Introduction: Asthma is characterized by a narrowing and inflammation of the bronchi, with symptoms of dyspnea, fatigue and exercise limitation. Physical therapy includes inspiratory muscle training and breathing exercises, given that an increase in inspiratory muscle strength and resistance can improve the symptoms of the disease.
Objective: To describe the effects of inspiratory muscle training (IMT) and breathing exercises in children with asthma.
Methods: This is a systematic review of the literature using the Cochrane, PubMed Scopus e Web of Science databases. The following descriptors were used: asthma, inspiratory muscle training, breathing exercises and child in Portuguese, English and Spanish. Two independent evaluators screened studies that used breathing exercises and IMT in children with asthma.
Results: Of a total of 312 titles, eight studies were included, of which six are randomized clinical trials and two are observational studies All the studies included breathing exercises, with the objective of adjusting breathing patterns and pulmonary ventilation, reducing pulmonary hyperinflation, bronchospasm and sensation of dyspnea. However, as these exercises were not performed solely, the effects of this intervention could not be verified. Two studies performed IMT and showed an increase in maximal respiratory pressure.
Conclusion: Breathing exercises are widely used in clinical practice as part of the management of asthma in children; however it is not possible to measure the effects in this population. IMT seems to improve inspiratory and expiratory muscle strength, but its indication in the pediatric population is not a standard procedure.
We investigated the levels of brain derived-neurotrophic factor (BDNF), cytokines and oxidative parameters in serum and tried to correlate them with the age and functionality of patients with Progressive Muscle Dystrophies (PMD). The patients were separated into six groups (case and controls pared by age and gender), as follows: Duchenne Muscular Dystrophy (DMD); Steinert Myotonic Dystrophy (SMD); and Limb-girdle Muscular Dystrophy type-2A (LGMD2A). DMD patients (±17.9 years old) had a decrease of functionality, an increase in the IL-1β and TNF-α levels and a decrease of IL-10 levels and superoxide dismutase activity in serum. SMD patients (±25.8 years old) had a decrease of BDNF and IL-10 levels and superoxide dismutase activity and an increase of IL-1β levels in serum.LGMD2A patients (±27.7 years old) had an decrease only in serum levels of IL-10. This research showed the first evidence of BDNF involvement in the SMD patients and a possible unbalance between pro-inflammatory and anti-inflammatory cytokine levels, along with decreased superoxide dismutase activity in serum of DMD and SMD patients.
Silicone breast implant is associated with complications inherent to the surgical procedure. Prosthesis coating with polyurethane, however, commonly reduces the incidence of such complications. In this paper, the authors evaluated the inflammatory histomorphometric profile and oxidative damage associated to the implant of polyester urethane sheets. Forty-eight Wistar rats were divided into Sham or polyester urethane groups (n = 8/group) and underwent a polyester urethane implant in the dorsal skinfold. Tissue samples were collected on days seven, 30, and 90 after surgery and subjected to histomorphometric analysis and biochemical tests. Results were analyzed by one-way ANOVA (p ≤ 0.05). Peri-implant tissue samples exhibited characteristic inflammatory response associated with the biomaterial, with increased vascularization on day seven and augmented levels of IL1-b and TNF-a after 30 days. Peri-implant fibrocystic population was small on day seven, but increased considerably after 90 days. A rise in the carbonyl group levels of skin samples in the polyester urethane group was observed on day seven. Findings suggest that polyester urethane sheets undergo biodegradation at an early stage after implantation, followed by increased vascularity and microencapsulation of biomaterial fragments, without persistent oxidative damage. Fiber arrangement inside the collagen matrix results in a fibrotic scar because of polyester urethane degradation.
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