Força muscular respiratória de mulheres obesas mórbidas e eutróficas

The morbid obesity is a clinical condition that affects functional capacity, and the respiratory muscles are also impaired. This study aimed to evaluate the inspiratory and expiratory muscle strength of morbidly obese women (OW) and eutrophic women (EW). Cross-sectional study, whose sample was composed by 21 women (14 OW and 7 EW) paired by age and height. Inspiratory and expiratory muscle strength evaluation was carried out by means of maximal inspiratory and expiratory pressure recordings (MIP and MEP, respectively) using manovacuometry. When comparing the maximal static respiratory pressures with predicted values for OW and EW, we observed that EW presented values of MIP=119.14±1.9 cmH2O (152% of predicted value) and MEP=141.1±10.2 cmH2O (98.5% of predicted value) within or above normal limits, while in OW group, MIP=66±18.7 cmH2O (84.3% of predicted value) and MEP=78.4±14.2 cmH2O (54.3% of predicted value) were lower than the predicted values. When comparing maximal static respiratory pressures of OW and EW, we observed a significant difference for MIP (66±18.7 versus 119±1.9 cmH2O) and MEP=78.4±14.2 versus 141.14±10.20) with statistical significance of 0.001. We conclude that respiratory muscle strength is notably decreased in OW when compared to EW.A obesidade mórbida é uma condição clínica que afeta a capacidade funcional, sendo a musculatura respiratória igualmente comprometida. Objetivou-se avaliar a força muscular inspiratória e expiratória de mulheres obesas mórbidas (MO) e eutróficas (ME). Estudo transversal com amostra composta por 21 mulheres (14 MO e 7 ME), pareadas pela idade e altura. A avaliação da força muscular inspiratória e expiratória foi realizada por meio da verificação das pressões inspiratória e expiratória por manovacuometria. Quando comparadas as pressões respiratórias estáticas máximas obtidas com os valores preditos para ME e MO, constata-se que as do primeiro grupo apresentam valores de P Imáx=119,14±1,9 cmH2O (152% do predito) e P Emáx=141,1±10,2 cmH2O (98,5% do predito) dentro dos limites de normalidade ou acima, enquanto no grupo de obesas mórbidas os valores de P Imáx=66±18,7 cmH2O (84,3% do predito) e P Emáx=78,4±14,2 cmH2O (54,3% do predito) foram inferiores aos preditos. Comparando-se as pressões respiratórias estáticas máximas obtidas de MO com ME, observa-se diferença significativa tanto para os valores de P Imáx (66±18,7 versus 119±1,9 cmH2O) como P Emáx (78,4±14,2 versus 141,14±10,20) com significância estatística de 0,001. Conclui-se que a força muscular respiratória é marcadamente diminuída em MO, quando comparadas a ME

Longitudinal evaluation the pulmonary function of the pre and postoperative periods in the coronary artery bypass graft surgery of patients treated with a physiotherapy protocol

<p>Abstract</p> <p>Background</p> <p>The treatment of coronary artery disease (CAD) seeks to reduce or prevent its complications and decrease morbidity and mortality. For certain subgroups of patients, coronary artery bypass graft surgery (CABG) may accomplish these goals. The objective of this study was to assess the pulmonary function in the CABG postoperative period of patients treated with a physiotherapy protocol.</p> <p>Methods</p> <p>Forty-two volunteers with an average age of 63 ± 2 years were included and separated into three groups: healthy volunteers (n = 09), patients with CAD (n = 9) and patients who underwent CABG (n = 20). Patients from the CABG group received preoperative and postoperative evaluations on days 3, 6, 15 and 30. Patients from the CAD group had evaluations on days 1 and 30 of the study, and the healthy volunteers were evaluated on day 1. Pulmonary function was evaluated by measuring forced vital capacity (FVC), maximum expiratory pressure (MEP) and Maximum inspiratory pressure (MIP).</p> <p>Results</p> <p>After CABG, there was a significant decrease in pulmonary function (p < 0.05), which was the worst on postoperative day 3 and returned to the preoperative baseline on postoperative day 30.</p> <p>Conclusion</p> <p>Pulmonary function decreased after CABG. Pulmonary function was the worst on postoperative day 3 and began to improve on postoperative day 15. Pulmonary function returned to the preoperative baseline on postoperative day 30.</p

Currents issues in cardiorespiratory care of patients with post-polio syndrome

ABSTRACT Post-polio syndrome (PPS) is a condition that affects polio survivors years after recovery from an initial acute attack of the poliomyelitis virus. Most often, polio survivors experience a gradual new weakening in muscles that were previously affected by the polio infection. The actual incidence of cardiovascular diseases (CVDs) in individuals suffering from PPS is not known. However, there is a reason to suspect that individuals with PPS might be at increased risk. Method A search for papers was made in the databases Bireme, Scielo and Pubmed with the following keywords: post polio syndrome, cardiorespiratory and rehabilitation in English, French and Spanish languages. Although we targeted only seek current studies on the topic in question, only the relevant (double-blind, randomized-controlled and consensus articles) were considered. Results and Discussion Certain features of PPS such as generalized fatigue, generalized and specific muscle weakness, joint and/or muscle pain may result in physical inactivity deconditioning obesity and dyslipidemia. Respiratory difficulties are common and may result in hypoxemia. Conclusion Only when evaluated and treated promptly, somE patients can obtain the full benefits of the use of respiratory muscles aids as far as quality of life is concerned

Six Minute Walk Test: Functional Evaluation and Prognosis in Heart Failure

The determination of functional capacity is of fundamental importance in monitoring and defining the prognosis of patients with heart failure (HF) may be the six minute walk test (6MWT) is a possibility. The 6MWT was first described by Balke in 1963 [1], since now applied in various clinical conditions, but still without proper standardization. In 2002, the American Thoracic Society (ATS) has established a guideline for performing the 6MWT [2].&nbsp;According to the ATS guidelines the 6MWT is a simple test, practical and inexpensive that aims to evaluate the functional capacity in submaximal intensity across the distance that an individual is able to go as soon as possible on a flat, hard surface in a period of six minutes. The 6MWT evaluates the overall condition and integrated responses of pulmonary, cardiovascular and neuromuscular systems and presents direct correlation with the maximal oxygen uptake (VO2max), which is described in the literature as the gold standard for determining the aerobic capacity [2].</p

[pt] UM JOGO DE OPÇÃO REAL EVOLUCIONÁRIA COM A OPÇÃO DE ADIAR O INVESTIMENTO

O objetivo desta dissertação é demonstrar que mesmo em ambientes em que a decisão do individuo não segue a racionalidade, podemos obter uma estratégia ótima. Com o auxilio do equilíbrio evolucionariamente estável (ESS), conseguimos analisar casos diferentes da literatura usual de teoria dos jogos em que mesmo com escolhas sem racionalidade, encontramos a melhor estratégia, para tal usaremos a metodologia do jogo de opções, união entre a teoria dos jogos e a metodologia de opções reais, juntamente com o conceito de equilíbrio evolucionariamente estável (ESS). Isso é demonstrado através da modelagem de um mercado duopolista assimétrico, sujeito a incertezas. Neste trabalho as firmas são diferentes, existe um duopólio assimétrico. Aqui as empresas são não homogêneas porque uma empresa tem custo operacional mais baixo do que a outra para o mesmo investimento. Isto significa que uma empresa tem vantagem competitiva sobre a rival. Os resultados do modelo mostram que, dependendo do tipo de estratégia assumida pela empresa, é possível que a empresa de baixo custo se torne líder como na literatura usual e em alguns casos encontramos que diferente da expectativa usual é possível que a empresa de alto custo venha a se tornar líder e demonstra que a premissa de racionalidade não é necessária para a escolha inicial da empresa utilizando o conceito de ESS para definir o equilíbrio assim como foi feito no trabalho de Xiao e Yu (2006).The objective of this dissertation is show that even in environments where the decision of the individual not follow rationality, we can get a optimal strategy. with the help of evolutionarily stable strategy, we analyze different cases of the usual literature on game theory that even with choices without rationality, we find the best strategy, for that we will use the option game methodology, which is the union between gaming theory methodology and option game methodology, with the concept of evolutionarily stable strategy (ESS). This is demonstrated through modeling of a duopolistic market, with uncertainties, in this dissertation firms are different. Here companies has no-Homogeneous cost because a company has lower operating costs than the other for the same investment. This means that a company has competitive advantage over rival. The model results show that, depending on the strategy assumed by the company it is possible that the low-cost company to become leader as usual in the literature and in some cases also shows that is possible to the high cost company to become leader and demonstrates that the premise of rationality are not necessary for choosing initial strategy, the company can find equilibrium using the concept of ESS to set the balance as was done in the paper of Xiao and YU (2006)

Psychological damage during the COVID-19 pandemic in Brazil

ISSN: 2526-9720 DOI: http://dx.doi.org/10.33233/eb.v19i3.4256Introdução: Em 11 de março de 2020 a COVID-19 foi caracterizada pela Organização Mundial de Saúde (OMS) como uma pandemia atrelada a diversos transtornos psíquicos, relacionados à impotência, ao medo, ao pânico e, principalmente, à falta de organização política e de liderança. Métodos: A proposta do presente artigo será, com base na literatura vigente, atualizar e produzir discussões provocativas acerca do atual contexto de pandemia. Para tal, foi realizada uma busca nas principais bases de dados Lilacs, Bireme e Pubmed, nos idiomas português e inglês, de artigos compreendidos no ano vigente. A escolha ocorreu de forma aleatória, obviamente, seguindo uma linha de reflexão. As palavras-chave pesquisadas foram: COVID-19, saúde mental, pandemia, SARS-COVID-19, Brasil. Discussão: Além dos males à integridade física, a COVID-19 também traz prejuízos desastrosos à saúde mental da população. O isolamento social é a principal medida estabelecida até o momento para retardar a propagação da COVID-19. Contudo, esse se relaciona à exacerbação de distúrbios psiquiátricos pré-existentes e ao desenvolvimento de novos quadros, sobretudo de depressão, ansiedade e estresse pós-traumático (todos relacionados ao aumento do risco de suicídio), além do aumento dos casos de violência doméstica. Conclusão: O prévio controle e prevenção da COVID-19 comporta-se como fator de proteção ou “alentecimento” contra problemas psicológicos de graus variados. Estudos evidenciaram que investir em educação em saúde a fim de se otimizar o conhecimento da população, no que se refere a COVID-19, auxilia no gerenciamento de comportamentos “otimistas”.SimIntroduction: On March 11, 2020, COVID-19 was characterized by the World Health Organization (WHO) as a pandemic linked to several psychological disorders, related to impotence, fear, panic and mainly the lack of political organization and leadership. Methods: The proposal of this article will be, based on the current literature, update and produce provocative discussions about the current pandemic context. To this end, it was carried out a search in the main databases Lilacs, Bireme and Pubmed in English and Portuguese from articles of the current year. The choice was made at random, obviously, following a line of reflection. The keywords searched were: COVID19, mental health, pandemic, SARS-COVID-19, Brazil. Discussion: Besides the harm to physical integrity, COVID-19 also brings disastrous damage to the mental health of the population. Social isolation is the main measure used to date to delay the spread of COVID-19. However, this is a problem related to the exacerbation of pre-existing psychiatric disorders and the development of new conditions, mainly of depression, anxiety and post-traumatic stress (all related to the increased risk of suicide), in addition to the increase in cases of domestic violence. Conclusion: The previous control and prevention of COVID-19 behaves as a protective factor or “retardation” against psychological problems of varying degrees. Studies have shown that investing in health education in order to optimize the knowledge of the population, about COVID-19, helps in the management of “optimistic” behaviors