Abstract Background: Chronic prostatitis has been a common disease reported with high frequency in ankylosing spondylitis (AS) even from decades ago. Infectious (Chlamydia trachomatis) or non-infectious (uric acid) prostatitis can hypothetically trigger vertebral inflammation in AS. This study aimed to assess the features of chronic prostatitis in patients with AS compared to healthy controls. Methods: A cross-sectional study including male patients with AS and healthy controls who agreed to undergo a prostate examination was conducted. Structured clinical interviews, prostate physical examinations, and cytological, biochemical, and microbiological tests on urinary samples collected before and after standardized prostatic massage (pre- and post-massage test) were performed. Results: Ninety participants (45 AS patients, mean age: 52.5 ± 10.0 years, with longstanding disease, 12.4 ± 6.9years, and 45 controls, mean age: 52.8 ± 12.1 years) were included. National Institutes of Health - Chronic Prostatitis Symptom Index (NIH-CPSI) scores were similar in the AS and control groups (4.0 [1.0-12.0] vs. 5.0 [1.0—8.5], p = 0.994). The frequencies of symptoms of chronic prostatitis (NIH-CPSI Pain Domain ≥4) were also similar in both groups (23.3% vs. 22.7%, p = 0.953). Results of polymerase chain reaction tests for Chlamydia trachomatis were negative in all tested urinary samples, and uric acid concentrations and leukocyte counts were similar in all pre- and post-massage urinary samples. Conclusions: In this study, chronic prostatitis occurred in male patients with AS, but its frequency and characteristics did not differ from those found in the healthy male population of similar age.

RESUMO Objetivo Realizar adaptação transcultural para o português brasileiro e verificar a validade de conteúdo de um instrumento de apoio à decisão originalmente produzido em língua inglesa (Making Choices: Feeding Options for Patients with Dementia), para auxiliar a escolha da via de alimentação de pacientes com disfagia por demência em estágio grave. Método Foi realizada a adaptação transcultural com duas traduções independentes do instrumento original, síntese das traduções, duas retrotraduções independentes, nova síntese e pré-teste com 30 cuidadores para produção da versão final em língua portuguesa. A validação de conteúdo da versão final foi realizada com a análise por um comitê de 35 especialistas (médicos, fonoaudiólogos e enfermeiros brasileiros com experiência no manejo de pacientes com demência em estágio grave) e baseada no índice de validade de conteúdo e na concordância entre múltiplos avaliadores pelo kappa de Fleiss. Resultados O nível de compreensão do instrumento pelos cuidadores foi adequado em todas as suas seções e seu conteúdo foi considerado válido pelo comitê de especialistas, de forma estatisticamente significativa. Conclusão O instrumento produzido de apoio à decisão para a escolha da via de alimentação em pacientes com demência grave e disfagia, denominado “Fazendo escolhas: opções de alimentação para pacientes com demência” obteve evidências de equivalência transcultural e de validade de conteúdo para uso na população brasileira. Novos estudos são necessários para avaliar seus efeitos sobre o processo de tomada de decisão em nossa população.

ABSTRACT Purpose Cross-cultural adaptation to Brazilian Portuguese and evaluation of content validity of a patient decision aid to help in choosing the feeding route for patients with severe dementia entitled “Making Choices: Feeding Options for Patients with Dementia”. Methods The cross-cultural adaptation involved two independent translations, synthesis of translations, two independent back-translations, their synthesis, and pretest with 30 caregivers. Content validation was based on analyzes of 35 Brazilian specialists (physicians, speech-language therapists and nurses experienced in caring for patients with severe dementia) through measures of content validity index and concordance between multiple judges by Fleiss’ kappa. Results The level of comprehension of the instrument by caregivers in the pretest was almost perfect. The specialists committee considered the contents of the instrument valid, in a statistically significant way. Conclusion The patient decision aid in Brazilian Portuguese entitled “Fazendo escolhas: opções de alimentação para pacientes com demência” obtained evidence of cross-cultural equivalence and content validity for use in the Brazilian population. Further studies are needed to assess its effects on the decision-making process in our population.

RESUMO OBJETIVO Descrever a distribuição e evolução histórica das vagas em cursos de graduação em medicina no Brasil. MÉTODOS Estudo transversal analítico de dados secundários. No Ministério da Educação obtiveram-se dados dos cursos de medicina e no Instituto Brasileiro de Geografia e Estatística foram obtidos dados populacionais e econômicos dos estados. RESULTADOS Havia no Brasil, até janeiro de 2018, 298 cursos de medicina (1,42 curso/milhão de habitantes), totalizando 31.126 vagas anuais, com 9.217 vagas gratuitas (29,6%) e 17.963 vagas no interior do País (57,7%). Nos estados há correlações positivas e significativas (p<0,001) das variáveis: “vagas em medicina” e “população” (R 0,92); “vagas em medicina” e “produto interno bruto” (“PIB”) (R 0,83); “percentual de vagas em medicina no interior” e “população no interior” (R 0,71) e “percentual de vagas em medicina no interior” e “PIB” (R 0,64). Há correlação negativa e significativa entre “percentual de vagas gratuitas” e “PIB” (R –0,54, p=0,003). Passaram a ser criados mais cursos pagos do que gratuitos e mais cursos no interior do que nas capitais a partir de 1964 (p <0,001), e a relação curso/milhão de habitantes aumentou a partir de 2002 (p<0,001). CONCLUSÕES A distribuição de vagas em cursos de medicina no Brasil correlaciona-se à população e à produção econômica de cada estado. A expansão do ensino médico brasileiro, acelerada além do crescimento populacional a partir de 2002, é baseada principalmente em cursos pagos no interior dos estados brasileiros, característica inalterada desde 1964.

SUMMARY BACKGROUND To describe the current distribution and historical evolution of undergraduate courses in medicine in Brasil. METHODS Analytical cross-sectional study of secondary data. Through the Ministry of Education, the data of the medical courses were obtained, and through the Brazilian Institute of Geography and Statistics, the population and economic data of the Brazilian states were obtained. RESULTS In Brasil, there were 298 medical courses (1,42 courses / million inhabitants) in January 2018, totaling 31,126 vacancies per year, with 9,217 gratuitous vacancies (29.6%) and 17,963 vacancies in the hinterland (57, 7%). In Brazilian states, there are positive and statistically significant (p <0.001) correlations of the variables: “vacancies” and “population” (R 0.92); “vacancies” and “gross domestic product” (“GDP”) (R 0.83); “percentage of vacancies in the hinterland” and “population in the hinterland” (R 0.71) and “percentage of vacancies in the hinterland” and “GDP” (R 0.64). There was a negative and statistically significant correlation between “gratuitous vacancy percentage” and “GDP” (R -0.54, p = 0.003). More paid courses than gratuitous courses and more courses in the hinterland than in the capitals have been created since 1964, in proportions that have remained similar since then, but in higher numbers since 2002. CONCLUSIONS The distribution of medical courses in Brasil correlates with the population and economical production of each state. The expansion of Brazilian medical education, which has been accelerated since 2002, is based mainly on paid courses in the hinterland, in the same pattern since 1964.

Abstract Background: To verify the validity of the 2016-revised Fibromyalgia Survey Questionnaire (FSQ) by telephone interview compared to self-administration and to produce a valid version of FSQ in Brazilian Portuguese language. Methods: The Brazilian version of FSQ was produced following the recommendations for cross-cultural adaptation. Validity of Brazilian FSQ self-administration was assessed by checking agreement of its results with fibromyalgia diagnosis according the 1990 American College of Rheumatology (ACR) criteria. Reproducibility and validity of FSQ by telephone were assessed by comparing its results with the previous FSQ self-administration. Results: A Brazilian Portuguese version (FSQ-Brazil) was produced. FSQ-Brazil had good internal consistency (Cronbach's alpha between 0.73 and 0.94). Agreement between the results obtained by self-administration of FSQ-Brazil and by telephone interview was substantial or almost perfect for almost all questions about pain sites and all questions about other somatic symptoms (Cohen's kappa higher than 0.6). There were small but significant bias toward higher scores of widespread pain index and fibromyalgia severity scale in the telephone interview compared to self-administration. Fibromyalgia definition by self-administration and telephone interview with FSQ-Brazil both revealed substantial agreement with the diagnosis based on ACR 1990 criteria (Cohen's kappa 0.62 and 0.65; respectively). Conclusions: FSQ-Brazil demonstrated good internal consistency, reproducibility and validity both by self-administration and by telephone interview. However, caution must be taken with the interpretation of quantitative scores of widespread pain index and symptoms severity scale, which slightly differed according the method (self-administration or interview) in our study.

Resumo Objetivos: Avaliar se o uso de instrumento de apoio para decisão compartilhada na escolha da via de alimentação em pacientes com demência em estágio grave traz benefício para a díade paciente/cuidador e avaliar a qualidade do processo decisório. Método: Busca nas bases de dados Medline, LILACS, IBECS, SciELO, WHOLIS por ensaios clínicos randomizados duplo cegos ou não, estudos quase-experimentais, observacionais de coorte, caso-controle ou transversais nos idiomas português, espanhol, inglês e francês. Resultados: Obtidos oito artigos que mostraram que o uso de apoio à decisão como método auxiliar de decisão compartilhada traz benefício, pois reduz o conflito decisional e aumenta o conhecimento dos cuidadores sobre o assunto. A qualidade do processo decisório é insatisfatória devido à baixa frequência das conversas entre cuidadores e equipe de saúde e a má avaliação dos cuidadores sobre a participação da equipe no processo decisório Conclusão: O instrumento de apoio à decisão compartilhada traz benefícios para cuidadores/pacientes submetidos à difícil tarefa de decidir a via de alimentação. Os achados sugerem que a atual qualidade do processo decisório é inadequada.

Abstract Objectives: To evaluate whether the use of a support tool for shared decision-making in the choice of feeding method for patients with severe dementia can benefit the patient/caregiver dyad, and to evaluate the quality of the decision-making process. Method: A search was performed in the Medline, LILACS, IBECS, SciELO, WHOLIS databases for randomized controlled trials, whether double-blind or otherwise, and quasi-experimental, cohort, case-control, or cross-sectional observational studies in Portuguese, Spanish, English and French. Results: Eight articles were found that showed that the use of a decision support tool, as an aid for the shared decision-making method, is beneficial as it reduces decisional conflict and increases the knowledge of caregivers about the subject. The quality of the decision-making process is unsatisfactory due to the low frequency of discussions between caregivers and the health team and the poor evaluation of caregivers about the participation of the team in the decision-making process. Conclusion: Decision support tools provide benefits for caregivers/patients undergoing the difficult task of deciding about feeding methods. Findings suggest that the current quality of decision-making is inadequate.

Resumo Objetivo: Avaliar os parâmetros associados à qualidade de vida em pacientes com doença de Paget óssea (DPO). Métodos: Avaliaram-se pacientes com DPO com os questionários SF-36 e WHOQOL-bref. Excluíram-se pacientes com outras doenças que pudessem causar comprometimento significativo da qualidade de vida. Buscou-se por correlações entre os resultados e idade, tempo de diagnóstico, tipo de envolvimento, dor relacionada com a DPO, limitação às atividades diárias, deformidades, fosfatase alcalina específica do osso, extensão do envolvimento e tratamento. Resultados: Incluíram-se 50 pacientes. Os resultados da pontuação total do SF-36 e seus domínios, saúde física e saúde mental, se correlacionaram significativamente com a dor óssea e deformidades. O estado civil se correlacionou significativamente com a pontuação total do SF-36 e com seu domínio saúde mental. Os níveis de BAP e a extensão da doença se correlacionaram significativamente com o domínio saúde física do SF-36. Depois da análise multivariada, os únicos parâmetros que permaneceram significativamente associados à pontuação total do SF-36 e aos seus domínios saúde mental e saúde física foram a dor e o estado civil. A pontuação total do WHOQOL-bref esteve significativamente associada à dor, ao comprometimento físico e a deformidades. O escore do Domínio 1 (físico) do WHOQOL-bref esteve significativamente associado ao estado civil, dor e deformidades, enquanto o Domínio 2 (psicológico) esteve associado ao estado civil, comprometimento físico e tipo de envolvimento. Depois da análise multivariada, a presença de dor, deformidades e estado civil esteve significativamente associada à pontuação total do WHOQOL-bref e à pontuação do seu Domínio 1. Os resultados do WHOQOL-bref 2 foram significativamente preditos pela dor e pelo estado civil. Conclusão: O principal fator associado aos escores do SF-36 foi a dor óssea, enquanto a dor óssea e as deformidades estiveram associadas ao WHOQOL-bref.

Abstract Objective: To evaluate the parameters associated with quality of life in patients with Paget's disease of bone. Methods: Patients with Paget's disease of bone were evaluated with SF-36 and WHOQOL-bref questionnaires. Patients with other diseases that could cause significant impairment of their quality of life were excluded. We searched for correlations between the results and: age, time from diagnosis, type of involvement, pain related to Paget's disease of bone, limitation to daily activities, deformities, bone specific alkaline phosphatase, the extent of involvement and treatment. Results: Fifty patients were included. Results of the SF-36 total score and its domains, physical and mental health, were significantly correlated with bone pain and deformities. Marital status was significantly correlated with the SF-36 total score and Mental Health Domain. BAP levels and disease extension were significantly correlated to SF-36 Physical Health Domain. After multivariate analysis, the only parameters that remained significantly associated with the SF-36 total score and to its Mental Health and Physical Health Domains were pain and marital status.The WHOQOL-bref total score was significantly associated with pain, physical impairment and deformities. WHOQOL-bref Domain 1 (physical) score was significantly associated with marital status, pain and deformities, while Domain 2 (psychological) score was associated with marital status, physical impairment and kind of involvement. After multivariate analysis, the presence of pain, deformities, and marital status were significantly associated with results of the WHOQOL-bref total score and its Domain 1. WHOQOL-bref domain 2 results were significantly predicted by pain and marital status. Conclusion: The main disease-related factor associated with SF-36 results in Paget's disease of bone patients was bone pain, while bone pain and deformities were associated with WHOQOL-bref.

ABSTRACT Objectives To analyze the role of moderate-to-vigorous physical activity (MVPA) in mediating the relationship between central adiposity and immune and metabolic profile in postmenopausal women. Materials and methods Cross-sectional study comprising 49 postmenopausal women (aged 59.26 ± 8.32 years) without regular physical exercise practice. Body composition was measured by dual-energy X-ray absorptiometry. Fasting blood samples were collected for assessment of nonesterified fatty acids, tumor necrosis factor-α (TNF-α), interleukin-6 (IL-6), adiponectin, insulin and estimation of insulin resistance (HOMA-IR). Physical activity level was assessed with an accelerometer (Actigraph GTX3x) and reported as a percentage of time spent in sedentary behavior and MVPA. All analyses were performed using the software SPSS 17.0, with a significance level set at 5%. Results Sedentary women had a positive relationship between trunk fat and IL-6 (rho = 0.471; p = 0.020), and trunk fat and HOMA-IR (rho = 0.418; p = 0.042). Adiponectin and fat mass (%) were only positively correlated in physically active women (rho = 0.441; p = 0.027). Physically active women with normal trunk fat values presented a 14.7% lower chance of having increased HOMA-IR levels (β [95%CI] = 0.147 [0.027; 0.811]). Conclusions The practice of sufficient levels of MVPA was a protective factor against immunometabolic disorders in postmenopausal women.

Abstract It is not yet clear which physical exercise protocols have greater potential to mitigate the functional decline in physical fitness (coordination, flexibility, strength, agility and cardiorespiratory capacity). Thus, the objective of this study was to compare different training modalities on physical fitness in women over 50 years of age and understand which training protocol is more effective for promoting significant improvements in physical fitness. The initial sample consisted of 79 subjects, of which 17 dropped out, resulting in a total of 62 subjects who completed the study and are included in the analysis (n = 62). The average age of the study population was 60.1±5.4 years, divided into five groups: aerobic training, concurrent training, multimodal training, functional training and control group. Physical fitness was analyzed through AAHPERD (American Alliance for Health, Physical Education, Recreation and Dance) tests (0 and eighth weeks). The ANOVA analyses (aleatory effect) show a main effect of time for coordination (p<0.001), strength (p = 0.004), agility (p<0.001) and cardiorespiratory capacity (p<0.001), and statistically significant interactions for coordination (p = 0.003) and cardiorespiratory capacity (p = 0.033). When comparing the average relative differences between the group (Δ%), significant improvement was observed in coordination and agility (p<0.001) in the multimodal and functional training groups. For cardiorespiratory fitness, there was a significant improvement in the aerobic, concurrent and multimodal training groups (p<0.001) and strength increased in the functional training group (p = 0.04). Functional training was demonstrated to be more effective at promoting significant improvements in physical fitness than the other investigated exercise protocols.

Resumo Objetivou-se propor a tabela normativa para a população brasileira de mulheres não ativas na pós-menopausa entre 50 e 69 anos por meio da bateria de teste de aptidão funcional da AAHPERD. Estudo de característica transversal, com 170 mulheres na pós-menopausa (dosagem de FSH>26,72 mIU/L). A população foi dividida em dois grupos: 50 a 59 anos (n=97) e de 60 a 69 anos (n=73). Os critérios de inclusão foram não participar de intervenção motora sistematizada nos seis meses anteriores ao período do estudo; não apresentar comprometimentos motores ou cognitivos que inviabilizassem a realização dos protocolos de avaliação, não apresentar comorbidade que pudessem impedir ou limitar a realização das avaliações. O grupo 50 a 59 anos apresentou valores médios de 55,6 ± 2,9 anos de idade, 54,0 ± 21,1 mUI/ ml para FSH, 11,3 ± 1,8 segundos para coordenação, 20,2 ± 4,0 repetições para força, 51,9 ± 11,8 centímetros para flexibilidade, 23,0 ± 2,4 segundos para agilidade e 497 ± 39 segundos para resistência aeróbia. O grupo de 60 a 69 anos apresentou média de 64,2 ± 2,8 anos de idade, 54,9 ± 16,1 mUI/ml para o FSH, 11,5 ± 2,5 segundos para coordenação, 20,2 ± 4,3 repetições para força, 54,4 ± 10,9 centímetros para flexibilidade, 24,5 ± 4,0 segundos para agilidade e 507 ± 47 segundos para resistência aeróbia. A proposta de apresentar uma tabela normativa foi possível com os dados analisados, sendo essa uma nova referência em relação a estudos de aptidão funcional especialmente em mulheres fisicamente inativas na pós-menopausa.

Abstract The aim of this study was to propose the normative table for the non-active postmenopausal Brazilian population composed of women aged 50-69 years through the AAHPERD functional fitness test battery. This is a cross-sectional study with 170 postmenopausal women (FSH dose> 26.72 mIU / L). The population was divided into two groups: 50-59 years (n = 97) and 60-69 years (n = 73). The inclusion criteria were not having participated of systematic motor intervention in the six months prior to the study period; not presenting motor or cognitive impairments that could impair the performance of evaluation protocols and absence of comorbidities that could prevent or limit evaluations. The group aged 50-59 years showed mean values of 55.6 ± 2.9 years for age, 54.0 ± 21.1 mIU / ml for FSH, 11.3 ± 1.8 seconds for coordination 20.2 ± 4.0 repetitions for strength, 51.9 ± 11.8 cm for flexibility, 23.0 ± 2.4 seconds for speed and 497 ± 39 seconds for aerobic resistance. The group aged 60-69 years showed mean values of 64.2 ± 2.8 years of age, 54.9 ± 16.1 mIU / ml for FSH, 11.5 ± 2.5 seconds for coordination, 20.2 ± 4.3 repetitions for strength, 54.4 ± 10.9 cm for flexibility, 24.5 ± 4.0 seconds for speed and 507 ± 47 seconds for aerobic resistance. The proposal of a normative table was made possible with the data analyzed, which is a new reference regarding functional fitness studies especially in physically inactive postmenopausal women.

OBJETIVO: analisar o nível de aptidão funcional de um grupo de mulheres na pós-menopausa da cidade de Presidente Prudente por meio do conjunto de testes de aptidão funcional da American Aliance for Health, Physical Education, Recreation and Dance e verificar se existe diferença entre grupos de mulheres na quinta e sexta década de vida. MÉTODOS: estudo de característica transversal, com 175 mulheres na pós-menopausa (dosagem de hormônio folículo estimulante>26,72 mIU/L) desenvolvido na cidade de Presidente Prudente no ano de 2013. Os critérios de inclusão foram não ter feito parte de nenhum tipo de intervenção motora sistematizada durante, pelo menos, seis meses do período que antecedeu a coleta de dados da investigação; não apresentar comprometimentos motores ou cognitivos que inviabilizassem a realização dos protocolos de avaliação, não apresentar doença crônica ou degenerativa, lesão musculo-esquelética ou comorbidade que pudessem impedir ou limitar a realização das avaliações. As avaliações foram conduzidas pelos mesmos avaliadores treinados. O grupo 50 a 59 anos apresentou valores médios para idade de 55,3±4,5 anos, FSH de 53,5±21,1 mUI/mL, coordenação 11,4±2,2 segundos, força 20,1±3,9 repetições, flexibilidade 51,7±11,8 centímetros, agilidade 23,2±2,8 segundos e Resistência aeróbia 500±43 segundos e o grupo 60 a 69 anos apresentou idade média de 65,1±4,1 anos com FSH de 54,9±15,9, coordenação 11,6±2,6 segundos, força 20,3±4,7 repetições, flexibilidade 54,6±11,2 centímetros, agilidade 24,7±4,3 segundos e Resistência aeróbia 508±51 segundos. CONCLUSÃO: foi possível analisar a aptidão funcional de mulheres na pós-menopausa por meio do conjunto de testes da American Aliance for Health, Physical Education, Recreation and Dance não havendo diferenças significativas para as variáveis força, flexibilidade, capacidade aeróbia e coordenação, sendo que apenas a variável agilidade demonstrou diferenças significativas. Recomenda-se outros estudos, buscando formular valores normativos para a população em questão.

PURPOSE: to analize the level of functional fitness of a group of postmenopausal women in the city of Presidente Prudente using the set of functional fitness tests of the American Alliance for Health, Physical Education, Recreation and Dance and to check whether there are differences between groups of women in the fifth and sixth decade of life. METHODS: This was a cross-sectional study conducted on 175 postmenopausal women (follicle stimulating hormone level>26.72 mIU/L) in the city of Presidente Prudente in 2013. The inclusion criteria were not being part of any type of systematic motor intervention for at least six months before the collection of research data; absence of motor or cognitive impairment that would prevent the evaluation protocols, and absence of chronic or degenerative disease, musculoskeletal injury or comorbidity that could prevent or limit the evaluations. The women were evaluated by the same trained examiners. The 50 to 59 year group showed a mean age of 55.3±4.5 years, mean FSH values of 53.5±21.1 mIU/mL, mean coordination of 11.4±2.2 seconds, mean strength of 20.1±3.9 repetitions, mean flexibility of 51.7±11.8 cm, mean 23.2±2.8 seconds agility and mean aerobic resistance of 500±43/2 . The 60 to 69 year group had a mean age of 65.1±4.1 years with FSH 54.9±15.9, 11.6±2.6 seconds coordination, strength 20.3±4.7 repetitions, 54.6±11.2 cm flexibility, agility 24.7±4.3 seconds, and aerobic resistance of 508±51 seconds. CONCLUSION: It was possible to analyze the functional fitness of postmenopausal women through the set of the American Alliance testing for Health, Physical Education, Recreation and Dance with no significant differences between groups for the variables strength, flexibility, aerobic capacity and coordination, and with only the speed variable showing significant differences. We recommend further studies seeking to formulate normative values for the population in question.

OBJETIVO: Avaliar o efeito de 8 semanas de treinamento funcional sobre a composição corporal de mulheres na pós-menopausa.MÉTODOS: Participaram do estudo 38 mulheres menopausadas, distribuídas em dois grupos: Grupo Treino (GT) e Grupo Controle (GC). As participantes do GT (n=21) realizaram, por um período de 8 semanas, um programa de exercícios físicos, com frequência de 3 vezes por semana, em dias não consecutivos, e duração de 90 minutos por sessão. Pelo mesmo período, as mulheres do GC (n=17) não realizaram nenhum tipo de atividade física sistematizada. Todas as participantes foram avaliadas no momento inicial da pesquisa e após 8 semanas. As avaliações foram conduzidas pelos mesmos avaliadores treinados. A análise da composição corporal foi realizada no equipamento de absortiometria de raios X de dupla energia (DEXA) que permite estimar a composição corporal no todo e por segmento. As participantes do GT realizaram um programa de exercícios físicos funcionais, 3 dias da semana (não consecutivos), com sessões compostas por 11 estações de exercícios desenvolvidas em formato de circuito. Os exercícios realizados tinham como proposta o desenvolvimento das capacidades força, agilidade, coordenação e propriocepção, e eram seguidos de exercício aeróbio (caminhada). Depois de constatada normalidade dos dados verificada pelo teste Shapiro-Wilk (p<0,05), procedeu-se ao teste t de Student para amostras independentes para verificação de possíveis diferenças em variáveis de composição corporal e antropométricas entre grupos nos dois momentos da intervenção (pré e pós-teste). Todas as análises foram realizadas com o software SPSS, v. 17.0 (SPSS Inc., Chicago, IL, USA) com valor de significância estabelecido em 5%.RESULTADOS: No momento inicial nenhuma diferença significante foi observada entre as variáveis de composição corporal, antropométricas e idade, indicando homogeneidade dos grupos. Após 8 semanas de treinamento, foram observadas diferenças significativas entre o GT e o GC quanto à gordura de tronco - GC=0,2±0,7 e GT=-0,4±0,5, gordura corporal total (kg) - GC=0,2±1,3 e GT=-0,7±0,8 e no peso total - GC=0,4±1,4 e GT =-0,6±1,1. A variável percentual de gordura total apresentou redução nos valores absolutos, porém sem significância, GC=0,1±1,5 e GT=-0,8±1,5.CONCLUSÃO: O treinamento funcional no formato de circuito pode ser usado como estratégia para alteração da composição corporal de mulheres na pós-menopausa, em especial na redução do tecido adiposo. Trata-se de um modelo que promove elevada aderência dos seus participantes, sugerindo ser uma proposta atrativa para a faixa etária investigada.

PURPOSE: To evaluate the effect of 8 weeks of functional training on body composition in postmenopausal women.METHODS: The study was conducted on 38 postmenopausal women, divided into two groups: Training Group (TG) and Control Group (CG). TG women (n=21) performed a program of physical exercise for a period of 8 weeks, 3 times a week on nonconsecutive days, with 90 minutes per session. For the same period, CG women (n=17) did not perform any systematic physical activity. All participants were assessed at baseline and after 8 weeks. The evaluations were performed by the same trained raters. Analysis of body composition was performed using dual-energy X-ray absorptiometry (DEXA), which allows estimation of body composition in the whole body and by segment. TG participants performed a functional exercise program 3 days a week (non-consecutive), with 11 stations consisting of exercises developed in circuit format sessions. The objectives of the exercises were the development of strength, agility, coordination and proprioception, followed by aerobic exercise (walking). After normality of the data was determined by the Shapiro-Wilk test (p<0.05), we applied the Student t-test for independent samples to check for possible differences in anthropometric variables and body composition between groups at both times of intervention (pre and post-test). All analyses were performed using the SPSS software v. 17.0 (SPSS Inc., Chicago, IL, USA) with the level of significance set at 5%.RESULTS: At baseline, no significant difference was observed between groups regarding anthropometric body variables or age composition, indicating homogeneity of the groups. After 8 weeks of training, significant differences were observed between TG and CG regarding fat - CG=0.2±0.7 and TG=-0.4±0.5, total body fat (kg) - CG=0.2±1.3 and TG=-0.7±0.8, and total weight - CG=0.4±1.4 and TG=-0.6±1.1. Percent body fat was reduced in terms of absolute values, although without significance: CG=0.1±1.5 and TG=-0.8±1.5.CONCLUSION: Functional training in circuit format can be used as a strategy to alter body composition in postmenopausal women, particularly in terms of reduction of adipose tissue. This is a model that promotes high adhesion on the part of the participants, suggesting that it is an attractive proposal for the investigated age group.

OBJETIVO: Verificar a relação entre gordura corporal total e de tronco com o desempenho da marcha em mulheres na menopausa.MÉTODOS: Trinta e nove mulheres na menopausa, com idade de 50 anos ou mais, foram avaliadas. As avaliações foram: peso e estatura para cálculo do índice de massa corporal (IMC), composição corporal pela técnica de Dual-Energy X-ray Absorptiometry (DEXA) e marcha utilizando um baropodômetro. As variáveis de composição corporal utilizadas foram gordura corporal total, percentual de gordura corporal e gordura de tronco, enquanto as variáveis da marcha foram porcentagem de tempo de duplo apoio e de apoio simples e velocidade. As mulheres foram divididas de acordo com a mediana em dois grupos para cada variável da composição corporal: menos e mais gordura corporal, menos e mais percentual de gordura e menos e mais gordura de tronco. Para comparar as variáveis de marcha nesses grupos, foi utilizado o teste de Mann-Whitney. Para avaliar as possíveis relações entre as variáveis de composição corporal e marcha, o teste de correlação de Spearman foi utilizado. Todas as análises foram realizadas com nível de significância de 5%.RESULTADOS: O grupo com mais gordura de tronco, quando comparado com o grupo com menos gordura de tronco, apresentou maiores valores de duplo apoio (p=0,007) e menores valores de apoio simples (0,03). Foram encontradas correlações significativas e positivas entre gordura de tronco e duplo apoio (R=0,40) e negativas entre gordura de tronco e apoio simples (R=-0,32).CONCLUSÃO: Mulheres na menopausa que apresentam maiores quantidade de gordura no tronco tendem a apresentar desempenho prejudicado na marcha.

PURPOSE: To determine the relationship between total body and trunk fat mass and gait performance in postmenopausal women.METHODS: Thirty-nine postmenopausal women aged 50 years or more were studied. The following items were determined: weight and height to calculate body mass index (BMI), body composition using the technique of Dual-Energy X-ray Absorptiometry (DXA), and gait using baropodometry. The body composition variables used were total body fat, percent body fat and trunk fat, while the gait variables were percent double stance time and single stance time and gait speed. The women were divided into two groups according to the median for each body composition variable: less and more body fat, less and more percent body fat and less and more trunk fat. To compare the gait variables between groups, we used the Mann-Whitney test. To evaluate the possible relationships between body composition variables and gait variables, we used the Spearman correlation test. All analyses were performed with the level of significance set at 5%.RESULTS: The group with more trunk fat showed longer double stance time (p=0.007) and lower values of single stance time (0.033) than the group with less trunk fat. We found significant and positive correlations between trunk fat and double stance time (R=0.40) and negative correlations between trunk fat and single stance time (R=-0.32).CONCLUSION: Postmenopausal women with a greater amount of trunk fat tended to have impaired gait performance.

Objectives To create a Brazilian version of the National Institutes of Health – Chronic Prostatitis Symptom Index (NIH-CPSI) using a cross-cultural adaptation process. Materials and Methods The nine items of the NIH-CPSI were translated to Portuguese, by two independent translators, of native Portuguese language origin, and it was obtained a single version, that was retranslated to English by two English native spoken translators, in order to correct any discrepancies. Those versions were compared to the original text, the modifications were applied and it was created a final version in Portuguese. That was pre-tested and applied to 30 patients with pain or perineal or ejaculatory disorder. To each item of the pre-final version it was assigned a score according to the grade of understanding and clarity in order to implement the adequate corrections. The final version in Portuguese was submitted to evaluations including face validation and psychometric proprieties of reproducibility and internal consistency, respectively evaluated by the (p) Pearson correlation coefficient and α Cronbach coefficient. Results All items applied to 30 patients during pre-test phase had a grade higher than 8 of understanding and clarity, and were considered clearly understandable by the patients. However, at face validation evaluation, there was an inconsistency of item three that was redone. The final produced version, called NIH-CPSI (Braz) showed good reproducibility (p = 0.89-0.99) and internal consistency (α Cronbach coefficient = 0.85-0.93). Conclusions NIH-CPSI was adapted to Brazilian spoken Portuguese and its original proprieties were maintained, being a valid instrument for evaluations of symptoms of chronic prostatitis in Brazilian patients.

Calcificação e ossificação do ligamento amarelo ou do ligamento longitudinal posterior são causas de mielopatia compressiva, mais frequentes nos níveis torácicos inferiores e bastante raras em populações ocidentais. A descompressão cirúrgica é a única terapia proposta, mas a doença costuma ser progressiva e sua recorrência após a cirurgia não é incomum. Mediadores inflamatórios podem ter algum papel na progressão da mielopatia compressiva, mas não se tem notícia de qualquer proposta de abordagem terapêutica envolvendo agentes anti-inflamatórios. Neste contexto, relatamos um caso de mielopatia compressiva por calcificação do ligamento amarelo em que se observou hiperproteinorraquia e resposta à corticoterapia. Tais informações são inéditas e podem fornecer novas ideias para a compreensão da doença.

Calcification and ossification of the ligamentum flavum or of the posterior longitudinal ligament are causes of compressive myelopathy, more frequent in the lower thoracic levels, and extremely rare in Western populations. Surgical decompression is the only therapy, but the disease is usually progressive, and its recurrence after surgery is common. Inflammatory mediators might play a role in the progression of compressive myelopathy, but, to our knowledge, the therapeutic approach involving anti-inflammatory agents has never been tried before. We report a case of compressive myelopathy due to calcification of the ligamentum flavum, in which hyperproteinorachia and response to steroid therapy have been observed. Those data have not been published before and might provide new ideas for the disease understanding.

O uso crônico de cocaína por inalação pode causar lesões destrutivas de linha média (LDLMIC), que podem ser difíceis de distinguir das lesões da granulomatose de Wegener (GW) nos ouvidos, nariz e garganta. Descrevemos o caso de uma paciente de 43 anos admitida com história de dois anos de obstrução nasal e rinorreia. Ela havia recebido o diagnóstico de GW há cinco meses e estava em tratamento com prednisona e ciclofosfamida. Ao exame físico apresentava perfuração de septo nasal e palato. Exames de laboratório mostraram elevação das proteínas de fase aguda e teste p-ANCA positivo. Ensaios ELISA antiproteinase 3 e mieloperoxidase foram negativos. Tomografia computadorizada (TC) dos seios paranasais mostrou destruição de septo nasal e palato, bem como sinusite maxilar bilateral. TC de tórax resultou normal. Biópsia da mucosa nasal revelou infiltrado inflamatório sem granuloma ou vasculite. Quando questionada, admitiu ser usuária de cocaína há cinco anos. Os imunossupressores foram suspensos e a paciente não mais fez uso da droga. Ela está sendo monitorada há seis meses e não desenvolveu novas lesões ou sintomas de outros órgãos. O diagnóstico diferencial em pacientes com LDLMIC pode ser desafiador. A avaliação deve incluir pesquisa de uso intranasal de cocaína. Embora o teste de ANCA não diferencie claramente o ANCA encontrado em alguns pacientes com LDLMIC daqueles em pacientes com GW, o envolvimento localizado e os achados de biópsia não típicos de vasculite granulomatosa de pequenos vasos devem ser reconhecidos como características das lesões induzidas por cocaína.

Chronic use of cocaine by inhalation may induce midline destructive lesions (CIMDL), which can sometimes be difficult to distinguish from the ear, nose and throat lesions of Wegener's Granulomatosis (WG). We describe the case of a 43-year-old female patient admitted with a two-year history of nasal obstruction and rhinorrhea. She had been diagnosed with WG for five months, being on prednisone and cyclophosphamide. On her physical examination, perforation of her nasal septum and palate was observed. Laboratory tests showed elevated acute phase proteins and a positive p-ANCA test. ELISA assays anti-proteinase 3 and myeloperoxidase were negative. The paranasal sinus computed tomography (CT) showed destruction of the nasal septum and palate, in addition to bilateral maxillary sinusitis. Chest CT was normal. Nasal mucosal biopsy revealed an inflammatory infiltrate, with neither granuloma nor vasculitis. When questioned, she admitted being a cocaine user for five years. Medical therapy and cocaine use were withdrawn. She has been followed up for six months and no other lesion or other organ symptoms occurred. Differential diagnosis in patients with midline destructive lesions can be very challenging. Evaluation should include enquiry about intranasal use of cocaine. Although ANCA testing does not clearly differentiate the ANCA found in some patients with CIMDL from those found in WG patients, the localized involvement and the biopsy findings non-characteristic of small vessel granulomatous vasculitis should be recognized as features for cocaine-induced lesions.