Background:Obesity is characterized by excessive accumulation of body fat, which causes damage to the health of individuals, such as breathing difficulties. Aim:To verify the results of non-invasive ventilation as a preventive strategy on the decline of respiratory function and postoperative complications in patients undergoing Roux-en-Y gastric bypass. Methods:This is a randomized trial, according to CONSORT standards, with obese adults aged 18-40 years. Randomized control group (n=25) only received guidelines regarding posture, early ambulation and cough stimuli, and in the NIV group (n=25), in addition to the aforementioned group, non-invasive ventilation was performed with two pressure levels, once day for 60 min, from the 1st to the 3rd postoperative day (POD). Both groups were evaluated in the preoperative period and in the 1st and 3rd POD for respiratory function, which were: slow vital capacity (VC), inspiratory capacity (IC), minute volume (MV), tidal volume maximal inspiratory muscle strength (Pimax) and peak expiratory flow (PEF). The length of hospital stay and the episodes of postoperative complications were recorded. Results:Of the 50 patients the majority were young adults with degrees of obesity between III and IV. In the intergroup analysis, there was an improvement in the CVL and MV only in the 1st POD in the NIV group, CI in the three moments evaluated in the NIV group and the PFE in the 1st and 3rd PDO also in this group. The most frequent complications were pneumonia, followed by operative wound infection and atelectasis. There was a significant difference between groups, showing a higher occurrence in pneumonia and atelectasis in the control group. The days of hospitalization and intensive care unit were similar. Conclusion:It was observed a faster recovery until the 3rd POD in the IC and PEF variables in the NIV group; in addition, there were fewer complications in this group.

Resumo:Objetivo: Analisou-se o impacto do treinamento físico moderado (TFM) e intenso (TFI) sobre o perfil leucocitário e a atividade microbicida de macrófagos alveolares, em 29 ratos machos Wistar. Métodos: Foram formados três grupos: controle-sedentário (CS), treino-moderado (TM) e treino-intenso (TI). Os TFM e TFI foram efetuados através da natação, com aumento progressivo de carga conforme o peso corporal, até um máximo de 3% para o TFM, e 5% para o TFI. As coletas de sangue para contagem total e diferencial dos leucócitos foram automatizadas através do analisador hematológico Sysmex XT-1800i (Roche®) antes e após o treino. E ao final realizou-se o lavado broncoalveolar para determinar a taxa de fagocitose e a produção de óxido nítrico (ON) de macrófagos. Resultados: O grupo TM apresentou valores maiores para o número de leucócitos (12,77±2,0 x 17,25±2,4 10³/mm³), linfócitos (8,87±1,0 x 12,5±2,1 10³/mm³) e neutrófilos (0,99±0,5 x 3,18±1,0 10³/mm³), p<0,05. Apresentou também uma maior produção de ON (15,77±4,9µmols/mL) e da taxa de fagocitose (38,6%±8,65) em relação ao CS (6,58±1,9µmols/mL e 24,4%±7,40, respectivamente). Enquanto que, o grupo TI apresentou menor taxa de fagocitose (13,1%±1,52 x 24,4%±7,40), maior produção de ON (38,40± 2,1x 6,58±1,9 µmols/mL) e aumento apenas, no valor dos neutrófilos (2,6±1,4x 0,99±0,5 10³/mm³) quando comparado ao CS, p<0,001. Conclusões: O TFM proporcionou melhora nos mecanismos de defesa dos animais adultos. Enquanto que o TFI reduziu a taxa de fagocitose o que poderá implicar em prejuízo da atividade microbicida dos animais. Palavras-chave: Exercício físico. Leucócitos. Fagocitose. Óxido nítrico. Effect of moderate and intense physical training on the mechanisms of defense in adult ratsAbstract: Objective: To assess the impact of moderate (MPT) and intense physical training (IPT) on the white blood cell profile and the microbicide activity of alveolar macrophages in 29 Wistar male rats. Methods: The sample was separated into three groups: control group (sedentary), moderate training (MT), and intense training groups (IT). Swimming was the tool used to classify both moderate and intense training groups with a progressive increase of exercise load regarding body weight (up to 3% for the moderate physical training and 5% for the intense training group). The blood samples used to count total and differential leucocytes were automated by a hematological analyzer Sysmex XT-1800i (Roche®) before and after training sessions. At the end of the process, a bronchoalveolar lavage was carried out so to determine the amount of phagocytosis and the production of nitric oxide (NO) of the macrophages. Results: The MT showed an increase in the number of leucocytes (12,77±2,0x17,25±2,4 10³/mm³), lymphocytes (8,87±1,0x 12,5±2,1 10³/mm³) and neutrophils (0,99±0,5x3,18 ±1,0 10³/mm³), p<0,05. There was also a higher production of NO (15,77±4,9µmols/mL) as well as a higher phagocytosis rate of (38,6%±8,65) as to the control group (6,58±1,9 µmols/mL and 24,4%±7,40, respectively). Whereas the IT ...

Introduction: Exercise and the amino acid L-Arginine can promote anatomical and physiological changes in the skeletal muscle. Objective: The objective of this work was to analyze the influence of L-arginine associated with exercise in the skeletal muscle fibers. Methods: To carry out our research, 24 male Wistar rats divided into 4 groups according to the administration of Arginine and physical exercise were used. The experimental groups were distributed as follows: Arginine-Exercise (AE, n = 6), Arginine--Not Exercised (AN, n = 6), Water-Exercise (WE, n = 6) and Water-Not Exercised (WN, n = 6). The amino acid L-Arginine was administered via orogastric intubation, at dose of 300mg/kg, daily from the 7th to 35th days of life of the animal. The exercise was performed on motorized treadmill for 30 minutes/day, 5 times a week, from 15th to 35th days of life of the animal. At the age of 35-45 days, the animals were weighed and sacrificed in order to collect the gastrocnemius muscle. The gastrocnemius muscle was measured, weighed and processed for histological analysis. The muscle's images were taken in order to calculate the mean diameter of the muscle fiber. Data were expressed as mean ± standard deviation and analyzed using SPSS. The Shapiro-Wilk, one-way ANOVA and Tukey's tests (p <0.05) were applied. Results: Concerning body weight and gastrocnemius weight, there was no significant difference when all the experimental groups were compared. However, the AN group presented the highest mean diameter when compared to the other groups. Conclusion: This fact suggests that orogastric administration of Arginine offered to the animals that were not exercised, promotes muscle hypertrophy. On the other hand, exercise by itself did not lead to increase in mean diameter of the skeletal muscle.

Introdução: A sobrecarga corporal devida à obesidade contribui no surgimento de alterações no sistema musculoesquelético e respiratório. Objetivo: Analisar as evidências científicas referentes à influência da obesidade sobre a postura do tronco, a resposta cinético-funcional do diafragma e a função pulmonar em crianças e adolescentes. Métodos: Trata-se de uma revisão de literatura, utilizando as bases de dados Medline, Cochrane, Embase, Lilacs e Web of Sciences, nos idiomas inglês, português e espanhol, nos últimos 10 anos. Foram utilizados os descritores: “obesidade’, “postura”, “diafragma”, “função pulmonar”, “adolescentes”, “adultos jovens”. Os critérios de exclusão foram: estudos que abordaram distúrbios neuromusculares associados, cifoescoliose, fibrose cística, enfisema pulmonar, asma e DPOC e artigos não disponíveis na íntegra. Resultados: Foram identificados 226 estudos, porém 10 foram analisados. Os resultados apontaram que a postura do tronco nos obesos é hipercifótica, hiperlordótica e com anteversão pélvica, além de apontar indícios de repercussão na dinâmica respiratória, com redução da mobilidade do diafragma e dos volumes e capacidades pulmonares. Conclusão: A obesidade contribui para a ocorrência de hipercifose, hiperlordose e anteversão da pelve, bem como na diminuição da atividade do diafragma e função pulmonar.