular events. It was observed that the viral load was lower in ARTVL+ than noARTVL+. The noARTVL+ demonstrated more lower frequency components (LF: 44.4±17.2nu; p

To compare the effects of different waveforms of 1MHz and 3MHz therapeutic ultrasound on endothelial function in healthy subjects.Randomised placebo-controlled, crossover study with concealed allocation and assessor blinding.Imaging Centre of the University Hospital.Thirty volunteers aged between 18 and 35 years were divided into two homogeneous groups (1MHz and 3MHz).Continuous (CUT; 0.4W/cmEndothelial function was evaluated using the flow-mediated dilation (FMD) technique.Both 1MHz [CUT: mean difference 4%, 95% confidence interval (CI) 2 to 6%, P0.001; PUT: mean difference 4%, 95% CI 2 to 6%, P0.001] and 3MHz (CUT: mean difference 4%, 95% CI 2 to 6%, P0.001; PUT: mean difference 4%, 95% CI 2 to 6%, P0.001) of therapeutic ultrasound increased %FMD by approximately 4% compared with the placebo waveforms. The endothelium-dependent vasodilator responses were the same for both types of waves and frequencies. No differences in baseline diameter, hyperaemic flow, and nitroglycerin-mediated diameter and vasodilation were observed between groups.Both CUT and PUT ultrasound waveforms improved endothelial function. The 1MHz and 3MHz frequencies of therapeutic ultrasound led to similar improvement in endothelial function in healthy volunteers. Clinical trial registration number RBR-4z5z3t.

Objective Chia seed oil is the richest source of plant-based ω-3 fatty acid, α-linolenic acid, but its potential and mechanisms of action to treat obesity are unclear. The aim of the study was to evaluate the effects of chia oil (ChOi) supplementation on body composition and insulin signaling in skeletal muscles of obese mice. Methods Male C57 BL/6 mice (n = 8/group) were fed regular control chow or a high-fat diet (HFD) for 135 d. Another HFD group additionally received ChOi from 90 to 135 d. Results Consumption of ChOi reduced fat mass accumulation and increased lean mass as evidenced by nuclear magnetic resonance. Moreover, obese mice treated with ChOi showed higher tyrosine phosphorylation of insulin receptor substrate 1, greater activation of protein kinase B, and increased translocation of glucose transporter type 4 in skeletal muscle tissue in response to insulin. ChOi supplementation improved glucose levels and insulin tolerance; decreased serum insulin, leptin, and triacylglycerols; and increased blood high-density lipoprotein cholesterol levels. All these effects caused by the use of ChOi seemed to be independent of the resolution of inflammation because the markers of inflammation were not altered in animals fed the HFD. Conclusion The molecular effects observed in muscle tissue together with changes in body composition may have contributed to the increased glucose tolerance and to the healthy phenotype presented by obese animals treated with ChOi.

Objective: To evaluate television and simultaneous electronic devices use in adolescents with musculoskeletal pain and musculoskeletal pain syndromes. Methods: A cross-sectional study was performed in 299 healthy adolescents of a private school. All students completed a self-administered questionnaire, including: demographic data, physical activities, musculoskeletal pain symptoms, and use of simultaneous television/electronic devices (computer, internet, electronic games, and cell phones). Seven musculoskeletal pain syndromes were also evaluated: juvenile fibromyalgia, benign joint hypermobility syndrome, myofascial syndrome, tendinitis, bursitis, epicondylitis, and complex regional pain syndrome. Results: Inter-rater agreement between pretest and retest was 0.83. Musculoskeletal pain and musculoskeletal pain syndrome were found in 183/299 (61%) and 60/183 (33%), respectively. The median age (15 [10–18] vs. 14 [10–18] years, p = 0.032) and years of education (10 [5–12] vs. 9 [5–12] years, p = 0.011) were significantly higher in adolescents with musculoskeletal pain when compared with those without this condition. The frequencies of female gender (59% vs. 47%, p = 0.019), cell phone use (93% vs. 81%, p = 0.003), and simultaneous use of at least two electronic devices (80% vs. 67%, p = 0.011) were significantly higher in the former group. Further comparisons between adolescents with and without musculoskeletal pain syndromes revealed that the frequency of female gender was significantly higher in the former group (75% vs. 25%, p = 0.002), and with a significantly reduced median of weekends/holidays electronic games use (1.5 [0–10] vs. 3 [0–17] h/day, p = 0.006). Conclusions: A high prevalence of musculoskeletal pain/syndromes was observed in female adolescents. Musculoskeletal pain was mostly reported at a median age of 15 years, and students used at least two electronic devices. Reduced use of electronic games was associated with musculoskeletal pain syndromes. Resumo: Objetivo: Avaliar o uso de televisão e dispositivos eletrônicos em adolescentes com dor e síndromes musculoesqueléticas. Métodos: Foi feito um estudo transversal com 299 adolescentes saudáveis de uma escola particular. Todos os alunos responderam a um questionário autoaplicável, que incluiu perguntas sobre: dados demográficos, prática de atividade física, sintomas de dor musculoesquelética e o uso de televisão/ dispositivos eletrônicos (computador, internet, jogos eletrônicos e celular). Sete síndromes musculoesqueléticas foram avaliadas: fibromialgia juvenil, síndrome de hipermobilidade articular benigna, síndrome miofascial, tendinite, bursite, epicondilite e síndrome de dor regional complexa. Resultados: A concordância entre o pré-teste e reteste foi de 0,83. Dor musculoesquelética e síndromes musculoesqueléticas foram encontradas em 183/299 (61%) e 60/183 (33%), respectivamente. As medianas de idade [15 (10-18) versus 14 (10-18) anos, p = 0,032] e de anos de escolaridade [10 (5-12) vs. 9 (5-12) anos, p = 0,010] foram significantemente maiores em adolescentes com dor musculoesquelética em comparação com aqueles sem essa condição. As frequências do sexo feminino (59% versus 47% p = 0,019), uso do telefone celular (93% contra 81%, p = 0,003) e do uso simultâneo de pelo menos dois dispositivos eletrônicos (80% vs. 67%, p = 0,011) foram significantemente maiores no grupo de adolescentes com dor musculoesquelética. Comparações adicionais entre os adolescentes com e sem síndromes musculoesqueléticas revelaram que a frequência do sexo feminino foi significantemente maior no primeiro grupo de (75% versus 25%, p = 0,002), e com mediana significantemente reduzida de horas de jogos eletrônicos aos finais de semana e feriados [1,5 (0-10) vs. 3 (0-17) horas/dia, p = 0,006]. Conclusões: Uma alta prevalência de dor/síndromes musculoesqueléticas foi observada em adolescentes do sexo feminino. A dor musculoesquelética foi predominantemente relatada entre alunos com mediana de idade de 15 anos e que usavam pelo menos dois dispositivos eletrônicos simultaneamente. O uso reduzido de jogos eletrônicos foi associado à presença de síndromes musculoesqueléticas. Keywords: Adolescent, Musculoskeletal pain, Musculoskeletal pain syndromes, Electronic devices, Palavras-chave: Adolescente, Dor musculoesquelética, Síndromes musculoesqueléticas, Dispositivos eletrônicos

Digital workflow is increasingly accessible in daily dental practice. It has several benefits in implantology, such as the possibility of precise planning, which results in faster and safer surgery and, consequently, reduced prosthetic complications. There are also disadvantages that must be taken into consideration for successful treatment, such as deviations between the planned and placed implant position and intraoral scanning inaccuracies. We report a clinical case in implantology in which digital workflow was used throughout the process, pointing out its facilities and complications in the daily practice of dental surgeons. The patient had grade II mobility and external root resorption of tooth 11. After virtual planning, a surgical guide was fabricated by a CAD/CAM system, with immediate placement of a dental implant using the guided surgery technique. At the end of the osseointegration period, intraoral scanning was performed for fabrication of the final prosthesis also by a CAD/CAM system. After placement, the patient approved the aesthetic and functional results of the implant. We observed advantages such as simplification of clinical steps and safety of the proposed planning, but there were also disadvantages such as the complexity of digital tools, deviations of the placed implant, and inaccuracy in color selection. It was concluded that digital workflow is a reality that can be integrated into daily dental practice, resulting in greater safety, predictability of results, and ease of use in all clinical stages. However, it should be noted that there are still inaccuracies in digital tools and that a steep learning curve is needed in this area, which, if neglected, may lead to unsatisfactory results.

de Brito, E, Teixeira, AdO, Righi, NC, Paulitcth, FdS, da Silva, AMV, and Signori, LU. Vitamins C and E associated with cryotherapy in the recovery of the inflammatory response after resistance exercise: A randomized clinical trial. J Strength Cond Res XX(X): 000-000, 2019-The objective of this research was to compare the effects of cryotherapy associated with vitamins (C and E) on the recovery of the inflammatory response from the resistance exercise (RE) session of untrained volunteers. Fourteen subjects (26.2 ± 5 years old, 25.8 ± 3 kg·m) underwent 4 sessions of RE with different forms of recovery. The RE consisted of 4 sets of 10 maximal repetitions for each exercise (extensor bench, squat, and leg press). The recoveries were randomized and comprised the passive (control), with vitamins C (1 g) and E (800 UI) supplementation 40 minutes before exercise, with cryotherapy (immersion in water 15° C for 10 minutes), and the association (vitamins and cryotherapy). Hemogram, inflammatory markers (C-reactive protein and creatine kinase [CK]), and parameters of oxidative stress (lipid peroxidation [LPO] and antioxidant capacity against radical peroxyl) were evaluated before (baseline) and after (0, 30, and 120 minutes) the RE sessions. Muscle pain (primary outcome) was evaluated 24 hours after exercise. C-reactive protein (p = 0.010) and LPO (p < 0.001) increased (120 minutes) only in passive recovery. Recovery with cryotherapy (30 minutes), with vitamins and the association (0 and 30 minutes) delayed increases in CK (p < 0.001). Antioxidant capacity against radical peroxyl increased (30 minutes) only in recovery with the association (p < 0.011). The pain decreased in the recoveries with cryotherapy and association (p < 0.001). The association of vitamins (C and E) with cryotherapy attenuated the inflammatory response and pain, favoring recovery after an acute RE session.

Dental surgeons need in-depth knowledge of the bone tissue status and gingival morphology of atrophic maxillae. The aim of this study is to describe preoperative virtual planning of placement of 5 implants and to compare the plan with the actual surgical results. Three-dimensional (3D) planning of rehabilitation using software programs enables surgical guides to be specially designed for the implant site and manufactured using 3D printing. A patient with 5 teeth missing was selected for this study. The patient's maxillary region was scanned with cone-beam computed tomography (CBCT), and a cast model was produced. After virtual planning using ImplantViewer, 5 implants were placed using a printed surgical guide. Two weeks after the surgical procedure, the patient underwent another CBCT scan of the maxilla. Statistically significant differences were detected between the virtually planned positions and the actual positions of the implants, with a mean deviation of 0.36 mm in the cervical region and 0.7 mm in the apical region. The surgical technique used enables more accurate procedures compared with the conventional technique. Implants can be better positioned, with a high level of predictability, reducing both operating time and patient discomfort.

Objetivo: Identificar na literatura científica nacional a importância do aleitamento materno exclusivo na primeira hora de vida do recém-nascido. Metodologia: Revisão integrativa, com abordagem qualitativa e coleta de dados nas bases Literatura Latino-Americana e do Caribe em Ciências da Saúde e no Banco de Dados em Enfermagem, utilizando os descritores “Aleitamento Materno” and “RecémNascido” and “Primeira Hora”. A busca resultou em 40 artigos, dos quais sete foram selecionados para a análise. Resultados: O leite materno é fundamental para o desenvolvimento saudável do recémnascido e a amamentação também é benéfica à mãe. Os fatores limitadores dessa prática foram a assistência restrita às normas da instituição hospitalar, o parto cesáreo, a não realização do pré-natal e a falta de incentivo ao alojamento conjunto. Conclusão: a amamentação na primeira hora de vida do recém-nascido constitui-se em um desafio, sendo imprescindível capacitação profissional para estímulo ao ato e o aprimoramento das políticas de promoção, proteção e apoio à amamentação para enfrentar seus fatores limitadores.

Beyond the regulation of cardiovascular function, baroreceptor afferents play polymodal roles in health and disease. Sepsis is a life-threatening condition characterized by systemic inflammation (SI) and hemodynamic dysfunction. We hypothesized that baroreceptor denervation worsens lipopolysaccharide (LPS) induced-hemodynamic collapse and SI in conscious rats. We combined: (a) hemodynamic and thermoregulatory recordings after LPS administration at a septic-like non-lethal dose (b) analysis of the cardiovascular complexity, (c) evaluation of vascular function in mesenteric resistance vessels, and (d) measurements of inflammatory cytokines (plasma and spleen). LPS-induced drop in blood pressure was higher in sino-aortic denervated (SAD) rats. LPS-induced hemodynamic collapse was associated with SAD-dependent autonomic disbalance. LPS-induced vascular dysfunction was not affected by SAD. Surprisingly, SAD blunted LPS-induced surges of plasma and spleen cytokines. These data indicate that baroreceptor afferents are key to alleviate LPS-induced hemodynamic collapse, affecting the autonomic control of cardiovascular function, without affecting resistance blood vessels. Moreover, baroreflex modulation of the LPS-induced SI and hemodynamic collapse are not dependent of each other given that baroreceptor denervation worsened hypotension and reduced SI.

Background : Fibrosarcomas are malignant neoplasms originating from fibroblasts that are normally located in the skin, subcutaneous tissue and adjacent to bones. The main treatment for fibrosarcoma is surgery. The removal of large neoplasms from dogs’ limbs usually leads to the formation of large skin defects, often preventing primary occlusion and thus requiring reconstructive surgery to close the wound. This paper reports on the surgical procedure and postoperative complications pursuant to the excision of a fibrosarcoma in the right forelimb and reconstruction with a full-thickness autologous graft in a dog. Case : We report a case of a 12-year-old Brazilian mastiff presenting a nodule located in the distal segment of the right forelimb, which had grown over a 2-year period. Blood and imaging tests were performed, which showed no changes and excluded the possibility of metastasis. The cytological examination was suggestive of a mesenchymal neoplasm. The patient underwent tumor excision surgery followed by reconstructive surgery with a full-thickness autologous graft to close the defect. The neoplasm was excised by means of a circular geometric figure incision using a 3 cm margin. The defect resulting from removal of the tumor was kept constantly moistened and wrapped in surgical compresses until grafting was performed. The graft was harvested from the region of the right flank based on a surgical field mold taken from the recipient bed. After harvesting the graft, all the subcutaneous tissue was removed until the hair follicles were visible. Fenestrations were then made throughout the entire graft and it was placed in the recipient bed and closed with 4-0 nylon using simple interrupted sutures. After the surgical procedure, the graft was covered with a water-based lubricating gel and bandaged, and the limb was immobilized. Cephalexin, meloxicam, tramadol and dipyrone were used as postoperative medications. The bandage was changed every 72 h. The postoperative complications observed involved the formation of seroma, infection and necrosis of the graft, which was removed and debrided on the 9th postoperative day. The defect generated after removal of the graft was treated using hydrocolloid dressings, which were changed every 5 days. Seven changes of the hydrocolloid dressings were required to ensure complete closure of the defect. A histopathological examination of the neoplasia revealed that it was a fibrosarcoma. Discussion : Fibrosarcomas are neoplasms with a low degree of malignancy, which metastasize only in an advanced stage of the disease. Treatment consists of surgical resection with a wide safety margin. Full-thickness skin grafts include the epidermis and the entire dermis and are applied to cover major defects in flexor surfaces and defects in distal extremities. The main reasons for skin graft failure are separation between the graft and the recipient bed, infection and movement. The formation of seroma mechanically separates the graft from its bed, impairing nutrition and revascularization. Hydrocolloids, which are flexible and highly absorbent membranes composed of pectin, gelatin and carboxymethyl cellulose, are useful in treating a variety of wounds. The complications that occurred in this case are consistent with others reported in the literature. The treatment of the open wound with hydrocolloid dressings proved to be quite satisfactory, allowing for complete healing of the wound.

Introduction: High-intensity resistance exercises (RE) cause an inflammatory response that reduces functionality. Objective: To evaluate the effects of Cold Water Immersion (CWI) on leukocytosis, oxidative stress parameters, inflammatory markers and delayed onset muscle soreness (DOMS) resulting from a RE session in untrained volunteers. Methods: Thirteen volunteers (aged 26 ± 5 years) who do not engage in RE were randomized and underwent Control RE and RE with CWI sessions. Exercise sessions (leg extension machine, squats and leg presses) consisted of four sets of 10 maximum repetitions (one-week interval between the assessment and the sessions). CWI consisted of immersion in water (15°C) to the umbilicus for 10 minutes immediately after the exercise session. Complete blood count, CRP, creatine kinase (CK) and lipoperoxidation (LPO) were assessed previously (baseline) and immediately, 30 minutes and 2 hours after RE. DOMS was assessed 24 hours after the sessions. Results: RE induced progressive leukocytosis (P

Obesity is associated with obstructive sleep apnea-hypopnea syndrome (OSA) and both induce endothelial dysfunction. However, the effect of OSA on endothelial function after bariatric surgery has not been investigated yet. This study aims to evaluate the impact of weight loss on endothelial function in patients with and without obstructive sleep apnea (OSA) in the first 6 months after bariatric surgery. This study was conducted at a university hospital, in Brazil. The sample consisted of 56 patients homogeneously divided into groups with and without OSA. All patients underwent Roux-en-Y gastric bypass (RYGB), and the diagnosis of OSA was performed by polysomnography. The patients were evaluated preoperatively and 6 months after surgery. The evaluations included anthropometric measures, electrical bioimpedance, clinical symptoms of OSA, and endothelial function (flow-mediated dilation). RYGB improved the anthropometric, bioimpedance, and endothelial function results in both groups. Patients presented a significant clinical improvement in OSA symptoms throughout the study. However, patients with OSA had an improvement in the endothelial function 2.5% lower (p

Highlights • FES is widely used in patients with chronic heart failure. • FES increased quadriceps muscle strength after eight weeks of training. • FES increased lower limb muscle endurance after eight weeks of training. • FES was unable to modify functional capacity after eight weeks of training., Background Functional electrical stimulation (FES) has shown benefits in patients with chronic heart failure. Therefore, it is possible that FES can benefit patients similarly after cardiac surgery. Objective This randomized placebo-controlled trial aimed to evaluate the effects of FES on lower limb functional capacity, strength, endurance, and muscle mass after discharge from cardiac surgery. Methods Twenty patients were allocated (1:1) to the group receiving FES to the quadriceps (FESG) or FES placebo (FESPG). FES was applied at a frequency of 15 Hz, with 0.5 ms pulse width, 5 s contraction time, and 10 s resting time, twice a week for 40 min over a period of eight weeks. Functional capacity was assessed using the six-minute walk test (6MWT), lower limb muscle strength using the one repetition maximum test (1RM), endurance using the sit-and-stand test (SST), and muscle using the perimeter of the thighs. Results Both groups increased the distance covered in the 6MWT (FESG: 49.6 m, 95% CI 15.9–83.3; FESPG: 41.5 m, 95% CI 7.8–75.2), but without a difference between groups. There were significant between-group differences for quadriceps muscle strength (7.2 kg, 95% CI 0.2–14.2) and muscle endurance (2.2 repetitions, 95% CI 1.0–3.4) in favor of the FESG. Conclusion FES improves lower limb muscle strength and endurance in patients after cardiac surgery. Larger trials are needed to confirm our findings.

Amoxicillin (AMX) is a widely used penicillin-type antibiotic whose presence in the environment has been investigated. In this work, the degradation of the AMX in aqueous solutions by ozonation, ozonation with UV radiation (O

Macrophage infiltration into adipose tissue (AT) is a hallmark of the chronic inflammatory response in obesity and is supported by an intense monocyte migration towards AT. Although it has been detected an increased proportion of circulating CD16+ monocyte subsets in obese subjects, the mechanisms underlying this effect and the contribution of these cells to the inflamed profile of obese AT are still poorly understood. We investigated whether factors secreted by human obese omental AT could polarize monocytes to CD16+ enriched phenotype, and how these changes could modify their migratory capacity towards adipose tissue itself. We show that explants of human obese omental AT, obtained during bariatric surgery, released higher levels of MIP1-α, TNFα, leptin and also VEGF, together with increasing amounts of microparticles (MP), when compared to explants of lean subcutaneous AT. A higher content of circulating MP derived from preadipocytes and leukocytes was also detected in plasma of obese subjects. Conditioned media or MP released from obese omental AT increased CD16 and CCR5 expression on CD14+CD16- monocytes and augmented their migratory capacity towards the conditioned media from obese omental AT, itself. This effect was inhibited when MIP1-α was neutralized. Additionally, we demonstrate that MP derived from obese omental AT carry and transfer TLR8 to monocytes, thus triggering an increase in CD16 expression in those cells. Our data shows a positive feedback loop between blood monocytes and obese omental AT, which releases chemotactic mediators and TLR8-enriched MP, thus inducing an up-regulation of CD16+ monocytes, favoring leukocyte infiltration in the obese omental AT.

Objective To investigate the role of obesity on the bone marrow microenvironment and evaluate its possible impact on the adipogenic potential of mesenchymal stem cells (MSC). Methods C57BL/6 male mice were fed with a high-fat diet (HFD) for 10 weeks. Femurs and tibiae were collected, and bone marrow mesenchymal stem cells (BM-MSC) were isolated and analyzed for proliferative potential, immunophenotype, and expression of adipogenesis markers. Their capacity to produce extracellular matrix proteins and proinflammatory cytokines in vitro was also evaluated. Results HFD mice presented a significant increase in bone marrow cellularity and higher tumor necrosis factor-α production in vitro. BM-MSC from HFD mice had higher proliferative capacity, produced more extracellular matrix proteins associated with adipogenesis, collagen I, and collagen IV, and showed increased constitutive expression of adipogenic markers, peroxisome proliferator-activated receptor-γ, and CCAAT/enhanced binding protein family-α, without changes in preadipocyte factor-1 expression. Incubation with adipocyte-differentiation medium induced further increase in CCAAT/enhanced binding protein family-α and augmented adiponectin expression in obese BM-MSC. These alterations did not result in increased adipogenic differentiation within the bone marrow. Moreover, BM-HSC from HFD mice, co-cultivated with BM-MSCs from lean mice, exerted paracrine effects on these cells, inducing augment of peroxisome proliferator-activated receptor-γ. Conclusions The data suggest that obesity promotes an inflammatory microenvironment in bone marrow that commits BM-MSC to adipogenesis.

Previous research suggests that omega-3 fatty acids from animal origin may promote the browning of subcutaneous white adipose tissue. We evaluated if supplementation with a plant oil (chia, Salvia hispanica L.) rich in alpha-linolenic fatty acid (C18:3; ω-3) would promote browning and improve glucose metabolism in animals subjected to an obesogenic diet. Swiss male mice (n = 28) were divided into 4 groups: C: control diet; H: high-fat diet; HC: animals in the H group supplemented with chia oil after reaching obesity; HCW: animals fed since weaning on a high-fat diet supplemented with chia oil. Glucose tolerance, inflammatory markers, and expression of genes and proteins involved in the browning process were examined. When supplemented since weaning, chia oil improved glucose metabolism and promoted the browning process and a healthier phenotype. Results of this study suggested that chia oil has potential to protect against the development of obesity-related diseases.

Beyond the regulation of cardiovascular function, baroreceptor afferents play polymodal roles. We hypothesized that baroreceptor denervation affects lipopolysaccharide (LPS)-induced systemic inflammation (SI) and hemodynamic collapse in conscious rats, and that these parameters are interconnected. We combine: a) hemodynamic and thermoregulatory recordings after LPS administration at a septic-like dose b) analysis of the cardiovascular complexity, c) evaluation of vascular function in mesenteric resistance vessels, and d) measurements of inflammatory cytokines (plasma and spleen). LPS-induced drop in blood pressure was higher in sino-aortic denervated (SAD) rats. LPS-induced hemodynamic collapse was associated with SAD-dependent autonomic disbalance. LPS-induced vascular dysfunction was not affected by SAD. Surprisingly, SAD blunted LPS-induced surges of plasma and spleen cytokines. These data indicate that sino-aortic afferents are key to alleviate LPS-induced cardiovascular collapse, affecting the autonomic cardiovascular control, without affecting resistance blood vessels. Moreover, baroreflex modulation of the LPS-induced SI and hemodynamic collapse seem not to be interconnected.

Nicotine delays the healing process and increases the levels of myeloperoxidase (MPO), an enzyme that plays a key role in the production of reactive oxygen species during the inflammatory process. Laser Photobiomodulation (PBM) is one of the most used electrophysical agents in the treatment of the calcaneal tendon, however, its effects on MPO activity need to be further elucidated. This study aimed to evaluate the effects of laser PBM on MPO activity after inflicting an injury to the calcaneal tendon of rats exposed to cigarette smoke. Thirty-four male Wistar rats with 90 days of age were used. After 14 days of exposure to cigarette smoke, the animals were divided into three experimental groups: control group (CG, n=12), not submitted to injury or treatment; sham group (ShG, n=10), submitted to partial calcaneal tendon injury and laser PBM simulation; and laser PBM group (PBMG, n=12), submitted to partial calcaneal tendon lesion and treated with laser PBM within the first minute after injury. PBM decreased MPO activity levels in PBMG compared to ShG (CG: 1.38±0.69pg/ml; ShG: 3.78±1.09pg/ml; PBMG: 2.58±0.93pg/ml; p

Background Emotional disorders are risk factors for atherosclerosis and consequent cardiovascular disease. However, it is not clear whether emotional symptoms (ESs) have direct effects on cardiovascular disease. The aim of the present study is to investigate the effects of early ESs on carotid atherosclerosis in young adults. Methods and Results We tested the association between expression of ESs at 11 and 15 years of age and carotid intima‐media thickness at 18 years of age in the 1993 Pelotas Birth Cohort (N=5249, n=4336 with complete mental health data). ES s were assessed using the Strengths and Difficulties Questionnaire. Propensity score weighting procedure was run using generalized boosted regression model to adjust for potential confounding between exposure and outcome. We also tested whether traditional cardiovascular risk factors could mediate this relationship. Adjusted high expression of ESs , both at 11 and 15 years of age, led to mean increases in carotid intima‐media thickness of 1.84 and 2.58 μm, respectively, at 18 years of age (both P ESs on carotid intima‐media thickness at age 18 years ( P ESs led to mean increases of 1.14 μm in females ( P P Conclusions In this large birth cohort, expression of ESs in adolescence was longitudinally associated with a higher carotid intima‐media thickness in young adults. The association is direct and not mediated by traditional cardiovascular risk factors. Interactions by sex might have important implications for designing future interventions.

The aim of this study was to review potential deviation factors in stereolithographic surgical guides for dental implantology, warnings, and limitations of the system.An electronic search in databases EMBASE, the Cochrane Library, and PubMed were conducted by 3 researchers to collect information on the accuracy of static computer-guided implant placement to summarize and analyze the overall accuracy. The latter included a search for correlations between factors such as support (teeth/mucosa/bone), number of templates, use of fixation pins, jaw, template production, guiding system, and guided implant placement in articles related to guided surgery with stereolithographic static systems. Studies published between 2012 and 2017 were reviewed.From 761 identified articles, a total of 24 articles were reviewed, which included 2767 dental implants. Data from studies analysis had shown a mean deviation of 3.08 degrees in angular position, 1.14 at the entry point, and 1.46 at apex position. Involved deviation factors were related to planning, laboratory, and surgical phases.Guided surgery may have a limited precision as technique, which surgeons need to be aware in the planning process. This review suggests some security measures in guided surgery process.

The purpose of this study was to determine the effects of different therapeutic 1-MHz ultrasound waveforms on endothelial function before and after cyclooxygenase (COX) inhibition. Forty-two healthy volunteers aged 27.2 ± 3.8 y underwent interventions and an evaluation for endothelial function (n = 15; with COX inhibition, n = 15; duration of the vasodilator effect, n = 12) by technique flow-mediated dilation. Continuous ultrasound therapy (0.4 W/cm(2 SATA)), pulsed ultrasound therapy (20% duty cycle, 0.08 W/cm(2 SATA)) or placebo (equipment power off) was randomly applied over the brachial artery for 5 min. COX inhibition (aspirin) was carried out 30 min before treatments. In relation to the placebo, flow-mediated dilation increased by 4.8% using continuous ultrasound and by 3.4% using pulsed ultrasound. After COX, flow-mediated dilation was enhanced by 2.1% by continuous ultrasound and 2.6% by pulsed ultrasound. This vasodilation persisted for 20 min. Continuous and pulsed therapeutic 1-MHz ultrasound waveforms improved endothelial function in humans, which provided them with anti-inflammatory vascular effects.

The development of the Internet is often seen as a source of demand for skilled workers and therefore a potential driver of the wage gap between skilled and unskilled workers. This paper focuses on the impact that international trade in online platforms has on the skilled-unskilled wage gap. Because online trade allows smaller firms with relatively more unskilled workers to access world markets, one can expect an expansion of online exports to reduce the wage gap. After correcting for potential endogeneity bias in a sample of 22 developing countries for which online trade and wage gap data can be matched, we find that a 1 percent increase in the share of online exports over GDP leads to a 0.01 percent decline in the skilled-unskilled wage gap.

Conselho Nacional de Desenvolvimento Cientifico e TecnologicoNational Council for Scientific and Technological Development (CNPq) [CNPq 303422/2015-7]

[EN] Nanoparticles have specific features (lipophilicity, surface charge, composition and size). Studies regarding the biological behavior of nanoparticles in diseases such diabetics and obesity are scarce. Here, we evaluated two nanoparticles: magnetic core mesoporous silica (MSN) (58 nm) and polycaprolactone (PCL) nanoparticle (280 nm) in obese mice. Changes in the biodistribution were observed, especially considering the mononuclear phagocyte system (MPS), and the visceral fat tissue. Nonetheless, our data corroborates the influence of size in the biodistribution in obese animals, supporting that smaller nanoparticles, may show a higher tissue deposition at spleen, due the associated splenomegaly and the complications arising from this state. Finally, our study demonstrated that, in obesity, probably due the low-grade inflammatory state associated with metabolic syndrome a difference in accumulation of nanoparticles was found, with profound impact in the tissue deposition of nanoparticles., The authors would like to thank the National Scientific and Technological Research Council (CNPQ) - no. 400018/2016-0 and the Rio de Janeiro State Research Foundation (FAPERJ) - E-26/102.940/2012 for funding. Authors also gratefully acknowledge the financial support from the Ministerio de Economía y Competitividad (Project MAT2012-38429-C04-01) and the Generalitat Valenciana (project PROMETEO/2009/016) for support.

Obstructive Sleep Apnea (OSA) and obesity are conditions that are gaining importance due to the high prevalence and influence on individuals’ health. Therefore, the aim of the study was to compare polysomnographic variables among Ob-structive Sleep Apnea (OSA) patients classified as eutrophic, overweight or obese. Eighty eight patients were evaluated divided in eutrophic (EG; n=21; BMI=23.4±1.3kg/m2), overweight (OWG; n=34; BMI=27.5±1.4kg/m2) and obese group (OG; n=33; BMI=33.6±2.9kg/m2) that carried out all-night basal polysomnography for the diagnosis of Obstructive Sleep Apnea (OSA). The following variables were analyzed: stages 1, 2 and 3 of sleep (N1, N2 and N3), REM sleep, index peri-odic movements of the lower limbs (PLMS), apnea and hypopnea (AHI), AHI in REM sleep (AHIREM) and micro-arousal rates (MAR). The OG presented an increase of the N2 (p=0,036), of the AHIREM (p=0.001) and of the MAR (p=0.004), in comparison to EG. The AHI was larger in the OG than in the EG (p

Introduction The use of non-invasive ventilation in the form of continuous positive airway pressure (CPAP) is among the main therapeutic options for patients with obstructive sleep apnea (OSA). Yet the effects of CPAP obtained on the first night of use are underreported. Objective To evaluate the acute effects of CPAP on polysomnographic variables in patients with OSA. Materials and methods This study is a case series with 31 patients (55.8 ± 11.4 years; 22 men) in the initial phase of CPAP treatment. The subjects were evaluated by means of polysomnography with and without CPAP (10.2 ± 3.1 cmH2O) and without CPAP, on different days, by means of the following variables: sleep stages 1, 2 and 3 (N1, N2 and N3), rapid eye movement (REM) sleep, apnea and hypopnea index (AHI), AHI in REM sleep (AHIREM) and the micro-arousal index (MAI). Results The use of CPAP resulted in a reduction of N2 (p < 0.001), AHI (p < 0.001), AHIREM (p < 0.001) and MAI (p = 0.001). There was an increase in N3 (p = 0.006) and REM sleep (p < 0.001) during the night with use of CPAP. Conclusion This study demonstrated that, from the first night of use by patients with OSA, CPAP promotes greater balance between sleep phases, and improves sleep quality. These results should be presented to patients and their families in order to encourage greater adherence in the initial phase of treatment with CPAP.

We evaluated the effects of an 8-week inspiratory muscle training (IMT, n = 5) or placebo IMT (P-IMT, n = 5) on maximal respiratory pressures, pulmonary function, functional capacity, and cardiac autonomic control in patients with type 2 diabetes and diabetic autonomic neuropathy (DAN). The IMT group had a greater increase in maximum inspiratory pressure as compared to P-IMT (p

Introduction: Functional electrical stimulation (FES) is a valuable resource in the treatment of spastic patterns. Objectives: Evaluate the acute effect of FES on physical and functional variables of the spastic upper limb and its association with respiratory variables. Methods: Nineteen patients received placebo inter - vention (on the sensory threshold) and FES (f=30 Hz, pulse width=0.3 ms, 30 min) in the spastic limb (secondary to stroke) on different days. Before the interven - tions, activities of daily living by the Barthel Index (BI), pulmonary function and respiratory muscle strength were evaluated. Before and after the interventions, sensory motor function by Fugl-Meyer Scale (FMS) and movement amplitude were evaluated. Results : FES increased shoulder abduction and internal rotation, elbow extension and FMS. The maximum expiratory pressure was related to BI and shoulder flexion. Conclusions : The application of FES improved physical and functional variables of the spastic limb, which were associated with expira - tory muscle strength.

This study compared the thermal changes of cutaneous and subcutaneous tissues exposed to different aerosols. Thirty-six adults Wistar rats were arranged in two treatment groups, one exposed to methyl salicylate (GSM; n = 9 skin and n = 9 subcutaneous) and the other exposed to diclofenac diethylammonium (GDD; n = 9 skin and n = 9 subcutaneous) aerosols. Five jets were applied for one-second through an apparatus to reduce spray dispersion (3 cmdiameter) in the lateral left thigh of the animals. Temperatures were measured every minute (min.) during 30 min., with a digital thermometer. In the skin tissue the sensor was positioned manually, in the subcutaneous tissue it was surgically inserted through the rear face and positioned in the lateral thigh. The skin temperature has homogeneously reduced in both groups. In the subcutaneous tissue the GDD has induced hypothermia from the 2 nd to 20 th min., the lowest temperature was recorded on the 7 th min. (-3.6 ± 0.2oC in relation to basal). Lowering the temperature by GSM took place from the 1 st to 21 st min, and the lowest temperature occurred on the 1 st min (-9.7 ± 0.5oC in relation to basal). In the three initial minutes the GSM had temperatures 25, 10 and 5% lower than the GDD. Aerosols have induced hypothermia in the tissues, while the GSM has decreased faster and reached lower values of temperature shown in the subcutaneous tissue.

Aims To compare the effects of high-intensity interval training (HIIT) versus moderate-intensity continuous training (MICT) on functional capacity and cardiometabolic markers in individuals prediabetes and type 2 diabetes (T2D). Methods The search was performed in PubMed (MEDLINE), EMBASE, PEDro, CENTRAL, Scopus, LILACS database, and Clinical Trials from the inception to July 2017, included randomized clinical trials that compared the use of HIIT and MICT in prediabetes and T2D adults. The risk of bias was defined by Cochrane Handbook and quality of evidence by GRADE. Results From 818 relevant records, seven studies were included in systematic review (64 prediabetes and 120 T2D patients) and five with T2D were meta-analyzed. HIIT promoted significantly increased of 3.02 mL/kg/min (CI95% 1.42–4.61) of VO2max, measured for functional capacity, compared to MICT. No differences were found between two modalities of exercises considering the outcomes HbA1c, systolic and diastolic blood pressure, total cholesterol, HDL and LDL cholesterol, triglycerides, BMI, and waist-to-hip ratio. Most of the studies presented unclear risk of bias, and low and very low quality of evidence. Conclusion HIIT induces cardiometabolic adaptations similar to those of MICT in prediabetes and T2D, and provides greater benefits to functional capacity in patients with T2D. PROSPERO: CRD42016047151.

Background/Aims Evaluation of esophageal clearance by orange juice swallowing could be useful to identify different categories of gastroesophageal reflux disease. We determined whether a juice test at the beginning of esophageal pH monitoring can identify nonerosive reflux disease (NERD) among heartburn patients. Methods Multiple swallows of orange juice (pH 3) were performed at the beginning of esophageal pH monitoring in 71 heartburn patients off acid-suppressive therapy. The area between pH drop below 5 and recovery to 5 was calculated from pH tracings and named Delta5 (mmol·L−1·sec). Fifteen healthy subjects served to determine Delta5 cutoff (95th percentile). Patients were classified as NERD, non-NERD (a mix of reflux hypersensitivity, functional heartburn, and undetermined), and erosive disease depending on acid exposure, reflux symptom analysis, and upper endoscopy. Results Delta5 cutoff in healthy subjects was 251 mmol·L−1·sec. Among 71 patients, 23 had NERD, 26 had non-NERD, and 22 had erosive disease. Compared to non-NERD, Delta5 was higher in both NERD (median [interquartile range]: 316 [213–472] vs 165 [105–225]; P < 0.01) and erosive disease (310 [169–625] vs 165 [105–225]; P < 0.01). An elevated Delta5 (> 251 mmol·L−1·sec) showed sensitivity of 74% and specificity of 81% for identification of NERD. Positive and negative likelihood ratios were 3.84 and 0.32 respectively, whereas test accuracy was 78%. Conclusions A juice test with calculation of Delta5 helps in the identification of true NERD among heartburn patients with endoscopy-negative reflux disease. In these patients, an elevated Delta5 could make prolonged reflux testing unnecessary.

[EN] Inflammation processes are difficult to manage, especially in certain diseases like cancer. The prognostic of the patient may change drastically during the therapy if an inflammation process occurs. In this direction several research groups are trying to develop new agents for treatment and imaging of the inflammation process in order to improve patients prognostics. In this study we have developed and evaluated two possible imaging agents for nuclear medicine procedure using mesoporous silica nano particles as the carrier system. In this direction we developed mesoporous silica nanoparticles loaded with betamethasone and mesoporous silica nanoparticles conjugated with dexamethasone nano particles, both labeled with technetium-99m (Tc-99m) and compared the biodistribution (pharmacokinetic) profile of the two formulations in an inflammation model of carrageenan-induced pleurisy in Wistar rats. The results demonstrated that in both cases the mesoporous silica was able to show the inflammation site with a high accumulation in the inflammatory site with great renal clearance. Considering the fact that radiopharmaceuticals are considered first-order drugs the pharmacokinetics profile are the same of the biodistribution. The cytotoxicity assay demonstrated that the use of mesoporous silica nanoparticles conjugated with dexamethasone nanoparticles is safer when compared to the mesoporous silica nanoparticles loaded with betamethasone. Nevertheless, both formulations may be used for inflammation process imaging. (C) 2016 Elsevier Inc. All rights reserved., The authors would like to thank the National Scientific and Technological Research Council CHAMADA MCTI/CNPQ/CBAB No 07/2014 (CNPQ) and the Rio de Janeiro State Research Foundation (FAPERJ) for funding.Authors also gratefully acknowledge the financial support from theMinisterio de Economia y Competitividad (Project MAT2012-38429-C04-01) and the GeneralitatValenciana (project PROMETEO/2009/016) for support.

Background Interleukin-6 (IL-6) plays a central role in atherosclerosis and inflammation. It may improve risk prediction in patients at intermediate cardiovascular risk. Objective To analyze the impact of serum IL-6 in predicting early angiographic coronary artery disease in patients at intermediate cardiovascular risk with chest pain. Methods In a cross-sectional study, patients referred for coronary angiography due to suspected coronary artery disease (CAD) were included. Coronary artery disease was defined as the presence of at least 30% stenosis in one or more coronary artery. Severity of CAD was classified by the anatomic burden score. Performance of serum IL-6 assay was compared with ACC/AHA atherosclerotic cardiovascular disease (ASCVD) risk score and hs-CRP through receiver operating characteristic (ROC) curves. Results We have included 48 patients with a mean 10-year ASCVD risk of 10.0 ± 6.8%. The prevalence of CAD was 72.9%. The presence of CAD was associated with higher mean levels of IL-6 (p = 0.025). Patients with CAD had significantly more overweight than subjects without CAD. In 27% of patients, IL-6 was >1.0 pg/mL and 100% of these patients had CAD, while only 64% in those with IL-6 1.0 pg/mL were further reclassified into ASCVD high risk due to the presence of coronary lesions. Conclusion In intermediate risk patients referred for coronary angiography, a serum IL-6 level above 1 pg/mL is predictive of significant CAD. IL-6 determination may be useful to reclassify ASCVD intermediate risk patients into higher risk categories.

RESUMO A fisioterapia carece de análises bibliométricas que relatem os aspectos mais relevantes da produção científica, bem como o perfil das publicações das diversas especialidades da profissão. Esta análise bibliométrica objetivou avaliar os artigos publicados em periódicos brasileiros na área da fisioterapia e verificar sua relação com as especialidades da profissão. Este estudo transversal envolveu 15 periódicos com algum enfoque na área de fisioterapia, considerando os artigos publicados entre 2011 e 2014. Os dados dos periódicos foram coletados em cada home page. Foram analisados os artigos classificados dentre as especialidades da fisioterapia, reconhecidas pelo Conselho Federal de Fisioterapia e Terapia Ocupacional. A região Sudeste apresentou o maior número de periódicos e a maior produção científica. O Qualis B1 e B4 foram os mais frequentes. Dentre os 2.683 artigos encontrados, 1.664 (62%) estiveram vinculados à área de fisioterapia. O tempo entre submissão e aceite foi de 157 (68-243) dias e do aceite à publicação de 109 (60-177) dias. A fisioterapia traumato-ortopédica concentrou o maior número de publicações (34,3%). As pesquisas quantitativas (80,8%) e com seres humanos (83,9%), bem como a estatística inferencial (67,7%), foram as mais frequentes e predominaram dentre as especialidades. A fisioterapia permanece em ascensão quanto à quantidade e qualidade de suas pesquisas no Brasil, vislumbrando o crescimento da prática profissional baseada em evidência nas suas diversas especialidades. Porém, o tempo até a publicação dos artigos ainda é demorado. A maior prevalência de pesquisas quantitativas e de estatística inferencial pode promover avanços substanciais à profissão. RESUMEN La fisioterapia precisa de análisis bibliométricas que plantean los aspectos más relevantes de la producción científica, así como el perfil de las publicaciones de las diversas especialidades de la profesión. En este análisis bibliométrica se pretende evaluar los textos publicados en revistas brasileñas en el área de fisioterapia y comprobar su relación con las especialidades de la profesión. En este estudio de tipo transversal se investigó 15 revistas con enfoque en fisioterapia, teniendo en cuenta los textos publicados entre 2011 y 2014. Se recolectaron los datos de las revistas electrónicas en sus páginas iniciales. Se evaluaron los textos clasificados entre las especialidades de fisioterapia, reconocidas por el Consejo Federal de Fisioterapia y Terapia Ocupacional. La región Sudeste de Brasil fue la con mayor cantidad de revistas y mayor producción científica. El Qualis B1 y B4 fueron los más frecuentes. De los 2.683 textos encontrados, 1.664 (62%) relacionaban al área de la fisioterapia. El tiempo de presentación y aceptación fue de 157 (68-243) días, y el tiempo de la aceptación a la publicación fue de 109 (60-177) días. La fisioterapia traumatología y ortopedia fue la que más publicó (34,3%). Los estudios cuantitativos (80,8%) y con seres humanos (83,9%), así como la estadística inferencial (67,7%), fueron los más frecuentes y predominantes en las especialidades. La fisioterapia sigue creciendo en cuanto a la cuantidad y calidad de sus estudios en Brasil, con crecimiento de la práctica profesional en evidencia en sus distintas especialidades. Sin embargo, todavía se lleva mucho tiempo para publicar los textos. La mayor prevalencia de estudios cuantitativos y de estadística inferencial puede promocionar avances sustanciales a la profesión. ABSTRACT Physical therapy lacks bibliometric analyses that report the most relevant aspects of its scientific production, as well as the profile of publications of the several specialties of this profession. This bibliometric analysis aimed to evaluate the articles published in Brazilian journals in the field of Physical Therapy and verify their relationship with the profession specialties. This cross-sectional study involved 15 journals with a focus on Physical Therapy, considering articles published between 2011 and 2014. Data of the journals were collected in each home page. We analyzed articles classified among the specialties of Physical Therapy, recognized by the Federal Council of Physical and Occupational Therapy. The Southeast region presented the greatest number of journals and the largest scientific production. Qualis B1 and B4 were the most frequent ones. Among the 2,683 articles, 1,664 (62%) were linked to the area of Physical Therapy. The time between submission and acceptance was 157 (68-243) days, and, from acceptance to publication, 109 (60-177) days. Trauma-Orthopedic Physical Therapy concentrated the highest number of publications (34.3%). Quantitative (80.8%) and human subject research (83.9%), as well as inferential statistics (67.7%), were the most frequent ones and prevailed among the specialties. Physical Therapy remains on the rise regarding the quantity and quality of its research in Brazil, glimpsing the growth of evidence-based professional practice in its various specialties. However, its articles still take a long time to be published. The higher prevalence of quantitative research and inferential statistics may promote substantial progress to the profession.

No processo de envelhecimento, o indivíduo passa por mudanças fisiológicas, destacando-se o declínio da função pulmonar. A espirometria de incentivo, utilizada em diversas populações, ainda não deixa clara a diferença entre os métodos a volume e a fluxo sobre variáveis respiratórias em sujeitos idosos. O objetivo do estudo foi comparar os efeitos da espirometria de incentivo - volume e fluxo, sobre a função pulmonar, força muscular respiratória e mobilidade tóraco-abdominal de idosos saudáveis. Trata-se de um ensaio clínico com 48 idosos, entre 60 e 84 anos de idade, randomizados para espirometria de incentivo a volume (n=23) ou a fluxo (n=25). Foram avaliadas as pressões inspiratória (PImáx) e expiratória (PEmáx) máximas, volumes e capacidades pulmonares e cirtometria tóraco-abdominal pré e pós-treinamento domiciliar. Os dados foram analisados pela análise de variância de duas vias com medidas repetidas. Houve aumento da PImáx, PEmáx, capacidade vital forçada (CVF), volume expiratório forçado no primeiro segundo, volume minuto, volume corrente e cirtometria a nível xifoide e umbilical em ambos os grupos (p

FUNDAMENTO: A obesidade tem sido identificada como importante fator de risco no desenvolvimento de doencas cardiovasculares, porem outros fatores exercem influencia, combinados ou nao a obesidade, e devem ser considerados na estratificacao de risco cardiovascular em pediatria. OBJETIVO: Analisar a associacao entre medidas antropometricas e fatores de risco cardiovascular, investigar os determinantes para as mudancas da pressao arterial (PA) e propor uma equacao de predicao para circunferencia de cintura (CC) em criancas e adolescentes. METODOS: Foram avaliadas 1.950 criancas e adolescentes, com idade entre 7-18 anos. Foi investigada a gordura visceral pela CC e a relacao cintura-quadril, PA e indice de massa corporal (IMC). Em uma subamostra selecionada aleatoriamente desses voluntarios (n = 578), foram medidos o colesterol total, a glicemia e os triglicerideos. RESULTADOS: A CC se correlacionou positivamente com o IMC (r = 0,85; p < 0,001) e a PA (PAS r = 0,45 e PAD = 0,37; p < 0,001). A glicemia e os triglicerideos apresentaram correlacao fraca com a CC (r = 0,110; p = 0,008 e r = 0,201; p < 0,001, respectivamente). O colesterol total nao se correlacionou com nenhuma variavel. Idade, IMC e CC foram preditores significativos nos modelos de regressao para PA (p < 0,001). Propoe-se uma equacao de predicao da CC para criancas e adolescentes: meninos: y = 17,243 + 0,316 (altura em cm); meninas: y = 25,197 + 0,256 (altura em cm). CONCLUSAO: A CC esta associada com fatores de risco cardiovascular e apresenta-se como fator preditor de risco para hipertensao em criancas e adolescentes. A equacao de predicao para CC proposta em nosso estudo deve ser testada em futuros trabalhos.