Estimation of Maximal Work Rate Based on the 6-Minute Walk Test and Fat-Free Mass in Chronic Obstructive Pulmonary Disease

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

Zinco plasmático e estado nutricional em idosos

OBJETIVO: Neste estudo foi avaliado o zinco plasmático associado ao estado nutricional de 80 indivíduos idosos saudáveis, atendidos no Centro de Reabilitação da Prefeitura Municipal de Araraquara, SP, entre 1998 e 1999. MÉTODOS: Os participantes foram entrevistados para obtenção dos dados de ingestão de alimentos e, a partir desses dados, foram estimados o consumo de macronutrientes e de zinco dietético. A concentração do zinco plasmático foi dosada por Espectroscopia de Emissão Atômica com Plasma de Argônio Induzido. Para a avaliação nutricional foram tomadas as medidas do peso corporal, altura, circunferência do braço e prega cutânea triciptal. RESULTADOS: A alimentação das mulheres foi adequada em proteínas e lipídios, mas insuficiente em carboidratos e energia. Os homens apresentaram ingestão suficiente de energia, mas com excesso de lípides associado à insuficiência de carboidratos. A ingestão média de zinco, pelas mulheres (10,8±4,1mg/d) e pelos homens (19,7±7,2mg/d), estava de acordo com a recomendação. As concentrações plasmáticas de zinco nas mulheres (7,2±3,5µmol/L) e nos homens (6,5±3,8µmol/L) estavam abaixo das referências para a idade, e não foram correlacionadas com o zinco alimentar. Foi detectada correlação significante e positiva entre o zinco plasmático e a ingestão de proteína; entretanto, essa correlação se apresentou negativa com a idade. CONCLUSÕES: A redução da biodisponibilidade do zinco dietético pode ter sido devida ao consumo elevado de leguminosas e ao consumo reduzido de carnes que, associados à ingestão energética insuficiente das mulheres, tiveram repercussões nas concentrações plasmáticas daquele nutriente. É necessária a atenção nutricional voltada aos idosos, visando melhorar a biodisponibilidade do zinco alimentar, e para prevenir ou corrigir sua deficiência por meio de suplementação.

Relationship of upper-limb and thoracic muscle strength to 6-min walk distance in COPD patients

Study objectives: This study was developed to investigate the influence of thoracic and upperlimb muscle function on 6-min walk distance (6MWD) in patients with COPD.Design: A prospective, cross-sectional study.Setting: the pulmonary rehabilitation center of a university hospital.Patients: Thirty-eight patients with mild to very severe COPD were evaluated.Measurements and results: Pulmonary function and baseline dyspnea index (BDI) were assessed, handgrip strength, maximal inspiratory pressure (Pimax), and 6MWD were measured, and the one-repetition maximum (1RM) was determined for each of four exercises (bench press, lat pull down, leg extension, and leg press) performed on gymnasium equipment. Quality of life was assessed using the St. George Respiratory Questionnaire (SGRQ). We found statistically significant positive correlations between 6MWD and body weight (r = 0.32; p < 0.05), BDI (r = 0.50; p < 0.01), FEV, (r = 0.33; p < 0.05), PImax (r = 0.53; p < 0.01), and all values of 1RM. A statistically significant negative correlation was observed between 6MWD and dyspnea at the end of the 6-min walk test (r = -0.29; p < 0.05), as well as between 6MWD and the SGRQ activity domain (r = -0.45; p < 0.01) and impact domain (r = -0.34; p < 0.05) and total score (r = -0.40; p < 0.01). Multiple regression analysis selected body weight, BDI, Pimax, and lat pull down IRM as predictive factors for 6MWD (R-2 = 0.589).Conclusions: the results of this study showed the importance of the skeletal musculature of the thorax and upper limbs in submaximal exercise tolerance and could open new perspectives for training programs designed to improve functional activity in COPD patients.

Queixas osteomusculares relacionadas ao trabalho relatadas por mulheres de centro de ressocialização

Considerando as queixas de origem laboral um problema de saúde pública, objetivou-se, com o presente estudo, analisar a freqüência da população que refere queixas osteomusculares e a associação de ocorrência e severidade destas às variáveis antropométricas e de trabalho. Tomou-se 146 mulheres de um centro de ressocialização feminino, que responderam a um questionário validado contendo informações sobre dados antropométricos e queixas osteomusculares relacionadas ao trabalho. O estudo da associação entre e dentro das variáveis foi feito pelo teste de Goodman. Observou-se elevada freqüência de ocorrência de queixas após início de atividade laboral (94,19%). As participantes com necessidade de afastamento apresentaram maiores valores em idade e peso. Queixa acentuada foi mais referida na coluna do tronco. Afastamento foi mais referido para as que trabalhavam há mais tempo. Concluiu-se que é alta a freqüência de queixas relacionadas ao trabalho e que há associação entre maiores valores de peso e de estatura e nível de severidade acentuado; maiores valores de idade e de peso e necessidade de afastamento; níveis acentuados de queixas e região da coluna e entre maior tempo de serviço e necessidade de afastamento.

An outbreak of chlamydiosis in captive blue-fronted Amazon parrots (Amazona aestiva) in Brazil

Fifty-eight blue-fronted Amazon parrot (Amazona aestiva) nestlings, recovered from the illegal trade, became ill at a wildlife rehabilitation center in São Paulo State, Brazil. Clinical signs observed were nonspecific, and the mortality rate was 96.5% despite initial treatment with norfloxacin. Postmortem examinations were performed on 10 birds. Liver and spleen smears showed structures suggestive of Chlamydophila psittaci in four cases. Diagnosis was confirmed by seminested polymerase chain reaction on tissue samples. Other birds from the same location showed no clinical signs of the disease, although high complement fixation titers to C. psittaci were found in 10 adult psittacines. All birds in the facility were treated with doxycycline. The two surviving nestlings did not recover after two doxycycline treatments and were euthanatized. The high mortality rate observed in this outbreak was attributed to poor conditions of husbandry and delays in the diagnosis and treatment of the disease. After diagnosis, improved control measures for chlamydiosis were instituted.

Fatores de risco para doenças cardiovasculares em idosos com diabetes mellitus tipo 2

The aim of this study was to analyze the risk factors related to the cardiovascular diseases (CVRF) in elderly type 2 diabetics. A cross-sectional observational study was carried out on 100 elderly patients attending the Rehabilitation Center of Araraquara (CRRA), São Paulo State, Brazil, from March to December, 2004. The majority were married, female, white, with a low income and low educational level. Regarding habits and style of life, the subjects had an adequate diet, were sedentary, non-smoking and non-drinking. In the population of 100, 42% were overweight, 42% obese, 71% had above-normal waist measurements and 84% high waist-to-hip ratios. Concerning the CVRF, it was observed that more than half had hypertension, hypercholesterolaemia and hypertriglyceridaemia. 84% had high values of LDL-cholesterol and 59% HDL-cholesterol levels below the reference values, 78% high levels of fasting glycemia, 76% glycohemoglobin and 57% fibrinogen and thus subject to cardiovascular risk. The results showed a high frequency of cardiovascular risk factors, differing according to sex and the age.

Perfil audiológico e genético de pacientes com perda auditiva sensorioneural não sindrônica atendidos no Hospital das Clínicas da Faculdade de Medicina de Botucatu-Universidade Estadual Paulista

Pós-graduação em Bases Gerais da Cirurgia - FMB

Fatores de risco para doenças cardiovasculares em idosos com diabetes mellitus tipo 2

Pós-graduação em Biociências e Biotecnologia Aplicadas à Farmácia - FCFAR

Estudo da helmintofauna de tartarugas marinhas procedentes da costa brasileira

Pós-graduação em Biologia Geral e Aplicada - IBB

Sexagem molecular em aves: contribuições à conservação biológica e á divulgação científica

Pós-graduação em Ciências Biológicas (Genética) - IBB

Correlation Between Laryngeal Sensitivity and Penetration/Aspiration After Stroke

Stroke is the most common neurological disease in adults that is associated with deglutition disorders. The presence of laryngeal sensitivity is very important in developing safe swallowing without risk of pulmonary complications. The aim of this study was to correlate laryngeal sensitivity with laryngeal penetration and tracheal aspiration after swallows of three food consistencies (puree, thickened liquid, and liquid) in poststroke individuals in the late phase. A cross-sectional clinical study was performed with 91 post-ischemic stroke individuals, with oropharyngeal dysphagia, who were in rehabilitation center treatment from 2009 to 2011. They had a mean age of 68.1 years and average time since injury was 22.6 months; 39 had injury to the right hemisphere and 52 had injury to the left hemisphere. All underwent fiberoptic endoscopic evaluation of swallowing and evaluation of laryngeal sensitivity by touching the tip of the endoscope to the arytenoids and aryepiglottic folds. The linear correlation coefficient of Spearman was applied to evaluate the correlation between laryngeal penetration and tracheal aspiration and the presence/absence of laryngeal sensitivity. There was a negative correlation between the observation of penetration and tracheal aspiration and laryngeal sensitivity, with all bolus consistencies (p < 0.001 for aspiration and p a parts per thousand currency sign 0.01 for penetration). The absence of laryngeal sensitivity determines the more frequent findings of penetration and tracheal aspiration. This sensory stimulus in the mucosa of the pharynx and larynx is an essential element for safe swallowing and its deficiency associated with altered motor activity can cause laryngeal penetration and aspiration in poststroke individuals regardless of food consistency.

Classificação do grau de comprometimento motor e do índice de massa corpórea em crianças com paralisia cerebral

Children with cerebral palsy due to movement and posture disorders might have an injured nutritional state. This study's objective was to classify the body mass index of children with cerebral palsy and verify its relation with the injury level of gross motor function. Twenty children, male and female sex, with cerebral palsy with ages between 2 and 14 years participated in the study. They were chosen from a rehabilitation center with physiotherapy, occupational and speech therapy accompaniment. Children were classified according to the gross motor function classification scale. The anthropometric measures of each child weight, heel-knee length, estimated stature and body mass index were gauged. The body mass index was classified according to the Center for Disease Control and Prevention's body mass index percentile calculator for children and teenagers. The obtained data didn't show any relation between the gross motor function and body mass index. The reduced number of participants and the fact of all children be accompanied in dysphagia clinics and, when necessary, nutrition clinics, might have influenced these results.

Dopplerfluxometria e avaliação morfométrica do fígado, baço, rins e grandes vasos abdominais de onças pardas (Puma concolor) da região Campo Grande, Mato Grosso do Sul, Brasil

Pós-graduação em Biotecnologia Animal - FMVZ

Diagnostic accuracy of the EMG parameters associated with anterior knee pain in the diagnosis of patellofemoral pain syndrome

Objective To assess the diagnostic accuracy of the surface electromyography (sEMG) parameters associated with referred anterior knee pain in diagnosing patellofemoral pain syndrome (PFPS). Design Sensitivity and specificity analysis. Setting Physical rehabilitation center and laboratory of biomechanics and motor control. Participants Pain-free subjects (n=29) and participants with PFPS (n=22) selected by convenience. Interventions Not applicable. Main Outcome Measure The diagnostic accuracy was calculated for sEMG parameters’ reliability, precision, and ability to differentiate participants with and without PFPS. The selected sEMG parameter associated with anterior knee pain was considered as an index test and was compared with the reference standard for the diagnosis of PFPS. Intraclass correlation coefficient, SEM, independent t tests, sensitivity, specificity, negative and positive likelihood ratios, and negative and positive predictive values were used for the statistical analysis. Results The medium-frequency band (B2) parameter was reliable (intraclass correlation coefficient=.80–.90), precise (SEM=2.71–3.87 normalized unit), and able to differentiate participants with and without PFPS (P<.05). The association of B2 with anterior knee pain showed positive diagnostic accuracy values (specificity, .87; sensitivity, .70; negative likelihood ratio, .33; positive likelihood ratio, 5.63; negative predictive value, .72; and positive predictive value, .86). Conclusions The results provide evidence to support the use of EMG signals (B2 – frequency band of 45–96Hz) of the vastus lateralis and vastus medialis muscles with referred anterior knee pain in the diagnosis of PFPS.

Characterization of the motor performance in infants with a diagnosis of Cerebral Palsy in process of rehabilitation: the importance of the proactivity of caregivers

Introduction: The progress in technology, associated to the high survival rate in premature newborn infants in neonatal intensive care units, causes an increase in morbidity. Individuals with CP present complex motor alterations, with primary deficits of abnormal muscle tone affecting posture and voluntary movement, alteration of balance and coordination, decrease of force, and loss of selective motor control with secondary problems of contractures and bone deformities.Objective: The aim of this work is to describe the spontaneous movement and strategies that lead infants with cerebral palsy to move.Methods: Seven infants used to receive assistance at the Essential Stimulation Center of CIAM (Israeli Center for Multidisciplinary Support - Philanthropic Institution), with ages ranging between six and 18 months with diagnosis of Cerebral Palsy (CP) were assessed.Results: The results show the difficulty presented by the infants with respect to the spontaneous motor functions and the necessity of help from the caregiver in order to perform the functional activity (mobility). Prematurity prevails as the major risk factor among the complications.Conclusion: The child development can be understood as a product of the dynamic interactions involving the infant, the family, and the context. Thus, the social interactions and family environment in which the infant live may encourage or limit both the acquisition of skills and the functional independence.