This is a randomized controlled study that demonstrates the antihypertensive efficacy of aerobic aquatic exercise.

BackgroundAquatic therapy promotes short-term benefits for patients with knee osteoarthritis (OA), and it may be the first therapeutic option for this pathological condition. The objective of this study was to investigate the effects of an aquatic therapy program on pain intensity, functional ability, and quality of life in older people with knee OA.Methods/designThis is a parallel, two-arm, open, randomized controlled clinical trial with older people with knee OA. Volunteers will be allocated to an aquatic intervention group (WG), subjected to the intervention, or to a control group, not be subjected to any kind of intervention. Data collection pre- and postintervention will be composed of the evaluation of the perception of pain by visual analogue scale with application of nociceptive stimuli in four anatomical points of the knee, functional fitness tests, and application of the World Health Organization Quality of Life Scale abbreviated version and Western Ontario and McMaster Universities Osteoarthritis Index. The program will last 12 weeks, consisting of aerobic and functional exercises in the form of circuit training.DiscussionThe objective of this clinical trial is to evaluate the effect of aquatic therapy in elderly patients with knee OA. The study is guided by practice-based scientific evidence for the use of aquatic rehabilitation exercises. It is expected that the WG volunteers will show reduced pain intensity, increased flexibility, and improved functional capacity and quality of life. It is believed that the desired results can be attributed to physical and physiological effects of immersion in warm water associated with the exercise protocol proposed. The data will be published after completion of the study.Trial registrationBrazilian Registry of Clinical Trials (ReBEC) registration number: RBR-78h48d. Registered on 19 August 2015.Electronic supplementary materialThe online version of this article (doi:10.1186/s13063-017-2061-x) contains supplementary material, which is available to authorized users.

Exercise-related interventions have been recommended as one of the main components in the management of fibromyalgia syndrome (FMS). Water therapy, which combines water's physical properties and exercise benefits, has proven effective in improving the clinical symptoms of FMS, especially pain, considered the hallmark of this syndrome. However, to our knowledge, the mechanisms underlying water therapy effects on pain are still scarcely explored in the literature. Therefore, this narrative review aimed to present the current perspectives on water therapy and the physiological basis for the mechanisms supporting its use for pain management in patients with FMS. Furthermore, the effects of water therapy on the musculoskeletal, neuromuscular, cardiovascular, respiratory, and neuroendocrine systems and inflammation are also addressed. Taking into account the aspects reviewed herein, water therapy is recommended as a nonpharmacologic therapeutic approach in the management of FMS patients, improving pain, fatigue, and quality of life. Future studies should focus on clarifying whether mechanisms and long-lasting effects are superior to other types of nonpharmacological interventions, as well as the economic and societal impacts that this intervention may present.

Resumo: Introdução: O diabetes mellitus tipo 2 (DM2) é um distúrbio crônico com morbimortalidade que limita a qualidade de vida devido às complicações. Objetivo: Avaliar, por meio de questionários, os aspectos físicos, emocionais e sociais que envolvem a doença e a qualidade de vida de pacientes com DM tipo 2 de uma unidade básica de saúde (UBS) de Bauru (SP The impact of diabetes mellitus on the quality of life of patients of Primary Health CareAbstract: Introduction: Diabetes Mellitus type 2 (DM2) is a chronic disorder with morbidity and mortality, which limits the quality of life due to complications. Objective: To evaluate through questionnaires the physical, emotional and social issues surrounding the disease and quality of life of patients with type 2 DM of a Basic Health Unit (BHU) of Bauru/SP. Method: The participants (patients type 2 DM, over 40 years, both genders, registered in the BHU Vila Cardia, Bauru-SP) answered the B-PAID questionnaire (DM impact perspective on quality of life and emotional aspects); DQOL (satisfaction, impact, social/ vocational preoccupation related to DM) and QAD (self-care). The data were presented descriptively, it was correlated with the time of DM with scores of B-PAID and DQOL questionnaires by Spearman correlation (p <0.05). Results: The sample consisted of 59 individuals, aged 63.5 ± 10 years, weight 79 ± 13 kg, BMI 29 ± 4 kg/m 2 . The questionnaire B-PAID indicated score of 19 (11-48) points evidencing low emotional suffering, the DQOL indicated that the most frequent preoccupation were the complications of DM and the QAD found lower adherence in "sweet ingest" and higher in "ingesting the indicated number of drugs". There was a positive correlation of DM time with the score of B-PAID, the shorter the duration of disease, less emotional suffering. Conclusion: It is expected that this study will contribute to provide information about the patients and direct health interventions, aiming to improve the quality of life and self-care of type 2 DM.

ObjectiveTo associate the pre- and intraoperative variables with postoperative complications of patients undergoing coronary artery bypass graft surgery.MethodsThe pre- and intraoperative risk factors of individuals of both genders with diagnosis of coronary insufficiency undergoing coronary artery bypass graft have been studied.ResultsFifty-eight individuals with median age 62 ± 10 year-old were included in the study, 67% of whom were male. Fourteen (24.1%) patients were smokers, 39 (67.2%) had previous myocardial infarction history, 11 (19%) had undergone coronary angioplasty, 74% had hypertension, 27% had diabetes mellitus, 64% had dyslipidemia and 15.5% had chronic obstructive pulmonary disease. Eighteen (31%) patients presented postoperative complications, most frequent being: infection in surgical incision, difficulties in deambulation, dyspnea, urinary infection and generalized weakness. Male patients had fewer complications than females (P=0.005). Patients with chronic obstructive pulmonary disease remained hospitalized for longer time periods (P=0.019). Postoperative complications occurred in 50% of the patients with creatinine increased, while only 27.1% of the patients with normal value of creatinine had complications (P=0.049). In addition, complications occurred in 50% of the patients with diabetes mellitus, while only 23.8% of patients without diabetes mellitus had complications (P=0.032). The intraoperative factors showed no statistically significant differences.Conclusion The preoperative factors are associated with postoperative complications in patients undergoing coronary artery bypass graft surgery.