Effects of an aerobic physical training program on psychosocial characteristics, quality-of-life, symptoms and exhaled nitric oxide in individuals with moderate or severe persistent asthma

OBJETIVO: Avaliar o papel de um programa de condicionamento físico aeróbio nos aspectos psicossociais, qualidade de vida, sintomas e óxido nítrico exalado (NOe) de adultos com asma persistente moderada ou grave. MATERIAIS E MÉTODOS: Vinte pacientes foram divididos aleatoriamente em Grupo Controle (GC, n= 10; programa de educação e exercícios respiratórios) e Grupo Treinado (GT, n= 10; programa de educação e exercícios respiratórios mais condicionamento aeróbio, 70% potência máxima obtida). A intervenção aconteceu duas vezes por semana durante três meses. Antes e após, foram avaliados a capacidade aeróbia máxima, a função pulmonar, a dispnéia ao esforço, os níveis de ansiedade e depressão e a qualidade de vida. Mensalmente, eram avaliados o NOe em repouso e o número de dias livres de sintomas. RESULTADOS: Apenas o GT apresentou redução dos sintomas (GT 24,8 [IC95%= 23-27] versus GC 15,7 [IC95%= 9-21] dias livres de sintomas, p< 0,05), dos níveis de NOe (GT 25,8 [IC95%= 15,3-44] versus GC 44,3 [IC95%= 24-60] ppb, p< 0,05), da ansiedade (GT 39,3 [IC95%= 37-50] versus GC 40,9 [IC95%= 37-50] escore, p< 0,001) e da depressão (GT 6,6 [IC95%= 1-21] versus GC 9 [IC95%= 1-20] escore, p< 0,001), melhora da qualidade de vida (GT 42,8 [IC95%= 34,3-71,7] versus GC 69,7 [IC95%= 45,1-87,9] %, p< 0,001), e incremento da aptidão aeróbia (GT 25,7 [IC95%= 16,2-31,3] versus GC 20,5 [IC95%= 17,3-24,1] mL/kg/min, p< 0,001). CONCLUSÕES: Os resultados sugerem que o treinamento físico reduz o NOe, os sintomas e melhora a qualidade de vida e os aspectos psicossociais de adultos com asma persistente moderada ou grave.OBJECTIVE: To evaluate the role of an aerobic physical training program on psychosocial characteristics, quality of life, symptoms and exhaled nitric oxide of adults with moderate or severe persistent asthma. METHODS: Twenty patients were randomly assigned to a Control Group (CG, n= 10, education program and respiratory exercises) and a Trained Group (TG, n= 10, education program and respiratory exercises plus aerobic training at 70% of the maximum power obtained). The intervention took place twice a week for three months. Maximum aerobic capacity, pulmonary function, effort dyspnea, anxiety levels, depression levels and quality of life were assessed before and after the treatment. Exhaled nitric oxide at rest and the number of days without asthma symptoms were evaluated every month. RESULTS: The TG presented increased numbers of symptom-free days (TG 24.8 days [95%CI= 23-27] versus CG 15.7 days [95%CI= 9-21]; p< 0.05), decreased exhaled nitric oxide levels (TG 25.8 ppb [95%CI= 15.3-44.0] versus CG 44.3 ppb [95%CI= 24-60]; p< 0.05), decreased anxiety scores (TG 39.3 [95%CI= 37-50] versus CG 40.9 [95%CI= 37-50]; p< 0.001), decreased depression scores (TG 6.6 [95%CI= 1-21] versus CG 9 [95%CI= 1-20]; p< 0.001), improved quality of life (TG 42.8% [95%CI= 34.3-71.7] versus CG 69.6% [95%CI= 45.1-87.9]; p< 0.001) and improved aerobic aptitude (TG 25.7 mL/kg/min [95%CI= 6.2-31.3] versus CG 20.5 mL/kg/min [95%CI= 17.3-24.1]; p< 0.001). CONCLUSIONS: Our results suggest that physical training reduces exhaled nitric oxide and symptoms and improves the quality of life and psychosocial characteristics of adults with moderate or severe persistent asthma.Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)Conselho Nacional de Pesquisa (CNPq

Antiophidian properties of plant extracts against Lachesis muta venom

Snakebites comprise a serious health problem in several countries due to their global incidence, which exceeds 2.5 million per year, and the elevated number of victim fatalities. To counteract envenomations, antivenoms have been used regularly for more than a century. Apart from side effects including anaphylactic reactions, antivenoms are not able to efficiently neutralize local tissue damage, which contributes to increasing the severity and morbidity observed in patients. This fact, in turn, may be responsible for economic hardship, particularly in rural populations of developing countries. In the present work, we evaluated the antiophidian properties of 12 Brazilian plant extracts against the hemolytic, coagulant, hemorrhagic and proteolytic effects of Lachesis muta venom. Taken together, our data revealed that most of these aqueous products were capable of inhibiting those activities at different levels, except for Sapindus saponaria extract. In contrast, Stryphnodendron barbatiman extract completely neutralized all the analyzed biological activities. Thus, we may conclude that Brazilian flora may also be useful against L. muta accidents.(FAPERJ) Fundacao de Amparo a Pesquisa do Estado do Rio de JaneiroFAPESPCNPqCoordenacao de Aperfeicoamento de Pessoal de Nivel Superior (CAPES)International Foundation for Science (IFS, Sweden

Determinants of health care utilisation: The case of Timor-Leste

© The Author(s) 2018. Background: Health financing and delivery reforms designed to achieve universal health coverage (UHC) need to be informed by an understanding of factors that both promote access to health care and undermine it. This study examines the level of health care utilisation in Timor-Leste and the factors that drive it. Methods: Data from a nationally representative cross-sectional survey of health care utilisation in 1712 households were used to develop multilevel models exploring how need and predisposing and enabling factors explain health care utilisation at both primary and secondary care facilities. Results: Need was found to be the key driver in seeking both primary care and hospital services. Rural households were less likely to go to hospital (odds ratio 0.7) than urban households. The poorest quintile was also less likely to use more expensive hospital services than other socio-economic groups. Conclusions: Understanding the determinants of seeking health care in Timor-Leste is of considerable policy significance, because health care is free at the point of use. Our findings indicate that the public resources for health care are subsidising the rich more than the poor. Health care reforms in Timor-Leste need to reduce the 'other' costs of health care, such as distance barriers, to address these inequities

Patchiness in habitat distribution can enhance biological diversity of coastal engineering structures

© 2018 John Wiley & Sons, Ltd. Urbanization of coastal habitats is increasing worldwide. However, most man-made structures are poor surrogates for the habitats they replace and can strongly impact the diversity and functioning of coastal habitats. The value of coastal engineering can be enhanced by the provision of microhabitats that facilitate colonization by marine life. One step forward is moved in this research by combining species coexistence theory, resource patchiness and applied ecology in order to find ways that maximize the biological diversity of coastal defence structures. Featureless areas of a seawall were modified by the addition of microhabitats (resource) that were distributed in different configurations of patchiness. Gastropod diversity peaked at intermediate levels of microhabitat patchiness. This appeared to be driven by different patterns of resource use among species. Gastropods dispersed longer distances on unmodified seawalls than on natural rocky shores, but when microhabitats were added the dispersal decreased. The ability to find microhabitats differed among species. Our results confirm that patchiness in microhabitat distribution affects biodiversity. The extent of microhabitat patchiness could potentially be tailored by coastal engineers to meet specific conservation priorities: increasing diversity versus increasing number of individuals

Analysis of the variability of nursing care by pathology in a sample of nine Belgian hospitals

info:eu-repo/semantics/published27th Patient Classification Systems International (PCSI) Working Conference, Montreal, Canada, October 201