Proposta de um protocolo de terapia celular para o tratamento da doença pulmonar obstrutiva crônica

The main feature of pulmonary emphysema is airflow obstruction resulting from the destruction of the alveolar walls distal to the terminal bronchioles. Existing clinical approaches have improved and extended the quality of life of emphysema patients. However, no treatment currently exists that can change the disease course and cure the patient. The different therapeutic approaches that are available aim to increase survival and/or enhance the quality of life of emphysema patients. In this context, cell therapy is a promising therapeutic approach with great potential for degenerative pulmonary diseases. In this protocol proposition, all patients will be submitted to laboratory tests, such as evaluation of heart and lung function and routine examinations. Stem cells will be harvested by means of 10 punctures on each anterior iliac crest, collecting a total volume of 200 mL bone marrow. After preparation, separation, counting and labeling (optional) of the mononuclear cells, the patients will receive an intravenous infusion from the pool of Bone Marrow Mononuclear Cells (BMMC). This article proposes a rational and safe clinical cellular therapy protocol which has the potential for developing new projects and can serve as a methodological reference for formulating clinical application protocols related to the use of cellular therapy in COPD. This study protocol was submitted and approved by the Brazilian National Committee of Ethics in Research (CONEP - Brazil) registration number 14764. It is also registered in ClinicalTrials.gov (NCT01110252). (c) 2013 Sociedade Portuguesa de Pneumologia. Published by Elsevier Espana, S.L. All rights reserved.

Eletroestimulação em pacientes portadores de doença pulmonar obstrutiva crônica

Patients with Chronic Obstructive Pulmonary Disease may have muscle dysfunction, which ultimately reduce the functional capacity. Neuromuscular electrical stimulation (NMES) is a technique that can be effective in these patients, and implies low overload to the cardiorespiratory system. The aim of this study was to investigate the effects of NMES on muscle strength and cardiorespiratory fitness in COPD patients. Five patients (2 men, 3 women) were evaluated, with a mean age of 70.40 ± 6.61 years, and underwent anamnesis, anthropometric measurements, spirometry, pulmonary function, cardiopulmonary functional capacity and muscle strength in the lower limbs. After the evaluations, the patients were enrolled in a program of electrical stimulation of the quadriceps muscles, performed 3 times per week for 5 weeks. Each session lasted for 30 minutes, being reassessed at the end of the 15 sessions. Statistically significant response is observed to gain strength in lower limb (p = 0.005), but no significant responses were observed for the distance in six minute walking test before and after the test protocol for electrical stimulation. Showing that with NMES was located just gain muscle strength without effects on functional capacity, and there are few studies that investigate these effects, so further studies are needed to investigate this relationship.

Associação do treinamento resistido e aeróbico em pacientes com doença pulmonar crônica

Introduction: The pulmonary rehabilitation (PR) is composed of aerobic and resisted exercises that improve the functional capacity to the exercise, life quality and decrease respiratory symptoms in subjects with chronic pulmonary disease. Objective: Assess the effects of a combined PR program in the cardiorespiratory function and peripheral muscle strength in subjects with chronic pulmonary disease. Method: Patients with chronic pulmonary disease were submitted to the PR program, which was developed on 24 sessions of 60 minutes (three times per week). The program was composed of aerobic exercises (two times per week) and resisted exercises (once a week). Before and after the PR the patients were submitted to manovacuometry in order to measure the maximum inspiratory pressure (MIP) and the maximum expiratory pressure (MEP), ventilometry, peek expiratory flow (PEF), six minute walking test (6MWT) and one maximum repetition (1RM). The data are presented in absolute frequency, percentage and mean±standard deviation. The t Student test was used to compare data before and after the PR and the ANOVA test to compare before, after and predicted distances in the 6MWT (p<0.05). Results: Seven patients were part of this study, 85.70% of women, 71.40% with pulmonary emphysema diagnosis. The mean age was 69.43±5.59 years old, the height was 1.61±0.07 m, the mean weight was 66.20±8.40 kg and the body mass index mean was 25.50±2.48 kg/m². From the variables assessed, the MEP increased from 79.71±13.69 to 84.42±12.83 cmH2O (p=0,03), the PEF increase from 255.71±66.3 to 320.00±93.63 l/min (p=0,03) and the distance in the 6MWT from 415.28±47.90 to 483,79±79,77 m (p=0,02). The load in the 1RM test in the reverse peck deck exercise (before - - 17.10±8.10kg; after – 210.40±9.00kg), knee in leg extension machine (before – 17.10±9.50kg; after – 26.40±13.10kg) and hip extensors (right before – 48.60±22.10kg; after – 62.90±19.30kg; and left before – 46.40±20.10kg; after – 62.10±18.20kg) increased significantly (p<0,05). Conclusion: After the PR program there was improvement in the expiratory muscular strength, in the lower limbs strength and in the functional capacity. Besides that, there was a reduction in the airflow obstruction of the subjects with chronic pulmonary disease.

Função Pulmonar de pacientes submetidos a Cirurgia Bariátrica

Introduction: Obesity is a risk factor for postoperative pulmonary complications. Overweight can alter respiratory mechanics and decrease lung volumes and capacities. Bariatric surgery (BS) has been used as treatment for morbid obesity, but this surgery can lead to respiratory complications. Objective: To evaluate pulmonary function in morbid obese patients undergoing bariatric surgery. Methods: The patients were submitted to pulmonary function testing, including slow and forced vital capacity (SVC and FVC), forced expiratory volume in the first second (FEV1), Tiffenau index (FEV1/FVC), forced expiratory flow 25-75% (FEF25-75%) and maximal inspiratory and expiratory pressure (MIP and MEP). Descriptive analysis was performed. Results: We evaluated 18 patients, mean age of 37.33 ± 11.23 years, height 1.65 ± 0.09 m, weight 125.92 ± 25.24 kg and BMI 46.34 ± 9 20 kg/m2 , SVC 100.64 ± 22.91%, FVC 102.04 ± 21.82%, FEV1 104.85 ± 22.16%, FEV1 /FVC 83.54 ± 6.63% and FEF25-75% 84.47 ± 25.74%, 99.75 ± 24.55 for MIP and MEP 102.12 ± 25.06 cmH2O. Conclusion: The bariatric surgery candidates had normal values for manovacuometry and spirometry.

Hemorragia pulmonar induzida por exercício: fatores predisponentes, prevenção e tratamento

The Exercise Induced Pulmonar Haemorrhage (EIPH) affect a large amount of atlethe horses. It affects the horse's performance in any kind of competition and it can represent incresead spending of money or even an economic loss. Thoroughbred horses are the most affectef breed by EIPH because of intensive activity. Meanwhile any other kind of horse breed that is involved in athletic competition can also be affected by EIPH as well. In this brief work we are presenting the most common causes and factors from the EIPH as well the prevention and some types of treatment available nowadays

Avalição ecocardiográfica do ventrículo direito e da pressão arterial pulmonar em portadoresde hipertireoidismo

Pós-graduação em Fisiopatologia em Clínica Médica - FMB

Avaliação da força, estresse muscular e marcadores inflamatórios de indivíduos com doença pulmonar obstrutiva crônica submetidos a treinamento resistido com tubos elásticos

Pós-graduação em Fisioterapia - FCT

Função pulmonar em indivíduos com SAOS antes e após o uso do CPAP: estudo randomizado duplo cego

Pós-graduação em Bases Gerais da Cirurgia - FMB

Sangria aberta ou artéria do progresso: a emigração ibérica oitocentista nos debates sobre a colonização do além-mar

Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)

Avaliação ultrassonográfica da artéria carótida comum em equinos da raça Quarto de Milha

Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)

Avaliação da maturidade pulmonar de cordeiros nascidos a termo e prematuros pela análise citológica, Test de Clements e contagem de corpos lamelares do líquido amniótico

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Natação Adaptada: análise da função pulmonar de pessoas com deficiência

The research discusses the pulmonary function of the students of SORRI that are part of the Project for the extension of the Department of Physical Education in Bauru Swimming for People with Disabilities during the aquatic activities, noting the changes in efficiency class of breathing with the practice of aquatic activity, by the analysis of the volume and respiratory capacity. The respiratory control is essential in the process of adaptation to the liquid medium, because a student who fails to immerse the face in the water will not be able to adopt a horizontal position sufficiently stable. The practice of aquatic activities requires a great effort of breathing. Therefore, the practice of aquatic activities influence favorably the breathing, because the movements performed in the water tone the diaphragm, which is the essential muscle of the breathing, allowing an improvement in pulmonary ventilation. For the purposes of this study, the sample was composed of 10 students of the SORRI of the city of Bauru forming part of the project Swimming for People with Disabilities, practicing swimming once a week for 1 hour. For the collection of lung volumes and capacities was used a transducer of air flow and a unit of data collection, model MP36, both of the brand Biopac connected to a computer, where the data were collected and recorded for later analysis. Two tests were carried out in a day with each participant in the project of swimming, and a test at the beginning of the lesson, at rest, and another after a series of 10 breaths carried out within the swimming pool. These tests were performed in the months of March and April. The analysis of the data was through the medium of the figures and also individually, noting the changes in respiratory function of students practicing aquatic activities, without which there would be no comparison between the participants. The measurements of the scores on the pre- and post-exercise show that the...

Interação entre as vias de sinalização de receptores serotoninérgicos e Β-adrenérgicos em artéria femoral de ratos

Fundamento: A doença coronária tem sido amplamente estudada em pesquisas cardiovasculares. No entanto, pacientes com doença arterial periférica (DAP) têm piores resultados em comparação àqueles com doença arterial coronariana. Portanto, os estudos farmacológicos com artéria femoral são altamente relevantes para a melhor compreensão das respostas clínicas e fisiopatológicas da DAP. Objetivo: Avaliar as propriedades farmacológicas dos agentes contráteis e relaxantes na artéria femoral de ratos. Métodos: As curvas de resposta de concentração à fenilefrina contrátil (FC) e à serotonina (5-HT) e os agentes relaxantes isoproterenol (ISO) e forskolina foram obtidos na artéria femoral de ratos isolada. Para as respostas ao relaxamento, os tecidos foram contraídos com FC ou 5-HT. Resultados: A potência de classificação na artéria femoral foi de 5-HT > FC para as respostas contráteis. Em tecidos contraídos com 5-HT, as respostas de relaxamento ao isoproterenol foram praticamente abolidas em comparação aos tecidos contraídos com FC. A forskolina, um estimulante da adenilil ciclase, restaurou parcialmente a resposta de relaxamento ao ISO em tecidos contraídos com 5-HT. Conclusão: Ocorre uma interação entre as vias de sinalização dos receptores β-adrenérgicos e serotoninérgicos na artéria femoral. Além disso, esta pesquisa fornece um novo modelo para estudar as vias de sinalização serotoninérgicas em condições normais e patológicas que podem ajudar a compreender os resultados clínicos na DAP.

Maturidade pulmonar e fetal de bezerros da raça holandesa preta e branca tecém-nascidos, a termo e hígidos: análise do líquido amniótico

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Caracterização histomorfológica de lesões granulomatosas sugestivas de tuberculose ganglionar e pulmonar em bovinos abatidos na região noroeste do estado de SãoPaulo

Tuberculosis infection among humans transmitted by products of animal origin can be caused by Mycobacterium bovis, a concern in developing countries, because the number of human cases is relatively high compared with countries that have implemented programs to eradicate bovine tuberculosis for many years. Because it is a chronic disease with subclinical evolution, it is transmitted to other animals in the herd livestock resulting in high loss losses resulting high (10 to 25%), as well as the zoonotic nature of the disease on public health. This work aimed to study the histomorphology of granulomas in samples of lymph nodes and lungs of animals with suggestive lesions of tuberculosis, as well as those similar to the sanitary inspection. The animals clinically healthy ante-mortem, were slaughtered in a slaughterhouse in the northwestern state of Sao Paulo between April 2008 and April 2009, considering that carcasses had lymph nodes with lesions typical of tuberculosis, exhibiting nodular and hemorrhagic appearance. The caseous or calcified lesions, purulent or not, of various sizes and shapes, were also evaluated. Of the 307,661 animals slaughtered in the mentioned period, 494 gross suggestive lesions of tuberculosis and from 29 cities in the state of Sao Paulo, 16 from Mato Grosso do Sul, Goias 15, one from Mato Grosso and Paraná. Among these, 200 samples (40,5%) were processed for histopathological evaluation by hematoxylin-eosin (HE) and 90 (45%) were subjected to Ziehl-Neelsen (ZN) and examined by light microscopy. In HE staining, histopathological changes of tuberculosis were found in 197 (98,5%), classified according to the stage of development adopted by Wango et al.(31), where 29 samples were included in stage I (14,5%), 53 in stage II (26,5%), 87 in stage III (43,5%), 28 in stage IV (14%). In the ZN staining Mycobacterium sp was found in 89 (99%) of the specimens. The rate of tuberculosis in the herd studied was 0,16%. We conclude that the identification of the disease in slaughterhouses and meat companies from significant gross lesions, enables the implementation of effective measures, specifically the origin of the disease in cattle herds, providing control measures to prevent its spread.