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Abstract Background Life trauma is highly prevalent in the general population and posttraumatic stress disorder is among the most prevalent psychiatric consequences of trauma exposure. Brazil has a unique environment to conduct translational research about psychological trauma and posttraumatic stress disorder, since urban violence became a Brazilian phenomenon, being particularly related to the rapid population growth of its cities. This research involves three case-control studies: a neuropsychological, a structural neuroimaging and a molecular neuroimaging study, each focusing on different objectives but providing complementary information. First, it aims to examine cognitive functioning of PTSD subjects and its relationships with symptomatology. The second objective is to evaluate neurostructural integrity of orbitofrontal cortex and hippocampus in PTSD subjects. The third aim is to evaluate if patients with PTSD have decreased dopamine transporter density in the basal ganglia as compared to resilient controls subjects. This paper shows the research rationale and design for these three case-control studies. Methods and design Cases and controls will be identified through an epidemiologic survey conducted in the city of São Paulo. Subjects exposed to traumatic life experiences resulting in posttraumatic stress disorder (cases) will be compared to resilient victims of traumatic life experiences without PTSD (controls) aiming to identify biological variables that might protect or predispose to PTSD. In the neuropsychological case-control study, 100 patients with PTSD, will be compared with 100 victims of trauma without posttraumatic stress disorder, age- and sex-matched controls. Similarly, 50 cases and 50 controls will be enrolled for the structural study and 25 cases and 25 controls in the functional neuroimaging study. All individuals from the three studies will complete psychometrics and a structured clinical interview (the Structured Clinical Interview for DSM-IV and the Clinician-Administered PTSD Scale, Beck Anxiety Inventory, Beck Depression Inventory, Global Assessment of Function, The Social Adjustment Scale, Medical Outcomes Study 36-Item Short-Form Health Survey, Early Trauma Inventory, Clinical global Impressions, and Peritraumatic Dissociative Experiences Questionnaire). A broad neuropsychological battery will be administered for all participants of the neuropsychological study. Magnetic resonance scans will be performed to acquire structural neuroimaging data. Single photon emission computerized tomography with [(99m)Tc]-TRODAT-1 brain scans will be performed to evaluate dopamine transporters. Discussion This study protocol will be informative for researchers and clinicians interested in considering, designing and/or conducting translational research in the field of trauma and posttraumatic stress disorder.

Research suggests that sedentary behavior (SB) and obesity are associated with disabilities in basic activities (BADL) and instrumental (IADL) activities of daily living. However, there is a lack of studies investigating this association in community-dwelling older adults. Thus, the aim of this study was to investigate the association between different SB typologies, isolated and in conjunction with obesity, and their associations with BADL and IADL disabilities in community-dwelling Brazilian older adults. This was a cross-sectional study using data from older adults (≥60 years) who participated in the Brazilian National Health Survey (2019). The exposures were obesity (BMI > 27 kg/m 2 ) and the amount of time spent daily on SB watching television (SB TV < 3 and ≥3 h/day) and engaging in leisure activities (SB leisure < 3 and ≥3 h/day), analyzed both separately and jointly. The outcomes were BADL and IADL disabilities. The main results showed that isolated SB TV ≥ 3 h/day (OR: 1.26; 95% CI: 1.14; 1.39) and SB TV ≥ 3 h/day combined with obesity (OR: 1.55; 95% CI: 1.37; 1.75) increased the odds of BADL and IADL disabilities. Obesity alone (OR: 1.21; 95% CI: 1.07; 1.36) increased only the odds of BADL disabilities. Moreover, SB leisure ≥ 3 h/day without obesity reduced the odds of IADL disabilities (OR: 0.56; 95% CI: 0.41; 0.76). Ideally, older adults should be encouraged to prevent obesity, reduce excessive periods spent in SB watching TV, and increase the daily periods spent in leisure activities, thus minimizing the likelihood of disabilities in functional activities.

Objective: Chronic Ankle Instability (CAI) or Functional Ankle Instability (FAI) is a condition characterized by laxity and mechanical instability in the ankle joint. This instability interferes with the activities and physical-functional parameters of athletes, which leads to repetitive ankle sprains. The current systematic review was carried out to identify the effects of whole-body vibration exercise (WBVE) in athletes with CAI., Methods: We conducted electronic searches in Pubmed, the Cochrane Library, Embase, Web of Science, Scopus, Science Direct, Allied Health Literature (CINAHL) and Academic Search Premier (ASP) (EBSCO) databases on 26 February 2022. Registers were identified, and studies were selected for inclusion according to the eligibility criteria. The methodological quality was assessed by the Physiotherapy Evidence Database (PEDro) scale., Results: Seven studies were included with a mean methodological quality score of 5.85, considered 'regular' quality on the PEDro scale. WBVE interventions in athletes with CAI showed that this exercise contributes to a better response on parameters of neuromuscular performance, muscle strength and consequently in balance and postural control, variables that are for the management of CAI., Conclusion: WBVE interventions in sports modalities promote physiological responses that may lead to positive effects in several parameters. The protocols proposed in each modality can be carried out in practice and are considered effective additional exercise and training methods beyond traditional types of training for athletes. However, more studies are needed on athletes with this condition, with specific protocols, to highlight the possible physiological and physical-functional responses. Protocol study registration: PROSPERO (CRD42020204434).

Gross motor development in the preschool phase depends on several factors that remain poorly understood. This study aimed to investigate whether level of habitual physical activity (HPA) and global cognitive function (CF) can be used as predictors of gross motor skills in Brazilian preschoolers and to verify their possible mediators. A cross-sectional study was conducted with 166 children, aged 3-5 years. Gross motor skills, HPA, CF and possible mediators (e.g., sex, prematurity) were evaluated. Preschoolers with little HPA, low CF, and girls were more likely to have gross motor performance below expected, but female gender did not mediate HPA or CF. Therefore, HPA and CF, in addition to females, may be independent predictors of delayed gross motor skills in Brazilian preschoolers.

Inflammation is a chronic, sterile, low-grade inflammation that develops with advanced age in the absence of overt infection and may contribute to the pathophysiology of sarcopenia, a progressive and generalized skeletal muscle disorder. Furthermore, a series of biomarkers linked to sarcopenia occurrence have emerged. To aid diagnostic and treatment strategies for low muscle mass in sarcopenia and other related conditions, the objective of this work was to investigate potential biomarkers associated with appendicular lean mass in community-dwelling older women. This is a cross-sectional study with 71 older women (75 ± 7 years). Dual-energy X-ray absorptiometry was used to assess body composition. Plasmatic blood levels of adipokines (i.e., adiponectin, leptin, and resistin), tumor necrosis factor (TNF) and soluble receptors (sTNFr1 and sTNFr2), interferon (INF), brain-derived neurotrophic factor (BDNF), and interleukins (IL-2, IL-4, IL-5, IL-6, IL-8, and IL-10) were determined by enzyme-linked immunosorbent assay. Older women with low muscle mass showed higher plasma levels of adiponectin, sTNFr1, and IL-8 compared to the regular muscle mass group. In addition, higher adiponectin plasma levels explained 14% of the lower appendicular lean mass. High adiponectin plasmatic blood levels can contribute to lower appendicular lean mass in older, community-dwelling women.

Introduction: COVID-19 is a public health emergency all around the world. Severe illness occurred in about 14% of patients and 5% of patients developed critical illness, but the prognosis for these patients remains unclear., Objective: To describe the prognosis in hospitalized adults with COVID-19., Methods: The MEDLINE, EMBASE, AMED, and COCHRANE databases were searched for studies published up to 28 June 2021 without language restrictions. Descriptors were related to "COVID-19" and "prognosis". Prospective inception cohort studies that assessed morbidity, mortality and recovery in hospitalized people over 18 years old with COVID-19 were included. Two independent reviewers selected eligible studies and extracted the available data. Acute respiratory distress syndrome (ARDS) and multiple organ failure (MOFS) were considered as outcomes for morbidity and discharge was considered for recovery. The Quality in Prognosis Studies (QUIPS) tool was used to assess risk of bias. Analyses were performed using Comprehensive Meta-Analysis (version 2.2.064)., Results: We included 30 inception cohort studies investigating 13,717 people hospitalized with COVID-19 from different countries. The mean (SD) age was 60.90 (21.87) years, and there was high proportion of males (76.19%) and people with comorbidities (e.g., 49.44% with hypertension and 29.75% with diabetes). Findings suggested a high occurrence of morbidity, mainly related to ARDS. Morbidity rates varied across studies from 19% to 36% in hospital wards, and from 13% to 90% in Intensive Care Units-ICU. Mortality rates ranged from 4% to 38% in hospital wards and from 8% to 51% in ICU. Recovery rates ranged up to 94% and 65% in hospital wards and ICU, respectively. The included studies had high risk of bias in the confounding domain., Conclusions: The prognosis of people hospitalized with COVID-19 is an issue for the public health system worldwide, with high morbidity and mortality rates, mainly in ICU and for patients with comorbidities. Its prognosis emphasizes the need for appropriate prevention and management strategies.

(1) The evidence points to an increase in oxygen reactive species as one of the possible causes of fibromyalgia (FM). In addition, it is plausible that an imbalance in redox markers can be associated with pain amplification and dynapenia in FM patients. The aim of our study was to investigate possible factors associated with muscle pain and lean body mass in FM patients. (2) Methods: This was a quantitative, exploratory and cross-sectional study of 47 patients with FM (53.45 + 7.32 years). We evaluated self-perceptions of muscle pain, lean body mass, body composition, quality of life, sleep quality, depression index, muscle performance and oxidative stress biomarkers. (3) Results: We observed that lower blood levels of antioxidants and poor quality of life explained 21% of the greater muscle pain. In addition, high blood levels of oxidative stress, worse muscle performance and poor quality of life explained 27% of the lower lean mass in patients with FM. (4) Conclusions: Larger amounts of lipid peroxidation and reductions in antioxidant levels, in addition to lower muscle performance and poor life quality, are possible independent contributors to greater muscle pain and lower lean body mass in FM patients.

Objective: To determine the cardiorespiratory and metabolic demand of the Six-Minute Pegboard and Ring Test (6PBRT) in healthy young adults and its association with maximal arm cycle ergometer test (arm CET)., Methods: Volunteers were randomized to performed the 6PBRT test or arm CET. The second test was performed after 48 h. Oxygen consumption (VO 2 ), heart rate (HR), dyspnea and upper limb fatigue were assessed during the tests. Demographic data, body composition, level of physical activity, arm strength and endurance were also evaluated., Results: During 6PBRT, VO 2 values increased from 5.8 to 11.1 mL kg -1 .min -1 (p < 0.001). VO 2peak, HR Mean and HR max at 6PBRT were 47.2% and close to 65% respectively of those achieved during the arm CET. There was a positive correlation between the score on 6PBRT and VO 2mean and VO 2peak achieved at arm CET (r = 0.268; p = 0.003 and r = 0.247; p = 0.046 respectively). No correlation was found between the HR mean , HR peak, level of physical activity or strength with 6PBRT (p > 0.05). Handgrip endurance had a positive correlation with score on 6PBRT (r = 0.237; p = 0.054). Body Mass Index, body fat and fat mass were negatively correlated with the score on 6PBRT (r = 0.301; p = 0.014, 0.329; p = 0.007 and r = 0.427; p = 0.001)., Conclusions: The 6PBRT test showed a moderate cardiorespiratory and metabolic demand in healthy individuals in comparison of arm CET. BMI, body fat and fat mass correlated with the score on 6PBRT., (Copyright © 2021 Elsevier Ltd. All rights reserved.)

Background: The search for ever more lasting and safe aesthetic modalities is a constant. For this reason, biostimulation is finding more and more space in clinics; relatively simple, effective, and safe procedures, a procedure that delivers what it promises. Biostimulation is nothing more than an increase in collagen production, primarily type I, with the aim of facial or body rejuvenation., Aims: Evaluated some years ago as remarkable antimicrobial therapy, today it gains notoriety for its versatility in other areas, one of which is biostimulation, which has been growing. This paper aims to report a case of biostimulation through ozone therapy, as well as the protocol used, its indications, and contraindications., Patients/methods: A case report of rejuvenation with ozone therapy and a literature review., Results: Among biostimulatory treatments available, one has been gaining space among professionals and scientific recognition, ozone therapy., Conclusion: It is a promising aesthetic therapeutic modality with efficient and safe results and high patient compliance and satisfaction., (© 2021 Wiley Periodicals LLC.)

Background: Overweight and obesity are conditions associated with sedentary lifestyle and accumulation of abdominal fat, determining increased mortality, favoring chronic diseases, and increasing cardiovascular risk. Although the evaluation of body composition and fat distribution are highly relevant, the high cost of the gold standard techniques limits their wide utilization. Therefore, the aim of this work was to explore the relationships between simple anthropometric measures and BIA variables using multivariate linear regression models to estimate body composition and fat distribution in adults., Methods: In this cross-sectional study, sixty-eight adult individuals (20 males and 48 females) were subjected to bioelectrical impedance analysis (BIA), anthropometric measurements (waist circumference (WC), neck circumference (NC), mid-arm circumference (MAC)), allowing the calculation of conicity index (C-index), fat mass/fat-free mass (FM/FFM) ratios, body mass index (BMI) and body shape index (ABSI). Statistical analyzes were performed with the R program. Nonparametric Statistical tests were applied to compare the characteristics of participants of the groups (normal weight, overweight and obese). For qualitative variables, the Fisher's exact test was applied, and for quantitative variables, the paired Wilcoxon signed-rank test. To evaluate the linear association between each pair of variables, the Pearson correlation coefficient was calculated, and Multivariate linear regression models were adjusted using the stepwise variable selection method, with Akaike Information Criterion ( p ≤ 0.05)., Results: BIA variables with the highest correlations with anthropometric measures were total body water (TBW), body fat percentage (BFP), FM, FFM and FM/FFM. The multiple linear regression analysis showed, in general, that the same variables can be estimated through simple anthropometric measures., Conclusions: The assessment of fat distribution in the body is desirable for the diagnosis and definition of obesity severity. However, the high cost of the instruments (dual energy X-ray absorptiometry, hydrostatic weighing, air displacement plethysmography, computed tomography, magnetic resonance) to assess it, favors the use of BMI in the clinical practice. Nevertheless, BMI does not represent a real fat distribution and body fat percentage. This highlights the relevance of the findings of the current study, since simple anthropometric variables can be used to estimate important BIA variables that are related to fat distribution and body composition.

Introduction: Considering the relevance of the quality of life (QoL) and the consequences of the 2019 new coronavirus disease (COVID-19) due to the social distancing, this systematic review aimed to summarize effects of the COVID-19 in the QoL of the studied populations., Areas Covered: Four databases, the methodological quality and the risk of bias in selected publications were investigated. Seven thousand and fifty-one individuals from Italy, Saudi Arabia, China, and Vietnam. Online system and printed questionnaires were used to assess the QoL, as patients affected by primary antibody deficiencies, residents, people from endemic and no endemic regions, and individuals with COVID-19. Different types of questionnaires are utilized to evaluate health-related quality of life (HRQOL). The methodological quality of three papers was good with low risk of bias and a decrease in the QoL., Expert Opinion: The QoL of studies populations where COVID-19 was reported, worsened. Nevertheless, considering some indicators (infant mortality, average income, life expectancy, health coverage, and average schooling years), the standard of life and subsequently the quality of life among the presented countries (China, Vietnam, Italy, and Saudi Arabia) are different. Therefore, the simple comparison of these populations and the conclusions from this comparison must be done carefully.

Importance: Fibromyalgia is a chronic condition that results in a significant burden to individuals and society., Objective: To investigate the effectiveness of therapies for reducing pain and improving quality of life (QOL) in people with fibromyalgia., Data Sources: Searches were performed in the MEDLINE, Cochrane, Embase, AMED, PsycInfo, and PEDro databases without language or date restrictions on December 11, 2018, and updated on July 15, 2020., Study Selection: All published randomized or quasi-randomized clinical trials that investigated therapies for individuals with fibromyalgia were screened for inclusion., Data Extraction and Synthesis: Two reviewers independently extracted data and assessed risk of bias using the 0 to 10 PEDro scale. Effect sizes for specific therapies were pooled using random-effects models. The quality of evidence was assessed using the Grading of Recommendations Assessment (GRADE) approach., Main Outcomes and Measures: Pain intensity measured by the visual analog scale, numerical rating scales, and other valid instruments and QOL measured by the Fibromyalgia Impact Questionnaire., Results: A total of 224 trials including 29 962 participants were included. High-quality evidence was found in favor of cognitive behavioral therapy (weighted mean difference [WMD], -0.9; 95% CI, -1.4 to -0.3) for pain in the short term and was found in favor of central nervous system depressants (WMD, -1.2 [95% CI, -1.6 to -0.8]) and antidepressants (WMD, -0.5 [95% CI, -0.7 to -0.4]) for pain in the medium term. There was also high-quality evidence in favor of antidepressants (WMD, -6.8 [95% CI, -8.5 to -5.2]) for QOL in the short term and in favor of central nervous system depressants (WMD, -8.7 [95% CI, -11.3 to -6.0]) and antidepressants (WMD, -3.5 [95% CI, -4.5 to -2.5]) in the medium term. However, these associations were small and did not exceed the minimum clinically important change (2 points on an 11-point scale for pain and 14 points on a 101-point scale for QOL). Evidence for long-term outcomes of interventions was lacking., Conclusions and Relevance: This systematic review and meta-analysis suggests that most of the currently available therapies for the management of fibromyalgia are not supported by high-quality evidence. Some therapies may reduce pain and improve QOL in the short to medium term, although the effect size of the associations might not be clinically important to patients.

Few studies have provided information on parasitological indexes or other ecological characteristics of lice populations that parasitize small mammals in the Neotropical region. We used lice parasitizing a rodent species, Trinomys iheringi, as a study model to investigate the effect of parasite occurrence and intensity on the body condition of rodents and the effect of climatic conditions, sex and age class of T. iheringi . We also provide information on prevalence, mean intensity, aggregation, sexual ratio of adult lice, and proportion between life stages and lice parasitizing T. iheringi . The study was conducted in Ilha Grande, an island in southeastern Brazil. We used a logistic regression to run a model of lice occurrence using climatic variables (rainfall, temperature, humidity), and then adding sex and age classes. A total of 39 T. iheringi individuals were captured with 17 parasitized (43.58%). These animals hosted Gyropus (martini) martini (n = 94), Gliricola sp . (n = 8), and Pterophthirus wernecki (n = 2). The model with humidity and sex variables showed that the occurrence of lice was negatively associated with humidity. There are more males than females infested with lice, while most of the young individuals are not infested. The higher lice occurrence in the low humidity coincides with the birth period of  T. iheringi . The contact among individuals are higher during the reproductive period of the host species, but males are more suscetible to the lice parasitism due to higher testosterone levels that reduce the immunocompetence. The distribution pattern of lice was aggregated, but there was no correlation between body condition index and lice infestation intensity. We highlight that the major occurrence of lice occurs in the driest period of the year, that males are more prone to parasitism by lice than females, and adults more prone than young., Competing Interests: The authors declare there are no conflict of interest., (© 2020 The Authors.)

Objective: To investigate the acute effect of whole-body vibration (WBV) on handgrip strength (HS) and electromyographic activity of the flexor digitorum superficialis muscle of healthy women in the static push-up position., Methods: Twenty-eight women received four experimental tests in a randomized order: A) Control - rest in seating position with feet on the floor and hands in the supine position on the lower limbs. There was no vibration stimulus; B) Placebo - push-up position with their hands on the vibratory platform that remained disconnected, but with a sonorous stimulus mimicking the vibration; C) Low vibration and D) High vibration - push-up position with their hands on the vibratory platform using one of the vibratory stimulus intensity: low vibration: 25 Hz/2 mm/49.30 m s -2 ; or high vibration: 45 Hz/2 mm/159.73 m s -2 . Participants remained 5 min in each situation. HS and electromyography (EMG) were performed at baseline and after all four experimental tests. The index of neural efficiency (i.e. the ratio between EMG and HS) was also calculated to determine the efficiency of muscle contraction. Statistical analysis was performed by ANOVA two-way design mixed test with Tukey's post hoc test, being considered significant p < 0.05., Results: High vibration increased HS compared with all the other experimental tests (p = 0.0006, F = 6.03). There was a reduction of EMG activity of the flexor digitorum superficialis muscle only after high vibration (p = 0.0135, F = 6.22), which was accompanied by lower values of the index of neural efficiency after intervention (between-group difference, p = 0.0002, F = 0.674)., Conclusion: WBV in the push-up position has an acute positive effect on HS accompanied by a lower index of neural efficiency, providing a better efficiency of muscle contraction., (Copyright © 2020 Elsevier Ltd. All rights reserved.)

COVID-19 is a highly infectious respiratory disease which leads to several clinical conditions related to the dysfunction of the respiratory system along with other physical and psychological complaints. Severely affected patients are referred to intensive care units (ICUs), limiting their possibilities for physical exercise. Whole body vibration (WBV) exercise is a non-invasive, physical therapy, that has been suggested as part of the procedures involved with pulmonary rehabilitation, even in ICU settings. Therefore, in the current review, the World Association of Vibration Exercise Experts (WAVEX) reviewed the potential of WBV exercise as a useful and safe intervention for the management of infected individuals with COVID-19 by mitigating the inactivity-related declines in physical condition and reducing the time in ICU. Recommendations regarding the reduction of fatigue and the risk of dyspnea, the improvement of the inflammatory and redox status favoring cellular homeostasis and the overall improvement in the quality of life are provided. Finally, practical applications for the use of this paradigm leading to a better prognosis in bed bound and ICU-bound subjects is proposed.

Although High Intensity Interval Training (HIIT) are being associated to increase cardiovascular and metabolic adaptation, there is controversy and limited information about the effects of HIIT on hippocampal oxidative stress, pro- and anti-inflammatory cytokines balance and neurotrophic status. Thus, this study evaluated the effects of six weeks of HIIT on hippocampal redox state (oxidative damage and enzymatic and non-enzymatic antioxidant defenses), neuroimmune mediators (TNFα, IL-6, IL-1β and IL-10) and brain-derived neurotrophic (BDNF) levels. After six weeks of HIIT young adults male Wistar rats presented reduced oxidative damage and increased enzymatic (superoxide dismutase) and non-enzymatic activity in hippocampus. Moreover HIIT induced a decrease in cytokine content (TNFα, IL-6, IL-1β and IL-10) and enhanced hippocampal BDNF levels. In conclusion, the present study showed for the first time a positive effect of six weeks of HIIT on reducing hippocampal oxidative stress by decreasing lipoperoxidation and inflammatory markers, as well enhancing antioxidant defenses and BDNF content., (Copyright © 2017 Elsevier Inc. All rights reserved.)

Background: The ability to control skin blood flow decreases with advancing age and some clinical disorders, as in diabetes and in rheumatologic diseases. Feasible clinical strategies such as whole-body vibration exercise (WBVE) are being used without a clear understanding of its effects. The aim of the present study is to review the effects of the WBVE on blood flow kinetics and its feasibility in different populations., Material and Methods: The level of evidence (LE) of selected papers in PubMed and/or PEDRo databases was determined. We selected randomized, controlled trials in English to be evaluated., Results: Six studies had LE II, one had LE III-2 and one III-3 according to the NHMRC. A great variability among the protocols was observed but also in the assessment devices; therefore, more research about this topic is warranted., Conclusion: Despite the limitations, it is can be concluded that the use of WBVE has proven to be a safe and useful strategy to improve blood flow. However, more studies with greater methodological quality are needed to clearly define the more suitable protocols.

Background: This study aimed to verify the association between obesity-related biomarkers and cognitive and motor development in infants between 6 and 24 months of age., Methods: A cross-sectional study was conducted with 50 infants and plasma levels of leptin, adiponectin, resistin, soluble tumor necrosis factor receptors 1 and 2 (sTNFR1 and sTNFR2), chemokines, brain-derived neurotrophic factor (BDNF), serum cortisol and redox status were measured. The Bayley-III test was utilized to evaluate cognitive and motor development, and multiple linear stepwise regression models were performed to verify the association between selected biomarkers and cognitive and motor development., Results: A significant association was found among plasma leptin and sTNFR1 levels with cognitive composite scores, and these two independents variables together explained 37% of the variability of cognitive composite scores (p=0.001). Only plasma sTNFR1 levels were associated and explained 24% of the variability of motor composite scores (p=0.003)., Conclusions: Plasma levels of sTNFR1 were associated with the increase in cognitive and motor development scores in infants between 6 and 24 months of age through a mechanism not directly related to excess body weight. Moreover, increase in plasma levels of leptin reduced the cognitive development in this age range., (Copyright © 2017 Elsevier B.V. All rights reserved.)

Childhood obesity is related to a cascade of neuroendocrine inflammatory changes. However, there remains a gap in the current literature regarding the possible occurrence of these changes in overweight/obese infants. The objective of this study was to evaluate adipokines, cortisol, brain-derived neurotrophic factor (BDNF) and redox status in overweight/obese infants versus normal-weight peers. A cross-sectional study was conducted with 50 infants (25 in the overweight/obese group and 25 in the normal-weight group) between 6 and 24 months. Plasma levels of leptin, adiponectin, resistin, soluble tumor necrosis factor (TNF) receptors, chemokines, BDNF, serum cortisol and redox status were measured. Unpaired Student's t-test was used to analyze the results and a probability of p<0.05 was acceptable for rejection of the null hypothesis. The Pearson correlation was used to verify the association between the biomarkers analyzed in each group. Plasma levels of leptin (p = 0.0001), adiponectin (p = 0.0007) and BDNF (p = 0.003), and serum cortisol (p = 0.048) were significantly higher in overweight/obese infants than normal-weight infants. In contrast, the concentration of thiobarbituric acid reactive substances (TBARS) (p = 0.004), and catalase (p = 0.045) and superoxide dismutase activity (p = 0.02) were lower in overweight/obese infants than normal-weight peers. All the results together indicate neuroendocrine inflammatory response changes in overweight/obese infants between 6 and 24 months. Although there is already an environment that predisposes for a subsequent pro-inflammatory response, neuroendocrine secretion changes that permit the control of the inflammatory process in this age interval can be observed., Competing Interests: The authors have declared that no competing interests exist.

Chronic exposure to cigarette smoke seems to be related to an increase of pro-inflammatory cytokines, oxidative stress and changes in muscular and physical performances of healthy smokers. However, these parameters have not yet been evaluated simultaneously in previous studies. The participants of this study were healthy males divided into two groups: smokers (n=20) and non-smokers (n=20). Inflammation was evaluated by measuring plasma levels of the cytokines IL-10, IL-6 e TNF-α, and of the soluble receptors sTNFR1 and sTNFR2. Oxidative stress was evaluated by determination of thiobarbituric acid reactive substances (TBARS) plasma levels, total antioxidant capacity of plasma and erythrocytes activity of the antioxidant enzymes superoxide dismutase (SOD) and catalase. Muscular performance was evaluated by measuring the peak torque of knee flexors and extensors, and by determining the total work of the knee extensors. Physical performance was assessed by measuring the peak oxygen uptake (VO2 peak), the maximum heart rate (HRmax) and the walking distance in the shuttle walking test. Smokers showed an increase in the levels of the sTNFR1 and TBARS and a decrease in the total antioxidant capacity of plasma, in the catalase activity and in the total work (P<0.05). IL-6, IL-10, sTNFR2, SOD, peak torque, VO2 peak, HRmax and walking distance were similar between groups. Smokers presented increased oxidative stress and skeletal muscle dysfunction, demonstrating that the changes in molecular and muscular parameters occur simultaneously in healthy smokers.

Although it is well known that physical training ameliorates brain oxidative function after injuries by enhancing the levels of neurotrophic factors and oxidative status, there is little evidence addressing the influence of exercise training itself on brain oxidative damage and data is conflicting. This study investigated the effect of well-established swimming training protocol on lipid peroxidation and components of antioxidant system in the rat brain. Male Wistar rats were randomized into trained (5 days/week, 8 weeks, 30 min; n=8) and non-trained (n=7) groups. Forty-eight hours after the last session of exercise, animals were euthanized and the brain was collected for oxidative stress analysis. Swimming training decreased thiobarbituric acid reactive substances (TBARS) levels (P<0.05) and increased the activity of the antioxidant enzyme superoxide dismutase (SOD) (P<0.05) with no effect on brain non-enzymatic total antioxidant capacity, estimated by FRAP (ferric-reducing antioxidant power) assay (P>0.05). Moreover, the swimming training promoted metabolic adaptations, such as increased maximal workload capacity (P<0.05) and maintenance of body weight. In this context, the reduced TBARS content and increased SOD antioxidant activity induced by 8 weeks of swimming training are key factors in promoting brain resistance. In conclusion, swimming training attenuated oxidative damage and increased enzymatic antioxidant but not non-enzymatic status in the rat brain.

The aim of this study was to investigate the cardiovascular autonomic acute response, during recovery after handcycle training, in quadriplegics with spinal cord injury (SCI). [Subjects and Methods] Seven quadriplegics (SCIG -level C6-C7, male, age 28.00 ± 6.97 years) and eight healthy subjects (CG -male, age 25.00 ± 7.38 years) were studied. Their heart rate variability (HRV) was assessed before and after one handcycle training. [Results] After the training, the SCIG showed significantly reduced: intervals between R waves of the electrocardiogram (RR), standard deviation of the NN intervals (SDNN), square root of the mean squares differences of sucessive NN intervals (rMSSD), low frequency power (LF), high frequency power (HF), and Poincaré plot (standard deviation of short-term HRV -SD1 and standard deviation of long-term HRV -SD2). The SDNN, LF, and SD2 remained decreased during the recovery time. The CG showed significantly reduced: RR, rMSSD, number of pairs of adjacent NN intervals differing by more than 50 ms (pNN50), LF, HF, SD1, and sample entropy (SampEn). Among these parameters, only RR remained decreased during recovery time. Comparisons of the means of HRV parameters evaluated between the CG and SCIG showed that the SCIG had significantly lower pNN50, LF, HF, and SampEn before training, while immediately after training, the SCIG had significantly lower SDNN, LF, HF, and SD2. The rMSSD30s of the SCIG significantly reduced in the windows 180 and 330 seconds and between the windows 300 seconds in the CG. [Conclusion] There was a reduction of sympathetic and parasympathetic activity in the recovery period after the training in both groups; however, the CG showed a higher HRV. The parasympathetic activity also gradually increased after training, and in the SCIG, this activity remained reduced even at three minutes after the end of training, which suggests a deficiency in parasympathetic reactivation in quadriplegics after SCI.

Hypertension is characterized by a pro-inflammatory status, including redox imbalance and increased levels of pro-inflammatory cytokines, which may be exacerbated after heat exposure. However, the effects of heat exposure, specifically in individuals with inflammatory chronic diseases such as hypertension, are complex and not well understood. This study compared the effects of heat exposure on plasma cytokine levels and redox status parameters in 8 hypertensive (H) and 8 normotensive (N) subjects (age: 46.5±1.3 and 45.6±1.4 years old, body mass index: 25.8±0.8 and 25.6±0.6 kg/m2, mean arterial pressure: 98.0±2.8 and 86.0±2.3 mmHg, respectively). They remained at rest in a sitting position for 10 min in a thermoneutral environment (22°C) followed by 30 min in a heated environmental chamber (38°C and 60% relative humidity). Blood samples were collected before and after heat exposure. Plasma cytokine levels were measured using sandwich ELISA kits. Plasma redox status was determined by thiobarbituric acid reactive substances (TBARS) levels and ferric reducing ability of plasma (FRAP). Hypertensive subjects showed higher plasma levels of IL-10 at baseline (P<0.05), although levels of this cytokine were similar between groups after heat exposure. Moreover, after heat exposure, hypertensive individuals showed higher plasma levels of soluble TNF receptor (sTNFR1) and lower TBARS (P<0.01) and FRAP (P<0.05) levels. Controlled hypertensive subjects, who use angiotensin-converting-enzyme inhibitor (ACE inhibitors), present an anti-inflammatory status and balanced redox status. Nevertheless, exposure to a heat stress condition seems to cause an imbalance in the redox status and an unregulated inflammatory response.

Objectives: The aim of the study was to evaluate the plasma levels of inflammatory mediators in subjects exposed to silica, with and without silicosis compared with unexposed control group; and to check the association between inflammatory mediators with pulmonary function, quality of life, functional capacity, and dyspnea grade., Methods: Inflammatory mediators were measured by enzyme-linked immunosorbent assay. There were 30 subjects exposed to silica and 24 control group., Results: Interleukin-6 plasma levels were higher in subjects exposed to silica with and without silicosis than in the control group. There was a positive correlation between radiological severity and the quality of life, whereas there was a negative correlation between radiological severity and pulmonary function. A negative correlation between sTNFR1 plasma level and functional capacity was found. Interleukin-10 was negatively correlated with the quality of life total score and was positively correlated with the functional capacity and pulmonary function.

Osteoarthritis of the knee (kOA) is a disease that mainly affects the elderly and can lead to major physical and functional limitations. However, the specific effects of walking, particularly on the immune system, are unknown. Therefore, this study aimed to analyze the effect of 12 weeks of walking (3×/week) on the leukocyte profile and quality of life (QL) of elderly women with kOA. Sixteen women (age: 67±4 years, body mass index: 28.07±4.16 kg/m2) participated in a walking program. The variables were assessed before and after 12 weeks of training with a progressively longer duration (30-55 min) and higher intensity (72-82% of HRmax determined using a graded incremental treadmill test). The QL was assessed using the Medical Outcomes Study 36-Item Short Form Health Survey (SF-36), and blood samples were collected for analysis with a cell counter and the San Fac flow cytometer. Walking training resulted in a 47% enhancement of the self-reported QL (P<0.05) and a 21% increase in the VO2max (P<0.0001) in elderly women with kOA. Furthermore, there was a reduction in CD4+ cells (pre=46.59±7%, post=44.58±9%, P=0.0189) and a higher fluorescence intensity for CD18+CD4+ (pre=45.30±10, post=64.27±33, P=0.0256) and CD18+CD8+ (pre=64.2±27, post=85.02±35, P=0.0130). In conclusion, the walking program stimulated leukocyte production, which may be related to the immunomodulatory effect of exercise. Walking also led to improvements in the QL and physical performance in elderly women with kOA.

Individuals with systemic arterial hypertension have a higher risk of heat-related complications. Thus, the aim of this study was to examine the thermoregulatory responses of hypertensive subjects during recovery from moderate-intensity exercise performed in the heat. A total of eight essential hypertensive (H) and eight normotensive (N) male subjects (age=46.5±1.3 and 45.6±1.4 years, body mass index=25.8±0.8 and 25.6±0.6 kg/m2, mean arterial pressure=98.0±2.8 and 86.0±2.3 mmHg, respectively) rested for 30 min, performed 1 h of treadmill exercise at 50% of maximal oxygen consumption, and rested for 1 h after exercise in an environmental chamber at 38°C and 60% relative humidity. Skin and core temperatures were measured to calculate heat exchange parameters. Mean arterial pressure was higher in the hypertensive than in the normotensive subjects throughout the experiment (P<0.05, unpaired t-test). The hypertensive subjects stored less heat (H=-24.23±3.99 W·m-2vs N=-13.63±2.24 W·m-2, P=0.03, unpaired t-test), experienced greater variations in body temperature (H=-0.62±0.05°C vsN=-0.35±0.12°C, P=0.03, unpaired t-test), and had more evaporated sweat (H=-106.1±4.59 W·m-2vs N=-91.15±3.24 W·m-2, P=0.01, unpaired t-test) than the normotensive subjects during the period of recovery from exercise. In conclusion, essential hypertensive subjects showed greater sweat evaporation and increased heat dissipation and body cooling relative to normotensive subjects during recovery from moderate-intensity exercise performed in hot conditions.

The purpose of this study was to compare the effects of light-emitting diode (LED) irradiation and whole-body vibration (WBV) delivered either in isolation or combination (LED + WBV), warm-up (WU), and a control (C) treatment on performance during a sprint bicycle exercise. Ten cyclists performed a 30-second sprint cycle test under these conditions. The LED light was applied at 4 points bilaterally. Whole-body vibration consisted of 5 minutes of squats associated with WBV. LED + WBV consisted of WBV followed by LED therapy. Warm-up consisted of 17 minutes of moderate-intensity bicycle exercise. Control consisted of 10 minutes at rest. Blood lactate (BL) and ammonia (BA) levels and skin temperature (ST) were determined. Peak power (842 ± 117 vs. 800 ± 106 vs. 809 ± 128 W [p = 0.02 and p = 0.01]), relative power (12.1 ± 1.0 vs. 11.5 ± 0.9 vs. 11.6 ± 1.0 W·kg [p = 0.02 and p = 0.02]), and relative work (277 ± 23 vs. 263 ± 24 vs. 260 ± 23 J·kg [p = 0.02 and p = 0.003]) were higher in the WU group compared with the control and LED groups. In the LED + WBV group, peak (833 ± 115 vs. 800 ± 106 W [p = 0.02]) and relative (11.9 ± 0.9 vs. 11.5 ± 0.9 W·kg [p = 0.02]) power were higher than those in the control group, and relative work (272 ± 22 vs. 260 ± 23 J·kg [p = 0.02]) were improved compared with the LED group. There were no differences for BL, BA, and ST. The findings of this study confirmed the effectiveness of a warm-up as a preparatory activity and demonstrated that LED + WBV and WBV were as effective as WU in improving cyclist performance during a sprint bicycle exercise.

The cerebrovascular accident (CVA), high-impact disease II, affects the basic functions of the limbs, leading to changes of sensory, language, and motor functions. The search for resources that minimize the damage caused by this disease grows every day. The clinical use of low-intensity laser therapy (LILT) has provided major breakthroughs in the treatment of muscular disorders and prevention of muscle fatigue. Thus, the objective of the present study is to analyze the answers and immediate adaptations of the rectus femoris and vastus medialis of spastic hemiparetic patients, facing the increase in peak torque and triggering muscle fatigue, after application of LILT. Double-blind clinical trials were conducted with 15 volunteers post-CVA with spasticity, of both genders, between 40 and 80 years old. To this end, the volunteers went through three consecutive stages of rating (control, placebo, and laser). All performed tests of isometric contraction on the patient's hemiparetic side. Significant differences were observed with regard to the increase in muscle performance (p = 0.0043) and the reduction in blood lactate concentration (p < 0.0001) of the post-LILT muscles. The LILT (diode laser, l100 mW 808 nm, 4.77 J/cm(2)/point, 40 s/AP) can be employed during and after spastic muscle-strengthening exercises, contributing to the improvement of motor function of the patient. After application of LILT, we found increased torque as well as decreased in lactate level in patients with spasticity.

Background: The application of the Shuttle Walking Test (SWT) to assess cardiorespiratory fitness and the intensity of this test in healthy participants has rarely been studied. This study aimed to assess and correlate the cardiorespiratory responses of the SWT with the cardiopulmonary exercise testing (CEPT) and to develop a regression equation for the prediction of peak oxygen uptake (VO2 peak) in healthy sedentary adult men., Methods: In the first stage of this study, 12 participants underwent the SWT and the CEPT on a treadmill. In the second stage, 53 participants underwent the SWT twice. In both phases, the VO2 peak, respiratory exchange ratio (R), and heart rate (HR) were evaluated., Results: Similar results in VO2 peak (P>0.05), R peak (P>0.05) and predicted maximum HR (P>0.05) were obtained between the SWT and CEPT. Both tests showed strong and significant correlations of VO2 peak (r = 0.704, P = 0.01) and R peak (r = 0.737, P<0.01), as well as the agreement of these measurements by Bland-Altman analysis. Body mass index and gait speed were the variables that explained 40.6% (R2 = 0.406, P = 0.001) of the variance in VO2 peak. The results obtained by the equation were compared with the values obtained by the gas analyzer and no significant difference between them (P>0.05) was found., Conclusions: The SWT produced maximal cardiorespiratory responses comparable to the CEPT, and the developed equation showed viability for the prediction of VO2 peak in healthy sedentary men.

Cucullanus tucunarensis n. sp. (Cucullanidae) is described parasitizing the peacock bass Cichla piquiti (Cichlidae) from the Tocantins River, Tocantins State, Brazil. The new species is unique and differs from all its congeners by having a tail tip provided with several sclerotized spine-like processes on its ventral side, present in both the male and female. Furthermore, C. tucunarensis n. sp. is compared with other species of the genus recorded in the same zoogeographical region and in the same group of hosts (Perciformes).

The aim of the study was to analyze the concentrations of sTNFR1 and sTNFR2 in both plasma and synovial fluid of patients with primary knee osteoarthritis (OA) and to determine their relationship to self-reported pain, stiffness and physical function. Twenty-seven patients with knee OA and 19 healthy subjects were enrolled in the study. The Western Ontario and McMaster University Osteoarthritis Index questionnaire was used to evaluate self-reported physical function, pain and stiffness. The sTNFR1 and sTNFR2 levels in the plasma and synovial fluid were measured by enzyme-linked immunosorbent assay. The sTNFR1 levels in synovial fluid of OA patients (2,587 ± 66.12 pg/mL) were 2.5-fold higher than in corresponding blood samples and were 1.5-fold higher than in the plasma of healthy controls. The plasma sTNFR2 levels in the patients with knee OA were lower than in healthy controls (2,249 ± 126.3 vs. 2,700 ± 126.3 pg/mL, p < 0.05), and sTNFR2 levels in synovial fluid of knee OA patients (2,021 ± 107.0 pg/mL) were lower than in the plasma of healthy controls. Synovial fluid sTNFR1 levels were negatively correlated with pain and physical function self-reported (r s - 0.6785, p < 0.0001 and r s - 0.4194, p = 0.03, respectively). Synovial fluid sTNFR2 levels were negatively correlated with pain and joint stiffness (r s - 0.5433, p = 0.01 and r s - 0.4249, p = 0.02, respectively). The findings of this study demonstrated the presence of soluble receptors for TNF-alpha, particularly sTNFR1, in the synovial fluid of patients with primary knee OA and the relationship of these receptors with clinical parameters.

Objective: A systematic review was performed to estimate the accuracy of human epididymis protein 4 (HE4) assay in the diagnosis of ovarian tumors., Methods: A comprehensive search of the MEDLINE (PubMed), EMBASE, Cochrane Central Register of Controlled Trials, IBECS, BIOSIS, Web of Science, SCOPUS, congress abstracts, and Grey literature (Google scholar; British Library) from January 1990 to April 2013 was conducted. Studies that evaluated HE4 levels for the diagnosis of ovarian tumors and compared them with paraffin-embedded sections as the diagnostic standard were included., Results: Forty-five studies were analyzed, which included 10,671 women and 3946 ovarian cancer cases. The pooled sensitivity for the diagnosis of borderline tumors or ovarian cancer was 78% (95% confidence interval, 77%-79%), and the specificity was 86% (95% confidence interval, 85%-87%). Summary receiver operating characteristic curves were constructed. For malignant and borderline ovarian tumors versus benign lesions, the area under the curve was 0.916. Besides the overall analysis, stratification was performed in premenopause and postmenopause, early and late stages, and for accuracy by enzyme-linked immunosorbent assay and chemiluminescence microparticle immuno assay., Conclusions: A HE4 level is a useful preoperative test for predicting the benign or malignant nature of pelvic masses.

The aim of this study was to analyze the levels of brain-derived neurotrophic factor (BDNF) in both the plasma and synovial fluid of patients with primary knee osteoarthritis compared with control individuals and to investigate the relationship between BDNF levels and self-reported pain. Twenty-seven patients with knee osteoarthritis (OA) and 19 healthy subjects were enrolled in the study. Anteroposterior knee radiographs were taken to determine the disease severity of the affected knee. Radiographic grading of OA in the knee was performed using the Kellgren-Lawrence criteria. The BDNF levels in the plasma and synovial fluid were measured by enzyme-linked immunosorbent assay. The mean plasma BDNF levels of the knee OA patients were significantly higher than that of the healthy controls (2,378 ± 1,067.2 vs. 1,756 ± 804.3 pg/mL, p < 0.05). BDNF levels in the synovial fluid of OA patients (358.9 ± 178.4 pg/mL) were sixfold lower than in corresponding blood samples (p < 0.0001) and fourfold lower than in the plasma of healthy controls (p < 0.0001). Subsequent analyses showed that the plasma BDNF levels significantly correlated with self-reported pain (Western Ontario and McMaster Universities Osteoarthritis Index) (r s = 0.39, p = 0.04). Furthermore, no correlation was found between the plasma and synovial fluid BDNF concentrations and knee OA severity. The findings of this study suggest that systemic BDNF levels are most likely associated with the mechanism of joint pain in knee OA in the acute stage of joint inflammatory process. Further studies are necessary to address the functional role of BDNF in the modulation of pain to establish new therapeutic implications.

The Amazon region, known for its mega-biodiversity, also holds large reserves of petroleum and natural gas. The increasing exploitation of natural gas and crude oil in the Amazon has not been accompanied by studies evaluating the impact of these pollutants on local biological communities, particularly aquatic organisms. The aim of the present study was to determine the values of acute and chronic toxicity of crude oil from Urucu to larvae of Chironomus kiiensis Tokunaga, 1936. The LD5048h of crude oil for second-instar larvae of C. kiiensis was 26.5 mg/L, and mortality for the majority of concentrations tested was greatest during the first 24 hours of the experiment. The survival of eggs of C. kiiensis exposed to concentrations of crude oil was also evaluated but did not differ significantly among the treatments. Despite the high tolerance observed for the species in the experiments, there is a possibility that in the natural environment the oil interacts with other factors, leading to synergistic effects, so further studies are needed to assess the effects of this pollutant on aquatic insect species.

The objective of this study was to assess the acute effect of different intensities of whole body vibration (WBV) on muscle performance. 8 recreationally trained males were randomly subjected to one of 3 experimental conditions: (A) WBV 2 mm [45 Hz and 2 mm], (B) WBV 4 mm [45 Hz and 4 mm], and (C) no WBV. To assess PAP, the peak concentric torque of knee flexors and extensors was measured during a set of 3 unilateral knee flexor-extensions at 60°/s(-1) in an isokinetic dynamometer. The power output and height during vertical jumps were also evaluated. These measurements were performed both before and after the experimental conditions and then compared. Comparing the knee flexion data from the conditions with and without WBV indicate that WBV potentiated the peak torque during unilateral knee flexion in the isokinetic test (p < 0.05). In addition, the power output (p = 0.01) and vertical height of jump (p = 0.03) were also potentiated by WBV. However, increasing the vibratory stimulus did not further potentiate the results. Thus, it is suggested that WBV be used before explosive events competition because WBV promotes post-activation potentiation., (© Georg Thieme Verlag KG Stuttgart · New York.)

Knee osteoarthritis is a common disease in the elderly population worldwide. The alleviation of the symptoms associated with this disease can be achieved with physical exercise that induces a cascade of molecular and cellular processes. Of the neurotrophins, brain-derived neurotrophic factor (BDNF) appears to be the most affected by physical activity. Moreover, BDNF seems to have a negative modulatory role in inflammation, and its production by skeletal muscle cells or by cells of the immune system drives the immunoprotective role of physical activity in situations of chronic inflammation. Therefore, the aim of this study was to evaluate plasma BDNF concentrations in elderly individuals presenting with knee osteoarthritis. To accomplish this, sixteen volunteers (mean age 67 ± 4.41 years) presenting with clinically and radiographically diagnosed knee osteoarthritis were evaluated during acute exercise (1 session of 20 min on a treadmill) and after chronic exercise (12 weeks of aerobic training, consisting of a 50-min walk 3 times per week). Additionally, both a functional assessment (during a 6-min walk) and a pain perception assessment were performed at the start and at the end of physical exercises (training). The plasma BDNF concentrations were measured by ELISA. For the population studied, acute exercise increased the levels of BDNF only before the 12-week training period (p < 0.001). Moreover, the training augmented the plasma concentrations of BDNF (p < 0.0001) and improved clinical parameters (functional p < 0.001; pain perception p < 0.01).

Objective: To evaluate the plasma levels of CCL2, CCL3, CCL11, CCL24, tumor necrosis factor alpha, sTNFR1, and sTNFR2 in subjects exposed to silica (SES) with and without silicosis compared with unexposed reference control group, and their associations with the radiological severity and duration of exposure to silica., Methods: Fifty-seven SES; 36 with silicosis and 22 subjects in control group, were included in the study., Results: CCL3, CCL24, sTNFR1, and sTNFR2 were increased in SES and in SES with silicosis than in controls. There were no differences in the levels of CCL2, CCL11, or tumor necrosis factor alpha. The sTNFR2 level was greater in SES with silicosis than in SES without silicosis. There was a positive correlation between sTNFR1 and sTNFR2 and the radiological severity and time of exposure to silica. sTNFR2 was associated with all categories of radiological severity., Conclusion: sTNFR2 is associated with silicosis severity and early exposure to silica.

Objective: to understand the ways in which adolescent fathers participate in the breast feeding process in the family environment in North-eastern Brazil., Methods: a descriptive, exploratory, qualitative study was undertaken involving 10 couples with infants aged 6-8 months living in a single community in Recife, Pernambuco, Brazil. Data were collected using semi-structured interviews with questions to guide the interviewer. Data were analysed using thematic content analysis, and interpreted under the theoretical reference of being an adolescent father within the context of breast feeding., Findings: from the data collected, three themes were identified: knowledge of the benefits of breast feeding for the child's health; discontinued participation of the father in breast feeding during the pregnancy-childbearing cycle; and exclusion of the adolescent father from the breast feeding process. The adolescent fathers knew about the benefits of breast feeding in terms of the child's health, but did not mention benefits for the mother, the family or society. For some adolescent fathers, their participation in the breast feeding process started during pregnancy, whereas for others, it was only initiated after the infant was born. One of the fathers was prevented, by his wife and mother-in-law, from participating in the breast feeding process., Conclusions: the involvement of adolescent fathers in the breast feeding process oscillated during the pregnancy-childbearing cycle. This may be due to the patriarchal cultural heritage, Brazilian paternity laws, and the fact that these fathers were adolescents. This study showed that adolescent parents were knowledgeable about breast feeding. Finally, fathers want a new model of parenting in which the man participates in child care., (Crown Copyright © 2013. Published by Elsevier Ltd. All rights reserved.)

The influence of the knee flexion on muscle activation and transmissibility during whole body vibration is controversially discussed in the literature. In this study, 34 individuals had electromyography activity (EMG) of the vastus lateralis and the acceleration assessed while squatting with 60° and 90° of knee flexion either with or without whole-body vibration (WBV). The conditions were maintained for 10s with 1min of rest between each condition. The main findings were (1) the larger the angle of knee flexion (90° vs. 60°), the greater the EMG (p<0.001), with no difference on acceleration transmissibility; (2) for both angles of knee flexion, the addition of WBV produced no significant difference in EMG and higher acceleration compared to without WBV (p<0.001). These results suggest that the larger the knee flexion angle (60° vs. 90°), the greater the muscle activation without acceleration modification. However, the addition of WBV increases the transmissibility of acceleration in the lower limbs without modification in EMG of vastus lateralis., (Copyright © 2013 Elsevier Ltd. All rights reserved.)

Hemoparasites were surveyed in 60 free-living pampas deer Ozotoceros bezoarticus from the central area of the Pantanal, known as Nhecolândia, State of Mato Grosso do Sul, Brazil, through the analysis of nested PCR assays and nucleotide sequencing. Blood samples were tested for Babesia/Theileria, Anaplasma spp., and Trypanosoma spp. using nPCR assays and sequencing of the 18S rRNA, msp4, ITS, and cathepsin L genes. The identity of each sequence was confirmed by comparison with sequences from GenBank using BLAST software. Forty-six (77%) pampas deer were positive for at least one hemoparasite, according to PCR assays. Co-infection occurred in 13 (22%) animals. Based on the sequencing results, 29 (48%) tested positive for A. marginale. Babesia/Theileria were detected in 23 (38%) samples, and according to the sequencing results 52% (12/23) of the samples were similar to T. cervi, 13% (3/23) were similar to Babesia bovis, and 9% (2/23) were similar to B. bigemina. No samples were amplified with the primers for T. vivax, while 11 (18%) were amplified with the ITS primers for T. evansi. The results showed pampas deer to be co-infected with several hemoparasites, including species that may cause serious disease in cattle. Pampas deer is an endangered species in Brazil, and the consequences of these infections to their health are poorly understood., (Copyright © 2013 Elsevier GmbH. All rights reserved.)

Background: The association between the ankle brachial index (ABI) and the measurement of intimal medial thickness (IMT) has not been fully studied., Objective: We aimed to evaluate whether the prevalence of carotid atherosclerosis was higher in patients with ABI < 0.9 than in those with ABI > 0.9., Methods: From January 2011 to December 2011, 118 patients (48 men and 70 women) were enrolled. ABI and IMT Measurements were performed in all patients. Patients were divided in Group 1 (ABI < 0.9) and Group 2 (ABI > 0.9) according to ABI values. Mann-Whitney, Chi-square and Fischer tests were used for comparison among the groups. Pearson's correlation was used to assess correlation between ABI and IMT., Results: The prevalence of ABI < 0.9 was 29.7%, whereas carotid atherosclerosis > 1.5 mm was 34.7 %. Clinical characteristics were similar between groups 1 and 2: mean age (64 ± 9 vs. 62 ± 7.2 years, p = 0.1), male gender (40% vs. 41%, p = 0.9), hypertension (74% vs. 59%, p = 0.1), diabetes mellitus (54% vs. 35%, p = 0.051), dyslipidemia (26% vs. 24%, p = 0.8), smoking (57% vs. 65%, p = 0.4). The prevalence of carotid atherosclerosis was higher in group 1 (48.6% vs. 28.9%, p = 0.04). Pearson's correlation between ABI and IMT was -0.235, with a p value = 0.01., Conclusion: Patients with ABI < 0.9 showed a higher prevalence of carotid atherosclerosis. There was a negative correlation between ABI and IMT.

Despite its illegality in Brazil, about 31% of all pregnancies end in abortion. Most abortions are performed by unskilled personnel and under unsafe conditions, resulting in increased female mortality. This study used data from a cross-sectional representative sample of 3,047 puerperal women, in 1999-2000, part of a national multicenter study on the prevalence of syphilis in Brazil. Of these, 1,838 women with at least one previous pregnancy before the reference pregnancy were included in the analysis. The outcomes studied were voluntary prior fetal loss, spontaneous prior fetal loss, and no prior fetal loss. The analysis was carried out using multinomial logistic regression. The results indicated a high number of fetal losses per woman (up to six); and 31% of the losses were voluntary. The absence of prenatal care, history of STD in the reference pregnancy, and absence of living children were factors that increased the odds of fetal loss. For voluntary fetal loss, being non-white, having more than one partner in the previous year, and an early age at first sexual intercourse also increased the odds of fetal loss. These data confirm the public health relevance of abortion in Brazil. Characteristics related to women´s vulnerability should be considered in family planning programs in order to reduce the number of abortions and their consequences. Counseling must also be provided, targeting women with a previous abortion.

The enemy release hypothesis is frequently used to explain the success of invaders, postulating that introduced species have escaped from their native enemies, including parasites. Here, we tested this hypothesis for the tucunaré (Cichla piquiti), a predatory cichlid, and its endoparasites. First, the parasites and their influence on the condition of the hosts in the native environment, the Tocantins River (TO), were compared to an environment where the fish was introduced, the Paraná River (PR). Then, comparisons of the abundances of Diplostomidae eye flukes and Contracaecum sp. larval nematodes were made between the introduced tucunaré and two predators native to the PR, Hoplias malabaricus and Raphiodon vulpinus. Nine species of endoparasites were recorded in total, five of which occurring in both localities. Total species richness did not differ between localities, and fish condition was negatively affected by the cestodes Sciadocephalus megalodiscus only in the TO. In the PR, abundance of Contracaecum sp. did not differ between natives and invaders; however, eye flukes were more abundant in the native fish H. malabaricus, which may represent an advantage to the invader if they were competing for prey. These results did not support the idea that the escape from parasites favoured the establishment of C. piquiti in the PR. Instead, the escape from the parasites' effects seems a better explanation, and further studies examining effects on host physiology and/or fitness in the native and introduced ranges are needed.

The aim of this study was to investigate the effect of adding whole-body vibration (WBV; frequency = 35 to 40 Hz; amplitude = 4 mm) to squat training on the T-cell proliferative response of elderly patients with osteoarthritis (OA) of the knee. This study was a randomized controlled trial in which the selected variables were assessed before and after 12 weeks of training. Twenty-six subjects (72 ± 5 years of age) were divided into three groups: 1) squat training with WBV (WBV, N = 8); 2) squat training without WBV (N = 10), and 3) a control group (N = 8). Women who were ≥60 years of age and had been diagnosed with OA in at least one knee were eligible. The intervention consisted of 12 uninterrupted weeks of squatting exercise training performed 3 times/week. Peripheral blood mononuclear cells were obtained from peripheral blood collected before and after training. The proliferation of TCD4+ and TCD8+ cells was evaluated by flow cytometry measuring the carboxyfluorescein succinimidyl ester fluorescence decay before and after the intervention (∆). The proliferative response of TCD4+ cells (P = 0.02, effect size = 1.0) showed a significant decrease (23%) in the WBV group compared to the control group, while there was no difference between groups regarding the proliferative response of TCD8+ cells (P = 0.12, effect size = 2.23). The data suggest that the addition of WBV to squat exercise training might modulate T-cell-mediated immunity, minimizing or slowing disease progression in elderly patients with OA of the knee.

The purpose of this study was to compare the effects of passive warm-up (PW), whole-body vibration (WBV), and control (C) on high-intensity performance during sprint cycle exercise. Six recreationally trained men performed a 30-second sprint cycle test after the 3 aforementioned conditions; each test was carried out on a different day after balanced-order experimental tests. The WBV consisted of 5 minutes of squats associated with WBV (45 Hz, 2 mm). The PW consisted of 30 minutes of PW using a thermal blanket on the thighs and legs (35 W). The C consisted of 30 minutes of no warm-up with the subject lying down. Motor neuron excitability from the vastus lateralis muscle, evaluated by electromyography (EMG), was determined before exercise at rest and during sprint cycle exercise. Blood lactate levels (BLs), evaluated by spectroscopy, and muscle temperature (MT) of the thigh, estimated indirectly by measuring skin temperature, were determined at following time points: before exercise at rest (before and after experimental conditions), immediately, and 3 minutes after the 30-second sprint cycle test. Peak power, relative power, relative work, time of peak power, and pedaling cadence were significantly higher in the WBV compared with that for C (p < 0.05). Although MT was significantly greater in PW compared with that in WBV and C before exercise (p < 0.01), no significant differences were observed between the experimental conditions for BL immediately after sprint cycle exercise (p = 0.35) and in EMG during sprint cycle exercise (p = 0.16). Thus, it is plausible to suggest WBV as a method for an acute increase in high-intensity performance during sprint cycle exercise for athletes immediately before competition or training.

Objective: To investigate the effects of squat exercises combined with whole-body vibration on the plasma concentration of inflammatory markers and the functional performance of elderly individuals with knee osteoarthritis (OA)., Design: Clinical, prospective, randomized, single-blinded study., Setting: Exercise physiology laboratory., Participants: Elderly subjects with knee OA (N=32) were divided into 3 groups: (1) squat exercises on a vibratory platform (platform group, n=11); (2) squat exercises without vibration (squat group, n=10); and (3) the control group (n=11)., Interventions: The structured program of squat exercises in the platform and squat groups was conducted 3 times per week, on alternate days, for 12 weeks., Main Outcome Measures: Plasma soluble tumor necrosis factor-α receptors 1 (sTNFR1) and 2 (sTNFR2) were measured using immunoassays (the enzyme-linked immunosorbent assay method). The Western Ontario and McMaster Universities Osteoarthritis Index questionnaire was used to evaluate self-reported physical function, pain, and stiffness. The 6-minute walk test, the Berg Balance Scale, and gait speed were used to evaluate physical function., Results: In the platform group, there were significant reductions in the plasma concentrations of the inflammatory markers sTNFR1 and sTNFR2 (P<.001 and P<.05, respectively) and self-reported pain (P<.05) compared with the control group, and there was an increase in balance (P<.05) and speed and distance walked (P<.05 and P<.001, respectively). In addition, the platform group walked faster than the squat group (P<.01)., Conclusions: The results suggest that whole-body vibration training improves self-perception of pain, balance, gait quality, and inflammatory markers in elderly subjects with knee OA., (Copyright © 2012 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.)

This study was aimed at verifying the relationship between the severity illness index and the occurrence of healthcare associated infections. A prospective cohort was conducted in an intensive care unit of a university hospital, between August 2009 and February 2001. The Average Severity Index Score was used to evaluate the severity of illness. Data was collected by active surveillance and processed in SPSS. Univariate analysis was carried out, statistical signficance when p < 0.05 and confidence interval of 95%. The severity illness index was related to the occurrence of healthcare associated infection, as well as the length of stay in the intensive care unit, patient type, use of invasive procedure, antimicrobials, colonization and patient outcome (p < 0.05). The occurrence of infections was also apredictive factor for the occurrence of death (p = 0.000). These findings reinforce the idea that the occurrence of healthcare associate infections is a complex multifactorial chain, with emphasis on the clinical severity of the patient.

Background: Treatment of hypertension includes pharmacological and nonpharmacological interventions. Among the nonpharmacological interventions emphasizes the practice of regular physical exercise. However, the effects of aerobic exercise training on cardiovascular and metabolic parameters in elderly hypertensive women are still controversial., Objectives: The purpose of this study was to assess the effects of a walking program on metabolic and cardiovascular parameters at rest and during the recovery period following maximal exercise by hypertensive elderly women., Methods: Twelve elderly women with hypertension started a 2-week walking program. Rest blood cholesterol and anthropometric data, as well as blood pressure and heart rate at rest and after progressive maximal exercise were measured before and after training., Results: There were significant differences between the pre- and posttraining periods in VO(2)max, systolic blood pressure, diastolic blood pressure, and mean blood pressure. There were no changes in serum cholesterol levels after the training. During the recovery period following the progressive test, the fall in heart rate and mean blood pressure after 10 minutes of recovery was significantly higher after training., Conclusion: The proposed walking program did not alter serum cholesterol, but it did reduce resting blood pressure, improve aerobic performance and accelerate the fall in heart rate and mean blood pressure during the postprogressive maximal aerobic exercise recovery period in elderly hypertensive women.

Biological invasions are considered a major threat to biodiversity around the world, but the role of parasites in this process is still little investigated. Here, we compared parasite infections of a host species in the areas where it originated and where it was introduced, and in native and introduced species in the same environment, using the endoparasites of the fish Plagioscion squamosissimus (Sciaenidae) in 3 Brazilian basins. Samples were taken in 2 rivers where the species is native, i.e., Solimões River (SO) and Tocantins River (TO), and where the species was introduced, the upper Paraná River (PR). In addition, abundances of diplostomids and larval nematodes were compared between P. squamosissimus and 2 native competitors in the PR, Hoplias malabaricus and Raphiodon vulpinus. In total, 13 species of endoparasites were recorded, but only Austrodiplostomum sp. and cestode cysts were present in all localities. Although infracommunity richness was similar, their species composition was slightly different among localities. General linear models using the relative condition factor of fish as response variables, and abundance of the most prevalent parasites as possible predictors showed that the condition of fish is negatively correlated with parasite abundance only in the native range (TO). Abundance of diplostomid eye flukes was higher in the PR, and in the native species H. malabaricus when compared to the invader, which might present an advantage for P. squamosissimus if they compete for prey. However, although P. squamosissimus may have lost some of its native parasites during its introduction to the PR, it is now possibly acting as a host for native generalist parasites.