O efeito de um programa de exercício físico na capacidade funcional, nos fatores de risco de progressão da doença coronária e na qualidade de vida em doentes cardíacos

Considerando que a prática de exercício físico com uma intensidade pelo menos moderada melhora a capacidade funcional (Maines et al., 1997; Clara et al., 2002; Olney et al., 2006), a qualidade de vida (Leal et al., 2005; Azevedo & Leal, 2009; Flynn et al., 2009) e diminui os fatores de risco coronários (Maines et al., 1997; Squires & Hamm, 2007; Perk, 2009; Pimenta, 2010), propõe-se com o presente estudo analisar o efeito do exercício físico supervisionado, em fase ambulatório precoce, realizada na comunidade, ao nível da recuperação de doentes cardíacos. Método: Aplicar-se-á um estudo experimental, em doentes cardíacos de ambos os sexos, entre os 28 e os 80 anos. Atribuir-se-á particular ênfase às alterações induzidas pela aplicação do programa de exercício físico nos parâmetros bioquímicos (colesterol total, C-LDL, C-HDL, triglicéridos e glicose), na composição corporal (peso, índice de massa corporal, perímetro da cintura), na capacidade funcional (consumo de oxigénio pico –V02 pico, equivalente metabólico, duplo produto), no nível de atividade física, na ingestão alimentar e na qualidade de vida. O estudo terá uma duração superior a três meses, comparando dois grupos, um grupo submetido ao exercício físico supervisionado (ES) e outro aos cuidados usuais (CU), os quais serão alvo de duas avaliações (inicial e final), avaliando-se a média e o desvio-padrão para todas as variáveis em estudo e recorrendo-se aos testes não paramétricos e paramétricos, para um nível de significância de p< .05. Resultados: Foram elegidos 52 doentes, sendo que 22 participaram no grupo cuidados usuais (CU) e 30 no grupo exercício físico supervisionado (ES), observando-se que o grupo ES apresentou melhorias mais acentuadas quando comparadas com o grupo CU, ao nível dos seguintes indicadores: dispêndio de kcal/semana (+697.22% vs +320.20%); PC (-3.19% vs +5.85%); CT (-23.92% vs -9.29%), C-LDL (-32.52% vs -8.92%); total de kcal/dia ingeridas (-33,31% vs -2.58%); VO2 pico (+30.88% vs -3.57%); qualidade de vida geral (+53.86% vs +2.96%). Conclusão: Concluindo que o exercício físico multicomponente, inserido na fase de ambulatório precoce na comunidade, potencia a recuperação de doentes cardíacos influenciando positivamente os fatores de risco de progressão da doença coronária, a capacidade funcional e a qualidade de vida fundamentais para que o doente possa, pelos seus próprios meios, retomar a sua vida na comunidade.

Clinic protocol for diagnostic evaluation

This paper reviews clinic diagnostic hearing evaluations.

A student handbook for the laryngectomy clinic

This paper presents a handbook for students introducing them to the Laryngectomy Clinic of Central Institute for the Deaf and providing them basic facts regarding laryngectomees and alaryngeal speech.

Does a supervised recreation program influence the personality of the deaf?

This paper discusses the effect of play on the personality of hearing impaired children.

Narration for instructional video: operation and maintenance of the Nucleus 22 Channel Cochlear Implant

This paper presents the narration for an educational video on cochlear implants and the implantation process aimed at parents and teachers of hearing-impaired children.

Common errors made by clinic patients responding to the W-22 and NU-6 word lists

This paper presents a study of common errors made during speech discrimination testing.

Patient satisfaction in the Central Institute for the Deaf Clinic

This paper discusses a patient satisfaction survey developed for the Central Institute for the Deaf Clinic. The goal of the survey project was to establish a patient satisfaction for services baseline and to examine factors affecting patient satisfaction, such as degree of hearing loss, gender, age, and experience of the audiologist.

Evaluation of noise levels experienced by medically fragile neonates during emergency helicopter transport

There was a concern medically fragile infants may be exposed to high noise levels during emergency helicopter transport. This study had been initiated in 2007. Data was collected using a Larson Davis noise dosimeter. The purpose of this study was to collect additional data to evaluate the noise exposure experienced by medically fragile neonates during emergency transport via helicopter inbound/outbound of St. Louis Children’s Hospital, St. Louis, MO. The results suggested neonates may be exposed to noise levels ranging 85 to 95 dBA during transport. These high noise exposures may pose a risk to hearing.

Reduced capacity to sustain positive emotion in major depression reflects diminished maintenance of fronto-striatal brain activation

Anhedonia, the loss of pleasure or interest in previously rewarding stimuli, is a core feature of major depression. While theorists have argued that anhedonia reflects a reduced capacity to experience pleasure, evidence is mixed as to whether anhedonia is caused by a reduction in hedonic capacity. An alternative explanation is that anhedonia is due to the inability to sustain positive affect across time. Using positive images, we used an emotion regulation task to test whether individuals with depression are unable to sustain activation in neural circuits underlying positive affect and reward. While up-regulating positive affect, depressed individuals failed to sustain nucleus accumbens activity over time compared with controls. This decreased capacity was related to individual differences in self-reported positive affect. Connectivity analyses further implicated the fronto-striatal network in anhedonia. These findings support the hypothesis that anhedonia in depressed patients reflects the inability to sustain engagement of structures involved in positive affect and reward.

The maintenance requirement of domestic drakes

1. Mature domestic drakes of 7 genotypes, ranging in live weight from 1.1to 5.1 kg, were each given a daily allowance of feed just below the level of recorded ad libitum intake. 2. House temperature was maintained at 26 degrees C for 16 weeks and then at 10 degrees C for a further 8 weeks. 3. Under these conditions, live weight quickly adjusted to the level of feed supplied and then remained stable. 4. Regression of metabolisable energy intake on live weight (W) yielded estimates of maintenance requirement of 583 kJ/kg W-0.75 center dot d at 10 degrees C and 523 kJ/kg W-0.75 center dot d at 26 degrees C.

A comparative evaluation of functions for partitioning nitrogen and amino acid intake between maintenance and growth in broilers

The results from three types of study with broilers, namely nitrogen (N) balance, bioassays and growth experiments, provided the data used herein. Sets of data on N balance and protein accretion (bioassay studies) were used to assess the ability of the monomolecular equation to describe the relationship between (i) N balance and amino acid (AA) intake and (ii) protein accretion and AA intake. The model estimated the levels of isoleucine, lysine, valine, threonine, methionine, total sulphur AAs and tryptophan resulting in zero balance to be 58, 59, 80, 96, 23, 85 and 32 mg/kg live weight (LW)/day, respectively. These estimates show good agreement with those obtained in previous studies. For the growth experiments, four models, specifically re-parameterized for analysing energy balance data, were evaluated for their ability to determine crude protein (CP) intake at maintenance and efficiency of utilization of CP intake for producing gain. They were: a straight line, two equations representing diminishing returns behaviour (monomolecular and rectangular hyperbola) and one equation describing smooth sigmoidal behaviour with a fixed point of inflexion (Gompertz). The estimates of CP requirement for maintenance and efficiency of utilization of CP intake for producing gain varied from 5.4 to 5.9 g/kg LW/day and 0.60 to 0.76, respectively, depending on the models.

Evaluation of NRC, UC Davis and ADAS approaches to estimate the metabolizable energy values of feeds at maintenance energy intake from equations utilizing chemical assays and in vitro determinations

Feed samples received by commercial analytical laboratories are often undefined or mixed varieties of forages, originate from various agronomic or geographical areas of the world, are mixtures (e.g., total mixed rations) and are often described incompletely or not at all. Six unified single equation approaches to predict the metabolizable energy (ME) value of feeds determined in sheep fed at maintenance ME intake were evaluated utilizing 78 individual feeds representing 17 different forages, grains, protein meals and by-product feedstuffs. The predictive approaches evaluated were two each from National Research Council [National Research Council (NRC), Nutrient Requirements of Dairy Cattle, seventh revised ed. National Academy Press, Washington, DC, USA, 2001], University of California at Davis (UC Davis) and ADAS (Stratford, UK). Slopes and intercepts for the two ADAS approaches that utilized in vitro digestibility of organic matter and either measured gross energy (GE), or a prediction of GE from component assays, and one UC Davis approach, based upon in vitro gas production and some component assays, differed from both unity and zero, respectively, while this was not the case for the two NRC and one UC Davis approach. However, within these latter three approaches, the goodness of fit (r(2)) increased from the NRC approach utilizing lignin (0.61) to the NRC approach utilizing 48 h in vitro digestion of neutral detergent fibre (NDF:0.72) and to the UC Davis approach utilizing a 30 h in vitro digestion of NDF (0.84). The reason for the difference between the precision of the NRC procedures was the failure of assayed lignin values to accurately predict 48 h in vitro digestion of NDF. However, differences among the six predictive approaches in the number of supporting assays, and their costs, as well as that the NRC approach is actually three related equations requiring categorical description of feeds (making them unsuitable for mixed feeds) while the ADAS and UC Davis approaches are single equations, suggests that the procedure of choice will vary dependent Upon local conditions, specific objectives and the feedstuffs to be evaluated. In contrast to the evaluation of the procedures among feedstuffs, no procedure was able to consistently discriminate the ME values of individual feeds within feedstuffs determined in vivo, suggesting that the quest for an accurate and precise ME predictive approach among and within feeds, may remain to be identified. (C) 2004 Elsevier B.V. All rights reserved.

Assembly and maintenance of the sarcomere night and day

The assembly of sarcomeric proteins into the highly organized structure of the sarcomere is an ordered and complex process involving an array of structural and associated proteins. The sarcomere has shown itself to be considerably more complex than ever envisaged and may be considered one of the most complex macromolecular assemblies in biology. Studies over the last decade have helped to put a new face on the sarcomere, and, as such, the sarcomere is being redefined as a dynamic network of proteins capable of generating force and signalling with other cellular compartments and metabolic enzymes capable of controlling many facets of striated myocyte biology.