Claudio Gil Araujo

MD, PhD
Professor/Medical Researcher
Federal Univ of Rio de Janeiro... · Heart Institute Edson Saad

Publications

  • Source
    Claudio Gil Soares de Araujo
    [Show abstract] [Hide abstract]
    ABSTRACT: In their professional practices, physicians often face unexpected situations or chance on innovative proposals and ideas. As a result of their training and competence, they usually come up with hypotheses to be tested and research is conducted. This research is completed and their results submitted for presentations at conferences as free communications. Nevertheless, the realization of this creative process is only complete when a scientific manuscript is published in a journal. At this ultimate stage, most efforts seem not be brought to a standstill 1,2 . There are several reasons why scholars, interns, residents, graduate students and even experienced physicians may find it difficult to move forward from congress' abstracts to full manuscripts published in journals. However, the most significant hindrance rests with the difficulty writing the mere 25-30 paragraphs of an original manuscript. Many freeze and give up in front of a blank paper or a blinking cursor on a blank word processor's page on the monitor screen. In the previous manuscript 3 , we analyzed and suggested improvements to the process of peer review. In this point of view, we propose a practical strategy to systematize the writing of scientific paragraphs, aiming to simplify the task of scientific writing. This way, our intent is to increase the rate of publication of full manuscripts based on several outstanding abstracts presented annually at major medical conferences, and facilitate the currently overburdened process of peer review. The format of scientific communication has been evolving greatly over the centuries 4-7 , making reading more objective and standardized. One of the important tools in this process is the IMRaD format 4,5,7 , an acronym derived from the initials of the main sections of a manuscript -introduction, methods, results and discussion. Throughout the twentieth century, the IMRaD format has been increasingly applied, accounting for about 10% of the manuscripts in the 1950s, being dominant in the 1960s, and reaching 80% in the 1970s 7 . Presently, IMRad is the format recommended and adopted by the main medical journals all over the world, including the ABC (Arquivos Brasileiros de Cardiologia). In addition to the IMRaD format, original manuscripts submitted for publication should meet specific standards and rules of each journal. Although a fairly uniform pattern tends to prevail, there are differences that should be observed at the time of writing. For instance, the number of words is limited to 4,500 in ABC and 5,000 in JACC, including text and references. Considering that the references are usually limited to 30-40, and have around 1,000 words, circa 3,500-4,000 are left for the text's body, i.e., to be used in the 25-30 paragraphs of IMRaD, representing about 130 words each. In the pursuit for evidence and objective data, as a convenience sample, all original manuscripts published in the January 2012 and 2013 editions of ABC and JACC journals have been analyzed (the first two numbers of these months for the latter). There was a fairly clear trend about the total number of paragraphs and distribution of paragraphs in four sections of the IMRaD of a manuscript. For the 20 ABC's manuscripts and 34 JACC's ones, the average number of paragraphs was 28.9 and 28.2 (p = 0.703), respectively, with 1/3 of them having 25-30 paragraphs, and 57% of the total manuscripts having overall 22-33 paragraphs. This relative constancy should be observed and highlighted, considering that the topics and areas covered, as well as the background and the nationality of the authors, are quite different. Thus, this confirms the assumption that there is a basic format to be followed for an effective publication. Figure 1 illustrates the distribution of paragraphs for the various IMRaD sections in the two journals analyzed. Although there is some variability among the manuscripts, the introduction is clearly a section with fewer paragraphs (p < 0.001), while the remaining sections are somewhat balanced (p > 0.05), especially for original manuscripts of JACC, in which the sections of methods, results and discussion tend to have eight to nine paragraphs. When the distributions of paragraphs between ABC and JACC are compared, introductions and discussions tend to have more paragraphs in ABC than in JACC, respectively, 3.8 versus 2.4 (p < 0.01) and 10.4 versus 8.8 (p = 0.04). Based on these results, in our personal experience as authors of original manuscripts and according to other authors' opinions 4,8-10 , a simple content model may be proposed within the IMRaD format, taking 25-30 paragraphs as standard for an original manuscript. For practical purposes, one page is considered one page in a word processor, with conventional margins and with a 1.5 line spacing and font size 11. Unfolding the sections Introduction: 1 page (ideally), maximum 400 words over 1-4 paragraphs (ideally 3) – some journals restrict this to 350 words (E.g.: ABC); 5-10 references. e21 Viewpoint Araújo 25-30 paragraphs to write the manuscript Arq Bras Cardiol. 2014; 102(2):e21-e23 *These paragraphs are optional, and often the contents can se incorporated into the previous paragraph(s). Figure 1 -Comparative analysis on the number of paragraphs per section of IMRaD for original manuscripts between Arquivos Brasileiros de Cardiologia (Arq Bras Cardiol) and Journal of The American College of Cardiology (JACC). I: introduction; M: methods; R: results; D: discussion. The box-plot represents median values, the first and third quartiles and 5 th and 95 th percentiles.*Significant difference between the number of paragraphs of the two journals for this section. Methods: 2-3 pages (possibly higher in experiments resorting to innovative methods or plenty of techniques or sophisticated statistics) – not exceeding 750 words over 6-9 paragraphs; 5-15 references Results: 2-3 pages of text, figures and tables, as strictly necessary; not exceeding 1,000 words over 4-9 paragraphs; usually without references. Discussion: 3-4 pages of text; this is usually the most extensive part of the manuscript relating to word count (4,8-10) , with 1,000-1,500 words distributed over up to 10 paragraphs; including a conclusion paragraph, although some journals consider the latter another text section. The discussion usually has 10-20 references, with some of them possibly appearing in previous text sections.
    Arquivos brasileiros de cardiologia 03/2014; 102(2):e21. · 1.32 Impact Factor
  • Source
    Claudio Gil Araujo, Luciano Belém, Ilan Gottlieb
  • Source
    Claudio Gil Soares De Araújo
    [Show abstract] [Hide abstract]
    ABSTRACT: Artigo recebido em 24/07/13; revisado em 09/08/13; aceito em 12/08/13. Palavras-chave Artigo de Revista; Redação; Metodologia; Bibliometria. DOI: xxx/abc.2013xxxx No exercício profissional, o médico se depara frequentemente com situações inéditas ou propostas e ideias inovadoras. Muitas vezes, como fruto do seu treinamento e competência, surgem hipóteses a serem testadas e são realizadas pesquisas. Essas pesquisas são concluídas e os seus resultados submetidos a apresentações como temas livres em congressos. Contudo, a efetiva concretização desse processo criativo só ocorre com a publicação do artigo científico e é nesta última etapa que a grande maioria dos esforços esbarra e não avança 1,2 . Há várias razões pelas quais os acadêmicos, os internos, os residentes e os estudantes de pós-graduação e até mesmo os médicos profissionalmente mais experientes podem não avançar do resumo em congresso para o artigo completo em um periódico científico, porém, muito provavelmente, a mais importante é a dificuldade na redação dos apenas 25-30 parágrafos que compõem um artigo original. Diante de uma folha de papel vazia ou de um cursor piscando em uma página em branco do processador de texto na tela do monitor, muitos param e desistem. Em artigo anterior 3 , analisamos e sugerimos aprimoramentos para o processo de revisão por pares. No presente ponto de vista, propomos uma estratégia prática de sistematização da redação dos parágrafos científicos, visando simplificar essa tarefa. Pretende-se, assim, aumentar a taxa de publicação como artigo completo de muitos dos excelentes resumos de comunicações apresentadas anualmente nos principais congressos médicos e facilitar o atualmente congestionado processo de revisão por pares. O formato da comunicação científica vem evoluindo bastante ao longo dos séculos 4-7 , tornando a leitura mais objetiva e padronizada. Dentro desse processo, destaca-se a formatação IMRaD 4,5,7 , sigla derivada das iniciais das principais seções do artigo -introdução, métodos, resultados e discussão. Ao longo do século XX, o formato IMRaD passou a ser cada vez mais utilizado, representando cerca de 10% dos artigos na década de 1950, passando a predominar nos anos 1960 e alcançando 80% nos anos 1970 7 . Atualmente, o IMRaD é o formato recomendado e adotado pelos principais periódicos científicos da área médica de todo o mundo, incluindo os Arquivos Brasileiros de Cardiologia (ABC). Além da formatação IMRaD, o artigo original submetido para publicação deve atender a normas e regras específicas de cada um dos periódicos. Ainda que tenda a prevalecer um padrão razoavelmente uniforme, diferenças existem e devem ser observadas por ocasião da redação. Por exemplo, o número de palavras é limitado a 4.500 nos ABC e a 5.000 no JACC, incluindo o texto propriamente dito e as referências. Considerando que a parte das referências, em geral limitadas a 30-40, usa cerca de mil palavras, sobram algo como 3.500-4.000 para o corpo do texto, ou seja, para serem utilizados nos 25-30 parágrafos do IMRaD, correspondendo a cerca de 130 palavras cada um. Na busca por evidências e dados objetivos, foram analisados, como amostra de conveniência, todos os artigos originais publicados nos números de janeiro de 2012 e de 2013 dos ABC e do JACC (neste somente os dois primeiros números desses meses). Observou-se uma tendência bastante clara para o número total de parágrafos e para a sua distribuição dos parágrafos pelas quatro seções do IMRaD de um artigo. Para os 20 artigos dos ABC e os 34 artigos do JACC, o número médio de parágrafos foi de 28,9 e de 28,2 (p = 0,703), respectivamente, com 1/3 deles contendo 25-30 parágrafos e 57% do total de artigos com o total de 22-33 parágrafos. Essa relativa constância é bastante interessante de observar e destacar, considerando que os tópicos e áreas abordados, assim como a formação e até mesmo a nacionalidade dos autores, são bastante diversos. Sendo assim, corrobora-se a ideia de que existe um formato básico a ser seguido para uma efetiva publicação. A Figura 1 ilustra a distribuição dos parágrafos para as diversas seções do IMRaD nos dois periódicos analisados. Embora haja alguma variabilidade entre os artigos, a introdução é claramente a seção com menor número de parágrafos (p < 0,001), enquanto há certo equilíbrio entre as demais seções (p > 0,05), especialmente para os artigos originais do JACC, no qual as seções de métodos, resultados e discussão tendem a ter entre oito e nove parágrafos. Quando são comparadas as distribuições de parágrafos entre os ABC e o JACC, verifica-se que a introdução e a discussão tendem a ter mais parágrafos nos ABC do que no JACC, respectivamente, 3,8 versus 2,4 (p < 0,01) e 10,4 versus 8,8 (p = 0,04). Com base nesses resultados, na nossa experiência pessoal como autor de artigos originais e na opinião de outros autores 4,8-10 , é possível propor, dentro da formatação IMRaD, um modelo simples do conteúdo a ser abordado nos 25-30 parágrafos que costumam compor um artigo científico original. Para efeito prático, considera-se uma lauda como uma página no processador de texto, com margens convencionais e utilizando o espaçamento de 1,5 linhas e fonte de tamanho 11. e21 Ponto de Vista Araújo 25 a 30 parágrafos para escrever o artigo Arq Bras Cardiol. 2014; 102(2):e21-e23 Desdobrando as seções Introdução: 1 lauda (idealmente); máximo de 400 palavras em 1-4 parágrafos (ideal 3) – algumas revistas limitam a 350 palavras (p. ex., ABC); 5-10 referências. Métodos: 2-3 laudas (eventualmente maior em experimentos com métodos inovadores ou com muitas técnicas ou estatística muito complexa) – não exceder 750 palavras em 6-9 parágrafos; 5-15 referências. Resultados: 2-3 laudas de texto, e figuras e tabelas conforme o estritamente necessário; não exceder 1.000 palavras em 4-9 parágrafos; normalmente sem referências. Discussão: 3-4 laudas de texto; costuma ser a parte mais extensa do artigo em número de palavras (4, 8-10), com 1.000-1.500 palavras distribuídas em até 10 parágrafos; inclui um parágrafo de conclusões, ainda que alguns periódicos o coloquem como mais uma seção do texto; costuma contemplar 10-20 referências, algumas delas podendo já ter aparecido em seções anteriores do texto. Desdobrando os parágrafos Introdução 1. Problema – o que se sabe?
  • Carlos Vieira Duarte, Jonathan Myers, Claudio Gil Soares de Araújo
    [Show abstract] [Hide abstract]
    ABSTRACT: Although substantial evidence relates reduced exercise heart rate (HR) reserve and recovery to a higher risk of all-cause mortality, a combined indicator of these variables has not been explored. Our aim was to combine HR reserve and recovery into a single index and to assess its utility to predict all-cause mortality. Retrospective cohort analysis. Participants were 1476 subjects (937 males) aged between 41 and 79 years who completed a maximal cycle cardiopulmonary exercise test while not using medication with negative chronotropic effects or having an implantable cardiac pacemaker. HR reserve (HR maximum - HR resting) and recovery (HR maximum - HR at 1-min post exercise) were calculated and divided into quintiles. Quintile rankings were summed yielding an exercise HR gradient (EHRG) ranging from 2 to 10, reflecting the magnitude of on- and off-HR transients to exercise. Survival analyses were undertaken using EHRG scores and HR reserve and recovery in the lowest quintiles (Q1). During a mean follow up of 7.3 years, 44 participants died (3.1%). There was an inverse trend for EHRG scores and death rate (p < 0.05) that increased from 1.2% to 13.5%, respectively, for scores 10 and 2. An EHRG score of 2 was a better predictor of all-cause mortality than either Q1 for HR reserve (<80 bpm) or HR recovery alone (<27 bpm): age-adjusted hazard ratios: 3.53 (p = 0.011), 2.52 (p < 0.05), and 2.57 (p < 0.05), respectively. EHRG, a novel index combining HR reserve and HR recovery, is a better indicator of mortality risk than either response alone.
    European journal of preventive cardiology. 01/2014;
  • Source
    Plínio Santos Ramos, Aline Sardinha, Antonio Egidio Nardi, Claudio Gil Soares de Araújo
    [Show abstract] [Hide abstract]
    ABSTRACT: Panic disorder (PD) patients often report respiratory symptoms and tend to perform poorly during maximal cardiopulmonary exercise testing (CPX), at least partially, due to phobic anxiety. Thus, we hypothesized that a submaximal exercise variable, minimum VE/VO2 - hereafter named cardiorespiratory optimal point (COP) -, may be useful in their clinical assessment. Data from 2,338 subjects were retrospectively analyzed and 52 (2.2%) patients diagnosed with PD (PDG) (70% women; aged 48±13 years). PD patients were compared with a healthy control group (CG) precisely matched to number of cases, age and gender profiles. PDG was further divided into two subgroups, based on having achieved a maximal or a submaximal CPX (unwilling to continue until exhaustion). We compared COP, VO2 max, maximum heart rate (HR max) between PDG and CG, and also COP between maximal and submaximal PD subgroups. COP was similar between PDG and CG (21.9±0.5 vs. 23.4±0.6; p = 0.07), as well as, for PD subgroups of maximal and submaximal CPX (22.0±0.5 vs. 21.6±1.3; p = 0.746). Additionally, PD patients completing a maximal CPX obtained VO2 max (mL.kg-1.min-1) (32.9±1.57 vs 29.6±1.48; p = 0.145) and HR max (bpm) similar to controls (173±2.0 vs 168±2.7; p = 0.178). No adverse complications occurred during CPX. Although clinically safe, it is sometimes difficult to obtain a true maximal CPX in PD patients. Normalcy of cardiorespiratory interaction at submaximal effort as assessed by COP may contribute to reassure both patients and physicians that there is no physiological substrate for exercise-related respiratory symptoms often reported by PD patients.
    PLoS ONE 01/2014; 9(8):e104932. · 3.53 Impact Factor
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Resumo Fundamentos: A ansiedade cardíaca (AC) é o medo de sensações cardíacas, caracterizado por sintomas recorrentes de ansiedade em pacientes com ou sem doença cardiovascular. O Questionário de Ansiedade Cardíaca (QAC) é uma ferramenta para avaliar a AC, já adaptado, mas não validado em português. Objetivo: Este trabalho apresenta as três fases dos estudos de validação do QAC brasileiro. Métodos: Foram recrutados 98 pacientes com doença arterial coronária, a fim de extrair a estrutura fatorial e avaliar a confiabilidade do QAC (fase 1). O objetivo da fase 2 foi explorar a validade convergente e divergente. Cinquenta e seis pacientes completaram o QAC, juntamente com o Escala de sensações corporais (ESC) e o Versão brasileira do Social Phobia Inventory (SPIN). Para determinar a validade discriminante (fase 3), comparamos os escores do QAC de dois subgrupos formados por pacientes da fase 1 (n = 98), de acordo com os diagnósticos de transtorno do pânico e agorafobia obtidos com o MINI – Mini International Neuropsychiatric Interview (Mini Entrevista Neuropsiquiátrica Internacional). Resultados: A solução de dois fatores foi a mais interpretável (46,4% da variância). As subescalas foram denominadas de "Medo e Hipervigilância" (n = 9; alfa = 0,88) e "Evitação" (n = 5; alfa = 0,82). Foi encontrada correlação significativa do fator 1 com o escore total do ESC (p < 0,01), mas não com o fator 2. Os fatores do SPIN apresentaram correlações significativas com as subescalas do QAC (p < 0,01). Na fase 3, os escores dos pacientes "Cardíacos com pânico" foram significativamente maiores no fator 1 do QAC (t = -3,42; p < 0,01, IC = -1,02 a -0,27), e maiores, mas não significativamente diferentes, no fator 2 (t = -1,98; p = 0,51, IC = -0.87 a 0,00).
  • Source
    Carlos Vieira Duarte, Claudia Lucia Barros de Castro, Claudio Gil Soares de Araújo
    [Show abstract] [Hide abstract]
    ABSTRACT: Treinamento para disfunção vagal cardíaca com repetições da transição repouso-exercício Título em inglês: Training for cardiac vagal dysfunction with repetitions of rest-exercise transition Resumo Disfunção vagal cardíaca está associada com um pior prognóstico clínico e um dos potenciais benefícios do exercício físico regular é aumentar o tônus vagal cardíaco (TVC). Como nas tran-sições repouso-exercício-repouso o TVC é rapidamente inibido e reativado, hipotetizou-se que um treinamento repetido desta transição -denominado treinamento vagal (TV) -, em indiví-duos com TVC reduzido, poderia reverter essa disfunção. Participantes que ingressaram em um programa de exercício supervisionado (PES) com índice vagal cardíaco (IVC) baixo (≤ 1,30 no 44 pacientes (64% homens; 65,5 ±11,4 anos) finalizaram o estudo. Houve discreta melhora no IVC ao final de 16 semanas (1,19 vs 1,22; p=0,02), mas não se pôde afirmar que a diferença no IVC se deveu ao período em que foi realizado o TV (p=0,36). Portanto, 16 semanas de PES incluindo oito semanas de TV aumentou a resposta vagal à transição repouso -exercício, embora não tenha sido possível atribuir os resultados exclusivamente ao TV. Futuros estudos são necessários para esclarecer se o TV, com maior número de repetições e/ou período de duração mais longo, poderá promover uma melhora mais acentuada do TVC em indivíduos com níveis iniciais baixos. Palavras-chave Sistema nervoso parassimpático; Reabilitação cardíaca; Teste de 4 segundos; Testes autonômicos. Abstract Vagal dysfunction is related to a worse clinical prognosis and one of the potential benefits of regular exercise is to increase cardiac vagal tone (CVT). Since CVT is quickly inhibited and reactivated in the fast rest-exercise-rest transition, it was hypothesized that a training of this transition – called vagal training (VT) -in individuals with reduced CVT could reverse this condition. Patients with low cardiac vagal index (CVI) (≤ 1.30 on the 4-secondexercise test) starting a supervised exercise program (SEP) were randomized in a crossover design (two phases, eight weeks each), with or without three weekly VT sessions. VT consisted of five repetitions of sudden, fast unloaded pedaling for five seconds in a cyclergometer, and resting seated for 55 seconds. After applying strict inclusion and exclusion criteria (medication use, clinical condition and adherence to SEP), 44 patients (64 % men and 65.5 ± 11.4 years) completed the study. There was a slight improvement in the CVI at the end of 16 weeks (1.19 vs 1.22, p = 0.02), but it could not be stated this difference was due to the VT (p = 0.36). Therefore, 16 weeks of SEP, including eight weeks of VT training, increased the CVI of those with lower CVI, but this improvement could not be attributed exclusively to the additional VT. Further studies are needed to clarify if more repetitions or a longer period of VT would promote even greater CVT recovery.
  • Source
    Antonio Felipe Simão, Dalton Precoma, Jadelson Andrade, Claudio Gil Soares de Araújo
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Hypertension, or the chronic elevation in resting arterial blood pressure (BP), is a significant risk factor for cardiovascular disease and estimated to affect ~1 billion adults worldwide. The goals of treatment are to lower BP through lifestyle modifications (smoking cessation, weight loss, exercise training, healthy eating and reduced sodium intake), and if not solely effective, the addition of antihypertensive medications. In particular, increased physical exercise and decreased sedentarism are important strategies in the prevention and management of hypertension. Current guidelines recommend both aerobic and dynamic resistance exercise training modalities to reduce BP. Mounting prospective evidence suggests that isometric exercise training in normotensive and hypertensive (medicated and non-medicated) cohorts of young and old participants may produce similar, if not greater, reductions in BP, with meta-analyses reporting mean reductions of between 10 and 13 mmHg systolic, and 6 and 8 mmHg diastolic. Isometric exercise training protocols typically consist of four sets of 2-min handgrip or leg contractions sustained at 20-50 % of maximal voluntary contraction, with each set separated by a rest period of 1-4 min. Training is usually completed three to five times per week for 4-10 weeks. Although the mechanisms responsible for these adaptations remain to be fully clarified, improvements in conduit and resistance vessel endothelium-dependent dilation, oxidative stress, and autonomic regulation of heart rate and BP have been reported. The clinical significance of isometric exercise training, as a time-efficient and effective training modality to reduce BP, warrants further study. This evidence-based review aims to summarize the current state of knowledge regarding the effects of isometric exercise training on resting BP.
    Sports Medicine 10/2013; · 5.32 Impact Factor
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Cardiac Anxiety (CA) is the fear of cardiac sensations, characterized by recurrent anxiety symptoms, in patients with or without cardiovascular disease. The Cardiac Anxiety Questionnaire (CAQ) is a tool to assess CA, already adapted but not validated to Portuguese. This paper presents the three phases of the validation studies of the Brazilian CAQ. To extract the factor structure and assess the reliability of the CAQ (phase 1), 98 patients with coronary artery disease were recruited. The aim of phase 2 was to explore the convergent and divergent validity. Fifty-six patients completed the CAQ, along with the Body Sensations Questionnaire (BSQ) and the Social Phobia Inventory (SPIN). To determine the discriminative validity (phase 3), we compared the CAQ scores of two subgroups formed with patients from phase 1 (n = 98), according to the diagnoses of panic disorder and agoraphobia, obtained with the MINI - Mini International Neuropsychiatric Interview. A 2-factor solution was the most interpretable (46.4% of the variance). Subscales were named "Fear and Hypervigilance" (n=9; alpha = 0.88), and "Avoidance", (n = 5; alpha = 0.82). Significant correlation was found between factor 1 and the BSQ total score (p<0.01), but not with factor 2. SPIN factors showed significant correlations with CAQ subscales (p < 0.01). In phase 3, "Cardiac with panic" patients scored significantly higher in CAQ factor 1 (t = -3.42; p < 0.01, CI = -1.02 to -0.27), and higher, but not significantly different, in factor 2 (t = -1.98; p = 0.51, CI = -0.87 to 0.00). These results provide a definite Brazilian validated version of the CAQ, adequate to clinical and research settings.
    Arquivos brasileiros de cardiologia 10/2013; · 1.32 Impact Factor
  • Source
    Plínio Santos Ramos, Claudio Gil Soares De Araújo
    [Show abstract] [Hide abstract]
    ABSTRACT: Análise da estabilidade de uma variável submáxima em teste cardiopulmonar de exercício: ponto ótimo cardiorrespiratório Analysis of the stability of a submaximal variable in the cardiopulmonary exercise testing: Cardiopulmonary optimal point Resumo O presente estudo teve por objetivo investigar a estabilidade do ponto ótimo cardiorrespiratório (POC) em dois testes cardiopulmonares de exercício máximos (TCPEs), realizados em cicloer-gômetro de membros inferiores. Para tanto, foram analisados retrospectivamente os dados de 1334 indivíduos avaliados por no mínimo duas vezes entre 1995 e 2013, sendo identificados, a partir de rígidos critérios de inclusão, 222 pacientes (159 homens) com a idade de 55±11,6 anos. Logo, foram verificados os dados do POC obtidos a partir da análise da ventilação e do consumo de oxigênio em cada minuto do TCPE, o VO 2 máximo, e as curvas de eficiência do consumo de oxigênio (OUES) e do equivalente ventilatório de dióxido de carbono (VE/VCO 2 slope), sendo a estabilidade avaliada pelos coeficientes de correlação intraclasse. A mediana do intervalo de tempo entre os dois TCPEs foi de 1,6 anos. Os valores de cada uma das variáveis obtidas nos dois TCPEs apresentaram altas e significativas associações (p <0,01), sendo: VO-2 max r i = 0,93 (IC95% = 0,91 a 0,94); POC r i = 0,87; (IC95% = 0,82 a 0,90); OUES r i = 0,90 (IC95% = 0,87 a 0,93) e VE/VCO 2 slope r i = 0,74 (IC95% = 0,67 a 0,80). Concluímos que, em condições controladas, o POC é um índice ventilatório bastante estável em TCPEs realizadas em indivíduos adultos, com níveis de estabilidade similar ou superior de outras variáveis ou índices consagrados na literatura, corroborando, dessa forma, seu potencial de utilização em pesquisas fisiológicas e na prática clínica. Palavras-chave
  • Source
    Débora Helena Balassiano, Claudio Gil Soares de Araújo
    [Show abstract] [Hide abstract]
    ABSTRACT: BACKGROUND: The heart rate (HR) achieved at the end of an exercise test (ET) is called maximal HR and is known to have clinical and epidemiological relevance. For its correct measurement, it is necessary that the ET be truly maximal. OBJECTIVE: To evaluate the influence of a history of intense physical activity and/or participation in sports competitions during youth on the maximal HR (% of age-predicted HR) on a clinical cardiopulmonary exercise test (CPET). METHODS: A total of 600 non-athlete individuals (65.8% males) with a mean age of 46 ± 13.7 years, under primary prevention of cardiovascular diseases and who underwent maximal CPET, were retrospectively selected. Their physical activity profile during childhood/adolescence (PAPCA) was classified in scores growing from 0 to 4, with value 2 corresponding to their respective age-predicted levels. RESULTS: None of the 20 individuals with maximal HR values equal to or greater than 200 bpm had been inactive or somewhat active during childhood/adolescence. A significant association was observed between PAPCA scores and maximal HR (% of age-predicted HR) (p = 0.02), with a 7-bpm higher value for PAPCA scores 3-4 (32.9% of the sample) in comparison to PAPCA 0-2. CONCLUSION: Two hypotheses exist to explain these results in individuals who had been more active during youth: a) persistence of chronic adaptations to training on the cardiac chronotropism, or b) higher ability and/or motivation to achieve a truly maximal CPET. Information on the physical activity profile during childhood / adolescence may contribute to the interpretation of maximal HR on ET.
    Arquivos brasileiros de cardiologia 04/2013; · 1.32 Impact Factor
  • Source
    Claudio Gil Soares de Araújo, Artur Haddad Herdy, Ricardo Stein
    Arquivos brasileiros de cardiologia 04/2013; 100(4):e51-e53. · 1.32 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: Although aging is commonly linked to a reduction in joint range of motion, it is unclear if all body joints behave similarly. To address this issue, the main purpose of this study was to compare age-related loss of mobility of seven body joints. A total of 6,000 participants (3,835 men and 2,165 women) aged 5 to 92 years took part in this study. The maximal passive range of motion of 20 movements was evaluated by Flexitest, and each movement was scored from 0 to 4. Composite scores were obtained for each of seven joints and for overall flexibility (Flexindex (FLX)) by adding individual movement scores. Confirming previous findings, FLX systematically decreased with aging (p < .001), with female participants being more flexible for all ages (p < 0.001) and having a more gradual, 0.6 % vs. 0.8 %/year, age reduction (p < .001). Starting at 30 and 40 years, respectively, for male and female participants, the relative contribution of each composite joint score to FLX dramatically changed. Shoulder contribution to FLX male's score went from 13.9 % at 28 years of age to only 5.2 % at 85 years of age. In general, proportionally, shoulder and trunk became less flexible, while elbow and knee mobility was preserved to a greater extent. Our findings indicated that age-related loss of mobility is rather joint-specific, which could be related to distinct routine usage patterns of the major body joints along life.
    Age 03/2013; · 6.28 Impact Factor
  • Arq Bras Cardiol. 01/2013; 101(6 Suppl 2):1-63.
  • [Show abstract] [Hide abstract]
    ABSTRACT: Background:While cardiorespiratory fitness is strongly related to survival, there are limited data regarding musculoskeletal fitness indicators. Our aim was to evaluate the association between the ability to sit and rise from the floor and all-cause mortality.Design:Retrospective cohort.Methods:2002 adults aged 51-80 years (68% men) performed a sitting-rising test (SRT) to and from the floor, which was scored from 0 to 5, with one point being subtracted from 5 for each support used (hand/knee). Final SRT score, varying from 0 to 10, was obtained by adding sitting and rising scores and stratified in four categories for analysis: 0-3; 3.5-5.5, 6-7.5, and 8-10.Results:Median follow up was 6.3 years and there were 159 deaths (7.9%). Lower SRT scores were associated with higher mortality (p < 0.001). A continuous trend for longer survival was reflected by multivariate-adjusted (age, sex, body mass index) hazard ratios of 5.44 (95% CI 3.1-9.5), 3.44 (95% CI 2.0-5.9), and 1.84 (95% CI 1.1-3.0) (p < 0.001) from lower to higher SRT scores. Each unit increase in SRT score conferred a 21% improvement in survival.Conclusions:Musculoskeletal fitness, as assessed by SRT, was a significant predictor of mortality in 51-80-year-old subjects. Application of a simple and safe assessment tool such as SRT, which is influenced by muscular strength and flexibility, in general health examinations could add relevant information regarding functional capabilities and outcomes in non-hospitalized adults.
    European journal of preventive cardiology. 12/2012;
  • C V Duarte, C G Araujo
    [Show abstract] [Hide abstract]
    ABSTRACT: Cardiac vagal tone (CVT), a key determinant of resting heart rate (HR), is progressively withdrawn with incremental exercise and nearly abolished at maximal effort. While maximal HR decreases with age, there remains a large interindividual variability of results for any given age. In the present study, we hypothesized that CVT does not contribute to age-independent maximal HR. Data were obtained from 1 000 (39±14 years old) healthy subjects (719 men) who were not taking medications affecting CVT or maximal HR performed a clinically normal and truly maximal cardiopulmonary exercise testing. CVT was estimated using the cardiac vagal index (CVI), a dimensionless ratio obtained by dividing 2 cardiac cycle durations - end of exercise and pre-exercise -, reflecting HR increases during a 4-s unloaded cycling test (a vagally-mediated response). Maximal HR was expressed as % of that predicted by age (208-0.7 × age (years)). Linear regression analyses identified that CVI can explain only 1% of the % age-predicted maximal HR variability with a high standard error of estimate (~6.3%), indicating the absence of a true physiological cause-effect relationship. In conclusion, the influence of CVI on % of age-predicted maximal HR is null in healthy subjects, suggesting distinct physiological mechanisms and potential clinical complementary role for these exercise-related variables.
    International Journal of Sports Medicine 11/2012; · 2.27 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: OBJECTIVE: The purpose of this study was to establish whether flexibility influences the ability to sit and rise from the floor. DESIGN: Subjects aged 6-92 yrs (n = 3927 [2645 men]) performed the Sitting-Rising Test (SRT) and the Flexitest on the same laboratory visit. The SRT evaluates components of musculoskeletal function by assessing the subject's ability to sit and rise from the floor, which was scored from 0 to 5, with 1 point being subtracted from 5 for each support used (hand/knee). The subject's final SRT score, varying from 0 to 10, was obtained by adding the sitting and rising scores. The Flexitest evaluates the maximum passive range of motion of 20 body joint movements. For each one of the movements, there are five possible scores, 0-4, in a crescent mobility order. Adding the results of the 20 movements provides an overall flexibility score called the Flexindex (FLX). RESULTS: The SRT score differed when the Flexindex results were stratified into quartiles: 6-26, 27-35, 36-44, and 45-77 (P < 0.001). The SRT and Flexindex scores were moderately and positively associated (r = 0.296; P < 0.001). In addition, the subjects with an SRT score of 0 are less flexible for all 20 Flexitest movements than those scoring 10 are. CONCLUSIONS: Although seemingly simple tasks, the actions of sitting and rising from the floor are also partially dependent on flexibility in male and female subjects of a wide age range. Future studies should explore the potential benefit of regular flexibility exercises for these actions.
    American journal of physical medicine & rehabilitation / Association of Academic Physiatrists 11/2012; · 1.56 Impact Factor
  • Source
    Plínio Santos Ramos, Djalma Rabelo Ricardo, Claudio Gil Soares de Araújo
    [Show abstract] [Hide abstract]
    ABSTRACT: BACKGROUND: At the maximal Cardiopulmonary Exercise Testing (CPET), several ventilatory variables are analyzed, including the ventilatory equivalent for oxygen (VE/VO2). The minimum VE/VO2 value reflects the best integration between the respiratory and cardiovascular systems and may be called "Cardiorespiratory Optimal Point (COP)". OBJECTIVE: To determine the behavior of the COP according to gender and age in healthy adults and verify its association with other CPET variables. METHODS: Of 2,237 individuals, 624 were selected (62% men and 48 ± 12 years), non- athletes, healthy, who were submitted to maximal CPET. COP or minimum VE/VO2 was obtained from the analysis of ventilation and oxygen consumption in every minute of CPET. We investigated the association between age and COP for both genders, as well as associations with: VO2max, VO2 at anaerobic threshold (VO2AT), oxygen uptake efficiency slope (OUES) and with maximum VE. We also compared the intensity of exertion (MET) at the COP, AT and VO2max. RESULTS: COP increases with age, being 23.2 ± 4.48 and 25.0 ± 5.14, respectively, in men and women = (p < 0.001). There are moderate and inverse associations with VO2max (r = -0.47; p < 0.001), with VO2AT (r = -0.42; p < 0.001) and with OUES (r = -0.34; p < 0.001). COP occurred, on average, at 44% do VO2max and before AT (67% of VO2max) (p < 0.001). CONCLUSION: COP, a submaximal variable, increases with age and is slightly higher in women. Being modestly associated with other ventilation measures, there seems to be an independent contribution to the interpretation of the cardiorespiratory response to CPET.
    Arquivos brasileiros de cardiologia 10/2012; · 1.32 Impact Factor
  • Source
    A Sardinha, C G S Araújo, A E Nardi
    [Show abstract] [Hide abstract]
    ABSTRACT: Regular physical exercise has been shown to favorably influence mood and anxiety; however, there are few studies regarding psychiatric aspects of physically active patients with coronary artery disease (CAD). The objective of the present study was to compare the prevalence of psychiatric disorders and cardiac anxiety in sedentary and exercising CAD patients. A total sample of 119 CAD patients (74 men) were enrolled in a case-control study. The subjects were interviewed to identify psychiatric disor- ders and responded to the Cardiac Anxiety Questionnaire. In the exercise group (N = 60), there was a lower prevalence (45 vs 81%; P 0.001) of at least one psychiatric diagnosis, as well as multiple comorbidities, when compared to the sedentary group (N = 59). Considering the Cardiac Anxiety Questionnaire, sedentary patients presented higher scores compared to exercisers (mean ± SEM = 55.8 ± 1.9 vs 37.3 ± 1.6; P 0.001). In a regression model, to be attending a medically supervised exercise program presented a relevant potential for a 35% reduction in cardiac anxiety. CAD patients regularly attending an exercise program presented less current psychiatric diagnoses and multiple mental-related comorbidities and lower scores of cardiac anxiety. These salutary mental effects add to the already known health benefits of exercise for CAD patients.
    Brazilian journal of medical and biological research = Revista brasileira de pesquisas medicas e biologicas / Sociedade Brasileira de Biofisica ... [et al.] 09/2012; · 1.08 Impact Factor

59 Following View all

155 Followers View all