REABILITAÇÃO FÍSICA NO PACIENTE SUBMETIDO AO TRANSPLANTE CARDÍACO: REVISÃO INTEGRATIVA

Introduction: Heart transplantation is an intervention that seeks to replace the heart that is insufficient to maintain the metabolic demands necessary for the functioning of the body, when not performed early, the risk of death increases with the time of exposure. Thus, the replacement by a heart donated by individuals, especially in brain death, is necessary for the maintenance of life for these individuals. However, to classify the patient who is able to receive the transplant, it is crucial that the unit has protocols with clinical criteria and diagnostic tests, and for the classification of the donor, the same requirement is presente. It is notorious that pre and post transplant patients have a decrease in their functionality and quality of life, in this scenario the rehabilitation of the transplant patient provides a longer life expectancy and greater independence for daily activities. Goal: The present study aims to carry out an integrative review on the physical rehabilitation of patients undergoing heart transplantation. Method: an integrative review study was carried out, including studies published in the last ten years that fully addressed the use of physical exercise as a rehabilitation method in patients undergoing heart transplantation. The studies come from the Pubmed, Pedro and Cochrane databases. Results: Physical rehabilitation in patients undergoing heart transplantation promotes positive effects on quality of life and survival. Interval and high-intensity exercises with adequate monitoring are the most indicated for this patient profile.Introducción: El trasplante de corazón es una intervención que busca reemplazar el corazón que es insuficiente para mantener las demandas metabólicas necesarias para el funcionamiento del organismo, cuando no se realiza a tiempo el riesgo de muerte aumenta según el tiempo de exposición. Con esto, la sustitución por un corazón dado por individuos principalmente en muerte cerebral es necesaria para el mantenimiento de la vida de estos individuos. Sin embargo, para clasificar al paciente que es capaz de recibir el trasplante, es crucial que la unidad cuente con protocolos con criterios clínicos y pruebas diagnósticas, y para la clasificación del donante existe el mismo requisito. Es notorio que el paciente antes y después del trasplante de corazón ha disminuido la funcionalidad y la calidad de vida. En este escenario, la rehabilitación del paciente trasplantado proporciona una mayor esperanza de vida y una mayor independencia para las actividades diarias. Objetivo: Este estudio tiene como objetivo realizar una revisión integradora sobre la rehabilitación física de los pacientes sometidos a trasplante de corazón. Método: se realizó un estudio de revisión integradora en el que se incluyeron estudios publicados en los últimos diez años que abordaron completamente el uso del ejercicio físico como método de rehabilitación en pacientes sometidos a trasplante cardíaco. Los estudios provienen de las bases de datos Pubmed, Pedro y Cochrane. Resultados: La rehabilitación física en pacientes sometidos a trasplante cardíaco promueve efectos positivos sobre la calidad de vida y la supervivencia. Los ejercicios de intervalo.Introdução: O transplante cardíaco é uma intervenção que busca substituir o coração que está insuficiente para manter as demandas metabolicas necesárias para o  funcionamento do organismo,  quando não realizado precocemente o risco de óbito aumenta conforme ao tempo de exposição. Com isso, a substituição por um coração doado por individuos principalmente em morte encefálica se faz necessário para a manutenção da vida desses individuos. No entanto, para classificar o paciente que está apto à receber o transplante é crucial a unidade possuir protocolos com critérios clínicos e exames diagnósticos, e para a classificação do doador se faz presente o mesmo requerimento. É notório que o paciente pré e pós transplante cardíaco possui diminuição da sua funcionalidade e qualidade de vida. Neste cenario a reabilitação do paciente transplantado  proporciona uma maior expectativa de vida e maior independencia para as atividades cotidianas. Objetivo: O presente estudo tem como objetivo realizar uma revisão integrativa sobre a reabilitação física do paciente submetido ao transplante cardíaco. Método: realizou-se um estudo de revisão integrativa no qual incluiu-se estudos publicados nos últimos dez anos que abordaram na íntegra a utilização de exercícios físicos como método de reabilitação nos pacientes submetidos ao transplante cardíaco. Os estudos são advindos das bases de dados Pubmed, Pedro e Cochrane. Resultados: A reabilitação física no paciente submetido ao transplante cardíaco promove efeitos positivos na qualidade de vida e na sobrevivência. Os exercícios intervalados e os de alta intensidade com adequada monitorização são os que promovem maior beneficio para esse perfil de pacient

Atuação da fisioterapia na UTI / Physiotherapy performance at UTI

Introdução: A atuação do fisioterapeuta nos centros de unidade de terapia intensiva é indispensável para a diminuição dos efeitos deletérios advindos do imobilismo prolongado e afecções clínicas. Objetivo: Esta pesquisa possui como objetivo geral mostrar a atuação do fisioterapeuta dentro da unidade de terapia intensiva e como objetivo especifico verificar quais condutas são utilizadas por esses profissionais na assistência que visam a melhora clínica e funcional dos pacientes. Método: Para a realização desse trabalho, foi realizado um levantamento bibliográfico no período compreendido entre fevereiro e abril de 2019, utilizando uma busca da literatura nos sites do Ministério da Saúde, COFFITO e por meio de consulta nas bases de dados eletrônicos Scielo, PubMed, Google Acadêmico e MEDLINE. Resultados: Observou-se a eficácia das condutas fisioterapêuticas na melhora clínica, funcional e no ganho de força dos pacientes que receberam tais intervenções, além do mais, a fisioterapia pode reduzir o tempo de internação hospitalar dos pacientes. Conclusão: É notório a importância do fisioterapeuta em está inserido no contexto hospitalar para possibilitar uma diminuição das morbidades adquiridas no período de internação e posteriormente melhorar a qualidade de vida desses pacientes após a alta hospitalar.

Intervenções fisioterapêuticas na distrofia muscular de duchenne: revisão de literatura / Physiotherapeutic interventions in duchenne muscular dystrophy: literature review

Introdução: A distrofia muscular de duchenne é uma doença genética que causa fraqueza muscular progressiva e leva à paralisia total e à morte súbita nos últimos anos da adolescência ou em adultos jovens. Por volta dos cinco anos de idade, a criança começa a apresentar dificuldade de correr ou saltar, a manobra de Gowers ou manobra do levantar miopático,  é um sinal médico que indica a fraqueza dos músculos proximais, especificamente aqueles do membro inferior, devido à atrofia muscular evidente. A hidroterapia é um recurso que vem crescendo no Brasil e começa a ser aceito como opção de tratamento para Distrofia Muscular Progressivas devido as propriedades físicas da água e a movimentação voluntaria. Objetivo: Esta pesquisa tem como objetivo geral verificar o papel do fisioterapeuta e suas condutas nos pacientes com distrofia muscular de duchenne, fazendo uma análise criteriosa dos protocolos de tratamento que possuem embasamento cientifico. Metodologia: O presente artigo tem como fundamento um levantamento bibliográfico realizado nas principais bases de dados eletrônicas Scielo, Pubmed, foram utilizados um total de 11 artigos. Optou-se por incluir estudos com grande amostragem para verificar seus impactos e quais intervenções fisioterapêuticas na distrofia muscular de duchenne. Resultados: Os achados remetentes aos 11 artigos selecionados para o trabalho em questão, concluiu que a Fisioterapia obteve-se um retardo da doença, e prevenção de complicações secundárias. Conclusão: Diante do presente estudo, se conclui que é fundamental a importância do fisioterapeuta na vida do paciente com DMD, pois retarda a evolução da doença e traz mais qualidade de vida para o paciente. 

Risk factors associated with death in Brazilian children with severe dengue: a case-control study

Objective: The purpose of this case-control study was to evaluate risk factors associated with death in children with severe dengue. Methods: The clinical condition of hospitalized patients with severe dengue who died (cases, n = 18) was compared with that of hospitalized patients with severe dengue who survived (controls, n = 77). The inclusion criteria for this study were age under 13 years; hospital admission in São Luis, northeastern Brazil; and laboratory-confirmed diagnosis of dengue. Results: Severe bleeding (hemoptysis), a defining criterion for dengue severity, was the factor most strongly associated with death in our study. We also found that epistaxis and persistent vomiting, both included as warning signs in the World Health Organization (WHO) classification of dengue, were strongly associated with death. No significant association was observed between any of the laboratory findings and death. Conclusions: The finding that epistaxis and persistent vomiting were also associated with death in children with severe dengue was unexpected and deserves to be explored in future studies. Because intensive care units are often limited in resource-poor settings, any information that can help to distinguish patients with severe dengue with a higher risk to progress to death may be crucial

Risk factors associated with death in Brazilian\ud children with severe dengue: a case-control study

Objective:\ud \ud The purpose of this case-control study was to evaluate risk factors associated with death in children with severe dengue.\ud \ud Methods:\ud \ud The clinical condition of hospitalized patients with severe dengue who died (cases, n = 18) was compared with that of hospitalized patients with severe dengue who survived (controls, n = 77). The inclusion criteria for this study were age under 13 years; hospital admission in São Luis, northeastern Brazil; and laboratory-confirmed diagnosis of dengue.\ud \ud Results:\ud \ud Severe bleeding (hemoptysis), a defining criterion for dengue severity, was the factor most strongly associated with death in our study. We also found that epistaxis and persistent vomiting, both included as warning signs in the World Health Organization (WHO) classification of dengue, were strongly associated with death. No significant association was observed between any of the laboratory findings and death.\ud \ud Conclusions:\ud \ud The finding that epistaxis and persistent vomiting were also associated with death in children with severe dengue was unexpected and deserves to be explored in future studies. Because intensive care units are often limited in resource-poor settings, any information that can help to distinguish patients with severe dengue with a higher risk to progress to death may be crucial.This research was funded by grants BICUFMA 00366/07, BIC-UFMA 00377/07 and BD-00266/09 from Fundac¸a˜o de Amparo a` Pesquisa e ao Desenvolvimento Cientı´fico e Tecnolo´gico do Maranha˜o (FAPEMA), Sa˜o Luı´s, Maranha˜ o, Brazil. GFS was the recipient of a junior research fellowship in 2007-2008 from the Universidade Federal do Maranha˜o, Sa˜o Luı´s, Maranha˜ o, Brazil. The funders had no role in the study design, data collection and analysis, decision to publish or preparation of the manuscript

Building a Portuguese Coalition for Biodiversity Genomics

The diverse physiography of the Portuguese land and marine territory, spanning from continental Europe to the Atlantic archipelagos, has made it an important repository of biodiversity throughout the Pleistocene glacial cycles, leading to a remarkable diversity of species and ecosystems. This rich biodiversity is under threat from anthropogenic drivers, such as climate change, invasive species, land use changes, overexploitation or pathogen (re)emergence. The inventory, characterization and study of biodiversity at inter- and intra-specific levels using genomics is crucial to promote its preservation and recovery by informing biodiversity conservation policies, management measures and research. The participation of researchers from Portuguese institutions in the European Reference Genome Atlas (ERGA) initiative, and its pilot effort to generate reference genomes for European biodiversity, has reinforced the establishment of Biogenome Portugal. This nascent institutional network will connect the national community of researchers in genomics. Here, we describe the Portuguese contribution to ERGA’s pilot effort, which will generate high-quality reference genomes of six species from Portugal that are endemic, iconic and/or endangered, and include plants, insects and vertebrates (fish, birds and mammals) from mainland Portugal or the Azores islands. In addition, we outline the objectives of Biogenome Portugal, which aims to (i) promote scientific collaboration, (ii) contribute to advanced training, (iii) stimulate the participation of institutions and researchers based in Portugal in international biodiversity genomics initiatives, and (iv) contribute to the transfer of knowledge to stakeholders and engaging the public to preserve biodiversity. This initiative will strengthen biodiversity genomics research in Portugal and fuel the genomic inventory of Portuguese eukaryotic species. Such efforts will be critical to the conservation of the country’s rich biodiversity and will contribute to ERGA’s goal of generating reference genomes for European species.info:eu-repo/semantics/publishedVersio

Search for new particles in events with energetic jets and large missing transverse momentum in proton-proton collisions at root s=13 TeV

A search is presented for new particles produced at the LHC in proton-proton collisions at root s = 13 TeV, using events with energetic jets and large missing transverse momentum. The analysis is based on a data sample corresponding to an integrated luminosity of 101 fb(-1), collected in 2017-2018 with the CMS detector. Machine learning techniques are used to define separate categories for events with narrow jets from initial-state radiation and events with large-radius jets consistent with a hadronic decay of a W or Z boson. A statistical combination is made with an earlier search based on a data sample of 36 fb(-1), collected in 2016. No significant excess of events is observed with respect to the standard model background expectation determined from control samples in data. The results are interpreted in terms of limits on the branching fraction of an invisible decay of the Higgs boson, as well as constraints on simplified models of dark matter, on first-generation scalar leptoquarks decaying to quarks and neutrinos, and on models with large extra dimensions. Several of the new limits, specifically for spin-1 dark matter mediators, pseudoscalar mediators, colored mediators, and leptoquarks, are the most restrictive to date.Peer reviewe

Combined searches for the production of supersymmetric top quark partners in proton-proton collisions at root s=13 TeV

A combination of searches for top squark pair production using proton-proton collision data at a center-of-mass energy of 13 TeV at the CERN LHC, corresponding to an integrated luminosity of 137 fb(-1) collected by the CMS experiment, is presented. Signatures with at least 2 jets and large missing transverse momentum are categorized into events with 0, 1, or 2 leptons. New results for regions of parameter space where the kinematical properties of top squark pair production and top quark pair production are very similar are presented. Depending on themodel, the combined result excludes a top squarkmass up to 1325 GeV for amassless neutralino, and a neutralinomass up to 700 GeV for a top squarkmass of 1150 GeV. Top squarks with masses from 145 to 295 GeV, for neutralino masses from 0 to 100 GeV, with a mass difference between the top squark and the neutralino in a window of 30 GeV around the mass of the top quark, are excluded for the first time with CMS data. The results of theses searches are also interpreted in an alternative signal model of dark matter production via a spin-0 mediator in association with a top quark pair. Upper limits are set on the cross section for mediator particle masses of up to 420 GeV

Probing effective field theory operators in the associated production of top quarks with a Z boson in multilepton final states at root s=13 TeV

Peer reviewe