O exercício físico é uma das principais terapêuticas utilizadas para o paciente hipertenso, pois reduz a pressão arterial (PA) e os fatores de risco cardiovasculares, diminuindo a morbimortalidade. OBJETIVO: Analisar os efeitos do exercício físico na PA de idosos hipertensos, com base nos resultados de pesquisas empíricas realizadas no período de 2000 a 2010. METODOLOGIA: Revisão sistemática de estudos experimentais, em inglês, português e espanhol, nas bases eletrônicas MEDLINE, PubMed, Lilacs, Cochrane e PEDro, publicados entre 2000 e 2010, utilizando os descritores hipertensão, atividade física, exercício físico, idoso, exercício aeróbio e treinamento de resistência. RESULTADOS: Foram encontrados 19 artigos e incluídos 12 artigos, sendo divididos em categorias temáticas: exercício aeróbico (6 artigos), exercício resistido (4), exercício aeróbico associado ao resistido (2). Entre os exercícios aeróbicos, três artigos evidenciaram redução na pressão arterial sistólica (PAS) e pressão arterial diastólica (PAD). Três artigos afirmam que treinamento resistido reduz significativamente os valores de PAS em repouso e pressão arterial média (PAM), apenas um artigo não registrou uma redução significativa na PAD e frequência cardíaca (FC) de repouso. A utilização dos exercícios aeróbicos associados aos resistidos foram superiores aos demais, pois apontaram reduções significativas na PAS, PAD, PAM e FC de repouso, confirmando as recomendações da VI Diretriz Brasileira de Hipertensão Arterial, mas os estudos em idosos são escassos. CONCLUSÃO: Esta revisão confirma os benefícios oriundos da prática do exercício físico na redução da PA após o exercício em idosos hipertensos.
This paper compiles and analyzes some of the most current works related to upper limb prosthesis with emphasis on man-machine interfaces. A brief introduction of the basic subjects is given to explain what a prosthesis is, what types of prostheses exist, what they serve for, how they communicate with the user (control and feedback), and what technologies are involved. The method used in this review is also discussed, as well as the cataloging process and analysis of articles for the composition of this review. Each article is analyzed individually and its results are presented in a succinct way, in order to facilitate future research and serve as a source for professionals related to the area of prosthesis, such as doctors, engineers, researchers, and anyone interested in this subject. Finally, the needs and difficulties of the current prostheses, as well as the negative and positive points in the results are analyzed, and the progress achieved so far is discussed.
Salicylate intoxication is a cause of tinnitus and comorbidly associated with anxiety in humans. In a previous work, we showed that salicylate induces anxiety-like behavior and hippocampal type 2 theta oscillations (theta2) in mice. Here we investigate if the anxiogenic effect of salicylate is dependent on age and previous tinnitus experience. We also tested whether a single dose of DMT can prevent this effect. Using microwire electrode arrays, we recorded local field potential in young (4-5-month-old) and old (11-13-month-old) mice to study the electrophysiological effect of tinnitus in the ventral hippocampus (vHipp) and medial prefrontal cortex (mPFC) in an open field arena and elevated plus maze 1 h after salicylate (300 mg/kg) injection. We found that anxietylike behavior and increase in theta2 oscillations (4-6 Hz), following salicylate pre-treatment, only occurs in young (normal hearing) mice. We also show that theta2 and slow gamma oscillations increase in the vHipp and mPFC in a complementary manner during anxiety tests in the presence of salicylate. Finally, we show that pretreating mice with a single dose of the hallucinogenic 5-MeO-DMT prevents anxiety-like behavior and the increase in theta2 and slow gamma oscillations after salicylate injection in normal hearing young mice. This work further support the hypothesis that anxiety-like behavior after salicylate injection is triggered by tinnitus and require normal hearing. Moreover, our results show that hallucinogenic compounds can be effective in treating tinnitus-related anxiety.
Background: Postoperative respiratory complications (PRCs) are common after liver transplantation (LT) and contribute significantly to the related morbidity and mortality. Objective: The aim of this paper was to determine the incidence of PRCs after LT and the value of simple exercise capacity measures as independent predictors of PRCs. Methods: We conducted a prospective cohort study of consecutive adults submitted to LT at a University Hospital in Fortaleza Brazil from March 2013 to March 2015. At baseline, exercise capacity was assessed with the 6-minute walk test (6MWT) and the 6-minute step test (6MST), lung function was tested by spirometry, and respiratory muscle strength was measured by maximal respiratory pressure. Additional relevant pre- and intraoperative data were collected through interview and chart review, and their association with the incidence of PRCs was evaluated. Results: The study included 100 subjects, 44% of whom presented at least 1 of the PRCs. In the univariate analysis, poor 6MST and 6MWT results and a longer preoperative cold ischemia time were associated with PRCs. The logistic regression analysis showed that PRCs were less likely to occur when preoperative walking distances were longer: the odds ratio (95% CI) was reduced to 0.589 (0.357-0.971) for each 50 m walked (p = 0.03). Likewise, PRCs were more likely to occur in patients with longer preoperative cold ischemia times: the odds ratio (95% CI) increased to 1.008 (1.002-1.015) for each minute (p = 0.01). Conclusion: The incidence of PRCs is high in LT patients. A prolonged cold ischemia time and preoperative 6MWT results were independent predictors of PRCs in this patient population.
Com a pandemia de COVID-19, é necessário o rápido entendimento das prováveis e graves sequelas que os pacientes sobreviventes podem desenvolver, assim como torna-se urgente traçar planos de ação para enfrentar tal situação desde o processo de alta hospitalar até a inserção em serviços de reabilitação cardiopulmonar. De acordo com recomendações internacionais, uma avaliação individualizada deve ser realizada e documentada no momento da alta, a qual deve contemplar as necessidades imediatas (controle dos sintomas como dispneia, fadiga e dor), assim como as necessidades a curto e médio prazo (melhora da função física e emocional; retorno ao trabalho; dentre outros). É aconselhável que nas primeiras semanas após a alta, o paciente seja atendido através de comunicação digital, a qual deve incluir imagem e áudio por questões de segurança. Componentes mandatórios dos programas de reabilitação cardiopulmonar incluem exercícios de força e resistência, além do trabalho da musculatura inspiratória. A abordagem educacional, é item importante no processo de tratamento. A reabilitação de doentes críticos acometidos por COVID-19 após alta hospitalar é de fundamental importância, especialmente naqueles que evoluíram com o quadro grave da doença, e que necessitaram de internação em UTI.
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