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

Características dos programas de residência médica em cardiologia do estado do Rio Grande do Norte

The present study had as goal to evaluate Rio Grande do Norte state’s medical residency programs (MRP) in Cardiology. It’s a descriptive study, including a documental analysis of the program’s accreditation processes (PAP) of cardiology’s medical residency in Rio Grande do Norte state in 2014 and the analysis of the resident’s perception about his professional education as a specialist in Cardiology. Beside the documental analysis of the PAPs, it was applied a semi-structured questionnaire with closed questions Likert style and open questions to all the current and former residents of the MRPs analyzed. Two MRPs in Cardiology were identified in Rio Grande do Norte state, one hosted in a public institution and the other in a private institution. The documental analysis showed a greater amount of preceptors with a good level of ownership on the public institution in comparison with the private one, as well as a bigger number of publications, participation in congresses and in book’s publications. The private institution presents a better Urgency’s infrastructure, with emergency room and cardiologic ICU. It IS clear that the residents are aware of how a good residency must work, as well as the strengths and fragilities of their own residences. Most of Onofre Lopes Universitary Hospital’s residents point out as a strength the organization, participation and quality of the preceptors, practice activities and scientific debates, great amount of patients and the visits and debates with the preceptors on the sickrooms. As the greatest fragilities, they emphasize the lack of a urgency service of their own and a specialized ICU. In Coração Hospital of Natal (HCor), it is listed as weak points the theoretic scheduling and the few ambulatory practices. As positive aspects, they report the preceptors, the agility on the execution of exams, a good number of serious patients and procedures. In both residences, it is seen a certain difficulty in accepting the important and mandatory items imposed by the rules of the Medical Residences’ National Committee, such as: biostatistics, bioethics, medical ethic, epidemiology and research methodology. Besides that, the residents recognize that both hospitals have a good infrastructure and technological support, especially in imaging methods. The evaluation of PRMCs identifies the strengths of each program and the aspects to be improved in both programs. It also allowed the observation of difficulties in accepting some regulations contained in the CNRM resolution by the resident, such as participation in activities such as biostatistics, epidemiology and research methodology as well as the improvement needs of specific technical training, such as in emergency care. Thus, our results make possible to develop strategies for continued improvement of PRMC in RN state. In addition, it enabled the preparation of the resident’s manual in cardiology, containing even a breakdown of resident evaluation system, which could serve as a model for other residency programs.