RESUMO
BACKGROUND: A considerable proportion of contemporary youth have a high risk of obesity-related disorders such as cardiovascular disease, metabolic syndrome, or non-alcoholic fatty liver disease (NAFLD). Although there is consistent evidence for the positive effects of physical activity on several health aspects, most adolescents in Colombia are sedentary. It is, therefore, important to implement strategies that generate changes in lifestyle. The HEPAFIT study aims to examine whether a 6-month exercise program has benefits for hepatic fat content and cardiovascular health outcomes among overweight/obese adolescents from Bogotá, Colombia. METHODS/DESIGN: Altogether, 100 hundred overweight/obese, sedentary adolescents (aged 11-17 years) attending two public schools in Bogotá, Colombia, will be included in a parallel-group randomized controlled trial. Adolescents will be randomly assigned to an intervention group following one of four curricula: (1) the standard physical education curriculum (60 min per week of physical activity, n = 25) at low-to-moderate intensity; (2) a high-intensity physical education curriculum (HIPE, n = 25), consisting of endurance and resistance games and non-competitive activities, such as running, gymkhanas, lifting, pushing, wrestling, or hauling, for 60-min sessions, three times per week, with an energy expenditure goal of 300 to 500 kcal/session at 75-85% maximum heart rate (HRmax); (3) a low-to-moderate intensity physical education curriculum (LIPE, n = 25) consisting of endurance and resistance games and non-competitive activities (e.g., chasing, sprinting, dribbling, or hopping) for 60-min sessions, three times per week with an energy expenditure goal of 300 kcal/session at 55-75% HRmax; and (4) a combined HIPE and LIPE curriculum (n = 25). The HIPE, LIPE, and combined interventions were performed in addition to the standard physical education curriculum. The primary outcome for effectiveness is liver fat content, as measured by the controlled attenuation parameter 1 week after the end of the intervention program. DISCUSSION: The translational focus may be suitable for collecting new information in a school setting on the possible effects of physical activity interventions to reduce liver fat content and to improve metabolic profiles and the cardiometabolic health of overweight/obese adolescents. This may lead to the more efficient use of school physical education resources. TRIAL REGISTRATION: ClinicalTrials.gov, NCT02753231 . Registered on 21 April 2016.
Assuntos
Tecido Adiposo/metabolismo , Exercício Físico , Estilo de Vida Saudável , Fígado/metabolismo , Obesidade Infantil/terapia , Educação Física e Treinamento/métodos , Serviços de Saúde Escolar , Tecido Adiposo/fisiopatologia , Adiposidade , Adolescente , Fatores Etários , Biomarcadores/sangue , Criança , Colômbia , Nível de Saúde , Humanos , Fígado/fisiopatologia , Obesidade Infantil/sangue , Obesidade Infantil/diagnóstico , Obesidade Infantil/fisiopatologia , Ensaios Clínicos Controlados Aleatórios como Assunto , Método Simples-Cego , Fatores de Tempo , Resultado do Tratamento , Redução de PesoRESUMO
Different anesthesia methods can variably influence excitotoxic lesion effects on the brain. The main purpose of this review is to identify potential differences in the toxicity to nervous system cells of two common inhalation anesthesia methods, isoflurane and sevoflurane, used in combination with an excitotoxic lesion procedure in rodents. The use of bioassays in animal models has provided the opportunity to examine the role of specific molecules and cellular interactions that underlie important aspects of neurotoxic effects relating to calcium homeostasis and apoptosis activation. Processes induced by NMDA antagonist drugs involve translocation of Bax protein to mitochondrial membranes, allowing extra-mitochondrial leakage of cytochrome C, followed by sequence of changes that ending in activation of CASP-3. The literature demonstrates that the use of these anesthetics in excitotoxic surgery increases neuroinflammation activity facilitating the effects of apoptosis and necrosis on nervous system cells, depending on the concentration and exposure duration of the anesthetic. High numbers of microglia and astrocytes and high levels of proinflammatory cytokines and caspase activation possibly mediate these inflammatory responses. However, it is necessary to continue studies in rodents to understand the effect of the use of inhaled anesthetics with excitotoxic lesions in different developmental stages, including newborns, juveniles and adults. Understanding the mechanisms of regulation of cell death during development can potentially provide tools to promote neuroprotection and eventually achieve the repair of the nervous system in pathological conditions.
Assuntos
Anestésicos Inalatórios/toxicidade , Sistema Nervoso/efeitos dos fármacos , Neurotoxinas/toxicidade , Anestésicos Inalatórios/administração & dosagem , Animais , Sistema Nervoso/patologia , Neurotoxinas/administração & dosagem , RoedoresRESUMO
This study explored the association between pubertal stage and anthropometric and cardiometabolic risk factors in youth. A cross-sectional study was conducted in 2877 Colombian children and adolescents (9-17.9 years of age). Weight, height, and waist circumference were measured and body mass index (BMI) was calculated. A biochemical study was performed to determine the cardiometabolic risk index (CMRI). Blood pressure was evaluated and pubertal stage was assessed with the Tanner criteria. Hierarchical multiple regression analyses were performed. The most significant variable (p < 0.05) in the prognosis of cardiometabolic risk was found to be the BMI in both boys and girls. In the case of girls, the pubertal stage was also a CMRI predictive factor. In conclusion, BMI was an important indicator of cardiovascular risk in both sexes. Pubertal stage was associated with cardiovascular risk only in the girls.
Assuntos
Cardiopatias/epidemiologia , Doenças Metabólicas/epidemiologia , Puberdade/fisiologia , Adolescente , Índice de Massa Corporal , Criança , Colômbia/epidemiologia , Feminino , Cardiopatias/etiologia , Humanos , Masculino , Doenças Metabólicas/etiologia , Fatores de RiscoRESUMO
OBJECTIVE: The main purpose of this study was to describe a group of Colombian physical therapists' beliefs and attitudes towards Evidence-Based Practice (EBP), their education, knowledge and skills for implementing EBP, the use of relevant literature in clinical practice, access to and availability of scientific information and perceived barriers to including EBP in practice. METHODS: This was a cross-sectional study which involved 1,064 Colombian physical therapists. The study used a 50-item screening questionnaire EBP developed to estimate attitudes, beliefs, knowledge and skills regarding. This instrument has been adapted and was validated previously in Colombia by Flórez-López et al. RESULTS: The population mostly consisted of young females (77.2%) aged 22 to 29 years old (79.4%). Most respondents had an undergraduate degree (87.7%). The physical therapists stated that they had positive attitudes and beliefs regarding EBP, most of them answering that they agreed or strongly agreed that EBP is necessary (71.6%), the relevant literature is useful for practice (61.3%), EBP improves the quality of patient care (64.1%) and evidence helps in decision-making (44.5%). Forty-one percent of the respondents indicated that a lack of research skills was the most important barrier to the use of evidence in practice. CONCLUSION: The physical therapists reported that they had a positive attitude to EBP and were interested in learning about or improving the skills necessary to adopt EBP in their clinical practice.
OBJETIVO: Describir en un grupo colombiano de fisioterapeutas las i) creencias y actitudes hacia la practica basada en la evidencia (PBE), ii) la educación, el conocimiento y las habilidades para implementar la PBE; iii) el uso de la literatura relevante en la práctica clínica; iv) el acceso y la disponibilidad de información científica; y v) la percepción de las barreras para la inclusión de la PBE. MÉTODOS: Se realizó un estudio transversal en 1,064 fisioterapeutas colombianos. El estudio usó el cuestionario que consta de 50-ítems para estimar las actitudes, creencias, conocimientos y habilidades hacia la PBE. Dicho instrumento fue adaptado y validado en Colombia por Flórez-López et al. RESULTADOS: La mayoría de la población participante fueron mujeres (77.2%) en edades comprendidas entre 22 y 29 años (79.4%). El 87.7% de los encuestados eran titulados en fisioterapia. Los fisioterapeutas manifestaron tener actitudes y creencias positivas hacia la PBE. Una mayoría respondió que estaba de acuerdo o muy de acuerdo en que es necesaria la PBE (71.6%), en que la literatura es útil para la práctica clínica (61.3%), que la PBE mejora la calidad de la atención a los pacientes (64.1%), y en que la evidencia ayuda en la toma de decisiones clínicas (44.5%). El 41.0% de los encuestados indicaron que la falta de habilidades de investigación era la barrera más importante para el uso de la evidencia científica en la práctica clínica. CONCLUSIONES: Los fisioterapeutas manifestaron una actitud positiva acerca la PBE y estaban interesados en aprender o mejorar las habilidades necesarias para adoptar la PBE en la práctica clínica.
Assuntos
Competência Clínica , Prática Clínica Baseada em Evidências , Conhecimentos, Atitudes e Prática em Saúde , Fisioterapeutas/estatística & dados numéricos , Adulto , Atitude do Pessoal de Saúde , Colômbia , Estudos Transversais , Feminino , Humanos , Masculino , Fisioterapeutas/normas , Especialidade de Fisioterapia/métodos , Especialidade de Fisioterapia/normas , Inquéritos e Questionários , Adulto JovemRESUMO
Objective: The main purpose of this study was to describe a group of Colombian physical therapists' beliefs and attitudes towards Evidence-Based Practice (EBP), their education, knowledge and skills for implementing EBP, the use of relevant literature in clinical practice, access to and availability of scientific information and perceived barriers to including EBP in practice. Methods: This was a cross-sectional study which involved 1,064 Colombian physical therapists. The study used a 50-item screening questionnaire EBP developed to estimate attitudes, beliefs, knowledge and skills regarding. This instrument has been adapted and was validated previously in Colombia by Flórez-López et al. Results: The population mostly consisted of young females (77.2%) aged 22 to 29 years old (79.4%). Most respondents had an undergraduate degree (87.7%). The physical therapists stated that they had positive attitudes and beliefs regarding EBP, most of them answering that they agreed or strongly agreed that EBP is necessary (71.6%), the relevant literature is useful for practice (61.3%), EBP improves the quality of patient care (64.1%) and evidence helps in decision-making (44.5%). Forty-one percent of the respondents indicated that a lack of research skills was the most important barrier to the use of evidence in practice. Conclusion: The physical therapists reported that they had a positive attitude to EBP and were interested in learning about or improving the skills necessary to adopt EBP in their clinical practice.
Objetivo: Describir en un grupo colombiano de fisioterapeutas las i) creencias y actitudes hacia la practica basada en la evidencia (PBE), ii) la educación, el conocimiento y las habilidades para implementar la PBE; iii) el uso de la literatura relevante en la práctica clínica; iv) el acceso y la disponibilidad de información científica; y v) la percepción de las barreras para la inclusión de la PBE. Métodos: Se realizó un estudio transversal en 1,064 fisioterapeutas colombianos. El estudio usó el cuestionario que consta de 50-ítems para estimar las actitudes, creencias, conocimientos y habilidades hacia la PBE. Dicho instrumento fue adaptado y validado en Colombia por Flórez-López et al. Resultados: La mayoría de la población participante fueron mujeres (77.2%) en edades comprendidas entre 22 y 29 años (79.4%). El 87.7% de los encuestados eran titulados en fisioterapia. Los fisioterapeutas manifestaron tener actitudes y creencias positivas hacia la PBE. Una mayoría respondió que estaba de acuerdo o muy de acuerdo en que es necesaria la PBE (71.6%), en que la literatura es útil para la práctica clínica (61.3%), que la PBE mejora la calidad de la atención a los pacientes (64.1%), y en que la evidencia ayuda en la toma de decisiones clínicas (44.5%). El 41.0% de los encuestados indicaron que la falta de habilidades de investigación era la barrera más importante para el uso de la evidencia científica en la práctica clínica. Conclusiones: Los fisioterapeutas manifestaron una actitud positiva acerca la PBE y estaban interesados en aprender o mejorar las habilidades necesarias para adoptar la PBE en la práctica clínica.