Categorias de Aptidão Física Baseadas no VO2max em População Brasileira com Suposto Alto Nível Socioeconômico e sem Cardiopatia Estrutural

Background The most widely used data for cardiorespiratory fitness (CRF) referrals are from the Cooper Clinic, which uses calculated maximal oxygen uptake (VO₂max) values.Objective To develop CRF values from cardiopulmonary exercise testing (CPX) in a Brazilian population with high socioeconomic level and free of structural heart disease. VO₂max testing results were compared with the Cooper Clinic and FRIEND Registry data.Methods CPX data from consecutive individuals between January 1,2000, and May 31,2016 were used in this study. Inclusion criteria were: VO₂max by a pre-specified definition. We built a CRF chart according to VO₂max percentiles: very poor (≤20%), poor (20-40%), fair (40-60%), good (60-80%), excellent (80-90%), and superior (≥90%). Kappa correlation was used to analyze our data in comparison with that of the other two databases. Statistical tests with p<0.005 were considered significant.Results Final cohort included 18,186 tests: 12,552 men, 5,634 women (7–84 years). The most recurrent response was “good” (20.2%). There was a mean difference in weight, height, body mass index (BMI), and age in the CRF chart. An inverse correlation existed between VO₂max and age, weight, and BMI. Using a linear regression and these variables, a predictive equation was developed for VO₂max. Our findings differed from that of the other databases.Conclusion We developed a classification for CRF and found higher values in all classification ranges of functional capacity in contrast to the Cooper Clinic and FRIEND Registry. Our findings offer a more accurate interpretation of ACR in this large Brazilian population sample when compared to previous standards based on the estimated VO2max. (Arq Bras Cardiol. 2020; 115(3):468-477)     

Estimation of pulse pressure variation and cardiac output in patients having major abdominal surgery: a comparison between a mobile application for snapshot pulse wave analysis and invasive pulse wave analysis

Pulse pressure variation (PPV) and cardiac output (CO) can guide perioperative fluid management. Capstesia (Galenic App, Vitoria-Gasteiz, Spain) is a mobile application for snapshot pulse wave analysis (PWAsnap) and estimates PPV and CO using pulse wave analysis of a snapshot of the arterial blood pressure waveform displayed on any patient monitor. We evaluated the PPV and CO measurement performance of PWAsnap in adults having major abdominal surgery. In a prospective study, we simultaneously measured PPV and CO using PWAsnap installed on a tablet computer (PPV_PWAsnap, CO_PWAsnap) and using invasive internally calibrated pulse wave analysis (ProAQT; Pulsion Medical Systems, Feldkirchen, Germany; PPV_ProAQT, CO_ProAQT). We determined the diagnostic accuracy of PPV_PWAsnap in comparison to PPV_ProAQT according to three predefined PPV categories and by computing Cohen’s kappa coefficient. We compared CO_ProAQT and CO_PWAsnap using Bland-Altman analysis, the percentage error, and four quadrant plot/concordance rate analysis to determine trending ability. We analyzed 190 paired PPV and CO measurements from 38 patients. The overall diagnostic agreement between PPV_PWAsnap and PPV_ProAQT across the three predefined PPV categories was 64.7% with a Cohen’s kappa coefficient of 0.45. The mean (±?standard deviation) of the differences between CO_PWAsnap and CO_ProAQT was 0.6?±?1.3 L min^??1 (95% limits of agreement 3.1 to ??1.9 L min^??1) with a percentage error of 48.7% and a concordance rate of 45.1%. In adults having major abdominal surgery, PPV_PWAsnap moderately agrees with PPV_ProAQT. The absolute and trending agreement between CO_PWAsnap with CO_ProAQT is poor. Technical improvements are needed before PWAsnap can be recommended for hemodynamic monitoring.

     

Impaired performance of women with patellofemoral pain during functional tests

ObjectiveTo compare the performance, reliability, and validity of functional tests between women with and without patellofemoral pain.MethodsTwenty women with a diagnosis of patellofemoral pain between 18 and 40 years of age and 20 age-matched pain-free controls participated in the study. All participants performed a set of five function tests: sitting-rising test, sit-to-stand in 30 seconds, stair-climb test, stair descent test, and six-minute step test. To investigate reliability, participants were assessed on two different days, seven days apart, by two independent investigators blinded to the results of the other investigator. Validity was evaluated through associations with the results on the Anterior Knee Pain Scale.ResultsPerformance in the tests was worse in women with patellofemoral pain than in the control group for the sit-to-stand in 30 seconds (mean difference [MD] 3.4reps; 95%CI: 0.4, 6.4), stair-climb test (MD: 0.36 s; 95%CI: 0.1, 0.63), and six-minute step test (MD: 45reps; 95%CI: 20, 70). No differences were observed for the sitting-rising and stair descent tests. All tests in both groups showed moderate to excellent intra- and inter-rater reliability (intraclass correlation coefficients: 0.61 to 0.91 and 0.72 to 0.96, respectively). Finally, only the results on the sit-to-stand in 30 seconds test correlated with the Anterior Knee Pain Scale (r = 0.44, p = 0.047) in the patellofemoral pain group.ConclusionWomen with patellofemoral pain present lower performance on some functional tests. Functional tests are reliable in patients with patellofemoral pain, although they are not associated with the results on the Anterior Knee Pain Scale self-questionnaire.     

Bio-elastomer nanocomposites reinforced with surface-modified graphene oxide prepared via in situ coordination polymerization

This article proposes a method to produce bio-elastomer nanocomposites, based on polyfarnesene or polymyrcene, reinforced with surface-modified graphene oxide (GO). The surface modification is performed by grafting alkylamines (octyl-, dodecyl-, and hexadecylamine) onto the surface of GO. The successful grafting was confirmed via spectroscopic (FTIR and Raman) and X-ray diffraction techniques. The estimated grafted amines appear to be around 30 wt%, as calculated via thermogravimetric analysis, increasing the inter-planar spacing among the nanosheets as a function of alkyl length in the amine. The resulting modified GOs were then used to prepare bio-elastomer nanocomposites via in situ coordination polymerization (using a ternary neodymium-based catalytic system), acting as reinforcing additives of polymyrcene and polyfarnesene. We demonstrated that the presence of the modified GO does not affect significantly the catalytic activity, nor the microstructure-control of the catalyst, which led to high cis-1,4 content bio-elastomers (>95%). Moreover, we show via rheometry that the presence of the modified-GO expands the capacity of the elastomer to store deformation or applied stress, as well as exhibit an activation energy an order of magnitude higher.

This article proposes a method to produce bio-elastomer nanocomposites, based on polyfarnesene or polymyrcene, reinforced with surface-modified graphene oxide (GO).     

Mitigation of Cd toxicity by Mn in young plants of cacao,evaluated by the proteomic profiles of leaves and roots

Cd is a non-essential metal and highly toxic to plants, animals and humans, even at very low concentrations. Cd has been found in cocoa beans and in their products, as in the case of chocolate. Mn plays an important role in photosynthetic and can interact with Cd and attenuate its toxic effects on plants. The objective of this work was to evaluate the mechanisms of Mn response in the mitigation of Cd toxicity in young plants of the CCN 51 cacao genotype submitted to 0.8?mmol?Cd kg^?1, 1.6?mmol Mn kg^?1 or the combination of 0.4?mmol?Cd kg^?1?+?0.8?mmol Mn kg^?1 soil, together with the control treatment (without addition of Cd and Mn in soil), by means of analysis of changes in the profile of exclusive proteins (EP) and differentially accumulated proteins (DAP). Leaf and root proteins were extracted and quantified from the different treatments, followed by proteomic analysis. About eight DAP and 38 EP were identified in leaves, whereas in roots 43 DAP and 21 EP were identified. Some important proteins induced in the presence of Cd and repressed in the presence of Cd?+?Mn or vice versa, were ATPases, isoflavone reductase, proteasome and chaperonin. It was concluded that proteins involved in oxidoreduction and defense and stress response processes, in addition to other processes, were induced in the presence of Cd and repressed in the presence of Cd?+?Mn. This demonstrated that Mn was able to mitigate the toxic effects of Cd on young plants of the CCN 51 cocoa genotype.