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The performance of getting up from the floor from a supine position (Supine-to-Stand task, STS) can be considered a milestone in motor development and a potential indicator of motor competence in global terms. However, the knowledge about the performance of STS task and anthropometric characteristics is limited. This study examined the relationship between STS task performance and anthropometry in youth and the differences between the sexes, range age and nationality. Participants (n= 397; 45% girls) from Spain and Brazil (M= 9.13 years; SD= 3.79) had the following variables measured: timed STS task, mass, height, chronological age, hip, and waist circumference; Body Mass Index (BMI), Waist/Hip Ratio (WHR), Waist/Height Ratio (WHtR) were calculated. The analysis included ANOVA, Pearson's correlation test and Stepwise multiple regression analysis in four age groups. Age was the variable that obtained statistically significant associations with timed STS task in the youngest age group; the BMI in the children group corresponded to the second childhood phase, and the WHR and the WHtR in the oldest age group. The timed STS task decreased as age groups were increasingly older, confirming that timed STS is strongly associated with growth and maturation processes; there were little differences between sexes or nationalities. [ABSTRACT FROM AUTHOR]

Objective: to assess the risk for the development of injuries related to surgical positioning. Method: a crosssectional study with a sample comprised by adults undergoing elective surgeries (n=146) in Paraná, Brazil. The Risk Assessment Scale for the Development of Injuries arising from Surgical Positioning was applied, with extraction of sociodemographic variables. Descriptive and inferential analyses were performed. Results: men (49.3%) and women (50.7%) presented equal distribution of appointments, mostly in the Orthopedics specialty (39.7%). The following stood out as per the scale applied: use of conventional mattress + cotton field cushions as a support surface (100%); supine position (78%); upper limbs with opening less than 90º (70.5%); regional anesthesia (54.1%), and surgical time of 1h-2h (46.6%). A mean score of 17.6±3.29 points was found and 75.3% of the sample presented low risk for the development of injuries related to surgical positioning. Conclusion: around 25% of the sample presented a higher risk of injuries arising from surgical positioning. [ABSTRACT FROM AUTHOR]

Objective: A pressure injury (PI) is a localised area of damage to the skin and/or underlying soft tissue as a result of a sustained mechanical loading. There are three key aetiological mechanisms to PI formation--direct cell deformation, inflammatory oedema and ischaemic damage--which are typically activated sequentially to drive a spiral of injury. This article discusses the role of the perioperative prone position as a rational approach to reducing the recurrence of pelvic PI after reconstructive surgery. Method: Patients with deep PI in the pelvic region, who were operated on from 2011 to 2019, were retrospectively evaluated. The protocol of care included training in the prone position, followed by maintenance of the prone position for 4-6 weeks postoperatively. The reconstruction was performed with fasciocutaneous and myocutaneous local or regional flaps. Results: The study evaluated a total of 26 patients. The rate of recurrence of PIs was 15.4% (4/26) in the mean follow-up of 54 months. Regarding postoperative complications, four cases of partial dehiscence of the suture occurred. Conclusion: This perioperative protocol of maintaining a prone position seems to be safe for the patient, and it can be used to prevent or reduce the recurrence of deep PIs on the pelvic region after reconstructive surgery. Declaration of interest: The authors have no conflicts of interest to declare. [ABSTRACT FROM AUTHOR]

Introduction: This paper aims to determine the incidence of pressure ulcers (PUs) and serious adverse events in patients in the prone position. Methods: A retrospective cohort study was conducted from 2015 to 2017 in the intensive care unit of a university hospital in Porto Alegre, southern Brazil. Data were collected from electronic medical records using a structured questionnaire and analyzed by descriptive and analytical statistics. Results: Thirty-seven patients were evaluated. Of these, 8 (21.6%) had PUs after prone positioning. One (2.7%) adverse event occurred during prone positioning, 3 (8%) when patients were alternately placed in the swimmer's position, and none when patients were returned to the supine position. Conclusions: The incidence of serious adverse events and PUs was lower than that reported in previous studies. A hypothesis is that the use of cushions for positioning, standardized nursing care, checklists, and team training are responsible for this outcome. [ABSTRACT FROM AUTHOR]

BACKGROUND: Firefighters' activities require constant adjustments of the cardiovascular system with cardiac autonomic function (CAF) playing an important role. Despite the crucial role of CAF in regulating stress response, little is known about firefighters' CAF. OBJECTIVE: We aimed to characterize the resting on-duty and off-duty CAF of male firefighters, in association with cardiorespiratory fitness (CRF). METHODS: We evaluated 38 firefighters in an on-duty rest condition and 26 firefighters in an off-duty laboratory-controlled condition. CAF was addressed by means of heart rate variability (HRV). We compared HRV measurements between CRF categories (<12METs vs ≥12METs). Wilcoxon, Mann-Whitney texts and Spearman correlation were used and General Linear Model was applied for age and BMI adjustments. RESULTS: Firefighters' resting CAF is characterized by a predominant sympathetic modulation and a large inter-individual dispersion in all HRV indices, in both groups. We found a positive correlation between a higher CRF, the overall CAF and the higher parasympathetic activity (p < 0,03). Firefighters with CRF ≥12 METs showed a higher parasympathetic modulation. CONCLUSIONS: Firefighters' resting CAF is characterized by a predominant sympathetic modulation and a large inter-individual dispersion in all HRV indices, in both groups. Our results support mandatory physical training focused in improving firefighters' CAF as a cardiopretective effect. [ABSTRACT FROM AUTHOR]

Objective to evaluate women's knowledge about the best baby sleeping position and to identify factors associated with a greater probability of putting infants to sleep in an unsafe position, in Rio Grande, Southern Brazil. Method This is a cross-sectional population-based study that included all women who bore children in 2013 in this municipality. A single, standardized questionnaire was given within 48 h after delivery in the only two local maternity hospitals. The outcome was that women reported the lateral and the ventral decubitus as the best sleeping positions for babies. A Chi square test was used for proportions and Poisson regression was used with robust variance adjustment in the multivariate analysis. The prevalence ratio was the measure of effect used. Results We included 2624 women in this study. Of these, 82.1% (95% CI 80.6-83.6) stated that the baby should sleep in the lateral or ventral decubitus positions. 76.4% reported having acquired this knowledge from their mothers and 34.7% were willing to adopt the correct (supine) sleeping position for their child if recommended by doctors. The adjusted analysis showed that the lower the schooling of the mothers and the greater the number of people per bedroom and number of children, the greater the probability of women choosing an unsafe baby sleeping position. Conclusions for Practice This study showed that the percentage of women who are unaware of the correct baby sleeping position is very high, that doctors should be convinced to recommend the supine baby sleeping position, and that campaigns on this subject should also include grandparents as a priority intervention group. [ABSTRACT FROM AUTHOR]

Aim To compare the effect of sleeping position on physiological and behvioural responses in preterm infants. Methods A quasi-experimental study was conducted in a neonatal intensive care unit in the south of Brazil. The sample was 24 preterm newborns with gestational age ≤32 weeks, who were randomly separated into four groups: right side position, supine position, left side position and prone position. The physiological and behavioral variables were evaluated before, during and after positioning. Findings During the intervention, heart rate decreased in right side position, supine position, and prone position. The respiratory rate reduced in all positions and peripheral oxygen saturation remained stable in most positions. Behavioural scores were reduced in supine, left side and prone positions. Conclusions Positioning according to a standard operating procedure was able to produce more positive responses in prone and supine position groups during the intervention. [ABSTRACT FROM AUTHOR]

Objective: To describe respiratory function in a series of patients with late-onset Pompe disease after the definitive diagnosis and before enzyme replacement therapy. Methods: This was a cross-sectional study involving patients with a definitive molecular diagnosis of late-onset Pompe disease. The data analyzed included age at symptom onset; age at definitive diagnosis; type of initial symptoms; time from symptom onset to diagnosis; FVC in the sitting and supine positions; six-minute walk distance; and locomotor ability. Analyses were carried out using frequencies, medians, minimum values, and maximum values. Results: Six patients were included in the study. The median age at symptom onset was 15 years (range, 13-50 years), and the median age at diagnosis was 39.5 years (range, 10-64 years). The median time from symptom onset to diagnosis was 8 years (range, 0-45 years). In all cases, the initial manifestation of the disease had been motor weakness. The median FVC in percentage of the predicted value (FVC%) in the sitting and supine positions was 71.0% (range, 22.9-104.6%) and 58.0% (range, 10.9-106.9%), respectively. The median ▵ FVC% was 24.5% (range, -4.59 to 52.40%).The median six-minute walk distance was 391.7 m (range, 97-702 m). Conclusions: In this case series, the time from symptom onset to diagnosis was long. Although respiratory signs or symptoms were not the initial manifestations of the disease, 66.7% of the patients showed reduced FVC% in the sitting and supine positions at diagnosis. [ABSTRACT FROM AUTHOR]

Objective: To evaluate the maximum bite force (MBF) in subjects with and without Temporomandibular Dysfunction (TMD), in three different positions (sitting, lying and standing). Methods: The sample consisted of 60 individuals, aged between 19 and 35 years, who were divided into two groups: with TMD (n = 30) and without TMD (n = 30). First, the RDC/TMD questionnaire was applied and, after diagnosis, all of the subjects selected were submitted to the measurement of MBF, on each side (right and left), in three different positions (sitting, lying and standing), by means of a digital gnatodynamometer. Results: No significant difference in mean MBF was found between the two groups; however, the mean MBF for the subjects, comparing the same side and different positions, was significantly different, being smaller when the individual was lying down. Conclusions: According to the results, it was concluded that the MBF is influenced by the change of position. [ABSTRACT FROM AUTHOR]

Objective: To verify whether the time spent in prone, supine, or seated positions differed between term and preterm infants; and to determine whether a single verbal guidance session for parents changed the time spent in different positions, and, consequently, the motor development scores, after one month in preterm infants., Methods: Sixty-one infants from a full-term and preterm group from Brazil were included. Motor development was assessed by the Alberta Infant Motor Scale (AIMS) and the parents registered the time spent in each position on a 24-hour schedule. A month after verbal guidance, a second assessment was performed only on the preterm infants., Results: The positioning times awake determined for the full-term and preterm parents were similar. Preterm infants spent more time in the prone sleeping position (2.1 vs. 0.8 h; p=0.037) than full-term infants. The AIMS percentile scores did not differ significantly between the groups. For preterm infants, the time spent in all positions did not change during the second assessment (n=18)., Conclusions: The fact that some parents position their infants in the prone posture during sleeping periods reinforce the importance of parental education approaches for sudden infant death syndrome (SIDS) prevention during the first months of life. The verbal guidance provided to parents of preterm infants did not influence the AIMS percentile and time spent in various positions but increased preterm parents' confidence in placing their infants in a prone position to play.

Purpose To evaluate the frequency of preterm infant positions during sleep, and to investigate the association among positions, arousals, sleep patterns, and time of day. Design and Methods This observational study was conducted in a neonatal unit with 10 preterm infants. Polysomnographic and video recordings during 24 hr identified sleep positions, arousals, sleep patterns, and time of day. Results Preterm infants were placed most frequently in the supine position (58.4%), followed by right side (24.9%), left side (15.5%), and prone (1.2%). The longest amount of time spent sleeping, and the most frequent number of arousals, occurred in the supine position, followed by prone, left-side, and right-side positions. After controlling for length of time spent in each position, the number of arousals per hour was the greatest in the supine position (13.562 ± 0.732) and least in the prone position (11.56 ± 4.754; p < .001). There were no significant differences in arousals according to position and sleep pattern (indeterminate, quiet, active sleep) or position and time of day (morning, afternoon, twilight, night). Practice Implications Nurses should evaluate the frequency of preterm infant arousals in each position, and use more often those positions that lead to a lower frequency of arousals and better sleep quality. [ABSTRACT FROM AUTHOR]

Background: The effects of non-invasive ventilation (NIV) on the breathing pattern and thoracoabdominal motion of patients with amyotrophic lateral sclerosis (ALS) are unknown. Objectives: 1) To analyze the influence of NIV on chest wall volumes and motion assessed by optoelectronic plethysmography in ALS patients and 2) to compare these parameters in the supine and sitting positions to those of healthy individuals (without NIV). Method: Nine ALS patients were evaluated in the supine position using NIV. In addition, the ALS patients and nine healthy individuals were evaluated in both sitting and supine positions. Statistical analysis was performed using the paired Student t-test or Wilcoxon test and the Student t-test for independent samples or Mann-Whitney U test. Results: Chest wall volume increased significantly with NIV, mean volume=0.43 (SD=0.16)L versus 0.57 (SD=0.19)L (p=0.04). No significant changes were observed for the pulmonary rib cage, abdominal rib cage, or abdominal contribution. The index of the shortening velocity of the diaphragmatic muscle, mean=0.15 (SD=0.05)L/s versus 0.21 (SD=0.05)L/s (p<0.01), and abdominal muscles, mean=0.09 (SD=0.02)L/s versus 0.14 (SD=0.06)L/s (p<0.01), increased during NIV. Comparisons between the supine and sitting positions showed similar changes in chest wall motion in both groups. However, the ALS patients presented a significantly lower contribution of the abdomen in the supine position compared with the controls, mean=56 (SD=13) versus 69 (SD=10) (p=0.02). Conclusions: NIV improved chest wall volumes without changing the contribution of the chest wall compartment in ALS patients. In the supine position, ALS patients had a lower contribution of the abdomen, which may indicate early diaphragmatic dysfunction. [ABSTRACT FROM AUTHOR]

Objective: Sudden infant death syndrome (SIDS) is a major cause of death among children aged <1 year. Campaigns to educate physicians have been effective to reduce its incidence. We assessed the knowledge of Brazilian pediatricians' regarding risk factors for SIDS, their familiarity with the first Brazilian SIDS campaign launched in 2009, and self-reported changes in practices following this campaign.Methods: Active members of the Brazilian Society for Pediatrics who had been in practice for at least two years at the time of the campaign were invited. Pediatricians answered an online survey including eight multiple-choice questions and one open-ended question. Invitees were chosen by chance draw to reflect the geographic distribution of pediatricians in the five regions of the country.Results: The survey was answered by 1654 pediatricians (mean [SD] age: 46 [11.5] years; mean [SD] professional practice time: 20.2 [11.52] years). Bedding items (77.7%), prone sleeping position (72.9%), bed sharing (66.3%), and smoking (59.2%) were recognized as risk factors for SIDS. Most pediatricians (88.2%) were familiar with the campaign, and 84.7% were aware of the current recommendation of supine sleeping position to prevent SIDS. The effectiveness of the first Brazilian SIDS campaign could be measured by a change in practice; before the campaign, 67.5% recommended lateral position and 23.1% the supine, and after the campaign, 76.2% recommended supine and 10.4% lateral. However, 12.8% still recommend prone position.Conclusions: The majority of pediatricians changed their advice to parents after the educational campaign and became familiar with risk factors for SIDS. Continuous educational campaigns focusing on physicians resistant to changing practices should be provided. [ABSTRACT FROM AUTHOR]

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The objective was to assess the effects of cardiovascular autonomic nervous system through the heart rate variability (HRV) in subject with complete spinal cord injury (SCI) at different levels. 32 subjects participated in the study, divided into three groups: 13 tetraplegic patients (G1), 8 paraplegic patients (G2) and 11 healthy subjects formed the control group (CG). All underwent the assessment HRV, made from data obtained by record of 15 minutes, generated by the cardiac monitor, connected to a laptop, which recorded on recording on-line RR intervals. The HR at rest in the supine position was lower in G1 compared to G2 and CG. HRV was highest in G1 in the supine position. HRV was lower in the standing position in the G1 compared to G2 and CG, as a consequence of the greater decrease in BP. Spectral analysis showed a reduction in G1 and GC of high-frequency power (decrease in vagal activity) and increased the ratio B / A represents the intensity decreased vagal tone in G1 and increased adrenergic activity in GC. The results showed an autonomic dysfunction in tetraplegics and paraplegics equivalent results in the control group. [ABSTRACT FROM AUTHOR]

How to cite this article de Almeida Paula H.A., de Cássia Lanes Ribeiro R., de Lima Rosado L.E.F.P., Abranches M.V. & do Carmo Castro Franceschini S. (2012) Relationship between waist circumference and supine abdominal height measured at different anatomical sites and cardiometabolic risk factors in older women. J Hum Nutr Diet. Abstract Objectives: To measure waist circumference (WC) and supine abdominal height (SAH) at different anatomic sites and to assess the relationship with cardiometabolic risk factors in women aged >60 years. Methods: The present study included 113 women from Viçosa, Minas Gerais, Brazil. The evaluations comprised anthropometric, biochemical and haemodynamic measurements. Different anatomical sites were used to measure WC: (i) the midpoint between the last rib and iliac crest; (ii) umbilical level; (iii) immediately above the iliac crests; and (iv) the narrowest point between the last rib and the iliac crest. Measurements were also taken at different anatomic sites for SAH: (i) the midpoint between the iliac crests; (ii) umbilical level; (iii) higher abdominal diameter; and (iv) the narrowest point between the last rib and the iliac crest. Results: It was found that 35.4% of women were overweight, and the area (SE) body mass index was 25.8 (4.2) kg/m2. WC at the umbilical level [area (SE) area under the curve (AUC) = 0.694 (0.079)] and SAH at the midpoint between the iliac crests [AUC = 0.747 (0.076)] showed the largest areas under the receiver operating characteristic curve ( P < 0.05) with respect to the identification of cardiometabolic risk factors associated with the metabolic syndrome (MS) where, of the two measures, SAH showed the greatest predictive potential. Conclusions: The results obtained in the present study suggest that, for the assessment of older women, the umbilical level and the midpoint between the iliac crests should used to measure WC and SAH, respectively. SAH showed the greatest predictive power for cardiometabolic risk factors associated with the MS in older women. [ABSTRACT FROM AUTHOR]

The objective of this study was to identify dermatoglyphic characteristics and the quality of the physical strength in high-performance para-athletes in the supine power lifting category. This study included ten male athletes aged between 18 and 40 years who had qualified for the Brazilian Regional Championships. The athletes were randomly distributed into the following three groups: group 1 ( n = 4) comprising athletes with the best results for relative strength, group 2 ( n = 4) comprising athletes with intermediate results for relative strength, and group 3 ( n = 2) comprising athletes with the lowest results for relative strength. To determine the strength potential of the athletes, the one repetition maximum test was chosen, and to identify their genetic profile their fingerprints were analyzed by the method of Cummins and Midlo using paper and ink. The data showed no homogeneity between the groups. Group 1 showed a higher genetic predisposition and better results for the quality of their physical strength. These results indicate that dermatoglyphics may be an important tool to identify and guide athletes according to their genetic potential. [ABSTRACT FROM AUTHOR]

Questions: What is the effect of increasing pressure support during the application of manual chest wall compression with vibrations for secretion clearance in intubated patients in intensive care? Design: A randomised trial with concealed allocation, assessor blinding and intention-to-treat analysis. Participants: 66 patients receiving mechanical ventilation for greater than 48 hours. Intervention: All participants were positioned supine in bed with the backrest elevated 30 degrees. The experimental group received manual chest wall compression with vibrations during which their pressure support ventilation was increased by 10 cmH2O over its existing level. The control group received manual chest wall compression with vibrations but no adjustment of the ventilator settings. Both groups then received airway suction. Outcome measures: The primary outcome was the weight of the aspirate. Secondary outcomes were pulmonary and haemodynamic measures and oxygenation. Results: Although both treatments increased the weight of the aspirate compared to baseline, the addition of increased pressure support during manual chest wall compression with vibrations did not significantly increase the clearance of secretions, mean betweengroup difference in weight of the aspirate 0.4g, 95% CI -0.5 to 1.4. Although several other measures also improved in one or both groups with treatment, there were no significant differences between the groups for any of the secondary outcomes. Conclusion: Although increasing pressure support has previously been shown to increase secretion clearance in intubated patients, the current study did not show any benefits when it was added to chest wall compression with vibrations. [ABSTRACT FROM AUTHOR]

Background: The cosmetic treatment of varicose veins is the main activity of most vascular surgeons in Brazil. In order to obtain satisfactory cosmetic results, careful planning of varicose vein operations is necessary. Objective: Marking (or "mapping") the varicose veins with indelible ink is an essential step in planning cosmetic surgeries for lower limb varicose veins. In the present study, the role of transcutaneous phleboscopy (TcPh) in planning varicose vein operations is evaluated. Methods: A series of 100 consecutive patients, all female, were evaluated with TcPH as part of their varicose vein operations planning. A total of 171 limbs with varicose veins (71 bilateral and 29 unilateral) were evaluated. The process of marking the varicose veins followed the same protocol in all cases. Firstly, the varicose veins were marked by inspection and palpation, with the patient standing, using an indelible black ink pen. Secondly, with the patients resting in supine and prone positions, the varicose veins detected with TcPh were marked again with red or blue ink. The marks made by the two methods were then compared. Results: In 41 patients, for a total of 80 limbs (46.8%), the marks were altered after use of TcPh. Reasons for such changes were: 1) identification of other varicose veins; 2) identification of reticular veins draining complex telangiectasias; and 3) changes in the position of the marks placed with the patient standing. with the patient standing. Conclusions: TcPh has altered the planning of varicose vein surgeries in 46.8% of all limbs evaluated, especially when the patients had complex telangiectasias, associated with reticular varicose veins. [ABSTRACT FROM AUTHOR]

Background: Non-supine infant sleep position is an important modifiable risk factor for sudden unexpected death in infancy. The aim of this study was to assess the prevalence of supine sleep position and associated factors among 3-month-old infants from a birth cohort in the city of Pelotas, southern Brazil.Methods: The present study evaluated longitudinal data from the 2015 Pelotas Birth Cohort. Study outcome was supine infant sleep position, defined as the appropriate position, among 3-month-old children. Demographic, socioeconomic, behavioral, and health characteristics collected at birth and at the 3-month follow-up were investigated as possible associated factors. The prevalence of each associated factor was investigated, and crude and hierarchical adjusted analyses were performed using Poisson regression.Results: Among the 4108 infants assessed in this study, 2274 (55.4%) slept in supine position at 3 months and only 66 (1.6%) in prone position. Maternal white skin color, higher family income and maternal schooling, advanced maternal age, maternal cohabiting with a partner, receiving counseling from health care professionals and non-bed-sharing were associated with higher prevalence of infants sleeping in supine position at 3 months. All these variables remained associated in our hierarchical adjusted analyses except maternal cohabitation with a partner. Participants with white mothers were more likely to sleep in supine position (PR: 1.23; 95%CI: 0.75-0.89) compared to participants with black mothers. Those belonging to the richest quintile were more likely to sleep in supine position (PR: 1.49; 95%CI: 1.35-1.65) compared to those who belong to the poorest. Mothers aged 31-36 years were more likely to choose supine sleep position (PR: 1.65; 95%CI: 1.42-1.92) compared to mothers younger than 19 years.Conclusions: The findings of the present study showed the influence of maternal age, socioeconomic status, and counseling on infant sleep habits as predictors of choice of infant sleep position in a Brazilian population. It is recommended to implement informative campaigns and public policies to at-risk population and to improve recommendations from health care professionals. [ABSTRACT FROM AUTHOR]

Heart rate variability (HRV) among other methods can be used to assess diabetic cardiac autonomic neuropathy by cardiac intervals were recorded. However, the amount of error depending on this measurement methodology is unclear. To evaluate the intra- and inter-rater reliability to calculate HRV indices, comparing different times and by different trained examiners in patients with type 2 diabetes mellitus (T2DM). Thirty individuals of both genders, aged between 18 and 45 years, with T2DM. The RR interval (RRi) were recorded during a 10 min period on supine position using a portable heart rate monitor (Polar® S810i model). HRV indices were calculated by the software Kubios® HRV analysis (version 2.2). Linear (Mean RRi; STD RR; Mean HR; rMSSD; RR Tri; TINN LF; HF; total power) and non-linear (SD1; SD2; DFα1; DFα2, ApEn and, SampEn) indices were calculated by two examiners with an interval of one week between them. Substantial to excellent was found for reliability of the intra-examiner, with intraclass correlation coefficient (ICC) values ranging from 0.79 to 0.99, standard error of measurement (SEM) between 0.02 and 123.49 (in percentage: 1.83 and 16.67), and minimum detectable change (MDC) between 0.07 and 342.30. Regarding the inter-examiner reliability, substantial to excellent reliability was found, with ICC values ranging from 0.73 to 0.97, SEM between 0.04 and 178.13 (in percentage: 3.26 and 24.18), and MDC between 0.11 and 493.77. The use of the portable heart rate monitor to measure HRV showed acceptable intra and inter reliability in individuals with T2DM, supporting the use of this method of evaluation in research and clinical practice. [ABSTRACT FROM AUTHOR]

The study aims to investigate the influence of different postures on spasticity results by pendulum test in patients with spinal cord injury (SCI). The setting was at the University of Campinas (UNICAMP), Campinas, SP, Brazil. Five individuals with SCI and five individuals in the control group were included. All individuals went through the pendulum test in three different positions: supine, semi-supine at an angle of 30°, and sitting up at an angle of 60°. An electrogoniometer was attached to the right leg for measurement of knee joint angles. All situations were performed five times. Blood pressure was monitored during tests. Relaxation index (RI), normalized relaxation index (RIn), test duration in seconds, initial flexion angle, and resting angle were analyzed at three different positions. Results were compared between different positions, and statistically no differences were found. In individuals with SCI, RI (1.83 ± 0.2), RIn (1.14 ± 0.13), and test duration values (13.95 ± 4.14), in sitting up position, were similar to the control group results. In sitting up position, patients showed spasticity reduction. However, the other two postures produce pain and increase blood pressure in patients with tetraplegia. Therefore, these postures should be avoided in patients with lesions above T6, due to possible autonomic dysreflexia symptoms., (Copyright © 2015 International Center for Artificial Organs and Transplantation and Wiley Periodicals, Inc.)

Background: It was reported that autonomic nervous system function is altered in subjects with chronic obstructive pulmonary disease (COPD). We evaluated short- and long-term fractal exponents of heart rate variability (HRV) in COPD subjects., Patients and Methods: We analyzed data from 30 volunteers, who were divided into two groups according to spirometric values: COPD (n = 15) and control (n = 15). For analysis of HRV indices, HRV was recorded beat by beat with the volunteers in the supine position for 30 minutes. We analyzed the linear indices in the time (SDNN [standard deviation of normal to normal] and RMSSD [root-mean square of differences]) and frequency domains (low frequency [LF], high frequency [HF], and LF/HF), and the short- and long-term fractal exponents were obtained by detrended fluctuation analysis. We considered P < 0.05 to be a significant difference., Results: COPD patients presented reduced levels of all linear exponents and decreased short-term fractal exponent (alpha-1: 0.899 ± 0.18 versus 1.025 ± 0.09, P = 0.026). There was no significant difference between COPD and control groups in alpha-2 and alpha-1/alpha-2 ratio., Conclusion: COPD subjects present reduced short-term fractal correlation properties of HRV, which indicates that this index can be used for risk stratification, assessment of systemic disease manifestations, and therapeutic procedures to monitor those patients.

Background: Few studies in Brazil have been published about sudden infant death syndrome (SIDS), and none has addressed the mother's orientation about placing the infant to sleep in the supine position. The aim of this study was to evaluate the effect on mothers of an individual educational intervention in the maternity ward about infant sleep position., Methods: A randomized clinical trial was conducted with a study sample of 228 mother-infant pairs assigned to an intervention or a control group. The intervention consisted of an individual orientation session at the maternity ward, at which folders and an oral explanation were given to mothers at discharge about the importance of the supine position as a preventive measure for SIDS. The outcome was the sleeping position at 3 months of age assessed during a home visit. The variables with p< 0.2 at a bivariate analysis were included in a logistic regression model., Results: Among mothers in the intervention group, 42.9 percent put their infants to sleep in a supine position at the 3-month visit, compared with 24 percent of mothers in the control group (p = 0.009). In a multivariate analysis, the intervention at the hospital was the only variable that influenced maternal practices with respect to infant sleep positioning (OR 2.22; 95% CI 1.17-4.19)., Conclusions: An individual educational session in the maternity ward about infant sleep position significantly increased the prevalence of supine position for sleeping in the infant's third month. Nevertheless, the intervention was not sufficient to guarantee that most mothers would put their infants to sleep in the recommended position.

Background: Cardioinhibitory response (CIR) is defined as asystole >3 seconds in response to 5-10 seconds of carotid sinus massage (CSM). Pacemaker implantation is indicated for patients with unexplained syncope episodes and CIR., Objective: To determine the prevalence and predictors of CIR in patients with a high prevalence of cardiovascular disease, and assess the clinical significance of CIR in patients with a history of unexplained syncope or falls., Methods: Cross-section design study. Outpatients, aged > or =50 years, referred to the electrocardiography sector of a tertiary hospital. Those with dementia, carotid bruit, and history of myocardial infarction, stroke or transient ischemic attack in the preceding 3 months were excluded. CSM was performed by a single investigator, with the patients in the supine position. CSM was applied on the right side and then on the left side during 10 seconds each time., Results: 502 patients underwent CSM. CIR was present in 52 patients (10.4%; 95% CI: 7.7%-13%). Independent predictors of CIR were male gender (OR: 2.61%; CI 95%: 1.3%-5.1%), structural heart disease (OR: 3.28%; CI 95%: 1.3%-7.9%) and baseline heart rate (P<0.05). The sensitivity of the CIR to CSM in syncope evaluation was low (9.8%). Specificity was high (89.5%), being even better in women (95.3%) and in those without structural heart disease (96.2%)., Conclusion: CIR was detected in 10.4% of the patients aged > or = 50 years. In males and in patients with structural heart disease CIR was more common. In women and patients with no apparent structural heart disease, the presence of CIR was a highly specific finding in the evaluation of syncope or falls.