2 nd Brazilian Consensus on Chagas Disease, 2015

Abstract Chagas disease is a neglected chronic condition with a high burden of morbidity and mortality. It has considerable psychological, social, and economic impacts. The disease represents a significant public health issue in Brazil, with different regional patterns. This document presents the evidence that resulted in the Brazilian Consensus on Chagas Disease. The objective was to review and standardize strategies for diagnosis, treatment, prevention, and control of Chagas disease in the country, based on the available scientific evidence. The consensus is based on the articulation and strategic contribution of renowned Brazilian experts with knowledge and experience on various aspects of the disease. It is the result of a close collaboration between the Brazilian Society of Tropical Medicine and the Ministry of Health. It is hoped that this document will strengthen the development of integrated actions against Chagas disease in the country, focusing on epidemiology, management, comprehensive care (including families and communities), communication, information, education, and research

Análise da função respiratória na doença de Parkinson Analysis of breathing function in Parkinson's disease

Avaliou-se a função respiratória de 40 parkinsonianos (P), entre 50 e 80 anos, nos estágio I a III da Escala de Hoehn e Yahr e de 40 não parkinsonianos (NP), com características semelhantes. A amplitude torácica de 1,8±0,8 cm nos P foi menor que 4,3±1,0 cm nos NP (p=0,00001), assim como os percentuais das capacidades vital e vital forçada de 66,8±20,3% e 69,6±22,2% nos P e de 82,3±15,7% e 82,7±16,6% nos NP (p=0,00001 e p=0,0023). Apresentaram-se equivalentes as pressões inspiratória e expiratória máximas, de 33,5±12,7 cmH2O e 36, 3±17,8 cmH2O nos P e de 37,0±12,2 cmH2O e 43,1±16,6 cmH2O nos NP (p=0,1753 e 0,0398), o volume do 1º segundo da curva expiratória forçada de 71,3±25,6% nos P e 80,6±23,6% nos NP (p=0,0899) e o percentual da capacidade vital forçada expirada em um segundo, de 104,5±19,9% nos P e 97,4±22,8% nos NP (p=0,1234). Os parkinsonianos evidenciaram restrição respiratória e diminuição de amplitude torácica, sem alteração da força muscular respiratória.<br>We studied 40 parkinsonian patients (P), mean age 50-80 years, with Hoehn and Yahr stages I-III and 40 no parkinsonian patients (NP), with similar characteristics. The results of the thoracic amplitude was 1,8±0,8cm of P that showed a reduction to 4,3±1,0 cm of NP (p=0,00001), the vital capacity and forced vital capacity, 66,8±20,3% and 69,6±22,2% of P was decreased that 82,3±15,7% and 82,7±16,6% of NP (p=0,00001 and p=0,0023). There was not difference among the maximal inspiratory and expiratory mouth pressures, 33,5±12,7 cmH2O and 36,3±17,8 cmH2O of P and 37,0±12,2 cmH2O and 43,1±16,6 cmH2O of NP (p=0,1753 and p=0,0398), the forced expiratory volume in 1 second, 71,3±25,6% of P and 80,6±23,6% of NP (p=0,0899), and the forced expiratory volume in 1 second/ forced vital capacity, 104,5±19,9% of P and 97,4±22,8% of NP (p=0,1234). The parkinsonian patients present restrictive pulmonary dysfunction, low chest wall compliance and the respiratory muscle strenght do not decreased