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Understanding the differences in ventilatory responses during exercise between patients with fibromyalgia and those with other chronic pain disorders is crucial for developing effective therapeutic interventions, especially in exercise to identify the better physical therapy prescription. Both populations face unique challenges that impact their ability to engage in physical activity; yet, the underlying physiological responses can vary significantly. In this context, the methodology of this study entailed conducting a comparative analysis of the ventilatory response during exercise in patients with fibromyalgia and those with other chronic pain disorders. The experimental protocol included a total of 31 participants (n = 13 diagnosed with fibromyalgia and n = 18 diagnosed with other chronic pain conditions). All participants completed a stress test, where the ventilatory parameters were measured in three stages (i.e., resting, incremental exercise, and recovery). The results revealed significant differences (p<0.05) in ventilatory responses between both groups. Patients with fibromyalgia exhibited reduced time for the aerobic threshold and a higher respiratory frequency in the anaerobic threshold compared to those with other chronic pain disorders. Furthermore, fibromyalgia patients demonstrated higher values in the ventilatory coefficient during the test and in the recovery stage. In conclusion, these differences underscore the need for tailored exercise programs that specifically address the unique ventilatory challenges faced by fibromyalgia patients to improve their physical function and overall quality of life.

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Introducción. La evaluación de la condición física (CF), junto con otros indicadores de salud, es una estrategia utilizada para conocer el estado actual de los escolares. El principal objetivo fue medir en escolares sanluiseños el estado de salud actual, los niveles de CF y construir tablas de referencias de CF. Población y métodos. Escolares entre 9 y 12 años de edad (ambos sexos) fueron evaluados con dos indicadores de salud: índice de masa corporal y presión arterial. La CF fue medida con la batería ALPHA-Fitness. El orden de las pruebas fue el siguiente: tensión arterial, masa corporal, estatura, longitud de pie y mano, salto en longitud, velocidad en 30 metros, agilidad 4 × 10 m y la prueba de ida y vuelta en 20 metros. Se calculó el índice de masa corporal (IMC) y la maduración biológica. Resultados. Fueron evaluados 15548 escolares. Los valores promedios fueron presión arterial sistólica 101 ± 10 mmHg y diastólica 66 ± 7 mmHg; IMC 20,2 ± 4,3 kg/m2. Para la CF fueron las siguientes: componente cardiorrespiratorio VO2 máx. 39,87 ± 3,2 ml/kg/min y velocidad alcanzada en la prueba de ida y vuelta en 20 m 8,9 ± 0,6 km/h; componente neuromuscular; salto en longitud: 120,6 ± 23,9 cm, velocidad 30 m: 6,56 ± 0,85 s, agilidad 4 × 10 m: 15,17 ± 1,82 s. El rendimiento siempre fue superior en el grupo masculino (p <0,001). Conclusión. Los escolares mostraron niveles saludables de presión arterial. El 50 % de la muestra fue clasificada con sobrepeso u obesidad según el IMC. En ambos sexos, se observaron bajos niveles de CF. Por primera vez, se elaboraron tablas de referencia de CF en escolares sanluiseños

Introduction. The assessment of physical fitness (PF), is useful strategy to know the current status of schoolchildren. Our primary objective was to measure the current health status and PF levels of schoolchildren in San Luis and to develop PF reference tables. Population and methods. Schoolchildren aged 9 to 12 years (boys and girls) were assessed based on 2 health indicators: body mass index and blood pressure. PF was measured using the ALPHA-Fitness test battery. Blood pressure, body mass, height, foot and hand length, standing long jump, 30 m sprint, 4 × 10 m agility test, and 20 m shuttle run test were assessed. The body mass index (BMI) and biological maturation were estimated. Results. A total of 15 548 schoolchildren were assessed. Average systolic blood pressure was 101 ± 10 mmHg and diastolic blood pressure, 66 ± 7 mmHg; BMI: 20.2 ± 4.3 kg/m2. Average PF was, in the cardiorespiratory component, VO2 max.: 39.87 ± 3.2 mL/kg/min and speed reached during the 20 m shuttle run test: 8.9 ± 0.6 km/h; in the musculoskeletal component, standing long jump: 120.6 ± 23.9 cm, 30 m sprint: 6.56 ± 0.85 s, 4 × 10 m agility test: 15.17 ± 1.82 s. The performance was better in the boys group (p < 0.001). Conclusion. Blood pressure was normal. Fifty percent of the sample was overweight or obese as per their BMI. Both boys and girls showed low PF levels. PF reference tables for schoolchildren from San Luis were developed for the first time.

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Introduction. The assessment of physical fitness (PF), is useful strategy to know the current status of schoolchildren. Our primary objective was to measure the current health status and PF levels of schoolchildren in San Luis and to develop PF reference tables. Population and methods. Schoolchildren aged 9 to 12 years (boys and girls) were assessed based on 2 health indicators: body mass index and blood pressure. PF was measured using the ALPHA-Fitness test battery. Blood pressure, body mass, height, foot and hand length, standing long jump, 30 m sprint, 4 × 10 m agility test, and 20 m shuttle run test were assessed. The body mass index (BMI) and biological maturation were estimated. Results. A total of 15 548 schoolchildren were assessed. Average systolic blood pressure was 101 ± 10 mmHg and diastolic blood pressure, 66 ± 7 mmHg; BMI: 20.2 ± 4.3 kg/m 2 . Average PF was, in the cardiorespiratory component, VO2 max.: 39.87 ± 3.2 mL/kg/min and speed reached during the 20 m shuttle run test: 8.9 ± 0.6 km/h; in the musculoskeletal component, standing long jump: 120.6 ± 23.9 cm, 30 m sprint: 6.56 ± 0.85 s, 4 × 10 m agility test: 15.17 ± 1.82 s. The performance was better in the boys group (p < 0.001). Conclusion. Blood pressure was normal. Fifty percent of the sample was overweight or obese as per their BMI. Both boys and girls showed low PF levels. PF reference tables for schoolchildren from San Luis were developed for the first time.

Introducción. La evaluación de la condición física (CF), junto con otros indicadores de salud, es una estrategia utilizada para conocer el estado actual de los escolares. El principal objetivo fue medir en escolares sanluiseños el estado de salud actual, los niveles de CF y construir tablas de referencias de CF. Población y métodos. Escolares entre 9 y 12 años de edad (ambos sexos) fueron evaluados con dos indicadores de salud: índice de masa corporal y presión arterial. La CF fue medida con la batería ALPHAFitness. El orden de las pruebas fue el siguiente: tensión arterial, masa corporal, estatura, longitud de pie y mano, salto en longitud, velocidad en 30 metros, agilidad 4 × 10 m y la prueba de ida y vuelta en 20 metros. Se calculó el índice de masa corporal (IMC) y la maduración biológica. Resultados. Fueron evaluados 15 548 escolares. Los valores promedios fueron presión arterial sistólica 101 ± 10 mmHg y diastólica 66 ± 7 mmHg; IMC 20,2 ± 4,3 kg/m 2 . Para la CF fueron las siguientes: componente cardiorrespiratorio VO2 máx. 39,87 ± 3,2 ml/kg/min y velocidad alcanzada en la prueba de ida y vuelta en 20 m 8,9 ± 0,6 km/h; componente neuromuscular; salto en longitud: 120,6 ± 23,9 cm, velocidad 30 m: 6,56 ± 0,85 s, agilidad 4 × 10 m: 15,17 ± 1,82 s. El rendimiento siempre fue superior en el grupo masculino (p <0,001). Conclusión. Los escolares mostraron niveles saludables de presión arterial. El 50 % de la muestra fue clasificada con sobrepeso u obesidad según el IMC. En ambos sexos, se observaron bajos niveles de CF. Por primera vez, se elaboraron tablas de referencia de CF en escolares sanluiseños.

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Photobiomodulation (PBM) has ergogenic effects on aerobic and anaerobic efforts and may improve sports performance. As Brazilian jiu-jitsu (BJJ) fighting requires both aerobic and anaerobic metabolism, so PBM may be effective in increasing the physical performance of BJJ athletes. Thus, this study aimed to verify the effects of PBM with different energy doses (6 or 12 J per point) on high-intensity intermittent anaerobic performance in BJJ athletes. METHODS: Eleven male athletes performed three lower limb Wingate testing sessions. At the beginning of each session, in a randomized, crossover, double-blind fashion, the athletes received PBM with a dose of 6 J (4.5 J/cm2) or 12 J (9.1 J/cm2), or placebo (PLA) at 17 points in each lower limb. In each session, the squat jump (SJ) and three Wingate test series were performed, with a 3-minute interval between series. Heart rate (HR) was collected immediately before, after each Wingate test, and at 1, 3, and 5 minutes after the last test. The rate of perceived exertion (RPE) was reported after each Wingate test. Differences between Wingate tests and treatment sessions were set at p<0.05. RESULTS: No differences were observed between treatments in SJ height, Wingate performance, HR, and RPE (p>0.05; for all comparisons). The Wingate test session promoted a reduction in anaerobic capacity in the second and third sets in all conditions, indicating fatigue (p<0.05). CONCLUSION: Treatment with PBM did not produce a dose-dependent ergogenic response in high-intensity intermittent performance in BJJ athletes.

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Abstract Background Obesity and overweight in childhood can increase the risk of developing cardiovascular disease throughout live. Objectives This study provides an update of a meta-analysis of randomized clinical trials (RCT) published in 2014, to assess the effects of physical activity interventions on preventing cardiovascular risk factors in childhood. Methods This update combines data from the previous search with new data obtained from June 2013 to June 2020. Searches were performed on PubMed, EMBASE and Cochrane CENTRAL. The RCTs enrolled used interventions with physical activity longer than six months in school children aged 6-12 years, and evaluated body mass index (BMI), systolic blood pressure (SBP), diastolic blood pressure (DBP), total cholesterol (TC), triglyceride (TG), and low-density lipoprotein (LDL) and high-density lipoprotein (HDL) levels. Data analysis was performed using a random-effects model and a P value <0.05 was considered statistically significant. Results A total of 28,603 articles were retrieved, and 17 RCTs (11,952 subjects) were included. Physical activity interventions were associated with reduction in SBP [−2.11mmHg (95%CI −3.67, −0.54), I243%], DBP [−2.08mmHg (95%CI −3.68, −0,49), I265%] and TG [-0.08mmol/L (95% CI -0.13, -0.03), I20%], and increase in TC [0.17mmol/L (95%CI 0.04, 0.30), I20%]. However, the interventions were not associated with reductions in BMI [−0.03 kg/m2 (95%CI −0.17, 0.10), I20%]. Conclusion This update confirms and reinforces the beneficial effects of physical activity intervention in reducing systolic and diastolic blood pressure and TG levels.

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Resumo Fundamento: Há dados limitados sobre o valor prognóstico da ressonância magnética cardíaca (RMC) em estresse em pacientes idosos. Objetivo: Determinar o valor prognóstico da RMC em estresse com adenosina em idosos com doença arterial coronariana (DAC) conhecida ou suspeita. Métodos: Entre 2010 e 2015, pacientes consecutivos com 65 anos ou mais encaminhados para RMC em estresse com adenosina foram acompanhados para a ocorrência de eventos cardíacos graves (morte cardíaca e infarto do miocárdio não-fatal) e eventos cardiovasculares adversos maiores (ECAM) que também incluíram hospitalização por insuficiência cardíaca e acidente vascular cerebral isquêmico. As análises univariadas e multivariadas foram realizadas para determinar o valor prognóstico da isquemia miocárdica, com valor de p <0,05 considerado estatisticamente significante. Resultados: Após um período médio de seguimento de 50,4 meses em 324 pacientes (48% do sexo masculino, 73±7 anos), ocorreram 21 eventos cardíacos graves e 52 ECAM. Pacientes com isquemia miocárdica (n=99) apresentaram taxas significantemente maiores de eventos cardíacos graves (HR 5,25 [IC 95% 2,11-13,04], p<0,001) e ECAM (HR 3,01 [IC 95% 1,75-5,20], p<0,001) do que aqueles sem isquemia. A análise multivariada determinou a isquemia como preditor independente de eventos cardíacos graves (HR 3,14 [IC 95% 1,22-8,07], p=0,02) e ECAM (HR 1,91 [IC 95% 1,02-3,59], p=0,04). A isquemia forneceu um valor prognóstico incremental sobre fatores clínicos e fração de ejeção do ventrículo esquerdo para predizer eventos cardíacos graves e ECAM (p<0,01 para ambos). Nenhum evento adverso grave ocorreu durante ou imediatamente após os exames de RMC. Conclusão: A RMC em estresse com adenosina é segura e demonstra valor prognóstico em idosos com DAC conhecida ou suspeita.

Abstract Background: There is limited data on the prognostic value of stress cardiac magnetic resonance (CMR) in older adults. Objective: To determine the prognostic value of adenosine stress CMR in older individuals with known or suspected coronary artery disease (CAD). Methods: Between 2010 and 2015, consecutive patients aged 65 years or older referred for adenosine stress CMR were followed for the occurrence of severe cardiac events (cardiac death and nonfatal myocardial infarction) and major adverse cardiovascular events (MACE) that also included hospitalization for heart failure and ischemic stroke. Univariate and multivariate analyses were performed to determine the prognostic value of myocardial ischemia, with p-value <0.05 considered statistically significant. Results: After a mean follow-up period of 50.4 months in 324 patients (48% male, 73±7 years), 21 severe cardiac events and 52 MACE occurred. Patients with myocardial ischemia (n=99) had significantly higher rates of severe cardiac events (HR 5.25 [95% CI 2.11-13.04], p<0.001) and MACE (HR 3.01 [95% CI 1.75-5.20], p<0.001) than those without ischemia. Multivariable analysis determined ischemia as an independent predictor of severe cardiac events (HR 3.14 [95% CI 1.22-8.07], p=0.02) and MACE (HR 1.91 [95%CI 1.02-3.59], p=0.04). Ischemia provided an incremental prognostic value over clinical factors and left ventricular ejection fraction for predicting severe cardiac events and MACE (p<0.01 for both). No severe adverse events occurred during or immediately after CMR examinations. Conclusion: Adenosine stress CMR is safe and has prognostic value in older adults with known or suspected CAD.

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In assessing the quality of seed lots, the vigor tests are complementary to the germination test and they identify differences in the degree of deterioration of the lots. For safflower, there is little information regarding these tests. In this way, the intention of this study was to adapt the accelerated aging test methodology to assess the physiological potential of safflower seeds (Carthamus tinctorius). For this purpose, 12 seed lots were evaluated for thousand-seed weight, germination, first germination count, seedling emergence test (emergence percentage, emergence speed index, relative emergence frequency and the initial, final and mean times) and accelerated aging. For the accelerated aging test, the traditional and saline methods were used. For this, the samples were conditioned in periods of 0, 8, 16, 24, 32 and 48 hours at 42 °C. Afterwards, they were submitted to the germination test, with evaluation of normal seedlings on the 3rd day. The 12 lots were evaluated within each period, in independent experiments. The data were submitted to analysis of variance and the means were compared using the Scott-Knott clustering method at 5% probability. In the traditional accelerated aging test the periods of 16, 24, 32 and 48 hours were more efficient in differentiating the lots in vigor levels, as they stratified the lots in three classes and the time of 8 hour classified the lots in two levels of vigor. In the accelerated saline aging method the time 32 hours were more efficient since it ranked seed lots at three levels of vigor and the periods of 8, 16 and 24 hour stratified the lots in two levels. In results obtained by the principal component analysis it was verified. The variables traditional accelerated aging for 24 and 32 hours correlated with emergence in the field. Therefore, the traditional accelerated aging test at 42 °C for 24 hours are promising for evaluating the physiological quality of safflower seeds.

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OBJECTIVE: Heart failure with preserved ejection fraction is a highly prevalent disease; some advances for improving the diagnosis are the development of the H2FPEF score and the diastolic stress test for the evaluation of diastolic function. The objective is to describe the clinical and echocardiographic characteristics of patients referred for stress tests, and the association between the H2FPEF score and the results of the diastolic test. METHODS: This is an analytical, observational, retrospective study. An exercise stress test was performed. The Chi-square test was used to establish an association between H2FpEF score and diastolic stress test results. Patients over the age of 18, in sinus rhythm, with the left ventricular ejection fraction > 54%, with no more than mild diastolic dysfunction on the baseline echocardiogram were included in the study. RESULTS: A total of 99 patients met the eligibility criteria. About 49.5% were women, median age was 62.2 years. The H2FPEF score was low in 27.2%, intermediate 71.7%, and 1% in the high range. There was a high prevalence of hypertension 58.6%, diabetes 12.1%, and coronary disease 20.2%. The stress test was positive for diastolic dysfunction in 36.4% of the patients. A statistically significant association was found between the H2FPEF score and the diastolic stress test (p = 0.02). CONCLUSIONS: Although clinical scores such as H2FPEF help identify patients, a high percentage of patients are classified in the intermediate range. The diastolic stress test can help to make the diagnosis of diastolic function in this group of patients.

OBJETIVO: La insuficiencia cardíaca con fracción de eyección preservada (FCFEp) es una enfermedad de alta prevalencia, sin embargo, aún falta una estrategia de referencia para establecer el diagnóstico de FCFEp. Algunos de los avances más importantes para mejorar el diagnóstico de FCFEp son la puntuación H2FPEF y la prueba de esfuerzo para la evaluación de la función diastólica durante el ejercicio. El objetivo es describir las características clínicas y ecocardiográficas de los pacientes remitidos para pruebas de esfuerzo en un centro de referencia colombiano, y la asociación entre el puntaje H2FPEF con los resultados de la prueba de estrés diastólica. MÉTODOS: Se trata de un estudio analítico, observacional y retrospectivo. Se realizó una ecocardiografía de esfuerzo solicitada por disnea o fatiga. La prueba Chi cuadrado se utilizó para establecer una asociación entre la puntuación H2FpEF y los resultados de la prueba diastólica. Se incluyeron pacientes mayores de 18 años, en ritmo sinusal, con fracción de eyección del ventrículo izquierdo igual o superior al 55%, con una disfunción diastólica no mayor de leve en el ecocardiograma basal. RESULTADOS: Un total de 99 pacientes cumplieron los criterios de inclusión. El 49,5% de la población eran mujeres, la edad media fue de 62.2 años. La puntuación H2FPEF fue baja en 27.2%, intermedia 71,7% y 1% en el rango alto. Hubo una alta prevalencia de hipertensión 58.6%, diabetes 12.1% y enfermedad coronaria 20.2%. La prueba de esfuerzo fue positiva para disfunción diastólica en el 36,4% de los pacientes. Se encontró una asociación estadísticamente significativa entre la puntuación H2FPEF y la prueba de esfuerzo diastólico (p = 0.02). CONCLUSIONES: Aunque puntuaciones clínicas como H2FPEF ayudan a identificar a los pacientes, un alto porcentaje de pacientes se clasifican en el rango intermedio. La prueba de esfuerzo diastólico puede ayudar a realizar el diagnóstico de función diastólica en este grupo de pacientes.

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To verify the glycemic safety of a maximal cardiorespiratory test (V̇ O2max) in T1DM patients and correlate the maximum cardiorespiratory values with metabolic control parameters such as glycemia, glycated hemoglobin, time of diagnosis (TD), and fat (body [GC] and visceral [GV]). The cross-sectional study evaluated ten T1DM patients (age 24.9 ± 7.5 years; time of diagnosis 11.5 ± 7.4; body mass index 22 ± 2 kg/m2 ). Metabolic glycemic control variables (before and after), glycated hemoglobin (HbA1c), time since diagnosis and total and visceral fat were collected. The CENESP maximum test protocol was used on the treadmill with direct maximal oxygen uptake (V̇ O2max). Normality test, paired t-test and correlations (p <0.05) were performed. In the results, blood glucose pre 189 ± 67 mg/dL vs. post 172 ± 66 mg/dL (p = 0.140). The V̇ O2max with a regular average score for men and women (37.4 ± 6.6 ml.kg.min-1). There was a negative and almost perfect correlation with TD, GC and GV (p = 0.028, p <0.000, and p <0.000). We conclude that is possible to perform a CENESP maximal with glycemic safe in T1DM. However, TD, GC, and GV negatively interfere with cardiorespiratory fitness and should be verified before the test. (AU)

Verificar a segurança glicêmica de um teste cardiorrespiratório máximo (V̇ O2max) em pacientes com diabetes mellitus tipo 1 (DM1) e correlacionar os valores com parâmetros de controle metabólico como glicemia, hemoglobina glicada, tempo de diagnóstico (DT) e gordura (corporal[GC] e visceral[GV]). O estudo transversal avaliou dez DM1 (idade 24,9 ± 7,5 anos; tempo de diagnóstico 11,5 ± 7,4; índice de massa corporal 22 ± 2 kg/m2). Foram coletadas variáveis de controle glicêmico metabólico (antes e depois), hemoglobina glicada (HbA1c), tempo de diagnóstico e gordura total e visceral. O protocolo de teste máximo do CENESP foi utilizado na esteira com consumo máximo direto de oxigênio (V̇ O2max). Teste de normalidade, teste t pareado e correlações (p<0,05) foram realizados. Nos resultados, glicemia pré 189 ± 67 mg/dL vs. pós 172 ± 66 mg/dL (p = 0,140). O V̇ O2max com pontuação média regular para homens e mulheres (37,4 ± 6,6 ml.kg.min-1). Houve correlação negativa e quase perfeita com DT, GC e GV (p = 0,028; p < 0,000 e p < 0,000). Concluímos que é possível realizar um CENESP máximo com segurança glicêmica no DM1. No entanto, DT, GC e GV interferem negativamente na aptidão cardiorrespiratória e devem ser verificados antes do teste.

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This study aims to explore biochemical changes in saliva during cardiorespiratory exercise using attenuated-total-reflectance-Fourier-transform-infrared-spectroscopy (ATR-FTIR). Saliva and blood samples were obtained from six athletes at rest, and after running at speeds of 10, 11, 12, 13, 14, 15, 16, 17, 18, 19, and 20 kilometers-per-hour (km/h) on a treadmill (maximal stress test). Saliva ATR-FTIR spectra were analyzed using deconvolution and multivariate analysis. Area-under-the-curve calculations suggest differential changes in glucose, lactate, protein, lipids, carbohydrate and phosphate content in saliva during the test. Increases in glucose and lactate levels with increasing speeds were verified by simultaneous measurement of blood glucose and lactate levels using standard equipment (Roche®). Multivariate principal-component-analysis (PCA) showed discrete clusters for low (rest-14 km/h) and high (15 - 20 km/h) speeds, and PCA-linear-discriminant-analysis showed 100% classification of 18 - 20 km/h as high speed. Overall, results suggest the possibility of using this non-invasive saliva-based ATR-FTIR method for biochemical assessment during sports exercise and stress tests.

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BACKGROUND: Exercise oscillatory ventilation (EOV) is related to worse prognosis in patients with heart failure (HF). However, its determination is subjective and there is no standard measure to identify it. The aim of the study was to evaluate and characterize the EOV of patients with HF using the ventilation dispersion index (VDI). METHODS AND RESULTS: Patients underwent cardiopulmonary exercise testing (CPX), EOV was assessed by 2 reviewers and the VDI was calculated. The receiver operator curve analysis was used to assess the ability of the VDI to predict EOV. Pearson's correlation test was performed to determine the relationship between VDI and CPX variables. Forty-three patients with HF underwent CPX and were divided into 2 groups: with a VDI of less than 0.601 and a VDI of 0.601 or greater. An area under the curve of 0.759 was observed in the receiver operator curve analysis between VDI and EOV (P = .008). The VDI showed a significant correlation with the ventilatory CPX variables. According to the cut-off point obtained on the receiver operator curve, patients with a VDI of 0.601 or greater had lower left ventricular ejection fraction and higher values of resting minute ventilation and peak minute ventilation. CONCLUSIONS: The VDI proved to be a good predictor of EOV in patients with HF.

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Stress is a major risk factor for bipolar disorder. Even though we do not completely understand how stress increases the risk for the onset and poorer course of bipolar disorder, knowledge of stress physiology is rapidly evolving. Following stress, stress hormones - including (nor)adrenaline and corticosteroid - reach the brain and change neuronal function in a time-, region-, and receptor-dependent manner. Stress has direct consequences for a range of cognitive functions which are time-dependent. Directly after stress, emotional processing is increased at the cost of higher brain functions. In the aftermath of stress, the reverse is seen, i.e., increased executive function and contextualization of information. In bipolar disorder, basal corticosteroid levels (under non-stressed conditions) are generally found to be increased with blunted responses in response to experimental stress. Moreover, patients who have bipolar disorder generally show impaired brain function, including reward processing. There is some evidence for a causal role of (dysfunction of) the stress system in the etiology of bipolar disorder and their effects on brain system functionality. However, longitudinal studies investigating the functionality of the stress systems in conjunction with detailed information on the development and course of bipolar disorder are vital to understand in detail how stress increases the risk for bipolar disorder.

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ABSTRACT Introduction: The two-dimensional (2D) methods of dynamic assessment of knee valgus are popular because of their low cost and the fact that they are easy to implement. It is believed that dynamic valgus of the knee is one of the main disorders responsible for non-contact lesions of the anterior cruciate ligament. There are two categories of reliability with regard to data collectors: inter-rater (reliability among multiple data collectors) and intra-rater (reliability of a single data collector). Objectives: To assess intra and inter-rater reliability during the step-down test in professional soccer athletes, using initial and final angles for each test repetition. Methods: The sample consisted of 29 professional soccer players. All study participants were considered by club physiotherapists to be free of any musculoskeletal injury and were performing daily training tasks. Two male evaluators participated in the study. Results: For each data group, mean and standard deviation were determined. The intra- and inter-rater reliability of all data was determined using the intraclass correlation coefficient (ICC), with a confidence interval of 95% and alpha of p ≤ 0.05. Rater 1 was classified in the first intra-rater stage of the analysis for heel touch, with good to excellent reliability. For the inter-rater analysis, both for heel touch and for greater valgus angle, there was excellent reliability among the raters. Conclusion: It was concluded that there is high inter-rater and intra-rater reliability through two-dimensional analysis using the Step Down Test in professional soccer athletes. Level of evidence II; Development of diagnostic criteria in consecutive patients (with a "gold" reference standard applied).

RESUMO Introdução: Os métodos bidimensionais (2D) de avaliação dinâmica de valgo de joelho são populares devido ao baixo custo e à grande facilidade de implementação. Acredita-se que o valgo dinâmico do joelho seja um dos principais responsáveis pelas lesões do ligamento cruzado anterior sem contato direto. Existem duas categorias de confiabilidade com relação aos coletores de dados: confiabilidade entre vários coletores, que é a confiabilidade interavaliador e a confiabilidade de um único coletor de dados, denominada confiabilidade intra-avaliador. Objetivos: Avaliar a confiabilidade intra e interavaliadores durante o Step Down Test em atletas profissionais de futebol, utilizando angulações iniciais e finais de cada repetição do teste. Métodos: A amostra foi composta por 29 jogadores de futebol profissional. Todos os participantes do estudo foram considerados livres de qualquer lesão musculoesquelética por fisioterapeutas do clube e estavam realizando tarefas diárias de treinamento. Dois avaliadores do sexo masculino participaram do estudo. Resultados: Para cada grupo de dados, a média e o desvio padrão foram determinados. A confiabilidade intra e interavaliadores de todos os dados foi determinada pelo coeficiente de correlação intraclasse (ICC), com intervalo de confiança de 95% e alfa de p ≤ 0,05. O avaliador 1 foi classificado no primeiro passo intra-avaliador da análise para toque do calcanhar com boa a excelente confiabilidade. Para análise interavaliadores, tanto para o toque do calcanhar quanto para maior ângulo valgo, houve excelente confiabilidade entre os avaliadores. Conclusão: Existe alta confiabilidade interavaliador e intra-avaliador por meio da análise bidimensional utilizando o Teste Step Down em atletas profissionais de futebol. Nível de evidência II; Desenvolvimento de critérios diagnósticos em pacientes consecutivos (com padrão de referência "ouro" aplicado).

RESUMEN Introducción: Los métodos bidimensionales (2D) de evaluación dinámica de valgo de rodilla son populares debido al bajo costo y a la gran facilidad de implementación. Se cree que el valgo dinámico de rodilla sea uno de los principales responsables por las lesiones del ligamiento cruzado anterior sin contacto directo. Existen dos categorías de confiabilidad con relación a los colectores de datos: confiabilidad entre varios colectores, que es la confiablidad interevaluador y la confiabilidad de un único colector de datos, denominada confiabilidad intraevaluador. Objetivos: Evaluar la confiabilidad intra e interevaluadores durante el Step Down Test en atletas profesionales de fútbol, utilizando angulaciones iniciales y finales de cada repetición del test. Métodos: La amuestra fue compuesta por 29 jugadores de fútbol profesional. Todos los participantes del estudio fueron considerados libres de cualquier lesión musculoesquelética por fisioterapeutas del club y estaban realizando tareas diarias de entrenamiento. Dos evaluadores de sexo masculino participaron del estudio. Resultados: Para cada grupo de datos, fueron determinados el promedio y la derivación estándar. La confiabilidad intra e interevaluadores de todos los datos fue determinada por el coeficiente de correlación intraclase (ICC), con intervalo de confianza de 95% y alfa de p ≤ 0,05. El evaluador 1 fue clasificado en el primer paso interevaluador del análisis para toque del talón con buena a excelente confiabilidad. Para análisis interevaluadores tanto para o toque del talón como para mayor ángulo valgo, hubo excelente confiabilidad entre los evaluadores. Conclusión: Existe alta confiabilidad interevaluador e intraevaluador por medio del análisis bidimensional utilizando el Test Step Down en atletas profesionales de fútbol. Nivel de evidencia II; Desarrollo de criterios diagnósticos en pacientes consecutivos (con estándar de referencia "oro" aplicado).

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The RR-interval time series or tachograms obtained from electrocardiograms have been widely studied since they reflect the cardiac variability, and this is an indicative of the health status of a person. The tachogram can be seen as a highly non-linear and complex time series, and therefore, should be analyzed with non-linear techniques. In this work, several entropy measures, Sample Entropy (SampEn), Approximate Entropy (ApEn), and Fuzzy Entropy (FuzzyEn) are used as a measure of heart rate variability (HRV). Tachograms belonging to thirty-nine subjects were obtained from a cardiac stress test consisting of a rest period followed by a period of moderate physical activity. Subjects are grouped according to their physical activity using the IPAQ sedentary and active questionnaire, we work with youth and middle-aged adults. The entropy measures for each group show that for the sedentary subjects the values are high at rest and decrease appreciably with moderate physical activity, This happens for both young and middle-aged adults. These results are highly reproducible. In the case of the subjects that exercise regularly, an increase in entropy is observed or they tend to retain the entropy value that they had at rest. It seems that there is a possible correlation between the physical condition of a person with the increase or decrease in entropy during moderate physical activity with respect to the entropy at rest. It was also observed that entropy during longer physical activity tests tends to decrease as fatigue accumulates, but this decrease is small compared to the change that occurs when going from rest to physical activity.

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Introducción: Existen beneficios en salud al realizar ejercicio físico, sin embargo, son pocas las investigaciones que reportan el rendimiento anaeróbico y su correlación con indicadores cardiorrespiratorios. Por tal motivo, el propósito de esta investigación fue determinar valores de rendimiento cardiorrespiratorio y aptitud anaeróbica después de un programa de ejercicio aeróbico en el cual se determinó la correlación entre ellos. Métodos: 22 hombres (20±2 años) conformaron dos grupos, G1-(entrenamiento), 6 semanas/tres días por semana, intensidad horaria de 45 minutos/día, G2-(Control). Antes y después realizaron un test de Wingate y una prueba de esfuerzo de predominancia aeróbica. Resultados: Aumentos significativos entre el pre-pos en G1 en VO2máx y vatios que mejoraron 7,6 % y 15,9 % respectivamente, diferencia significativa en la PP y en PM/kg con una mejora del 18,8 % y 18,9 %, respectivamente. Conclusión: Un programa de ejercicio aeróbico submáximo en bicicleta estática aumenta el rendimiento cardiorrespiratorio y rendimiento anaeróbico sin que exista una relación de dependencia entre las diferentes variables.

Introduction: There are health benefits when performing physical exercise, however, there are few investigations that report anaerobic performance and its correlation with cardiorespiratory indicators, for this reason, the purpose of this research was to determine the values of cardiorespiratory performance and anaerobic fitness after an aerobic exercise program determining the correlation between them. Method: 22 men (20 ± 2 years), were divided into two groups, G1 (training), 6 weeks, three days a week with an hourly intensity of 45 minutes per day, G2 (control). Before and after exercise they performed a Wingate test and a predominantly aerobic stress test. Results: Significant increases between pre-post in G1 in VO2Max and watts improving 7.6% and 15.9% respectively, a significant difference in PP and PM/kg improving 18.8% and 18.9% respectively. Conclusion: A submaximal aerobic exercise program on a stationary bike increases cardiorespiratory performance and anaerobic performance without a dependency relationship between the different variables.

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RESUMEN Introducción: La obesidad es una enfermedad multisistémica que constituye un factor de riesgo coronario y se asocia frecuentemente a otros, como la hipertensión arterial, la diabetes y la dislipidemia, todo lo cual aumenta el riesgo de enfermedad cardiovascular. Objetivo: Determinar la respuesta cardiovascular de los pacientes con obesidad durante una prueba de esfuerzo. Método: Estudio observacional, descriptivo y transversal con 67 participantes obesos (45 mujeres y 22 hombres), con promedio de edad de 35±12,6 años. Para el desarrollo de esta investigación se obtuvieron variables antropométricas, signos vitales, escala de Borg, cuestionario para factores de riesgo cardiovascular, y se realizó una prueba de esfuerzo en tapiz rodante con protocolo de Bruce. Resultados: Los principales factores de riesgo cardiovascular encontrados fueron el sedentarismo (100%) y los antecedentes patológicos familiares (76%). Se obtuvo una frecuencia cardíaca máxima promedio de 172,82±18,81 latidos por minuto, que fue superior en las mujeres (173,9±17,5 vs. 168,9±22,1) y al asociarla con los factores de riesgo cardiovascular se encontró que fue mayor en los pacientes con menos de 4 factores de este tipo (179,4±17,7 vs. 167,1±18,6). Conclusiones: Se encontró una disminución de la respuesta cardiovascular en relación con el esfuerzo esperado para la prueba de esfuerzo. A mayor número de factores de riesgo cardiovascular presentes, menor fue la frecuencia cardíaca máxima alcanzada.

ABSTRACT Introduction: Obesity is a multisystemic disease and a coronary risk factor that is frequently associated with others, such as high blood pressure, diabetes and dyslipidemia. These all increase the risk of heart disease. Objective: We aimed to determine the cardiovascular response of obese patients during a stress test. Methods: An observational, descriptive and cross-sectional study was conducted with 67 obese participants (45 women and 22 men) aged 35±12.6 years on average. To develop our research, we analyzed anthropometric variables and vital signs. The Borg scale, a cardiovascular risk factor interview and a Bruce treadmill stress test protocol were also applied. Results: The main cardiovascular risk factors found were sedentary lifestyle (100%) and family history of disease (76%). An average maximum heart rate of 172.82±18.81 beats per minute was obtained, which was higher in women (173.9±17.5 vs. 168.9±22.1). It was found to be higher in patients with less than four cardiovascular risk factors (179.4±17.7 vs. 167.1±18.6) when associated with cardiovascular risk factors. Conclusions: A decrease in cardiovascular response was found in relation to the expected test effort. The greater the number of cardiovascular risk factors, the lower the maximum heart rate achieved.

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Abstract Introduction: nowadays, with the increase of world obesity and the numbers of morbidly obese people, a concerning public health problem that is difficult to solve rises up. Objective: to analyse the physiological responses after the 6-minute walk tests and maximum stress test in the arm cycle ergometer in morbidly obese pre-bariatric surgery women. Methods: fifteen level III obesity women aged 35.6 ± 6.6 years took part in this experiment. Firstly, they went through an anamnesis and body composition analysis; secondly, they were submitted to a 6-minute walk test and a maximum stress test in arm cycle ergometer on alternate days. Results: patients were able to perform the maximum stress test and showed better aerobic potentials in the arm cycle ergometer than in the 6-minute walk test. No significant differences were found between SPO2 and diastolic blood pressure between the moments of rest and after the tests, neither in the systolic blood pressure after the 6-minute walk test and the values of rest and post 5 minutes in the maximum stress test. The main differences found were between the maximum systolic blood pressure in the cycle ergometer test and the other moments and the heart rate after the tests and the heart rate at rest. Conclusion: the maximum stress test in arm cycle ergometer is a safe method that allows greater requirement and control applied to the heart system than in the 6-minute walk test. In addition, it allows the development of a more individualized aerobic training and prescription of aerobic physical exercise program.

Resumen Introducción: Actualmente, con el aumento de la obesidad en el mundo y del número de obesos mórbidos se evidencia un problema de salud pública de difícil resolución. Objetivo: analizar las respuestas fisiológicas tras las pruebas de caminata de 6 minutos y de esfuerzo máximo en cicloergómetro de brazos en obesas mórbidas precirugía bariátrica. Métodos: se evaluaron 15 mujeres con obesidad grado III con edad media de 35,6 ± 6,6 años, las cuales participaron inicialmente de una anamnesis con el análisis de la composición corporal y posteriormente participaron en días alternos de la prueba de 6 minutos de caminata y del mismo, prueba de esfuerzo máximo en cicloergómetro de brazos. Resultados: las pacientes lograron realizar la prueba de esfuerzo máximo y demostraron mejores potenciales aeróbicos en el cicloergómetro de brazos que en la prueba de caminata. No se encontraron diferencias significativas entre la SPO2 y la presión arterial diastólica entre los momentos de reposo y después de las pruebas y también en la presión arterial sistólica posterior a la prueba de caminata y los valores de reposo y después de 5 minutos en la prueba de esfuerzo máximo. Las principales diferencias se observaron entre la presión arterial sistólica máxima en la prueba en cicloergómetro y los otros momentos y en la frecuencia cardiaca después de las pruebas y las frecuencias cardiacas en reposo. Conclusión: la prueba de esfuerzo máximo en cicloergómetro de brazos es un método seguro que posibilita mayor exigencia y control aplicado al sistema cardíaco que en la prueba de caminata. Adicionalmente, permite un programa de entrenamiento y una prescripción del ejercicio físico aeróbico más individualizados.

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BACKGROUND: Interstitial fibrosis (IF) on kidney biopsy is one of the most potent risk factors for kidney disease progression. The furosemide stress test (FST) is a validated tool that predicts the severity of acute kidney injury (especially at 2 h) in critically ill patients. Since furosemide is secreted through the kidney tubules, the response to FST represents the tubular secretory capacity. To our knowledge there is no data on the correlation between functional tubular capacity assessed by the FST with IF on kidney biopsies from patients with chronic kidney disease (CKD). The aim of this study was to determine the association between urine output (UO), Furosemide Excreted Mass (FEM) and IF on kidney biopsies after a FST. METHODS: This study included 84 patients who underwent kidney biopsy for clinical indications and a FST. The percentage of fibrosis was determined by morphometry technique and reviewed by a nephropathologist. All patients underwent a FST prior to the biopsy. Urine volume and urinary sodium were measured in addition to urine concentrations of furosemide at different times (2, 4 and 6 h). We used an established equation to determine the FEM. Values were expressed as mean, standard deviation or percentage and Pearson Correlation. RESULTS: The mean age of the participants was 38 years and 44% were male. The prevalence of diabetes mellitus, hypertension and diuretic use was significantly higher with more advanced degree of fibrosis. Nephrotic syndrome and acute kidney graft dysfunction were the most frequent indications for biopsy. eGFR was inversely related to the degree of fibrosis. Subjects with the highest degree of fibrosis (grade 3) showed a significant lower UO at first hour of the FST when compared to lower degrees of fibrosis (p = 0.015). Likewise, the total UO and the FEM was progressively lower with higher degrees of fibrosis. An inversely linear correlation between FEM and the degree of fibrosis (r = - 0.245, p = 0.02) was observed. CONCLUSIONS: Our findings indicate that interstitial fibrosis correlates with total urine output and FEM. Further studies are needed to determine if UO and FST could be a non-invasive tool to evaluate interstitial fibrosis. TRIAL REGISTRATION: ClinicalTrials.gov NCT02417883.

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ABSTRACT BACKGROUND: Dyspnea and poorer physical performance are conditions that may be related and be present among the elderly. However, few studies have evaluated associations between these variables. OBJECTIVE: To determine whether there is an association between dyspnea and physical performance among community-dwelling older adults of both sexes (age 60 years and over). DESIGN AND SETTING: Cross-sectional study conducted in the city of Macapá, state of Amapá, Brazil. METHODS: Socioeconomic and health data were collected using a structured form. Frailty syndrome was assessed based on the frailty phenotype proposed by Fried et al. Dyspnea was measured using the modified Medical Research Council (mMRC) scale and physical performance was measured using the Short Physical Performance Battery (SPPB). Data were analyzed using a linear regression model. RESULTS: A total of 411 subjects (70.15 ± 7.25 years) were evaluated, most of them females (66.4%). It was observed from the mMRC scale that 30.9% (n = 127) of the subjects had some dyspnea symptoms: grade 1 was most frequent. The physical performance score from the SPPB was 9.22 ± 2.01. Higher dyspnea scores were associated with poor physical performance, both in the crude analysis (β = -0.233; P = 0.028) and after adjustment for frailty condition (β = -0.148; P = 0.002) and for the socioeconomic and health variables (age, sex, number of diseases, smoking habit and frailty status) (β = -0.111; P = 0.025). CONCLUSION: Higher dyspnea score was independently associated with poor physical performance among community-dwelling older adults.

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INTRODUCTION: Eugenia umbelliflora fruits are an important source of phloroglucinols, as eugenial C and eugenial D, related to antimicrobial activity against Staphylococcus aureus. However, for the establishment of new antimicrobial substances, it is essential to know their stability profile, in view of driving the administration route and the release system development. METHODOLOGY: The in silico approaches, based on the Fukui indices and bond dissociation analysis, were performed. Eugenial C and eugenial D, isolated from the green fruits of E. umbelliflora, with purity > 90%, were submitted to stress degradation including: acid (0.5 mM hydrochloric acid) and alkaline (0.5 mM sodium hydroxide) hydrolysis, and oxidation (0.25% hydrogen peroxide), in different periods, monitoring by high-performance liquid chromatography with ultraviolet detector (HPLC-UV). Eugenial C was also submitted to UV-visible radiation (2,400 lux/h) and dry/humid heating (40°C, 75% relative humidity). RESULTS: In silico studies indicated that both molecules have regions of high susceptibility to nucleophilic and electrophilic attack as well as sites likely to suffer auto-oxidation. Under in vitro tests, both phloroglucinols proved to be very unstable under hydrolysis (eugenial C and D were degraded 23.8% and 89.0% in acid and 78.4% and 97.8% in alkaline conditions, respectively) and oxidation (eugenial C and D degraded 31.9% and 28.6%, respectively), both during 5 min. Eugenial C degraded 12.6% and 63.8% under dry and humid heat, respectively, without photosensitivity. CONCLUSION: The in vitro stress tests monitored by HPLC-UV were in agreement with in silico degradation prediction. Phloroglucinols could be unstable if administered by oral route and also under environmental conditions demanding a protective release system.

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