No abstract

HIV infection is associated with impaired dynamic and isokinetic strength in men compared to HIV-uninfected controls, but not in women.

Elevated concentration of homocysteine has been identified as an independent risk factor for the development of cardiovascular disease and is frequently associated with oxidative stress. Moreover, studies have shown that people living with human immunodeficiency virus (PLHIV) present elevated concentration of homocysteine and oxidative stress compared with people without HIV. Our purpose was to describe blood homocysteine and oxidative stress markers in PLHIV and those without HIV infection, and to examine the effects of a 16-week combined training exercise program (CTE) on oxidative stress and homocysteine concentrations of PLHIV. We included 49 PLHIV (21 men, 28 women) and 33 people without HIV infection (13 men, 20 women). After baseline evaluations, 30 PLHIV were randomized to either CTE (trained group, n = 18) or the control group (n = 12); CTE consisted of aerobic and strength exercise sessions during 16 weeks, 3 times a week. Plasma homocysteine, oxidative damage markers, folate, and vitamin B12 were assessed pre- and post-training and by hyperhomocysteinemia (homocysteine ≥ 15 μmol/L) status. At baseline, PLHIV had higher levels of homocysteine and malondialdehyde, as well as reduced circulating folate when compared with people without HIV infection. CTE resulted in a 32% reduction (p < 0.05) in homocysteine concentration and a reduction in lipid hydroperoxide in PLHIV with hyperhomocysteinemia, which was not observed in those without hyperhomocysteinemia. Hyperhomocysteinemic participants experienced a 5.6 ± 3.2 μmol/L reduction in homocysteine after CTE. In summary, 16 weeks of CTE was able to decrease elevated homocysteine concentration and enhance redox balance of PLHIV with hyperhomocysteinemia, which could improve their cardiovascular risk.

HighlightsHIV-positive subjects present higher strength indices for the dominant versus the non-dominant leg.Strength asymmetry between limbs was observed in up to 58% of subjects.Lower-limb strength asymmetry is associated with impaired balance and gait.

Resumo:Este artigo tem por objetivo refletir sobre como a dimensão territorial tem sido abordada na atual política de saúde brasileira. Traz, inicialmente, uma aproximação da discussão teórica sobre a categoria território e suas implicações à política social. Posteriormente, analisa como essa categoria foi incorporada nos princípios e diretrizes do Sistema Único de Saúde -SUS, nos principais programas implantados e nos instrumentos normativos da política de saúde a partir de 1990. Conclui-se que: a dimensão territorial esteve presente desde a concepção do SUS por meio da diretriz de regionalização das ações e serviços. Nos principais programas implantados nos anos 1990, a dimensão territorial teve um caráter de recortes geográficos e os instrumentos normativos deram centralidade ao processo de descentralização. Contudo, a partir dos anos 2000, a estratégia de regionalização, apontando para a perspectiva territorial, ganha maior significado. Entretanto, ainda é preciso ultrapassar a lógica meramente político-administrativa e atuar na perspectiva de identificar as reais necessidades das populações, suas potencialidades, diversidades e particularidades, na direção de "território usado" a que se refere Milton Santos. Palavras