Adriana Kessler

A Sindrome Metabolica (SM) e uma epidemia associada a alta morbi-mortalidade cardiovascular e ao elevado custo socioeconomico, o que a torna um problema de saude publica em todo o mundo. Este trabalho consiste em um estudo observacional descritivo, com amostra consecutiva composta por pacientes com diagnostico de SM participantes de um Projeto de Extensao em Reabilitacao Cardiovascular e Metabolica (PERCVM) da Universidade Feevale, que teve como objetivo verificar o perfil clinico de pacientes portadores de SM. Para a coleta de dados, foi utilizada uma ficha de avaliacao composta pelas variaveis: idade, sexo, distância percorrida no teste da caminhada de seis minutos, valores da pressao inspiratoria maxima e da pressao expiratoria maxima obtidas atraves de um manovacuometro e frequencia cardiaca maxima do teste ergometrico. A amostra foi composta por cinco pacientes, sendo quatro (80%) do sexo feminino. Todos os participantes apresentaram as caracteristicas clinicas de SM, tendo com...

Objective: To evaluate the effectiveness of the breath-stacking technique as a method of ventilatory muscle training. Methods: Thirty-eight healthy youngsters were included in the study. The maximum respiratory pressures were evaluated in cmH2O by a digital manovacuometer. The breath-stacking system (face mask attached to a T-tube with a unidirectional inspiratory valve) was used as an overload method in a 4-week 12-session ventilatory muscle training program. Results: Both maximal inspiratory and expiratory pressures increased significantly after ventilatory muscle training for all. Positive peak pressure also increased significantly at the end of the program. Conclusion: Breath-stacking generates sufficient overload to ventilatory muscles to consistently increase maximal respiratory pressures when used in a ventilatory muscle training protocol. The technique was well tolerated, although it needs to be tested in clinical situations involving muscle weakness and other organic dysfun...

Type II Hyperprolinemia is an inherited disorder caused by a deficiency of delta1-pyrroline-5-carboxilic acid dehydrogenase, whose biochemical hallmark is proline accumulation in plasma and tissues. Although neurologic symptoms occur in most patients, the neurotoxicity of proline is still controversial. The main objective of this study was to investigate the effect of acute and chronic administration of proline on creatine kinase activity in the homogenates of cerebellum and midbrain from Wistar rats. Acute treatment was performed by subcutaneous administration of one injection of proline to 22-day-old rats. For chronic treatment, proline was administered four times a day from the 6th to the 21st postpartum day. The results showed that creatine kinase activity was significantly inhibited in the cerebellum and midbrain of rats subjected to acute proline administration. In contrast, this activity was increased in animals subjected to chronic administration. We also measured the in vit...

Contextualizacao: O breath-stacking (BS) e uma tecnica de facil aplicabilidade e apresenta um potencial terapeutico no aumento de volumes pulmonares, porem a sua efetividade enquanto treinamento muscular ventilatorio (TMV) ainda nao foi suficientemente estudada. Objetivo: Avaliar os efeitos do TMV por BS em individuos jovens e higidos. Metodo: A amostra foi composta por 34 participantes, submetidos a avaliacao de pressao inspiratoria (PI) e pressao expiratoria (PE) maximas inicialmente e ao final de cada semana. O TMV por BS foi realizado acoplando-se a mascara, um tubo T e uma valvula unidirecional inspiratoria. Foram realizadas tres vezes semanais, durante quatro semanas. Cada sessao foi composta por tres series de tres minutos, com intervalos de tres minutos. Resultados: PI e PE maximas e carga foram maiores no sexo masculino do que no sexo feminino independentemente do momento das avaliacoes. Em relacao as avaliacoes, nos homens a PI Max aumentou significativamente a partir da 1...

Purpose To evaluate the effects of transcutaneous electrical nerve stimulation (TENS) compared to placebo TENS and a control group on pain, pulmonary function, respiratory muscle strength, and analgesic medications in the postoperative period of thoracotomy in an Intensive care unit (ICU). Methods Patients who had undergone posterolateral thoracotomy were randomly allocated to receive TENS during ICU stay, or placebo TENS, or into the control group. All groups received conventional physiotherapy. We analysed the intensity of pain, pulmonary function, respiratory muscle strength, and use of analgesia medications. Outcomes were evaluated before surgery, immediately after, 24 and 48 h after ICU admission. Results Forty-five patients were included. Regarding pain perception, there was no difference between groups ( p  = 0.172), but there was a significant reduction in pain intensity for patients receiving TENS after first physiotherapy session compared to baseline (4.7 ± 3.2 vs 3.3 ± 2....

Background/Aims The negative impact caused by haematopoietic stem cell transplantation still requires further investigation. This study aims to investigate the effects of this procedure on skeletal muscle strength, functional performance and fatigue sensation in the hospitalisation phase. Methods This prospective cohort study aimed to assess physical performance by measuring ventilatory muscle strength, peripheral muscle strength and fatigue in patients who underwent haematopoietic stem cell transplantation. Results The sample consisted of 30 patients of both sexes (63% men) with a mean age of 48.6 ± 13.2 years. Maximal inspiratory pressure and expiratory pressure decreased by 19% and 16%, respectively (P<0.001). There was a 16% reduction in handgrip strength in the second assessment (P<0.001), as well as a reduction of 30.6% in the 30-Second Chair Stand Test (P<0.001). The fatigue test score increased exponentially (60%) (P<0.001). Individuals with worse results in the ...

O atendimento fisioterapêutico do paciente oncológico é uma tarefa que desafia o conhecimento, principalmente quando se trata em ambiente hospitalar. Recursos tecnológicos de alta complexidade são essenciais tanto para o diagnóstico quanto para o manejo clínico desses pacientes que apresentam grande diversidade de repercussões fisiopatológica, exigindo raciocínio ágil e embasamento teórico sólido e atualizado. Do ponto de vista motor, mais especificamente no âmbito da funcionalidade, a variabilidade de apresentações clinicamente possíveis de serem encontradas neste ambiente é praticamente impossível de ser descrita ou mesmo estimada. Levando em consideração as possíveis combinações entre problemas neuromusculares, musculoesqueléticos, cardiopulmonares há inúmeras possibilidades de prejuízo funcional. É perfeitamente plausível presumir que as alterações da funcionalidade sejam tão variadas que a probabilidade de encontrar padrões definidos seja muito pequena.            Ainda assim, ...

Introdução: Complicações pulmonares pós-operatórias podem ocorrer após cirurgias pulmonares afetando desfavoravelmente o curso clínico e aumentando o risco de morbidades e mortalidade. A Fisioterapia respiratória atua prevenindo, amenizando ou revertendo essas possíveis complicações, sendo a inspirometria de incentivo uma das técnicas utilizadas.Objetivo: Avaliar o efeito do uso da inspirometria de incentivo no período pós-operatório de cirurgia torácica sobre a função pulmonar, força da musculatura ventilatória, complicações pulmonares e o tempo de internação hospitalar.Materiais e Métodos: A busca incluiu as bases Medline/Pubmed, Embase e Scielo, além de busca manual, de setembro a outubro de 2015. Foram incluídos estudos randomizados que avaliaram o uso da inspirometria de incentivo em comparação com outros métodos de tratamento fisioterapêutico em pacientes no pós-operatório de cirurgia torácica (pulmonar).Resultados: Dos 480 artigos encontrados, três foram incluídos. Todos os e...

Type II Hyperprolinemia is an inherited disorder caused by a deficiency of delta1-pyrroline-5-carboxilic acid dehydrogenase, whose biochemical hallmark is proline accumulation in plasma and tissues. Although neurologic symptoms occur in most patients, the neurotoxicity of proline is still controversial. The main objective of this study was to investigate the effect of acute and chronic administration of proline on creatine kinase activity in the homogenates of cerebellum and midbrain from Wistar rats. Acute treatment was performed by subcutaneous administration of one injection of proline to 22-day-old rats. For chronic treatment, proline was administered four times a day from the 6th to the 21st postpartum day. The results showed that creatine kinase activity was significantly inhibited in the cerebellum and midbrain of rats subjected to acute proline administration. In contrast, this activity was increased in animals subjected to chronic administration. We also measured the in vit...

To assess the diagnostic efficiency of the third generation cardiac troponin T assay in routine clinical practice. Prospective observational study of unselected consecutive admissions. Multicentre study in 43 teaching and non-teaching hospitals in 13 countries. 1105 hospital admissions, median age 67 years (range 15-96 years, 63.7% male) with suspected acute coronary syndromes (72.3% of cases) or other non-specific symptoms where cardiac disease required exclusion (27.7%). Over the study period, myoglobin, creatine kinase MB isoenzyme (CK-MB), and cardiac troponin T where measured in parallel with conventional diagnostic tests. Final diagnostic classification involved standard ECG changes and CK-MB mass exceeding 5.0 microg/l. Diagnostic efficiency was assessed by receiver operator characteristic curve analysis including and excluding patients with unstable angina. Measurement of cardiac troponin T was diagnostically equivalent to CK-MB and both were better than myoglobin, with area...

The present study was conducted to determine whether the urinary levels of excreted enzymes, gamma-glutamyltransferase (GGT), alkaline phosphatase (ALP), lactate dehydrogenase (LDH), aspartate (AST) and alanine aminotransferases (ALT), can efficiently indicate, within 24 h, an acute nephrotoxicity due to an overdose of paracetamol (PAR). A baseline urine was collected from the experimental group. Thereafter, blood collected from the orbital sinus (1.0 ml) and paracetamol (650 mg/kg of body weight) was administered by gavage. After the drug administration, animals were returned to the metabolic cages and then urine was collected in the next 22 h. Blood and urine collection was performed at time 0+24 h (T(24)), as well as at times 48 and 72 h (T(48) and T(72)). After the last urine and blood collection, the rats were killed and the kidneys removed and prepared for histological examination. Plasma creatinine and urinary levels of creatinine (to determinate glomerular filtration rate-GFR), GGT, ALP, LDH, ALT and AST were measured. Kidney tissues were stained with hematoxylin and eosin stain for histological assessment. Urinary levels of GGT, ALP and LDH enzymes were significantly higher (P<0.05) at T(24) when compared to the levels at T(0) and returned to basal levels at T(48) and T(72). The number of urinary epithelial cells at T(24) was significantly higher when compared to the control time (T(0)) (P<0.001). The GFR was significantly reduced 24, 48 and 72 h after the drug administration. The number of urinary epithelial cells and urinary enzymes levels are a simple and low cost procedure that is available and can help in the detection of renal acute lesions.

The present study was conducted to determine whether the urinary levels of excreted enzymes, gamma-glutamyltransferase (GGT), alkaline phosphatase (ALP), lactate dehydrogenase (LDH), aspartate (AST) and alanine aminotransferases (ALT), can efficiently indicate, within 24 h, an acute nephrotoxicity due to an overdose of paracetamol (PAR). A baseline urine was collected from the experimental group. Thereafter, blood collected from the orbital sinus (1.0 ml) and paracetamol (650 mg/kg of body weight) was administered by gavage. After the drug administration, animals were returned to the metabolic cages and then urine was collected in the next 22 h. Blood and urine collection was performed at time 0+24 h (T(24)), as well as at times 48 and 72 h (T(48) and T(72)). After the last urine and blood collection, the rats were killed and the kidneys removed and prepared for histological examination. Plasma creatinine and urinary levels of creatinine (to determinate glomerular filtration rate-GFR), GGT, ALP, LDH, ALT and AST were measured. Kidney tissues were stained with hematoxylin and eosin stain for histological assessment. Urinary levels of GGT, ALP and LDH enzymes were significantly higher (P<0.05) at T(24) when compared to the levels at T(0) and returned to basal levels at T(48) and T(72). The number of urinary epithelial cells at T(24) was significantly higher when compared to the control time (T(0)) (P<0.001). The GFR was significantly reduced 24, 48 and 72 h after the drug administration. The number of urinary epithelial cells and urinary enzymes levels are a simple and low cost procedure that is available and can help in the detection of renal acute lesions.