QUESTION 1 You have a hybrid Exchange Server 2016 organization. Some of the mailboxes in the research department are hosted on-premises. Other mailboxes in the research department are stored in Microsoft Office 365. You need to search the mailboxes in the research department for email messages that contain a specific keyword in the message body. What should you do? A. From the Exchange Online Exchange admin center, search the delivery reports. B. Form the on-premises Exchange center, search the delivery reports. C. From the Exchange Online Exchange admin SY0-401 exam center, create a new In-Place eDiscovery & Hold. D. From the Office 365 Compliance Center, create a new Compliance Search. E. From the on-premises Exchange admin center, create a new In-Place eDiscovery & Hold. Correct Answer: E QUESTION 2 You have an Exchange Server 2016 organization. You plan to enable Federated Sharing. You need to create a DNS record to store the Application Identifier (AppID) of the domain for the federated trust. Which type of record should you create? A. A B. CNAME C. SRV D. TXT Correct Answer: D QUESTION 3 Your company has an Exchange Server 2016 200-310 exam Organization. The organization has a four- node database availability group (DAG) that spans two data centers. Each data center is configured as a separate Active Directory site. The data centers connect to each other by using a high-speed WAN link. Each data center connects directly to the Internet and has a scoped Send connector configured. The company's public DNS zone contains one MX record. You need to ensure that if an Internet link becomes unavailable in one data center, email messages destined to external recipients can 400-101 exam be routed through the other data center. What should you do? A. Create an MX record in the internal DNS zone B. B. Clear the Scoped Send Connector check box C. Create a Receive connector in each data center. D. Clear the Proxy through Client Access server check box Correct Answer: AQUESTION 4 Your network contains a single Active Directory forest. The forest contains two sites named Site1 and Site2. You have an Exchange Server 2016 organization. The organization contains two servers in each site. You have a database availability group (DAG) that spans both sites. The file share witness is in Site1. If a power failure occurs at Site1, you plan to mount the databases in Site2. When the power is restored in Site1, you Cisco CCNP Security 300-207 exam SITCS need to prevent the databases from mounting in Site1. What should you do? A. Disable AutoReseed for the DAG. B. Implement an alternate file share witness. C. Configure Datacenter Activation Coordination (DAC) mode. D. Force a rediscovery of the EX200 exam network when the power is restored. Correct Answer: C QUESTION 5 A new company has the following: Two offices that connect to each other by using a low-latency WAN link In each office, a data center that is configured as a separate subnet Five hundred users in each office You plan to deploy Exchange Server 2016 to the network. You need to recommend which Active Directory deployment to use to support the Exchange Server 2016 deployment What is the best recommendation to achieve the goal? A. Deploy two forests that each contains one site and one site link. Deploy two domain controllers to each forest. In each forest configure one domain controller as a global catalog server B. Deploy one forest that contains one site and one site link. Deploy four domain controllers. Configure all of the domain controllers as global catalog servers. C. Deploy one forest that contains two sites and two site links. Deploy two domain controllers to each site in each site, configure one domain controller as a global catalog server D. Deploy one forest that contains two sites and one site link. Deploy two domain controllers to each site. Configure both domain controllers as global catalog servers Correct Answer: C QUESTION 6 How is the IBM Content Template Catalog delivered for installation? A. as an EXE file B. as a ZIP file of XML files C. as a Web Appli cati on Archive file D. as a Portal Application Archive file Correct Answer: D QUESTION 7 Your company has a data center. The data center contains a server that has Exchange Server 2016 and the Mailbox server role installed. Outlook 300-101 exam anywhere clients connect to the Mailbox server by using thename outlook.contoso.com. The company plans to open a second data center and to provision a database availability group (DAG) that spans both data centers. You need to ensure that Outlook Anywhere clients can connect if one of the data centers becomes unavailable. What should you add to DNS? A. one A record B. two TXT records C. two SRV records D. one MX record Correct Answer: A QUESTION 8 You have an Exchange Server 2016 EX300 exam organization. The organization contains a database availability group (DAG). You need to identify the number of transaction logs that are in replay queue. Which cmdlet should you use? A. Test-ServiceHealth B. Test-ReplicationHealth C. Get-DatabaseAvailabilityGroup D. Get-MailboxDatabaseCopyStatus Correct Answer: D QUESTION 9 All users access their email by using Microsoft Outlook 2013 From Performance Monitor, you discover that the MSExchange Database\I/O Database Reads Average Latency counter displays values that are higher than normal You need to identify the impact of the high counter values on user connections in the Exchange Server organization. What are two client connections 400-051 exam that will meet performance? A. Outlook on the web B. IMAP4 clients C. mobile devices using Exchange ActiveSync D. Outlook in Cached Exchange ModeE. Outlook in Online Mode Correct Answer: CE QUESTION 10 You work for a company named Litware, Inc. that hosts all email in Exchange Online. A user named User1 sends an email message to an Pass CISCO 300-115 exam - test questions external user User 1 discovers that the email message is delayed for two hours before being delivered. The external user sends you the message header of the delayed message You need to identify which host in the message path is responsible for the delivery delay. What should you do? A. Review the contents of the protocol logs. B. Search the message tracking logs. C. Search the delivery reports 200-355 exam for the message D. Review the contents of the application log E. Input the message header to the Exchange Remote Connectivity Analyzer Correct Answer: E QUESTION 11 You have an Exchange Server 2016 organization. The organization contains three Mailbox servers. The servers are configured as shown in the following table You have distribution group named Group1. Group1 contains three members. The members are configured as shown in the following table. You discover that when User1 sends email messages to Group1, all of the messages are delivered to EX02 first. You need to identify why the email messages sent to Group1 are sent to EX02 instead. What should you identify? A. EX02 is configured as an expansion server. B. The arbitration mailbox is hosted 300-320 exam on EX02.C. Site2 has universal group membership caching enabled. D. Site2 is configured as a hub site. Correct Answer: A

Home / Saúde / Sarcopenia

Sarcopenia

O que é

Sarcopenia é uma condição médica que se refere à perda degenerativa da massa muscular esquelética e da coordenação, geralmente como resultado do processo de envelhecimento.

Deficiências em proteínas e alterações da concentração hormonal são geralmente vistos como as causas específicas da sarcopenia.

O termo sarcopenia vem do grego, significando literalmente “uma pobreza da carne”.

A massa muscular é feita de proteínas, o corpo normalmente procura um equilíbrio ideal entre o uso e a produção de proteínas para garantir a saúde dos músculos.

À medida que as pessoas envelhecem, a capacidade do organismo de produzir proteínas diminui.

As alterações hormonais que ocorrem com o envelhecimento também afetam esta produção, uma vez que os hormônios são a principal fonte de produção de proteínas.

O resultado desta proteína decrescente geralmente leva à incapacidade do corpo para manter a massa muscular.

A maioria dos sinais comuns do envelhecimento, tais como a pele enrugada, caixas torácicas afundados, e a inclinação causada por uma diminuição do suporte muscular para a medula espinhal pode ser atribuído a este processo.

Sarcopenia também dificulta a coordenação motora, como a atrofia da massa muscular torna o movimento mais difícil. É por isso que as pessoas mais velhas podem não ter coordenação ou mover de forma mais lenta. Estudos de casos médicos também mostraram que o processo de sarcopenia geralmente aumenta após a idade de 80 anos.

Embora a sarcopenia seja geralmente relacionada ao envelhecimento, ela também pode ocorrer em outros contextos. Condições ambientais e exposição à poluição podem causar sintomas de sarcopenia. Várias doenças degenerativas também podem levar a sarcopenia ou ter sarcopenia como um sintoma.

Embora o processo de envelhecimento é inevitável, existem inúmeras maneiras de ajudar a minimizar os efeitos da sarcopenia. O exercício geralmente pode ajudar a manter a força da massa muscular e manter algum nível de coordenação motora. Isso pode ajudar a compensar a perda natural de proteínas que o processo de envelhecimento implica.

Diminuição da Massa Muscular

Sarcopenia

O avanço da idade adulta está associado a profundas alterações na composição corporal, cujo principal componente é a diminuição da massa muscular esquelética. Esta perda relacionada com a idade no músculo esquelético tem sido referida como sarcopenia.

A redução relacionada à idade no músculo é uma causa direta da diminuição da força muscular relacionada à idade.

A massa muscular (não a função) parece ser o principal determinante das diferenças de força relacionadas à idade e ao sexo.

Esta relação é independente da localização do músculo (extremidades superiores e inferiores) e função (extensão vs. flexão).

Redução da força muscular nos idosos é uma das principais causas para o aumento da sua prevalência de deficiência.

Com o avanço da idade e níveis extremamente baixos de atividade visto no mais velho, força muscular é um componente crítico da capacidade de andar.

A alta prevalência de quedas entre os idosos institucionalizados pode ser conseqüência da menor força muscular.

O gasto energético diário diminui progressivamente ao longo da vida adulta.

Em indivíduos sedentários, o principal determinante do gasto energético é a massa sem gordura, que diminui cerca de 15% entre a terceira e a oitava década de vida, contribuindo para uma menor taxa metabólica basal em idosos.

Os dados indicam que a preservação da massa muscular e a prevenção da sarcopenia podem ajudar a prevenir a diminuição da taxa metabólica. Além do seu papel no metabolismo energético, o músculo esquelético e o seu declínio relacionado com a idade podem contribuir para alterações associadas à idade, tais como redução da densidade óssea, sensibilidade à insulina e capacidade aeróbia.

Causa

Embora nenhum diagnóstico de consenso tenha sido alcançado, a sarcopenia é cada vez mais definida pela perda de massa muscular e perda da função ou força muscular.

Sua causa é amplamente considerada como multifatorial, com declínio neurológico, alterações hormonais, ativação da via inflamatória, declínio da atividade, doenças crônicas, infiltração de gordura e má nutrição, tudo isso mostrado ser fatores contribuintes. descobertas moleculares recentes relacionados com apoptose, declínio mitocondrial, e o sistema de angiotensina no músculo esquelético puseram em evidência os mecanismos biológicos que podem ser contributivo.

As intervenções em geral continuam a alvejar a nutrição e o exercício.

Perda da Massa Muscular

A sarcopenia é a perda degenerativa da massa muscular esquelética (0,5-1% de perda por ano após a idade de 50), qualidade e força associada com o envelhecimento.

A maioria das pessoas começa a perder quantidades modestas de massa muscular após os 30 anos, mas a perda de força resultante aumenta exponencialmente com a idade.

A sarcopenia é um componente da síndrome da fragilidade.

Possíveis efeitos da sarcopenia incluem diminuição da força muscular, problemas de mobilidade, fraqueza, ossos fracos (osteoporose), quedas e fraturas, diminuição dos níveis de atividade, diabetes, ganho de peso na idade média e perda de função física e independência.

É frequentemente um componente da caquexia.

Pode também existir independentemente da caquexia. Enquanto a caquexia inclui mal-estar e é secundária a uma patose subjacente (como o cancro), a sarcopenia pode ocorrer em pessoas saudáveis e não necessariamente inclui mal-estar.

Resumo

Sarcopenia continua a ser um importante problema clínico que afeta milhões de adultos mais velhos.

Apesar da sua elevada prevalência, não foi desenvolvida uma definição consensual clara.

Causas incluem declínios nos hormônios e número de junções neuromusculares, aumento da inflamação, diminuição da atividade e nutrição inadequada.

Novas descobertas moleculares que podem afetar a sarcopenia incluem alterações na biologia mitocondrial, no sistema de angiotensina e na apoptose.

As intervenções para sarcopenia continuam a ser desenvolvidas com maior ênfase em exercícios e intervenções nutricionais.

O desenvolvimento farmacêutico foi parcialmente retardado pela falta de uma definição de consenso para a sarcopenia.

Fonte: www.ncbi.nlm.nih.gov/www.wisegeek.com/aginginmotion.org

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