Instituto Vita

São Paulo, Brazil

Instituto Vita

São Paulo, Brazil

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Pereira-Lancha L.O.,University of Sao Paulo | Pereira-Lancha L.O.,Instituto Vita | Coelho D.F.,University of Sao Paulo | Coelho D.F.,Instituto Vita | And 3 more authors.
Journal of the American College of Nutrition | Year: 2010

The search for the causes of obesity has involved genetic abnormalities and endocrine and neural lesions. Although evidence suggests that genetics plays an important role in body weight regulation, rapid increases in obesity rates do not seem to be caused by significant genetic changes within populations. Total energy expenditure and total energy intake are not the only factors that regulate body fat. Nitrogen and carbohydrate balances are eased by the capacity of the organism for adjusting amino acids and glucose oxidation rates, respectively. Regarding fat, this mechanism is considerably less precise; a fat intake increase does not stimulate its oxidation on the same basis. In addition, dietary fat is stored very efficiently as body fat. Elevated carbohydrate ingestion enhances glycogen reserves, which usually are much smaller than the maximum capacity of storage and enlargement of these stores, thus stimulating this nutrient's oxidation. These data point to a very well controlled carbohydrate balance in the body. Various studies show lack of efficiency of the hyperlipidic diet in stimulating satiety. Signals arising from the gastrointestinal tract play a fundamental role in regulation of appetite and energy intake, and evidence indicates that the gastrointestinal and hormonal mechanisms involved in the suppression of appetite and in energy intake are compromised in obesity. A high-fat diet is important in its origin. Additional studies are necessary to explain the mechanisms that lead to adipose tissue retention resulting in a fat-rich diet.


Prado J.M.,University of Sao Paulo | Dinato M.C.M.,Instituto Vita | Duarte M.,University of Sao Paulo
Gait and Posture | Year: 2011

The ability to transfer weight from one lower limb to the other is essential for the execution of daily life activities and little is known about how weight transfer during unconstrained natural standing is affected by age. This study examined the weight transfer ability of elderly individuals during unconstrained standing (for 30. min) in comparison to young adults. The subjects (19 healthy elderly adults, range 65-80 years, and 19 healthy young adults, range 18-30 years) stood with each foot on a separate force plate and were allowed to change their posture freely at any time. The limits of stability and base of support width during standing, measures of mobility (using the timed up and go and the preferred walking speed tests), and fear of falling were also measured. In comparison to the young adults, during unconstrained standing the elderly adults produced four times fewer weight transfers of large amplitude (greater than half of their body weight). The limits of stability and base of support width were significantly smaller for the elderly adults but there were no significant differences in the measures of mobility and in the fear of falling score compared to young adults. The observed significant age-related decrease in the use of weight transfer during unconstrained standing, despite any difference in the measured mobility of the subjects, suggests that this task reveals unnoticed and subtle differences in postural control, which may help to better understand age related impairments in balance that the elderly population experiences. © 2010 Elsevier B.V.


Junqueira L.D.,Federal University of ABC | Amaral L.Q.,University of Sao Paulo | Iutaka A.S.,Instituto Vita | Duarte M.,Federal University of ABC
Gait and Posture | Year: 2015

We investigated the effects on women of carrying an infant in front, focusing on the pelvic and spinal posture and the displacement of the body's center of gravity. For such, we compared mothers to non-mothers not carrying anything or carrying the same load (a doll) and the mothers carrying their infants. Twenty mothers and 44 women who did not have children were analyzed for their movement and posture during walking and standing still with a motion capture system. Walking while carrying a load was slower and with a shorter stride length than while not carrying a load. The mothers' group walked slower and with a shorter stride length than the non-mothers' group. During walking and standing still, the women decreased their angle of pelvic anteversion, increased lumbar lordosis, increased thoracic kyphosis, and increased trunk backward inclination while carrying a load in comparison with not carrying anything. In addition, we observed some small differences in the spinal angles of mothers when carrying their infants compared to when carrying a doll. When standing still, the women carrying a load displaced backwards their vertical projection of the center of gravity to exactly compensate the destabilizing load at the front that resulted in no net change of the body-plus-load center of gravity. In general, these changes are qualitatively similar to the ones observed during pregnancy. © 2015 Elsevier B.V.


Bitar A.C.,Instituto Vita | Demange M.K.,University of Sao Paulo | D'Elia C.O.,Instituto Vita | Camanho G.L.,University of Sao Paulo
American Journal of Sports Medicine | Year: 2012

Background: Over the long term, acute patellar dislocations can result in patellar instability, with high recurrence rates after nonoperative treatment.Purpose: To compare the results of operative (reconstruction of the medial patellofemoral ligament [MPFL]) versus nonoperative treatment of primary patellar dislocation.Study Design: Randomized controlled trial; Level of evidence, 1.Methods: Thirty-nine patients (41 knees) (mean age, 24.2 years; range, 12-38 years) with acute patellar dislocation were randomized into 2 groups. One group was treated nonoperatively with immobilization and physiotherapy, the other was treated surgically with MPFL reconstruction; both groups were evaluated with minimum follow-up of 2 years. The Kujala questionnaire was applied to assess pain and quality of life, and recurrence was evaluated. Pearson 2 or Fisher exact test was used in the statistical evaluation.Results: The statistical analysis showed that the mean Kujala score was significantly lower in the nonoperative group (70.8), when compared with the mean value of the surgical group (88.9; P =.001). The surgical group presented a higher percentage of "good/excellent" results (71.43%) on the Kujala score when compared with the nonoperative group (25.0%; P =.003). The nonoperative group presented a large number of recurrences and subluxations (7 patients; 35% of cases), whereas there were no reports of recurrences or subluxations in the surgical group.Conclusion: Treatment with MPFL reconstruction using the patellar tendon produced better results, based on the analyses of posttreatment recurrences and the better final results of the Kujala questionnaire after a minimum follow-up period of 2 years. © 2012 The Author(s).


Poortmans J.R.,Free University of Brussels | Carpentier A.,Free University of Brussels | Pereira-Lancha L.O.,Instituto Vita | Lancha Jr. A.,University of Sao Paulo
Brazilian Journal of Medical and Biological Research | Year: 2012

Skeletal muscle is the major deposit of protein molecules. As for any cell or tissue, total muscle protein reflects a dynamic turnover between net protein synthesis and degradation. Noninvasive and invasive techniques have been applied to determine amino acid catabolism and muscle protein building at rest, during exercise and during the recovery period after a single experiment or training sessions. Stable isotopic tracers (13C-lysine, 15N-glycine, 2H5-phenylalanine) and arteriovenous differences have been used in studies of skeletal muscle and collagen tissues under resting and exercise conditions. There are different fractional synthesis rates in skeletal muscle and tendon tissues, but there is no major difference between collagen and myofibrillar protein synthesis. Strenuous exercise provokes increased proteolysis and decreased protein synthesis, the opposite occurring during the recovery period. Individuals who exercise respond differently when resistance and endurance types of contractions are compared. Endurance exercise induces a greater oxidative capacity (enzymes) compared to resistance exercise, which induces fiber hypertrophy (myofibrils). Nitrogen balance (difference between protein intake and protein degradation) for athletes is usually balanced when the intake of protein reaches 1.2 g·kg-1·day-1 compared to 0.8 g·kg-1·day-1 in resting individuals. Muscular activities promote a cascade of signals leading to the stimulation of eukaryotic initiation of myofibrillar protein synthesis. As suggested in several publications, a bolus of 15-20 g protein (from skimmed milk or whey proteins) and carbohydrate (± 30 g maltodextrine) drinks is needed immediately after stopping exercise to stimulate muscle protein and tendon collagen turnover within 1 h.


Castanharo R.,University of Sao Paulo | Da Luz B.S.,University of Sao Paulo | Bitar A.C.,Instituto Vita | D'Elia C.O.,Instituto Vita | And 2 more authors.
Journal of Orthopaedic Science | Year: 2011

Background More than 2 years after undergoing anterior cruciate ligament (ACL) reconstruction, women still present bilateral asymmetries during multijoint movement tasks. Given the well-known ACL-injury gender bias, the goal of this study was to investigate whether males also present such asymmetries more than 2 years after undergoing ACL reconstruction. Methods This study involved 12 participants submitted to ACL reconstruction in the ACL group and 17 healthy participants in the control group. The mean postoperative period was 37 months. The participants executed bilateral countermovement jumps and load squat tasks. The kinematics and ground reaction forces on each lower limb and pelvis were recorded, and used to compute bilateral peak vertical ground reaction forces, peak knee and hip joint powers in the sagittal plane, and the ratio between these powers. Results For the jump task, the groups had the same performance in the jump height, but for the ACL group the peak knee joint power on the operated side was 13% lower than on the non-operated side (p = 0.02). For the squat task, the hip-knee joint power ratio on the operated side of the ACL group was 31% greater than on the non-operated side (p = 0.02). Conclusions The ACL group presented a deficit in the operated knee that had its energy generation over time (joint power) partially substituted by the hip joint power of the same side. The fact that, even after more than 2 years following the ACL reconstruction and returning to regular activity, the ACL group still had neuromuscular asymmetries suggests a need for improvement in the ACL reconstruction surgery procedures and/or rehabilitation protocols. © The Japanese Orthopaedic Association 2011.


PubMed | Hospital Felicio Rocho, Instituto Vita and University of Sao Paulo
Type: Journal Article | Journal: Revista brasileira de ortopedia | Year: 2015

Lateral hip snapping is a nosological entity that is often unknown to many orthopedists and even to some hip surgery specialists. It comprises palpable and/or audible snapping on the lateral face of the hip that is sometimes painful, caused by muscle-tendon friction on the greater trochanter during flexion and extension of the coxofemoral joint. In the following, we describe a new test for diagnosing lateral hip snapping, which is eminently clinical.


PubMed | Instituto Vita and University of Sao Paulo
Type: Journal Article | Journal: Revista brasileira de ortopedia | Year: 2015

Hip arthroscopy is a safe method for treating a variety of pathological conditions that were unknown until a decade ago. Femoroacetabular impingement is the commonest of these pathological conditions and the one with the best results when treated early on. The instruments and surgical technique for hip arthroscopy continue to evolve. New indications for hip arthroscopy has been studied as the ligamentum teres injuries, capsular repair in instabilities, dissection of the sciatic nerve and repair of gluteal muscles tears (injuries to the hip rotator cuff), although still with debatable reproducibility. The complication rate is low, and ever-better results with fewer complications should be expected with the progression of the learning curve.


PubMed | University of Campinas and Instituto Vita
Type: Journal Article | Journal: Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA | Year: 2016

To determine whether professional and amateur athletes showed differences in ankle function when treated with endoscopic technique for posterior ankle impingement syndrome, to verify the impact of the presence of associated lesions in clinical evolution and to assess time to return to sport (we hypothesize that time will be the only difference between groups).Thirty-two athletes with a diagnosis of posterior impingement syndrome underwent surgery endoscopically. The American Orthopaedics Foot and Ankle Society (AOFAS) scale was used to compare functional results between amateur (15) and professional athletes (17). The satisfaction, time to return to sport, operative time, intraoperative findings and complications were evaluated, and the presence of associated injuries interfering in these results was verified.The preoperative AOFAS score range for the professional group was 62.9 14 preoperatively and 92.3 7.7 postoperatively, and for the amateur group was 67.9 19.7 and 94 9.3. The satisfaction was excellent or good in 94 % of all cases and fair in 6%. The average time of surgery was 48.3 + 25 min. Bone involvement was present in 100% of cases and complications in three cases. Time to return to sports was similar (n.s.) in both groups, and the mean time was 15.6 13.7 and 16.3 9 weeks, respectively.No significant difference regarding functional results and time to return to sports between professionals and amateur athletes operated was found. Athletes showed mainly good and excellent results and low complication rate. The presence of associated injuries did not significantly influence the results. With these results, the high-level athlete can better programme their surgeries so they can fully recover and perform better in the most important competitions.Level III.


PubMed | Instituto Vita
Type: Journal Article | Journal: Revista brasileira de ortopedia | Year: 2016

We present a case report of an 18 year-old gymnast who was diagnosed with a scaphoid stress fracture associated with a distal radial epiphysiolysis, reporting the treatment of choice. After a brief literature review about this rare association, the authors ask for attention concerning the importance of physical and image examination in making right diagnosis and finding associated injuries.

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