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- ItemAcesso aberto (Open Access)Anthropometric profile and physical performance characteristic of the Brazilian amputee football (soccer) team(Universidade Estadual Paulista, 2013-09-01) Simim, Mário Antônio de Moura; Silva, Bruno Victor Corrêa da; Marocolo Júnior, Moacir; Mendes, Edmar Lacerda; Mello, Marco Tulio de [UNIFESP]; Mota, Gustavo Ribeiro da; Federal University of Triângulo Mineiro; Universidade Federal de São Paulo (UNIFESP)Amputee football is a variation of conventional soccer in which athletes with lower limb amputation and one athelete with upper limb amputation (the goalkeeper) participate. The objective of this study was to investigate the anthropometric and physical characteristics of amputee football athletes and to verify differences between heart rate peak (HRpeak) and equations for predicting maximum heart rate (HRmax). Twelve amputee soccer players from the Brazilian team participated in this study. The body mass, height and body composition were measured. The physical tests used were: the 20 m running test, the T-square test and the Yo Yo intermitent recovery test - level 1 (YYIRT1). The percentage of fat was significantly different between midfielders and defenders. No significant differences were found between positions in the physical tests. The HRpeak was significantly lower than all of HRmax prediction equations tested. We conclude that the indicators of physical performance did not differ significantly between the different tactics roles of players, and that, after intermittent maximum effort, the cardiac response was lower when compared with the investigated HRmax prediction equations.
- ItemSomente MetadadadosImmediate and 24-h blood pressure-lowering effects of arm crank exercise in patients with traumatic lower-limb amputation: a randomized cross-over study(Lippincott Williams & Wilkins, 2018) Paula-Ribeiro, Marcelle [UNIFESP]; Martinez, Daniel G.; Lima, Jorge R. P.; Laterza, Mateus C.Aim: This study aimed to investigate the clinic and 24-h postexercise hypotension (PEH) after a moderate-intensity arm crank exercise session in individuals with traumatic lower-limb amputation.Participants and methodsNine men (4617 years) with unilateral traumatic lower-limb amputation participated in two experimental sessions conducted randomly: an aerobic exercise (EXE: arm crank ergometer, 30min) or a control session (CON: participants remained seated on the cycle ergometer, 30min). Clinic and 24-h systolic, diastolic, and mean blood pressure (BP) response were measured after both sessions. The clinical measurements of blood flow and forearm vascular resistance (FVR) were also performed.ResultsCompared with the preintervention period, the BP levels did not change in the CON session. However, EXE resulted in a significant hypotensive effect in systolic (-10 +/- 0.9mmHg, P0.05), diastolic (-11 +/- 1.5mmHg, P0.05), and mean BP (-11 +/- 1.2mmHg, P0.05) during the entire postexercise period. The PEH was accompanied by a decreased FVR over the entire postintervention period (P0.05). Significant reductions were found for 24-h average systolic, diastolic, and mean BP levels (P=0.03, 0.01, and 0.02, respectively) following EXE compared with the CON session.ConclusionThese results showed, for the first time, that individuals with traumatic lower-limb amputation presented immediate and 24-h PEH after a single bout of arm crank exercise testing. The PEH at the clinic condition was justified, at least in part, by the reduction in peripheral FVR.
- ItemAcesso aberto (Open Access)Is surgical debridement necessary in the diabetic foot treated with photodynamic therapy?(Taylor & Francis Ltd, 2017) Tardivo, Joao Paulo; Serrano, Rodrigo; Zimmermann, Livia Maria; Matos, Leandro Luongo; Baptista, Mauricio S.; Silva Pinhal, Maria Aparecida; Atallah, Alvaro N. [UNIFESP]Background: Diabetic patients are susceptible to developing foot ulcerswith serious complications such as osteomyelitis and amputations. Treatment approaches are still empirical and the benefit of usual procedures such as surgical debridement has not been properly evaluated. Photodynamic Therapy (PDT) is a non-invasive and highly efficient method for the treatment of the diabetic foot, being able to eradicate the infection and to stimulate healing, decreasing considerably the amputation risk. In the day-to-day practice of our service, we have been faced with the question whether debridement is necessary before PDT. In here, we designed a study to answer that question. Methods: Patients were divided in two groups: In one of the groups (n = 17), debridement was performed before PDT and in the other (n = 40) only PDT treatment was performed. PDT sessions were performed once a week in all patients until healing was achieved, as indicated by visual inspection as well as by radiographic and laboratory exams. At the start of the study, the two groups had no statistical differences concerning their clinical features: average age, gender, insulin use, diabetes mellitus onset time and previous amputations. Results: PDT was effective in the treatment of 100% of the patients showing no relapses after one year of follow up. The group submitted to PDT without previous debridement had a statistically significant (p = 0.036, Mann-Whitney) shorter cure time (29 days, similar to 27%). Conclusion: Our data indicates that debridement is not necessary in the treatment of diabetic foot in patients that have enough peripheral arterial perfusion. In addition, we reproduced previous studies confirming that PDT is an efficient, safe, simple and affordable treatment method for the diabetic foot.
- ItemSomente MetadadadosOsteosarcoma in patients younger than 12 years old without metastases have similar prognosis as adolescent and young adults(Wiley-Blackwell, 2015-07-01) Prates Eleuterio, Sabrina Jeane [UNIFESP]; Senerchia, Andreza Almeida [UNIFESP]; Almeida, Maria Teresa; Da Costa, Cecilia Maria; Lustosa, Daniel; Calheiros, Luiz Mario; Silva Barreto, Jose Henrique; Brunetto, Algemir Lunardi; Pacheco Donato Macedo, Carla Renata [UNIFESP]; Petrilli, Antonio Sergio [UNIFESP]; Universidade Federal de São Paulo (UNIFESP); Universidade de São Paulo (USP); Hosp Canc AC Camargo; Hosp Canc Ceara; Soc Pernambucana Combate Ao Canc; Soc Oncol Bahia; Hosp Clin Porto AlegreBackgroundChildhood cancer is relatively rare and tends to present specific age distribution, as a prognostic factor for some of these diseases. Information on how young age affects prognosis, response to chemotherapy, and local control options in children versus AYA with osteosarcoma (OST) is minimal.MethodsIn order to identify the main differences in clinicalpathologic features, surgical approaches and survival rates of primary high grade OST of the extremity between children (n=156; <12 years old) and AYA (n=397; 12-30 years old), the institutional database with 553 patients treated by BOTG studies over 15 years were reviewed.ResultsThere were no differences in metastasess at diagnosis, tumor size, and grade of necrosis between the two age groups. the rate of amputation was 30% higher in the children group (P=0.018). the rate of limb salvage surgery using reconstruction with allograft or autograft was 70% higher in the children group (P=0.018) while endoprosthesis rate was 40% higher in the AYA group (P=0.018). the log rank test revealed that survival is similar between the two age groups for non-metastatic patients (P=0.424 for OS and P=0.393 for EFS). Metastatic patients of both ages group had higher risk of dying compared to non-metastatic (HR 3.283 95% CI 2.581-4.177; P<0.001). Children with metastases at diagnosis had less OS time (P=0.049) and EFS time (P=0.032) than adolescents.ConclusionNon-metastatic OST in preadolescent patients does not appear to be significantly differentfrom those seen in AYA patients, but has local control challenges. Children presenting with metastases should be considered an ultra-high-risk group. Pediatr Blood Cancer 2015;62:1209-1213. (c) 2015 Wiley Periodicals, Inc.
- ItemSomente MetadadadosPredicted annual costs for inpatients with diabetes and foot ulcers in a developing country-a simulation of the current situation in Brazil(Wiley-Blackwell, 2010-01-01) Rezende, K. F.; Ferraz, M. B. [UNIFESP]; Malerbi, D. A.; Melo, N. H.; Nunes, M. P.; Pedrosa, H. C.; Chacra, A. R. [UNIFESP]; Univ Fed Sergipe; Universidade Federal de São Paulo (UNIFESP); Brazilian Diabet SocAims the objective of this cost-of-illness analysis was to quantify the annual costs associated with hospital admission for people with diabetes and foot ulcers in Brazil.Methods A hypothetical cohort was simulated using a decision tree model. Prevalence and incidence rates and clinical outcomes were estimated from published studies and applied to the general Brazilian population over 30 years. Costs were quoted in Brazilian real (BRL) and converted to US dollars ($ US) at the 2008 currency exchange rate ($US1 = BRL 1.64). in the sensitivity analysis, we reduced and increased rates to assess the robustness of the cost estimates.Results in this hypothetical cohort there are 6.48 million (95% confidence interval 4.47-7.12) Brazilians citizens with Type 2 diabetes. Each year, approximately 323 000 (89 500-484 500) of these people develop foot ulcers and almost 97 200 (17 900 169 600) require hospital admission as a result. Each year, almost 46 300 (8500-80 900) limb amputations and 12 400 (2300 21 700) deaths occur as a result of diabetic foot disease in Brazil. the annual cost associated with these hospital admissions is estimated to be almost $ US264m ($ US51m-461m). the estimated cost for patients with amputation is nearly $ US128m ($ US24.5m-222.3m).Conclusions Our model shows that the social and economic impact of diabetic foot disease in Brazil is high. Government decision makers should reflect on the current situation and provide organized foot care throughout the whole country.