Displasia neuronal intestinal: análise de critérios morfológicos e comparação de métodos diagnósticos

Pós-graduação em Patologia - FMB

Manifestações sistêmicas na doença pulmonar obstrutiva crônica

Chronic obstructive pulmonary disease is progressive and is characterized by abnormal inflammation of the lungs in response to inhalation of noxious particles or toxic gases, especially cigarette smoke. Although this infirmity primarily affects the lungs, diverse extrapulmonary manifestations have been described. The likely mechanisms involved in the local and systemic inflammation seen in this disease include an increase in the number of inflammatory cells (resulting in abnormal production of inflammatory cytokines) and an imbalance between the formation of reactive oxygen species and antioxidant capacity (leading to oxidative stress). Weakened physical condition secondary to airflow limitation can also lead to the development of altered muscle function. Chronic obstructive pulmonary disease presents diverse systemic effects including nutritional depletion and musculoskeletal dysfunction (causing a reduction in exercise tolerance), as well as other effects related to the comorbidities generally observed in these patients. These manifestations have been correlated with survival and overall health status in chronic obstructive pulmonary disease patients. In view of these facts, the aim of this review was to discuss findings in the literature related to the systemic manifestations of chronic obstructive pulmonary disease, emphasizing the role played by systemic inflammation and evaluating various therapeutic strategies.

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.