Resposta da função autonômica, transporte mucociliar e potência aeróbia máxima de pacientes com doença pulmonar obstrutiva crônica submetidos a um treinamento aeróbio

Pós-graduação em Fisioterapia - FCT

Evolução de pacientes portadores de peumopatias crônicas e hipoxemia transitória ao esforço tratados com oxigenoterapia domiciliar prolongada durante o sono e ao esforço

Pós-graduação em Fisiopatologia em Clínica Médica - FMB

Cardiovascular risk and mortality in end-stage renal disease patients undergoing dialysis: sleep study, pulmonary function, respiratory mechanics, upper airway collapsibility, autonomic nervous activity, depression, anxiety, stress and quality of life: a prospective, double blind, randomized controlled clinical trial

Background: Chronic kidney disease (CKD) is one of the most serious public health problems. The increasing prevalence of CKD in developed and developing countries has led to a global epidemic. The hypothesis proposed is that patients undergoing dialysis would experience a marked negative influence on physiological variables of sleep and autonomic nervous system activity, compromising quality of life.Methods/Design: A prospective, consecutive, double blind, randomized controlled clinical trial is proposed to address the effect of dialysis on sleep, pulmonary function, respiratory mechanics, upper airway collapsibility, autonomic nervous activity, depression, anxiety, stress and quality of life in patients with CKD. The measurement protocol will include body weight (kg); height (cm); body mass index calculated as weight/height(2); circumferences (cm) of the neck, waist, and hip; heart and respiratory rates; blood pressures; Mallampati index; tonsil index; heart rate variability; maximum ventilatory pressures; negative expiratory pressure test, and polysomnography (sleep study), as well as the administration of specific questionnaires addressing sleep apnea, excessive daytime sleepiness, depression, anxiety, stress, and quality of life.Discussion: CKD is a major public health problem worldwide, and its incidence has increased in part by the increased life expectancy and increasing number of cases of diabetes mellitus and hypertension. Sleep disorders are common in patients with renal insufficiency. Our hypothesis is that the weather weight gain due to volume overload observed during interdialytic period will influence the degree of collapsibility of the upper airway due to narrowing and predispose to upper airway occlusion during sleep, and to investigate the negative influences of haemodialysis in the physiological variables of sleep, and autonomic nervous system, and respiratory mechanics and thereby compromise the quality of life of patients.

Cardiopulmonary effects of butorphanol in sevoflurane-anesthetized guineafowl (Numida meleagris)

Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)

Volumetric upper airway assessment in patients with transverse maxillary deficiency after surgically assisted rapid maxillary expansion

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

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.

Exercise training as treatment in cancer cachexia

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

Effect of Pursed-Lip Breathing in Patients With COPD: Linear and Nonlinear Analysis of Cardiac Autonomic Modulation

Objective: The aim of the present study was to evaluate the effect of pursed-lip breathing (PLB) on cardiac autonomic modulation in individuals with chronic obstructive pulmonary disease (COPD) while at rest. Methods: Thirty-two individuals were allocated to one of two groups: COPD (n = 17; 67.29 +/- 6.87 years of age) and control (n = 15; 63.2 +/- 7.96 years of age). The groups were submitted to a two-stage experimental protocol. The first stage consisted of the characterization of the sample and spirometry. The second stage comprised the analysis of cardiac autonomic modulation through the recording of R-R intervals. This analysis was performed using both nonlinear and linear heart rate variability (HRV). In the statistical analysis, the level of significance was set to 5% (p = 0.05). Results: PLB promoted significant increases in the SD1, SD2, RMSSD and LF (ms(2)) indices as well as an increase in alpha(1) and a reduction in alpha(2) in the COPD group. A greater dispersion of points on the Poincare plots was also observed. The magnitude of the changes produced by PLB differed between groups. Conclusion: PLB led to a loss of fractal correlation properties of heart rate in the direction of linearity in patients with COPD as well as an increase in vagal activity and impact on the spectral analysis. The difference in the magnitude of the changes produced by PLB between groups may be related to the presence of the disease and alterations in the respiration rate.

Relação do índice bispetral e da taxa de supressão do traçado do eletroencefalograma com disfunção cognitiva pós-operatória em cirurgia de revascularização do miocárdio

Pós-graduação em Anestesiologia - FMB

Efeito da suplementação de cloreto de amônio sobre os equilíbrios eletrolítico e ácido-básico e o pH urinário de ovinos confinados

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

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.

Ivabradine: Just another New Pharmacological Option for Heart Rate Control?

Ivabradine (IVB) is a heart rate lowering agent that acts via selective inhibition of the pacemaker funny current in sinoatrial nodal P cells, thus, reducing heart rate at rest and during exercise with minimal effect on myocardial contractility, blood pressure, and intracardiac conduction. IVB exerts no effect on external respiratory function parameters and it may also play a role in patients with concurrent chronic obstructive pulmonary disease. This property constitutes an important advantage over β-blockers. IVB acts by reducing the heart rate in a mechanism different from β-blockers, calcium channel blockers or late sodium channel blockers, three commonly prescribed antianginal drugs. As clinical trials have shown, it is remarkably well-tolerated and offers an alternative for patients who cannot take β-blockers. The combination of IVB and atenolol at commonly used doses in patients with chronic stable angina produced additional efficacy with no untoward effect on safety or tolerability. Additionally, side effects are rare and largely limited to a luminous phenomenon or phosphenes. This sensation is thought to be due to a block of Ih in the retina, a current very similar to cardiac If channels. IVB is contraindicated in patients with sick sinus syndrome or sinus node dysfunction and in patients taking hepatic inhibitors of Cytochrome P450 family 3, subfamily A, polypeptide 4 (abbreviated CYP3A4), with exception of omeprazole or lansoprazole. This review briefly summarizes the main studies regarding this drug.

Microdissection testicular sperm extraction causes spermatogenic alterations in the contralateral testis

Testicular sperm extraction (TESE) associated with intracytoplasmic sperm injection has allowed many men presenting non-obstructive azoospermia to achieve fatherhood. Microdissection TESE (microTESE) was proposed as a method to improve sperm retrieval rates in these patients; however, there have been failures. Little is known about whether microTESE leads to spermatogenic alterations in the contralateral testis. We assessed histological outcomes of experimental microTESE in the contralateral testis of adult male rabbits. Nine adult male rabbits were divided into three groups: control (testicular biopsy to observe normal histological and morphometric values), sham (incision of the tunica vaginalis, and a contralateral testicular biopsy to observe histological and morphometric patterns, 45 days later), and study (left testicular microTESE, and a right testicular biopsy to observe histological and morphometric patterns, 45 days later). Sections were assessed by calculating Johnsen-like scores, and measuring total tubule diameter, lumen diameter and epithelial height. The results were compared using ANOVA and Bonferroni's statistical analysis. Morphometric evaluation of the seminiferous tubules did not demonstrate differences between the three groups. However, microTESE caused spermatogenic alterations, leading to maturation arrest in the contralateral testis.

Choque

The shock, now known as a clinical syndrome due to a systemic breakdown in tissue perfusion leading to cellular hypoxia, metabolic changes and consequently organ dysfunction, is a condition that affects both humans and animals and should be classified as an emergency. For its dynamic course the therapy becomes a challenge, all the time time spared in diagnosis and treatment is essential to save the patient's life, so knowledge of its physiopathology can become of great value, and in order to clarify it better, shock has been divided didactically into: cardiogenic, hypovolemic, distributive, and obstructive, so the best approach may be chosen to this situation, noting that the therapy in general is the sum of several procedures that aims to compensate for the animal so that the underlying cause of shock may be treated

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