ABSTRACT BACKGROUND: Detraining can partially or completely reduce training-induced metabolic adaptations. However, the duration for which the rehabilitation effects persist after detraining, especially in patients with heart disease, remains unclear. OBJECTIVES: To evaluate the principle of reversibility/detraining in patients with heart disease via the 6-minute walk test (6MWT) after a period of rest. DESIGN AND SETTING: A retrospective cohort study developed at the Rehabilitation Center of the Universidade Federal do Triângulo Mineiro in Uberaba/MG, Brazil. METHODS: This clinical, retrospective longitudinal study involved 20 patients with heart disease who underwent 5 months of supervised cardiac rehabilitation (CR). The mean age of participants was 64.05 ± 9.25 years. The initial rehabilitation was followed by an interruption period and rehabilitation for another 5 months. Functional capacity was assessed using the 6MWT. RESULTS: In the specific analysis of the distance covered, values of P = 0.03 and P = 0.01 were obtained on comparing post-training (669.64 ± 58.80 meters) with post-detraining (640.82 ± 101.23 meters) and post-detraining with post-retraining (650.82 ± 96.28 meters), respectively. No significant difference was observed for the comparison between training and retraining (P = 0.83). CONCLUSION: Cardiovascular rehabilitation positively stimulates functional capacity, whereas detraining significantly reduces it. The 6MWT is effective in measuring changes in physical capacity. BACKGROUND traininginduced induced adaptations However unclear OBJECTIVES reversibilitydetraining reversibility 6minute minute 6 MWT (6MWT rest SETTING UberabaMG Uberaba MG Uberaba/MG Brazil METHODS clinical 2 CR. CR . (CR) 6405 64 05 64.0 925 9 25 9.2 years RESULTS covered 003 0 03 0.0 001 01 posttraining post 669.64 66964 669 (669.6 5880 58 80 58.8 meters postdetraining 640.82 64082 640 82 (640.8 10123 101 23 101.2 postretraining 650.82 65082 650 (650.8 9628 96 28 96.2 meters, , respectively 0.83. 083 0.83 83 0.83) CONCLUSION it (CR 64. 92 9. 00 0. 669.6 6696 66 (669. 588 8 58. 640.8 6408 (640. 1012 10 101. 650.8 6508 65 (650. 962 96. 08 0.8 669. (669 640. (640 1 650. (650 (66 (64 (65 (6 (

Abstract Excessive alcohol consumption is considered a risk factor for bone health, as it causes a reduction in mass and increases the risk of fracture. However, the determination of bone mineral density (BMD) has not always been an adequate predictor of bone fragility. Thus, the hypothesis arises that chronic alcohol consumption interferes with collagen synthesis and the quality of bone trabeculae, with consequent bone fragility. Groups: Control (n = 6; water intake only during the entire study period); Ethanol (n = 6; ingestion of ethyl alcohol according to the protocol for inducing chronic alcohol consumption). The chronic alcohol consumption model did not cause a significant change in BMD, but there was a significant reduction of 20% in the thickness of the bone trabeculae and of 1.56% in the collagen located in the neck region of immature rat femurs. Although there was no significant change in the mineral matrix, the changes in the organic matrix were able to provide a significant reduction in bone strength. The results suggest harmful effects of alcohol intake on the bone quality of young adult animals and draw attention to the need to also consider methods for the diagnosis of collagen as an element of bone fragility.

RESUMO Objetivo: Verificar a influência do consumo experimental crônico de álcool no crescimento longitudinal da tíbia e em parâmetros de qualidade óssea de ratos jovens. Métodos: Dez ratos controle receberam água, outros dez receberam álcool etílico nas concentrações estabelecidas no protocolo para indução. Após eutanásia, as amostras de sangue foram coletadas por punção cardíaca e processadas para avaliar os níveis de fosfatase alcalina por espectrofotometria automatizada. Após a coleta de sangue, ambas as tíbias foram dissecadas, pesadas e medidas em comprimento. Foram realizadas análises do conteúdo mineral ósseo e resistência mecânica, por meio da análise da força máxima e rigidez. Resultados: Houve comprometimento da saúde óssea, com redução de 35,3% no nível de fosfatase alcalina no plasma (p<0,01), redução de 10% na massa da tíbia (p<0,05) e queda de 5,3% no comprimento das tíbias (p<0,0001). Também foi observada redução de 10% na densidade mineral óssea (p<0,01), que levou à redução de 17,2% na força máxima (p<0,01) e 22,6% na rigidez (p<0,001). Conclusão: O consumo crônico de álcool afetou os ossos de ratos jovens, tornando-os mais fracos e osteopênicos. Ainda, os ossos longos eram mais curtos, sugerindo interferência no crescimento. Nível de evidência III, Estudo caso-controle.

ABSTRACT Objective: To assess the effect of chronic alcohol consumption on the longitudinal growth of the tibia and bone quality parameters in young rats under an experimental setup. METHODS: The control (n=10) rats received only water. The ethanol (n=10) rats received ethyl alcohol at concentrations established in the protocol for the induction of chronic alcohol consumption. The blood samples were immediately collected via cardiac puncture and processed to evaluate the levels of alkaline phosphatase by automated spectrophotometry. Following blood sample collection, both tibias were dissected, and weighed; the tibial length was measured., and the samples were stored in a freezer for future analysis of the bone mineral content and mechanical resistance, known as maximal load and stiffness. RESULTS: Compromised bone health, with a 35.3% decrease in the serum alkaline phosphatase levels (p < 0.01), a 10% decrease in the tibial mass (p < 0.05), and a 5.3% decrease in the tibial length (p < 0.0001) were noted. Furthermore, a 10% decrease in the bone mineral density was observed (p < 0.01), which led to a 17.2% decrease in the maximum strength (p < 0.01) and 22.6% decrease in stiffness (p < 0.001). CONCLUSION: Chronic consumption of alcohol affected the bones of young rats, making them weaker and osteopenic. In addition, the long bones were shorter, suggesting interference with growth. Level of Evidence III, Case Control Study.

Resumo Introdução: O alcoolismo é um grande problema de saúde pública, de elevado custo social e que afeta vários aspectos da atividade humana. Hepatopatia é uma das primeiras consequências do abuso de álcool, podendo ocorrer esteatose, cirrose hepática e hepatite. Outros órgãos, porém, também são afetados, ocorrendo alterações patológicas, como pancreatite, cardiomiopatias, dislipidemias e aterosclerose. Objetivo: Identificar a ocorrência e a intensidade de aterosclerose em alcoolistas com cirrose hepática, observando alterações macro e microscópicas do depósito lipídico e de fibras colágenas e fígado. Verificar a associação de depósito lipídico e de fibras colágenas com gênero, idade e índice de massa corporal (IMC). Relacionar alcoolismo, cirrose hepática e aterosclerose. Método: Foi realizado estudo com base em laudos de autópsias de pacientes com cirrose hepática alcoólica, sendo estudados aortas e fígados para verificar a ocorrência e a intensidade de aterosclerose, bem como a quantidade de colágeno encontrada. Resultados: A aterosclerose microscópica foi maior em jovens (lesão inicial) e em pacientes com cirrose hepática alcoólica. A análise macroscópica da aterosclerose nas aortas mostrou que pacientes com faixas etárias mais avançadas apresentaram classificações mais intensas. A aterosclerose, tanto micro quanto macroscopicamente, e a porcentagem de fibrose no fígado e na aorta foram mais expressivas no gênero feminino. Conclusão: Os pacientes cirróticos apresentaram maior porcentagem de fibrose e lipidose, e podem representar um grupo susceptível à acelerada progressão de doenças cardiovasculares. Estudos investigativos contribuem para o direcionamento das intervenções promotoras da saúde, reduzindo a mortalidade e os custos no tratamento das doenças cardiovasculares.

Summary Introduction: Alcoholism is a major public health problem, which has a high social cost and affects many aspects of human activity. Liver disease is one of the first consequences of alcohol abuse, and steatosis, liver cirrhosis and hepatitis may occur. Other organs are also affected with pathological changes, such as pancreatitis, cardiomyopathies, dyslipidemias and atherosclerosis. Objective: To identify the occurrence and degree of atherosclerosis in alcohol-dependent individuals with liver cirrhosis, observing macroscopic and microscopic changes in lipid and collagen deposits and in the liver. We also aimed to verify the association of lipid and collagen fiber deposits with gender, age and body mass index, and to relate alcoholism, liver cirrhosis and atherosclerosis. Method: We performed a study based on autopsy reports of patients with alcoholic liver cirrhosis, with analysis of aorta and liver fragments to verify the occurrence and degree of atherosclerosis, as well as collagen contents. Results: Microscopic atherosclerosis was higher in young subjects (early injury) and in patients with alcoholic liver cirrhosis. The macroscopic analysis of atherosclerosis in aortas showed that patients in more advanced age groups presented more severe classifications. Atherosclerosis, both micro and macroscopically, and the percentage of fibrosis in the liver and aorta were more expressive in females. Conclusion: Cirrhotic patients presented a higher percentage of fibrosis and lipidosis, and may represent a group susceptible to the accelerated progression of cardiovascular diseases. Investigative studies contribute to targeting health-promoting interventions, reducing the mortality and costs of treating cardiovascular disease.

Resumo Introdução: Indivíduos com síndrome de Down (SD) apresentam alterações que afetam o sistema musculoesquelético, provocando padrões anormais e alterando os eixos anatômicos morfológicos e mecânicos que proporcionam uma estabilidade intrínseca ao esqueleto, podendo desencadear desalinhamentos e alterações ortopédicas na vida adulta. Objetivo: O objetivo desse estudo foi avaliar a o alinhamento postural antes e após o tratamento equoterapêutico em indivíduos com SD. Métodos: Foram avaliados cinco indivíduos com SD por meio do aplicativo SAPO de avaliação postural, antes e após vinte e sete sessões. Realizou-se a análise qualitativa descritiva por meio do Cluster e análise estatística utilizando o programa Sigma Stat 2.0, considerando estatisticamente significativas as diferenças em que o valor p foi menor que 5%. Resultados: Foi possível verificar melhoras no alinhamento de ombro, de cabeça, de quadril e membros inferiores, bem como diminuição da cifose e da protrusão de cabeça. Conclusão: Os indivíduos com SD apresentaram mudanças satisfatórias no comportamento motor que refletiram em uma melhora da postura estática após o tratamento na equoterapia.

Abstract Introduction: Individuals with Down syndrome (DS) have alterations that affect the musculoskeletal system, causing abnormal patterns, and alter the morphological anatomical and mechanical axes that provide intrinsic stability to the skeleton, and can trigger misalignments and orthopedic disorders in adulthood. Objective: The objective of student to evaluate posture and postural alignment before and after the hippotherapyin individuals with DS. Methods: Posture of five individuals with DS was evaluated by the software SAPO before and after 27 sessions the hippotherapy. Data were subjected to qualitative descriptive analysis using cluster and statistical analysis with the aid of the software Sigma Stat 2.0, considering differences as statistically significant at p-value < 5%. Results: Improvements were achieved for the alignment of shoulder, head, hip, and lower limbs, in addition to decrease in kyphosis and head protrusion. Conclusion: Patients with DS demonstrated satisfactory changes in motor behavior reflected in improved static posture after treatment with hippotherapy.

OBJECTIVES: To describe the morphological features of atherosclerosis in the aortas of autopsied patients (ranging from young adults to the elderly), thus providing new tools for a more sensitive morphological evaluation. METHOD: We collected 141 aorta samples. We assessed the macroscopic degree of atherosclerosis, thickness of the intima and media, lipid and collagen depositions in the intima, and the infiltration of mast cells into the layers of the aorta. We correlated the findings with gender, age, race and cause of death. RESULTS: The degree of atherosclerosis was significantly higher in the elderly. The aorta was thicker in the elderly and in cases with a cardiovascular cause of death. The thickness of the intima was significantly greater in the elderly, in males and in cases with a cardiovascular cause of death. The lipid content in the intima of the aorta was significantly higher in Caucasians. Older people and men had a significantly higher number of mast cells. CONCLUSION: A macroscopic evaluation is a good indicator of the severity of atherosclerosis, but a more detailed analysis, namely evaluating the thickness of the layers of the aorta and the number of mast cells, may further elucidate the changes in the constituents of this vessel.