BackgroundThe emergence of diseases such as dyslipidemia, systemic arterial hypertension, insulin resistance and metabolic syndrome in children and adolescents has brought about a change in the epidemiologic profile of the pediatric population. As action to promote health in the school environment is a useful tool for changing the pattern of health/disease in the young population, the present study aimed to identify schools that promote healthy eating and physical activity and to study the relationship between these practices and the prevalence of overweight, hypertension, insulin resistance and hypercholesterolemia in adolescents.MethodsA cross-sectional population-based study was conducted with 2400 adolescents aged from 12 to 17 years old and participating in the “Study of Cardiovascular Risk in Adolescents” (ERICA – Estudo de Riscos Cardiovasculares em Adolescente). The association between dependent (overweight, insulin resistance, hypertension and dyslipidemia) and independent variables (implementation of health promoting initiative in schools) was investigated using the chi-square test and prevalence ratio (PR) with a confidence index (CI) of 95%.ResultsThe unsatisfactory implementation of a “health promoting environment” (PR = 1.02; CI 95%: 1.0; 1.04) and “partnerships with the health sector” (PR = 1.03; CI 95%: 1.01; 1.05) were linked to a high prevalence of overweight in adolescents. Hypercholesterolemia was found to be higher in the schools with unsatisfactory implementation of “healthy eating and health on the scholar curriculum” (PR = 1.71; CI 95%: 1.22; 2.44) and those lacking a “healthy-eating promoting environment” (PR = 1.29; CI 95%: 1.10; 1.54). Schools with unsatisfactory implementation of a “health-eating promoting environment” (PR = 1.36; CI 95%: 1.04; 1.79) and those lacking “partnership with the health sector” (PR = 2.12; CI 95%: 1.38; 3.24) had more adolescents with insulin resistance. There was no association between hypertension and any other component studied.ConclusionSchools which have implemented adequate health promotion in their curriculums showed a lower prevalence of overweight, insulin resistance and hypercholesterolemia in adolescents.
Muscle-tendon unit length plays a crucial role in quadriceps femoris muscle (QF) physiological adaptation, but the influence of hip and knee angles during QF neuromuscular electrical stimulation (NMES) is poorly investigated. We investigated the effect of muscle length on maximum electrically induced contraction (MEIC) and current efficiency. We secondarily assessed the architecture of all QF constituents and their tendon-aponeurosis complex (TAC) displacement to calculate a stiffness index. This study was a randomized, repeated measure, blinded design with a sample of twenty healthy men aged 24.0 ± 4.6. The MEIC was assessed in four different positions: supine with knee flexion of 60° (SUP60); seated with knee flexion of 60° (SIT60); supine with knee flexion of 20° (SUP20), and seated with knee flexion of 20° (SIT20). The current efficiency (MEIC/maximum tolerated current amplitude) was calculated. Ultrasonography of the QF was performed at rest and during NMES to measure pennation angle (θp) and fascicle length (Lf), and the TAC stiffness index. MEIC and current efficiency were greater for SUP60 and SIT60 compared to SUP20 and SIT20. The vastus lateralis and medialis showed lower θp and higher Lf at SUP60 and SIT60, while for the rectus femoris, in SUP60 there were lower θp and higher Lf than in all positions. The vastus intermedius had a similar pattern to the other vastii, except for lack of difference in θp between SIT60 compared to SUP20 and SIT20. The TAC stiffness index was greater for SUP60. We concluded that NMES generate greater torque and current efficiency at 60° of knee flexion, compared to 20°. For these knee angles, lengthening the QF at the hip did not promote significant change. Each QF constituent demonstrated muscle physiology patterns according to hip and/or knee angles, even though a greater Lf and lower θp were predominant in SUP60 and SIT60. QF TAC index stiffened in more elongated positions, which probably contributed to enhanced force transmission and slightly higher torque in SUP60. Our findings may help exercise physiologist better understand the impact of hip and knee angles on designing more rational NMES stimulation strategies.Clinical Trial Registrationwww.ClinicalTrials.gov, identifier NCT03822221.
Quadriceps neuromuscular electrical stimulation (NMES) may stimulate patellar tendon remodeling and recovery, but it is unclear if hip and knee joint angles during NMES affect patellar tendon loading. Therefore, the purpose of this study was to evaluate the effects of hip and knee joint angles on patellar tendon properties during quadriceps NMES. Twenty healthy men performed quadriceps NMES in supine with 60º of knee flexion (SUP60), seated with 60º of knee flexion (SIT60), supine with 20º of knee flexion (SUP20), and seated with 20º of knee flexion (SIT20). Patellar tendon mechanical and material properties were determined during maximum quadriceps evoked contraction. Patellar tendon force, stress, and stiffness were greater for SUP60 and SIT60 compared to SUP20 and SIT20. Young's modulus was greater for SUP60 and SIT60 compared to SIT20. Tendon elongation, strain, resting length, and average CSA were not different between conditions. In conclusion, during quadriceps NMES, the patellar tendon is loaded more when the knee is flexed to 60º compared to 20º. These findings suggest that clinicians should favor 60º of knee flexion over 20º during NMES when the goal is to load the patellar tendon. Further research is needed to determine optimal positioning for maximal patellar tendon loading. The trial was registered at clinicaltrials.gov under protocol NCT03822221 on January 30, 2019.
Introduction: vertebral arteries (VA) are the formation factors of the Transverse Foramens (TF) and the largerst anatomical structures that occupy them. Variations in the presence, size and course of VAs affect the morphology of TFs considerably, besides being the probable cause of formation of the accessory transverse foramen (ATF). Knowledge of the presence of the ATF and its variations are important for a safe surgery. Material and Methods: the present study has analyzed 165 cervical vertebrae. The ATF has been classified as unilateral or bilateral, complete or incomplete and anterior, posterior or lateral regarding the transverse foramen of the respective cervical vertebrae analyzed. Quantitative data was collected through a digital caliper. Results: 36 (21.82%) of the vertebrae presented the ATF, with 25 (15.15%) of them carrying the ATF unilaterally, while the remaining 11 (6.67%) had the foramen bilaterally. 28 (59.57%) ATF were classified as incomplete and 19 (40.43%) were classified as complete. 44 (93.62%) were identified as posterior and 3 (6.38%) were anterior to the TF. Regarding the morphometric data, there was no difference between the longitudinal measurement (LM) and transverse measurement (TM) on the right and left sides of the vertebrae analyzed. Conclusion: it has been shown for the first time the prevalence of ATF in individuals in a population of Northeastern Brazil. The morphological knowledge can be surgical and clinically important as it may suggest alterations in the vertebral artery and in the venous plexuses that surround it in its vertebral segment of passage in the transverse foramina.
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