Modulation of the autonomic nervous system on heart rate can be compromised in chronic kidney disease and may result in changes in the frequency and duration of the cardiac cycle. The aim of this study was to evaluate autonomic modulation in active and sedentary renal transplant recipients. Twenty renal-transplanted individuals were analyzed at the Centro de Prevenção de Doenças Renais (Kidney Disease Education Centre), in the academic hospital of Universidade Federal do Maranhão, and were divided into the active group (AG) and the sedentary group (SG). The AG comprised of six men and four women (age 43.10 ± 13.02) and was in regular concurrent training intervention for 8 weeks, while the SG was composed of three men and seven women (age 36.8 ± 9.26). Analysis of heart rate (HR) variability in time and frequency domain demonstrated that HR mean values in the SG and AG were 787.32 ± 79.60 and 870 ± 106.66 ms, respectively. Differences were observed in the time domain and frequency domain. The total index of low frequency and high frequency showed no differences between the SG and AG. Biochemical variables presented significantly lower levels after 8 weeks of training. Higher heart rate variability in the time domain and greater vagal modulation was observed in the AG. The AG ad greater vagal modulation when compared to the SG, with removal of the sympathetic and increased parasympathetic in the behaviour was confirmed by sympatho-vagal balance. The AG also presented significant improvements in the frequency domain.
The left ventricular noncompaction is a congenital cardiomyopathy characterized by the presence of abnormal trabeculations in the left ventricle. The present study describes the case of a 14-year-old female Para athlete, who plays goalball. She was asymptomatic, with history of congenital nystagmus and mild visual impairment, who presented nonspecific electrocardiographic abnormalities during pre-competition screening. Cardiac magnetic resonance imaging showed left ventricular non-compaction (non-compacted to compacted layer ratio equal to 2.5) and mild biventricular systolic dysfunction. Initially, the patient was excluded from sports participation and clinical follow-up was performed every three months. Patient remained asymptomatic during the one-year follow-up, with no history of unexplained syncope, marked impairment of systolic function or significant ventricular arrhythmias at the exercise stress test. Finally, she was released for competitive goalball participation and clinical follow-up was continued every 6 months. There is no consensus regarding the eligibility criteria for sports participation in cases of left ventricular non-compaction. Thus, it is prudent to individualize the decision regarding practice of sports, as well as to consider participation in competitive sports for asymptomatic individuals and with no disease repercussions.
Introdução: A definição do brincar é complexa e não háconsenso a este respeito. O brincar permite um desenvolvimentosaudável das crianças e, naturalmente, prepara-as para enfrentaros desafios da idade adulta. Apesar da valorização em saúdepública, revisões sistemáticas que resumam os diferentesachados sobre o brincar ainda são raras. Objetivos: Este estudotem como objetivo rever a literatura recente sobre o brincare resumir seus efeitos positivos sobre saúde das crianças.Material e Métodos: Esta revisão sistemática foi desenvolvidaatravés de busca por artigos publicados nos idiomas portuguêsou inglês, entre 2006 e 2016, nas bases de dados ElsevierScopus, Medical Literature Analysis and Retrieval SystemOnline, Latin American and Caribbean Health SciencesLiterature e Scientific Electronic Library Online. Resultados:A estratégia de busca identificou 12 artigos que atendiamaos critérios de elegibilidade: seis estudos qualitativos, trêsrevisões narrativas, uma revisão sistemática, um estudoquantitativo e um estudo quali-quantitativo. Conclusão: Osdados apresentados reforçam que o brincar é extremamenteimportante para a saúde das crianças. Os benefícios do brincarvão além de contribuir para um adequando crescimentobiológico e desenvolvimento das crianças. Brincar influenciapositivamente o desenvolvimento mental e social, bem comocontribui para uma boa saúde psicossocial. Nos dias de hoje, otempo reduzido para brincar priva as crianças de experiênciasfundamentais para seu desenvolvimento social, afetivo,criatividade e bem-estar. Possivelmente, essa privação nainfância terá efeitos na idade adulta.
RESUMOIntrodução: Um adequado estado de hidratação é de suma importância para os participantes de corridas de rua, tanto para um melhor desempenho esportivo, quanto na prevenção dos distúrbios causados pelo calor. Objetivo: O estudo visa avaliar o estado de hidratação de indivíduos do sexo masculino em corrida de rua de 15 km. Métodos: A amostra foi composta por 15 indivíduos do sexo masculino (37,67±7,22 anos) praticantes habituais de corrida de rua. O estado de hidratação foi avaliado antes e após a corrida através dos seguintes parâmetros: peso corporal, coloração e gravidade específica da urina (GEU), análise da impedância bioelétrica (BIA), níveis de hemoglobina (Hb) e hematócrito (Ht). Na análise dos dados, foi utilizado o teste t de Student pareado ou o teste de Wilcoxon, aceitando-se como estatisticamente significante p < 0,01. Resultados: Houve diminuição do peso corporal dos indivíduos após a corrida (p<0,0001), assim como elevação dos níveis de Hb e Ht. Apesar da diminuição observada na GEU após o exercício, não houve melhora significativa do padrão de coloração da urina ou diferença entre o conteúdo inicial e final de água corporal total. A temperatura ambiente (TA) e umidade relativa do ar (URA) foram de 38,75±1,79°C e 37,37±4,66%, respectivamente. Conclusão: O exercício no ambiente em questão conduziu os indivíduos a um estado de desidratação, apenas detectado pela análise da variação do peso corporal e de parâmetros sanguíneos através dos níveis de Hb e Ht. Parâmetros urinários como a coloração da urina e GEU, assim como aqueles obtidos através da BIA, provavelmente foram confundidos por variáveis não controladas pelo presente estudo. Palavras
Abstract:Although many health professionals believe that exercise protects the athletes against thrombosis, it is discussed whether elite athletes are exposed to many thrombogenic acquired risk factors such as: dehydration, hemoconcentration, repeated microtraumas and extended periods of immobilization during travel or injury. Additionally, the use of combined oral contraceptive (COC) may increases the risk of venous thrombosis fourfold in healthy women. We report a case of a 21-years-old professional female football athlete who developed deep vein thrombosis (DVT) followed by pulmonary embolism (PE). The outpatient hypercoagulability workup was negative and the case was associated to the use of COC pills. The patient was treated with rivaroxaban for 5 months, with complete resolution of the symptoms. There are a few cases in the literature of venous thromboembolism (VTE) involving athletes. Cases of VTE attributable to the use of COC are extremely rare in this population. The diagnosis of VTE in athletes is a challenge for physicians, because the symptoms may erroneously be confused with musculoskeletal complaints. Team physicians who work with female athletes should be alert to modifiable risk factors for VTE, as well as able to perform the early diagnosis and initial clinical management of this condition. DVT should be considered as a differential diagnosis of calf pain in women, especially in athletes, due to the well-defined increase on the risk of thrombosis with the use of COC pills.
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