Silvana Schwerz Funghetto

Association of body composition with sarcopenic obesity in elderly women

The aim of the present study was to investigate the prevalence of sarcopenic obesity and its association with obesity and sarcopenia in elderly Brazilian women. Two hundred and seventy-two sedentary women with a mean age of 66.75 ± 5.38 years were recruited for participation in this study. Obesity was determined by both body mass index and dual-energy X-ray absorptiometry (DXA) evaluations. Sarcopenic obesity diagnosis was established from the ratio between fat-free mass and body surface area as obtained by DXA. There was no association of obesity with sarcopenic obesity (P = 0.424). In contrast, sarcopenia was significantly related to sarcopenic obesity (P < 0.001), although most of the elderly women with sarcopenia (n = 171) did not exhibit sarcopenic obesity. These results highlight the importance of diagnosing sarcopenic obesity as elderly women exhibiting sarcopenia could be either eutrophic or obese.

Decreased functional capacity and muscle strength in elderly women with metabolic syndrome

Purpose To compare the metabolic parameters, flexibility, muscle strength, functional capacity, and lower limb muscle power of elderly women with and without the metabolic syndrome (MetS). Methods This cross-sectional study included 28 older women divided into two groups: with the MetS (n = 14; 67.3 ± 5.5 years; 67.5 ± 16.7 kg; 1.45 ± 0.35 m; 28.0 ± 7.6 kg/m2), and without the MetS (n = 14; 68.7 ± 5.3 years; 58.2 ± 9.9 kg; 1.55 ± 0.10 m; 24.3 ± 3.8 kg/m2). Body composition was evaluated by dual-energy X-ray absorptiometry and dynamic muscle strength was assessed by one-maximum repetition (1RM) tests in leg press, bench press and biceps curl exercises. Six-minute walk test, Timed Up and Go (TUG); 30-second sitting-rising; arm curl using a 2-kg dumbbell, sit-and-reach (flexibility), and vertical jump tests were performed. Results There was no difference between groups regarding age (P = 0.49), height (P = 0.46), body fat (%) (P = 0.19), systolic (P = 0.64), diastolic (P = 0.41) and mean blood pressure (P = 0.86), 30-second sitting-rising (P = 0.57), 30-s arm curl (P = 0.73), leg press 1RM (P = 0.51), bench press 1RM (P = 0.77), and biceps curl 1RM (P = 0.85). However, women without the MetS presented lower body mass (P = 0.001), body mass index (BMI) (P = 0.0001), waist circumference (P = 0.02), waist-to-height ratio (P = 0.02), fat body mass (kg) (P = 0.05), lean body mass (kg) (P = 0.02), blood glucose (P = 0.05), triglycerides (P = 0.03), Z-score for the MetS (P = 0.05), higher high-density lipoprotein-cholesterol (HDL-C) (P = 0.002), better performance on TUG (P = 0.01), flexibility (P = 0.03), six-minute walk test (P = 0.04), vertical jump (P = 0.05) and relative muscle strength for leg press (P = 0.03), bench press (P = 0.04) and biceps curl (P = 0.002) exercises as compared to women with the MetS. Conclusion Elderly women with the MetS have higher metabolic risk profile and lower functional capacity, muscle strength, lower limb power and flexibility as compared to women without the MetS. The evaluation of functional capacity may help to determine the degree of physical decline in older persons with the MetS, while exercise interventions should be encouraged.

Understanding the individual responsiveness to resistance training periodization

This study was designed to compare the effects of linear periodization (LP) and undulating periodization (UP) on functional capacity, neuromuscular function, body composition, and cytokines in elderly sedentary women. We also aimed to identify the presence of high responders (HR), medium responders (MR), and low responders (LR) for irisin, interleukin-1 beta (IL-1β), toll-like receptor-4 (TLR-4), and brain-derived neurotrophic factor (BDNF) to resistance training (RT). Forty-nine elderly women were assigned to a control group, LP, and UP scheme. Functional capacity, body composition, maximal strength, irisin, TLR-4, BDNF, and IL-1β were evaluated. Both periodization models were effective in improving 45° leg press 1RM, chair-stand, arm curl, and time-up and go tests, with no significant differences in body composition and cytokines. Furthermore, HR, MR, and LR were identified for irisin, IL-1β, TLR-4, and BDNF, with differences between groups and moments. This study provides evidence that both periodization models were effective in improving functional capacity and neuromuscular function, with no effect on body composition and cytokines (probably as a consequence of the different responsiveness). Furthermore, for the first time, HR, MR, and LR were identified for irisin, IL1-β, TLR-4, and BDNF in response to RT.

Elderly women with metabolic syndrome present higher cardiovascular risk and lower relative muscle strength

ABSTRACT Objective: To compare the metabolic, anthropometric, arterial blood pressure, and muscle strength parameters of elderly women with and without metabolic syndrome. Methods: A case-control study with 27 (67.3±4.8 years of age, 31.0±5.0kg/m2) elderly women with metabolic syndrome and 33 (68.8±5.6 years of age, 27.2±5.3kg/m2) sedentary control elderly women. They were submitted to an evaluation of body composition by means of dual-energy X-ray absorptiometry and muscle strength testing with 10 maximal repetitions of knee extension. Results: When compared to the elderly women without metabolic syndrome, those with the metabolic syndrome had higher levels for body mass (72.2±13.5 versus 63.4±14.6kg, p=0.03), body mass index (31.0±5.0 versus 27.2±5.3kg/m2, p=0.007), fat mass (30.9±9.9 versus 24.4±8.5kg, p=0.01), systolic arterial pressure (125.1±8.2 versus 119.3±8.7mmHg, p=0.01), diastolic arterial pressure (75.5±6.9 versus 71.4±6.7mmHg, p=0.03), mean arterial pressure (92.5±6.2 versus 87.1±6.7mmHg, p=0.004), blood glucose (103.8±19.1 versus 91.1±5.9mg/dL, p=0.001), triglycerides (187.1±70.2 versus 116.3±36.7mg/dL, p=0.001), and creatine kinase (122.6±58.6 versus 89.8±32.5U/L, p=0.01); lower levels were found for fat-free mass (55.9±5.8 versus 59.3±6.7%; p=0.05), HDL-C (40.7±5.0 versus 50.5±10.1mg/dL, p=0.001), and relative muscle strength (0.53±0.14 versus 0.62±0.12, p=0.01). Conclusion: Elderly women with metabolic syndrome have a higher cardiovascular risk and less relative muscle strength when compared to those without metabolic syndrome. Relative muscle strength may be related to the cardiovascularr risk factors of the metabolic syndrome.

Nossa vida após o câncer de mama: percepções e repercussões sob o olhar do casal

This is a qualitative study, conducted at a Clinic of Mastology of a public hospital of the Federal District, which aimed to know the impact of breast cancer in the lives of couples, women submitted to mastectomy and their partners. The sample consisted of three couples, five women submitted to mastectomy and three partners. Semi-structured interviews were conducted, which gave rise to two broad categories: Perceptions about breast cancer and Consequences in everyday life. The diagnosis of cancer is received as a traumatic one, bringing feelings of mutilation, dependence, prejudice and loss of femininity. One conclude that significant changes occur in married life and that mutual support is needed to better cope with the disease, followed by the necessary family support.This is a qualitative study, conducted at a Clinic of Mastology of a public hospital of the Federal District, which aimed to know the impact of breast cancer in the lives of couples, women submitted to mastectomy and their partners. The sample consisted of three couples, five women submitted to mastectomy and three partners. Semi-structured interviews were conducted, which gave rise to two broad categories: Perceptions about breast cancer and Consequences in everyday life. The diagnosis of cancer is received as a traumatic one, bringing feelings of mutilation, dependence, prejudice and loss of femininity. One conclude that significant changes occur in married life and that mutual support is needed to better cope with the disease, followed by the necessary family support.

Identification of high responders for interleukin-6 and creatine kinase following acute eccentric resistance exercise in elderly obese women

OBJECTIVES Resistance exercise is used as a non-pharmacological tool to elicit both gains in and maintenance of physical function in the elderly. Thus, the present study examined the acute response of creatine kinase and interleukin-6 following an eccentric resistance exercise session in elderly obese women classified as high responders or normal responders. DESIGN Cross-sectional field study. METHODS Ninety elderly obese women (69.4 ± 6.01 years) were tested for a 10 repetition maximum on the leg extension exercise and then completed an acute eccentric resistance exercise session consisting of seven sets of 10 repetitions at 110% of 10 repetition maximum with a rest of 3 min between sets. Subjects were divided into normal response or high response on the basis of the peak serum interleukin-6 (NR = 59 and HR = 7) and creatine kinase (NR = 81 and HR = 9) concentration being greater than (HR) or less than (NR) the 90th percentile. RESULTS Creatine kinase was higher at 0 h, 3h, 24h and 48 h following the ERE for the HR group. The peak creatine kinase was significantly higher in HR group versus the normal response group. The average increase in the serum interleukin-6 Δ for the HR group (∼ 850%) was significantly higher versus the normal response group (∼ 55%). Serum interleukin-6 was significantly higher at 0 h and 24h following eccentric resistance exercise only for the high response group, while peak levels were significantly higher in high response group versus the normal response group (p ≤ 0.005). Only one subject met the criteria to be classified as high response for both creatine kinase and interleukin-6 responsiveness. CONCLUSIONS Elderly individuals classified as high response experienced greater creatine kinase and interleukin-6 responses to ERE. Thus, a prudent approach for eccentric resistance exercise prescription might be programming additional recovery days and/or lower intensity training, especially in the beginning stages of a program.

Interleukin-6 − 174G/C gene polymorphism affects muscle damage response to acute eccentric resistance exercise in elderly obese women

The IL-6 gene polymorphism has been associated with disease prevalence and different physiological responses to exercise. Eccentric resistance exercise (ERE) is considered a nonpharmacological tool to prevent the chronic degenerative profile associated with aging and obesity. Consequently, the aim of the present study was to investigate the influence of IL-6 -174G/C polymorphism on acute interleukin-6 (IL-6) and creatine kinase (CK) temporal response to ERE in elderly obese women. Ninety women completed seven sets of ten repetitions (eccentric only) of an acute ERE session at 110% of the ten repetitions maximum (10RM). IL-6 genotypes displayed no difference at baseline. ERE induced changes in CK concentration over time occurred only in the GG group, F(2.619, 136.173)=5.199, p=0.003, with CK activity increased from 106.8±6.9 U/l pre-intervention to 122.7±11.2 U/l at 24 h and 131.9±14.4 U/l at 48 h post-exercise. IL-6 concentration in the GG group was lower than the CC/CG group only at 0 h post-exercise (3.78±0.58 pg/ml versus 6.51±1.91 pg/ml, p=0.030). Only the GG genotype group had higher CK activity 24-48 h following ERE and greater CK integral values, while IL-6 activity over 48 h was higher in the CC/CG genotype group. In conclusion, IL-6 genotype affects CK and IL-6 in response to ERE. It is of interest that the ERE protocol induced an elevation in CK, indicating possible muscle damage without exacerbating IL-6 and CK for the GG genotype.

Non Pharmacological Interventions for Chemotherapy Induced Nauseas and Vomits: integrative review

Nausea and vomiting are one of the most common gastrointestinal toxicities of antineoplastic treatment; it may affect negatively patient`s nutritional condition, hidroeletrolitic balance and quality of life. This study aimed to identify evidences in medical literature regarding non-pharmacologic interventions to prevent and treat chemotherapy induced nausea and vomiting. We performed an integrative review on online databases for that purpose. We elected 9 articles from this research, which presented the following possible non-pharmacological interventions for chemotherapy emesis: accupressure, acupuncture, electroacupuncture, relaxing techniques and yoga. The authors concluded that the results suggested that these interventions should be recommended for cancer patients, mainly those presenting chemotherapy emesis in consecutive cycles.

Princípios éticos como norteadores no cuidado domiciliar

Home care is a health care strategy that aims to emphasize the autonomy of the patient as well as to enhance their functional skills in their home. The aim is to reflect the observance of ethical principles in home care, in the form of home assistance. The study is exploratory and descriptive, addressing a critical review of the literature, according to the analysis of Bardin. Home care is becoming indispensable in reducing hospital costs, hospitalization, number of hospitalizations and number of clinical complicationsm as well as increased family participation in patient care, providing a better quality of life. However, it is necessary to take into consideration the purpose and quality of care delivered, analyzing it from the perspective of ethical principles in order not to make this kind of care only beneficial to one party, but a common good to all subjects involved in this care.

Comparison of Inflammatory, Metabolic, and Anthropometric Parameters in Elderly Women With and Without Insulin Resistance

The objective of the present study was to investigate the relationship between inflammatory, metabolic, and anthropometrical parameters of elderly women with insulin resistance (IR) and without insulin resistance (WIR). One hundred and seventy-two elderly women aged 67.5 (± 5 years) were submitted to anthropometrical analysis, by dual energy X-ray absorptiometry, and biochemistry tests such as lipidogram, fasting blood glucose, glycosylated hemoglobin, insulin, C-reactive protein, Interleukin-6, tumor necrosis factor-alpha, and Interferon-gamma. Body mass index, waist circumference, waist-to-hip ratio, body fat mass, triglycerides, very low density lipoprotein, fasting glucose, and insulin were significantly higher, while lean body mass was lower (p < 0.05), in elderly with IR as compared to WIR. There was no significant difference between groups in the inflammatory parameters. Elderly women with IR present increased anthropometrical and metabolic parameters that predispose them to several chronic nontransmissible diseases. Additional inflammatory parameters should be used in elderly women to define an optimal relationship with insulin resistance in clinical practice.