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Artigo La problematización para la capacitación a distancia de los recursos humanos en salud en Brasil(Revista Internacional de Tecnología, Conocimiento y Sociedad, 2018) Castro, Janete Lima de; Vilar, Rosana Lúcia Alves de; Dias, María Aparecida; https://orcid.org/0000-0003-1823-9012Este trabajo analiza el uso del método de la problematización en una experiencia de educación a distancia de profesionales de la salud en Brasil, con la utilización de medios de comunicación integrados. El método de la problematización está dirigido a la adquisición del conocimiento vinculado al contexto social, lo cual permite una comparación entre la práctica vivida y los contenidos propuestos, para una reflexión y comprensión reelaborada de esta práctica. Los resultados obtenidos confirmaron la funcionalidad del método como opción pedagógica mediante la utilización de medios de comunicación conectados entre ambiente virtual, libro impreso y seguimiento del profesor tutor. Al final del curso, los proyectos de intervención elaborados fueron exitosos, indicando un aprendizaje significativo, con posibilidades de cambios efectivos en las prácticasArtigo Sedentary behavior is associated with physical activity, functional capacity, and a history of stroke in patients with heart failure. A cross-sectional study(FapUNIFESP (SciELO), 2018) Souza, Dyego Leandro Bezerra de; Bendassolli, Ila MF; Oliveira, Antonio G; Costa, Eduardo Calda; Maia, Eulália MC; https://orcid.org/0000-0001-8426-3120Abstract — Aims: Sedentary behavior (SB) has emerged as an important risk factor for poor health. Evidence showed that patients with heart failure (HF) exhibit high levels of SB, and that high SB increases mortality among such patients. We aimed to identify factors associated with SB in HF patients. Methods: A cross-sectional study was carried out with adults with HF and categorized under New York Heart Association (NYHA) functional class I–III. Sociodemographic, clinical, and health information were gathered. Evaluation of SB (by sitting time) and moderate-to-vigorous physical activity (MVPA) was performed by self-reported measures. Functional capacity was assessed using the Duke Activity Status Index. Simple and multivariate linear regression analyses were performed to identify the most suitable predictive model. Results: The sample (n = 80) comprised predominantly of patients in functional class I, men, and with an average age of 50.8 years. Time spent on SB totaled to 7.69 ± 2.35 h/day. Weekly volume of MVPA, functional capacity, and previous stroke were predictors of higher SB. Using simple linear regression analysis, the variables body mass index, quality of life, NYHA functional class, total comorbidities, dyslipidemia, MVPA in the leisure domain, and the use of diuretics, statins, and sildenafil were shown to have a statistically significant association with SB. Conclusion: In patients with HF, a longer time spent in SB was associated with low volumes of MVPA, low functional capacity, and history of stroke. More studies are needed to corroborate these findingsArtigo Qualidade de vida e aspectos psicossociais da síndrome dos ovários policísticos: um estudo quali-quantitativo(Thieme Open, 2013-11) Moreira, Simone da Nóbrega Tomaz; Sá, Joceline Cássia Ferezini de; Costa, Eduardo Caldas; Azevedo, George Dantas deObjetivos: avaliar a qualidade de vida das mulheres com síndrome dos ovários policísticos (SOP) e compreender a experiência vivida por essas mulheres diante dos sintomas que apresentam. Métodos: este estudo compreendeu duas abordagens metodológicas - quantitativa e qualitativa, de forma complementar. Foi avaliada a qualidade de vida de 213 mulheres (abordagem quantitativa) por meio do SF-36, sendo 109 com SOP (Grupo Caso: 26,8±5,4 anos) e 104 mulheres saudáveis (Grupo Controle: 23,9±6,7 anos). A análise estatística compreendeu a utilização dos testes t de Student e qui-quadrado, além dos testes de correlação de Pearson. O nível de significância adotado foi de 5%. Das mulheres do Grupo SOP, 15 participaram do estudo qualitativo, tendo sido entrevistadas mediante uso de roteiro semiestruturado. Os dados qualitativos foram analisados por meio da técnica análise de conteúdo temática categorial. Resultados: mulheres com SOP apresentaram comprometimento na qualidade de vida quando comparadas ao Grupo Controle (capacidade funcional: 76,5±20,5 e 84,6±15,9, respectivamente; aspectos físicos: 56,4±43,3 e 72,6±33,3; estado geral de saúde: 55,2±21,0 e 62,5±17,2; vitalidade: 49,6±21,3 e 55,3±21,3; aspectos sociais: 55,3±32,4 e 66,2±26,7; aspectos emocionais: 34,2±39,7 e 52,9±38,2; saúde mental: 50,6±22,8 e 59,2±20,2). Em relação aos dados qualitativos, a análise temática categorial aponta que sentimentos de "anormalidade", tristeza, medo e ansiedade estiveram associados aos principais sintomas da SOP: hirsutismo, irregularidade menstrual, infertilidade e obesidade. Esses sintomas repercutiram na vida social, na esfera profissional e no relacionamento conjugal dessas mulheres. Conclusão: a SOP compromete a qualidade de vida das mulheres, levando-as a se sentirem diferentes das outras mulheres. Por causa disso, a mulher com SOP não necessita apenas de tratamento médico para as repercussões reprodutivas, estéticas e metabólicas, mas de atendimento multiprofissionalArtigo Variabilidade da frequência cardíaca como método de avaliação do sistema nervoso autônomo na síndrome dos ovários policísticos(Thieme Open, 2013-09) Sá, Joceline Cássia Ferezini de; Costa, Eduardo Caldas; Silva, Ester da; Azevedo, George Dantas deA síndrome dos ovários policísticos (SOP) é uma condição endócrina que está associada a diversos fatores de risco cardiometabólico, tais como obesidade central, resistência à insulina, diabetes tipo 2, síndrome metabólica e hipertensão arterial. Esses fatores estão associados à hiperatividade adrenérgica, que é um importante fator prognóstico para o desenvolvimento de distúrbios cardiovasculares. Nos últimos anos, diante das alterações cardiometabólicas comuns na SOP, estudos têm investigado o controle autonômico cardíaco dessas pacientes, principalmente empregando-se a variabilidade da frequência cardíaca (VFC). Nesse sentido, nesta revisão, discorreremos sobre os achados recentes dos estudos que buscaram investigar a VFC em mulheres com SOP, assim como os métodos não invasivos de análise do controle autonômico a partir de índices básicos relacionados a essa metodologia de investigaçãoArtigo The impact of body mass on inflammatory markers and insulin resistance in polycystic ovary syndrome(Taylor and Francis, 2015-11-06) Santos, Ana Celly Souza dos; Soares, Nayara Pereira; Costa, Eduardo Caldas; Sá, Joceline Cássia Ferrezini de; Azevedo, George Dantas de; Lemos, Telma Maria Araújo MouraObjective: to evaluate inflammatory markers and insulin resistance (IR) in women with and without polycystic ovary syndrome (PCOS), with different body mass index (BMI). Methods: tumor necrosis factor-alpha (TNF-a), interleukin-6 (IL-6) and C-reactive protein (CRP) were assessed in serum samples from 40 women in reproductive age. Patients were divided into four groups: I (non-eutrophic with PCOS, n¼12), II (non-eutrophic without PCOS, n¼10), III (eutrophic with PCOS, n¼8) and IV (eutrophic without PCOS, n¼10) being non-eutrophic, the overweight and obese women with BMI425 kg/m2 and eutrophic women with BMI524.9 kg/m2. Homeostatic model assessment (HOMA-IR) was calculated for evaluation of IR. Results: PCOS patients showed increased levels of CRP (p50.01) and HOMA-IR (p50.01). When divided by BMI, both non-eutrophic and eutrophic PCOS showed increased CRP levels (p50.01) and HOMA-IR (p50.01). There were no differences in TNF-a and IL-6 levels between groups. Conclusion: in the PCOS group, the levels of CRP and IR were elevated, compared to their counterparts, regardless of body massArtigo Affect-regulated exercise: an alternative approach for lifestyle modification in overweight/obese women with polycystic ovary syndrome(Taylor and Francis, 2015-09-25) Costa, Eduardo Caldas; Sá, Joceline Cássia Ferezini de; Costa, Ingrid Bezerra Barbosa; Meireles, Rodrigo da Silva Rosa Veleda; Lemos, Telma Maria Araújo Moura; Elsangedy, Hassan Mohamed; Krinski, Kleverton; Azevedo, George Dantas deObjective: affect-regulated exercise (‘‘ARE’’) is an alternative approach to guide exercise intensity based on feeling of pleasure. The aim of this study was to analyze if overweight/obese women with polycystic ovary syndrome (PCOS) meet the American College of Sports Medicine (ACSM) recommendation regarding to exercise intensity to improve health status during a single bout of ‘‘ARE". Methods: a sample of 14 overweight/obese women with PCOS (18–34 years) performed a single bout of ‘‘ARE’’ (40 min of aerobic exercise on outdoor track). The Feeling Scale (FS) was used to guide ‘‘ARE’’ intensity/pace maintaining an affective valence between ‘‘good’’ and ‘‘very good’’ during all time. Heart rate (HR), speed, % of HR at first and second ventilatory threshold (VT1 and VT2) and time spent at moderate (64–76% of HRmax) and vigorous (77–95% of HRmax) intensity during ‘‘ARE’’ were measured with a global positioning system (GPS) device. Results: volunteers exercised at 73% (68–78%) of HRmax, 5.8 (5.2–6.2) km/h, 93.4% of HR at VT1 (89.3–98.2) and 80.5% of HR at VT2 (75.3–84.6) and spent 480% of time at moderate intensity. Conclusions: overweight/obese women with PCOS met the ACSM recommendation regarding exercise intensity to improve health status when exercised between ‘‘good’’ and ‘‘very good’’ of FS. Thus, ‘‘ARE’’ may be an interesting approach to be used in clinical practice regarding to exercise prescription and/or physical activity adviceArtigo Diet-Induced weight loss reduces DNA damage and cardiometabolic risk factors in overweight/obese women with polycystic ovary syndrome(Karger Publishers, 2016-04-14) Soares, Nayara Pereira; Santos, Ana Celly Souza dos; Costa, Eduardo Caldas; Azevedo, George Dantas de; Damasceno, Débora Cristina; Fayh, Ana Paula Trussardi; Lemos, Telma Maria Araujo MouraAims: we aimed to investigate the impact of following a diet to induce weight loss (500 kcal deficit per day) over DNA damage and cardiometabolic risk factors in women with overweight/obesity diagnosed with polycystic ovary syndrome (PCOS). Methods: a study was conducted in Natal, RN, Brazil selecting overweight/obese (body mass index ≥25 and <39 kg/m2) women (18-35 years). The levels of DNA damage were assessed by a single cell gel electrophoresis. Repeated 24 h dietary recall questionnaires, anthropometry, biochemical profile and sex hormones were collected at baseline and after 12 weeks of intervention. Results: Women exhibiting a decrease in the markers of DNA damage: tail intensity (24.35 ± 5.86 - pre diet vs. 17.15 ± 5.04 - post-diet; p < 0.001) and tail moment (20.47 ± 7.85 - pre diet vs. 14.13 ± 6.29 - post-diet; p < 0.002). Reduction of calorie intake, weight loss, decreased sexual hormone and cardiometabolic markers such as insulin, homeostasis model assessment of insulin resistance and low-density lipoprotein cholesterol were verified In the multivariate regression analysis, quantitative insulin sensitivity check index and progesterone were responsible for the variation markers in DNA damage before the diet, losing its influence upon diet. Conclusion: DNA damage and the impact of cardiometabolic risk factors decreased after the intervention in women with PCOS, indicating the relevance of a nutritional approach in this group of patientsArtigo Aerobic exercise improves cardiac autonomic modulation in women with polycystic ovary syndrome(Elsevier, 2016-01) Sá, Joceline Cassia Ferezini de; Costa, Eduardo Caldas; Silva, Ester da; Tamburús, Nayara Y.; Porta, Alberto; Medeiros, Leany F.; Lemos, Telma Maria Araujo Moura Lemos; Soares, Elvira M. M.; Azevedo, George Dantas deBackground: this study aimed to evaluate the effects of aerobic exercise on cardiac autonomic modulation in women with polycystic ovary syndrome (PCOS). Methods: thirty women with PCOS (25.8 ± 4.8 years old; body mass index, BMI ≥ 25 kg/m2) were divided into two groups; exercise group (n = 15) and control group (n = 15). R–R interval was recorded during 15-min at rest in the supine position. Heart rate variability (HRV) was analyzed by linear (rMSSD, SDNN, LF, HF, LFnu, HFnu, and LF/HF) and nonlinear methods (Shannon entropy, SE; symbolic analyses, 0 V%, 1 V%, 2LV%, and 2UV%) at baseline and after 16 weeks. The multivariate analysis of covariance was used to analyze the effects of exercise on HRV indexes, adjusted for changes in BMI, fasting insulin, and testosterone level. Results: the exercise group increased parasympathetic modulation (rMSSD, HF, HFnu, 2UV%; (p b 0.05)) and decreased sympathetic modulation (LF, LFnu, 0 V%; (p b 0.05)) independently of changes in BMI, fasting insulin, and testosterone level. Moreover, the exercise group decreased resting HR and systolic blood pressure (p b 0.05). All parameters remained unchanged in the control group. Conclusions: aerobic exercise increased vagal modulation and decreased sympathetic modulation in women with PCOS. This finding reinforces the recommendations for exercise during the clinical management of these patientsArtigo Aerobic training improves quality of life in women with Polycystic Ovary Syndrome(Lippincott, Williams & Wilkins, 2018-07) Costa, Eduardo Caldas; Sá, Joceline Cássia Ferezini de; Stepto, Nigel Keith; Costa, Ingrid Bezerra Barbosa; Farias Junior, Luiz Fernando; Moreira, Simone da Nóbrega Tomaz; Soares, Elvira Maria Mafaldo; Lemos, Telma Maria Araujo Moura; Browne, Rodrigo Alberto Vieira; Azevedo, George Dantas dePurpose: to investigate the effects of a supervised aerobic exercise training intervention on health-related quality of life (HRQL), cardiorespiratory fitness, cardiometabolic profile, and affective response in overweight/obese women with polycystic ovary syndrome (PCOS). Methods: twenty-seven overweight/obese inactive women with PCOS (body mass index, ≥ 25 kg·m−2; age 18 to 34 yr) were allocated into an exercise group (n = 14) and a control group (n = 13). Progressive aerobic exercise training was performed three times per week (~150 min·wk−1) over 16 wk. Cardiorespiratory fitness, HRQL, and cardiometabolic profile were evaluated before and after the intervention. Affective response (i.e., feeling of pleasure/displeasure) was evaluated during the exercise sessions. Results: the exercise group improved 21% ± 12% of cardiorespiratory fitness (P < 0.001) and HRQL in the following domains: physical functioning, general health, and mental health (P < 0.05). Moreover, the exercise group decreased body mass index, waist circumference, systolic and diastolic blood pressure, and total cholesterol level (P < 0.05). The affective response varied from “good” to “fairly good” (i.e., positive affective response) in an exercise intensity-dependent manner during the exercise training sessions. Conclusions: progressive aerobic exercise training improved HRQL, cardiorespiratory fitness, and cardiometabolic profile of overweight/obese women with PCOS. Moreover, the participants reported the exercise training sessions as pleasant over the intervention. These results reinforce the importance of supervised exercise training as a therapeutic approach for overweight/obese women with PCOSArtigo Clustering of risk factors for cardiometabolic diseases in low-income, female adolescents(Sociedade Brasileira de Endocrinologia e Metabologia, 2016-06) Melo, Elza Maria Fernandes Seabra de; Azevedo, George Dantas de; Silva, João Batista da; Lemos, Telma Maria Araujo Moura; Maranhão, Técia M. O.; Freitas, Ana Karla Monteiro Santana de Oliveira; Spyrides, Maria H.; Costa, Eduardo CaldasObjective: To assess the prevalence and clustering patterns of cardiometabolic risk factors among low-income, female adolescents. Materials and methods: Cross-sectional study involving 196 students of public schools (11-19 years old). The following risk factors were considered in the analysis: excess weight, central obesity, dyslipidemia, high blood pressure, and high fasting glucose. The ratio between observed and expected prevalence and its confidence interval were used to identify clustering of risk factors that exceeded expected prevalence in the population. Results: The most prevalent risk factors were dyslipidemia (70.9%), and central obesity (39.8%), followed by excess weight (29.6%), and high blood pressure (12.8%). A total of 42.9% of adolescents had two or more risk factors, and 24% had three or more. Excess weight, central obesity, and dyslipidemia were common risk factors in the clustering patterns that showed higher-than-expected prevalence. Conclusions: Clustering of risk factors (≥ two factors) among the adolescents showed considerable prevalence, and there was a non-casual coexistence of excess weight, central obesity, and dyslipidemia (mainly low HDL-cholesterol).