Jefferson Petto

Comparison of Postprandial Lipemia between Women who are on Oral Contraceptive Methods and Those who are not

Background: Postprandial Lipemia (PPL) is a physiological process that reflects the ability of the body to metabolize lipids. Even though the influence of oral contraceptives (OC) on PPL is not known, it is a known fact that their use increases fasting lipid values. Objective: To compare the PPL between women who are on OC and those who are not. Methods: A prospective analytical study which assessed eutrophic women, aged between 18 and 28 years old, who were irregularly active and with fasting triglycerides ≤150 mg/dL. They were divided into two groups: oral contraceptive group (COG) and non-oral contraceptive group (NCOG). Volunteers were submitted to the PPL test, in which blood samples were collected in time 0 (12-hour fasting) and after the intake of lipids in times 180 and 240 minutes. In order to compare the triglyceride deltas, which reflect PPL, the two-tailed Mann-Whitney test was used for independent samples between fasting collections and 180 minutes (∆1) and between fasting and 240 minutes (∆2). Results: Forty women were assessed and equally divided between groups. In the fasting lipid profile, it was observed that HDL did not present significant differences and that triglycerides in COG were twice as high in comparison to NCOG. Medians of ∆1 and ∆2 presented significant differences in both comparisons (p ≤0.05). Conclusion: The results point out that women who are irregularly active and use OC present more PPL in relation to those who do not use OC, which suggests that in this population, its chronic use increases the risk of heart conditions.

Resting blood lactate in individuals with sickle cell disease

Background The most common hereditary hemoglobin disorder, affecting 20 million individuals worldwide, is sickle cell disease. The vascular obstruction resulting from the sickling of cells in this disease can produce local hypoxemia, pain crises and infarction in several tissues, including the bones, spleen, kidneys and lungs. Objective To determine red blood group genes in a Brazilian populations. Methods The present study is characterized as a case control study, with the aim of identifying the baseline blood lactate concentration in individuals with hemoglobin SS and SC diseases. One-way ANOVA with the Tukey post-test was used to analyze the results and a p-value < 0.05 was considered significant. Calculations were made using the INSTAT statistical program. The graphs were generated using the ORING program. The study sample was composed of 31 men and women residing in the city of Santo Antônio de Jesus, Bahia, Brazil. The individuals were divided into two groups: Group GC of 16 subjects who did not present with any type of structural hemoglobinopathy; and Group GE composed of 15 individuals with ages between 2 and 35 years old, who had the SS and SC genotypes. Sample analyses were performed with 3 mL of blood during fasting. Results The baseline blood lactate concentration of the SS and SC individuals was higher than that of the control group (p<0.001) with means of 4.86 ± 0.95; 3.30 ± 0.33; 1.31 ± 0.08 IU/L for SS, SC and controls, respectively. This corroborates the initial research hypothesis. Conclusion The baseline blood lactate of SS and SC individuals is 3 to 4 times higher than that of healthy subjects, probably due to the fact that these patients have a metabolic deviation to the anaerobic pathway.

Inspiratory Muscle Training and Functional Capacity in Patients Undergoing Cardiac Surgery

Introduction Cardiac surgery is a highly complex procedure which generates worsening of lung function and decreased inspiratory muscle strength. The inspiratory muscle training becomes effective for muscle strengthening and can improve functional capacity. Objective To investigate the effect of inspiratory muscle training on functional capacity submaximal and inspiratory muscle strength in patients undergoing cardiac surgery. Methods This is a clinical randomized controlled trial with patients undergoing cardiac surgery at Instituto Nobre de Cardiologia. Patients were divided into two groups: control group and training. Preoperatively, were assessed the maximum inspiratory pressure and the distance covered in a 6-minute walk test. From the third postoperative day, the control group was managed according to the routine of the unit while the training group underwent daily protocol of respiratory muscle training until the day of discharge. Results 50 patients, 27 (54%) males were included, with a mean age of 56.7±13.9 years. After the analysis, the training group had significant increase in maximum inspiratory pressure (69.5±14.9 vs. 83.1±19.1 cmH2O, P=0.0073) and 6-minute walk test (422.4±102.8 vs. 502.4±112.8 m, P=0.0031). Conclusion We conclude that inspiratory muscle training was effective in improving functional capacity submaximal and inspiratory muscle strength in this sample of patients undergoing cardiac surgery.

Postprandial lipemia and subclinical inflammation on active women taking oral contraceptive

Fundamentos: Mulheres em uso de contraceptivo oral combinado (COC) apresentam perfil lipidico de jejum, lipemia pos-prandial (LPP) e proteina C-reativa (PCR) maiores do que mulheres que nao utilizam COC. O exercicio fisico apresenta bons resultados no controle lipidico e inflamatorio. Objetivo: Comparar os valores do perfil lipidico de jejum, da LPP e da PCR entre mulheres ativas e irregularmente ativas em uso de COC. Metodos: Avaliadas 44 mulheres em uso de COC, da cidade de Salvador, BA, estratificadas em dois grupos: grupo ativo (GA; n=22) formado por mulheres fisicamente ativas e grupo irregularmente ativo (GIA; n=22) formado por mulheres irregularmente ativas. Nos dois grupos, apos jejum de 12 horas, realizada a dosagem do perfil lipidico de jejum e da PCR. A seguir, as voluntarias ingeriram um composto contendo 25 g de gordura e foram dosados os triglicerideos para verificar a LPP. Utilizado o teste de Mann-Whitney para comparacao da LPP e PCR. Resultados: Os valores dos deltas dos triglicerideos que representam a LPP respectivamente para o GA e GIA foram: 93±38,4 mg/dL vs. 163±49,6 mg/dL e 89±50,9 mg/dL vs. 156±47,6 mg/dL (p˂0,01). Os valores da PCR respectivamente para GA e GIA foram: 1,1 mg/L (0,4-2,1 mg/L) e 2,1 mg/L (0,8-3,4 mg/L) (p=0,04). Conclusao: Neste estudo, mulheres ativas em uso de COC apresentaram triglicerideos e LDL de jejum, LPP e PCR significativamente menores que mulheres irregularmente ativas em uso de COC.

Behavior of Pulmonary Function after Hospital Discharge in Patients Submitted to Myocardial Revascularization

Mailing Address: André Luiz Lisboa Cordeiro Rua Japão, 94. Postal Code: 44052-022, Caseb, Feira de Santana, BA Brazil. E-mail: andrelisboacordeiro@gmail.com Behavior of Pulmonary Function after Hospital Discharge in Patients Submitted to Myocardial Revascularization André Luiz Lisboa Cordeiro,1,2 Letícia Gardênia Romualdo da Silva,2 Milena Oliveira Pinto,2 Jaclene da Silva Araújo,2 André Raimundo Guimarães,3 Jefferson Petto1,4,5,6 Escola Bahiana de Medicina e Saúde Pública,1 BA Brazil Faculdade Nobre,2 BA Brasil Instituto Nobre de Cardiologia,3 BA Brasil Universidade Salvador,4 BA Brasil Faculdade Adventista da Bahia,5 BA Brasil Faculdade Social da Bahia,6 BA Brasil

Elevation of Oxidized Lipoprotein of Low Density in Users of Combined Oral Contraceptives

Background The use of combined oral contraceptive (COC) has been related to changes in glycemic, lipid metabolism, increased oxidative stress, and systemic blood pressure, which could suggest a higher oxidation of low-density lipoprotein cholesterol (LDL-cholesterol) in women on use of COC. Objective To test the hypothesis that there is a difference in the plasma values of oxidized LDL among women who use and do not use COC, as well as to evaluate the correlation between it and the lipid profile and high-sensitivity C-reactive protein (hs-CRP). Methods Forty-two women with ages between 18 and 35 years old, who were eutrophic, irregularly active, with triglycerides < 150 mg/dL, blood glucose < 100 mg/dL, and who used or did not use COC were selected. These women were allocated in the COC group, formed by 21 women on COC use for at least 1 year; and a control group (CG), consisting of 21 women who had not used any type of hormonal contraceptive for at least 1 year. A significance level of 5% was adopted for statistical analyses. Results It was observed that GCOC showed higher values of oxidized LDL than the CG, respectively 384 mU/mL versus 283 mU/mL (p < 0.01). A positive correlation between oxidized LDL and LDL-cholesterol (r = 0.3, p < 0.05), with total cholesterol (r = 0.47, p < 0.01) and with triglycerides (r = 0.32, p < 0.03) was observed, and there was no correlation with the hs-CRP. In the categorized analysis of oxidized LDL, 71.4% of GCOC women, and 28.6% of the CG remained above the established cutoff point. Conclusion Women who use COC have higher plasma levels of oxidized LDL, and there is a positive correlation between oxidized LDL and other lipid variables.

Barriers to cardiovascular rehabilitation care in a northeast city of Brazil

67 ABSTRACT Identifying barriers by regions of Brazil can be a valuable strategy to improve the insertion and adherence of patients with cardiopathy to cardiovascular rehabilitation programs. Objective: To identify and describe the reasons that lead to the non-inclusion of individuals with cardiopathy in cardiovascular rehabilitation programs. Methods: Descriptive cross-sectional study with 79 individuals of both sexes, aged over 50 years, with cardiopathy from five private cardiology clinics. To identify the factors that interfered with the inclusion of patients in cardiovascular rehabilitation programs, the scale of barriers for cardiac rehabilitation was applied. This instrument is composed of 22 items, 21 of which are closed and objective questions. Individuals were instructed to tick “YES” or “NO” for each target item on the scale if they identified the item as a barrier to inclusion / adherence. Results: 64 (81%) of the sample did not know about the existence of cardiovascular rehabilitation and its benefits. For 50 (63%) the distance from the residence to the rehabilitation center was a barrier. In addition, the cost of urban mobility 37 (47%) and the lack of indication of the physician as unnecessary 32 (40%) were also pointed as barriers. Conclusion: The results of this study indicate that the main reasons for non-insertion in cardiovascular rehabilitation programs were the lack of knowledge about the benefits of this type of program, the distance of the patients’ residence to the nearest center and the displacement cost.

Effects of neural mobilization techniques on muscular strength: a systematic review

Introduction: Historically skeletal muscle strength has been the subject of numerous scientific investigations. Which, besides defining its role in health and disease process also identified neuromuscular mechanisms to modify it. Another interesting point is that in recent decades, authors have suggested that neural mobilization techniques can modify the neuromuscular physiology, however, little is known about its effects on muscle strength. Objective: To systematically investigate the effects of neural mobilization techniques on muscle strength. Methods: A systematic review performed in Google Scholar databases, Latindex, Lilacs, Pubmed and Scielo, through the descriptors: Muscle Strength, Muscle Contraction, Neural Mobilization and Neurodynamics Mobilization. Transverse and longitudinal controlled studies were included. Studies testing the neural mobilization of the muscle contraction force or humans or animals healthy or to peripheral nerve injury. The selected studies were published between the years 2010 and 2014 in national and international journals with Qualis between B1 and B2 according to an evaluation of the top professional development coordination. Results: The screening process resulted in the identification of 70 studies, of which only five not fit the eligibility criteria. Selected manuscripts indicated acute and chronic effects of neural mobilization on muscle strength in healthy volunteers with peripheral nerve damage by leprosy and rats with sciatic neuropathy. Conclusion: The results of this study indicate positive effects of neural mobilization in relation to the recruitment of muscle fibers, increasing strength and maintaining muscle strength in healthy volunteers and the peripheral nervous system injury.

C-reactive protein in oral contraceptive users: related factors and cardiovascular risk

Mailing Address: Alan Carlos Nery dos Santos Escola Bahiana de Medicina e Saúde Pública. Av. Dom João VI, 275. Postal Code: 44657-086. Brotas – Salvador, BA – Brazil E-mail: alansantos.pos@bahiana.edu.br C-Reactive Protein in Oral Contraceptive Users: Related Factors and Cardiovascular Risk Alan Carlos Nery dos Santos1, Jefferson Petto1, Francisco Tiago Oliveira de Oliveira2, Diego Passos Diogo1, Ana Marice Teixeira Ladeia1 Programa de Mestrado e Doutorado em Medicina e Saúde Humana da Escola Bahiana de Medicina e Saúde Pública – EBMSP1, Salvador, BA; Escola Bahiana de Medicina e Saúde Pública – EBMSP2, Salvador, BA – Brazil

Importance of academic quality in the treatment of chronic venous insufficiency

Chronic venous insufficiency (CVI) is the inability of the venous complex to drain blood from the tissues to the heart, lasting more than three months, mainly due to valvular insufficiency of the lower limbs. Inability of the venous complex results in increased venous vascular pressure and consequent formation of reticular and varicose veins1.In the later stages, CVI evolves with cutaneous and subcutaneous alterations, ulcerations and, in 1-3% of the individuals, amputation2,3.