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La sangre es una mezcla de componentes que tiene su propia identidad. Una de las propiedades físicas que adquiere es su viscosidad, la cual es la resistencia que ofrece para desplazarse. A diferencia de sus componentes (como glucosa, hemoglobina, colesterol, etc.), la sangre no posee un nivel único de viscosidad, sino que esta es variable debido a diversos factores. Exponemos algunos principios físicos que nos permitirán entender mejor esta dinámica de la viscosidad sanguínea, y su posible aplicación en algunos fenómenos hemodinámicos, así como la complejidad de su medición en la práctica clínica habitual.

Blood is a mixture of components that has its own identity. One of the physical properties that it acquires is its viscosity, which is the resistance it offers to move. Unlike its components (such as glucose, hemoglobin, cholesterol, etc.), blood does not have a single level of viscosity, but it is variable due to various factors. We present some physical principles that will allow us to better understand these dynamics of blood viscosity, and its possible application in some hemodynamic phenomena, as well as the complexity of its measurement in routine clinical practice.

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Objetivo : determinar las características sociodemográficas y los modos adaptativos afectados en pacientes diabéticos atendidos en centros de salud del Distrito Chambo-Riobamba. Método : estu- dio con enfoque mixto, descriptivo­transversal, en población constituida por 157 pacientes con ECNT, de los centros del Distrito Chambo-Riobamba, Ecuador; seleccionando 40 mayores de 19 años, salud mental apta para llenar los instrumentos, con diagnóstico de diabetes Mellitus tipo II, residencia regular en los sectores mencionados y que estén de acuerdo con participar, durante el período abril-agosto 2017. Resultados : se observó que el 67,5% son de sexo femenino, mayores de 65 años, el 75% con instrucción básica y el 52,5% ama de casa. Tuvieron un 90% en el nivel medio y poca adaptación a las limitaciones por la enfermedad y el 82,5% pocas veces o nunca reali- za actividad física. El 77,5% manifiestó cambios emocionales y en relación con el apoyo familiar se evidenció que el 80% no lo recibió. Conclusiones : las características sociodemográficas distin- tivas en la población de estudio fueron: predominio del género femenino, adultos mayores, amas de casa, de instrucción básica. Tomando en cuenta los modos adaptativos en el fisiológico los pacientes manifiestan poca adaptación a la enfermedad. Mientras que de forma mayoritaria a veces o nunca realizaban actividad física. En el modo psicosocial, el auto-concepto se encuentra alterado; así como en el de interdependencia la mayoría de los individuos a veces o nunca recibían soporte familiar, relacionando con un déficit de búsqueda de sistemas de apoyo y el régimen terapéutico.

Objective: to determine the sociodemographic characteristics and the adaptive modes affected in diabetic patients treated in health centers of the Chambo-Riobamba District during the period April-August 2017. Method: a study with a mixed, descriptive-cross-sectional approach was carried out in a population made up of 157 patients with NCD, they were attended in the centers of the Chambo-Riobamba District, Ecuador. 40 patients over 19 years of age were selected considering aspects such as mental health suitable to fill out the instruments, diagnosed with type II diabetes mellitus, regular residence in the aforementioned sectors and who agree to parti- cipate. Results: it was observed that 67.5% are female, over 65 years of age, 75% have basic education and 52.5% are housewives. They had 90% in the medium level and little adaptation to the limitations due to the disease and 82.5% rarely or never did physical activity. 77.5% mani- fested emotional changes and in relation to family support and 80% did not receive it. Conclu- sions: the distinctive sociodemographic characteristics in the study population were the predo- minance of the female gender, older adults, housewives, basic education. Taking into account the adaptive modes in the physiological, patients showed little adaptation to the disease. Most of them sometimes or never did physical activity. In the psychosocial mode, the self-concept was altered; as well as in the interdependence, most individuals sometimes or never received family support, related to a deficit in the search for support systems and the therapeutic regimen.

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Resumen Introducción: Los bajos niveles de Consumo Máximo de Oxígeno (VO2max) evaluados en escolares chilenos, sugieren la puesta en marcha de entrenamientos que mejoren la capacidad aeróbica. Objetivo: Analizar el efecto de un método de Entrenamiento Intervalado de Alta Intensidad sobre el Consumo Máximo de Oxígeno en escolares chilenos. Materiales y métodos: Treinta y dos escolares de octavo año básico divididos en dos grupos fueron parte del estudio (grupo experimental = 16 y grupo control = 16). La principal variable analizada fue el Consumo Máximo de Oxígeno a través del Test de Course Navette. Se aplicó un método de Entrenamiento Intervalado de Alta Intensidad basado en la Velocidad Aeróbica Máxima obtenida a través del Test. Para el análisis estadístico se utilizó un ANOVA Mixto. Resultados: El grupo experimental presentó un aumento significativo en el Consumo Máximo de Oxígeno entre el pre test y post test al ser comparado con el grupo control (p < 0.0001). Conclusión: Los resultados del estudio mostraron un efecto positivo del Entrenamiento Intervalado de Alta Intensidad sobre el Consumo Máximo de Oxígeno. Al término del estudio, se concluye que el Entrenamiento Intervalado de Alta Intensidad es una buena metodología de estimulación para escolares chilenos.

Abstract Introduction: The low levels of maximum oxygen consumption (VO2max) evaluated in Chilean schoolchildren suggest the startup of trainings that improve the aerobic capacity. Objective: To analyze the effect of a High-intensity Interval Training method on maximum oxygen consumption in Chilean schoolchildren. Materials and methods: Thirty-two high school students from the eighth grade, who were divided into two groups, were part of the study (experimental group = 16 students and control group = 16 students). The main analyzed variable was the maximum oxygen consumption through the Course Navette Test. A High-intensity Interval training method was applied based on the maximum aerobic speed obtained through the Test. A mixed ANOVA was used for statistical analysis. Results: The experimental group showed a significant increase in the Maximum Oxygen Consumption between the pretest and posttest when compared with the control group (p < 0.0001). Conclusion: The results of the study showed a positive effect of the High-intensity Interval Training on the maximum consumption of oxygen. At the end of the study, it is concluded that High-intensity Interval Training is a good stimulation methodology for Chilean schoolchildren.

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BACKGROUND: The kitesurfing athletes endure unexpected conditions in terms of the function of irregularities in the surface of the water that requires a correct proprioceptive response in order to maintain equilibrium and execute the required movements while maintaining contact with the board and the water. OBJECTIVES: The objective of this work was to use the star excursion balance test to compare the dynamic equilibrium of athletes who engage in kitesurfing activities with non-athletic subjects. METHODS: Fourteen kitesurfing athletes and fifteen sedentary male subjects completed three rounds of the star excursion balance test: familiarity, test one and test two. During each phase the eight directions of the test were performed three times on each leg and the maximum distance reached by the leg (cm) was measured before being divided by the length of the lower limb (%). To compare the intergroup averages, a student test t to independent samples was performed. To compare the averages across the eight directions in the same group, the repeated-measures ANOVA test was employed and to compare the averages of the right leg and the left leg, a student test t to dependent samples was used (α = 0.05). RESULTS: For both groups and in both legs, the distance reached in the medial, posteromedial, posterior and posterolateral directions was similar and further than the other directions. It was observed that the athletes in the comparison intergroup achieved superior results than those in the control group in the medial, posteromedial, posterior and posterolateral directions in both right and left legs and the lateral direction in the right leg (P < 0.05). CONCLUSIONS: Kitesurfing activities result in proportionate adaptations in the dynamic equilibrium of athletes, maybe in function of adaptations in the neuromuscular structure, resulting in a better performance in situations that cause disequilibrium.

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Objective:The objective of this study was to describe changes in the resting energy expenditure, substrate oxidation rate, and body composition in morbidly obese women subjected to short-term caloric restriction. Methods:This was a prospective study that included ten obese women with body mass index greater than 40 kg/m2 and aged between 20-50 years. The participants were hospitalized for eight days and received a controlled conventional low-calorie diet, 1200 kcal/day, for seven days. Body weight, body mass index, abdominal circumference, body composition, resting energy expenditure, and substrate oxidation rate were evaluated at the beginning and at the end of the study. Results:A significant reduction in body weight (p=0.005), body mass index (p=0.005), abdominal circumference (p=0.005), fat mass (p=0.005) and fat-free mass (p=0.008) was observed at the end of the study. There was an average reduction in resting energy expenditure of approximately 124 kcal/day (5%). Substrate oxidation rate did not show statistically significant changes. There was a positive correlation only between body weight reduction and fat-free mass reduction (r=0.753; p=0.012). Conclusion:There was an adaptive response of the resting energy expenditure with short-term energy restriction in morbidly obese women with a 5% reduction in resting energy expenditure and a positive correlation between weight loss and the fat-free mass, which indicates the influence of fat-free mass on the decrease in resting energy expenditure. Therefore, short-term caloric restriction in morbidly obese women led to a decrease in resting energy expenditure and fat-free mass, which suggests a rapid adaptation of energy expenditure.

Objetivo:Descrever as mudanças no gasto energético de repouso, na taxa de oxidação de substrato e na composição corporal em mulheres obesas mórbidas submetidas à restrição calórica de curto prazo. Métodos:Este foi um estudo prospectivo com dez mulheres obesas com índice de massa corporal maior que 40 kg/m2 e idade entre 20-50 anos. As participantes foram hospitalizadas por sete dias consecutivos e receberam uma dieta hipocalórica convencional controlada de 1200 kcal/dia. Peso corporal, índice de massa corporal, circunferência abdominal, composição corporal, gasto energético de repouso e taxa de oxidação de substratos foram avaliados no início e no final do estudo.Resultados:Reduções significativas no peso corporal (p=0,005), índice de massa corporal (p=0,005), circunferência abdominal (p=0,005), massa gorda (p=0,005) e massa livre de gordura (p=0,008) foram observadas no final do estudo. O gasto energético de repouso mostrou redução média de aproximadamente 124 kcal/dia (5%). A taxa de oxidação de substratos não apresentou mudanças estatisticamente significativas. Houve correlação importante apenas entre a redução do peso corporal e a redução da massa livre de gordura (r=0,753, p=0,012). Conclusão:Houve uma resposta adaptativa do gasto energético de repouso com restrição energética em curto prazo em mulheres obesas mórbidas, apresentando redução média de 5% do gasto energético de repouso e correlação entre a perda de peso e a massa livre de gordura, o que indica a influência da mesma na diminuição do gasto energético de repouso. Portanto, a restrição calórica de curto prazo em mulheres obesas mórbidas leva à diminuição no gasto energético de repouso e na massa livre de gordura, sugerindo uma rápida adaptação do gasto energético.

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Introdução: Atletas com lesão medular apresentam redução da sua capacidade aeróbia global, em comparação com indivíduos não portadores de deficiência. Porém, seu treinamento tem sido realizado igual ao de um atleta sadio, desconsiderando suas particularidades. Objetivo: Identificar o que tem sido relatado pela literatura nos últimos anos envolvendo a capacidade aeróbia de atletas cadeirantes com lesão medular. Métodos: Foi realizada uma revisão sistemática por meio de busca de artigos originais em inglês publicados e indexados na base de dados PubMed. Resultados: Foram encontrados 44 artigos originais, e destes, apenas 17 se enquadraram nos critérios de inclusão desta pesquisa. Conclusão: O nível da lesão e o grau de mobilidade afetaram diretamente a capacidade aeróbia dos esportistas. Atletas cadeirantes apresentaram VO2 pico e potência aeróbia semelhantes a dos atletas saudáveis, e FCmáx maior. Atletas cadeirantes de modalidades esportivas de esforço contínuo exibiram melhor capacidade aeróbia que atletas de esforços intermitentes.

Introduction: Athletes with spinal cord injury have overall aerobic capacity reduced, compared with non-disabled individuals. However, their training has been conducted the same way as a healthy athlete, disregarding their peculiarities. Objective: To identify what has been reported in the literature in recent years involving the aerobic capacity of wheelchair athletes with spinal cord injury. Methods: A systematic review by searching for original articles published in English and indexed in the PubMed database was performed. Results: Forty-four original articles were found and of these only 17 met our criteria for inclusion and exclusion of this research. Conclusion: The lesion level and the mobility degree directly affect the aerobic capacity of these athletes. Wheelchair athletes have VO2peak and aerobic power similar to healthy athletes, and higher HRmax. Wheelchair athletes in sports that require continuous effort exhibited better aerobic capacity than athletes in sports requiring only intermittent effort.

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The author makes comments about the shortening and loss of elasticity of the oculomotor muscle that remains slack for some time (contracture), by means of a reasoning based on the Hooke´s law and on the papers carried out to demonstrate that a muscle that remains relaxed for some time suffers a shortening due to loss of sarcomeres on the longitudinal direction and the increase of the cross-sectional area due to the increase of collagen tissue in the perimysium and the endomysium.

O autor procura demonstrar a razão da perda de elasticidade e do encurtamento do músculo oculomotor que permanece relaxado durante certo tempo (contratura), mediante raciocínio baseado na lei de Hooke e nos trabalhos que demonstram que o músculo oculomotor que permanece frouxo por algum tempo sofre encurtamento devido à perda de sarcômeros no sentido longitudinal e ao aumento da área da secção transversa, devida ao aumento do tecido colágeno do perimísio e do endomísio.

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Introdução: O sucesso da reabilitação de pacientes edêntulosrequer uma adaptação funcional e psicológica. A qualidade de vidaé marcantemente afetada pela quantidade de satisfação ouinsatisfação com a terapia bucal. A substituição dos dentesperdidos por tratamento reabilitador protético pode melhorar aqualidade de vida dos idosos, recuperando a integração familiar esocial, a manutenção da saúde geral e elevando a expectativa devida. Objetivo: Avaliar e comparar o impacto da reabilitação oralcom próteses implanto-muco-suportadas e com próteses totaisconvencionais na qualidade de vida de indivíduos. Métodos: Aamostra foi constituída por 36 indivíduos (18 homens e 18mulheres) que tiveram perda dentária na arcada inferior ereceberam reabilitação oral com próteses totais removíveis e asmesmas foram substituídas por próteses implanto-mucosuportadas.A idade média dos indivíduos foi de 60,98 anos. Umformulário no formato entrevista (Oral Health Impact Profile –OHIP-14) foi respondido por duas vezes, avaliando se a alteraçãoda condição bucal, ou seja, a substituição da prótese totalremovível pela implanto-muco-suportada, interferiram naqualidade de vida dos mesmos. Resultados: Houve diferençasignificante da qualidade de vida entre os dois tempos deavaliação, sendo que o impacto na qualidade de vida foi maiorquando os pacientes utilizavam próteses totais removíveis e esseimpacto diminuiu com a substituição por próteses totais implantomuco-suportadas. Conclusão: A qualidade de vida de pacientesmelhorou após a substituição de próteses totais removíveis porpróteses totais implanto-muco-suportadas.

Introduction: The success of the rehabilitation of edentulouspatients requires functional and physiologic adaptation. The qualityof life is markedly affected by the amount of satisfaction ordissatisfaction with the oral therapy. The substitution of lost teeth byprosthetic treatment can improve the quality of life of the elderly,recovering the familiar and social integration, maintaining generalhealth and elevating the life expectation. Objective: To investigateand compare the impact of the oral rehabilitation with totalremovable prosthesis or implant supported prosthesis in the qualityof life in individuals who suffered facial trauma with tooth loss.Methods: The sample comprised 36 individuals (18 mem and 18women) who suffered facial trauma with tooth loss, and receivedoral rehabilitation with total removable prosthesis, being thesesubstituted by implant supported prosthesis. The mean age was60.98. The individuals answered twice a formulary in interviewformat (Oral Health Impact Profile – OHIP-14) in order to evaluate ifthe change of the oral condition, i.e., the substitution of a totalremovable prosthesis by implant supported prosthesis interfere inthe quality of life of them. Results: There was significant differencein the impact in quality of life between the two times of evaluation,and the impact in the quality of life was greater when patients usedtotal removable prosthesis and this impact was reduced with thesubstitution by implant supported prosthesis. Conclusion: Thequality of life improved after the substitution of the total removableprosthesis by implant supported prosthesis.

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OBJETIVO: Verificar a efetividade de um programa de treinamento auditivo formal em idosos usuários de próteses auditivas intraaurais no período de aclimatização. MÉTODOS: A amostra foi composta por 18 idosos (idade média: 71, 38 anos), de ambos os sexos, adaptados há uma semana com próteses auditivas intra-aurais binaurais. Os participantes foram randomizados em dois grupos: Grupo Experimental (submetidos ao treinamento auditivo) e Grupo Controle (não submetidos ao treinamento auditivo). O Grupo Experimental participou de sete sessões de treinamento auditivo em cabina acústica, uma sessão por semana, com duração de 50 minutos cada. Os procedimentos de avaliação incluíram testes de reconhecimento de fala e questionário de auto-avaliação do handicap auditivo. Estes foram aplicados em duas oportunidades, antes (1ª avaliação) e depois (2ª avaliação) do treinamento auditivo no Grupo Experimental e na avaliação inicial e final do estudo no Grupo Controle. RESULTADOS: No Grupo Experimental, o Índice de Reconhecimento de Fala e Fala com Ruído Branco foram significantemente melhores após o treinamento auditivo (2ª avaliação). Já o estudo das relações sinal/ruído no teste de reconhecimento de sentenças no ruído revelou uma tendência (p-valor próximo a 0,05) de melhora na avaliação pós-treinamento. Observou-se nos idosos do Grupo Experimental que os resultados obtidos na 2ª avaliação não foram significantemente melhores aos obtidos no Grupo Controle em todos os testes. CONCLUSÃO: Pode-se concluir que um programa de reabilitação aural, incluindo treinamento auditivo formal beneficia os idosos no período de adaptação das próteses auditivas, bem como modifica o comportamento auditivo destes indivíduos.

PURPOSE: To investigate the efficiency of a formal auditory training program in hearing aid wearers during the acclimatization period. METHODS: Eighteen subjects (mean age of 71.38 years old), male and female, binaural intra-aural hearing aid users for one week participated in the study. Experimental (with auditory training) and Control (without training) groups were formed randomly. Subjects in the experimental group have undergone a formal auditory training program organized in seven 50-minute sessions, once a week. Evaluation procedures included speech recognition tests and a self-assessment questionnaire. These procedures were carried out before (1st evaluation) and after (2nd evaluation) the training for the Experimental Group and in the Initial and Final evaluation for the Control Group. RESULTS: In the experimental group, both the word recognition score (WRS) and the speech in noise test showed significantly improved results after the training (2nd evaluation). In the study of signal-to-noise ratio for sentence recognition in noise, there was a slight tendency (p-value near 0,05) of improvement in the evaluation after the training. It was also observed that for the Experimental Group the results in the 2nd evaluation have not revealed differences in comparison to the results of the Control Group in all tests. CONCLUSION: It could be concluded that the aural rehabilitation program, including formal auditory training beneficiates the elderly in the period of hearing aids adaptation and also modifies the auditory behavior of these subjects.

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