Avaliação da função pulmonar em obesos mórbidos com sonolência diurna excessiva

Background: Obesity impairment to the pulmonary function related to the magnitude of adiposity and is associated with excessive daytime sleepiness (EDS) and snoring, among others symptoms of respiratory disorders related to sleep. It is possible that obese individuals with excessive daytime sleepiness may make changes in lung function on spirometry monitored during the day as a consequence of fragmented sleep or episodes of nocturnal hypoventilation that cause respiratory and changes that can persist throughout the day. The combination of these findings alone sleepiness observed by subjective scales with pulmonary function in obese patients is unknown. Objective: To assess the influence of EDS and snoring on pulmonary function in morbidly obese and distinguish between different anthropometric markers, the snoring and sleepiness which the best predictors of spirometric function and respiratory muscle strength and endurance of these patients. Methods: We evaluated 40 morbidly obese markers on the anthropometric, spirometric respiratory variables, maximal inspiratory and expiratory pressures (MIP and MEP) and maximal voluntary ventilation (MVV) and the measured excessive daytime sleepiness (the Epworth sleepiness scale) and snoring (snoring scale of Stanford). The data were treated when the differences between the groups of obese patients with and without sleepiness, whereas the anthropometric variables, respiratory and snoring. Pearson's correlation was performed, and multiple regression analysis assessed the predictors of pulmonary function. For this we used the software SPSS 15.0 for windows and p <0.05. Results: 39 obese patients were included (28 women), age 36.92+11.97y, body mass index (BMI) 49.3+5.1kg/m², waist-hip ratio (WHR) 0.96+0.07 and neck circumference (NC) 44.1+4.2 cm. Spirometric values and respiratory pressures were up 80% of predicted values, except for endurance (MVV <80%). Obese with EDS have lower tidal volume. Positive correlation was observed between BMI and EDS, EDS and NC and between snoring and BMI, and negative correlation between EDS and tidal volume (TV), and between snoring and snoring FVC and FEV1. In linear regression the best predictor of pulmonary function was snoring, followed by NC. NC has more obese with higher strength (MEP, p = 0.031) and endurance (MVV p = 0.018) respiratory muscle. Conclusion: Obese with EDS tend to have lower TV. In addition, snoring and NC can better predict pulmonary function in obese when compared with other anthropometric markers or EDS. Obese patients with higher NC tend to have greater capacity for overall strength of respiratory muscles, but may have low muscle endurance

Avaliação da capacidade de caminhar do portador de obesidade mórbida utilizando teste de caminhada de 6 minutos

Introduction: The ability to walk is impaired in obese by anthropometric factors (BMI and height), musculoskeletal pain and level of inactivity. Little is known about the influence of body adiposity and the acute response of the cardiovascular system during whole the 6-minute walk test (6mWT). Objective: To evaluate the effect of anthropometric measures (BMI and WHR waist-to-hip ratio), the effort heart and inactivity in ability to walk the morbidly obese. Materials and Methods: a total 36 morbidly obese (36.23 + 11.82 years old, BMI 49.16 kg/m2) were recruited from outpatient department of treatment of obesity and bariatric surgery in University Hospital Onofre Lopes and anthropometric measurements of obesity (BMI and WHR), pulmonary function, pattern habitual physical activity (Baecke Questionnaire) and walking capacity (6mWT). The patient was checking to measure: heart rate (HR), breathing frequency (BF), peripheral oxygen saturation, level of perceived exertion, systemic arterial pressure and duplo-produto (DP), moreover the average speed development and total distance walking. The data were analysed between gender and pattern of body adiposity, measuring the behavior minute by minute of walking. The Pearson and Spearmam correlation coefficients were calculated, and stepwise multiple Regression examined the predictors of walking capacity. All analyses were performed en software Statistic 6.0. Results: 20 obese patients had abdominal adiposity (WHR = 1.01), waist circumference was 135.8 cm in women (25) and 139.8 cm in men (10). Walked to the end of 6mWT 412.43 m, with no differences between gender and adiposity. The total distance walked by obesity alone was explained by BMI (45%), HR in the sixth minute (43%), the Baecke (24%) and fatigue (-23%). 88.6% of obese (31) performed the test above 60% of maximal HR, while the peak HR achieved at 5-minute of 6mWT. Systemic arterial pressure and DP rised after walking, but with no differences between gender and adiposity. Conclusion: The walk of obese didn´t suffers influence of gender or the pattern of body adiposity. The final distance walked is attributed to excess body weight, stress heart, the feeling of effort required by physical activity and level of sedentary to obese. With a minute of walking, the obeses achieved a range of intensity cardiovascular trainning

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

Valores de referência para pressão inspiratória nasal SNIFF na população brasileira

The strength of respiratory muscle are frequently assessed by maximal inspiratory and expiratory pressure, however, the maneuvers to assess PImax and PEmax are difficult for many patients. The sniff nasal inspiratory pressure (SNIP) is a simple and noninvasive technique use to assess inspiratory muscles strength. Reference values have been previous established for SNIP in adults but no previous studies have provided reference values for SNIP in adult Brazilian population. The main objective of this study were propose reference values of SNIP for Brazilian population through establishment of relationship between anthropometric measurements, physical activity profile and SNIP and at the same time compare the values obtained with reference values previously published. We studied 117 subjects (59 male and 58 female) distributed in different age grouped 20-80 years old. The results showed on significant positive relationship between SNIP and height and negative correlation with age (p<0.05). In the multiple linear regression analysis only age continued to have an independent predictive role for the two dependent variables that correlated with SNIP. The values of SNIP found in Brazilian population were higher when compared with predict values of previous studies. The results of this study provide reference equations of SNIP for health Brazilian population from 20 to 80 years old

Equações preditivas para as pressões respiratórias máximas de crianças brasileiras

I ntroduction: The assessment of respiratory muscle strength is important in the diagnosis and monitoring of the respiratory muscles weakness of respiratory and neuromuscular diseases. However, there are still no studies that provide predictive equations and reference values for maximal respiratory pressures for children in our population. Aim: The purpose of this study was to propose predictive equations for maximal respiratory pressures in healthy school children. Method: This is an observational cross-sectional study. 144 healthy children were assessed. They were students from public and private schools in the city of Natal /RN (63 boys and 81 girls), subdivided in age groups of 7-8 and 9-11 years. The students presented the BMI, for age and sex, between 5 and 85 percentile. Maximal respiratory pressures were measured with the digital manometer MVD300 (Globalmed ®). The maximal inspiratory pressure (MIP) and maximal expiratory pressures (MEP) were measured from residual volume and total lung capacity, respectively. The data were analyzed using the SPSS Statistics 15.0 software (Statistical Package for Social Science) by assigning the significance level of 5%. Descriptive analysis was expressed as mean and standard deviation. T'Student test was used for unpaired comparison of averages of the variables. The comparison of measurements obtained with the predicted values in previous studies was performed using the paired t'Student test. The Pearson correlation test was used to verify the correlation of MRP's with the independent variables (age, sex, weight and height). For the equations analysis the stepwise linear regression was used. Results: By analyzing the data, we observed that in the age range studied MIP was significantly higher in boys. The MEP did not differ between boys and girls aged 7 to 8 years, the reverse occurred in the age between 9 and 11 years. The boys had a significant increase in respiratory muscle strength with advancing age. Regardless sex and age, MEP was always higher than the MIP. The reference values found in this study are similar to a sample of Spanish and Canadian children. The two models proposed in previous studies with children from other countries were not able to consistently predict the values observed in this studied population. The variables sex, age and weight correlated with MIP, whereas the MEP was also correlated with height. However, in the regression models proposed in this study, only gender and age were kept exerting influence on the variability of maximal inspiratory and expiratory pressures. Conclusion: This study provides reference values, lower limits of normality and proposes two models that allow predicting, through the independent variables, sex and age, the value of maximal static respiratory pressures in healthy children aged between 7 and 11 years old

Desempenho e efeitos agudos da espirometria de incentivo volume-orientada sobre os volumes pulmonares em pacientes após AVC e sujeitos saudáveis

O Acidente Vascular Cerebral (AVC) é uma síndrome clínica caracterizada por uma perturbação focal da função cerebral. Geralmente ocasiona quadro de disfunção motora acompanhada de prejuízo da função respiratória. Tendo em vista tal quadro e suas possíveis repercussões, a fisioterapia respiratória tem sido amplamente requisitada com o intuito reverter ou minimizar as complicações. Dentre os recursos utilizados para este fim, os espirômetros de incentivo são utilizados com o objetivo de restaurar os volumes pulmonares, modificando o padrão respiratório e de ventilação pulmonar, prevenindo a incidência das complicações pulmonares. O objetivo do presente estudo foi comparar o desempenho na realização da espirometria de incentivo volume-orientada (EI) e seus efeitos agudos sobre os volumes pulmonares em pacientes após AVC e sujeitos saudáveis. Foram selecionados 40 voluntários, de ambos os gêneros, divididos em grupo experimental (GE), composto por 20 pacientes após AVC e grupo controle (GC) composto por 20 sujeitos saudáveis, pareados quanto à idade, gênero e Índice de Massa Corpórea (IMC). A coleta dos dados foi realizada em duas etapas: (1) Avaliação cognitiva e neurofuncional (Mini Exame do Estado Mental, National Institute Stroke Scale, Medida de Independência Funcional, teste de desempenho da aprendizagem) (2) Avaliação Respiratória (espirometria, manovacuometria e cinemática tóraco-abdominal, através da Pletismografia Opto-eletrônica). A análise estatística foi realizada através do software Graphpad Prism 4.0, em que foram utilizados os testes t Student e ANOVA two-way para comparação intergrupos e adotado nível de significância de 5%. Os resultados mostraram que os pacientes apresentam desempenho inferior na aprendizagem da espirometria de incentivo, com uma média de erros maior 2,95 ± 1,39, quando comparados aos sujeitos saudáveis, 1,15 ± 0,98. Em relação à prática observacional utilizada não foi encontrada diferença entre a aprendizagem através do vídeo ou do terapeuta. Em relação aos efeitos agudos da espirometria de incentivo volume-orientada, os pacientes após AVC apresentaram valores de volume corrente 24,7%, 18% e 14,7% inferiores quando comparados aos sujeitos saudáveis nos momentos pré-EI, EI e pós-EI, porém a espirometria de incentivo induziu incrementos de volume similares em ambos os grupos estudados, com 75, 3% para os pacientes e 73,3% para os sujeitos saudáveis. A espirometria de incentivo promove ganhos significativos no volume corrente da parede torácica, tanto em pacientes acometidos por AVC como em sujeitos saudáveis, no entanto o desempenho da aprendizagem é inferior para os pacientes, para ambas as práticas com vídeo ou terapeuta

Equacões preditivas para as pressões respiratórias estáticas máximas de adolescentes brasileiros

Introduction: The reference values and prediction equations for maximal respiratory pressures (MRP) differ significantly between the available studies. This large discrepancy can be attributed to the different methodologies proposed. Although the importance of MRP is widely recognized, there are no Brazilian studies that provide predictive equations and reference values for PRM adolescents. Objectives: The purpose of this study was to provide normal values and propose predictive equations for maximal static respiratory pressures of Brazilian adolescents. Methods: An observational cross-sectional study, which evaluated 182 adolescents of both sexes aged between 12 and 18 years, enrolled in schools of the state and private in the city of Natal / RN. The selection of schools and participants of the study was randomly through a lottery system. The spirometric evaluation was performed through the digital spirometer One Flow FVC prior to the assessment of respiratory muscle strength. The MICs were measured with MVD digital manometer 300. Statistical analysis was performed using the SPSS 17.0 software STATISTICS, assigning the significance level of 5%. The normality of data distribution was verified using the Kolmogorov-Smirnov (KS). The descriptive analysis was expressed as mean and standard deviation. We used one-way ANOVA test to verify the difference of the averages of MRPs between age and gender and comparing the averages of MRPs between levels of physical activity. The test t'Student unpaired compared the averages of MRPs being ages and sexes. The comparison of mean values obtained in this study PRM with the values predicted using the equations mentioned above was relizada by testing paired t'Student. To verify the correlation between the PRM and the independent variables (age, weight, height) was used Pearson correlation test. Levene's test evaluated the homogeneity of variance. To obtain predictive equations analysis was used stepwise multiple linear regression. Results: There was no significant difference in mean age between the PRM. The male adolescents, regardless of age, showed superiority in MRP values when compared to the opposite sex. Weight, height and sex correlated with the PRM. Regression analysis suggested in this study, pointed out that the weight and sex had an influence in MIP and MEP only in relation to sex influenced. The mean for each PRM adolescents classified as very active were superior to those observed in adolescents classified as irregularly active. Conclusion: This study provides reference values and two models of predictive equations for maximal inspiratory and expiratory pressures, and to establish the lower limits of normality that will serve as an indispensable condition for careful evaluation of respiratory muscle strength in Brazilian adolescents

Efeitos da respiração em freno-labial sobre os volumes pulmonares e o padrão de hiperinsuflação dinâmica em pacientes com asma

Objectives: To evaluate how to develop dynamic hyperinflation (DH) during exercise, the influence of pursed-lip breathing in (PLB) on breathing pattern and operating volume in patients with asthma. Methods: We studied 12 asthmatic patients in three moments: (1) anthropometry and spirometry, (2) submaximal incremental cycle ergometer test in spontaneous breathing and (3), submaximal incremental test on a cycle ergometer with PLB using the Opto-electronic plethysmography. Results: Evaluating the end-expiratory lung volume (EEV) during submaximal incremental test in spontaneous breathing, patients were divided into euvolume and hyperinflated. The RFL has increased significantly, the variation of the EEV group euvolume (1.4L) and decreased in group hyperinflated (0.272L). In group volume observed a significant increase of 140% in Vt at baseline, before exercise, comparing the RFL and spontaneous breathing. Hyperinflated group was observed that the RFL induced significant increases of Vt at all times of the test incremental baseline, 50%, 100% load and 66% recovery, 250%, 61.5% and 66% respectively. Respiratory rate decreased significantly with PLB at all times of the submaximal incremental test in the group euvolume. The speed of shortening of inspiratory muscles (VtRcp/Ti) in the hyperinflated increased from 1.6 ± 0.8L/s vs. 2.55 ± 0.9L/s, whereas in the RFL euvolume group ranged from 0.72 ± 0.31L/s vs. 0.65 ± 0.2L/s. The velocity of shortening of the expiratory muscles (VtAb/Te) showed similarity in response to RFL. In group hyperinflated varied vs. 0.89 ± 0.47 vs. 0.80 ± 0.36 and ± 1.17 ± 1L vs. 0.78 ± 0.6 for group euvolume. Conclusion: Different behavior in relation to EEV in patients with moderate asthma were observed, the HD and decreased EEV in response to exercise. The breathing pattern was modulated by both RFL performance as at home, making it more efficient

Treinamento muscular inspiratório para asma: revisão sistemática com metanálise

In asthmatic, the lung hyperinflation leaves the inspiratory muscle at a suboptimal position in length-tension relationship, reducing the capacity of to generate tension. The increase in transversal section area of the inspiratory muscles could reverse or delay the deterioration of inspiratory muscle function. Objective: To evaluate the evidence for the efficacy of inspiratory muscle training (IMT) with an external resistive device in patients with asthma. Methods: A systematic review with meta-analysis was carried out. The sources researched were the Cochrane Airways Group Specialised Register of trials, Cochrane Central Register of Controlled Trials (The Cochrane Library Issue 11 of 12, 2012), MEDLINE, EMBASE, PsycINFO, CINAHL, AMED, ClinicalTrials.gov and reference lists of articles. All databases were searched from their inception up to November 2012 and there was no restriction on the language of publication. Randomised controlled trials that involved the use of an external inspiratory muscle training device versus a control (sham or no inspiratory training device) were considered for inclusion. Two reviewers independently selected articles for inclusion, evaluated risk of bias in studies and extracted data. Results: A total of five studies involving 113 asthmatic patients were included. Three clinical trials were produced by the same group. The included studies showed a significant increase in maximal inspiratory pressure (MD 13.34 cmH2O, 95% CI 4.70 to 21.98), although the confidence intervals were wide. There was no statistically significant difference between the IMT group and the control group for maximal expiratory pressure, peak expiratory flow rate, forced expiratory volume in one second, forced vital capacity, sensation of dyspnea and use of beta2-agonist. There were no studies describing exacerbation events that required a course of oral and inhaled corticosteroids or emergency department visits, inspiratory muscle endurance, hospital admissions and days of work or school. Conclusions: There is no conclusive evidence in this review to support or refute inspiratory muscle training for asthma, once the evidence was limited by the small number of studies included, number of participants in them together with the risk of bias. More well conducted randomized controlled trials are needed, such trials should investigate respiratory muscle strength, exacerbation rate, lung function, symptoms, hospital admissions, use of medications and days off work or school. IMT should also be assessed in the context of more severe asthma

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 de diferentes intensidades de pressão expiratória positiva sobre os volumes pulmonares em pacientes com acidente vascular encefálico

observar os efeitos agudos de diferentes intensidades de Pressão Expiratória Positiva (PEP) sobre a cinemática do complexo toracoabdominal de pacientes acometidos por Acidente Vascular Encefálico (AVE). Métodos: Foram selecionados 21 indivíduos com AVE e 16 indivíduos saudáveis pareados por idade sexo e IMC para grupo controle. Avaliamos função pulmonar, pressões dos músculos respiratórios e os volumes pulmonares por meio da Pletismografia Optoeletrônica durante três diferentes intensidades de PEP 10, 15 e 20 cmH2O. Resultados: o efeito da PEP no volume corrente (VC) do grupo AVE em relação ao grupo controle foi diferente. Enquanto o grupo controle aumentou o VC em relação a respiração tranquila em 343%, 395,2% e 431,8% nas PEP10, PEP15 e PEP20 cmH2O o grupo AVE aumento 186%, 218.8% e 209.5% (p < 0.0001). A PEP também influenciou de forma diferente em relação ao Tempo inspiratório com intensidades diferentes no grupo controle e AVE (p < 0.0001). No ciclo de trabalho foi observado um aumento no grupo controle nas PEP10 (p < 0.001) e PEP15 (p < 0.05) e no grupo AVE foi observada uma redução PEP20 (p < 0.01) quando comparada com a respiração tranquila. Os volumes operacionais do grupo AVE foi observado aumento do volume inspiratório final da parede torácica (Vifpt) e do Volume expiratório final da parede torácica (Vefpt) diferente do grupo controle que gerou aumento do Vifpt acompanhado de diminuição do Vefpt durante as três intensidades de PEP. Conclusão: A hiperinsuflação observada no grupo AVE demonstra que essa terapêutica deve ser utilizada com cautela especialmente nas intensidades maiores que 10 cmH2O para essa população

Avaliação dos efeitos agudos de diferentes niveis de PEP sobre o padrão respiratório e volumes operacionais de pacientes com Parkinson

Objetivo: Determinar os efeitos agudos de diferentes intensidades de pressão expiratória positiva sobre o padrão respiratório e volumes operacionais de pacientes com doença de Parkinson. Métodos: Foram eleitos para o estudo 23 pacientes em estágios II ou III da doença, estando na condição ON , sendo 8 excluídos, e 15 controles saudáveis. Os indivíduos foram submetidos a uma avaliação inicial, constando de dados gerais, avaliação antropométrica, função pulmonar e força muscular respiratória. Após esta etapa inicial, realizou-se a avaliação dos volumes pulmonares com pletismografia optoeletrônica associado a utilização de pressão expiratória positiva (PEP) em três intensidades de pressão positiva, 10 cmH2O, 15 cmH2O e 20 cmH2O em ordem aleatória. Resultados: O grupo Parkinson apresentou valores espirométricos e de força muscular respiratória significativamente menores que o grupo controle (p<0.01). Houve diferença nos valores de volume corrente (Vt) do grupo Parkinson em relação ao grupo controle na respiração tranqüila (p<0.001) e aumento no Vt do grupo Parkinson com uso das três intensidades de PEP (p<0.001), sem diferenças estatisticamente significativas entre as intensidades e com diferença na distribuição compartimental do Vt entre os grupos (p<0.001). O fluxo inspiratório médio e o volume minuto do grupo Parkinson foram menores em relação ao grupo controle na respiração tranqüila (p<0.001) e aumentaram com o uso das três intensidades de PEP (p<0.001), sem diferenças estatisticamente significativas entre as intensidades. Houve diferença na variação dos volumes operacionais entre os grupos em todas as intensidades de PEP (p < 0.001). O volume pulmonar expiratório final não aumentou no grupo Parkinson com uso de PEP. O volume pulmonar inspiratório final aumentou no grupo Parkinson em todas intensidades de PEP (p < 0.001), não havendo diferenças entre as intensidades. Conclusão: Os pacientes com doença de Parkinson apresentam alterações em diferentes componentes do padrão respiratório e a terapia com PEP determina modificações clinicamente importantes nos volumes pulmonares, considerando a intensidade de 10 cmH2O suficientes para este objetivo terapêutico

Validação da escala de fatigabilidade percebida para avaliação da fadiga em idosas

The term fatigability concerns the degree of fatigue associated with performing an activity of any type (physical, mental, emotional and / or social). Recently scales for assessing fatigue in the English language were created, however, gaps exist regarding the validity of these scales in relation to oxygen consumption and levels of perceived fatigue. Objective: To investigate the validity of perceived fatigability scale in older women frail and non-frail by the expired gases kinetics. Methods: This is a study of type validation, where were evaluated 48 elderly. The evaluation was conducted at two different sessions. In the first, data were collected demographic partners, as well as assessment of cognitive function, physical health, and the phenotype of frailty. The second was composed by the test 6-minute walk (6MWT) associated the expired gases kinects and assessment of perceived fatigability. Statistical analysis was performed a descriptive analysis and then we used the Pearson correlation test to evaluate the relationship between the measure of perceived fatigue and variables oxygen consumption (VO2), carbon dioxide production (VCO2), respiratory exchange ratio (RER)before and after 6MWT. We used a linear regression model initially considering the following explanatory variable: age, Body Mass Index (BMI), presence of frailty, comorbidities, level of physical activity, distance covered in the 6MWT , the energy cost of walking and severity of fatigability on performance. Results: The final sample consisted of 44 elderly women, 4 elderly were excluded because they didn t complete all phases of this study. The mean age obtained was 75 years (± 7.2 years). There was no significant correlation between fatigability measures and the values of VO2 ( r = .09 , p = .56 ) , VCO2 ( r = .173 , p = .26 ) , RER ( r = - .121 , p = .43 ). The final linear regression model showed that the energy cost of walking, the usual level of physical activity and the performance severity of fatigability explained 83.5 % (R2 = 0.835, p < 0.01) of the variation in the perceived fatigability. Conclusion: Our findings indicate a relationship between greater severity of fatigability and lower levels of physical activity and increased energy cost in walking, suggesting that the fatigability analyses using a simple numeric scale is valid and viable for assessment of fatigue in older women

Comportamento de parâmetros fisiológicos de homens e mulheres em condições de estresse laboral submetidos à técnica Watsu

The physiological variations of parameters in situations of laboral stress can function like indicator in the sprouting of disorder. Those conditions have led researchers to investigate alternatives that can favor the quality of life in persons under stress laboral. The present research had as objectives investigate the physiological behavior of parameters (blood pressure, heart hat and respiratory hat) of men and women in condition of stress laboral submitted to the technique Watsu. It was used a experimental methodology with a group formed by men and women in reproductive age, that work as salesclerk in a supermarket net in Natal/RN. The seven individuals selected were submitted to the three phases of the study (dependent groups), that consisted of the phase 1 of obtaining from the measure basal (control 1), in the phase 2 of immersion in the water (control 2), and phase 3 from the application the technique Watsu (experimental phase). It was verified that during the phase basal (condition 1) the physiological parameters (BPS, BPD, HH and RH) of both sexes evaluated showed the medium values of the women (average±detour-standard: BSP = 104.1±7.92; BPD = 70.83 ±7.92; HH = 77.58 ±3.87; RH = 19.83 ±2.58) similar those presented by the men (BPS = 118.75 ±7.55; BPD = 75.00 ±9.91; HH = 71.75 ±14.95; RH = 16.62 ±3.99). The evaluation of those parameters before and after immersion of the volunteers in the water (condition 2) showed a significant reduction (W = 3.0: p≤0.05) barely for the values of BPS presented by the sex females after immersion. In the men group, all of the physiological parameters analyzed did not vary significantly. Regarding the profile of those variables before and after application of the watsu (condition 3), was verified a significant increase (W= 0,0: p≤0.05) for the BPS one and SABP in the women. The Men did not show significant variation for all of the physiological parameters. Faced with the results presented, we are able to conclude that the systolic and diastolic blood pressures were the physiological parameters that are on influence from the Technique Watsu, only for the kind females

Avaliação do potencial de toxicidade de florações de cianobactérias como subsídio para ações de gestão ambiental em açudes do semiárido potiguar

Blooms negatively compromise the aquatic environment, plants, animals and human health.Some species are toxin-producing, such as the neurotoxin saxitoxin and the hepatotoxin microcystin, which may contaminate water reservoirs, as those existing in the semiarid region of Rio Grande do Norte (Brazil) which are used to supply the population, fishing, aquiculture and recreational activities, thereby providing the risk of human exposure through water intake, dermal contact and respiratory tract. Thus, it is recommended a constant monitoring of the density of cyanobacteria with the quantification of cyanotoxins. One goal with this work was the monitoring of water in four reservoirs in semiarid of RN through the identification and enumeration of cyanobacteria and through the identification and quantification of cyanotoxins by ELISA. Furthermore, we intended to assess the environmental perception of farmers and artisanal fishers in reservoirs of semiarid of RN through semi-structured interviews with questions mostly related to water and eutrophication. Through these objectives the aim was the development of management strategies for aquaculture and prevention of risks to public health. The results showed that the highest values of microcystins were found in the rainy season. Standards for drinking water, according to the guidelines of Ministry of Health 2914/2011 and CONAMA 357/05, setting the maximum values for raw water density of cyanobacteria: 50,000 cel.mL-1; microcystin: 1 μg. L-1 and saxitoxin: 3 μg. L-1. The values found for microcystin ranged between 0.00227 μg. L-1 and 24.1954 μg. L-1. From 128 samples analyzed, 27% were above the limit. There was no clear seasonal pattern for saxitoxins and their values ranged between 0.003 μg. L-1 and 0.766 μg. L-1 with none of the values above the limit. Furthermore, 76% of the densities of cyanobacteria values were above the limit. About environmental perception, 52 interviews were conducted and the results show that the respondents recognize the main uses of water of the rervoirs, recognize the importance and have a positive view about the reservoirs. They also realize that the water has a poor quality and can cause health problems. The results provide data showing the persistence of cyanobacteria and cyanotoxins, many times over the limit, reinforcing the importance of constant monitoring. The assessment of environmental perception gives foundation for later proposed environmental education linked to public health management into the context of this particular population, making it more effective