Introduction. Infant juvenile obesity is currently a worldwide public health problem and it is increasing at alarming rate in the Brazilian population, showing its relevance in terms of public health. Objectives. Determine the prevalence of overweight and obesity in children and adolescents between 2 and 19 years old in different regions of Brazil. Methods. The following electronic databases were searched (from September through November 2013): Medline (PubMed), LILACS, and SciELO, using the descriptors and Boolean operators (obesity) and (overweight) and (child) and (prevalence) and (Brazil). Prospective and/or cross-sectional designs studies were found regarding the prevalence of overweight and obese children and adolescents in the five regions of Brazil. Results. A total of 191 scientific articles were found of which 17 met all inclusion criteria. A higher prevalence of overweight was found in the south (25.7%) and north (28.8%) of the country, and obesity in the southeast (15.4%) and south (10.4%). Conclusions. The scope of the studies was mostly based on municipal coverage, which resulted in limitations for conclusive analysis, showing the need for further studies of prevalence at the national level, with emphasis on public health in obese children and adolescents throughout the Brazilian territory.
BackgroundThe International Index of Erectile Function has been proposed as a method for assessing sexual function assisting the diagnosis and classification of erectile dysfunction. However, IIEF was not validated for the Portuguese language. ObjectiveValidate the International Index of Erectile Function in patients with cardiopulmonary and metabolic diseases. MethodsThe sample consisted of 108 participants of to Cardiopulmonary and Metabolic program Rehabilitation (CPMR) in southern Brazil. The clarity assessment of the instrument was performed using a scale ranging from zero to 10. The construct validity was carried out by confirmatory factor analysis (KMO = 0.85; Barllet p < 0.001), internal consistency by Cronbach's alpha and reproducibility and interrater reliability via the test retest method. ResultsThe items were considered very clear with averages superior to 9. The internal consistency resulted in 0.89. The majority of items related correctly with their domains, with exception of three questions from sexual satisfaction domain, and one from erectile function. All items showed excellent stability of measure and substantial to almost perfect agreement. ConclusionThe present study showed that the IIEF is valid and reliable for use in participants of a cardiopulmonary and metabolic rehabilitation program.
Mobilization of critically ill patients admitted to intensive care units should be performed based on safety criteria. The aim of the present review was to establish which safety criteria are most often used to start early mobilization for patients under mechanical ventilation admitted to intensive care units. Articles were searched in the PubMed, PEDro, LILACS, Cochrane and CINAHL databases; randomized and quasi-randomized clinical trials, cohort studies, comparative studies with or without simultaneous controls, case series with 10 or more consecutive cases and descriptive studies were included. The same was performed regarding prospective, retrospective or cross-sectional studies where safety criteria to start early mobilization should be described in the Methods section. Two reviewers independently selected potentially eligible studies according to the established inclusion criteria, extracted data and assessed the studies' methodological quality. Narrative description was employed in data analysis to summarize the characteristics and results of the included studies; safety criteria were categorized as follows: cardiovascular, respiratory, neurological, orthopedic and other. A total of 37 articles were considered eligible. Cardiovascular safety criteria exhibited the largest number of variables. However, respiratory safety criteria exhibited higher concordance among studies. There was greater divergence among the authors regarding neurological criteria. There is a need to reinforce the recognition of the safety criteria used to start early mobilization for critically ill patients; the parameters and variables found might contribute to inclusion into service routines so as to start, make progress and guide clinical practice.
RESUMOIntrodução: O samba é uma dança de movimentos intensos e variados que proporcionam alegria e boa resposta cronotrópica, sendo plausível a expectativa de que beneficie o sistema cardiovascular. Objetivo: Desenvolver e avaliar um protocolo de samba brasileiro visando o treinamento físico na reabilitação cardíaca. Métodos: Quinze indivíduos com doença arterial coronariana estável, idade 60,74±5,96 anos, realizaram teste cardiopulmonar máximo com determinação da frequência cardíaca (FC) correspondente ao VO 2pico e primeiro e segundo limiares ventilatórios. Durante seis sessões executaram vinte passos de samba, em três andamentos musicais, classificados por metrônomo em lento, médio ou rápido. Posteriormente, realizaram três sessões para verificar o comportamento da FC e a percepção de esforço. A análise descritiva foi utilizada na caracterização da amostra e verificação da FC, o teste t ou teste de Wilcoxon foram utilizados para comparar o comportamento da FC (nas diferentes sessões), com nível de significância de 5%. Resultados: Houve boa adaptação aos passos de samba, com FC situando-se entre 62% e 72% da FC pico . Durante as sessões de dança os pacientes mantiveram-se em 86 ±4,17% do tempo na zona alvo proposta para treinamento físico na reabilitação (60% a 90% da FC pico ) e 77±2,26% do tempo na zona alvo considerada ideal, com a FC situada entre o primeiro e o segundo limiares ventilatórios. Durante todo o tempo os pacientes referiram percepção de esforço de leve a moderada. Conclusão: Os pacientes demonstraram boa adaptação ao protocolo de samba, que se mostrou em condições de ser adotado como proposta de treinamento na reabilitação cardíaca. Palavras-chave: exercício, terapia através da dança, doenças cardiovasculares. ABSTRACT Introduction: Samba requires intense and varied movements that provide happiness and good chronotropic res-
Reactive oxygen species play an important role in the pathophysiology of heart failure (HF). In contrast, regular physical exercise can promote adaptations to reactive oxygen species that are beneficial for patients with HF. We completed a systematic review of randomized controlled trials that evaluate the influence of exercise on oxidative stress in patients with HF. Articles were searched in the PubMed, Cochrane, SciELO, and LILACS databases. The search was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. The quality of the included studies was assessed using the Physiotherapy Evidence Database scale. We selected 12 studies with a total of 353 participants. The included patients had a left ventricle ejection fraction of < 52% and New York Heart Association functional class II or III disease. A significant increase was observed in peak oxygen consumption (between 10 and 46%) in the group that underwent training (TG). There was an improvement in the oxidative capacity of skeletal muscles in the TG, related to the positive activity of mitochondrial cytochrome c oxidase (between 27 and 41%). An increase in the expression of the enzymes glutathione peroxidase (41%), catalase (between 14 and 42%), and superoxide dismutase (74.5%), and a decrease in lipid peroxidation (between 28.8 and 58.5%) were observed in the TG. Physical training positively influenced the cardiorespiratory capacity and enhanced the benefits of oxidant and antioxidant biomarkers in patients with HF. High-intensity training promoted a 15% increase in the plasma total antioxidant capacity, whereas moderate training had no effect.
Erectile dysfunction (ED) is a highly prevalent problem that affects the quality of life, prognosis and survival of patients with heart failure (HF). In the management of ED, physical exercise is a therapeutic strategy that reduces disease-related symptoms and optimizes drug use. However, the repercussions of physical exercise on ED in individuals with HF still need to be elucidated. In this sense, the objective of this study was to evaluate the effects of physical exercise on erectile function (EF) in HF patients. This was a systematic review conducted according to PRISMA guidelines. Patients with HF, male and ejection fraction ≤ 45% were submitted to physical exercise of different modalities. The search for scientific articles was conducted in the electronic databases (PubMed, LILACS, Cochrane-Library, Science Direct) from the inception until October 2018, according to the MeSH dictionary descriptors, which were suitable for all databases. Results: Three studies were analyzed, includinng 99 male subjects, age ranging from 53 years (± 7.48) to 58 years (± 12). Seventy subjects were submitted to a physical exercise program and 29 were in the control group. In all studies, physical exercise showed positive results in the management of ED regardless of erectile dysfunction (ED) classification status and intensity of exercise used. It was concluded that physical exercise of different intensities was considered an effective therapeutic intervention to improve EF in individuals with HF and ED. Recently, it has been demonstrated that men with HF, younger than 66 years, monogamous, with ejection fraction below 35% are the individuals who report more difficulties in sexual life. 12,14 ED is defined and characterized as the inability to reach out and maintain the erection of the penis for enough time to allow
Introduction: Cardiopulmonary and metabolic rehabilitation programs (CPMR) have adopted physical training protocols that value high volume and high intensity, with the possible onset of the overtraining (OVT) syndrome. In this context, the systematic use of mood investigative tools can assist in early detection
Background: Patients with heart failure (HF) usually develop exercise intolerance. In this context, noninvasive ventilation (NIV) can help to increase physical performance. Objective:To undertake a systematic review and meta-analysis of randomized controlled trials that evaluated the effects of NIV on exercise tolerance in patients with HF. Method: Search Strategy: Articles were searched in the following databases: Physiotherapy Evidence Database (PEDro), Scientific Electronic Library Online (SciELO), and MEDLINE. Selection Criteria: This review included only randomized controlled trials involving patients with HF undergoing NIV, with or without other therapies, that used exercise tolerance as an outcome, verified by the distance travelled in the six-minute walk test (6MWT), VO2peak in the cardiopulmonary test, time spent in testing, and dyspnea. Data Collection and Analysis: The methodological quality of the studies was rated according to the PEDro scale. Data were pooled in fixed-effect meta-analysis whenever possible. Results: Four studies were selected. A meta-analysis including 18 participants showed that the use of NIV prior to the 6MWT promoted increased distance, [mean difference 65.29 m (95% CI 38.80 to 91.78)]. Conclusions:The use of NIV prior to the 6MWT in patients with HF may promote increased distance. However, the limited number of studies may have compromised a more definitive conclusion on the subject.
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