Impacto do tipo de parto sobre a mobilidade Toracoabdominal de recém-nascidos

Introduction: In newborns delivered by cesarean section, there is less chest compression and little amount of fluid is drained by gravity, which temporarily reduces thoracoabdominal mobility. Objetive: The objective of this study is to evaluate the impact of the type of delivery on newborns Thoracoabdominal Mobility. Methods: This is a cross-sectional study with newborns of gestational age between 37 and 41 weeks, of both sexes, with up to 72 hours of life, breathing in ambient air and born by normal delivery or cesarean section. The Thoracoabdominal Mobility was evaluated by videogrammetry using MATLAB Software and considered, in metric units (cm2), as the difference between the highest and lowest thoracoabdominal expansibility for each respiratory cycle. Results: Twenty-six infants were included, 11 were male and 50% were born by cesarean section. The mean gestational age was 39 ± 0,9 and 28 ± 18 hours of life. The mobility, difference between greater and lesser expansion, of the thoracic area in vaginal and cesarean delivery was 6 ± 3 cm2 and 7 ± 5 cm2 and the abdominal area was 29 ± 22 cm2 and 21 ± 14 cm2, respectively. This difference was not statistically significant between the two types of delivery for the thoracic area, but was statistically different for the abdominal area (p= 0.01). And the higher the respiratory rate, the lower the abdominal mobility (r= -0.57, p= 0.02). Conclusion: The data indicate that the type of delivery seems to influence abdominal mobility and respiratory rate. In the studied sample, newborns with cesarean section presented lower abdominal mobility.Introdução: Nos recém-nascidos de parto cesáreo, ocorre menor compressão torácica e pouca quantidade de líquido é drenada por ação da gravidade, o que diminui, transitoriamente, a mobilidade toracoabdominal. Objetivo: O objetivo do estudo é avaliar o impacto do tipo de parto na mobilidade torácica e abdominal em recém-nascidos. Método: Trata-se de um estudo transversal com recém-nascidos de idade gestacional entre 37 a 41 semanas, de ambos os sexos, com até 72 horas de vida, respirando em ar ambiente e nascidos de parto normal ou parto cesáreo. A mobilidade torácica e abdominal foram avaliadas pela videogrametria por meio do Software MATLAB e considerada, em unidades métricas (cm2), como a diferença da maior e menor expansibilidade toracoabdominal para cada ciclo respiratório.Resultados: Foram inclusos 26 recém-nascidos 11 do sexo masculino e 50% nascidos de parto cesáreo. A idade gestacional média foi de 39 ± 0,9 sem e tinham 28 ± 18 horas de vida. A mobilidade, diferença entre a maior e menor expansibilidade, da área torácica no parto vaginal e cesáreo foi 6 ± 3 cm2 e 7 ± 5 cm2 e da área abdominal foi de 29±22 cm2 e 21± 14 cm2, respectivamente. Esta diferença não foi estatisticamente significante entre os dois tipos de parto para a área torácica, mas mostrou-se diferente estatisticamente para a área abdominal (p = 0,01). E para os recém-nascidos de parto cesáreo, quanto maior a frequência respiratória, menor a mobilidade abdominal (r= -0,57; p = 0,02). Conclusão: Os dados indicam que o tipo de parto parece influenciar a mobilidade abdominal e a frequência respiratória. Na amostra estudada os recém-nascidos de parto cesáreo apresentaram menor mobilidade abdominal

Thoracoabdominal mobility evaluation by photogrammetry in newborns after expiratory flow increase technique

Abstract Introduction: Expiratory flow increase is a maneuver of respiratory physical therapy that promotes flow direction to the upper airways however, when applied in newborns, it may result in changes of thoracoabdominal mobility. Objective: To evaluate the thoracoabdominal mobility by photogrammetry in newborns after expiratory flow increase technique. Methods: Experimental blind study performed with newborns in supine position on a support table with upper limbs flexed, abducted and externally rotated and hip flexed at 110°. Adhesive markers were allocated for geometric delimitation of the thoracoabdominal compartment and expiratory flow increase technique was performed for 5 minutes with the therapist’s hands on the thorax and abdomen. Newborns were filmed before and after the maneuver and the frames were analyzed in AutoCAD® software by a blinded investigator at the time of the procedure. The largest and the smallest thoracoabdominal area were expressed in cm2 and the mean values were compared between two moments (pre and post maneuver) by paired t test. Results: Twenty newborns with a mean age of 39 weeks were included. Before the maneuver, thoracoabdominal area was 56.1 cm2 during expiration and 59.7 cm2 during inspiration, and after the maneuver the value was 56.2 cm2 during expiration and 59.8 cm2 during inspiration, with no statistical difference between before and after (p = 0.97, p = 0.92, respectively). Conclusion: Results demonstrate that expiratory flow increase technique does not seem to change thoracoabdominal mobility of healthy newborns

Thoracoabdominal mobility evaluation by photogrammetry in newborns after expiratory flow increase technique

<div><p>Abstract Introduction: Expiratory flow increase is a maneuver of respiratory physical therapy that promotes flow direction to the upper airways however, when applied in newborns, it may result in changes of thoracoabdominal mobility. Objective: To evaluate the thoracoabdominal mobility by photogrammetry in newborns after expiratory flow increase technique. Methods: Experimental blind study performed with newborns in supine position on a support table with upper limbs flexed, abducted and externally rotated and hip flexed at 110°. Adhesive markers were allocated for geometric delimitation of the thoracoabdominal compartment and expiratory flow increase technique was performed for 5 minutes with the therapist’s hands on the thorax and abdomen. Newborns were filmed before and after the maneuver and the frames were analyzed in AutoCAD® software by a blinded investigator at the time of the procedure. The largest and the smallest thoracoabdominal area were expressed in cm2 and the mean values were compared between two moments (pre and post maneuver) by paired t test. Results: Twenty newborns with a mean age of 39 weeks were included. Before the maneuver, thoracoabdominal area was 56.1 cm2 during expiration and 59.7 cm2 during inspiration, and after the maneuver the value was 56.2 cm2 during expiration and 59.8 cm2 during inspiration, with no statistical difference between before and after (p = 0.97, p = 0.92, respectively). Conclusion: Results demonstrate that expiratory flow increase technique does not seem to change thoracoabdominal mobility of healthy newborns.</p></div

Effects of a self-care educational program via telerehabilitation on quality of life and caregiver burden in amyotrophic lateral sclerosis: a single-blinded randomized clinical trial protocol

IntroductionThe implementation of a telerehabilitation protocol for self-care in the routine of caregivers of individuals with amyotrophic lateral sclerosis (ALS) has been associated with reduced levels of stress and improved quality of life. Moreover, it may reduce the difficulty of traveling to perform physical or other self-care activities. Thus, this study designed a clinical trial protocol to investigate the effects of a self-care education program via telerehabilitation on the burden and quality of life of caregivers of individuals with ALS.MethodsThis single-blinded randomized clinical trial will recruit 26 caregivers and randomly allocate them to the experimental (EG = 13) or control group (CG = 13). The EG will receive an informative booklet and participate in a 6-week synchronous telerehabilitation program with a neuropsychologist, nutritionist, and physiotherapist to discuss physical and mental health. The CG will receive an informative booklet on self-care and physical activity and weekly phone calls for 6 weeks to solve questions about the booklet. Outcomes will include the caregiver burden (Zarit scale), quality of life (World Health Organization Quality of Life BREF), pain (McGill Pain Questionnaire), stress (Perceived Stress Scale), and depression (Beck Depression Inventory), which will be evaluated at the baseline after the six-week program and 30 days after the program. Additionally, we will assess daily the nocturnal awakenings, sleep patterns, level of physical activity, and heart rate variability.DiscussionThis study aimed to investigate the effectiveness of telerehabilitation for caregivers of individuals with ALS. If effective, this program could be disseminated among health professionals, increasing the possibility of remotely monitoring individuals with difficulty performing physical activities.Trial registration numberNCT05884034 (clinicaltrials.gov)

Data_Sheet_2_Effects of a self-care educational program via telerehabilitation on quality of life and caregiver burden in amyotrophic lateral sclerosis: a single-blinded randomized clinical trial protocol.pdf

IntroductionThe implementation of a telerehabilitation protocol for self-care in the routine of caregivers of individuals with amyotrophic lateral sclerosis (ALS) has been associated with reduced levels of stress and improved quality of life. Moreover, it may reduce the difficulty of traveling to perform physical or other self-care activities. Thus, this study designed a clinical trial protocol to investigate the effects of a self-care education program via telerehabilitation on the burden and quality of life of caregivers of individuals with ALS.MethodsThis single-blinded randomized clinical trial will recruit 26 caregivers and randomly allocate them to the experimental (EG = 13) or control group (CG = 13). The EG will receive an informative booklet and participate in a 6-week synchronous telerehabilitation program with a neuropsychologist, nutritionist, and physiotherapist to discuss physical and mental health. The CG will receive an informative booklet on self-care and physical activity and weekly phone calls for 6 weeks to solve questions about the booklet. Outcomes will include the caregiver burden (Zarit scale), quality of life (World Health Organization Quality of Life BREF), pain (McGill Pain Questionnaire), stress (Perceived Stress Scale), and depression (Beck Depression Inventory), which will be evaluated at the baseline after the six-week program and 30 days after the program. Additionally, we will assess daily the nocturnal awakenings, sleep patterns, level of physical activity, and heart rate variability.DiscussionThis study aimed to investigate the effectiveness of telerehabilitation for caregivers of individuals with ALS. If effective, this program could be disseminated among health professionals, increasing the possibility of remotely monitoring individuals with difficulty performing physical activities.Trial registration numberNCT05884034 (clinicaltrials.gov).</p

Data_Sheet_1_Effects of a self-care educational program via telerehabilitation on quality of life and caregiver burden in amyotrophic lateral sclerosis: a single-blinded randomized clinical trial protocol.PDF

IntroductionThe implementation of a telerehabilitation protocol for self-care in the routine of caregivers of individuals with amyotrophic lateral sclerosis (ALS) has been associated with reduced levels of stress and improved quality of life. Moreover, it may reduce the difficulty of traveling to perform physical or other self-care activities. Thus, this study designed a clinical trial protocol to investigate the effects of a self-care education program via telerehabilitation on the burden and quality of life of caregivers of individuals with ALS.MethodsThis single-blinded randomized clinical trial will recruit 26 caregivers and randomly allocate them to the experimental (EG = 13) or control group (CG = 13). The EG will receive an informative booklet and participate in a 6-week synchronous telerehabilitation program with a neuropsychologist, nutritionist, and physiotherapist to discuss physical and mental health. The CG will receive an informative booklet on self-care and physical activity and weekly phone calls for 6 weeks to solve questions about the booklet. Outcomes will include the caregiver burden (Zarit scale), quality of life (World Health Organization Quality of Life BREF), pain (McGill Pain Questionnaire), stress (Perceived Stress Scale), and depression (Beck Depression Inventory), which will be evaluated at the baseline after the six-week program and 30 days after the program. Additionally, we will assess daily the nocturnal awakenings, sleep patterns, level of physical activity, and heart rate variability.DiscussionThis study aimed to investigate the effectiveness of telerehabilitation for caregivers of individuals with ALS. If effective, this program could be disseminated among health professionals, increasing the possibility of remotely monitoring individuals with difficulty performing physical activities.Trial registration numberNCT05884034 (clinicaltrials.gov).</p

The in vivo and in vitro roles of Trypanosoma cruzi Rad51 in the repair of DNA double strand breaks and oxidative lesions.

In Trypanosoma cruzi, the etiologic agent of Chagas disease, Rad51 (TcRad51) is a central enzyme for homologous recombination. Here we describe the different roles of TcRad51 in DNA repair. Epimastigotes of T. cruzi overexpressing TcRAD51 presented abundant TcRad51-labeled foci before gamma irradiation treatment, and a faster growth recovery when compared to single-knockout epimastigotes for RAD51. Overexpression of RAD51 also promoted increased resistance against hydrogen peroxide treatment, while the single-knockout epimastigotes for RAD51 exhibited increased sensitivity to this oxidant agent, which indicates a role for this gene in the repair of DNA oxidative lesions. In contrast, TcRad51 was not involved in the repair of crosslink lesions promoted by UV light and cisplatin treatment. Also, RAD51 single-knockout epimastigotes showed a similar growth rate to that exhibited by wild-type ones after treatment with hydroxyurea, but an increased sensitivity to methyl methane sulfonate. Besides its role in epimastigotes, TcRad51 is also important during mammalian infection, as shown by increased detection of T. cruzi cells overexpressing RAD51, and decreased detection of single-knockout cells for RAD51, in both fibroblasts and macrophages infected with amastigotes. Besides that, RAD51-overexpressing parasites infecting mice also presented increased infectivity and higher resistance against benznidazole. We thus show that TcRad51 is involved in the repair of DNA double strands breaks and oxidative lesions in two different T. cruzi developmental stages, possibly playing an important role in the infectivity of this parasite