Efeitos da perda de peso induzida pela cirurgia bariátrica sobre a função respiratória

Background: Obesity leads to alteration of lung volumes and capacities due to accumulation of fat in the chest wall and abdomen. Few studies have shown that weight loss induced by surgery improves lung function. Our objective was to evaluate the anthropometric development, pulmonary function, respiratory muscle, strength and endurance after weight loss induced by bariatric surgery. Methods: We evaluated in pre and post operative period variables of weight, BMI, NC, WHR and spirometric and respiratory pressure. Results: 39 subjects were evaluated, with age mean 35.9 ± 10.9 years, predominantly by women (76.3%). The weight mean decreased from 124.8 ± 17.5 kg to 88.8 ± 14.28 kg in post operative. The mean BMI ranged from 47,9 ± 5,6 Kg/m² to 34,3 ± 4,75 Kg/m². There was a significant increase in FVC from 3,63 ± 0,94 to 4,01±1,03, FEV1 from 3,03 ± 0,72 to 3,39 ± 0,85, FEF 25-75% from 3,41 ± 0,72 to 3,82 ± 0,94, PEF from 6,56 ± 1,47 to 7,81 ± 1,69, ERV from 0,35 ± 0,39 to 0,66 ± 0,38, MVV ranged from 103,43 ± 22,21 to 137,27 ± 29,84, all of them to p<0,01. The MIP and MEP showed no significant difference in pre and post operative. It was noted that for every centimeter reduced in neck circumference, an increase of 0.06 in FVC and 5.98 in MVV is observed. This is also observed in weight and BMI. Conclusion: We conclude that weight loss induced by bariatric surgery in obese provides a significant improvement in lung function and reduction of fat around the neck is more important in the generation of lung volume than the reduction of BMI

Jambolão (Syzygium cumini) desidratado por liofilização e secagem em leito de jorro: avaliação do impacto do processo de secagem e caracterização do potencial funcional do produto final

Tropical fruits have been extensively studied due to their functional potential attributed to the presence of natural bioactive compounds. The exotic fruit jambolan (Syzygium cumini) has been reported for its appreciable amount of phenolic compounds, especially anthocyanins and antioxidant capacity. Nevertheless, there are hardly any derived jambolan products in the Brazilian market. In addition to that, considerable volumes of fruit are lost due to their high perishability. Dried fruits have become an important fruit market segment due to its weight and volume reduction and decreased transportation and storage costs. Thus, this study evaluated the jambolan pulp submitted to spouted bed drying (JLJ) and lyophilization (JLI), besides assessing the drying impact on the final product. In order to achieve this, the process performance was calculated and compared, as well the physicochemical and bioactive characteristics (moisture, water activity (aw), solubility, hygroscopicity, density, color, structure through images obtained by scanning electron microscopy (SEM), concentration of bioactive (total phenolic compounds (TPC), anthocyanins, proanthocyanidins and ascorbic acid) and antioxidant activity. The results showed drying efficiency higher than 60% for both products and that JLJ group showed higher moisture and water activity when compared to the JLI group (p<0.05). The two types of drying were able to produce stable final product in the microbiological point of view, given that both showed aw < 0.6. The final products exhibited high solubility (73.7 to 81.6%) and low hygroscopicity (9.8 to 11.6%), desirable characteristics for dehydrated foods. Despite the losses caused by drying, the dried jambolan pulp by both methods showed high TPC (468.6 to 534.0 mg GAE/100g dm), anthocyanins (from 491.9 to 673.4 mg. eq. cyanidin-3-glicoside/100g dm), proanthocyanidins (66.9 to 76.6 mg QTE/g dm) and ascorbic acid (156.4 to 186.8 mg/100 g dm). Taken together, the results of this study reveal spouted dried and freeze dried jambolan pulp as bioactive-rich natural products with suitable physicochemical and functional characteristics to be used as food ingredients. The data also demonstrate the drying techniques as rational strategies for the exploitation of the exotic fruit jambolan

Ánálise da capacidade funcional e da distribuição regional da ventilação pulmonar em pacientes com doença de chagas

INTRODUCTION: Cardiac and pulmonary manifestations of the Chagas disease (CD) affect between 20-30% of the infected subjects. The chronic Chagas cardiomyopathy (CCC) has some peculiarities such as arrhythmias and, especially heart failure (HF) and is potentially lethal due to left ventricular dysfunction. How respiratory disorders, patients get progressive loss of functional capacity, which contributes to a poor quality of life related to disease. Measurements of lung volume by the movement of the chest wall surface are an alternative evaluation of lung function and kinematics of complex thoracoabdominal for these patients. OBJECTIVE: evaluate the kinematics of the thoracoabdominal complex through the regional pulmonary volumes and to correlate with functional evaluation of the cardiorrespiratory system in patients with Chagas disease at rest. MATERIALS AND METHODS: a cross-section study with 42 subjects had been divided in 3 groups, 15 composed for patients with CCC, 12 patients with HF of different etiologies and 15 healthful presented control group. An optoelectronic plethysmography (POE), Minnesota questionnaire, six minute walk test, spirometer and manovacuometer was used. RESULTS: It was observed in the 6MWT where group CRL presented greater distance 464,93±44,63m versus Group HF with 399,58± 32,1m (p=0,005) and group CCC 404±68,24m (p=0,015), both the groups presented difference statistics with regard to Group CRL. In the manovacuometer 54,59±19,98; of the group CCC and 42,11±13,52 of group IC found group CRL presented 81,31±15,25 of the predicted versus, presenting in relation to group CRL. In the POE it observed a major contribution in abdominal compartment in patients with IC if compared like CCC and control groups. On the basis of the questionnaire of quality of life of Minessota, verified a low one groups CCC and IC 43,2±15,2 and 44,4±13,1, respectively (p<0,05) when compared with the control group (19,6±17,31). CONCLUSION: it seems that the patients with CCC possess same functional and respiratory characteristics, observed for the POE, 6MWT, manovacuometer and spirometer to the patients of group HF, being able to consider similar interventions for this complementary group as therapeutical of this neglected disease

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

Influência da seca extrema na dinâmica fitoplanctônica de um reservatório da região tropical semiárida: uma abordagem morfofuncional

Droughts are climatic phenomena whose frequency has increased in the last decades and also compromised drinkable water supplies in semiarid regions. The lack of rain combined with high evaporation rates promotes a significant reduction of the volume of reservoirs in these regions. Shallower conditions favors nutrients concentration and phytoplankton overgrowth, including potentially toxic cyanobacteria blooming. Therefore, there is a tendency to the intensification of eutrophication in those reservoirs during drought periods. Phytoplankton can respond quickly to environmental conditions related to light and nutrient availability by changes in algal biomass and composition, therefore it is considered a good predictor of environmental variables. Two functional approaches - Reynolds’s Functional Groups (FG) and Kruk’s Morphologically Based Functional Groups (MBFG) - were used to assess which environmental variables were responsible for phytoplankton dynamics, in addition to compare which functional approach explains environmental changes better. This study highlights that the reduction of 90% in the volume of a tropical reservoir of Brazilian semi-arid region, as well as light limitation and nutrient increase, can promote phytoplankton overgrowth. Multivariate analyses using both functional approaches indicated a clear separation between high volumes and low volumes conditions, showing that light and nutrient availability were the main variables that better explained the combination of functional groups. The composition of phytoplankton assemblage changed from species of meso-eutrophic habitats (FG: F and J; MBFG: VI), to organisms of eutrophic and turbid environments (FG: SN and M; MBFG: VIII and VII) during shallower conditions. Both ecological approaches described properly the phytoplankton dynamics according to light and trophic state alterations related to the water volume reduction, therefore they can be considered as equivalent approaches for using in similar environments.

Os impactos na qualidade da água e do solo de um manancial tropical do semiárido devido ao uso e ocupação e evento de seca extrema

Human activities alter soil features, causing the deterioration of its quality. Land use and occupation in drainage basins of water supply reservoirs can change the environmental soil quality and, thus, lead to the expansion of the soil potential of being a diffuse pollution source. In the Brazilian semiarid region, the soils are generally shallow with high susceptibility to erosion, favoring the sediment and nutrients input into the superficial waterbodies, contributing to the eutrophication process. Moreover, this region has high temperatures and high evapotranspiration rates, that are generally higher than the precipitation rates, causing a negative hydric balance and big volume losses by evaporation. The water volume reduction increases the nutrients’ concentration and, therefore, exacerbates the eutrophication process, deteriorating the water quality. Thereby, we hypothesized that the eutrophication process of semiarid reservoirs is intensified both by the extreme climatic events of prolonged drought, and by the diffuse pollution due to the basin land use and occupation. The study aimed to test whether the land use and occupation activities of the basin and the severe drought events intensify the eutrophication process of a semiarid tropical reservoir. To verify the influence of human activities carried out in the water supply of drainage basin on the soil quality and the eutrophication process, we conducted the mapping of the kind of use and occupation, as well the calculation of erosion for each activity and the soil quality evaluation of the riparian zone and water quality of the water supply. For the water analyses, the samplings were carried out monthly in the deeper point, near dam. For the soil, deformed composite samples were taken for the physical and chemical attributes analysis, according to the identified land use and occupation classes. The results showed that extreme droughts drastically reduces the water volume and elevates the nutrients concentration, contributing, thus, to a bigger degradation of water quality. Furthermore, we verified that human activities in the drainage basin promote the diffuse pollution, by increasing the soil susceptibility to erosion and nutrients contents. Summarizing, our results support the investigated hypothesis that activities of land use and occupation and extreme drought generate a combined effect that provide the intensification of eutrophication process of semiarid reservoirs.

Alteração do estado trófico durante um evento de seca prolongada e seus impactos na biomassa algal de um manancial tropical da região semiárida

The main consequence of eutrophication is an increase in algal biomass, mainly cyanobacterial blooms. The high evaporation and low precipitation, characteristics of semiarid regions, contribute to the nutrients availability increase in drought periods and consequent aggravation of eutrophic condition in reservoirs. Climate changes tend to intensify eutrophication symptoms, mostly in a semiarid region. Therefore, the aim of this study was to evaluate the impact of an extended drought in algal biomass in Parelhas’s Boqueirão, a mesotrophic reservoir located in a semiarid tropical region. The low volume was associated to water quality degradation and to the high nutrients concentrations and low water transparency. The increase in nutrients availability in the water column, consequence of reduced precipitation and low reservoir’s volume, provided the necessary resources for algal growth and allowed a change in trophic state in Boqueirão reservoir. This study showed how an extended drought decreases water quality. The effect of drought in Boqueirão was late detected due to the reservoir´s low initial nutrients concentration. The reservoir´s volume reduction increased the nutrient availability along with the algal biomass increase and the reservoir´s trophic state change of mesotrophic to eutrophic.

Origem física das curvas sigmoidais respiratórias pressão-volume: recrutamento alveolar e elasticidade não-linear

An important unsolved problem in medical science concerns the physical origin of the sigmoidal shape of pressure volume curves of healthy (and some unhealthy) lungs. Such difficulties are expected because the lung, which is the most important structure in the respiratory system, is extremely complex. Its rheological properties are unknown and seem to depend on phenomena occurring from the alveolar scale up to the thoracic scale. Conventional wisdom holds that linear response, i.e., Hooke s law, together with alveolar overdistention, play a dominant role in respiration, but such assumptions cannot explainthe crucial empirical sigmoidal shape of the curves. In this doctorate thesis, we propose an alternative theory to solve this problem, based on the alveolar recruitment together with the nonlinear elasticity of the alveoli. This theory suggests that recruitment may be the predominant factor shaping these curves in the entire range of pressures normally employed in experiments. The proposed model correctly predicts the observed sigmoidal pressure volume curves, allowing us to discuss adequately the importance of this result, as well as its implications for medical practice

LCD-OpenPACS: sistema integrado de telerradiologia com auxílio ao diagnóstico de nódulos pulmonares em exames de tomografia computadorizada

Lung cancer is one of the most common types of cancer and has the highest mortality rate. Patient survival is highly correlated with early detection. Computed Tomography technology services the early detection of lung cancer tremendously by offering aminimally invasive medical diagnostic tool. However, the large amount of data per examination makes the interpretation difficult. This leads to omission of nodules by human radiologist. This thesis presents a development of a computer-aided diagnosis system (CADe) tool for the detection of lung nodules in Computed Tomography study. The system, called LCD-OpenPACS (Lung Cancer Detection - OpenPACS) should be integrated into the OpenPACS system and have all the requirements for use in the workflow of health facilities belonging to the SUS (Brazilian health system). The LCD-OpenPACS made use of image processing techniques (Region Growing and Watershed), feature extraction (Histogram of Gradient Oriented), dimensionality reduction (Principal Component Analysis) and classifier (Support Vector Machine). System was tested on 220 cases, totaling 296 pulmonary nodules, with sensitivity of 94.4% and 7.04 false positives per case. The total time for processing was approximately 10 minutes per case. The system has detected pulmonary nodules (solitary, juxtavascular, ground-glass opacity and juxtapleural) between 3 mm and 30 mm.