Fisioterapia respiratória na doença de parkinson idiopática: relato de caso

Disfunções respiratórias ocorrem na maioria dos pacientes com Doença de Parkinson Idiopática em estágios avançados, levando a elevados índices de morbimortalidade. O objetivo deste estudo foi relatar a evolução do caso de um paciente parkinsoniano no estágio IV da Escala de Hoehn e Yahr em que a intervenção fisioterapêutica foi especificamente direcionada às disfunções respiratórias. O paciente realizou fisioterapia respiratória durante cinco meses. Foram realizadas provas de função pulmonar (espirometria e manovacuometria) antes e após o período de tratamento. Houve melhora da função respiratória com aumento nos valores de capacidade vital forçada, volume expiratório forçado no 1o segundo, pico de fluxo expiratório, pressão inspiratória e expiratória máximas e ventilação voluntária máxima. Pode-se concluir que o paciente apresentou melhora importante dos sintomas respiratórios e da prova de função pulmonar após tratamento fisioterapêutico direcionado às disfunções respiratórias.Respiratory dysfunctions occur in great part of patients with Idiopathic Parkinson's Disease (IPD) in advanced stages, leading to a high incidence of morbidity and mortality. The main goal in this study was to present the evolution of a patient with IPD in the IV stage of Hoehn and Yahr scale, in which physical therapy was specifically directed to respiratory disfunctions. The patient has undergone respiratory physiotherapy during five months. He was submitted to pulmonary function tests (spirometry and maximal respiratory pressures assessment) before and after the treatment period. There was improvement of the respiratory function with better values of forced vital capacity, forced expiratory volume in 1 second, expiratory flow peak, maximal inspiratory and expiratory pressures and maximal voluntary ventilation. The patient showed great improvement in respiratory symptoms and function tests after physiotherapy directed to respiratory dysfunctions

Perfil da atividade física na vida diária de homens e mulheres idosos fisicamente independentes

This study compared the profile of daily activities and variables of functional fitness between elderly men and women, as well as the relation of their time spent walking per day with the remaining study variables concerning each gender. Thirty healthy elderly (15 men; 66 ± 6 years), sedentary and physically independent, had their daily activities evaluated objectively by a multi-axial accelerometer as well as their metabolic and functional fitness variables by means of specific protocols. Both men and women presented similar time spent in walking per day, even though men had higher intensity during walking. Women spent longer time standing, and men, sitting. A better performance was achieved by men in most physical tests in regard to absolute values but not in relative values. In conclusion, despite their different patterns of daily activities, elderly men and women do not differ in time spent walking per day.Este estudio comparó el perfil de la actividad de la vida diaria y variables de aptitud funcional entre hombres y mujeres mayores, así como la relación de su tiempo de caminata por día con las demás variables estudiadas en cada género. Treinta mayores saludables (15 hombres, 66±6 años), sedentarios y físicamente independientes, tuvieron sus actividades diarias evaluadas objetivamente por un acelerómetro multi-axial, así como variables de aptitud física y funcional evaluados por protocolos específicos. Todos presentaron tiempo gasto andando por día semejantes, a pesar de que los hombres se muevan con mayor intensidad. Las mujeres permanecieron más tiempo en pie y los hombres más tiempo sentados. Los hombres presentaron mejor desempeño en valores absolutos en la mayoría de los testes físicos, perono en valores relativos. Se concluyó que los hombres y las mujeres mayores no se difieren en tiempo de caminata por día.Este estudo comparou o perfil da atividade da vida diária e variáveis de aptidão funcional entre homens e mulheres idosos, bem como a relação de seu tempo de caminhada por dia com as demais variáveis estudadas em cada gênero. Trinta idosos saudáveis (15 homens, 66 ± 6 anos), sedentários e fisicamente independentes, tiveram suas atividades diárias avaliadas objetivamente por um acelerômetro multi-axial, bem como variáveis de aptidão física e funcional avaliadas por protocolos específicos. Homens e mulheres apresentaram tempo gasto andando por dia semelhantes, apesar dos homens se movimentarem com maior intensidade. As mulheres permaneceram mais tempo em pé e os homens mais tempo sentados. Os homens apresentaram melhor desempenho em valores absolutos na maioria dos testes físicos, mas não em valores relativos. Em conclusão, apesar de seus diferentes padrões de atividades diárias, os homens idosos e mulheres não diferem em tempo de caminhada por dia

Influência do posicionamento de membros superiores sobre os efeitos do treinamento muscular inspiratório de curta duração e alta intensidade em indivíduos jovens sadios

The purpose of the study was to analyse the effects of a short-term, high-intensity inspiratory muscle training (IMT) on healthy youth maximal respiratory pressures, with and without arm bracing postures. Thirty young women were randomly assigned to three groups: control group (CG); group training with no arm bracing (NAB); and group training with arm bracing (AB). The IMT consisted of three 10-minute daily supervised sessions for three consecutive days. Before, at the end, and one month after the end of training, subjects' maximal inspiratory pressures (MIP) and maximal expiratory pressures (MEP) were assessed. In NAB group a significant increase in MIP was found, from -75±10 to -97±14 cmH2O (pO objetivo do estudo foi analisar os efeitos de um treinamento muscular inspiratório (TMI) de curta duração e alta intensidade, com e sem o apoio de membros superiores, sobre as pressões respiratórias máximas em jovens saudáveis. Trinta jovens do sexo feminino foram aleatoriamente distribuídas em três grupos: o grupo controle (GC) fez treinamento placebo na posição sentada; o grupo GSA treinou em pé sem apoio de membros superiores; e o grupo GCA treinou com apoio de membros superiores. O TMI consistiu em três sessões diárias de 10 minutos em três dias consecutivos. Antes, ao final e após um mês do final do treino foram avaliadas a pressão inspiratória máxima (PImáx) e a pressão expiratória máxima (PEmáx). No GSA, houve aumento significante da PImáx após o treino de -75±10 para -97±14 cmH2O (

Efeitos de um programa de exercício físico para idosas sobre variáveis neuro-motoras, antropométrica e medo de cair

The objective of this study was to analyze the effects of a 19-month physical exercise program over lower limb strength (LLS), agility (AGI), body mass index (BMI) and fear of falling (FFALL) of functionally active elderly. Twenty eight elderly (68 ± 7 years) enrolled in a physical exercise program developed by the Northern Paraná University (Londrina-Pr). Classes were held twice a week, each lasting 70 minutes. The variables LLS, AGI, BMI and FFALL were evaluated in three stages (before, 7th and 19th months into the program), respectively by the tests of getting up from the chair in 30 seconds (Rikili & Jones, 1999), sitting and getting up from the chair and moving around the house (Okuma & Andreotti, 2004), anthropometric measurements weight and height (Matsudo, 2004) and an interview. Data were evaluated by descriptive statistics and non-parametric tests with a significance p < 0.05. The results show that during the program, the elderly ladies had significant improvements on the variables LLS and AGI but not on BMI and FFALL, and when separated by BMI levels, the ladies with normal levels presented a better performance than the overweighed ones. It was then concluded that the non decrease of the fear of falling during the program, despite the improvement of LLS and AGI, is due to the objectives of the program which did not aim at the elderly ladies' beliefs towards falls.O objetivo deste estudo foi analisar os efeitos de um programa de 19 meses de exercício físico nas variáveis de força de membros inferiores (FMI), agilidade (AGI), índice de massa corporal (IMC) e medo de cair (MCAIR) de mulheres idosas funcionalmente ativas. Participaram do estudo 28 mulheres (68 ± 7 anos) inseridas em um programa de exercícios físicos desenvolvido pela Universidade Norte do Paraná (Londrina - PR). As aulas foram realizadas duas vezes por semana com 70 minutos de duração cada. As variáveis FMI, AGI, IMC e MCAIR foram avaliadas em três momentos (antes, no 7o. e 19o. meses do programa), respectivamente pelos testes de levantar da cadeira em 30 segundos (Rikili & Jones, 1999), sentar e levantar-se da cadeira e locomover-se pela casa (Okuma & Andreotti, 2004), pelas medidas antropométricas peso e estatura (Matsudo, 2004) e por uma entrevista. Os dados foram analisados pela estatística descritiva e testes não paramétricos com significância p < 0,05. Os resultados mostram que, durante o programa, as idosas tiveram melhoras significativas nas variáveis FMI e AGI, mas não no IMC e MCAIR, e quando separadas por níveis de IMC, as idosas com níveis normais apresentaram melhor desempenho do que as com sobrepeso. Conclui-se que a não diminuição do medo de quedas durante o programa, apesar da melhora nas capacidades de FMI e AGI, deve-se aos objetivos do programa, que não visou modificar as crenças das idosas sobre as quedas

Impact of safety-related dose reductions or discontinuations on sustained virologic response in HCV-infected patients: Results from the GUARD-C Cohort

BACKGROUND: Despite the introduction of direct-acting antiviral agents for chronic hepatitis C virus (HCV) infection, peginterferon alfa/ribavirin remains relevant in many resource-constrained settings. The non-randomized GUARD-C cohort investigated baseline predictors of safety-related dose reductions or discontinuations (sr-RD) and their impact on sustained virologic response (SVR) in patients receiving peginterferon alfa/ribavirin in routine practice. METHODS: A total of 3181 HCV-mono-infected treatment-naive patients were assigned to 24 or 48 weeks of peginterferon alfa/ribavirin by their physician. Patients were categorized by time-to-first sr-RD (Week 4/12). Detailed analyses of the impact of sr-RD on SVR24 (HCV RNA <50 IU/mL) were conducted in 951 Caucasian, noncirrhotic genotype (G)1 patients assigned to peginterferon alfa-2a/ribavirin for 48 weeks. The probability of SVR24 was identified by a baseline scoring system (range: 0-9 points) on which scores of 5 to 9 and <5 represent high and low probability of SVR24, respectively. RESULTS: SVR24 rates were 46.1% (754/1634), 77.1% (279/362), 68.0% (514/756), and 51.3% (203/396), respectively, in G1, 2, 3, and 4 patients. Overall, 16.9% and 21.8% patients experienced 651 sr-RD for peginterferon alfa and ribavirin, respectively. Among Caucasian noncirrhotic G1 patients: female sex, lower body mass index, pre-existing cardiovascular/pulmonary disease, and low hematological indices were prognostic factors of sr-RD; SVR24 was lower in patients with 651 vs. no sr-RD by Week 4 (37.9% vs. 54.4%; P = 0.0046) and Week 12 (41.7% vs. 55.3%; P = 0.0016); sr-RD by Week 4/12 significantly reduced SVR24 in patients with scores <5 but not 655. CONCLUSIONS: In conclusion, sr-RD to peginterferon alfa-2a/ribavirin significantly impacts on SVR24 rates in treatment-naive G1 noncirrhotic Caucasian patients. Baseline characteristics can help select patients with a high probability of SVR24 and a low probability of sr-RD with peginterferon alfa-2a/ribavirin

The GenTree Platform: growth traits and tree-level environmental data in 12 European forest tree species

Background: Progress in the field of evolutionary forest ecology has been hampered by the huge challenge of phenotyping trees across their ranges in their natural environments, and the limitation in high-resolution environmental information. Findings: The GenTree Platform contains phenotypic and environmental data from 4,959 trees from 12 ecologically and economically important European forest tree species: Abies alba Mill. (silver fir), Betula pendula Roth. (silver birch), Fagus sylvatica L. (European beech), Picea abies (L.) H. Karst (Norway spruce), Pinus cembra L. (Swiss stone pine), Pinus halepensis Mill. (Aleppo pine), Pinus nigra Arnold (European black pine), Pinus pinaster Aiton (maritime pine), Pinus sylvestris L. (Scots pine), Populus nigra L. (European black poplar), Taxus baccata L. (English yew), and Quercus petraea (Matt.) Liebl. (sessile oak). Phenotypic (height, diameter at breast height, crown size, bark thickness, biomass, straightness, forking, branch angle, fructification), regeneration, environmental in situ measurements (soil depth, vegetation cover, competition indices), and environmental modeling data extracted by using bilinear interpolation accounting for surrounding conditions of each tree (precipitation, temperature, insolation, drought indices) were obtained from trees in 194 sites covering the species’ geographic ranges and reflecting local environmental gradients. Conclusion: The GenTree Platform is a new resource for investigating ecological and evolutionary processes in forest trees. The coherent phenotyping and environmental characterization across 12 species in their European ranges allow for a wide range of analyses from forest ecologists, conservationists, and macro-ecologists. Also, the data here presented can be linked to the GenTree Dendroecological collection, the GenTree Leaf Trait collection, and the GenTree Genomic collection presented elsewhere, which together build the largest evolutionary forest ecology data collection available

Between but not within species variation in the distribution of fitness effects

New mutations provide the raw material for evolution and adaptation. The distribution of fitness effects (DFE) describes the spectrum of effects of new mutations that can occur along a genome, and is therefore of vital interest in evolutionary biology. Recent work has uncovered striking similarities in the DFE between closely related species, prompting us to ask whether there is variation in the DFE among populations of the same species, or among species with different degrees of divergence, i.e., whether there is variation in the DFE at different levels of evolution. Using exome capture data from six tree species sampled across Europe we characterised the DFE for multiple species, and for each species, multiple populations, and investigated the factors potentially influencing the DFE, such as demography, population divergence and genetic background. We find statistical support for there being variation in the DFE at the species level, even among relatively closely related species. However, we find very little difference at the population level, suggesting that differences in the DFE are primarily driven by deep features of species biology, and that evolutionarily recent events, such as demographic changes and local adaptation, have little impact