Brazilian consensus on Duchenne muscular dystrophy. Part 2: rehabilitation and systemic care.

Significant advances in the understanding and management of Duchenne muscular dystrophy (DMD) have occurred since the publication of international guidelines for DMD care in 2010. Our objective was to provide an evidence-based national consensus statement for multidisciplinary care of DMD in Brazil. A combination of the Delphi technique with a systematic review of studies from 2010 to 2016 was employed to classify evidence levels and grade of recommendations for the guideline.

BETWEEN DREAMS AND REALITY: Migration of Brazilian women to Switzerland.

The general objective of this article was to study the process of illegal migration of Brazilian women to Switzerland and, more specifically, to analyze the motivations for migration, the difficulties found upon arrival, the circumstances that led them to get married and lastly an evaluation of the whole experience. The methodology was based in a qualitative approach. The participants were eight Brazilian women that illegally migrated to Switzerland but now are married with Swiss or European men.

On the functional capacity and quality of life of patients with acromegaly: are they candidates for rehabilitation programs?

[Purpose] This study compared patients having active acromegaly with those having controlled acromegaly in terms of peripheral muscle strength, body composition, and functional capacity. We also examined the associations between these measures. [Methods] A total of 14 patients with active acromegaly, 12 patients with controlled acromegaly, and 12 healthy controls were subjected to isometric dynamometry, surface electromyography, electrical bioimpedance, and a six-minute walk test.

Effects of ELTGOL and Flutter VRP1® on the dynamic and static pulmonary volumes and on the secretion clearance of patients with bronchiectasis.

Background: Although respiratory physical therapy is considered fundamental in the treatment of hypersecretive patients, there is little evidence of its physiological and therapeutic effects in bronchiectasis patients.

Objective: To evaluate the acute physiological effects of ELTGOL and Flutter VRP1® in dynamic and static lung volumes in patients with bronchiectasis and, secondarily, to study the effect of these techniques in sputum elimination.

Methods: Patients with clinical and radiological diagnosis of bronchiectasis were included.

Adiposity and postural balance control: correlations between bioelectrical impedance and stabilometric signals in elderly Brazilian women.

Objective: The purpose of this study was to investigate the correlation between body adiposity and postural control in elderly women.

Introduction: Aging and obesity account for a significant portion of healthcare spending. Life expectancy is increasing worldwide, and Rio de Janeiro has the largest proportion of elderly residents of all Brazilian states.

Comparison between cardiopulmonary exercise testing parameters and computed tomography findings in patients with thoracic sarcoidosis.

Background: Cardiopulmonary exercise testing (CPET) is a safe and clinically useful method to assess functional capacity and to follow disease progression and the response to treatment in several clinical conditions.

Aim: We set out to determine the relationship between outcome measures of CPET and high-resolution computed tomography (HRCT) findings in thoracic sarcoidosis.

Methods: A cross-sectional study was carried out in which 42 nonsmoking outpatients (22 females; median age = 46.

Non-pharmacological treatment of hypertension in primary health care: a comparative clinical trial of two education strategies in health and nutrition.

Background: Poor adherence to non-pharmacological treatment of hypertension represents a serious challenge for public health policies in several countries. This study was conducted to compare two intervention strategies regarding the adherence of adult women to dietary changes recommended for the treatment of hypertension in a community covered by Primary Health Care Unit.

Methods: This study is a randomized controlled trial of a sample composed of 28 women with hypertension enrolled in the Primary Health Care Unit located in the urban area of southeastern Brazil.

Grape extract and α-Tocopherol effect in cardiovascular disease model of Apo E -/- Mice.

Purpose: To verify the effect of consumption of grape extract isolated or combined with α-tocopherol supplementation on atherosclerosis model with Apo E -/- mice.

Methods: After six weeks of atherogenic diet, Apo E -/- mice were divided into the following groups: Control, Grape, Tocopherol and Grape plus Tocopherol. The treatment progressed for 11 weeks when animals were submitted to euthanasia.

CPAP decreases lung hyperinflation in patients with stable COPD.

Background: Dynamic hyperinflation, caused by expiratory flow limitation, markedly increases resting end-expiratory lung volume (functional residual capacity) in many COPD patients.

Objective: To determine the impact and duration of impact of CPAP on hyperinflation and airway resistance in patients with stable COPD.

Methods: In a case series, 21 patients underwent CPAP at 8 cm H(2)O for 15 min, then whole-body plethysmography immediately after, and at 15 and 30 min after CPAP.

Three physiotherapy protocols: effects on pulmonary volumes after cardiac surgery.

Objective: To evaluate inspiratory volume in patients undergoing cardiac surgery and to determine the effects that incentive spirometry (IS) and the breath stacking (BS) technique have on the recovery of FVC in such patients.

Methods: A prospective, controlled, randomized clinical trial involving 35 patients undergoing cardiac surgery at the Hospital de Força Aérea do Galeão (HFAG, Galeão Air Force Hospital), in the city of Rio de Janeiro, Brazil. The patients, all of whom performed mobilization and cough procedures, were randomly divided into three groups: exercise control (EC), performing only the abovementioned procedures; IS, performing the abovementioned procedures and instructed to take long breaths using an incentive spirometer; and BS, performing the abovementioned procedures, together with successive inspiratory efforts using a facial mask coupled to a unidirectional valve.

Understanding the mechanisms of glutamine action in critically ill patients.

Glutamine (Gln) is an important energy source and has been used as a supplementary energy substrate. Furthermore, Gln is an essential component for numerous metabolic functions, including acid-base homeostasis, gluconeogenesis, nitrogen transport and synthesis of proteins and nucleic acids. Therefore, glutamine plays a significant role in cell homeostasis and organ metabolism.

Different levels of Hsp72 in female rat myocardium in response to voluntary exercise and forced exercise.

Background: Physical exercise induces hemodynamic stress.

Objective: To evaluate if voluntary running and forced running induced different levels of stress protein (Hsp72) in the myocardium of female Wistar rats.

Methods: Female rats were randomly assigned to the following groups: forced treadmill running group (FR; n= 6), voluntary running group (VR; n=6) and control group (C; n=6).

Intravenous glutamine decreases lung and distal organ injury in an experimental model of abdominal sepsis.

Introduction: The protective effect of glutamine, as a pharmacological agent against lung injury, has been reported in experimental sepsis; however, its efficacy at improving oxygenation and lung mechanics, attenuating diaphragm and distal organ injury has to be better elucidated. In the present study, we tested the hypothesis that a single early intravenous dose of glutamine was associated not only with the improvement of lung morpho-function, but also the reduction of the inflammatory process and epithelial cell apoptosis in kidney, liver, and intestine villi.

Methods: Seventy-two Wistar rats were randomly assigned into four groups.

Effects of different nutritional support on lung mechanics and remodelling in undernourished rats.

This study investigated the impact of three different oral nutritional support regimens on lung mechanics and remodelling in young undernourished Wistar rats. In the nutritionally deprived group, rats received one-third of their usual daily food consumption for 4 weeks. Undernourished rats were divided into three groups receiving a balanced, glutamine-supplemented, or long-chain triglyceride-supplemented diet for 4 weeks.

Effects of undernutrition on respiratory mechanics and lung parenchyma remodeling.

Undernutrition thwarts lung structure and function, but there are disagreements about the behavior of lung mechanics in malnourished animals. To clarify this issue, lung and chest wall mechanical properties were subdivided into their resistive, elastic, and viscoelastic properties in nutritionally deprived (ND) rats and correlated with the data gathered from histology (light and electron microscopy and elastic fiber content), and bronchoalveolar lavage fluid analysis (lipid and protein content). Twenty-four Wistar rats were assigned into two groups.