Nocturnal oxyhemoglobin desaturation during sleep in congestive heart failure patients

Introduction: Sleep breathing disorders occur in 45% of patients with heart failure, with 36%50% manifesting Cheyne-Stokes respiration with central sleep apnea and 12% exhibiting obstructive sleep apnea. Several studies have shown that sleep pathophysiology may negatively affect the cardiovascular system and that cardiac dysfunction alters sleep and respiration. Objective: The aim of this study was to examine oxyhemoglobin desaturation during sleep in patients with congestive heart failure (CHF) using overnight pulse oximetry. Methods: Overnight pulse oximetry was conducted in the patients homes with wrist pulse oximeters and finger probes that were placed around the forefingers of 15 patients with CHF and ejection fractions less than 50%, who were classified as New York Heart Association functional classes II and III. Results: The patients were divided into two groups. The first group consisted of seven patients with oxyhemoglobin desaturation indices of over 5 events/h, and the second group contained eight patients with oxyhemoglobin desaturation indices of 5 or less events/h. Students t-tests did not show any significant differences between the groups. The patients body mass indices correlated positively with the total desaturation episodes and desaturation time less than 90% and correlated negatively with the arterial oxygen saturation nadir. Conclusion: Pulse oximetry monitoring during sleep can be used to detect sleep breathing disorders in stable patients with CHF

Symptomatic profile of infected individuals with HIV/AIDS in a physiotherapy department

Introduction: Changes in the profile of infected individuals with HIV and the chronicity of this condition become necessary a better understanding about the clinical changes caused by the disease. Objective: This study characterizes the physical symptoms of infected individuals with HIV in a physiotherapy department of a specialized HIV treatment center. Methods: A descriptive study with quantitative analysis was performed. All registered users in the physiotherapy department (138 individuals) from 2009 to 2013 were included. Data analysis considered absolute and relative frequencies of the variables of interest. Results: Most patients were female (55%) and the mean age was 35.0 years (± 16.8). Most users were usingantiretroviral therapy and had 4 to 10 years (51.8%) of the HIV diagnosis. Many patients have comorbidities and the most prevalent was cerebral toxoplasmosis. The most common physical complaints were hemiparesis, pain, alteration in muscle tone and lipodystrophy. Conclusion: According the symptomatic profile found, expanding the role of physiotherapists for infected individuals with HIV is necessary, since the physiotherapy has a wide range of preventive and therapeutic interventions that can increase functionality, independence level and social participation

Effects of non-invasive ventilatory support in tolerance to the effort of patients with hemodialysis

Introduction: The kidney system is responsible for the maintenance of homeostasis and in patients with Chronic Kidney Disease the kidney functions changes, contributing for the development of various complicationsthat will have adverse effects in tolerance to the physical exercise and in Quality of Life of this patients. Objective: To evaluate the Effects of non-invasive ventilatory support in tolerance to the patients physical exercise in dialysis. Methods: The patients performed two 6-minute walk tests, following an adapted protocol for treadmill, one of them without the use of non-invasive ventilatory support and the other with non-invasive ventilatory support during the walk. Besides, the patients answered a questionnaire of quality of life and the KDQOL-SFTM specific for the population under study. Results: It was noticed that there was not statistical difference in the distance recorded during the 6-minute walk tests. Regarding the quality of life, the greater impact of the disease was in relation to Professional Activity. Conclusion: In conclusion, a non-invasive ventilatory support did not cause significant effects in tolerance to the exercise of this population. However, we should take into consideration the limitations suffered during the research development

Body posture and pulmonary function in mouth and nose breathing children: cross-sectional study

Introduction: Mouth breathing can lead to changes in body posture and pulmonary function. However, the consequences are still inconclusive and a number of studies are controversial. Objective: Evaluate and correlate spirometric parameters and postural measures in mouth breathing children, and compare them to nose breathers. Methods: two groups of 6 to 12 year-old children were evaluated: mouth breathers (MB, n = 55)and nose breathers (NB, n = 45). Spirometry and body posture analysis using photogrammetry (SAPo 0.68® v) were carried out. The following spirometric measures were evaluated: peak expiratory flow (PEF), forced expiratory volume in 1 second (FEV1), forced vital capacity (FVC), FEV1/FVC ratio (%) and forced expiratory flow between 25% and 75% of FVC (FEF 25-75%). Biophotogrammetric measures analyzed were: horizontal alignment of acromions (HAA) and anterior superior iliac spine (HAASIS), Charpy angle, horizontal alignment of the head (HAH), cervical lordosis (CL), thoracic kyphosis (TK), lumbar lordosis (LL), cervical distance (CD) and lumbar distance (LD). Results: There were no intergroup differences in spirometric and postural variables. Positive and moderate correlations were found between CL and CD measures with PEF, FEV1, FVC and FEF 25-75%, while weak correlations were observed between lumbar lordosis and PEF, FEV1 and FVC. Conclusion: The breathing mode had no influence on postural and respiratory measures. However, greater forward head posture, with smaller cervical lordosis, was related to higher lung volumes and flows in both groups

Assessment of functional status in the ICU: instruments used in Brazilian settings

Introduction: Physical function impairment is a significant concern for patients who survive their intensive care unit (ICU) stay, due to its impact on the patient´s independence and functional status. In this context,the choice of a suitable instrument for the assessing functional status is important, because an inappropriate assessment could lead to incorrect conclusions regarding patient prognosis, treatment benefits, and condition. Objective: To identify which functional assessment tools are used in Brazil to assess patients who are in ICU. Additionally, we investigated the translation, adaptation, and validation of these instruments for use in this population. Methods: We searched Pubmed, SCIELO, Lilacs, and Scopus in November 2015. No language or date restrictions were applied to the search. Results: Ten studies and seven instruments were identified. The most commonly used instruments were the Karnofsky Performance Status Scale Scores and the Functional Independence Measure. Conclusion: The instruments found in the review were neither specifically developed to assess the functional status of ICU patients, nor were they validated for use in this population in Brazil. Transcultural development or adaptation studies should be conducted, followed by a validation process

Factors associated with mobility of the oldest old

Introduction: Several factors can be associated to the reduction of mobility among the elderly. Early identification of these factors is crucial, since it may lead to prevention of functional dependencies. Objective:To analyze the association between mobility, sociodemographic factors and the prevalence of noncommunicable chronic diseases (NCDs) in oldest old. Methods: The sample consisted of 120 elderly persons aged (80 and 95 years), with 76 of them being women (83 ± 3 years) and 44 of them men (83 ± 3 years). Sociodemographic factors and NCDs which we studied were: age, gender, marital status, education, nutritional status, ethnicity, hypertension, diabetes and osteoarticular diseases. Mobility was analyzed using a battery of Physical Performance Tests. For statistical analysis we used the chi-square test and binary logistic regression to examine the relationship between sociodemographic factors, NCDs and mobility. SPSS (17.0) software was used for this and the significance level was set at 5%. Results: Level of education (p e#8804; 0.001) and age (p = 0.034) are the two factors related to low mobility. However, the model built by multiple logistic regression analysis revealed that age is independently related to limited mobility in oldest old people (OR 3.29; 95% CI 1.09 to 9.87). Conclusion: Thus, oldest old >85 years are at a greater risk of decreased mobility independent of their education, marital and nutritional statuses and gender. We encourage further studies in this area. Studies which will not only address those facts considered in this study but that also examine family-related aspects, especially using longitudinal studies

Comparison of two incremental protocols for evaluation of hip extension

Introduction: The hip muscles play an important role in controlling the transverse and frontal plane of the femur during displacement. The hip extension and abduction/adduction exercises are among the most widely evaluated protocols both clinically and in research. Objective: To compare which assessment protocol in an isokinetic strength regime (distal grip-ankle vs. proximal grip-knee) best represents the action of hip extension and to analyze the test-retest reliability in the variables peak force (PF) and work (W). Methods: A total of 20 subjects participated in this research. All participants were female. The mean and standard deviations of age, weight and height were 21 ± 3.9 years, 65 ± 11 kg, 166 ± 3.4 cm, respectively. Results: Significant differences were found in both variables (PF and W) between protocols 1 and 2 (p elt; 0.05) on assessment days 1 and 2. No differences between days 1 and day 2 in either protocol (p elt; 0.05) were found. Index values of interclass correlation (ICC) of protocol 1 ranged between 0.38 and 0.86. In protocol 2 the ICC range was between 0.33 and 0.87. Conclusions: In light of these results, the hip extension exercise with a proximal grip best represents the strength of the muscle groups involved in this action