ObjectivesTo analyze patients after cardiac surgery that needed endotracheal reintubation and identify factors associated with death and its relation with the severity scores.MethodsRetrospective analysis of information of 1,640 patients in the postoperative period of cardiac surgery between 2007 and 2015.ResultsThe reintubation rate was 7.26%. Of those who were reintubated, 36 (30.3%) underwent coronary artery bypass surgery, 27 (22.7%) underwent valve replacement, 25 (21.0%) underwent correction of an aneurysm, and 8 (6.7%) underwent a heart transplant. Among those with comorbidities, 54 (51.9%) were hypertensive, 22 (21.2%) were diabetic, and 10 (9.6%) had lung diseases. Among those who had complications, 61 (52.6%) had pneumonia, 50 (42.4%) developed renal failure, and 49 (51.0%) had a moderate form of the transient disturbance of gas exchange. Noninvasive ventilation was performed in 53 (44.5%) patients. The death rate was 40.3%, and mortality was higher in the group that did not receive noninvasive ventilation before reintubation (53.5%). Within the reintubated patients who died, the SOFA and APACHE II values were 7.9 ± 3.0 and 16.9 ± 4.5, respectively. Most of the reintubated patients (47.5%) belonged to the high-risk group, EuroSCORE (> 6 points).ConclusionThe reintubation rate was high, and it was related to worse SOFA, APACHE II and EuroSCORE scores. Mortality was higher in the group that did not receive noninvasive ventilation before reintubation.

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RESUMOA osteoartrose é uma doença degenerativa comum, em que a articulação do joelho sofre um desgaste de seus componentes, a tíbia, o fêmur, a patela e os meniscos, provocando, assim, um quadro de dor, deformidade e rigidez articular. A artroplastia total de joelho (ATJ) apresenta-se como um tratamento eficaz para os casos mais avançados de osteoartrose. A técnica consiste na substituição dos componentes danificados da articulação por próteses inorgânicas, constituídas de bases metálicas e polietileno. A fisioterapia no paciente pós-ATJ tem a finalidade de restabelecer a função articular, melhorando a qualidade de vida e devolvendo a independência funcional ao paciente. Palavras-chave: artroplastia do joelho; joelho; reabilitação; fisioterapia. ABSTRACTOsteoarthritis is a degenerative joint disease, where the knee joint undergoes wear of its components; the tibia, the femur, the patella and the menisci, thus causing a painful condition, deformity and joint stiffness. Total knee arthroplasty (TKA) presents itself as an effective treatment for advanced cases of osteoarthritis. The technique involves replacing the damaged components of the joint inorganic prostheses, made of metal and polyethylene bases. Physical therapy in the post TKA patients, aims to restore joint function, improving the quality of life and functional independence returning to the patient. Keywords: arthroplasty, replacement, knee; knee; rehabilitation; physical therapy specialty. INTRODUÇÃOOs ossos que formam a articulação do joelho são: fêmur, tíbia e patela, estruturas ósseas que formam duas articulações distintas, a femoropatelar e a tibiofemoral; todavia, funcionalmente, essas duas articulações não podem ser sempre consideradas separadamente, pois existe uma relação mecânica entre elas, e são articulações que proporcionam sustentação ao corpo e podem, com o tempo, sofrer grande desgaste e degeneração, sendo assim necessário um procedimento cirúrgico em que se faz a troca da articulação degenerada por uma artificial.1 A artroplastia total de joelho (ATJ) é uma técnica que vem sido utilizada desde o final dos anos 1950 e o começo dos anos 1960, a qual visa substituir a articulação do joelho por uma prótese metálica. É dividida, de acordo com os componentes articulares a serem substituídos, em dois tipos: a artroplastia total, em que são substituídos todos os três compartimentos articulares (femorotibial medial, femorotibial lateral e o femoropatelar), e a unicompartimental, em que apenas um dos compartimentos, seja o femorotibial medial, seja o lateral, é substituído. A técnica tem indicação em pacientes com dor intensa e comprometimento das habilidades funcionais, destruição das superfícies articulares do joelho, instabilidade e diminuição de amplitude de movimento e vem ajudando no tratamento da osteoartrose e da artrite reumatoide, melhorando a qualidade de vida, a dor, a incapacidade e a rigidez causadas por essas doenças. 2A fisioterapia tem sido de fundamental importância para a reabilitação do pós-cirúrgico da ATJ, principalmente por...

ObjectiveA retrospective cohort study was preformed aiming to verify the presence of transient dysfunction of gas exchange in the postoperative period of cardiac surgery and determine if this disorder is linked to cardiorespiratory events.MethodsWe included 942 consecutive patients undergoing cardiac surgery and cardiac procedures who were referred to the Intensive Care Unit between June 2007 and November 2011.ResultsFifteen patients had acute respiratory distress syndrome (2%), 199 (27.75%) had mild transient dysfunction of gas exchange, 402 (56.1%) had moderate transient dysfunction of gas exchange, and 39 (5.4%) had severe transient dysfunction of gas exchange. Hypertension and cardiogenic shock were associated with the emergence of moderate transient dysfunction of gas exchange postoperatively (P=0.02 and P=0.019, respectively) and were risk factors for this dysfunction (P=0.0023 and P=0.0017, respectively). Diabetes mellitus was also a risk factor for transient dysfunction of gas exchange (P=0.03). Pneumonia was present in 8.9% of cases and correlated with the presence of moderate transient dysfunction of gas exchange (P=0.001). Severe transient dysfunction of gas exchange was associated with patients who had renal replacement therapy (P=0.0005), hemotherapy (P=0.0001), enteral nutrition (P=0.0012), or cardiac arrhythmia (P=0.0451).ConclusionPreoperative hypertension and cardiogenic shock were associated with the occurrence of postoperative transient dysfunction of gas exchange. The preoperative risk factors included hypertension, cardiogenic shock, and diabetes. Postoperatively, pneumonia, ventilator-associated pneumonia, renal replacement therapy, hemotherapy, and cardiac arrhythmia were associated with the appearance of some degree of transient dysfunction of gas exchange, which was a risk factor for reintubation, pneumonia, ventilator-associated pneumonia, and renal replacement therapy in the postoperative period of cardiac surgery and cardiac procedures.

Introduction: Malocclusion can be defined as an imbalance between the masticatory system and neuromuscular Temporomandibular joint. It is considered as a result of the sum of genetic, environmental and postural elements therefore of multifactorial origin. Objective: To review the existing literature if malocclusion influence in posture and balance of the subject. Methods: This is a systematic review, which searched up clinical studies, published between 2009 and 2014 in English, Portuguese and Spanish, in the databases SciELO, PubMed, Lilacs and Sience Direct, using the keywords malocclusion/posture and malocclusion/body balance. Studies were included that had to evaluate the posture and/or balance in patients with malocclusion, were excluded systematic reviews and studies that did not correspond to the proposed theme. Results: In addition to the articles found in all databases, the corpus generated by the literature consisted of 828 records; 13 of them responded to the proposed theme. About the selected literature, eight studies showed significant results regarding the relationship between malocclusion and posture, and two as malocclusion and body balance. Conclusion: it was concluded that malocclusion is associated with the posture of the changes, since the balance, only two studies presented this outcome and was in a considered positive for the worsening of static equilibrium, but with no clinical application, and another positive for improves dynamic balance.