Efeito agudo do salbutamol no sistema cardiovascular durante o exercício físico em pacientes com asma moderada ou grave: estudo aleatorizado, duplo-cego e cruzado

Salbutamol é um β2-agonista de curta duração frequentemente utilizado em pacientes com asma para prevenir os sintomas durante ou após exercício físico. Alterações hemodinâmicas em repouso estão bem descritas. Contudo são escassos os dados sobre os efeitos na frequência cardíaca (FC) e pressão arterial (PA) durante o exercício e na fase de recuperação em pacientes com asma moderada ou grave. Foi realizado um estudo aleatorizado, duplo-cego e cruzado, em que foram inclusos 15 indivíduos com asma moderada e grave, com média de idade de 46,4±9,3 anos. Os pacientes realizaram um teste de esforço máximo em dois dias não consecutivos, com administração de 400mcg de salbutamol ou 4 “puffs” de placebo. Durante todo o protocolo foi monitorada a FC, a PA, a percepção de esforço e o pico de fluxo expiratório (PFE). Após o uso do salbutamol, o valor do PFE aumentou em média de 28,0±47,7L/m, permanecendo maior nos tempos de 5, 10 e 15 minutos de recuperação passiva em relação ao placebo (p;0,05). Esses resultados sugerem que o uso de salbutamol é seguro, e que a FC não necessita de ser ajustada para prescrever a intensidade do exercício após a administração de salbutamol em indivíduos com asma moderada ou grave.Salbutamol es un agonista β2 de corta duración frecuentemente utilizado en pacientes con asma para prevenir los síntomas durante o después del ejercicio físico. Los cambios hemodinámicos en descanso están bien descritos. Sin embargo, son escasos los datos sobre los efectos en la frecuencia cardíaca (FC) y la presión arterial (PA) durante el ejercicio y en la fase de recuperación en pacientes con asma moderada o grave. Se realizó un estudio aleatorizado, doble ciego y cruzado, donde fueron incluidos 15 individuos con asma moderada y grave, con una media de edad de 46,4 ± 9,3 años. Los pacientes realizaron una prueba de esfuerzo máximo en 2 días no consecutivos, con administración de 400mcg de salbutamol o 4 «puffs» de placebo. Durante el protocolo se supervisaron la FC, PA, percibe el esfuerzo y el Pico flujo espiratorio (PEF). Después del uso del salbutamol, el valor del PFE aumentó en promedio de 28,0 ± 47,7 L/m, permaneciendo mayor en los tiempos 5, 10 y 15 minutos de recuperación pasiva con relación al placebo (p ; 0,05). Los resultados sugieren que el uso de salbutamol es seguro y que la FC no necesita ser ajustada para prescribir la intensidad del ejercicio después de la administración de salbutamol en individuos con asma moderada o grave.Salbutamol is a β2-agonist of short duration commonly used in patients with asthma to prevent symptoms during or after exercise. Hemodynamic changes at rest are well described. However, there is little data on the effects on heart rate (HR) and blood pressure (BP) during exercise and recovery phase in patients with moderate or severe asthma A randomized, double-blind, cross-over study was conducted, including 15 individuals with moderate and severe asthma, mean age 46.4±9.3 years. Patients underwent a maximal 2-day exercise test with 400 mcg salbutamol or 4 placebo puffs. Throughout the protocol, HR, BP, perceived exertion and peak of expiratory flow (PEF) were monitored. After the use of salbutamol, the PEF value increased by a mean of 28.0±47.7L/m, remaining increased at 5, 10 and 15 minutes of passive recovery compared to placebo (p;0.05). These results suggest that the use of salbutamol is safe and that HR does not need to be adjusted to prescribe exercise intensity following salbutamol administration in subjects with moderate or severe asthma

Acute effect of salbutamol on the cardiovascular system during exercise in patients with moderate or severe asthma: a randomized, double-blind, and cross-over study

<p></p><p>ABSTRACT Salbutamol is a β2-agonist of short duration commonly used in patients with asthma to prevent symptoms during or after exercise. Hemodynamic changes at rest are well described. However, there is little data on the effects on heart rate (HR) and blood pressure (BP) during exercise and recovery phase in patients with moderate or severe asthma A randomized, double-blind, cross-over study was conducted, including 15 individuals with moderate and severe asthma, mean age 46.4±9.3 years. Patients underwent a maximal 2-day exercise test with 400 mcg salbutamol or 4 placebo puffs. Throughout the protocol, HR, BP, perceived exertion and peak of expiratory flow (PEF) were monitored. After the use of salbutamol, the PEF value increased by a mean of 28.0±47.7L/m, remaining increased at 5, 10 and 15 minutes of passive recovery compared to placebo (p<0.05). The HR, BP and effort perception variables were similar across interventions at all stages of the protocol (p>0.05). These results suggest that the use of salbutamol is safe and that HR does not need to be adjusted to prescribe exercise intensity following salbutamol administration in subjects with moderate or severe asthma.</p><p></p

Effect of salbutamol on the cardiovascular response in healthy subjects at rest, during physical exercise, and in recovery phase: a randomized, double-blind, crossover study

<div><p>ABSTRACT Aim To evaluate the effect of the short-acting beta agonists (SABAs) salbutamol on cardiovascular response rest, exercise and recovery phase. Methods This study was conducted as a randomized, double-blind, placebo controlled, crossover study in 15 healthy adults, with a mean age of 30.2±6.6 years. Participants underwent a maximal effort test on two non-consecutive days with 400 mcg of salbutamol or placebo. Throughout the protocol, the variables HR, blood pressure (BP), perceived rate of effort (modified Borg scale) and peak expiratory flow (PEF) were monitored. Results After salbutamol, baseline HR and PEF had increase from 71±8 to 80±11 bpm (p<0.05) and 454.0±64.5 to 475.3±71.4 L/min (p < 0.05), respectively. The variables HR, BP and Borg were similar between interventions during all the protocol phases (p>0.05). Conclusion Administration of salbutamol increased rest heart rate; however, did not change heart rate, blood pressure and perceived exertion during exercise or recovery. This suggests that the salbutamol administration is safe and does not affect exercise intensity prescription in healthy subjects.</p></div

Risco e futuro da democracia brasileira : direito e política no Brasil contemporâneo

Nestes anos nos quais a democracia brasileira está lidando pela primeira vez e frontalmente com os fenômenos da corrupção instalada no sistema político em sua relação com os grandes grupos econômicos, a sua legitimidade, o equilíbrio constitucional e o devido processo legal estão sendo testados em seus limites. Este livro toma partido claramente do caminho democrático e republicano no combate à corrupção, que puna com rigor preservando os direitos legítimos dos processados e condenados, que garanta a publicidade democrática ao invés do uso manipulado e seletivo de informações, que garanta a imparcialidade e o universalismo dos atos, em detrimento de seus usos partidários ou instrumentais, que, enfim, combata a corrupção através do aprofundamento da consciência republicana e dos métodos de controle democrático, do aperfeiçoamento institucional, dos procedimentos e leis, da superação da impunidade

Brazilian Flora 2020: Leveraging the power of a collaborative scientific network

International audienceThe shortage of reliable primary taxonomic data limits the description of biological taxa and the understanding of biodiversity patterns and processes, complicating biogeographical, ecological, and evolutionary studies. This deficit creates a significant taxonomic impediment to biodiversity research and conservation planning. The taxonomic impediment and the biodiversity crisis are widely recognized, highlighting the urgent need for reliable taxonomic data. Over the past decade, numerous countries worldwide have devoted considerable effort to Target 1 of the Global Strategy for Plant Conservation (GSPC), which called for the preparation of a working list of all known plant species by 2010 and an online world Flora by 2020. Brazil is a megadiverse country, home to more of the world's known plant species than any other country. Despite that, Flora Brasiliensis, concluded in 1906, was the last comprehensive treatment of the Brazilian flora. The lack of accurate estimates of the number of species of algae, fungi, and plants occurring in Brazil contributes to the prevailing taxonomic impediment and delays progress towards the GSPC targets. Over the past 12 years, a legion of taxonomists motivated to meet Target 1 of the GSPC, worked together to gather and integrate knowledge on the algal, plant, and fungal diversity of Brazil. Overall, a team of about 980 taxonomists joined efforts in a highly collaborative project that used cybertaxonomy to prepare an updated Flora of Brazil, showing the power of scientific collaboration to reach ambitious goals. This paper presents an overview of the Brazilian Flora 2020 and provides taxonomic and spatial updates on the algae, fungi, and plants found in one of the world's most biodiverse countries. We further identify collection gaps and summarize future goals that extend beyond 2020. Our results show that Brazil is home to 46,975 native species of algae, fungi, and plants, of which 19,669 are endemic to the country. The data compiled to date suggests that the Atlantic Rainforest might be the most diverse Brazilian domain for all plant groups except gymnosperms, which are most diverse in the Amazon. However, scientific knowledge of Brazilian diversity is still unequally distributed, with the Atlantic Rainforest and the Cerrado being the most intensively sampled and studied biomes in the country. In times of “scientific reductionism”, with botanical and mycological sciences suffering pervasive depreciation in recent decades, the first online Flora of Brazil 2020 significantly enhanced the quality and quantity of taxonomic data available for algae, fungi, and plants from Brazil. This project also made all the information freely available online, providing a firm foundation for future research and for the management, conservation, and sustainable use of the Brazilian funga and flora