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Background: The number of questionnaires that measures physical activity levels has increased considerably. For Brazilian population it becomes a challenge, due to the need of a rigorous translation, adaptation and testing of measurement properties., Objective: Evaluate the methodological quality and criteria of physical activity questionnaires translated to Brazilian-Portuguese., Methods: Methodological quality and quality criteria was assessed using the COnsensus-based Standards for the selection of health Measurement INstruments checklist., Results: Sixty-nine studies were included, the most frequent questionnaires investigated were the International Physical Activity Questionnaire (n=16) and the Baecke Physical Activity Questionnaire (n=12). Translation (n=13), reliability (n=37) and construct validity (n=44) were the measurement properties commonly investigated. For reliability, most studies were rated as 'adequate' for methodological quality. The Intraclass Correlation Coefficient of the questionnaires ranged from 0.20 to 1.0. For construct validity, 31 analyses showed 'inadequate' methodological quality, due to poor description of the comparator instrument. High level of evidence on reliability were found for Baecke Physical Activity Questionnaire, Self-administered Physical Activity Checklist and Physical Activity Questionnaire of the Surveillance System of Risk Factors and Protection for Chronic Diseases; on construct validity for Self-administered Physical Activity Checklist, Physical activity Questionnaire for Adolescents, Physical activity Questionnaire for Older Children and Saúde naBoa Questionnaire., Conclusion: Most questionnaires showed poor methodological quality and measurement properties. The Baecke Physical Activity Questionnaire and Self-administred Physical Activity Checklist showed better scorings for methodological quality and quality criteria. Further high methodological quality studies are still warranted., (Copyright © 2019. Publicado por Elsevier Editora Ltda.)

Background: Older people's participation in structured exercise programs to improve balance and mobility is low. Senior Dance is an alternative option, as it may provide a safe and fun way of targeting balance., Objective: The aim was to investigate the effect of Senior Dance on balance, mobility, and cognitive function compared with a control intervention., Design: The study was a randomized controlled trial., Setting/patients: Eighty-two community-dwelling older people aged 60 years or over and cognitively intact were recruited in Brazil., Intervention: Participants were randomly allocated to 2 groups: Dance plus education (intervention group) and education alone (control group). The Senior Dance program consisted of 12 weeks of twice-weekly group-based dance classes. Participants in both groups attended a single 1-hour educational session on prevention of falls., Measurements: The primary outcome was single-leg stance with eyes closed. Secondary outcomes were timed sit-to-stand test, standing balance test, timed 4-m walk, and cognitive function tests, for example, Trail Making Test and Montreal Cognitive Assessment., Results: Of the 82 participants randomized, 71 (87%) completed the 12-week follow-up. Single-leg stance with eyes closed (primary outcome) improved in the Senior Dance group (mean difference [MD] = 2.3 seconds, 95% confidence interval [CI] = 1.1 to 3.6) compared with the control group at follow-up. Senior Dance group performed better in the standing balance tests (MD = 3.7 seconds, 95% CI = 0.6 to 6.8) and were faster in the sit-to-stand test (MD = - 3.1 seconds, 95% CI = -4.8 to -1.4) and 4-m walk test (MD = -0.6 seconds, 95% CI = -1.0 to -0.1). There were no significant between-group differences for cognitive function tests., Limitations: Participants and therapists were not blinded., Conclusion: Senior Dance was effective in improving balance and mobility but not cognitive function in community-dwelling older people., (© 2020 American Physical Therapy Association.)

Background: The Iconographical Falls Efficacy Scale (Icon-FES) is an innovative tool to assess concern of falling that uses pictures as visual cues to provide more complete environmental contexts. Advantages of Icon-FES over previous scales include the addition of more demanding balance-related activities, ability to assess concern about falling in highly functioning older people, and its normal distribution., Objective: To perform a cross-cultural adaptation and to assess the measurement properties of the 30-item and 10-item Icon-FES in a community-dwelling Brazilian older population., Methods: The cross-cultural adaptation followed the recommendations of international guidelines. We evaluated the measurement properties (i.e. internal consistency, test-retest reproducibility, standard error of the measurement, minimal detectable change, construct validity, ceiling/floor effect, data distribution and discriminative validity), in 100 community-dwelling people aged ≥60 years., Results: The 30-item and 10-item Icon-FES-Brazil showed good internal consistency (alpha and omega >0.70) and excellent intra-rater reproducibility (ICC 2,1 =0.96 and 0.93, respectively). According to the standard error of the measurement and minimal detectable change, the magnitude of change needed to exceed the measurement error and variability were 7.2 and 3.4 points for the 30-item and 10-item Icon-FES, respectively. We observed an excellent correlation between both versions of the Icon-FES and Falls Efficacy Scale - International (rho=0.83, p<0.001 [30-item version]; 0.76, p<0.001 [10-item version]). Icon-FES versions showed normal distribution, no floor/ceiling effects and were able to discriminate between groups relating to fall risk factors., Conclusion: Icon-FES-Brazil is a semantically and linguistically appropriate tool with acceptable measurement properties to evaluate concern about falling among the community-dwelling older population., (Copyright © 2018 Associação Brasileira de Pesquisa e Pós-Graduação em Fisioterapia. Publicado por Elsevier Editora Ltda. All rights reserved.)

Introduction: Automated assisted peritoneal dialysis (AAPD) has been shown to be successful as renal replacement therapy for elderly and physically incapable end-stage renal disease (ESRD) patients. In early 2003, a pioneer AAPD program was initiated at GAMEN Renal Clinic in Rio de Janeiro, Brazil. ♢, Objective: We evaluated the results of an AAPD program offered as an option to elderly ESRD patients with physical or cognitive debilities or as last resort to patients with vascular access failure or hemodynamic instability during hemodialysis. ♢, Methods: A cohort of 30 consecutive patients started AAPD from January 2003 to March 2008 and was followed to July 2009. Demographics, clinical and laboratory parameters, causes of death, and patient and technique survival were analyzed. ♢, Results: Median age of the patients was 72 years (range: 47 - 93 years), with 60% being older than 65. The Davies score was greater than 2 in 73% of patients, and the Karnofsky index was less than 70 in 40%. The overall peritonitis rate was 1 episode in 37 patient-months. The total duration of AAPD ranged from 3 to 72 months. Patient survival was 80% at 12 months, 60% at 24 months, and 23.3% at 48 months. The most common cause of death was cardiovascular problems (70%). ♢, Conclusions: In this clinical observational study, AAPD fulfilled its expected role, offering an opportune, reliable, and effective homecare alternative for ESRD patients with no other renal replacement therapy options.

Objectives: To determine the roles of body size and longitudinal body weight changes in the survival of incident peritoneal dialysis patients., Patients and Methods: Patients (n = 1911) older than 18 years of age recruited from 114 dialysis centers (Dec/ 2004-Oct/2007) and participating in the Brazilian Peritoneal Dialysis Multicenter Cohort Study were included. Clinical and laboratory data were collected monthly (except if the patient received a transplant, recovered renal function, was transferred to hemodialysis, or died)., Results: Survival analyses were performed using Kaplan-Meier survival curves and Cox proportional hazards. Total follow-up was 34 months. The mean age was 59 years (54% female). The weight category percentages were as follows: underweight: 8%; normal: 51%; overweight: 29%; and obese 12%. The multivariate model showed a higher risk of death for a body mass index <18.5 kg/m², a neutral risk between 25 and 29.9 kg/m² and a protective effect for an index >30 kg/m². Patients were divided into five categories according to quintiles of body weight changes during the first year of dialysis: <-3.1%, -3.1 to+0.12%, +0.12 to <+3.1% (reference category), +3.1 to +7.1% and >+7.1%. Patients in the lowest quintile had significantly higher mortality, whereas no negative impact was observed in the other quintiles., Conclusion: These findings suggest that overweight/obesity and a positive body weight variation during the first year of peritoneal dialysis therapy do not increase mortality in incident dialysis patients in Brazil.

Introduction: Imipenem-resistant Pseudomonas aeruginosa resulting from metallo-β-lactamases has been reported to be an important cause of nosocomial infection and is a critical therapeutic problem worldwide, especially in the case of bacteremia., Objectives: To determine the frequency of metallo-β-lactamases among imipenem-resistant Pseudomonas aeruginosa isolates and to compare methods of phenotypic and molecular detection., Methods: During 2006, 69 imipenem-resistant Pseudomonas aeruginosa samples were isolated from blood and tested for metallo-β-lactamase production using both phenotypic methods. Minimal Inhibitory Concentratrions (MIC) (μg/mL) was determined with commercial microdilution panels. Pulsed Field Gel Electrophoresis (PFGE) was performed among metallo-β-lactamase producers., Results: Of all the blood isolates, 34.5% were found to be imipenem-resistant Pseudomonas aeruginosa. Positive phenotypic tests for metallo-β-lactamases ranged from 28%-77%, and Polymerase Chain Reaction (PCR) were positive in 30% (of note, 81% of those samples were bla(SPM)₋₁ and 19% were bla(VIM)₋₂). Ethylenediamine tetracetic acid (EDTA) combinations for the detected enzymes had low kappa values; thus, care should be taken when use it as a phenotypic indicator of MBL. Despite a very resistant antibiogram, four isolates demonstrated the worrisome finding of a colistin MIC in the resistant range. PFGE showed a clonal pattern., Conclusion: Metallo-β-lactamases among imipenem-resistant Pseudomonas aeruginosa were detected in 30.4% of imipenem-resistant Pseudomonas aeruginosa isolates. This number might have been higher if other genes were included. SPM-1 was the predominant enzyme found. Phenotypic tests with low kappa values could be misleading when testing for metallo-β-lactamases. Polymerase Chain Reaction detection remains the gold standard.

Objective: To present an alternative method of detecting micrometastases in lymph nodes previously testing negative for non-small cell lung cancer (NSCLC) by routine hematoxylin-eosin staining., Methods: A total of 77 hilar and mediastinal lymph nodes resected from 18 patients with NSCLC were investigated for the presence of micrometastases using a combination of microarray analysis and immunohistochemistry., Results: Micrometastases were detected by identifying cytokeratin- and chromogranin-positive cells in lymph node microarrays. Of the 18 patients initially staged as pN0 through routine hematoxylin-eosin staining, 9 (50%) were restaged as N1, and the prognoses were re-evaluated in terms of histological and clinical parameters. The comparison of the survival curves revealed that survival was higher in the patients without micrometastases than in those with micrometastases. In addition, in the multivariate analysis adjusted for age, gender, histological type, and restaging, the presence of micrometastases proved to be an independent predictor of survival. Among patients who had been previously staged as pN0, the risk of death was found to be 7-times greater for those later diagnosed with micrometastases than for those in whom no micrometastases were identified., Conclusion: The combination of microarray analysis and immunohistochemistry might represent a low-cost and less time-consuming alternative for identifying occult micrometastases and predicting prognoses in surgically resected patients with pN0 NSCLC. Larger randomized, prospective studies are needed in order to determine the accuracy of this method.

Ten lots of mapará (Hypophthalmus sp.), captured from the Amazon River, Brazil, were analyzed for their lipid content and fatty acid composition. This knowledge would allow for the development of adequate processing methods and the formulation of therapeutic diets. Separation into neutral and phospholipids was accomplished by silica-gel column chromatography. Fat from the muscular tissue and from the orbital cavity of the mapará was analyzed by high-resolution gas chromatography-mass spectrometry in two different seasonal periods. There were high levels of saturated and monounsaturated fatty acids in the total and neutral lipid with the principal components 16:0, 18:1omega9, 18:0, 16:1omega7, 14:0, 18:3omega3, and 18:1omega7 in both seasons. In the phospholipids there was a high level of polyunsaturated fatty acids, including primarily 16:0, 18:1omega9, 18:0, 16:1omega7, 22:6omega3, 20:4omega6, 18:3omega3, and 20:5omega3. The ratio omega3/omega6 was the same in the muscular tissue and in the orbital cavity, in both seasonal periods. The muscle tissue could be used in diets that need high levels of polyunsaturated fatty acids, but use of the head to produce an omega3 fatty-acid-rich oil still requires greater study with respect to its economic viability.

Twenty-one volatile compounds were identified for the first time by GC-MS in umbu-caja and in camu-camu, plus 30 volatile compounds were identified in araça-boi samples. Terpenic compounds predominated among the volatile compounds in these fruit samples, with the major compounds being identified as cis-beta-ocimene and caryophyllene in the northeastern fruit; alpha-pinene and d-limonene were the most abundant volatile compounds in the headspace of the Amazonian fruit camu-camu. Sesquiterpenes were the most abundant compounds in the araça-boi sample, with germacrene D presenting a higher relative percentage. The chemical class of esters predominated in the cupuaçu sample. Ethyl butyrate and hexanoate were the major compounds in the headspace of this Amazonian fruit.