Natália Cristina de Oliveira

Gravidez e exercício

Com o crescente aumento de mulheres que praticam exercicios fisicos e esportes de forma regular, e importante que o especialista nas areas clinicas se mantenha atualizado sobre os beneficios e riscos da pratica esportiva durante a gravidez, no sentido de promover uma orientacao segura e precisa para suas pacientes gravidas.

Efficacy and safety of concurrent training in systemic sclerosis.

Pinto, ALS, Oliveira, NC, Gualano, B, Christmann, RB, Painelli, VS, Artioli, GG, Prado, DML, and Lima, FR. Efficacy and safety of concurrent training in systemic sclerosis. J Strength Cond Res 25(5): 1423-1428, 2011-The optimal training model for patients with systemic sclerosis (SSc) is unknown. In this study, we aimed to investigate the effects of a 12-week combined resistance and aerobic training program (concurrent training) in SSc patients. Eleven patients with no evidence of pulmonary involvement were recruited for the exercise program. Lower and upper limb dynamic strengths (assessed by 1 repetition maximum [1RM] of a leg press and bench press, respectively), isometric strength (assessed by back pull and handgrip tests), balance and mobility (assessed by the timed up-and-go test), muscle function (assessed by the timed-stands test), Rodnan score, digital ulcers, Raylands phenomenon, and blood markers of muscle inflammation (creatine kinase and aldolase) were assessed at baseline and after the 12-week program. Exercise training significantly enhanced the 1RM leg press (41%) and 1RM bench press (13%) values and back pull (24%) and handgrip strength (11%). Muscle function was also improved (15%), but balance and mobility were not significantly changed. The time-to-exhaustion was increased (46.5%, p = 0.0004), the heart rate at rest condition was significantly reduced, and the workload and time of exercise at ventilatory thresholds and peak of exercise were increased. However, maximal and submaximal &OV0312;o2 were unaltered (p > 0.05). The Rodnan score was unchanged, and muscle enzymes remained within normal levels. No change was observed in digital ulcers and Raynauds phenomenon. This is the first study to demonstrate that a 12-week concurrent training program is safe and substantially improves muscle strength, function, and aerobic capacity in SSc patients.

Aerobic exercise is safe and effective in systemic sclerosis.

Several studies have established that systemic sclerosis patients have a reduced exercise capacity when compared to healthy individuals. It is relevant to evaluate whether aerobic exercise in systemic sclerosis patients is a safe and effective intervention to improve aerobic capacity. Seven patients without pulmonary impairment and seven healthy controls were enrolled in an 8-week program consisting of moderate intensity aerobic exercise. Patients and controls had a significant improvement in peak oxygen consumption (19.72+/-3.51 vs. 22.27+/-2.53 and 22.94+/-4.70 vs. 24.55+/-3.00, respectively, p=0.006), but difference between groups was not statistically significant (p=0.149). This finding was reinforced by the fact that at the end of the study both groups were able to perform a significantly higher exercise intensity when compared to baseline, as measured by peak blood lactate (1.43+/-0.51 vs. 1.84+/-0.33 and 1.11+/-0.45 vs. 1.59+/-0.25, respectively, p=0.01). Patients improved the peak exercise oxygen saturation comparing to the baseline (84.14+/-9.86 vs. 90.29+/-5.09, p=0.048). Rodnan score was similar before and after the intervention (15.84+/-7.84 vs.12.71+/-4.31, p=0.0855). Digital ulcers and Raynauds phenomenon remained stable. Our data support the notion that improving aerobic capacity is a feasible goal in systemic sclerosis management. The long term benefit of this intervention needs to be determined in large prospective studies.

Imunocompetent Mice Model for Dengue Virus Infection

Dengue fever is a noncontagious infectious disease caused by dengue virus (DENV). DENV belongs to the family Flaviviridae, genus Flavivirus, and is classified into four antigenically distinct serotypes: DENV-1, DENV-2, DENV-3, and DENV-4. The number of nations and people affected has increased steadily and today is considered the most widely spread arbovirus (arthropod-borne viral disease) in the world. The absence of an appropriate animal model for studying the disease has hindered the understanding of dengue pathogenesis. In our study, we have found that immunocompetent C57BL/6 mice infected intraperitoneally with DENV-1 presented some signs of dengue disease such as thrombocytopenia, spleen hemorrhage, liver damage, and increase in production of IFNγ and TNFα cytokines. Moreover, the animals became viremic and the virus was detected in several organs by real-time RT-PCR. Thus, this animal model could be used to study mechanism of dengue virus infection, to test antiviral drugs, as well as to evaluate candidate vaccines.

Aerobic and resistance exercise in systemic sclerosis: State of the art

INTRODUCTION Patients with systemic sclerosis (SSc) experience reduced exercise capacity and muscle strength compared with healthy subjects. There are also indications of reduced levels of physical activity. OBJECTIVE To present the current knowledge of physical exercise in SSc. RESULTS Most studies presently available [three case studies, one single subject experimental design, one study comparing patients with healthy controls, one quasi experimental design (pre-post), two clinical trials and two random controlled trials] have included small samples of patients, mostly composed of patients with and without pulmonary involvement. It seems that patients with SSc without pulmonary involvement are able to perform and benefit from aerobic exercises of at least moderate intensity. Exercise tolerance, aerobic capacity, walking distance, muscle strength and muscle function as well as health-related quality of life (HRQL) have been found to be improved after participation in programmes including aerobic exercise and aerobic exercise combined with resistance exercises. Improvements seem to be only partially retained at follow up. Patients with pulmonary involvement may also experience improved muscle strength, physical and aerobic capacity, as well as HRQL following exercise. CONCLUSIONS Patients with SSc without pulmonary involvement can be recommended to be as physically active as the general population. Patients with mild pulmonary involvement can be recommended to be physically active by engaging in exercises of moderate intensity and to participate in moderate-load resistance exercises. Health professionals should inform patients with SSc about the importance of physical activity and avoidance of a sedentary lifestyle.

Knowledge about epilepsy in university health students: A multicenter study

Even with economic development and improvements in health care around the world, it is estimated that nowadays, 50 million people have epilepsy. It is one of the most prevalent neurological diseases, yet it is still surrounded by prejudice, stigma, lack of awareness, and wrong attitudes of the population towards the disease. The aim of this study was to evaluate and compare the knowledge about epilepsy in health students from different countries: Brazil, Argentina, Portugal, United States, and South Africa. Students were asked to complete a survey regarding knowledge about epilepsy (the Epilepsy Knowledge Questionnaire). One hundred and two students participated, 62.2% of them were female. Portuguese students had significantly higher values than the American ones (p=0.025). Regarding the medical aspects, on average, students hit 63.8% of the questions, and the students from Portugal had significantly higher average than the ones from the United States (p=0.0007). Statements with lower percent of correct answers were about pathophysiology, medication, and treatment of the disease. There were no differences between the scores obtained by the students of each country in the social aspects of the disease. Statements with higher percent of mistakes were about sports practice, labor, proceedings in case of convulsion, and ability to drive vehicles. General knowledge of senior health students about epilepsy was considered low, however, regarding the medical aspects of the disease, students from Brazil and Portugal exhibited a slightly superior knowledge. Changing the way of seeing and treating people with epilepsy brings, as a consequence, increased opportunities for these people in different sectors of society.

Comparação dos efeitos de exercícios resistidos versus cinesioterapia na osteoartrite de joelho

Increased life expectancy in several populations makes osteoarthritis (OA) an important public health issue, as it is a very prevalent chronic disease and leading cause of pain and disability among adults and elderly. Objective: The aim of this study was to compare pain, mobility, functional capacity, and strength of patients with knee osteoarthritis submitted to two different interventions: resistance exercise (REG) and kinesiotherapy (KIG). Methods: This was a prospective randomized single blind clinical trial, which involved the participation of 30 adults of both sexes diagnosed with knee OA. Volunteers were evaluated for pain, stiffness, function, functional mobility, and strength by a blinded evaluator before and after the interventions. Through a simple drawing, participants were randomly assigned to one of the two intervention groups, and underwent 15 twice-weekly treatment sessions, lasting 30 minutes each. Results: Both interventions promoted significant improvements in all variables, and there were no reports of any adverse effects throughout the research. Conclusion: Both resistance exercise and kinesiotherapy are effective in improving pain, stiffness, function, functional mobility, and strength in patients with knee OA

Corrigendum to “Immunocompetent Mice Model for Dengue Virus Infection”

[This corrects the article DOI: 10.1100/2012/525947.].

Lifestyle and Pain in Women With Knee Osteoarthritis

Osteoarthritis (OA) is the main cause of pain and disability in the elderly. The disease leads to chronic musculoskeletal pain, characterized by an abnormal excitability of pain conduction pathways, and lifestyle may interfere in this pathophysiological aspect. Thus, the aim of this study was to compare perceived pain, pressure pain threshold, and lifestyle of adult and elderly women with and without knee OA. A total of 143 women were recruited and divided into 2 groups: OA (n = 68) and control (n = 75). Volunteers were evaluated for pressure pain tolerance (algometry in vastus medialis and vastus lateralis muscles), perceived pain (visual analogue scale) and lifestyle (FANTASTIC questionnaire). Patients with OA of the present study presented higher weight (P = .001) and body mass index (P < .001) than controls. Results also revealed less tolerance to pressure pain (P < .001) and higher pain perception (P < .001) in patients with OA. OA group scored significantly lower in lifestyle questionnaire than controls (P = .03). Patients with OA in the present study who presented lifestyle scores below median presented significantly higher values of pain perception than the ones above it (P = .03). In conclusion, patients with OA present more sensitivity to pain, more perceived pain, and worse lifestyle than healthy individuals.

Limiar de tolerância de dor à pressão, estilo de vida, força muscular e capacidade funcional em idosas com sarcopenia

73 ABSTRACT Objective: The present study sought to assess the impact of this condition on muscle strength, functional capacity, lifestyle, and the pressure pain threshold. Methods: Elderly people considered healthy (n = 75) aged 60-75 years (66.8 ± 4.6 years) were studied in an observational and crosssectional design. Those who registered pain above 4 on the Visual Analogue Scale (VAS) and used analgesic and/or anti-inflammatory medication were excluded from the study. Body composition and presence of sarcopenia were evaluated by bioelectric impedance. Two groups were formed: CO control group (n = 51) and SARC sarcopenic group (n = 24, muscle mass index less than 6.86 kg/m2). Results: Functional capacity was determined by the 6-minute walk test (6MWT); handgrip strength and elbow flexion strength were both determined by dynamometry. Lifestyle was assessed by the FANTASTIC questionnaire. The pressure pain threshold was determined by algometry. Data were analyzed using the Student’s t-test (p < 0.05). CO and SARC did not differ regarding age, body fat percentage, lifestyle, 6MWT, elbow flexion strength, or in algometry measurements at almost any point. However, statistically significant differences between groups were found regarding handgrip strength and algometry in the right insertion of the biceps. Conclusion: Elderly women with significant reduction of muscle mass do not present impairments in functionality or in the sensation of muscle and tendon pain, probably due to a pre-sarcopenic condition.Objetivo: Avaliar o impacto desta condicao sobre a forca muscular, capacidade funcional, estilo de vida e limiar de tolerância de dor a pressao. Metodos: Idosas consideradas saudaveis (n = 75) de 60 a 75 anos (66,8 ± 4,6 anos) foram estudadas em um desenho observacional e transversal. Foram excluidas as que apresentavam dor maior do que 4 na Escala Visual Analogica (EVA) e que utilizavam medicacao analgesica e/ou anti-inflamatoria. A composicao corporal e a presenca de sarcopenia foram avaliadas por meio de impedância bioeletrica. Foram constituidos dois grupos: CO - grupo controle (n = 51) e SARC - grupo sarcopenia (n = 24, indice de massa muscular menor que 6,86 kg/m2 ). Resultados: A capacidade funcional foi determinada pelo Teste de Caminhada de 6 minutos (TC6min), e a forca de preensao manual e de flexao dos cotovelos por dinamometria. O estilo de vida foi avaliado pelo questionario FANTASTICO. O limitar de tolerância a dor foi determinado por algometria. Os dados foram analisados por meio do teste t de Student (p < 0,05). CO e SARC nao diferiram quanto a idade, percentual de gordura corporal, estilo de vida, TC6min, forca de flexao dos cotovelos e em praticamente todos os pontos analisados pela algometria. Entretanto, foram verificadas diferencas estatisticamente significantes entre os grupos em relacao a forca de preensao manual e na algometria da insercao direita do biceps braquial. Conclusao: Idosas com significante reducao de massa muscular nao exibem prejuizos em relacao a funcionalidade e sensacao de dor muscular e tendinea, provavelmente por uma condicao pre-sarcopenica