Comparação da resposta autonômica cardiovascular de praticantes de musculação, corredores de longa distância e não praticantes de exercício

The aim of the study was to compare the cardiovascular autonomic response (CAR) of recreational weight trainers, long distance runners and non-exercised subjects. Men, 21 to 55 years old, were grouped in: recreational weight trainers (W, n = 31), long distance runners (R, n = 28) and non-exercised (C, n = 35). Four strategies of evaluation of the CAR were selected: Resting heart rate (RHR), cold pressor test (CPT), heart rate variability (HRV) and heart rate recovery (HHR) following maximal exercise test. The RHR was lower (R = 54 ± 2; W = 62 ± 2; C= 65 ± 2 bpm; mean ± SE) and the HHR 60s post exercise was larger in the R group (R = 34 ± 3; W = 23 ± 1; C = 24 ± 2 bpm). The R group presented larger high-frequency (HF; 55.1 ± 4.0 n.u) and smaller low-frequency (LF; 43.1 ± 4.0 n.u) components of HRV than C group (HF = 40.7 ± 3.3; LF = 56.7 ± 3.5 n.u.). The W group did not show any differences compared to C group. The study's conclusion was that long-term weight-training program, unlike of long-term running training, it is not able to alter significantly the regulatory pattern of CAR.Objetivou-se comparar a resposta autonômica cardiovascular (RAC) de praticantes de musculação, corredores de longa distância e não praticantes de exercício. Homens, 21 a 55 anos, foram agrupados em: Praticantes Musculação (PM, n = 31); Praticantes Corrida (PC, n = 28); Controle (C, n = 35). Foram selecionadas quatro técnicas para avaliação da RAC: Frequência cardíaca de repouso (FCR), Teste pressórico do frio (TPF), Variabilidade da FC (VFC) e recuperação da FC pós-teste máximo em esteira. A FCR foi menor no grupo PC (PC = 54 ± 2; PM= 62 ± 2; C = 65 ± 2 bpm; média ± EPM). A recuperação da FC aos 60 s pós-teste de esforço foi maior no grupo PC (PC = 34 ± 3; PM = 23 ± 1; C = 24 ± 2; bpm). Quanto aos parâmetros espectrais de alta (HF) e baixa (LF) frequência da VFC, o grupo PC apresentou maior HF (55,1 ± 4,0 n.u) e menor LF (43,1 ± 4,0 n.u) comparado ao grupo C (HF = 40,7 ± 3,3; LF = 56,7 ± 3,5 n.u). O grupo PM não apresentou qualquer diferença de RAC em comparação ao grupo C. Conclui-se que prática contínua em musculação por longo prazo, diferentemente da prática de corrida de longa distância, não é capaz de alterar significativamente a RAC

Riabilitazione fonatoria con protesi: il ruolo del logopedista

laringectomia totale, protesi tracheo-esofagea, riabilitazione fonatori

Metodiche di riabilitazione fonatoria

Voce esofagea, laringofono, voce tracheo-esofaage

Comparação da resposta autonômica cardiovascular de praticantes de musculação, corredores de longa distância e não praticantes de exercício

Objetivou-se comparar a resposta autonômica cardiovascular (RAC) de praticantes de musculação, corredores de longa distância e não praticantes de exercício. Homens, 21 a 55 anos, foram agrupados em: Praticantes Musculação (PM, n = 31); Praticantes Corrida (PC, n = 28); Controle (C, n = 35). Foram selecionadas quatro técnicas para avaliação da RAC: Frequência cardíaca de repouso (FCR), Teste pressórico do frio (TPF), Variabilidade da FC (VFC) e recuperação da FC pós-teste máximo em esteira. A FCR foi menor no grupo PC (PC = 54 ± 2; PM= 62 ± 2; C = 65 ± 2 bpm; média ± EPM). A recuperação da FC aos 60 s pós-teste de esforço foi maior no grupo PC (PC = 34 ± 3; PM = 23 ± 1; C = 24 ± 2; bpm). Quanto aos parâmetros espectrais de alta (HF) e baixa (LF) frequência da VFC, o grupo PC apresentou maior HF (55,1 ± 4,0 n.u) e menor LF (43,1 ± 4,0 n.u) comparado ao grupo C (HF = 40,7 ± 3,3; LF = 56,7 ± 3,5 n.u). O grupo PM não apresentou qualquer diferença de RAC em comparação ao grupo C. Conclui-se que prática contínua em musculação por longo prazo, diferentemente da prática de corrida de longa distância, não é capaz de alterar significativamente a RAC

Integrated rehabilitation after total laryngectomy: a pilot trial study

BackgroundAcquisition and acceptance of the alaryngeal voice, psychological state, and Quality of Life (QoL) of laryngectomized patients.MethodsThirty-two patients who underwent total laryngectomy were included in the study; 17 of them were treated by a psychologist and a speech therapist (experimental group); 15 performed only speech therapy (control group).ResultsThe experimental group showed a significant improvement in all parameters of the INFVo scale, in the score of the Environment subscale and in the total score of the I-SECEL (Self-Evaluation of Communication Experiences after Laryngeal Cancer); in the Depression, Obsession-Compulsion and Paranoia areas of the SCL-90-R (Symptom Check List-90-Revised); and in the Social area (REL) of the WHOQOL-B (World Health Organization Quality of Life Scale-Brief).ConclusionsAn integrated rehabilitative approach to laryngectomized patients improves emotional state and psychosocial aspects and promotes acceptance and use of the new voice and recovery of a better quality of life

Treatment of Adolescents and Young Adults with Acute Lymphoblastic Leukemia (ALL): An Update of the GIMEMA Experience

Backgound: Adolescent and young (<30y) adults (AYAs) ALL represent a distinct population from both children and older adults. Recently it has been demonstrated that if AYA are treated according to pediatric schedules, Event Free Survival and Overall Survival (OS) can significantly improve (Ribera et al. 2008, Huguet et al. 2009). Nevertheless, which therapeutic strategy, a pediatric or an adult one, can, indeed, be the best approach in this cohort of pts it is still a matter of debate. (Usvasalo et al. 2008). We retrospectively reviewed the disease outcome of AYAs entered in a period over than 25 y in the 6 consecutive GIMEMA adult ALL trials in order to analyze the impact on Disease Free Survival(DFS) and OS of the different treatment strategies applied. Patients: Between 1982-2008, 1218 pts - median age 20.2 ys (range 12.0-30.0y)- were enrolled in the 6 GIMEMA studies; 30.4% of pts were 18y old, initial median WBC was 15.0x109/L (range 0.3-848.0), 72.9% of pts and 27.1% of pts were classified as B-lineage and T-ALL respectively, and 84 pts (13.1%) were Ph and/or BCR/ABL+ve. Results: Overall Remission Rate was 85.1% with no significant difference in terms of CR between the different protocols. From 1990, Ph and/or BCR/ABL+ve patients received a post-CR treatment including transplant and, since 2000, TKIs were also added. Comparing the studies, ALL0288 vs. ALL0183 and ALL0904, ALL2000 vs. ALL0183 and ALL0904, long-term DFS rate resulted significantly associated to protocol: (p=0.0078, p=0.0051, respectively) and (p=0.0044, p=0.0136, respectively), while OS resulted trend-associated to protocol (p=0.0891). One of the older study - ALL0288 - demonstrated a significantly lower Cumulative Incidence of Relapse (CIR) not only compared with the oldest ALL0183 (p<0.00001), but also with the following ALL0496 (p=0.0009), ALL2000 (0.0022) and ALL0904 (p=0.00002). Whether this was related to a more intensified treatment with reinduction cycles, both in consolidation and maintenance, foreseen in the ALL0288 study remains an open question; however, probably due to the less effective supportive care and, in particular, to the lack of growth factors, non-relapse mortality in CR was higher and the final outcome of ALL0288 did not significantly differed in terms of overall survival from other studies. Table 1 Protocol PDN Pretreat Induction Consolidation Maintenance pts. N. %OS (C.I. 95%) %DFS (C.I. 95%) %CIR (C.I. 95%) -------------------------------------------------------------------------------- ALL0183 - PVD + L-Asp PVD/L-VAMP/ VM-26+CA Standard (12 mths) 169 6y 35.6% (33.1-38.2) 6y 25.7% (23.9-27.6) 6y 69.4% (69.2-69.7) ALL0288 YES PVD + L-Asp ± Cy PV+Nov/L-VAMP/VM-26+CA Intensive vs. standard (24 mths) 456 6y 39.1% (37.4-41) 6y 37% (35.2-38.9) 6y 44.2% (44.1-44.3) ALL0394 - PV + Myeloid-like + L-Asp L-VAMP/VM-26+CA Standard (12 mths) 76 4y 50% (44.4-56.2) 4y 45.6% (40.1-51.9) 4y 45.9% (45-46.8) ALL0496 - PV + HD DNR + L-Asp VP-16+CA + Cy Standard + V-Cy/V-DNR Reinduction (36 mths) 231 6y 40.4% (37.8-43.2) 6y 36.1% (33.6-38.7) 6y 57.3% (57-57.6) ALL2000 YES PV + HD DNR + L-Asp VP-16+CA Standard + V-Cy/V-DN Reinduction (36 mths) 209 6y 44.4% (40.7-48.4) 6y 41.6% (38.3-45.2) 6y 55.9% (55.6-56.3) ALL0904 YES PV + HD DNR + L-Asp VP-16+CA Standard + V-Cy/V-DNR Reinduction (36 mths) 77 3y 47.6% (40.1-56.5) 3y 28.2% (23.9-33.4) 3y 66.4% (64.7-68.1) In conclusion, the overall results of the consecutive GIMEMA adult ALL trials conducted over the past 25 years show that only slight advances for specific subgroup of patients – i.e. Ph+ - have been obtained, mainly thanks to the introduction of targeted agents like TKIs. Also in the AYAs subgroup, the outcome remains dismal, and new approaches, possibly with more intensive pediatric-like regimens must be explored