Abstract Background Sex-specific pathology of coronary artery disease (CAD) has not been recognized. Women with obstructive or nonobstructive CAD associated with traditional risk factors have similar events; no studies have explored both populations in association with genetic markers. Objective To evaluate the DD genotype in overweight menopausal women and its association with CAD and traditional risk factors. Method This cross-sectional study included 356 menopausal women who underwent coronary angiography as CAD assessment. The patients’ DNA was extracted and polymorphisms were detected with a single polymerase chain reaction assay. Two groups were formed based on luminal lesions (normal [n = 134] or pathological [n = 222]) with a cutoff value > 30%, considering overweight and age. The chi-square test, Student’s t-test, and multivariate logistic regression were performed as appropriate (p < 0.05) using the following variables: overweight, diabetes, hypertension, dyslipidemia, smoking status, sedentary lifestyle, and a family history of CAD. Results The mean age of the sample was 63 + 8 years, and the mean BMI was 28 + 5 kg/m2. The DD genotype was slightly more prevalent in the pathological group (30.2% vs. 21.6%, p = 0.079), but this significantly changed when BMI > 25 was considered (33% vs. 18%, p = 0.012). In multivariate analysis with two threshold levels (> 50 and > 60 years), diabetes was significantly associated with CAD in both models (p = 0.021 vs. 0.009) but the genotype was only associated with younger age (p = 0.034). Conclusion These data support an association between atherosclerosis and the renin–angiotensin system in overweight menopausal women that is dependent on the age at which the ischemic event occurs.

Resumo Embora o comportamento sedentário (CS) esteja relacionado ao desenvolvimento de doenças metabólicas, ainda não há consenso na literatura sobre a associação entre o CS avaliado diretamente por acelerometria e a obesidade, especialmente quando essa relação é ajustada por fatores de risco cardiovascular e nível de atividade física. Objetivou-se avaliar a associação entre CS e obesidade ajustada por potenciais confundidores em adultos. Foram analisados os dados de 780 participantes do Estudo Epidemiológico sobre o Movimento Humano (EPIMOV). Dados relativos à massa corporal, índice de massa corporal (IMC) e porcentagem de gordura corporal (%GC) (bioimpedância elétrica) foram obtidos e, então, utilizados para estratificar os participantes. O CS foi medido objetivamente por meio de acelerômetros triaxiais colocados sob o quadril dominante durante as horas de vigília por, pelo menos, quatro dias consecutivos (4-7 dias). O CS e seu padrão não foram significativamente diferentes entre os grupos de obesidade. Embora o CS tenha apresentado algumas correlações significativas com a obesidade, o coeficiente de correlação e determinação indicou uma fraca associação entre o CS e a obesidade (por exemplo, IMC e %GC). A obesidade apresentou pouca ou nenhuma associação com o CS e seu padrão após o ajuste para potenciais fatores de confusão, principalmente quando avaliado com acelerômetro.

Abstract Although sedentary behavior (SB) is related to the development of metabolic diseases, there is still no consensus in literature about the association between accelerometer-based SB and obesity, especially adjusted for cardiovascular risk factors and level of daily physical activities. The aim was to evaluate the association between obesity and SB adjusted for potential confounders in adults. Data from 780 participants of the Epidemiology and Human Movement (EPIMOV) Study were analyzed. Body weight, body mass index (BMI), and fat body mass as percentage (%FBM) (bioelectrical impedance) were obtained and, then, used to stratify participants. SB was objectively measured using triaxial waist-worn accelerometers placed above the dominant hip during waking hours for at least four consecutive days (4-7 days). SB and its pattern were not significantly different between obesity groups. Although SB presented some significant correlations with obesity, the correlation and determination coefficient indicated weak association between SB and obesity (e.g., BMI and %FBM). Obesity presented little or no association with SB and its pattern after adjustment for potential confounders, especially when SB is measured through accelerometry.

Resumo Introdução: As respostas fisiológicas ao teste de caminhada de 6 minutos (TC6) têm sido cada vez mais avaliadas em pacientes com doenças cardiopulmonares. No entanto, estudos anteriores não incluíram pessoas saudáveis. Objetivo: Avaliar a intensidade do TC6, desenvolver uma série de equações preditivas para as variáveis fisiológicas e testar sua confiabilidade em indivíduos saudáveis de meia-idade e idosos. Método: Avaliamos 102 adultos saudáveis não treinados (54 mulheres, com idade de 61 ± 10 anos) e uma amostra de validação cruzada de 30 participantes. Nós medimos as respostas fisiológicas ao TC6 e ao teste de exercício cardiopulmonar (TECP) em esteira rolante. Resultados: Os valores de R2 para análise de regressão ajustados por idade, massa corporal, estatura e sexo variaram de 0,25 para frequência cardíaca e 0,46 para pico V ˙ O 2 A distância e o V ˙ O 2 no TC6 representou 110 ± 10% e 102 ± 15% dos valores previstos, respectivamente, usando nossas equações. A intensidade do TC6 correspondeu a 72 ± 13% do pico de V ˙ O 2 e 78 ± 23% do pico de frequência cardíaca no TECP. O pico de no TECP foi adequadamente previsto pelo pico de V ˙ O 2 (R2 = 0,76) e pela distância no TC6 (R2 = 0,54). Conclusão: O TC6 representa um teste de intensidade moderada a alta em adultos saudáveis de meia-idade e idosos e é válido para avaliar a capacidade máxima de exercício aeróbico. Respostas fisiológicas ao TC6 podem ser adequadamente previstas com uma combinação de dados antropométricos e demográficos.

Abstract Introduction: Physiological responses to the 6-min walk test (6MWT) have been increasingly evaluated in patients with cardiopulmonary diseases. However, previous studies did not include healthy persons. Objective: To evaluate the intensity of 6MWT, to develop a series of predictive equations for the physiological variables and to test their reliability in healthy middle-aged and older adults. Method: We evaluated 102 non-trained healthy adults (54 women, aged 61 ± 10 years) and a cross-validation sample of 30 participants. We measured physiological responses to the 6MWT and a cardiopulmonary exercise testing (CPET) on a treadmill. Results: The R2 values for regression analysis adjusted by age, body mass, stature, and sex ranged from 0.25 for heart rate and 0.46 for peak V ˙ O 2 The 6MWT distance and 6MWT peak V ˙ O 2 represented 110 ± 10% and 102 ± 15% of the predicted values, respectively, using our equations. The intensity of 6MWT corresponded to 72 ± 13% of the peak O2 and 78 ± 23% of the peak HR in the CPET. Peak V ˙ O 2 in the CPET was adequately predicted by 6MWT peak V ˙ O 2 (R2 = 0.76) and 6MWD (R2 = 0.54). Conclusion: The 6MWT represents a moderate to high-intensity test in middle-aged and older healthy adults and is valid for assessing maximal aerobic exercise capacity. Physiological responses to the 6MWT may be adequately predicted with a combination of anthropometrics and demographics.

Resumen Introducción: Las respuestas fisiológicas a la prueba de caminata de 6 minutos (PC6M) se han evaluado cada vez más en pacientes con enfermedades cardiopulmonares. Sin embargo, estudios anteriores no incluyeron a personas sanas. Objetivo: Evaluar la intensidad de la PC6M, desarrollar una serie de ecuaciones predictivas para las variables fisiológicas y probar su confiabilidad en individuos sanos de mediana edad y en ancianos. Método: Evaluamos 102 adultos sanos no entrenados (54 mujeres, con edad de 61 ± 10 años) y una muestra de validación cruzada de 30 participantes. Medimos las respuestas fisiológicas a la PC6M y a una prueba de ejercicio cardiopulmonar (PECP) en la cinta de correr. Resultados: Los valores de R2 para análisis de regresión ajustados por edad, masa corporal, estatura y sexo variaron de 0,25 para frecuencia cardíaca y 0,46 para pico O2. La distancia y el V ˙ O 2 en la PC6M representaron 110 ± 10% y 102 ± 15% de los valores previstos, respectivamente, usando nuestras ecuaciones. La intensidad de la PC6M correspondió a 72 ± 13% del pico de V ˙ O 2 y a 78 ± 23% del pico de frecuencia cardiaca en la PECP. El pico de V ˙ O 2 en la PECP fue adecuadamente previsto por el pico de V ˙ O 2 (R2 = 0,76) y por la distancia en la PC6M (R2 = 0,54). Conclusión: La PC6M representa una prueba de intensidad moderada a alta en adultos sanos de mediana edad y en ancianos y es válida para evaluar la capacidad máxima de ejercicio aeróbico. Las respuestas fisiológicas a la PC6M pueden ser previstas con una combinación de datos antropométricos y demográficos.

Resumo Introdução: O Comportamento sedentário (CS) tem sido descrito como fator de risco independente para saúde, a despeito da recomendação de atividade física moderada a intensa (AFMI). Contudo, pouco foi investigado se CS e AFMI são preditores da ocorrência de quedas. Objetivo: Comparar as associações entre CS e AFMI e a ocorrência de quedas em adultos de meia-idade e idosos. Método: Os participantes usaram acelerômetro triaxial no quadril dominante por sete dias para obtenção de CS e AFMI. A ocorrência de quedas e o risco cardiovascular foram avaliados através de autorrelato. Avaliamos o pico de torque (PT) isocinético da extensão de joelho, o pico de consumo de oxigênio (V’O2) em protocolo de rampa na esteira, e massa magra (MMC) e gordura (GC) corporais (bioimpedância elétrica). Comparamos o papel de CS e AFMI na ocorrência de quedas através de regressões lineares múltiplas ajustadas por idade, sexo, fatores de risco para doença cardiovascular, MMC, V’O2 pico, e PT da extensão de joelho. Resultados: Avaliamos 379 participantes de 40 - 80 anos. Quarenta e oito participantes reportaram, pelo menos, uma queda nos 12 meses anteriores ao estudo (14.5%). Os caidores apresentaram menor CS e maior AFMI. Eles eram predominantemente mulheres e idosos com menor aptidão física. Após as análises multivariadas, AFMI foi selecionada como preditor independente da ocorrência de quedas, aumentando o odds ratio de cair (1.184, 95% intervalo de confiança, 1.016 - 1.378). Conclusão: Os episódios de quedas, sobretudo em mulheres de meia-idade, foram associados com maior AFMI, indicando efeito adverso da AFMI nestes sujeitos.

Abstract Introduction: Sedentary behavior (SB) has been described as an independent risk factor for health, regardless of the recommended amount of moderate-to-vigorous physical activity (MVPA). However, SB and MVPA as predictors of falls have been poorly investigated. Objective: To compare the associations between SB and MVPA and the occurrence of falls in middle-aged and older adults. Method: The participants wore a triaxial accelerometer over the dominant hip for seven days to measure SB and MVPA. The occurrence of falls and cardiovascular risk factors were assessed by self-report. Isokinetic peak torque (PT) of knee extension, peak oxygen uptake (V’O2) in a ramp treadmill protocol, and lean (LBM) body mass and body fat (BFM) (bioelectrical impedance) were also assessed. The critical roles of SB and MVPA on the occurrence of falls were compared by multiple logistic regression adjusted for age, sex, cardiovascular risk factors, LBM, peak V’O2, and PT of knee extension. Results: 379 participants were evaluated, aged 40-80 years. Forty-eight participants reported at least one fall in the previous 12 months (14.5%). Fallers presented lower SB and higher MVPA. They were predominantly women and older adults with lower physical fitness. After multivariate analysis, MVPA, but not SB, was selected as an independent predictor of falls, increasing the odds ratio of having a fall (1.184, 95% confidence interval, 1.016 - 1.378). Conclusion: Episodes of falls in predominantly middle-aged and women subjects were associated with a higher amount of MVPA, not the opposite, indicating an adverse effect of MVPA in these subjects.

Resumen Introducción: El comportamiento sedentario (CS) se ha descrito como un factor de riesgo independiente para la salud, independientemente de la cantidad recomendada de actividad física moderada a vigorosa (AFMV). El CS y el AFMV como predictores de caídas fueron poco investigados. Objetivo: Comparar las asociaciones entre CS y AFMV, y la ocurrencia de caídas en adultos de mediana edad y mayores. Método: Los participantes usaron un acelerómetro triaxial durante siete días para medir CS y AFMV. La ocurrencia de caídas y factores de riesgo cardiovascular se evaluaron mediante autoinforme. Se evaluó el torque máximo isocinético (TM) de la extensión de la rodilla, el consumo máximo de oxígeno (V’O2) en un protocolo de rampa en la estera, y masas corporales magra (MMC) y grasa (GC) (impedancia bioeléctrica). Comparamos los papeles de CS y AFMV en la ocurrencia de caídas mediante la regresión logística múltiple ajustada por edad, sexo, factores de riesgo cardiovascular, MMC, pico de V’O2 y TM de la extensión de la rodilla. Resultados: Se evaluaron 379 participantes de 40 - 80 años. Cuarenta y ocho participantes informaron al menos una caída en los 12 meses previos (14,5%). Caedores presentaron menor CS y mayor AFMV. Eran predominantemente mujeres y mayores con menor aptitud física. Después de los análisis multivariados, AFMV, pero no CS, fue seleccionada como predictor independiente de caídas, lo que aumentó la odds ratio de tener una caída (1.184, intervalo de confianza del 95%, 1,016 - 1,378). Conclusión: los episodios de caídas en mujeres de mediana edad se asociaron con mayor AFMV, lo que indica un efecto adverso de AFMV en estos sujetos.

Resumo Levantamos a hipótese de que a prevalência de intolerância ao exercício (IE, pico de consumo de O2 < 83%pred.) não é significativamente afetada pelo índice de massa corporal (IMC) em adultos submetidos ao teste de exercício cardiopulmonar (TECP). Nosso objetivo foi avaliar a prevalência de IE e a influência do IMC em adultos assintomáticos. Foram avaliados os resultados do TECP de 780 adultos (idade 41 ± 13 anos). Os participantes foram estratificados de acordo com o IMC: eutrófico (n = 227), sobrepeso (n = 198), e obesidade grau 1 (n = 155), 2 (n = 131), e 3 (n = 69). Após a avaliação do risco cardiovascular, os participantes foram submetidos ao TECP em uma esteira, sob o protocolo de rampa. A prevalência de IE foi 20, 16, 21, 25, e 21% respectivamente nos grupos estratificados, e nenhuma diferença significativa foi encontrada. Os preditores da IE foi inatividade física, idade e tabagismo. A prevalência de IE em adultos assintomáticos é considerável, independentemente do IMC. A redução da aptidão cardiorrespiratória relacionada a obesidade parece ser clinicamente relevante como em não obesos.

Abstract We hypothesized that the prevalence of exercise intolerance (EI, peak O2 uptake < 83%pred.) is not significantly affected by body mass index (BMI) in adults undergoing cardiopulmonary exercise testing (CPET). We aimed to evaluate the prevalence of EI and the influence of BMI in asymptomatic adults. The results of 780 adults (age 41 ± 13 years) who underwent CPET were evaluated. Participants were stratified according to BMI: normal weight (n = 227), overweight (n = 198), and obese class 1 (n = 155), 2 (n = 131), and 3 (n = 69). After cardiovascular risk assessment, the participants underwent CPET on a treadmill ramp protocol. The prevalence of EI was 20, 16, 21, 25, and 21% in the stratified groups respectively, and no significant differences were found. Predictors of EI were physical inactivity, age, and smoking. The prevalence of EI in asymptomatic adults is considerable, regardless of BMI. The obesity-related reduction in cardiorespiratory fitness seems to be as clinically relevant as in non-obese counterparts.

Abstract New technical and scientific developments have been advocated to promote the success of the endodontic treatment. In addition to rotary and reciprocating systems, irrigating solution agitation has been suggested and passive ultrasonic irrigation (PUI) is the most used. Objective: To evaluate, in vitro, the effect of ultrasound streaming (US) in the disinfection of flattened root canal systems prepared by the ProTaper, BioRaCe and Reciproc systems, utilizing the microbiological culture. Methodology: Extracted human mandibular incisors (n=84) were used. Suspensions of Enterococcus faecalis (ATCC 29212) were standardized and inserted along with the teeth immersed in brain-heart infusion (BHI) broth. The contamination was made following a protocol during 5 days. The teeth were randomly divided into six groups: G1, ProTaper Universal; G2, ProTaper Universal with US; G3, BioRaCe; G4, BioRaCe with US; G5, Reciproc; and G6, Reciproc with US. Irrigation was performed with saline solution. After biomechanical preparation, microbiological samples were performed with sterilized paper points, which were diluted and spread on BHI agar; after 48 h, the colony forming units (CFU/mL) were counted for each sample. Results: Groups using ultrasonic agitation presented a greater antibacterial effect than the other ones, even using saline solution as irrigant. The ProTaper Universal system showed the best antibacterial activity of the tested systems (median of 0 CFU/mL with and without surfactant or ultrasonic activation [PUI]). Even with PUI, Reciproc (median of 2.5 CFU/mL with PUI and 5 without it) could not reduce as many colonies as ProTaper Universal without US. The BioRaCe system had greater bacterial reduction when using US (median of 0 CFU/mL with PUI and 30 without it). Conclusions: US promoted greater reduction in the number of bacteria in the flattened root canals prepared with nickel-titanium mechanized systems. Regarding the instruments used, the ProTaper Universal system was the most effective in reducing the bacterial number.

ABSTRACT BACKGROUND: Insulin resistance (IR) and progressive pancreatic β-cell dysfunction have been identified as the two fundamental features in the pathogenesis of obesity and non-insulin-dependent diabetes mellitus. We aimed to investigate correlations between anthropometric indices of obesity and IR in non-diabetic obese individuals, and the cutoff value from receiver operating characteristic (ROC) curve analysis. DESIGN AND SETTING: Cross-sectional study conducted in a private clinic. METHODS: We included obese individuals (body mass index, BMI ≥ 30 kg/m2) with no diabetes mellitus (fasting glucose levels ≤ 126 mg/dl). The participants were evaluated for the presence of cardiovascular risk factors and through anthropometric measurements and biochemical tests. Furthermore, IR was assessed indirectly using the homeostatic model assessment (HOMA)-IR and HOMA-β indexes. The area underthe curve (AUC) of the variables was compared.The sensitivity, specificity and cutoff of each variable for diagnosing IR were calculated. RESULTS: The most promising anthropometric parameters for indicating IR in non-diabetic obese individuals were waist-to-height ratio (WHtR), waist circumference (WC) and BMI. WHtR proved to be an independent predictor of IR, with risk increased by 0.53% in HOMA-IR, 5.3% in HOMA-β and 1.14% in insulin. For HOMA-IR, WHtR had the highest AUC value (0.98), followed by WC (0.93) and BMI (0.81). For HOMA-β, WHtR also had the highest AUC value (0.83), followed by WC (0.75) and BMI (0.73).The optimal WHtR cutoff was 0.65 for HOMA-IR and 0.67 for HOMA-β. CONCLUSION: Among anthropometric obesity indicators, WHtR was most closely associated with occurrences of IR and predicted the onset of diabetes in obese individuals.

Resumo O comportamento sedentário pode desempenhar papel importante nos resultados relacionados à saúde, independentemente da quantidade de atividade física na vida diária (AFVD). Nosso objetivo foi avaliar e comparar o comportamento sedentário, bem como a capacidade funcional em tabagistas e não tabagistas fisicamente ativos. Vinte e oito tabagistas adultos e 38 não tabagistas sem doenças respiratórias foram pareados por idade, sexo, índice de massa corporal, composição corporal, risco cardiovascular e AFVD moderada a intensa. Os participantes realizaram espirometria, teste de exercício cardiopulmonar (TECP), teste de caminhada de seis minutos (TC6), dinamometria isocinética e composição corporal (bioimpedância). Apesar da quantidade semelhante de AFVD moderada a intensa (mediana, 4,5h/semana para tabagistas e 4,0h/semana para os não tabagistas), os tabagistas passaram mais tempo deitados (mediana, 8,2h/semana: intervalo de confiança de 95%, 5,4 a 19,1 vs. 6,1h/semana: 3,7 a 11,2) e em atividades sedentárias (mediana, 100h/semana: 66 a 129 vs. 78h/semana: 55 a 122) em comparação com não tabagistas. Os tabagistas também apresentaram pior espirometria, pico de V’O2 e freqüência cardíaca máxima no TECP, TC6 e índices isocinéticos (p<0,05). Observamos uma forte correlação entre o tempo gasto deitado e a espirometria (r = - 0,730) nos tabagistas. O tabagismo está relacionado ao maior comportamento sedentário, apesar do nível AFVD adequado. Um nível AFVD adequado não reduziu os efeitos deletérios do tabagismo na capacidade funcional. Interromper o comportamento sedentário pode ser uma intervenção apropriada em tabagistas para a prevenção de doenças.

Abstract Sedentary behavior may play an important role for health outcomes, regardless of the amount of physical activity in daily life (PADL).We aimed to evaluate and compare sedentary behavior as well as physical capabilities in physically active smokers and non-smokers. Twenty-eight adult smokers and 38 non-smokers free of lung disease were matched for age, sex, body mass index, body composition, cardiovascular risk and moderate-to-vigorous PADL. Participants underwent spirometry, cardiopulmonary exercise test (CPET), six-minute walk test (6MWT), isokinetic dynamometry, and body composition (bioelectrical impedance).Despite the similar amount of moderate-to-vigorous PADL(median, 4.5h/week for smokers and 4.0h/week for non-smokers), smokers spent more time lying (median, 8.2h/week: 95% confidence interval, 5.4 to 19.1 vs. 6.1h/week: 3.7 to 11.2) and in sedentary activities (median, 100h/week: 66 to 129 vs. 78h/week: 55 to 122) compared to non-smokers. Smokers also presented worse spirometry, peak V’O2 and maximum heart rate in the CPET, 6MWT, and isokinetic indices (p<0.05). We observed a strong correlation between the time spent lying and spirometry (r = - 0.730) in smokers. Smoking is related to higher sedentary behavior, despite the suitable PADL. An appropriate PADL did not reduce the deleterious effects of smoking on physical capabilities. Interrupting sedentary behavior may be an appropriate intervention target in smokers for reducing the risk of diseases.

RESUMO CONTEXTO E OBJETIVOS: O impacto do porto de Santos, no Brasil, sobre a saúde da população é desconhecido. Nosso objetivo foi avaliar a associação entre viver nas proximidades da área portuária e a inatividade física e comportamento sedentário. TIPO DE ESTUDO E LOCAL: Estudo transversal desenvolvido em laboratório universitário e em uma clínica de diagnósticos. MÉTODOS: Foram selecionados 553 adultos saudáveis e seu nível de atividade física na vida diária foi avaliado usando acelerômetros. Foi realizada regressão linear múltipla e logística usando a inatividade física e o comportamento sedentário como desfechos e morar perto da área portuária como o fator de risco principal, ajustando para os principais confundidores. RESULTADOS: Entre todos os participantes, 15% residiam na área portuária. Estes deram 699 passos/dia a menos e apresentaram, por semana, 2,4% da atividade física mais sedentária, 2,0% menos tempo em pé e passaram 0,9% mais tempo deitados do que os residentes das demais regiões. Além disso, morar nas proximidades da área portuária aumentou o risco de inatividade física em 2,5 vezes, assim como o risco de maior comportamento sedentário (≥ 10 horas/dia) em 1,32 vezes. CONCLUSÃO: Morar perto do porto de Santos tem associação com a inatividade física, assim como o aumento do comportamento sedentário em adultos, independentemente de fatores de confusão. As razões para tal associação devem ser investigadas em estudos longitudinais.

ABSTRACT CONTEXT AND OBJECTIVE: The impact of the port of Santos, Brazil, on the population’s health is unknown. We aimed to evaluate the association between living near the port area and physical inactivity and sedentary behavior. DESIGN AND SETTING: Cross-sectional study developed at a university laboratory and a diagnostic clinic. METHODS: 553 healthy adults were selected and their level of physical activity in daily life was assessed using accelerometers. Multiple linear and logistic regressions were performed using physical inactivity and sedentary behavior as the outcomes and living near the port area as the main risk factor, with adjustments for the main confounders. RESULTS: Among all the participants, 15% were resident near the port area. They took 699 steps/day and presented, weekly, 2.4% more sedentary physical activity, 2.0% less time in standing position and 0.9% more time lying down than residents of other regions. Additionally, living near the port area increased the risk of physical inactivity by 2.50 times and the risk of higher amounts of sedentary behavior (≥ 10 hours/day) by 1.32 times. CONCLUSION: Living near the port of Santos is associated with physical inactivity and higher sedentary behavior among adults, regardless of confounders. The reasons for this association should be investigated in longitudinal studies.

Abstract Aim Evaluate and compare the proportion of PI and associated factors by IPAQ questionnaire, triaxial accelerometry and the combination of both. Adults aged ( 18 years were enrolled (n = 250). Methods We considered PI as < 600 MET-min/wk in the IPAQ total score, < 150 min/wk of moderate-to-vigorous physical activity in 7 days accelerometry, and the combination of both criteria. Clinical assessment, spirometry, cardiopulmonary exercise test, bioelectrical impedance, isokinetic dynamometry, postural balance, and six-minute walk test were also performed. For participants practicing aquatic, martial arts or cycling, only the IPAQ criterion was considered. Results Proportions of PI were significantly different among methods (IPAQ, 10%; accelerometry, 20%; combination, 25%). After multivariate logistic regressions, PI was determined by age, sex, educational level, risk factors for cardiovascular disease, lean body mass, cardiorespiratory fitness, and postural balance. Conclusion Thus, the combined method for determining PI and associated factors in adults showed great validity, indicating that questionnaires and accelerometers are complementary and should be utilized in combination in epidemiological studies.

ABSTRACT The knowledge of the internal anatomy of three-rooted mandibular molars may help clinicians to diagnose and plan the root canal treatment in order to provide adequate therapy when this variation is present. Objectives: To determine the prevalence of three-rooted mandibular molars in a Brazilian population using cone beam computed tomography (CBCT) and to analyze the anatomy of mandibular first molars with three roots through micro-CT. Material and Methods: CBCT images of 116 patients were reviewed to determine the prevalence of three-rooted first mandibular molars in a Brazilian subpopulation. Furthermore, with the use of micro-CT, 55 extracted three-rooted mandibular first molars were scanned and reconstructed to assess root length, distance between canal orifices, apical diameter, Vertucci's classification, presence of apical delta, number of foramina and furcations, lateral and accessory canals. The distance between the orifice on the pulp chamber floor and the beginning of the curvature and the angle of canal curvature were analyzed in the distolingual root. Data were compared using the Kruskal-Wallis test (α=0.05). Results: The prevalence of three-rooted mandibular first molars was of 2.58%. Mesial roots showed complex distribution of the root canal system in comparison to the distal roots. The median of major diameters of mesiobuccal, mesiolingual and single mesial canals were: 0.34, 0.41 and 0.60 mm, respectively. The higher values of major diameters were found in the distobuccal canals (0.56 mm) and the lower diameters in the distolingual canals (0.29 mm). The lowest orifice distance was found between the mesial canals (MB-ML) and the highest distance between the distal root canals (DB-DL). Almost all distal roots had one root canal and one apical foramen with few accessory canals. Conclusions: Distolingual root generally has short length, severe curvature and a single root canal with low apical diameter.

Objetivo: Determinar se há associações entre o nível de atividade física na vida diária (AFVD) e a função pulmonar em tabagistas adultos. Métodos: Foram selecionados 62 tabagistas adultos de um estudo epidemiológico, realizado na cidade de Santos (SP). Os participantes realizaram o teste de espirometria forçada para a avaliação da função pulmonar. O nível de AFVD foi avaliado pelo Questionário Internacional de Atividade Física e por acelerometria triaxial (aparelho utilizado por sete dias). O nível mínimo de AFVD, em termos de quantidade e intensidade, foi definido como 150 min/semana de atividade física moderada a vigorosa durante o monitoramento. As correlações entre as variáveis estudadas foram avaliadas pelo coeficiente de correlação de Pearson ou de Spearman conforme a distribuição das variáveis. A influência de AFVD nas variáveis espirométricas foi avaliada por meio de análise de regressão múltipla linear. O nível de significância foi estipulado em 5%. Resultados: Quando avaliados todos os preditores corrigidos para fatores de confusão e utilizando dados da função pulmonar como variáveis de desfecho, não foram observadas associações significativas entre a inatividade física avaliada por acelerometria e os índices espirométricos. As análises mostraram valores inferiores da CVF em participantes com hipertensão arterial e da relação VEF1/CVF nos participantes com diabetes mellitus. Os participantes obesos e os dislipidêmicos apresentaram valores inferiores de CVF e VEF1. Conclusões: Nossos resultados sugerem que a inatividade física apresenta associação pouco consistente com a função pulmonar de tabagistas adultos. A carga tabágica, assim como comorbidades cardiovasculares e metabólicas, deveriam ser priorizadas em estratégias preventivas da DPOC.

Objective: To determine whether the level of physical activity in daily life (PADL) is associated with pulmonary function in adult smokers. Methods: We selected 62 adult smokers from among the participants of an epidemiological study conducted in the city of Santos, Brazil. The subjects underwent forced spirometry for pulmonary function assessment. The level of PADL was assessed by the International Physical Activity Questionnaire and triaxial accelerometry, the device being used for seven days. The minimum level of PADL, in terms of quantity and intensity, was defined as 150 min/week of moderate to vigorous physical activity. Correlations between the studied variables were tested with Pearson's or Spearman's correlation coefficient, depending on the distribution of the variables. We used linear multiple regression in order to analyze the influence of PADL on the spirometric variables. The level of significance was set at 5%. Results: Evaluating all predictors, corrected for confounding factors, and using pulmonary function data as outcome variables, we found no significant associations between physical inactivity, as determined by accelerometry, and spirometric indices. The values for FVC were lower among the participants with arterial hypertension, and FEV1/FVC ratios were lower among those with diabetes mellitus. Obese participants and those with dyslipidemia presented with lower values for FVC and FEV1. Conclusions: Our results suggest that there is no consistent association between physical inactivity and pulmonary function in adult smokers. Smoking history should be given special attention in COPD prevention strategies, as should cardiovascular and metabolic comorbidities.

RESUMO: CONTEXTO E OBJETIVOS: A acelerometria fornece medida objetiva do nível de atividade física, porém não é viável na prática clínica. Assim, foram investigados testes de aptidão física capazes de predizer inatividade física em adultos. DESENHO E LOCAL: Estudo de teste diagnóstico, desenvolvido em laboratório universitário e uma clínica de diagnósticos. MÉTODOS: 188 participantes assintomáticos tiveram o nível de atividade física avaliado por acelerometria, ergoespirometria em esteira, composição corporal por bioimpedância, função muscular isocinética, equilíbrio postural em plataforma de força e teste de caminhada de seis minutos. Foram realizadas análise descritiva e regressão logística múltipla, incluindo idade, sexo, consumo de oxigênio, gordura corporal, centro de pressão, pico de torque de quadríceps, distância percorrida no teste de caminhada de seis minutos e passos/dia no modelo como preditores da inatividade física. Adicionalmente, foram determinadas a sensibilidade (S), especificidade (Sp) e área abaixo da curva dos principais preditores por meio de curvas de característica de operação do receptor. RESULTADOS: A prevalência da inatividade física foi 14%. O número médio de passos/dia (≤ 5357) foi o melhor preditor da inatividade física (S = 99%, Sp = 82%). O melhor teste de aptidão física foi a distância no teste de caminhada de seis minutos e ≤ 96% dos valores preditos (S = 70%; Sp = 80%). A gordura corporal > 25% também foi significativa (S = 83%, Sp = 51%). Após regressão logística, passos/dia e a distância no teste de caminhada de seis minutos permaneceram preditores da inatividade física. CONCLUSÃO: O teste de caminhada de seis minutos deve ser incluído em estudos epidemiológicos como ferramenta simples e barata para triagem da inatividade física.

ABSTRACT: CONTEXT AND OBJECTIVES: Accelerometry provides objective measurement of physical activity levels, but is unfeasible in clinical practice. Thus, we aimed to identify physical fitness tests capable of predicting physical inactivity among adults. DESIGN AND SETTING: Diagnostic test study developed at a university laboratory and a diagnostic clinic. METHODS: 188 asymptomatic subjects underwent assessment of physical activity levels through accelerometry, ergospirometry on treadmill, body composition from bioelectrical impedance, isokinetic muscle function, postural balance on a force platform and six-minute walk test. We conducted descriptive analysis and multiple logistic regression including age, sex, oxygen uptake, body fat, center of pressure, quadriceps peak torque, distance covered in six-minute walk test and steps/day in the model, as predictors of physical inactivity. We also determined sensitivity (S), specificity (Sp) and area under the curve of the main predictors by means of receiver operating characteristic curves. RESULTS: The prevalence of physical inactivity was 14%. The mean number of steps/day (≤ 5357) was the best predictor of physical inactivity (S = 99%; Sp = 82%). The best physical fitness test was a distance in the six-minute walk test and ≤ 96% of predicted values (S = 70%; Sp = 80%). Body fat > 25% was also significant (S = 83%; Sp = 51%). After logistic regression, steps/day and distance in the six-minute walk test remained predictors of physical inactivity. CONCLUSION: The six-minute walk test should be included in epidemiological studies as a simple and cheap tool for screening for physical inactivity.

Objetivo : Determinar se o distúrbio ventilatório restritivo (DVR) sugerido por espirometria está associado ao nível de atividade física na vida diária (AFVD), assim como a fatores de risco para doença cardiovascular (DCV), em adultos assintomáticos. Métodos : Um total de 374 participantes (média de idade, 41 ± 14 anos) realizou espirometria, que incluiu a determinação de CVF e VEF1. O DVR foi definido como a relação VEF1/CVF > 0,7 e CVF < 80% do valor previsto. Após a coleta de dados demográficos, dados antropométricos e dados relacionados aos fatores de risco para DCV, foram avaliados composição corporal, função muscular e equilíbrio postural, assim como realizados teste cardiopulmonar e teste de caminhada de seis minutos. O nível de AFVD foi medido por um acelerômetro triaxial. Resultados : O DVR sugerido por espirometria foi encontrado em 10% dos indivíduos. Após a regressão logística multivariada, ajustada para os fatores de confusão (AFVD e aptidão cardiorrespiratória), as seguintes variáveis permaneceram significativas (OR; IC95%) como preditoras de DVR: hipertensão arterial sistêmica (17,5; 1,65-184,8), tabagismo (11,6; 1,56-87,5), inatividade física (8,1; 1,43-46,4), maior área do centro de pressão durante apoio bipodal em plataforma de força (1,34; 1,05-1,71) e dislipidemia (1,89; 1,12-1,98). Conclusões : O DVR sugerido por espirometria parece ser um achado comum em adultos assintomáticos. Fatores de risco para DCV, principalmente hipertensão arterial sistêmica, tabagismo e sedentarismo, foram diretamente associados ao DVR, mesmo quando a análise foi ajustada para AFVD e aptidão cardiorrespiratória. Estudos longitudinais são necessários para melhorar a compreensão da etiologia do DVR, bem como para auxiliar na concepção de estratégias preventivas.

Objective : To determine whether a restrictive pattern on spirometry is associated with the level of physical activity in daily life (PADL), as well as with cardiovascular disease (CVD) risk factors, in asymptomatic adults. Methods : A total of 374 participants (mean age, 41 ± 14 years) underwent spirometry, which included the determination of FVC and FEV1. A restrictive pattern on spirometry was defined as an FEV1/FVC ratio > 0.7 and an FVC < 80% of the predicted value. After conducting demographic, anthropometric, and CVD risk assessments, we evaluated body composition, muscle function, and postural balance, as well as performing cardiopulmonary exercise testing and administering the six-minute walk test. The PADL was quantified with a triaxial accelerometer. Results : A restrictive pattern on spirometry was found in 10% of the subjects. After multivariate logistic regression, adjusted for confounders (PADL and cardiorespiratory fitness), the following variables retained significance (OR; 95% CI) as predictors of a restrictive pattern: systemic arterial hypertension (17.5; 1.65-184.8), smoking (11.6; 1.56-87.5), physical inactivity (8.1; 1.43-46.4), larger center-of-pressure area while standing on a force platform (1.34; 1.05-1.71); and dyslipidemia (1.89; 1.12-1.98). Conclusions : A restrictive pattern on spirometry appears to be common in asymptomatic adults. We found that CVD risk factors, especially systemic arterial hypertension, smoking, and physical inactivity, were directly associated with a restrictive pattern, even when the analysis was adjusted for PADL and cardiorespiratory fitness. Longitudinal studies are needed in order to improve understanding of the etiology of a restrictive pattern as well as to aid in the design of preventive strategies.

The department of Oral and Maxillofacial Surgery of the West General Hospital Dr. José Gregorio Hernández (OMS-WGH) located in the city of Caracas, Venezuela, provides emergency care 24 h a day, 365 days a year. Objective: To determine the age, gender and most frequent reason for consultation in the emergency room of the OMS-WGH between January 2006 and December 2012. Method: A cross-sectional retrospective epidemiological study was conducted on patients seen in the emergency room of the OMS-WGH, by evaluating 7,531 medical records of patients treated in that period. Results: There was a predominance of males with 58.3% (n = 4,391), and a mean age of 16 to 30 years old, with 46.5% (n = 3,509) of the patients having soft tissue trauma 65.71% (n = 4,949), 15.1% (n = 1,139) facial fractures, and 15.9% (n = 1,203) odontogenic infections. Conclusion: The male population between 16 and 30 years are more prone to soft tissue trauma.

El departamento de Cirugía Bucal y Maxilofacial del Hospital General del Oeste Dr. José Gregorio Hernández (OMS-GTH), ubicado en la ciudad de Caracas (Venezuela) proporciona atención de urgencia las 24 h del día, los 365 días del año. Objetivo: Determinar la edad, el sexo y el motivo de consulta más frecuente en las urgencias de OMS-GTH entre enero de 2006 y diciembre de 2012. Método: Hemos realizado un estudio transversal retrospectivo epidemiológico de los pacientes atendidos en las urgencias de OMS-GTH mediante una evaluación de 7.531 historias clínicas de los pacientes tratados entre ese período. Resultados: Predominó el sexo masculino con el 58,3% (n = 4.391); la edad promedio fue de 16 a 30 años de edad; el 46,5% (n = 3.509) de los pacientes presentaron trauma de tejidos blandos 65,71% (n = 4.949), el 15,1% (n = 1.139) fracturas faciales y el 15,9% (n = 1.203) infecciones odontogénicas. Conclusión: La población masculina entre 16 y 30 años es más propensa a trauma de tejidos blandos.