Heart Rate Variability Analysis in Revascularized Individuals Submitted to an Anaerobic Potency Test

The objective of this study was to analyze the behavior of autonomic modulation before, during and after the Modified Wingate Test (WanMT), through the analysis of Heart Rate Variability (HRV). Six volunteers between the ages of 40 and 70, post-revascularization procedures (angioplasty and/or surgery, mean duration 10 months), were submitted to supervised training for at least 10 to 14 months. The following protocol, divided into 5 phases, was used: 1) Rest Phase (RP): 180 seconds; 2) Submaximum Phase (SP): 30 seconds; 3) Maximum Phase (MP): 30 seconds; 4) Active Recuperation Phase (ARP); 120 seconds and; 5) Passive Recuperation Phase (PRP): 180 seconds. For the WanMT Test, we selected the load of 3.75% of corporal weight for all volunteers. To analyze the HRV, we used the following parameters: the interval RRr, MNN, SDNN, RMSSD and PNN50. We only observed results for the group according to RMSSD parameters during the rest phase of the test protocol in which the group remained in vagal presence and during all other phases in vagal depression. However, when we analyzed the PNN50, we observed that the group was in medium vagal presence during all of the phases of the test though there was no statistically significant difference (p> 0.05) between the phases. Therefore, we can say that all of the individuals had a similar profile in the autonomic response to the WanMT, confirmed by the parameters studied in the analysis of the HRV in the time domain

A IMPORTÂNCIA DA IMPLEMENTAÇÃO DOS CUIDADOS PALIATIVOS NA UNIDADE DE TERAPIA INTENSIVA

To discuss the importance of implementing palliative care in the intensive care unit through the existing literature. Methods: This is a qualitative integrative literature review. The search for the works involved in the research was carried out in the following databases: SCIELO, LILACS, BDENF and MEDLINE, using the health sciences descriptors: "Hospice care", "Palliative care" and "Intensive care unit". The inclusion criteria were: published between 2013 and 2023, with free access to full texts, articles in Portuguese, English and Spanish and related to the theme. Exclusion criteria were: duplicate articles, incomplete articles, abstracts, reviews, debates, articles published in event proceedings and unavailable in full. Results: This care has some principles that guarantee its effectiveness when implemented in the ICU, such as promoting individual and continuous care for patients, involving family members in this process, respecting the autonomy of the patient, establishing an environment conducive to the necessary care, among others. Conclusion: The study in question concludes that the implementation of palliative care in the ICU, despite having numerous barriers, promotes a less painful dying process when applied correctly by health professionals, among these aspects, the participation of the family in this process is emphasized.Discutir por meio da literatura existente acerca da importância da implementação dos cuidados paliativos na unidade de terapia intensiva. Métodos: Trata-se de uma revisão integrativa da literatura de caráter qualitativo. A busca dos trabalhos envolvidos na pesquisa foi realizada nas seguintes bases de dados: SCIELO, LILACS, BDENF e MEDLINE, a partir dos descritores em ciências da saúde: “Assistência hospitalar”, “Cuidados paliativos” e “Unidade de terapia intensiva”. Os critérios de inclusão foram: publicados no período entre 2013 e 2023, cujo acesso ao periódico era livre aos textos completos, artigos em idioma português, inglês e espanhol e relacionados a temática. Critérios de exclusão foram: artigos duplicados, incompletos, resumos, resenhas, debates, artigos publicados em anais de eventos e indisponíveis na íntegra. Resultados: Esses cuidados possuem alguns princípios que garantem a sua efetividade na implementação na UTI como promover o cuidado individual e continuo aos pacientes, envolver os familiares nesse processo, respeitar a autonomia do enfermo, estabelecer um ambiente propício aos cuidados necessários dentre outros. Conclusão: O estudo em questão conclui que a implementação dos cuidados paliativos na UTI apesar de possui inúmeras barreiras ele promover um processo de morrer menos doloroso quando aplicado corretamente por meio dos profissionais de saúde, dentre esses aspectos enfatiza-se a participação da família nesse processo

APPROACH AND TREATMENT OF NON-MELANOMA SKIN CANCER DURING PREGNANCY

Pregnancy presents unique challenges in diagnosing and treating non-melanoma skin cancer, the most common type of skin cancer. Hormonal and immunological changes during pregnancy can influence the development and progression of the disease, while ethical issues and concerns about fetal safety complicate the therapeutic approach. Therefore, it is crucial to understand how this condition is managed during pregnancy to ensure the best outcome for mother and baby. Objective: The objective of this systematic literature review is to analyze the approaches and treatments used for non-melanoma skin cancer during pregnancy, with a focus on maternal and fetal safety. Methodology: The review followed the PRISMA checklist guidelines. Articles published in the last 10 years were searched in the PubMed, Scielo and Web of Science databases. The descriptors used were "non-melanoma skin cancer", "pregnancy", "treatment", "approach" and "fetal safety". The inclusion criteria were studies that described cases of non-melanoma skin cancer during pregnancy, addressing treatment options and fetal safety considerations. The exclusion criteria were studies irrelevant to the topic, studies without access to the full text and studies not available in English, Portuguese or Spanish. Results: Analysis of the articles revealed several therapeutic approaches for non-melanoma skin cancer during pregnancy, including surgery, photodynamic therapy and cryotherapy. There was an emphasis on the individualized assessment of each case, taking into account the stage of the disease, the location of the tumor and the potential risks for the mother and fetus. Prevention was also highlighted, with an emphasis on sun protection and skin self-examination. However, some treatments have been delayed until after birth due to concerns about fetal safety. Conclusion: The management of non-melanoma skin cancer during pregnancy requires a multidisciplinary and individualized approach, considering the risks and benefits for the mother and fetus. Prevention, early diagnosis and adequate treatment are essential to guarantee the best result for both. More research is needed to further guide clinical practices in this area.Pregnancy presents unique challenges in diagnosing and treating non-melanoma skin cancer, the most common type of skin cancer. Hormonal and immunological changes during pregnancy can influence the development and progression of the disease, while ethical issues and concerns about fetal safety complicate the therapeutic approach. Therefore, it is crucial to understand how this condition is managed during pregnancy to ensure the best outcome for mother and baby. Objective: The objective of this systematic literature review is to analyze the approaches and treatments used for non-melanoma skin cancer during pregnancy, with a focus on maternal and fetal safety. Methodology: The review followed the PRISMA checklist guidelines. Articles published in the last 10 years were searched in the PubMed, Scielo and Web of Science databases. The descriptors used were "non-melanoma skin cancer", "pregnancy", "treatment", "approach" and "fetal safety". The inclusion criteria were studies that described cases of non-melanoma skin cancer during pregnancy, addressing treatment options and fetal safety considerations. The exclusion criteria were studies irrelevant to the topic, studies without access to the full text and studies not available in English, Portuguese or Spanish. Results: Analysis of the articles revealed several therapeutic approaches for non-melanoma skin cancer during pregnancy, including surgery, photodynamic therapy and cryotherapy. There was an emphasis on the individualized assessment of each case, taking into account the stage of the disease, the location of the tumor and the potential risks for the mother and fetus. Prevention was also highlighted, with an emphasis on sun protection and skin self-examination. However, some treatments have been delayed until after birth due to concerns about fetal safety. Conclusion: The management of non-melanoma skin cancer during pregnancy requires a multidisciplinary and individualized approach, considering the risks and benefits for the mother and fetus. Prevention, early diagnosis and adequate treatment are essential to guarantee the best result for both. More research is needed to further guide clinical practices in this area

The complete genome sequence of Chromobacterium violaceum reveals remarkable and exploitable bacterial adaptability

Chromobacterium violaceum is one of millions of species of free-living microorganisms that populate the soil and water in the extant areas of tropical biodiversity around the world. Its complete genome sequence reveals (i) extensive alternative pathways for energy generation, (ii) ≈500 ORFs for transport-related proteins, (iii) complex and extensive systems for stress adaptation and motility, and (iv) wide-spread utilization of quorum sensing for control of inducible systems, all of which underpin the versatility and adaptability of the organism. The genome also contains extensive but incomplete arrays of ORFs coding for proteins associated with mammalian pathogenicity, possibly involved in the occasional but often fatal cases of human C. violaceum infection. There is, in addition, a series of previously unknown but important enzymes and secondary metabolites including paraquat-inducible proteins, drug and heavy-metal-resistance proteins, multiple chitinases, and proteins for the detoxification of xenobiotics that may have biotechnological applications

A social and ecological assessment of tropical land uses at multiple scales: the Sustainable Amazon Network

Science has a critical role to play in guiding more sustainable development trajectories. Here, we present the Sustainable Amazon Network (Rede Amazonia Sustentavel, RAS): a multidisciplinary research initiative involving more than 30 partner organizations working to assess both social and ecological dimensions of land-use sustainability in eastern Brazilian Amazonia. The research approach adopted by RAS offers three advantages for addressing land-use sustainability problems: (i) the collection of synchronized and co-located ecological and socioeconomic data across broad gradients of past and present human use; (ii) a nested sampling design to aid comparison of ecological and socioeconomic conditions associated with different land uses across local, landscape and regional scales; and (iii) a strong engagement with a wide variety of actors and non-research institutions. Here, we elaborate on these key features, and identify the ways in which RAS can help in highlighting those problems in most urgent need of attention, and in guiding improvements in land-use sustainability in Amazonia and elsewhere in the tropics. We also discuss some of the practical lessons, limitations and realities faced during the development of the RAS initiative so far.Keywords: Social–ecological systems, Tropical forests, Land use, Interdisciplinary research, Sustainability, Trade-off

EFEITOS DA IMERSÃO EM ÁGUA AQUECIDA SOBRE O SISTEMA RESPIRATÓRIO

Durante a imersão em água aquecida ocorre um aumento no trabalho respiratório em torno de 60% em decorrência do aumento da pressão intratorácica pelo deslocamento sangüíneo da periferia para a região central do tórax e pela ação da pressão hidrostática contra a parede torácica. O objetivo deste estudo foi avaliar os efeitos da imersão em água aquecida sobre o sistema respiratório de estagiários de hidroterapia. Foram avaliados 22 indivíduos do sexo feminino que foram divididos em dois grupos, sendo o grupo 1 formado por 11 indivíduos pertencentes ao grupo controle, e o grupo 2 formado por 11 indivíduos pertencentes ao grupo experimental. Os indivíduos do grupo controle não participaram do estágio em Hidroterapia e, portanto, não foram submetidos à imersão. Todos os indivíduos realizaram exame de espirometria e manovacuometria, antes e após o período de estágio. Após o período de estudo houve um aumento estatisticamente significativo (p=0,026) da Pressão Inspiratória Máxima (PIMAX) e uma significativa redução (p=0,04) na Capacidade Inspiratória (CI) para o grupo experimental. Os demais parâmetros não apresentaram diferenças estatisticamente significativas. Os resultados deste estudo nas condições experimentais utilizadas permitem concluir que a imersão em água aquecida exerce importantes efeitos no sistema respiratório, demonstrando influência na força muscular inspiratória e na Capacidade inspiratória. Contudo, um estudo com maior número de indivíduos pode contribuir para melhor elucidar esses efeitos

Whole body vibration and blood glucose levels in elderly people: a pilot study

AIMS: To evaluate the effect of whole-body vibration therapy on blood glucose levels of elderly people using a vibratory platform. METHODS: The study included volunteers of both genders, aged between 60 and 75 years, without gait disorders or motor disabilities. Individuals with systemic disease, obesity, conflicting treatments, tobacco users, and those who could not understand the maneuvers were excluded. The study consisted of a single session of whole-body vibration. Heart rate, respiratory rate, arterial blood pressure, and blood glucose were obtained for each participant at baseline, immediately before the procedure. Volunteers were then placed in the standing position on the ground of an oscillating platform and treated for 10 min with a frequency of vibration set at 20 Hz (displacement ±6 mm; orbital vibration). Immediately after the whole-body vibration session, all data were collected again. Comparisons were made between baseline and post-treatment data. Normality was tested by Kolmogorov-Smirnov test. Data were analyzed using paired Student’s t-test or Wilcoxon test as appropriate. The level of significance was set at p<0.05. RESULTS: Eleven participants (seven men, four women) participated of the study. The mean age was 64.18±4.37 years. The results showed a significant decrease in the glycemic indexes (p=0.016) and an increase in the respiratory rate (p=0.047) after the whole-body vibration session. CONCLUSIONS: Healthy elderly subjected for 10 minutes to whole-body vibration set at 20 Hz presented reduction of blood glucose levels and increasing of respiratory rate.OBJETIVOS: Avaliar o efeito da terapia da vibração de corpo inteiro nos níveis de glicemia em idosos saudáveis, usando uma plataforma vibratória. MÉTODOS: O estudo incluiu voluntários de ambos os sexos, com idade entre 60 e 75 anos, sem distúrbios de marcha ou incapacidades motoras. Indivíduos com doença sistêmica, obesidade, tratamentos conflitantes, usuários de tabaco e aqueles que não conseguiram entender as manobras foram excluídos. O estudo consistiu em uma única sessão de vibração de corpo inteiro. A frequência cardíaca, a frequência respiratória, a pressão arterial e a glicemia foram obtidas para cada participante na linha de base, imediatamente antes do procedimento. Os voluntários foram então colocados na posição de pé no piso de uma plataforma oscilante e tratados durante 10 minutos com uma frequência de vibração ajustada em 20 Hz (deslocamento ±6 mm, vibração orbital). Imediatamente após a sessão de vibração de corpo inteiro, todos os dados foram coletados novamente. Foram feitas comparações entre dados iniciais e do pós-tratamento. A normalidade foi testada pelo teste de Kolmogorov-Smirnov. Os dados foram analisados usando o teste t de Student emparelhado ou o teste de Wilcoxon, conforme apropriado. O nível de significância foi definido em p<0,05. RESULTADOS: Onze participantes (sete homens e quatro mulheres) participaram do estudo. A média de idade foi de 64,18±4,37 anos. Os resultados mostraram uma diminuição significativa nos índices glicêmicos (p=0,016) e um aumento na frequência respiratória (p=0,047) após a sessão de vibração de corpo inteiro. CONCLUSÕES: Idosos saudáveis submetidos por 10 minutos à vibração de corpo inteiro, ajustada em 20 Hz, apresentaram redução dos níveis de glicemia e aumento da frequência respiratória

EFEITO DA ACUPUNTURA SISTÊMICA NA INTENSIDADE DA DOR DE PACIENTES COM CERVICALGIA

Dor é uma qualidade sensorial complexa, puramente subjetiva, difícil de ser definida, descrita ou interpretada. É um mecanismo de proteção do corpo, ocorre sempre que qualquer tecido estiver sendo lesado. As dores cervicais afetam 30% de homens e 43% de mulheres em algum momento de suas vidas. Para o alívio da cervicalgia existem evidências de que a acupuntura é efetiva através de sua técnica em estimular pontos reflexos que tenham a propriedade de restabelecer o equilíbrio, alcançando, assim, resultados na diminuição do quadro álgico. O objetivo deste estudo foi avaliar a influência de um protocolo de acupuntura sistêmica para tratamento de cervicalgia na intensidade de dor, pressão arterial e frequência cardíaca. Realizou-se um estudo clínico com 11 sujeitos, de ambos os sexos, com idade média de 32,0 ± 13,2 anos. O tratamento foi composto por 4 sessões de atendimento segmentadas em uma sessão semanal e a avaliação da dor foi realizada antes e após cada sessão através da escala visual analogica (EVA). Os resultados encontrados sugerem que a acupuntura reduziu a dor em pacientes portadores de cervicalgia após 4 semanas de tratamento

Data from: Cardiovascular variability analysis and baroreflex estimation in patients with type 2 diabetes in absence of any manifest neuropathy

Introduction: Indexes derived from spontaneous heart period (HP) and systolic arterial pressure (SAP) fluctuations can detect autonomic dysfunction in individuals with type 2 diabetes mellitus (DM) associated to cardiovascular autonomic neuropathy (CAN) or other neuropathies. It is unknown whether HP and SAP variability indexes are sensitive enough to detect the autonomic dysfunction in DM patients without CAN and other neuropathies. Methods: We evaluated 68 males aged between 40 and 65 years. The group was composed by DM type 2 DM with no manifest neuropathy (n = 34) and healthy (H) subjects (n = 34). The protocol consisted of 15 minutes of recording of HP and SAP variabilities at rest in supine position (REST) and after active standing (STAND). The HP power in the high frequency band (HF, from 0.15 to 0.5 Hz), the SAP power in the low frequency band (LF, from 0.04 to 0.15 Hz) and BRS estimated via spectral approach and sequence method were computed. Results: The HF power of HP was lower in DM patients than in H subjects, while the two groups exhibited comparable HF power of HP during STAND. The LF power of SAP was similar in DM and H groups at REST and increased during STAND in both groups. BRSs estimated in the HF band and via baroreflex sequence method were lower in DM than in H and they decreased further during STAND in both populations. Conclusion: Results suggest that vagal control of heart rate and cardiac baroreflex control was impaired in type 2 DM, while sympathetic control directed to vessels, sympathetic and baroreflex response to STAND were preserved. Cardiovascular variability indexes are sensitive enough to typify the early, peculiar signs of autonomic dysfunction in type-2 DM patients well before CAN becomes manifest

Correction: Cardiovascular Variability Analysis and Baroreflex Estimation in Patients with Type 2 Diabetes in Absence of Any Manifest Neuropathy.

[This corrects the article DOI: 10.1371/journal.pone.0148903.]