Função pulmonar de crianças com leucemia aguda na fase de manutenção da quimioterapia1

ResumoObjetivoO objetivo desse estudo foi avaliar a função pulmonar de crianças com leucemia aguda.MétodosTrata‐se de um estudo observacional do tipo analítico transversal com 34 crianças, divididas nos grupos A (17 crianças com leucemia aguda na fase de manutenção do tratamento quimioterápico) e B (17 crianças saudáveis). Os grupos foram pareados em relação ao sexo, idade e altura. A espirometria foi mensurada utilizando um espirômetro Microloop Viasys®, de acordo com as recomendações da American Thoracic Society e European Respiratory Society. As pressões respiratórias máximas foram mensuradas utilizando um manovacuômetro digital MVD300 (Globalmed®). As pressões inspiratória máxima e expiratória máxima foram mensuradas a partir do volume residual e da capacidade pulmonar total, respectivamente.ResultadosO grupo A apresentou diminuição significativa da pressão inspiratória máxima quando comparado ao grupo B. Não foram observadas diferenças entre os dados espirométricos dos dois grupos avaliados, bem como entre os valores de pressão inspiratória máxima e pressão expiratória máxima do grupo A com os limites inferiores propostos como referência.ConclusãoAs crianças com leucemia aguda, linfoide ou mieloide não apresentam mudança das variáveis espirométricas e da pressão expiratória máxima durante o período de manutenção do tratamento quimioterápico; no entanto, há uma diminuição da pressão inspiratória máxima.AbstractObjectiveThe aim of this study was to assess the pulmonary function of children with acute leukemia.MethodsCross‐sectional observational analytical study that enrolled 34 children divided into groups A (17 with acute leukemia in the maintenance phase of chemotherapy) and B (17 healthy children). The groups were matched for sex, age and height. Spirometry was measured using a spirometer Microloop Viasys® in accordance with American Thoracic Society and European Respiratory Society guidelines. Maximal respiratory pressures were measured with an MVD300 digital manometer (Globalmed®). Maximal inspiratory pressures and maximal expiratory pressures were measured from residual volume and total lung capacity, respectively.ResultsGroup A showed a significant decrease in maximal inspiratory pressures when compared to group B. No significant difference was found between the spirometric values of the two groups, nor was there any difference between maximal inspiratory pressure and maximal expiratory pressure values in group A compared to the lower limit values proposed as reference.ConclusionChildren with acute leukemia, myeloid or lymphoid, during the maintenance phase of chemotherapy exhibited unchanged spirometric variables and maximal expiratory pressure; However, there was a decrease in inspiratory muscle strength

Respiratory muscle strength of Brazilian adolescents: obtained and predicted values

ResumoObjetivos: Comparar os valores encontrados para as pressões respiratórias máximas de uma amostra de adolescentes brasileiros com os valores preditos por Wilson et al e Domènech-Clar et al. Método: Foram avaliados 156 adolescentes (84 meninos) entre 12 e 17 anos. As pressões respiratórias máximas foram avaliadas por meio de um manovacuômetro digital com os adolescentes sentados e utilizando um clipe nasal. As avaliações das pressões inspiratória e expiratória máximas foram realizadas a partir do volume residual e da capacidade pulmonartotal, respectivamente. A comparação dos valores das pressões respiratórias máximas obtidos no atual estudo com os preditos pelas equações propostas por Wilson et al e Domènech-Clar et al, foi realizada pelo teste t de Student pareado. Para verificar a associação entre estes valores, foi utilizado o teste de correlação de Pearson. Resultados: A média da pressão inspiratória máxima foi de 74,66 ± 22,95 cm H2O e de 103,52 ± 25,67 cm H2O para meninas e meninos, respectivamente. A média da pressão expiratória máxima foi de 86,23 ± 25,92 cm H2O e de 120,08 ± 27,37 cm H2O para meninas e meninos, respectivamente. O svalores obtidos não diferiram e também não se correlacionaram significativamente com os preditos através das equações propostas por Wilson et al., e Domènech-Clar et al. Conclusões: As equações propostas por Wilson et al. e Domènech-Clar et al., não foram capazes de predizer os valores das pressões respiratórias máximas na população estudada, indicando a necessidade de se usar na prática clínica valores de referência advindos de uma população saudável de mesma etnia.AbstractObjectives: To compare the obtained values for maximal respiratory pressures of a sample of Brazilian adolescents with the values predicted by Wilson et al. and Domènech-Clar et al. Methods: 156 adolescents (84 boys) aged between 12 and 17 years were assessed. Maximal respiratory pressures were assessed by a digital manometer with the adolescents in the seated position and wearing a nose clip. Maximal inspiratory and expiratory pressures were performed from residual volume and total lung capacity, respectively. Comparison of the values of maximal respiratory pressures obtained in this study with those predicted by the equations proposed by Wilson et al. and Domenèch-Clar et al., was performed by the paired Student’s t test. To verify the association between these values, the pearson’s correlation test was used. Results: Mean maximal inspiratory pressure was 74,66 ± 22,95 cm H2O and 103,52 ± 25,67 cm H2O for girls and boys, respectively. Mean maximal expiratory pressure was 86,23 ± 25,92 cm H2O and 120,08 ± 27,37 cm H2O for girls and boys, respectively. The values obtained by this study did not differ and also did not significantly correlate with those predicted by the equations proposed by Wilson et al., e Domènech-Claret al. Conclusions: The equations proposed by Wilson et al. and Domènech-Clar et al. were not successful in predicting the values for maximal respiratory pressures in the population studied, indicating the necessity of using in clinical practice reference values from a healthy population of the same ethnicity

Dating and context of «De civitatibus Persarum» tractat creation

Статья посвящена малоизученному средневековому трактату «De civitatibus Persarum». Рассматриваются вопросы, связанные с местом и временем его написания, структура, основные идеи и причины, побудившие анонимного автора к составлению трактата. В приложении помещен его перевод на русский язык. The article is devoted to a little known medieval tractate «De civitatibus Persarum». The article highlights a number of issues related to the tractate: the assumed time and place of its writing, the structure, the main ideas of the tractate, and the reasons for writing this work. The translation of the tractate from Latin into Russian can be found in the Annex to the article

Short title: Cardiac Rehabilitation in Brazil

Background: Brazil has insufficient cardiac rehabilitation (CR) capacity, yet density and regional variation in unmet need is unknown. Moreover, South America has CR guidelines, but whether delivery conforms has not been characterized. This study aimed to establish: (1) CR volumes and density, and (2) the nature of programs, and (3) compare these by: (a) Brazilian region and (b) to other upper middle-income countries (upper-MICs). Methods: In this cross-sectional study, a survey was administered to CR programs globally. Cardiac associations were engaged to facilitate program identification. Density was computed using Global Burden of Disease study ischemic heart disease (IHD) incidence estimates. Results were compared to data from the 29 upper-MICs with CR (N=249 programs). Results: CR was available in all 5 regions (only one program in North), with 30/75 programs initiating a survey (40.0% program response rate). There was only one CR spot for every 99 IHD patient. Most programs were funded by government/hospital sources (n=16, 53.3%), but in 11 programs (36.7%) patients depended on private health insurance. Guideline-indicated conditions were accepted in ≥70% of programs. Programs had a team of 3.8±1.9 staff (versus 5.9±2.8 in other upper-MICs, p<0.05), offering 4.0±1.6/10core components (versus 6.0±1.5in other upper-MICs, p<0.01; more tobacco cessation and return-to-work counselling needed in particular) over 44.5 sessions/patient (Q25-75=29-65) vs 32 sessions/patient (Q25-75=15-40) in other upper-MICs (p<0.01). Conclusion: Brazilian CR capacity must be augmented, but where available, services are consistent across regions, but differ from other upper-MICs in terms of staff size and core components delivered

Pressões respiratórias máximas de pico e sustentada na avaliação da força muscular respiratória de crianças

OBJETIVOS: comparar os valores de PImax e PEmax de pico e sustentado em uma população de crianças em idade escolar. MÉTODOS: estudo observacional descritivo de caráter transversal. Foram avaliadas 144 crianças saudáveis de 7 a 11 anos de ambos os gêneros. Foirealizada avaliação antropométrica e mensuraçãodas pressões respiratórias máximas, de pico e sustentada, através do manovacuômetro digital. A criança sorteou qual pressão respiratória iria realizar inicialmente. A medida da PImax foi realizada a partir da capacidade pulmonar total e a medida da PEmax a partir do volume residual. Os dados foram analisados através do programa SPSS 17.0 atribuindose o nível de significância de 5%. RESULTADOS: os achados obtidos foram: 78,53 ± 22,53 cmH2O para PIpico ; 91,11 ± 23,0 cmH2O para a PEpico e 72,95 ± 21,22 cmH2O e 86,25 ± 21,8 cmH2O para PIsust e PEsust, respectivamente. Osvalores obtidos através das pressões respiratórias de pico (PIpico e PEpico) foram significativamente superiores as medidas obtidas para as pressões respiratórias sustentadas (PIsust e PEsust) independentemente do gênero ou idade avaliada (p=0,001). CONCLUSÕES: a utilização de medidas de pico na avaliação das pressões respiratórias máximas, mais facilmente obtidas na prática clínica, pode comprometer a real mensuração da força muscular respiratória em crianças de 7 a 11 anos

Pulmonary function of children with acute leukemia in maintenance phase of chemotherapy

OBJECTIVE: The aim of this study was to assess the pulmonary function of children with acute leukemia.METHODS: Cross-sectional observational analytical study that enrolled 34 children divided into groups A (17 with acute leukemia in the maintenance phase of chemotherapy) and B (17 healthy children). The groups were matched for sex, age and height. Spirometry was measured using a spirometer Microloop Viasys(r) in accordance with American Thoracic Society and European Respiratory Society guidelines. Maximal respiratory pressures were measured with an MVD300 digital manometer (Globalmed(r)). Maximal inspiratory pressures and maximal expiratory pressures were measured from residual volume and total lung capacity, respectively.RESULTS: Group A showed a significant decrease in maximal inspiratory pressures when compared to group B. No significant difference was found between the spirometric values of the two groups, nor was there any difference between maximal inspiratory pressure and maximal expiratory pressure values in group A compared to the lower limit values proposed as reference.CONCLUSION: Children with acute leukemia, myeloid or lymphoid, during the maintenance phase of chemotherapy exhibited unchanged spirometric variables and maximal expiratory pressure; However, there was a decrease in inspiratory muscle strength

Cardiac rehabilitation availability and delivery in Brazil: a comparison to other upper middle-income countries.

Brazil has insufficient cardiac rehabilitation capacity, yet density and regional variation in unmet need is unknown. Moreover, South America has CR guidelines, but whether delivery conforms has not been described. This study aimed to establish: (1) cardiac rehabilitation volumes and density, and (2) the nature of programmes, and (3) compare these by: (a) Brazilian region and (b) to other upper middle-income countries (upper-MICs). In this cross-sectional study, a survey was administered to cardiac rehabilitation programmes globally. Cardiac associations were engaged to facilitate programme identification. Density was computed using Global Burden of Disease study ischaemic heart disease incidence estimates. Results were compared to data from the 29 upper-MICs with cardiac rehabilitation (N=249 programmes). Cardiac rehabilitation was available in all Brazilian regions, with 30/75 programmes initiating a survey (40.0% programme response rate). There was only one cardiac rehabilitation spot for every 99 ischaemic heart disease patient. Most programmes were funded by government/hospital sources (n=16, 53.3%), but in 11 programmes (36.7%) patients depended on private health insurance. Guideline-indicated conditions were accepted in ≥70% of programmes. Programmes had a team of 3.8±1.9 staff (versus 5.9±2.8 in other upper-MICs, p<0.05), offering 4.0±1.6/10 core components (versus 6.0±1.5 in other upper-MICs, p<0.01; more tobacco cessation and return-to-work counselling needed in particular) over 44.5 sessions/patient (Q25-75=29-65) vs. 32 sessions/patient (Q25-75=15-40) in other upper-MICs (p<0.01). Brazilian cardiac rehabilitation capacity must be augmented, but where available, services are consistent across regions, but differ from other upper-MICs in terms of staff size and core components delivered.This project was supported by a research grant from York University's Faculty of Health, Canada; Conselho Nacional de Pesquisa (CNPq# 305786/2014-8), Brazil; Coordenação de Aperfeiçoamento de Pessoal de N&iuml;vel Superior(CAPES - Código de Financiamento 001), Brazil and Fundação de Pesquisa de Minas Gerais (FAPEMIG # PPM00869-15 and 00554-17), Brazi

Validation of a self-administered version of the Mediterranean diet scale (MDS) for cardiac rehabilitation patients in Canada

<p>The Mediterranean dietary pattern has been linked with lower incidence of cardiovascular disease and the Mediterranean diet scale (MDS) has been created to incorporate and test the inherent characteristics of this dietary pattern. This study aimed to psychometrically validate a self-administered version of the MDS in cardiac rehabilitation (CR) patients in Canada. To establish content validity, the scale was reviewed by an expert interdisciplinary panel. A final version of the tool was tested in 150 CR patients. Cronbach’s alpha was 0.69. All ICC coefficients met the minimum recommended standard. Factor analysis revealed four factors, all internally consistent. Criterion validity was supported by significant differences in total scores by duration in CR. Construct validity was supported by agreements between the self-administered MDS and original MDS in all items and with the 3-day food record in 8 of 13 items. In conclusion, the self-administered version of the MDS demonstrated good reliability and validity.</p