The purpose of this study was to test the hypothesis that in obese children: 1) Ventilatory efficiency (VentE) is decreased during graded exercise; and 2) Weight loss through diet alone (D) improves VentE, and 3) diet associated with exercise training (DET) leads to greater improvement in VentE than by D. Thirty-eight obese children (10+/-0.2 years; BMI >95th percentile) were randomly divided into two study groups: D (n=17; BMI=30+/-1 kg/m (2)) and DET (n=21; 28+/-1 kg/m (2)). Ten lean children were included in a control group (10+/-0.3 years; 17+/-0.5 kg/m (2)). All children performed maximal treadmill testing with respiratory gas analysis (breath-by-breath) to determine the ventilatory anaerobic threshold (VAT) and peak oxygen consumption (VO (2) peak). VentE was determined by the VE/VCO (2) method at VAT. Obese children showed lower VO (2) peak and lower VentE than controls (p<0.05). After interventions, all obese children reduced body weight (p<0.05). D group did not improve in terms of VO (2) peak or VentE (p>0.05). In contrast, the DET group showed increased VO (2) peak (p=0.01) and improved VentE (DeltaVE/VCO (2)=-6.1+/-0.9; p=0.01). VentE is decreased in obese children, where weight loss by means of DET, but not D alone, improves VentE and cardiorespiratory fitness during graded exercise.

The purpose of this study was to test the hypotheses that in obese children: 1) hypocaloric diet (D) improves both heart rate recovery at 1 min (Δ HRR1) cfter an exercise test, and cardiac autonomic nervous system activity (CANSA) in obese children; 2) Diet and exercise training (DET) combined leads to greater improvement in both Δ HRR1 after an exercise test and in CANSA, than D alone. Moreover, we examined the relationships among Δ HRR1, CANSA, cardiorespiratory fitness and anthropometric variables (AV) in obese children submitted to D and to DET. 33 obese children (10 ± 0.2 years; body mass index (BMI) >95 (th) percentile) were divided into 2 groups: D (n=15; BMI=31 ± 1 kg/m²)) and DET (n=18; 29 ± 1 kg/m²). All children performed a maximal cardiopulmonary exercise test on a treadmill. The Δ HRR1 or LF/HF ratio (P>0.05). In contrast, the DET group showed increased peak VO₂ ( P=0.01) and improved Δ HRR1 (Δ HRR1=37.3 ± 2.6; P=0.01) and LF/HF ratio ( P=0.001). The DET group demonstrated significant relationships among Δ HRR1, peak VO₂ and CANSA (P<0.05). In conclusion, DET, in contrast to D, promoted improved ÄΔ HRR1 and CANSA in obese children, suggesting a positive influence of increased levels of cardiorespiratory fitness by exercise training on cardiac autonomic activity.

The minor A allele at PLIN4 was associated with higher risk of MS at baseline, whereas the PLIN6 SNP was associated with better weight loss, suggesting that these polymorphisms may predict outcome strategies based on multidisciplinary treatment for OCA.

O objetivo deste estudo foi avaliar a influência do tempo de hospitalização sobre o desenvolvimento neuromotor de recém-nascidos pré-termo (RNPT). Foi feito um estudo prospectivo com 67 RNPT de idade gestacional <36 semanas. O desenvolvimento neuromotor foi avaliado pela escala motora infantil de Alberta (Alberta infant motor scale, AIMS), aplicada no ambulatório de seguimento, quando os RN tinham mediana de idade corrigida de 39 a 44 semanas. Para a análise comparativa, os RNPT foram distribuídos em dois grupos segundo o tempo de hospitalização (TH): grupo A (n=35), com TH <34 dias, e grupo B (n=32), com TH >34 dias. Na análise estatística considerou-se o nível de significância p<0,05. Os escores medianos na AIMS (numa faixa possível de 0 a 21) foram 7 no grupo A, 5 no grupo B; foram encontradas fracas correlações significativas nos dois grupos (r=0,32; r=0,34) entre o escore na AIMS e o TH. Os resultados indicam que os RNPT que permaneceram por mais de 34 dias hospitalizados mostraram atraso no desenvolvimento neuromotor, sugerindo que, sem excluir outros fatores, quanto maior o tempo de internação do RN, maior seu comprometimento motor.

ResumoIntrodução: A dor no período neonatal é motivo de inúmeros estudos, sendo fundamental para a sua abordagem uma avaliação criteriosa e adequada.Objetivo: Comparar as variáveis fisiológicas com as comportamentais para a avaliação da dor em recém-nascido (RN) prematuro. Métodos: Estudo realizado entre fevereiro de 2003 e maio de 2004, com recém-nascidos de idade gestacional (IG) abaixo de 34 semanas e peso de nascimento menor que 1500 g, submetidos à ventilação mecânica e não sedados. As variáveis fisiológicas estudadas foram as freqüências cardíaca (FC) e respiratória (FR) e a saturação de oxigênio (SatO 2 ); as variáveis comportamentais foram avaliadas por meio da escala de dor do recém-nascido -Neonatal Infant Pain Scale (NIPS). Todas as variáveis foram controladas no terceiro dia de vida do RN, antes, imediatamente após e cinco minutos após o procedimento de aspiração endotraqueal. Resultados: Foram estudados 50 RNs com IG média ao nascimento de 29,98 ± 2,24 semanas e peso médio de nascimento de 1087,20 ± 350,06 g, sendo 28 (56%) RN do sexo feminino e a doença das membranas hialinas foi diagnosticada em todos os RNs estudados. Pelo teste t-Student verificou-se diferença significante na SatO 2 nos momentos estudados, sendo o mesmo não observado em relação a FC e FR. A mediana da NIPS foi maior nos momentos pós aspiração. As variáveis fisiológicas mostraram-se pouco sensíveis à detecção da dor (FC: 40,7%, FR: 24,1%, SatO 2 : 6,6%), e a escala NIPS mostrou-se mais específica para a mesma avaliação (86,6%). Conclusão: As variáveis fisiológicas apresentaram pouca sensibilidade e especificidade para a avaliação da dor no RN prematuro, quando avaliadas isoladamente. Palavras-chave:Recém-nascido; dor; avaliação da dor. AbstractIntroduction: Pain in the neonatal period is the objective of several studies, being important for its approach an adequate evaluation. Objective: To compare the physiological and behavioral variables with the behavior for assessment of pain in premature newborns (NB). Methods: Prospective study carried out from February/2003 to May/2004, including premature infants with gestational age (GA) below 34 weeks and birth weight less than 1.500 g, submitted to mechanical ventilation and not sedation. The physiological variables studied were: heart rate (HR), respiratory rate (RR) and oxygen saturation (SatO 2 ); the behavioral variables were evaluated by NIPS. All the variables have been controlled in the third day of life of NB, immediately after and five minutes after the procedure of endotracheal suction. Results: Fifty premature infants were studied with GA at birth of 29.98 ± 2.24 weeks and birth weight 1087.20 ± 350.06 g and the respiratory distress syndrome was diagnosed in all NB studied. Using t-Student test, it was verified significant difference on SatO 2 at the different moments studied; however, there was no statistical significant difference in relation to HR and RR. The median of NIPS was high on moments following suction. The physiological variables showed: low sensitivity on detec...