Exercícios respiratórios para asma: revisão sistemática com metanálise

Introdução: A asma se tornou um problema de saúde pública devido aos seus grandes custos em cuidados de saúde. Os exercícios respiratórios constituem uma intervenção não farmacológica de baixo custo e baixo risco que vem sendo utilizada por fisioterapeutas em diferentes países no tratamento de pacientes asmáticos. Objetivo: Avaliar a eficácia dos exercícios respiratórios no tratamento de pacientes adultos com asma nos seguintes desfechos: qualidade de vida, sintomas da asma, número de exacerbações agudas, episódios de hospitalização, mensurações fisiológicas (função pulmonar e capacidade funcional), número de consultas médicas, número de faltas no trabalho devido a exacerbações da doença, avaliação subjetiva do paciente em relação à intervenção. Método: Revisão sistemática de estudos controlados randomizados com metanálise realizada em parceria com a Colaboração Cochrane. As seguintes bases de dados foram consultadas: the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, EMBASE, CINAHL, AMED, e PsycINFO, além de busca manual em revistas da área e em resumos de congressos. Os seguintes termos foram utilizados: (breath*) and (exercise* or retrain* or train* or re-educat* or educat* or physiotherap* or "physical therap*" or "respiratory therapy" or buteyko ). As listas de referências dos estudos selecionados e registros de ensaios clínicos também foram consultados. A seleção dos estudos e a avaliação do risco de viés dos estudos incluídos foram realizadas de maneira independente por dois revisores. O software Review Manager foi utilizado para análise dos dados, no qual o modelo de efeito fixo foi utilizado. As variáveis contínuas foram expressas como diferença de média ponderada com um intervalo de confiança de 95%. A heterogeneidade dos resultados dos estudos incluídos foi realizada por meio da análise dos Forest plots. O teste qui-quadrado (Chi2) com um P valor de 0.10 foi utilizado para indicar significância estatística. O Índice de heterogeneidade (I2) foi implementado com um valor acima de 50% como um nível substancial de heterogeneidade. Resultados: 13 estudos envolvendo 906 pacientes estão atualmente incluídos na revisão. Os seguintes desfechos foram mensurados pelos estudos incluídos: qualidade de vida, sintomas da asma, número de exacerbações agudas e função pulmonar. Os estudos relataram uma melhora na qualidade de vida, sintomas da asma e número de exacerbações agudas. Seis dos onze estudos que avaliaram função pulmonar mostraram uma diferença significativa favorável aos exercícios respiratórios. Não houve relato de efeitos adversos. Devido à heterogeneidade substancial encontrada entre os estudos, metanálise foi possível apenas para sintomas da asma, a qual incluiu dois estudos e mostrou uma diferença significativa favorável aos exercícios respiratórios. A avaliação do risco de viés foi prejudicada devido ao relato incompleto de aspectos metodológicos pela maioria dos estudos incluídos. Conclusão: Embora os resultados encontrados pelos estudos incluídos demonstraram individualmente que os exercícios respiratórios podem ser importantes no tratamento da asma, não há evidência conclusiva nesta revisão para suportar ou refutar a eficácia desta intervenção no tratamento de pacientes asmáticos. Este fato foi devido às diferenças metodológicas entre os estudos incluídos e à ausência de relato de aspectos metodológicos por parte da maioria dos estudos incluídos. Não há dados disponíveis em relação aos efeitos dos exercícios respiratórios nos seguintes desfechos: episódios de hospitalização, número de consultas médicas, número de faltas no trabalho devido a exacerbações da doença, e avaliação subjetiva do paciente em relação à intervenção

Custos e benefícios de um programa de exercício aeróbios na doença pulmonar obstrutica crônica: ensaio cliníco aleatório controlado

Pulmonary Rehabilitation, especially due to aerobic exercise, positive impact in reducing morbidity/mortality of patients with COPD, however the economic impact with costs of implementing simple programs of aerobic exercise are scarce. This is a blind randomized clinical trials, which aimed to evaluate the costs and benefits of a simple program of aerobic exercise in individuals with COPD, considering the financial costs of the Public Health System and its secondary endpoints. We evaluated lung function, the distance walked during six minutes of walking, the respiratory and peripheral muscle strength, quality of life related to health (QLRH), body composition and level of activity of daily living (ADL) before and after eight weeks of an aerobic exercise program consisting of educational guidance for both groups, control and intervention and supervised walks to the intervention group. The health costs generated in both groups were calculated following table Brazilian Public Health System. The sample consisted of forty patients, two being excluded in the initial phase of desaturation during the walk test six minutes. Were randomized into control and intervention group thirty-eight patients, three were excluded from the control group and one was excluded from the intervention group. At the end, thirty-four COPD comprised the sample, 16 in the control group and 18 in the intervention group (FEV1: 50.9 ± 14% pred and FEV1: 56 ± 0.5% pred, respectively). After for intervention, the intervention group showed improvement in meters walked, the sensation of dyspnea and fatigue at work, BODE index (p <0.01) in QLRH, ADL level (p <0.001) as well as increased strength lower limbs (p <0.05). The final cost of the program for the intervention group was R $ 148.75, including: assessments, hiking supervised by a physiotherapist and reassessments. No patient had exacerbation of IG, while 2 patients in the CG exacerbated, generating an average individual cost of R $ 689.15. The aerobic exercises in the form of walking showed significant clinical benefits and economic feasibility of its implementation, due to low cost and easy accessibility for patients, allowing them to add their daily practice of aerobic exercises

Demonstração didática da interação entre correntes elétricas

Apresentamos a primeira experiência crucial de Ampère mostrando a interação entre dois fios metálicos conduzindo correntes elétricas. Discutimos sua importância na história da física. Descrevemos uma reprodução moderna dos procedimentos e observações de Ampère com materiais de baixo custo.

Validade e reprodutibilidade do Wii Balance Board para avaliação do equilíbrio vertical estático: um novo método de avaliação.

The Wii Balance Board (WBB) began to be investigated as a low-cost alternative for assessing static balance in vertical posture. However, studies employed methodological procedures that did not eliminate result variability between the tests and equipment used. Objective: Determine the validity and reproducibility of the WBB as an instrument for assessing static balance in the vertical position, using simultaneous data analysis and superimposed equipment. Methods: This is an accuracy study of 29 healthy young individuals of both sexes aged 18 to 30 years. Subjects were assessed 24h apart (test-retest), using unipodal and bipodal support tests, with eyes closed and open. To that end the WBB was placed on top of a force platform (FP) and data (postural sway) were collected simultaneously on both devices. Validity and reproducibility were analyzed using the interclass correlation coefficient (ICC). Finally, Bland-Altman analysis was applied to assess agreement. Results: The sample was composed of 23 women and 6 men, with mean age of 24.2±6.3 years, 60.7±6.3 kg and 1.64±4.2 m. The validity of the WBB compared to the FP was excellent for all 4 tasks proposed (ICC = 0.93 0.98). The reproducibility analyzed by test-retest was excellent for the bipodal support tasks (ICC = 0.93-0.98) and only moderate for the unipodal support tests (ICC = 0.46 0.70). Graphic analysis exhibited good agreement between the devices, since most of the measures were within the limits of agreement. Conclusion: this study proved the validity and reproducibility of the Wii Balance Board as an instrument for assessing static balance in vertical posture, using simultaneous analysis with superimposed equipment. Thus, the WBB has been increasingly used by physical therapists and other health professionals in their clinical practice, as both a rehabilitation and assessment tool

Influência da velocidade de avanço do rebolo nos danos de aços endurecidos retificados

A tendência mundial é o aumento da produtividade e da produção de peças cada vez mais sofisticadas, com elevado grau de tolerância geométrica, dimensional, com bom acabamento superficial, com baixo custo. A retificação é responsável pelo acabamento final no processo de usinagem de um material. No entanto, danos gerados nesta fase de produção comprometem todos os recursos utilizados nas fases anteriores. Grande parte dos problemas ocorridos na retificação deve-se à enorme temperatura gerada pelo processo devido às condições de usinagem. Atribui-se à velocidade de avanço, que está diretamente relacionada com a produtividade, os danos ocorridos na retificação, ficando esta variável limitada até valores que não proporcione danos. Neste trabalho, através da variação da velocidade de avanço no processo de retificação cilíndrica externa do aço ABNT D6, racionalizando a aplicação de dois fluidos de corte e usando um rebolo superabrasivo de CBN (nitreto de boro cúbico) com ligante vitrificado, avaliou-se a influência da velocidade de avanço nos danos superficiais de aços endurecidos. Os resultados permitiram concluir que a velocidade de avanço associada a uma eficiente refrigeração e lubrificação, não provocou danos térmicos (queima, trincas, tensões de tração) ao material. Tensões residuais e a rugosidade do material retificado apresentaram uma correlação com as condições de usinagem. O trabalho concluiu ser capaz um aumento dos índices de produtividade sem provocar danos nos componentes retificados.

Uma medida de calor específico sem calorímetro

Várias técnicas têm sido desenvolvidas para se obter o calor específico de sólidos e líquidos, incluindo a construção de experimentos de baixo custo para o ensino médio. Neste trabalho propomos uma maneira simples de se obter o calor específico de sólidos e líquidos. Por meio de curvas de calibração de resfriamento podemos estimar graficamente a perda de calor do sistema para sua vizinhança, e medir o calor específico do alumínio. Esta aproximação permite introduzir uma discussão sobre o processo dinâmico da troca de calor entre dos corpos.

Influência da temperatura no desempenho mecânico de compósitos PEI/fibras de vidro

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

Criar o próprio jogo didático ou apenas jogar? Efeitos de diferentes estratégias de ensino na motivação e aprendizado de ciências

The use of games as educational tools is common, however the effectiveness of games with educational purposes is still poorly known. In this study we evaluated three different low-cost teaching strategies make and play your own board game, just play an educational science game and make a poster to be exposed in the school regarding: (1) science learning; (2) use of deep learning strategies (DLS); and (3) intrinsic motivation. We tested the hypothesis that, in these three parameters evaluated, scores would be higher in the group that made and play their own game, followed respectively by the group that just played a game and the group that made a poster. The research involved 214 fifth-grade students from six elementary schools in Natal/RN. A group of students made and played their own science board game (N = 68), a second group played a science game (N = 75), and a third group made a poster to be exposed at school (N = 71). Our hypothesis was partly empirically supported, since there was no significant difference in science learning and in the use of DLS between the group that made their own game and the group that just played the game; however, both groups had significantly higher scores in science learning and in use of DLS than the group that made the poster. There was no significant difference in the scores of intrinsic motivation among the three experimental groups. Our results indicate that activities related to non-digital games can provide a favorable context for learning in the school environment. We conclude that the use of games for educational purposes (both making a game and just playing a game) is an efficient and viable alternative to teach science in Brazilian public school

Avaliação da influência do vento na circulação de uma lagoa de estabilização

Este artigo avaliou a influência do vento em diferentes profundidades na circulação de massa líquida da lagoa facultativa da estação de tratamento de esgotos do município de Álvares Florence, em São Paulo, Brasil, por meio de flutuadores com diferentes dimensões (15, 25 e 35 cm de comprimento). Por meio de um método simples, prático e de baixo custo, foi possível verificar o sentido de circulação da lagoa, o qual, por sua vez, está relacionado com a direção dos ventos.

A simple interferometric method to measure the calibration factor and displacement amplification in piezoelectric flextensional actuators

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

Influência espaço-temporal e fisiológica na absorção de nutrientes e elementos tóxicos por Eichhornia crassipes visando o uso adequado da sua biomassa: o caso do Rio Apodi/Mossoró - RN

This study aims to determine the amount of nutrients and toxic elements in aquatic macrophytes of species Eichhornia crassipes present in River Apodi/Mossoró - RN and check some of the possibilities of using the biomass produced, based on the influence of space - temporal and physiological absorption of nutrients by plants. For this, was determined: Leaf area, Leaf wet mass, Leaf dry mass, Real humidity, Apparent humidity, Ash, Total nitrogen, Crude protein, Calcium, Magnesium, Potassium, Total phosphorus, Sodium, Iron, Copper, Manganese, Zinc, Nickel, Cobalt, Aluminum, Cadmium, Lead and Total chromium at different times, 2 sampling points and 2 parts of plants (leaves and roots). The results show that the levels of nutrients, protein and toxic elements present in plant tissue of Eichhornia crassipes are influenced by spatial, temporal and physiological variability. In general, because the maximum values in the dry matter for total nitrogen (4.4088 g/100g), crude protein (27.5549 g/100g), total phosphorus (0.642 g/100 g), calcium (1.444 g/100g), magnesium (0.732 g/100 g), potassium (7.51 g/100 g), copper (4.4279 mg/100g), manganese (322.668 mg/100g), sodium (1.39 g/100g), iron (194.169 mg/100g) and zinc (3.5836 mg/100g), there was the possibility of using biomass of Eichhornia crassipes for various purposes such as in food animal, products production for human consumption, organic fertilizers, fabrication of brick low cost, and crafts. For all these applications requires a control of the levels of substances in plant tissue. Based on the levels of nutrients and crude protein, the younger plants (0 Month) would be best to have their biomass used. Moreover, one factor that contributes to the use of larger plants (6 Months), the levels of toxic elements which have significantly small or below the detection limit. Therefore, further studies quantifying the biomass produced/m2 at 0 and 6 months are needed for a more correct choice for the best time of harvest

Estudo do equilíbrio e cinética de adsorção de um corante aniônico em quitosana

The phenomenon of adsorption is of fundamental importance for the treatment of textile effluents and removal of dyes. Chitosan is characterized as an excellent adsorbent material, not only for its adsorption capacity but also the low cost production. Equilibrium and kinetic studies were developed in this study to describe the mechanism of adsorption of the anionic azo dye Orange G in chitosan, with the isotherms obtained from the variation of the concentration of dye in the continuous phase. The kinetics of the process was analyzed based on models involving the adsorption of molecules of the dye in nonpolar and polar sites. Adsorption experiments were carried out in water and in saline media with different NaCl concentrations, both for the determination of the equilibrium time as isotherms for making kinetic curves in which the amount of dye adsorbed measured indirectly varied with time. The experiments revealed the opening of the biopolymer structure with increasing concentration of Orange G, accompanied by high pH values and change on the type of interaction between the dye and the adsorbent surface, suggesting behavior advocated by the Langmuir equation in a certain range of concentration of the adsorbate and following the Henry's Law at higher concentrations, from the increased number of sites available for adsorption. The studies conducted showed that the saline medium reduces the chitosan s adsorption capacity according to a certain concentration, the occurrence of the cooperative adsorption process steps kinetic mechanism suggested as a new alternative for the interpretation of the phenomenon

Remediação de solos contaminados com diesel por lavagem com solução de tensoativos

Combating pollution of soils is a challenge that has concerned researchers from different areas and motivated the search for technologies that aim the recovery of degraded soils. Literature shows numerous processes that have been proposed with the intent of remediating soils contaminated by oils and other by-products of the oil industry, considering that the processes available have, generally, high operating costs, this work proposes a costeffective alternative to the treatment of Diesel-contaminated soils. The washing solutions were prepared using water as aqueous phase, the saponified coconut oil (OCS) as surfactant and n-butanol as co-surfactant. In this study, the soil was characterized by physical and chemical analyses. The study of diesel desorption from the soil was held in bath, using hexane and washing solutions, which had 10 and 20 wt.% active matter (AM - co-surfactant/surfactants) respectively. The study of the influence of active matter concentration and temperature in bath agitated used an experimental planning. The experiment also developed a system of percolation in bed to wash the soil and studied the influence of the concentration of active substance and volume of washing solution using an experimental planning. The optimal times to achieve hexane extraction were 30 and 180 min, while the best results using a 10% AM was 60 min and using a 20% AM was 120 min. The results of the experimental planning on bath showed that the maximum diesel removal was obtained when at a 20 wt.% of AM and under 50 °C, removing 99.92% of the oil. As for experiments in the system of percolation soil bed, the maximum diesel removal was high when the volume of the washing solution was of 5 L and the concentration of 20% AM. This experiment concluded that the concentration of AM and the temperature were vital to bath experiments for diesel removal, while in the system of percolation soil bed only concentration of AM influenced the soil remediation

Estudos de adsorção de tetraciclina e cromoglicato em partículas de quitosana

Among the polymers that stand out most in recent decades, chitosan, a biopolymer with physico-chemical and biological promising properties has been the subject of a broad field of research. Chitosan comes as a great choice in the field of adsorption, due to their adsorbents properties, low cost and abundance. The presence of amino groups in its chain govern the majority of their properties and define which application a sample of chitosan may be used, so it is essential to determine their average degree of deacetylation. In this work we developed kinetic and equilibrium studies to monitor and characterize the adsorption process of two drugs, tetracycline hydrochloride and sodium cromoglycate, in chitosan particles. Kinetic models and the adsorption isotherms were applied to the experimental data. For both studies, the zeta potential analyzes were also performed. The adsorption of each drug showed distinct aspects. Through the studies developed in this work was possible to describe a kinetic model for the adsorption of tetracycline on chitosan particles, thus demonstrating that it can be described by two kinetics of adsorption, one for protonated tetracycline and another one for unprotonated tetracycline. In the adsorption of sodium cromoglycate on chitosan particles, equilibrium studies were developed at different temperatures, allowing the determination of thermodynamic parameters

Estudos de adsorção de tetraciclina em partículas de quitosana

Due to its physico-chemical and biological properties, related to the abundance and low cost of raw material, chitosan has been recognized as a material of wide application in various fields, such as in drug delivery systems. Many of these properties are associated with the presence of amino groups in its polymer chain. A proper determination of these amino groups is very important, in order to properly specify if a given chitosan sample can be used in a particular application. Thus, in this work, initially, a comparison between the determination of the deacetylation degree by conductometry and elemental analysis was carried out using a detailed analysis of error propagation. It was shown that the conductometric analysis resulted in a simple and safe method for the determining the degree of deacetylation of chitosan. Subsequently, experiments were performed to monitor and characterize the adsorption of tetracycline on chitosan particles through kinetic and equilibrium studies. The main models of kinetics and adsorption isotherms, widely used to describe the adsorption on wastewater treatment systems and the drug loading, were used to treat the experimental data. Firstly, it was shown that an apparent linear t/q(t) × t relationship did not imply in a pseudo-second-order adsorption kinetics, differently of what has been repeatedly reported in the literature. It was found that this misinterpretation can be avoided by using non-linear regression. Finally, the adsorption of tetracycline on chitosan particles was analyzed using insights obtained from theoretical analysis, and the parameters generated were used to analyze the kinetics of adsorption, the isotherm of adsorption and to ropose a mechanism of adsorption