Síndrome metabólica em trabalhadores de um hospital universitário

IntroductionMetabolic syndrome (MS) is a major health problem, and has economic effects on enterprises. The workplace is thus an important environment for primary prevention of risk factors for cardiovascular disease.ObjectiveTo determine the prevalence of MS and variables related to its development in hospital workers.MethodsWe performed a cross-sectional study of 740 workers in a large university hospital. Socioeconomic variables, anthropometric and blood pressure measurements, and laboratory exams were analyzed. MS was defined according to the criteria of the International Diabetes Federation.ResultsOf the 740 workers, 72.4% were female and mean age was 34.9±9.5 years; 27.8% worked the morning shift, 20.3% the afternoon shift, 34.1% office hours, and 17.8% the night shift. As to educational level, 86.6% had finished high school or college. Waist circumference was high in 55.4%. Overall MS prevalence was 12.8%, 16.2% in males and 11.6% in females. Logistic regression analysis showed an independent association between MS and the following variables: elementary education, period of employment >10 years, office hours shift, and age group.ConclusionA diagnosis of MS was affected by age, educational level, work shift, and prolonged period of employment. Hospital workers do not differ from other populations and also need stimuli to make preventive changes to their behavior to modify cardiovascular risk factors.     

Endomiocardite de Löffler – a propósito de um caso clínico

Loeffler's endocarditis is an acute form of primary restrictive cardiomyopathy. We report the case of a young woman with pleuritic chest pain associated with fever and hypereosinophilia. She was hospitalized with suspected acute myopericarditis and was treated with aspirin, leading to clinical improvement. Ten days after discharge, she was rehospitalized due to recurrence of chest pain. The echocardiogram showed what appeared to be a mass filling the apex of the right ventricle (RV). She was referred for magnetic resonance imaging, which revealed marked myocardial thickening in the apex of the RV. The patient underwent an endomyocardial biopsy, resulting in a diagnosis of eosinophilic endocarditis. After treatment with prednisolone, all symptoms and the eosinophilia disappeared, and there was complete remission of the RV abnormalities. After three years of follow-up, the patient remains asymptomatic. This case shows that, even without an etiologic diagnosis of eosinophilia, the prognosis for Loeffler's endocarditis can be favorable if treatment is initiated early.     

A case of myopericarditis associated to Campylobacter jejuni infection in the Southern Hemisphere

Myopericarditis is an infrequent complication of acute diarrheal illness due to Campylobacter jejuni, and it has been mainly reported in developed nations. The first case detected in Chile – an upper-middle income country –, that is coincidental with the increasing importance of acute gastroenteritis associated to this pathogen, is described. Recognition of this agent in stools requires special laboratory techniques not widely available, and it was suspected when a young patient presented with acute diarrhea, fever, and chest pain combined with electrocardiogram (EKG) abnormalities and elevated myocardial enzymes. C. jejuni myopericarditis can easily be suspected but its detection requires dedicated laboratory techniques.     

Continuous and intermittent running to exhaustion at maximal lactate steady state: Neuromuscular,biochemical and endocrinal responses

ObjectiveThe aim of the present study was to characterize the neuromuscular, biochemical, and endocrinal responses from a running to exhaustion mode at the maximal lactate steady state intensity during continuous and intermittent protocols.DesignPre-post test measures.MethodsTwelve athletes performed an incremental treadmill test, several constant speed tests to determine the maximal lactate steady state at continuous and intermittent (5:1 ratio) models and two randomized tests until exhaustion at such intensities. Knee extension torque and blood sampling were collected before and immediately after the time to exhaustion tests.ResultsThe results showed a significant decrement (～15%) in torque production after time to exhaustion tests for both exercise models. In addition to neuromuscular impairment, an acute increase of 65% and 38% was observed creatine kinase, during continuous and intermittent running, respectively. Regarding hormonal responses when compared to baseline measurements, cortisol increased by 132% and 121% in the continuous and intermittent protocols, respectively. No correlation was found between biochemical, endocrinal and the neuromuscular variables.ConclusionsThe present findings showed that running until exhaustion performed at maximal lactate steady state, significantly impaired muscle strength and increased hormonal and muscle damage markers in two different protocols (i.e. continuous and intermittent) amongst trained runners.