Exercício físico de baixa intensidade na dpoc: comparação dos programas solo e aquático

Physical Exercise (PE) is a necessary component in the management in COPD patients, where respiratory symptoms are associated with reduced functional capacity. Even with the increase in the number of studies that have been published and the therapeutics success using aquatic therapy approach, studies using PE in water in COPD patients are so few. Objective: the aim of this present study was to analyze the effects of low intensity water exercise in COPD patients, developed in two different places aquatic and ground. Methods: This is a randomized clinical trial study, 42 patients with moderate to very severe DPOC were recruited for the study, mean age of 63,2  10,9 years old. Randomized in 3 groups: Control Group (CG), Land Group (LG) and Water Group (WG). The PE protocol was performed in a period of 8 weeks, with frequency of 3 times per week. The CG participated in an educational program. All the patients were assessed twice through spirometry, respiratory muscular strength, the 6-min walk test, the quality of life (SF-36 and SGRQ), the LCADL, the MRC, the BODE index and the upper limbs (UP) incremental test. Results: There was a significant difference after the approaches in DP6 from the WG (p=0,02); in VEF1 in LG (p=0,00) and WG (p=0,01); in MIP in LG (p=0,01) and WG (p=0,02); in MEP in LG (p=0,02) and WG (p=0,01); the MRC decreases in WG (p=0,00). there was an increase of the weight supported by the UP in LG (p=0,00) and WG (p=0,01). The LG showed an increase of the quality of life represented by the SGRQ total score (p=0,00). The BODE index decreased in LG (p=0,00) and WG (p=0,01). In LCDAL, the LG showed a decrease. Conclusion: This data in this present study suggest that both approaches of low intensity exercise showed to be beneficial in moderate to very severe COPD patients. The WG showed additional benefits in physical function, pointing to a new therapeutic modality for COPD patients

Efeitos da eletroestimulação sobre os parâmetros eletromiográficos e dinamométricos do músculo quadríceps femoral

To analyze the effects of electrical stimulation at two frequencies on the EMG parameters (EMG) and dynamometer, in muscles with different typing. MATERIALS AND METHODS: This is a controlled clinical trial, randomized and double blind. Sixty healthy volunteers (23.6 ± 4.2anos; 54.2 ± 7.7kg, 1.62 ± 0.009 cm) of both sexes were divided randomly into three groups: control group (CG), experimental group 1 (SG1) with application of the current Russian 30 HZ and experimental group 2 (EG2) at 70 Hz The volunteers performed an initial assessment (AV1) on the isokinetic dynamometer with three repetitions maximum voluntary isometric (MVC) for knee extension concomitant uptake of EMG for the VM muscle, VL and RF. Later, after application of NMES, they underwent an experimental protocol of isometric fatigue using 70% of MVIC, ending with the completion of a final assessment (AV2) in the same manner as the AV1. RESULTS: By analyzing the profile of the 60 subjects in three broad, VM showed a higher value of RMS behavior when the VL and RF (p = 0.03 and p = 0.02). With respect to Fmed the RF muscle (p = 0.001) showed a higher value for the VM. The VM muscle showed significant increases of Fmed (p = 0.05) after electrical stimulation at 70 Hz when compared the AV1 AV2 and RF showed significant decreases (p = 0.009) after stimulation at 30 Hz during the fatigue showed an increase RMS in the VM and VL, with a reduction in RF. For the variable Fmed was observed in three broad decline during fatigue. CONCLUSION: Our findings provide evidence that the muscles VM, VL and RF fiber typing are different besides indicating that the frequency of NMES tend to relate to the muscle stimulated. Finally suggests the surface EMG as a noninvasive method for characterizing muscle

Efeitos do treinamento de marcha sobre superfícies inclinadas em indivíduos com hemiparesia crônica: ensaio clínico controlado randomizado

Among the therapeutic approaches that can be used to achieve this goal is the gait training on sloping surfaces, but there are few scientific findings that elucidate the results of this practice. OBJECTIVE: To evaluate the effects of training on sloping surfaces on the gait of subjects with chronic hemiparesis. MATERIALS AND METHODS: A controlled, randomized, blinded clinical trial was conducted. Concluded the study twenty-four subjects with age between 40 and 70 years (54,91±9,3). Their neurological function, functional independence, motor function and balance assessed, besides the gait evaluation through kinemetry. The subjects were allocated into two groups: control group (CG) underwent gait training on treadmill with partial body weight support (PBWS) without inclination; and the experimental group (EG) submitted to gait training on treadmill with PBWS and inclination of 10%. Twelve training sessions were performed. The paired t Student test and Wilcoxon test were used in statistical analysis to compare findings before and after training for each group, and the t student test for independent samples and Mann-Whitney.test were used to compare the to groups. RESULTS: After training within-group changes were observed on balance recovery, motor function and functionality, in both experimental conditions. The EG showed changes after training on speed, stride length, step length of paretic and non-paretic side, paretic single support, double support time and non-paretic swing time. The CG the differences were detected on double support, paretic single support and hip range of movement. The EG showed better results when compared to CG on the variables: speed (p=0,034), non-paretic single support (p=0,02) and paretic swing time (p=0,02). CONCLUSION: gait training on sloping surfaces represents a promising strategy for gait training of subjects with chronic hemiparesis since it is can influence a greater number of gait variables, when compared with gait training on flat surface

Custos e benefícios de um programa de exercício aeróbios na doença pulmonar obstrutica crônica: ensaio cliníco aleatório controlado

Pulmonary Rehabilitation, especially due to aerobic exercise, positive impact in reducing morbidity/mortality of patients with COPD, however the economic impact with costs of implementing simple programs of aerobic exercise are scarce. This is a blind randomized clinical trials, which aimed to evaluate the costs and benefits of a simple program of aerobic exercise in individuals with COPD, considering the financial costs of the Public Health System and its secondary endpoints. We evaluated lung function, the distance walked during six minutes of walking, the respiratory and peripheral muscle strength, quality of life related to health (QLRH), body composition and level of activity of daily living (ADL) before and after eight weeks of an aerobic exercise program consisting of educational guidance for both groups, control and intervention and supervised walks to the intervention group. The health costs generated in both groups were calculated following table Brazilian Public Health System. The sample consisted of forty patients, two being excluded in the initial phase of desaturation during the walk test six minutes. Were randomized into control and intervention group thirty-eight patients, three were excluded from the control group and one was excluded from the intervention group. At the end, thirty-four COPD comprised the sample, 16 in the control group and 18 in the intervention group (FEV1: 50.9 ± 14% pred and FEV1: 56 ± 0.5% pred, respectively). After for intervention, the intervention group showed improvement in meters walked, the sensation of dyspnea and fatigue at work, BODE index (p <0.01) in QLRH, ADL level (p <0.001) as well as increased strength lower limbs (p <0.05). The final cost of the program for the intervention group was R $ 148.75, including: assessments, hiking supervised by a physiotherapist and reassessments. No patient had exacerbation of IG, while 2 patients in the CG exacerbated, generating an average individual cost of R $ 689.15. The aerobic exercises in the form of walking showed significant clinical benefits and economic feasibility of its implementation, due to low cost and easy accessibility for patients, allowing them to add their daily practice of aerobic exercises

Efeitos agudos do alongamento estático antes e após exercício e as características neuromusculares do membro inferior: estudo controlado, randomizado e cego

Objective: To evaluate the acute effects of static stretching before and after isokinetic exercise, neuromuscular and biomechanical properties of muscles Biceps Femoris (BF) and semitendinosus (ST). Methods: Eighty-nine volunteers of both genders, healthy and physically active, with a mean age of 22.52 ± 2.6 years and mean BMI 23.86 ± 3.2 kg/m² were randomized into 4 groups: Control Group (CG) made only one Protocol Exercise (PE) without performing the stretching, the Experimental Group 1 (EG1) did stretching before PE; EG2 did the stretching after PE and EG3 did stretching before and after PE. The volunteers were evaluated on the following variables: Range of motion (ROM), soreness, dynamometric variables concentric and eccentric, Neuromuscular Latency Time (NLT) and electromyographic. In the data analysis was assigned a significance level of 5%. Results: ADM and TLNM reported significant reduction in CG, but remained unchanged in GE with p<0,05 and p<0,01, respectively. As for the soreness, no differences between the groups. The electromyographic activity of the BF and ST, in the concentric phase, showed a significant decrease in all groups (p<0,01). However, in the eccentric phase, ST revealed reduction in all groups (p <0.01), except for the CG, while the BF remained unchanged in all groups. The PT showed significant reduction in both conditions (concentric and eccentric) for all groups, with no difference between them (p<0,01). Conclusion: The results of this study do not favor the use of static stretching, even of short duration, before physical activity. However, after exercise or at times unrelated to the sport, he should be given with the aim of avoiding muscle shortening

Avaliação clínica e comparativa da oclusão balanceada bilateral e desoclusão com guia canino sobre a função mastigatória de usuários de prótese total removível

The maintenance of masticatory function is especially important for patients who wear complete dentures due to the limitations of this type of prosthesis. Thus, the bilateral balanced occlusion (BBO) is used to achieve, besides other advantages, greater masticatory efficiency. However, analyzing critically the literature, it is observed that there is not enough scientific evidence that support the BBO as the most appropriate occlusal concept in complete dentures. This way, the purpose of the present study was to verify if complete dentures wearers with BBO present better masticatory efficiency and capacity than those with canine guidance (CG). A double-blind controlled crossover clinical trial was conducted. The sample was made of 24 completely edentulous patients. The subjects wore sets of complete dentures with both occlusal concepts for equal periods of 3 months. Objective data were collected through the masticatory efficiency test, performed by the colorimetric method, in which capsules of a synthetic material enclosing fuchsine- containing granules were used. Subjective data were recorded by patient´s ratings of their chewing function, which is the masticatory ability. No significant statistical difference was found for masticatory efficiency (p=0,0952) and masticatory ability (x2=0,5711/ p=0,4498) between the two occlusal concepts studied, as well as there was no correlation between these two variables (p=0,2985). Based on these results, it seems reasonable to use CG for the setup of complete dentures, since it is an easier and quicker technical procedure, until that future researches can come to complement this question

Expressão imuno-histoquímica das proteínas MMP-9, VEGF e FVW em lesões centrais e periféricas de células gigantes

Central giant cell lesion (CGCL) and peripheral giant cell lesion (PGCL) of the jaws have a distinct clinical behavior, although they share histopathologic features. It is still unclear whether these clinical differences are supported by a distinct pattern of immunoexpression of markers for multinucleated giant cells (GC) and mononuclear cells (MC). The purpose of this study was to compare the immunohistochemical expression of VEGF, MMP-9 in CG and MC and measure the vascularization by vWF to check whether there are differences in expression of these biomarkers between CGCL and PGCL. Paraffin wax blocks of 20 cases of LCCG and 20 LPCG were retrieved. MMP-9 immunoreactivity was greater in the CM of PGCL compared to VEGF (p<0.05). VEGF expression was greater in the CM of CGCL compared to PGCL (p<0.05) and it was greater in the overall expression of CGCL compared to PGCL (p<0.05). Vascularity was quantified by microvascular counting (MVC). MVC was greater in the PGCL compared CGCL (p<0.05). MMP-9 showed a greater tendency of expression in CGCL, though was not significant (p>0.05). We tested correlation between the proteins studied in each group and found a significant negative correlation between VEGF and vWF in CGCL (p<0.05). These results suggest that there are differences in the expression of VEGF in CM and overall expression between the lesions, although no statistically significant difference in the overall expression of the MMP-9. Then, there was a trend in increased expression of MMP-9 and VEGF in CGCL, possibly by the involvement of both proteins in osteoclastogenesis. Additionally, the results of this study indicate a higher degree of vascularization in PGCL compared to CGCL, fact that can be directly linked to the reactive nature of the PGCL, where the inflammatory process with its rich angiogenesis contributes significantly to these findings.

Exprassão imuno-histoquímica dos fatores de reabsorção óssea em lesões centrais e periféricas de células gigantes

The Giant Cell Lesions, both the Central Giant Cells Lesions (CGCL) as the Peripheral Giant Cells Lesions (PGCL), correspond to a group of oral lesions that are histologically similar entities; however they show a variable clinical behaviour. The purpose of this study was to compare the immunohistochemical expression of bone resorption factors RANK (Receptor Activator of Nuclear Factor kappa B), RANKL (Receptor Activator of Nuclear Factor kappa B Ligand) and OPG (Osteoprotegerin) between CGCL and PGCL. Additionally, these bone resorption factors were examined in terms of aggressiveness of these lesions. The sample consisted of 61 cases, 30 cases of PGCL and 31 CGCL (16 non-aggressive and 15 aggressive). The analysis was performed by quantification of mononuclear cells (MO) and giant multinucleated cells (CG) immunopositive to anti-RANK, anti-RANKL and anti-OPG antibodies in 10 fields. Moreover, according to the proportion between the amount of cells positive for RANKL and OPG, the cases were categorized into: RANKL>OPG, OPG>RANKL e RANKL=OPG. CGCL showed a higher amount of MO (p=0.002) and total cells (p=0.003) both positives to RANKL compared with the PGCL. Additionally, the CGCL revealed a significant association with the ratio of RANKL>OPG (p=0.001). Analysis of the bone resorption factors revealed no significant differences between aggressive and non-aggressive CGCL (p>0.05). It was observed a positive correlation between the markers themselves, and a negative correlation between lesion size and quantity of OPG positive MO cells (p=0,004) and total cells (p=0,009). Through these results, we suggest that the greatest CGCL resorptive potential compared to the PGCL, may have occurred to the high expression of RANKL. Furthermore differences in the biological behavior of aggressive and non-aggressive CGCL appear to be related to the expression of these bone resorption factors

Efeito do exercício físico matinal realizado sob luz solar no ciclo vigília-sono de adolescentes

The sleep onset and offset delay at adolescence in relation to childhood. Besides biological causes, some external factors as academic obligations and socialization contributes, increasing the burden of school and socialization. However, morning school schedules reduce sleep duration. Besides light strong effect, studies in humans have indicated that exercise influence circadian synchronization. To evaluate the effect of the morning exercise under sunlight on sleep-wake cycle (SWC) of adolescents, 160 high school students (11th year) were exposed to the following conditions: lesson in usual classroom (Group C), lesson in swimming pool exposed to sunlight (Group E), half of them carrying through physical activity (EE) and the other resting (EL). Each experimental group met two stages: assessment of SWC 1 week before and 1 week during the intervention, which was held in Monday and Wednesday between 7:45 and 8:30 am. In the baseline, there were applied the questionnaires "Health and Sleep" and cronotype evaluation (H & O). In addition, students were evaluated before and during the intervention by "Sleep Diary", "Karolinska Sleepiness Scale" (KSS), Psychomotor Vigilance Test (PVT) and actimetry. During the intervention, there was a delay in wake-up time on the weekend and a trend to greater sleep duration on week for the three groups. At the weekend, only the groups EE and EL increased sleep duration. There was no difference in bedtime, irregularity of sleep schedules and nap variables. The sleepiness showed a circadian pattern characterized by higher alertness levels at 11:30 am and sleepiness levels at bedtime and wake-up time on week. On weekends there were higher levels of alertness in these times. In the days of intervention, there was an increase of sleepiness at 11:30 am for groups EL and EE, which may have been caused by a relaxing effect of contact with the water of the pool. In addition, the group EE showed higher alert levels at 14:30 pm on Monday and at 8:30 am in the Wednesday, possibly caused by exercise arousal effect. The reaction time assessed through the TPV did not vary between the stages. The sleep quality improved in the three groups in the second stage, making impossible the evaluation of intervention effect. However, the sleep quality increased on Monday and Tuesday only on the group EE. From the results, it is suggested that the intervention promoted effects on the sleepiness at some day hours. In other SWC variables there were no effects, possibly due to a large SWC irregularity on weekends. Thus, the evaluation of higher weekly frequency EF is necessary, since only two days were insufficient to promote greater effect on adolescents SWC

Caracterização do ciclo sono/vigília de professores do ensino médio em natal/rn

In the school environment is fundamental the knowledge about the sleep-wake cycle (SWC), because we find children and adolescents with excessive sleepiness and learning difficulties. Furthermore, teachers with high demand and with different work schedule, which may contribute to changes in SWC. The aim of this study was to describe the SWC of high school teachers in Natal/RN. Habits and knowledge about sleep, chronotype, SWC, daytime sleepiness, sleep quality and job satisfaction were described in 98 high school teachers from public and private school. These parameters were compared according to the characteristics of work, family structure and gender. Data collection was performed with the use of questionnaires in two stages: 1) "health and sleep" (general characterization of sleep habits), Horne & Ostberg questionnaire (characterization of chronotype), Epworth Sleepiness Scale and the Index of Pittsburg Sleep Quality, 2) The sleep diary for 14 days. From the results, we observe that the teachers woke up and went to bed earlier in the week and showed a reduction of time in bed around 42min comparing to weekend. This reduction in time in bed during the week was accompanied by an increase in nap duration on weekend. In addition the teachers woke up earlier on Saturdays than on Sundays, probably due to housework and leisure. The teachers' knowledge about sleep was low in relation to individual differences and effect of alcoholic beverages on sleep, and high in the consequences of sleep deprivation. The differences found in comparisons on the characteristics of work, family structure and gender were punctual, except concerning the work schedule. The teacher who started work in the morning and finished in the night, woke up earlier, went to bed later and had less time in bed, when compared to teachers who work only in two shifts. In addition, teachers with late chronotypes who begin the work in the morning had a greater irregularity in the wake up time compared to teachers with earlier and intermediate chronotypes. Half of teachers have excessive sleepiness, which was positive correlated with work dissatisfaction. In general, teachers showed IPSQ averages equivalent to poor sleep quality and the women showed worst averages. From the results, it is suggested that the SWC of teachers varies according to work schedule, leading to irregularity and partial sleep deprivation in the week, although these responses vary according to chronotype. These changes are accompanied by excessive daytime sleepiness and poor sleep quality. However, it is necessary to expand the sample to clarify the influence of variables related to work, family structure and gender together

Investigação da influência do cochilo na aprendizagem escolar

There is a known positive effect of nocturnal sleep for brain plasticity and the consolidation of declarative and procedural memories, as well as for the facilitation of insight in problem solving. However, a possible pro-mnemonic effect of daytime naps after learning is yet to be properly characterized. The goal of this project was to evaluate the influence of daytime naps on learning among elementary and middleschool students, measuring the one-day (acute), and semester-long (chronic) effects of post-learning naps on performance. In the Acute Day-Nap condition, the elementary students were exposed to a class and then randomly divided into three groups: Nap (N), Game-based English Class (GBEC) and Traditional English Class (TEC). There were 2 multiple-choice follow-up tests to evaluate students performance in the short and long runs. In the short run, the N group outperformed the other two groups; and such tendency was maintained in the long run. In the chronic condition, the middle-school students were randomly separated into two groups: Nap (N) and Class (C) and were observed during one academic term. The N group had increased school performance in relation to the C group. In the statistical analyses, independent t-tests were applied considering the scores significant when p<0,05, expressed in terms of average ± average standard error. Results can be interpreted as an indication that a single daytime nap opportunity is not enough to ensure learning benefits. Therefore, more research is needed in order to advocate in favor of a daytime nap as a pedagogical means of promoting enhanced school performance

Avaliação do comportamento termoanalítico e oxidativo do biodiesel de mamona

In this work biodiesel was gotten through the transesterification reaction using the oil of castor as source of triglycerides and using the methylic route for obtaining of esters. For the characterization of biodiesel and its mixtures with mineral diesel oil, physical chemical parameters and several analytical techniques had been used, as well as: gas chromatography (GC), nuclear magnetic resonance of proton (1H NMR), infrared spectroscopy (IR) and thermal analysis. The chromatography confirmed the complete reaction of esters in biodiesel presenting a 97,08% conversion. The 1H - NMR presented singlet in 3,6 ppm corresponding to the hydrogen of the group ester RCOO CH3. The infrared presented a strong band in 1741 cm-1 referring to stretching C=O of ester and an average band in 1175 cm-1 referring C O deformation. With the data of thermal analysis it was possible to observe the thermal and oxidative stability of the samples changing the atmospheres of synthetic air and nitrogen, where stages of the thermal decomposition had been verified and had been attributed to the volatilization and/or decomposition of the triacylglycerides. The thermal degradation of the samples was carried through 150 and 210°C during 1, 12, 24 and 48 hours and was observed change in the thermogravimetric profile, therefore an increase in the number of stages of the thermal decomposition also occurred indicating characteristic intermediate composites of polymerization, being this confirmed through the rheological study that presented brusque increase of viscosity. The kinetic study showed that the activation energy has the following order: biodiesel > mineral diesel oil > mixtures biodiesel/diesel

Tratamento eletroquímico de água produzida sintética para remoção de hidrocarbonetos policíclicos aromáticos

The aim of this work is the treatment of produced water from oil by using electrochemical technology. Produced water is a major waste generated during the process of exploration and production in the oil industry. Several approaches are being studied aiming at the treatment of this effluent; among them can be cited the biological process and chemical treatments such as advanced oxidation process and electrochemical treatments (electrooxidation, electroflotation, electrocoagulation, electrocoagulation). This work studies the application of electrochemical technology in the treatment of the synthetic produced water effluent through the action of the electron, in order to remove or transform the toxic and harmful substances from the environment by redox reactions in less toxic substances. For this reason, we used a synthetic wastewater, containing a mixture H2SO4 0,5M and 16 HPAs, which are: naphthalene, acenaphthylene, acenaphthene, fluorene, phenanthrene, anthracene, fluoranthene, pyrene, benzo (a) anthracene, chrysene, benzo(b)fluoranthene, benzo(k) fluoranthene, benzo(a)pyrene, indeno(1,2,3-cd)pyrene, dibenzo(a, h)anthracene, benzo(g, h, i)perylene. Bulk electrochemical oxidation experiments were performed using a batch electrochemical reactor containing a pair of parallel electrodes, coupled with a power supply using a magnetic stirrer for favoring the transfer mass control. As anodic material was used, a Dimensionally Stable Anode (DSA) of Ti/Pt, while as cathode was used a Ti electrode. Several samples were collected at specific times and after that, the analysis of these samples were carried out by using Gas Chromatography Coupled to Mass Spectrometry (GC - MS) in order to determine the percentage of removal. The results showed that it was possible to achieve the removal of HPAs about 80% (in some cases, more than 80%). In addition, as an indicator of the economic feasibility of electrochemical treatment the energy consumption was analyzed for each hour of electrolysis, and based on the value kWh charged by ANEEL, the costs were estimated. Thus, the treatment costs of this research were quite attractive

Estudo dos principais fatores que influenciam na solubilização dos hpas em águas

Polycyclic aromatic hydrocarbons (PAHs) constitute a family of compounds characterized by having two or more condensed aromatic rings and for being a class of substances that are widely distributed in the environment as a complex mixture, being very persistent in the environment due to its low solubility in water. The application of chemometric methods to analytical chemistry has provided excellent results in studying the solubility of PAHs in aqueous media in order to understand the mechanisms involved in environmental contamination. The method consists in analyzing the solubilization of PAHs from diesel oil in water varying parameters such as stirring time, volume of oil added and pH, using a full factorial design of two levels and three factors. PAHs were extracted with n-hexane and analyzed by fluorescence spectroscopy because they have molecular characteristics fluorescent due to the large number of condensed rings and links, and gas chromatography coupled to a mass spectrometer (GC-MS). The results of fluorescence analysis showed that only the stirring time and pH influenced the solubility of PAHs in diesel fuel. How is a non-selective technique for the study of fluorescence was performed on form and semi-quantitative. And for the chromatographic analysis the results showed that the solubility of the different PAHs is influenced differently so that you can classify them into groups by the results of the effects

Dessulfurização oxidativa em diesel utilizando catalisadores à base de vanádio ou manganês

The oxidative desulfurization process (ODS) of a commercial diesel fuel was performed under mild conditions in the presence of catalysts based on vanadium or manganese, supported on alumina, clays (commercial, natural and pillared) and zeolites (NaX, NaY, beta, mordenite and ZSM-5). The catalysts were synthesized by wet impregnation and characterized by X-ray diffraction, textural analysis by N2 adsorption and scanning electron microscopy. The dibenzothiophene (DBT) was used as sulfur compound in catalytic evaluation. The reactions were performed using acetonitrile as solvent and the hydrogen peroxide as oxidant at 55°C. The reaction products were analized by gas chromatography (GC-FID). In the studied conditions, the process was efficient due to the DBT was converted to its corresponding sulfone. Both DBT and corresponding sulfone were extracted by the solvent. Removals and oxidations up to 100% of sulfur compound were achieved. The catalysts supported on ZSM-5 zeolite showed are more effective for oxidation reaction of sulfur compound, presenting the best results. It was observed for oxidation reaction, that vanadium catalysts were more effective and manganese catalysts showed best results for removal of sulfur compounds