Nandrolone Decanoate and Physical Effort: Histological and Morphometrical Assessment in Adult Rat Uterus

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

OVARIAN HISTOLOGY and FOLLICULAR SCORE IN FEMALE RATS TREATED WITH NANDROLONE DECANOATE and SUBMITTED TO PHYSICAL EFFORT

The study was conducted to analyze the histology of the ovaries of adults rats treated with steroids, and submitted or not to physical effort. The control group consisted of females submitted to physical effort and sedentary females, both of which received a physiological solution of 0.9% saline. Treated females, sedentary or not, received 6 mg/kg of body weight of nandrolone decanoate. The steroid and physiological solution were administered intraperitoneally, with a single injection per week for 4 consecutive weeks. The applied physical effort was swimming (20 minutes daily, 5 days/week, for the 4 weeks of treatment). Serial sections (5 mu m) of ovaries were prepared for histological evaluation and follicular score. The weight of ovaries and hypophysis, the number of antral and atretic follicles, and the area of corpus luteum were all affected by the steroids. In the ovaries of the control groups, well-developed corpus luteum was observed. In the treated groups, the cortical stroma was occupied by ovarian interstitial tissue. The females treated with steroids presented estral acyclicity. The use of nandrolone decanoate, whether associated with physical effort or not, affected the morphological pattern of the ovaries.

A new measurement of energy expenditure and physical activity in patients treated by maintenance hemodialysis

Purpose: The accurate estimation of total energy expenditure (TEE) is essential to allow the provision of nutritional requirements in patients treated by maintenance hemodialysis (MHD). The measurement of TEE and resting energy expenditure (REE) by direct or indirect calorimetry and doubly labeled water are complicated, timeconsuming and cumbersome in this population. Recently, a new system called SenseWear® armband (SWA) was developed to assess TEE, physical activity and REE. This device works by measurements of body acceleration in two axes, heat production and steps counts. REE measured by indirect calorimetry and SWA are well correlated. The aim of this study was to determine TEE, physical activity and REE on patients on MHD using this new device. Methods and materials: Daily TEE, REE, step count, activity time, intensity of activity and lying time were determined for 7 consecutive days in unselected stable patients on MHD and sex, age and weightmatched healthy controls (HC). Patients with malnutrition, cancer, use of immunosuppressive drugs, hypoalbumemia <35 g/L and those hospitalized in the last 3 months, were excluded. For MHD patients, separate analyses were conducted in dialysis and non-dialysis days. Relevant parameters known to affect REE, such as BMI, albumin, pre-albumin, hemoglobin, Kt/V, CRP, bicarbonate, PTH, TSH, were recorded. Results: Thirty patients on MHD and 30 HC were included. In MHD patients, there were 20 men and 10 women. Age was 60,13 years ± 14.97 (mean ± SD), BMI was 25.77 kg/m² ± 4.73 and body weight was 74.65 kg ± 16.16. There were no significant differences between the two groups. TEE was lower in MHD patients compared to HC (28.79 ± 5.51 SD versus 32.91 ± 5.75 SD kcal/kg/day; p <0.01). Activity time was significantly lower in patients on MHD (101.3 ± 12.6SD versus 50.7 ± 9.4 SD min; p = 0.0021). Energy expenditure during the time of activity was significantly lower in MHD patients. MHD patients walked 4543 ± 643 SD vs 8537 ± 744 SD steps per day (p <0.0001). Age was negatively correlated with TEE (r = -0.70) and intensity of activity (r = -0.61) in HC, but not in patients on MHD. TEE showed no difference between dialysis and non-dialysis days (29.92 ± 2.03 SD versus 28.44 ± 1.90 SD kcal/kg/day; p = NS), reflecting a lack of difference in activity (number of steps, time of physical activity) and REE. This finding was observed in MHD patients both older and younger than 60 years. However, age stratification appeared to have an influence on TEE, regardless of dialysis day, (29.92 ± 2.07 SD kcal/kg/day for <60 years-old versus 27.41 ± 1.04 SD kcal/kg/day for ≥60 years old), although failing to reach statistical significance. Conclusion: Using SWA, we have shown that stable patients on MHD have a lower TEE than matched HC. On average, a TEE of 28.79 kcal/kg/day, partially affected by age, was measured. This finding gives support to the clinical impression that it is difficult and probably unnecessary to provide an energy amount of 30-35 kcal/kg/day, as proposed by international guidelines for this population. In addition, we documented for the first time that MHD patients exert a reduced physical activity as compared to HC. There were surprisingly no differences in TEE, REE and physical activity parameters between dialysis and non-dialysis days. This observation might be due to the fact that patients on MHD produce a physical effort to reach the dialysis centre. Age per se did not influence physical activity in MHD patients, contrary to HC, reflecting the impact of co-morbidities on physical activity in this group of patients.

Évaluation de la régulation de l'oxygénation dans les capillaires de la tête du nerf optique suivant un effort physique dynamique

Il est généralement accepté que les lits vasculaires oculaires auraient la faculté d’autoréguler leur apport sanguin afin de contrebalancer les variations de pression de perfusion oculaire (PPO). Plusieurs études ont tenté d’évaluer ce mécanisme en mesurant les effets d’une variation de la PPO - induite par un exercice ou par une augmentation de la pression intra-oculaire (PIO) à l’aide d’une suction sclérale - sur le débit sanguin oculaire (DSO). Or, les méthodes de mesure du DSO utilisées jusqu'à maintenant présentent de nombreux désavantages et limites, ce qui rend difficile leur usage clinique. De récents développements dans le domaine des investigations non-invasives des paramètres sanguins oculaires proposent un modèle capable de mesurer en temps réel la concentration en oxygène, un autre paramètre important du métabolisme rétinien. Dans le cadre de la présente étude, ce nouveau modèle est utilisé afin de mesurer les effets d’un effort physique dynamique sur la concentration d’oxygène dans les capillaires de la tête du nerf optique (COTNO) de sujets jeunes et en santé. Six jeunes hommes non fumeurs ont participé à l’étude. L’effort physique dynamique consistait en une séance de bicyclette stationnaire de 15 minutes menant à une augmentation du pouls à 160 battements par minute. La COTNO était mesurée avant et immédiatement après la séance d’exercice. La pression artérielle (PA) et la PIO étaient mesurées ponctuellement alors que le pouls et la saturation sanguine en oxygène (SpO2) au niveau digital étaient mesurés tout au long de l’expérience. L’effort physique a entrainé une réduction de la PIO chez tous les sujets, une réduction de la COTNO chez tous les sujets sauf un tandis que la SpO2 demeura constante chez tous les sujets. Une corrélation quadratique entre les variations de la PIO et de la COTNO a pu être notée. Ces résultats suggèrent une corrélation directe entre les variations de la COTNO et celles de la PPO et de la PA. Les résultats de la présente étude suggèrent que les variations de la COTNO chez un sujet en santé suite à un effort physique dynamique pourraient représenter sa capacité à compenser un tel effort. De plus, les changements métaboliques sanguins induits par l’effort physique dynamique pourraient représenter une cause commune aux variations de la PIO et de la COTNO.

Adaptações cardio-respiratorias em atletas : estudo em diferentes fases do treinamento fisico

Universidade Estadual de Campinas. Faculdade de Educação Física

Estudo da frequencia cardiaca de atletas de handebol segundo situação de jogo, durante 3 partidas oficiais dos 42º Jogos Regionais da Zona Leste do Estado de São Paulo

Universidade Estadual de Campinas . Faculdade de Educação Física

Quality of life, life satisfaction and happiness in shift- and non-shiftworkers

OBJECTIVE: To investigate the quality of life, life satisfaction, happiness and demands of work in workers with different work schedules. METHODS: The survey was carried out on professional workers in social care. Some were shiftworkers whose schedule included night shifts (N=311), some were shiftworkers without night shifts (N=207) and some were non-shiftworkers (N=1,210). Surveys were mailed and the response rate was 86%. For the purpose of this study several variables were selected from the Survey: The Quality of Life Profile, which measures importance, satisfaction, control and opportunities in nine domains of life plus measures of happiness, life satisfaction and demands of work. RESULTS: While both groups of shiftworkers, compared to non-shiftworkers, reported needing more physical effort to complete their work, and reported 'being' more physically tired, no differences were found in reports of overall happiness, life satisfaction or total quality of life. However, night-shiftworkers reported greater percentage of time unhappy than the other two groups of workers. In analyses of the quality of life, night-shiftworkers were less satisfied with domains of spiritual 'being' and physical and community 'belonging' than day-shiftworkers and non-shiftworkers. They also reported having fewer opportunities to improve their physical 'being', leisure, and personal growth than the other two groups. CONCLUSIONS: Quality of life in specific domains in night-shiftworkers was rated worse than in other groups of workers. Domain-based quality of life assessment gives more information regarding the particular needs of workers than overall or global measures of well-being.

Paul Auster and the music of change: building new stories

In the work of Paul Auster (Newark, 1947 - ), we find two main themes: the sense of loss and existential drift and the loneliness of the individual fully committed to the work of writing, as if he had been confined to the book that commands his life. However, this second theme is clearly the dominant one because the character's space of solitude may include its own wandering, because this wandering is also often performed inside the four walls of a room, just like it is narrated inside the space of the page and the book. Both in his poetry, essays and fiction, Auster seems to face the work of writing as an actual physical effort of effective construction, as if the words that are aligned in the poem-text were stones to place in a row when building a wall or some other structure in stone.

Actualities on Nuclear Medicine Applications in Sports Medicine

Aims: This paper aims to address some of the main possible applications of actual Nuclear Medicine Imaging techniques and methodologies in the specific context of Sports Medicine, namely in two critical systems: musculoskeletal and cardiovascular. Discussion: At the musculoskeletal level, bone scintigraphy techniques proved to be a mean of diagnosis of functional orientation and high sensibility compared with other morphological imaging techniques in the detection and temporal evaluation of pathological situations, for instance allowing the acquisition of information of great relevance in athletes with stress fractures. On the other hand, infection/inflammation studies might be of an important added value to characterize specific situations, early diagnose of potential critical issues – so giving opportunity to precise, complete and fast solutions – while allowing the evaluation and eventual optimization of training programs. At cardiovascular system level, Nuclear Medicine had proved to be crucial in differential diagnosis between cardiac hypertrophy secondary to physical activity (the so called "athlete's heart") and hypertrophic cardiomyopathy, in the diagnosis and prognosis of changes in cardiac function in athletes, as well as in direct - and non-invasive - in vivo visualization of sympathetic cardiac innervation, something that seems to take more and more importance nowadays, namely in order to try to avoid sudden death episodes at intense physical effort. Also the clinical application of Positron Emission Tomography (PET) has becoming more and more widely recognized as promising. Conclusions: It has been concluded that Nuclear Medicine can become an important application in Sports Medicine. Its well established capabilities to early detection of processes involving functional properties allied to its high sensibility and the actual technical possibilities (namely those related with hybrid imaging, that allows to add information provided by high resolution morphological imaging techniques, such as CT and/or MRI) make it a powerful diagnostic tool, claiming to be used on an each day higher range of clinical applications related with all levels of sport activities. Since the improvements at equipment characteristics and detection levels allows the use of smaller and smaller doses, so minimizing radiation exposure it is believed by the authors that the increase of the use of NM tools in the Sports Medicine area should be considered.

Análise da relação entre intensidade da actividade física realiada com a sensação subjectiva de esforço na população com idade igual ou superior a 75 anos

RESUMO: Objectivo: O objectivo geral do estudo é analisar a relação entre intensidade da actividade física (AF) realizada pela população idosa com 75 anos ou mais, com a respectiva sensação subjectiva de esforço (SSE). Introdução: Em Portugal, e de acordo o Instituto Nacional de Estatística, em 2011 cerca de 19% da população tem mais de 65 anos. Em 2050, as estimativas apontam que esta percentagem seja de 25%, ou seja, um quarto do país. O envelhecimento propicía um declínio físico e funcional, e para o retardar estão recomendados 150 minutos por semana de AF moderada. A forma como tem sido avaliada a AF tem por base um pressuposto de comparação com valores de gasto energético de uma população com uma média de 40 anos. É fundamental a realização de estudos que analisem a associação entre o nível de intensidade de AF com a SSE, para aferir se esta comparação é transponível para esta faixa etária. Metodologia: Trata-se de um estudo observacional analítico transversal, com uma amostra constituída por 39 participantes, com uma mediana 77,0 anos de idade (percentil 25: 76,0; percentil 75: 80,0), sendo a mínima 75 e a máxima 86 anos. As variáveis são a SSE e a intensidade de cada actividade realizada. O protocolo de avaliação foi constituído pelo questionário de caracterização sóciodemográfica, Diário de AF e a Escala de Borg RPE 6-20. Resultados: Existe uma associação negativa significativa entre a idade e o gasto energético total (rs = -0,365, p=0,022) e uma associação negativa, moderada e significativa entre a idade e a SSE reportada média (rs = -0,521, p=0,001) e máxima (rs = -0,465, p=0,003). Observou-se uma associação positiva e significativa entre a SSE máxima diária e o tempo total dedicado a actividades físicas (r=0,367 e p=0,022) e o gasto energético total (r=0,569, p<0,001). Verificou-se igualmente que quanto maior o gasto energético total diário, maior a média da SSE (r=0,411; p=0,009). Existe uma concordância moderada e significativa (Kappa=0,475; p<0,001) entre a sensação reportada pelo participante e a classificação atribuída em cada actividade pelo Compêndio de Actividades Físicas (Ainsworth et al, 1993). No entanto, com uma tendência para a subestimação dos MET’s atribuídos a cada actividade Conclusão: Os resultados do estudo sugerem que existe uma associação positiva e significativa entre intensidade da AF realizada e a SSE, aquando da realização da mesma actividade. Apesar desta associação ser moderada, este estudo sugere que a classificação que o Compêndio utiliza não é directamente aplicável à população idosa com 75 anos ou mais.-------------ABSTRACT: Purpose: The overall objective of the study is to analyze the relationship between intensity of physical activity performed by the elderly population with 75 years or more with their subjective feeling of effort. Background: In Portugal, according with data from Instituto Português de Estatística, in 2011 aproximately 19% of the population has more than 65 years old. In 2050, estimates suggest that this percentage will be 25%, which means a quarter of the country. The way in which physical activity has been evaluated is based on a comparing assumption with values of energy expenditure in a population with an average of 40 years. It is critical to conduct studies to examine the association between the level of intensity of physical activity with the subjective feeling of effort, to assess whether this comparison is applied to this age group. Methods: This is a cross sectional observational study with a sample of 39 participants, with a median age of 77.0 years (25th percentile: 76.0; 75th percentile: 80.0), with the minimum age 75 years and maximum age 86 years. The variables are the subjective feeling of physical effort and intensity of each activity. It was applied one protocol evaluation consisting of a questionnaire of sociodemographic characteristics, A journal of physical activities and Borg RPE 6-20 scale. Results: There is a significant negative association between age and total energy expenditure (rs = -0.365, p = 0.022) and a negative, moderate and significant association between age and average (rs = -0.521, p = 0.001) and maximum subjective feeling of exertion reported (rs = -0.465, p = 0.003). There was a significant positive association between the subjective feeling of daily maximum effort and total time spent on physical activity (r = 0.367 and p = 0.022) and total energy expenditure (r = 0.569, p <0.001). It was also found that the higher the total daily energy expenditure, the higher the average of the subjective sense of effort (r = 0.411, p = 0.009). There is a moderate and significant correlation (kappa = 0.475, p <0.001) between the sensation reported by the participant and the rank assigned to each activity by Compendium of Physical Activities (Ainsworth et al, 1993). However, there is a tendency to over-estimate the subjective feeling of effort, or underestimation of METs assigned to each activity Conclusion: Study results suggest a positive and significant association between the level of intensity of physical activity and the subjective feeling of exertion, within the same activity. Even though this association is moderated, this study suggests that the Compendium of Physical Activities rating doesn’t suit for individuals with 75 years old or more.

Comparing standard and low-cost tools for gradient evaluation along potential cycling paths

Promoting the use of non-motorized modes of transport, such as cycling, is an important contribution to the improvement of mobility, accessibility and equity in cities. Cycling offers a fast and cheap transportation option for short distances, helping to lower pollutant emissions and contributing to a healthier way of life. In order to make the cycling mode more competitive in relation to motorized traffic, it is necessary to evaluate the potential of alternatives from the perspective of the physical effort. One way to do so consists of assessing the suitability of locations for implementing cycling infrastructures. In this work, four tools to determine the gradient along potential cycling paths are compared. Furthermore, an evaluation of the reliability of some low-cost tools to measure this parameter was conducted, by comparison with standard measurements using cartographic plans, on a field case study applied to the city of Braga, Portugal. These tools revealed a good level of accuracy for the planning stage, but proved to be less reliable for use in design.

Catecholaminergic polymorphic ventricular tachycardia. An important diagnosis in children with syncope and normal heart

Syncope in children is primarily related to vagal hyperreactivity, but ventricular tachycardia (VT) way rarely be seen. Catecholaminergic polymorphic VT is a rare entity that can occur in children without heart disease and with a normal QT interval, which may cause syncope and sudden cardiac death. In this report, we describe the clinical features, treatment, and clinical follow-up of three children with syncope associated with physical effort or emotion and cathecolaminergic polymorphic VT. Symptoms were controlled with beta-blockers, but one patient died suddenly in the fourth year of follow-up. Despite the rare occurrence, catecholaminergic polymorphic VT is an important cause of syncope and sudden death in children with no identified heart disease and normal QT interval.

Fontan Operation and the Cavopulmonary Technique: Immediate and Late Results According to the Presence of Atrial Fenestration

OBJECTIVE: To compare immediate and late results in patients with or without fenestration who underwent cavopulmonary anastomosis so that we could assess the efficiency of the technique. METHODS: Sixty-two patients underwent surgery between 1988 and 1999, 41 with fenestration (group I -G I) and 21 without fenestration (group II -G II). Tricuspid atresia was prevalent in group I (23-56%) and single ventricle was prevalent in group II (14-66%). Mean ages at the time of operation were 7.3 years in group I and 7.6 in group II. At late follow-up, mean ages were 10.6 years in group I and 12.8 years in group II. RESULTS: Immediate and late mortality were 7.3% in G-I and 4.7% in G-II. Significant pleural effusion occurred in 41.4% of G-I patients and in 23.8% of G-II patients. Significant pericardial effusion occurred in 29.2% and 14.2%, respectively, in groups I and II. Central venous pressure was greater in G-II, 17.7 cm in H2O, as opposed to 15 cm in G-I. Hospital stay was similar between the groups, 26.3 and 21.8 days, respectively. Cyanosis and arterial insaturation occurred in 5 patients, and 4 patients were in functional class II, all from G-I. At late follow-up, 58 (93.5%) were in functional class I. Sinus rhythm was present in 94%, and pulmonary perfusion was similar in both groups. Eleven patients who underwent spirometry had good tolerance to physical effort. CONCLUSION: Atrial fenestration did not improve the immediate or late follow-up of patients who underwent cavopulmonary anastomosis, and is, therefore, dispensable.