87 results on '"Armele, Dornelas"'
Search Results
2. Correlation between peripheral endothelial function, oxygen consumption and ventilatory efficiency in heart transplantation recipients
- Author
-
de Souza, Juliana Andrade Ferreira, Catai, Aparecida Maria, de Moura-Tonello, Sílvia Cristina Garcia, Araújo, Bruna T.S., Barros, Ana Eugênia V.R., de Aguiar, Maria Inês Remígio, Campos, Shirley Lima, de Andrade, Armèle Dornelas, and Brandão, Daniella Cunha
- Published
- 2024
- Full Text
- View/download PDF
3. Applicability of heart rate variability for cardiac autonomic assessment in long-term COVID patients: A systematic review
- Author
-
Ferreira, Ádrya Aryelle, Abreu, Raphael Martins de, Teixeira, Rodrigo Souza, da Silva Neto, Herculano Ribeiro, Roriz, Pedro Igor Lustosa, Silveira, Matheus Sobral, de Novaes Assis Dantas, Fabianne Maisa, De Andrade, Armele Dornelas, Schwingel, Paulo Adriano, and Neves, Victor Ribeiro
- Published
- 2024
- Full Text
- View/download PDF
4. Mapping peripheral and abdominal sarcopenia acquired in the acute phase of COVID-19 during 7 days of mechanical ventilation
- Author
-
Pedro Henrique de Moura, Helga de Souza, Daniella Cunha Brandão, Carlos Barros, Mario Correia, Cyda Reinaux, Wagner Souza Leite, Armele Dornelas de Andrade, and Shirley Lima Campos
- Subjects
Medicine ,Science - Abstract
Abstract Our aim was to map acquired peripheral and abdominal sarcopenia in mechanically ventilated adults with COVID-19 through ultrasound measurements. On Days 1, 3, 5 and 7 after admission to critical care, the muscle thickness and cross-sectional area of the quadriceps, rectus femoris, vastus intermedius, tibialis anterior, medial and lateral gastrocnemius, deltoid, biceps brachii, rectus abdominis, internal and external oblique, and transversus abdominis were measured using bedside ultrasound. A total of 5460 ultrasound images were analyzed from 30 patients (age: 59.8 ± 15.6 years; 70% men). Muscle thickness loss was found in the bilateral anterior tibial and medial gastrocnemius muscles (range 11.5–14.6%) between Days 1 and 3; in the bilateral quadriceps, rectus femoris, lateral gastrocnemius, deltoid, and biceps brachii (range 16.3–39.1%) between Days 1 and 5; in the internal oblique abdominal (25.9%) between Days 1 and 5; and in the rectus and transversus abdominis (29%) between Days 1 and 7. The cross-sectional area was reduced in the bilateral tibialis anterior and left biceps brachii (range 24.6–25.6%) between Days 1 and 5 and in the bilateral rectus femoris and right biceps brachii (range 22.9–27.7%) between Days 1 and 7. These findings indicate that the peripheral and abdominal muscle loss is progressive during the first week of mechanical ventilation and is significantly higher in the lower limbs, left quadriceps and right rectus femoris muscles in critically ill patients with COVID-19.
- Published
- 2023
- Full Text
- View/download PDF
5. Agreement between two methods for assessment of maximal inspiratory pressure in patients weaning from mechanical ventilation
- Author
-
Emanuelle Olympia Silva Ribeiro, Rik Gosselink, Lizandra Eveline da Silva Moura, Raissa Farias Correia, Wagner Souza Leite, Maria das Graças Rodrigues de Araújo, Armele Dornelas de Andrade, Daniella Cunha Brandão, and Shirley Lima Campos
- Subjects
agreement ,biomedical technology assessment ,mechanical ventilation ,respiratory muscles ,respiratory system diagnostic technique ,Medical emergencies. Critical care. Intensive care. First aid ,RC86-88.9 - Abstract
Background Respiratory muscle strength in patients with an artificial airway is commonly assessed as the maximal inspiratory pressure (MIP) and is measured using analogue or digital manometers. Recently, new electronic loading devices have been proposed to measure respiratory muscle strength. This study evaluates the agreement between the MIPs measured by a digital manometer and those according to an electronic loading device in patients being weaned from mechanical ventilation. Methods In this prospective study, the standard MIP was obtained using a protocol adapted from Marini, in which repetitive inspiratory efforts were performed against an occluded airway with a one-way valve and were recorded with a digital manometer for 40 seconds (MIPDM). The MIP measured using the electronic loading device (MIPELD) was obtained from repetitively tapered flow resistive inspirations sustained for at least 2 seconds during a 40-second test. The agreement between the results was verified by a Bland-Altman analysis. Results A total of 39 subjects (17 men, 55.4±17.7 years) was enrolled. Although a strong correlation between MIPDM and MIPELD (R=0.73, P
- Published
- 2022
- Full Text
- View/download PDF
6. Ventilation asymmetry, diaphragmatic mobility and exercise capacity in men with traumatic brachial plexus injury
- Author
-
Fuzari, Helen Kerlen Bastos, de Andrade, Armèle Dornelas, Barcelar, Jacqueline de Melo, Sarmento, Antônio, Bernardino, Silvya Nery, de Souza, Fernando Henrique Moraes, and de Oliveira, Daniella Araújo
- Published
- 2022
- Full Text
- View/download PDF
7. Influence of Mechanical Ventilation Modes on the Efficacy of Nebulized Bronchodilators in the Treatment of Intubated Adult Patients with Obstructive Pulmonary Disease
- Author
-
Cibelle Andrade Lima, Shirley Lima Campos, Monique Pontes Bandeira, Wagner Souza Leite, Daniella Cunha Brandão, Juliana Fernandes, James B. Fink, and Armele Dornelas de Andrade
- Subjects
bronchodilator ,mechanical ventilation ,asthma ,COPD ,nebulizers and vaporizers ,inhalation ,Pharmacy and materia medica ,RS1-441 - Abstract
Background: Little has been reported in terms of clinical outcomes to confirm the benefits of nebulized bronchodilators during mechanical ventilation (MV). Electrical Impedance Tomography (EIT) could be a valuable method to elucidate this gap. Objective: The purpose of this study is to evaluate the impact of nebulized bronchodilators during invasive MV with EIT by comparing three ventilation modes on the overall and regional lung ventilation and aeration in critically ill patients with obstructive pulmonary disease. Method: A blind clinical trial in which eligible patients underwent nebulization with salbutamol sulfate (5 mg/1 mL) and ipratropium bromide (0.5 mg/2 mL) in the ventilation mode they were receiving. EIT evaluation was performed before and after the intervention. A joint and stratified analysis into ventilation mode groups was performed, with p < 0.05. Results: Five of nineteen procedures occurred in controlled MV mode, seven in assisted mode and seven in spontaneous mode. In the intra-group analysis, the nebulization increased total ventilation in controlled (p = 0.04 and ⅆ = 2) and spontaneous (p = 0.01 and ⅆ = 1.5) MV modes. There was an increase in the dependent pulmonary region in assisted mode (p = 0.01 and ⅆ = 0.3) and in spontaneous mode (p = 0.02 and ⅆ = 1.6). There was no difference in the intergroup analysis. Conclusions: Nebulized bronchodilators reduce the aeration of non-dependent pulmonary regions and increase overall lung ventilation but there was no difference between the ventilation modes. As a limitation, it is important to note that the muscular effort in PSV and A/C PCV modes influences the impedance variation, and consequently the aeration and ventilation values. Thus, future studies are needed to evaluate this effort as well as the time on ventilator, time in UCI and other variables.
- Published
- 2023
- Full Text
- View/download PDF
8. Effectiveness of inspiratory muscle training associated with a cardiac rehabilitation program on sympathetic activity and functional capacity in patients with heart failure: a study protocol for a randomized controlled trial
- Author
-
Jéssica Costa Leite, Daniella Cunha Brandão, Simone Cristina Soares Brandão, Helen Kerlen Bastos Fuzari, Tainá Maria Vidal, Jasiel Frutuoso, Maria Inês Remígio, Bruna Thays Santana de Araújo, Shirley Lima Campos, and Armele Dornelas de Andrade
- Subjects
Heart failure ,Sympathetic hyperactivation ,Functional capacity ,Cardiac rehabilitation ,Inspiratory muscle training ,Medicine (General) ,R5-920 - Abstract
Abstract Background Individuals affected by heart failure (HF) may present fatigue, dyspnea, respiratory muscle weakness, and sympathetic activity hyperstimulation of the myocardium, among other symptoms. Conducting cardiac rehabilitation (CR) programs can be associated with inspiratory muscle training. The aim of this study was to evaluate the efficacy of inspiratory muscular training (IMT) associated with a CR program on modulating myocardial sympathetic activity and maximal functional capacity, submaximal functional capacity, thickness, and mobility of the diaphragm muscle in patients with HF. Methods We will conduct a clinical, controlled, randomized, double-blind trial that will include sedentary men and women who are 21–60 years old and who have diagnosed systolic HF and a left ventricular ejection fraction of less than 45%. Participants will be randomly assigned to one of two groups: experimental and control. The control group will follow the conventional CR protocol, and the experimental group will follow the conventional CR protocol associated with IMT 7 days a week. The two proposed exercise protocols will have a frequency of three times a week for a period of 12 weeks. The sympathetic innervation of the cardiac muscle, the maximum and submaximal functional capacity, diaphragm mobility and thickness, and the quality of life of the participants will be evaluated before and after the intervention protocol. Discussion This clinical trial will be the first study to investigate the additional effects of IMT on CR in sympathetic hyperstimulation in the myocardium. The results of this study will contribute to developing therapeutic strategies collaborating to elucidate whether the association of IMT with CR can induce clinical benefits for patients with HF. Trial registration ClinicalTrials.gov identifier: NCT02600000 . Registered November 9, 2015. Retrospectively registered.
- Published
- 2020
- Full Text
- View/download PDF
9. Addition of proprioceptive neuromuscular facilitation to cardiorespiratory training in patients poststroke: study protocol for a randomized controlled trial
- Author
-
Renata Janaína Pereira de Souza, Daniella Cunha Brandão, José Vicente Martins, Juliana Fernandes, and Armele Dornelas de Andrade
- Subjects
Clinical trial ,Stroke ,Breathing exercises ,Gait ,Respiratory muscles ,Rehabilitation ,Medicine (General) ,R5-920 - Abstract
Abstract Background Individuals affected by stroke present with changes in cardiovascular and respiratory functions. Cardiorespiratory training (CRT) is one of the classic intervention guidelines for cardiorespiratory fitness. CRT in association with the proprioceptive neuromuscular facilitation (PNF) technique for respiratory muscles could improve the quality of life, cardiorespiratory function and gait parameters of patients after stroke. Objective To assess the effects of respiratory and trunk patterns of CRT associated with PNF on the quality of life, gait, oxygen consumption, respiratory muscle strength and thoracic volumes. Methods/design A blind, randomized clinical trial with allocation confidentiality will be performed. Forty patients will be randomized into four groups: CRT-lower limb (LL) plus PNF; CRT-LL and respiration; CRT-upper limb (UL) plus PNF; or CRT-UL and respiration. Individuals will be evaluated at three different times (pretreatment, after 20 days of treatment and 1 month after the end of treatment). The treatment protocol consists of respiratory exercises, 30 min of CRT (cycle ergometer) and then repetition of the respiratory exercises, performed three times a week over a period of 20 days. Primary outcome measures are quality of life, gait, balance, peak oxygen uptake and rib cage compartment volumes. As secondary outcomes, respiratory function and maximal inspiratory and expiratory pressures will be measured. Discussion The association of PNF with CRT may be a viable and accessible alternative to increase cardiorespiratory function in patients with stroke. Trial registration ClinicalTrials.gov, NCT03171012. Registered on 6 June 2017.
- Published
- 2020
- Full Text
- View/download PDF
10. Impacto do fast track em cirurgia cardíaca de adultos: desfechos clínicos e hospitalares
- Author
-
Cibelle Andrade Lima, Maria Karoline Richtrmoc, Wagner Souza Leite, Diogo André Rodrigues Galdino Silva, Wildberg Alencar Lima, Shirley Lima Campos, and Armele Dornelas de Andrade
- Subjects
Extubação ,Procedimentos cirúrgicos cardíacos ,Respiração artificial ,Capacidade vital ,Tempo de internação ,Unidades de terapia intensiva ,Medical emergencies. Critical care. Intensive care. First aid ,RC86-88.9 - Abstract
RESUMO Objetivo: Comparar o impacto de duas estratégias de fast track quanto ao momento de extubação e retirada da ventilação mecânica invasiva de adultos no pós-operatório cardíaco em desfechos clínicos e hospitalares. Métodos: Estudo de coorte retrospectivo com pacientes submetidos à cirurgia cardíaca. Os pacientes foram classificados de acordo com o tempo de extubação em Grupo Controle (extubados após 6 horas de admissão na unidade de terapia intensiva, com tempo máximo de ventilação mecânica de 18 horas), Grupo 1 (extubados em sala de operação após término da cirurgia) e Grupo 2 (extubados em até 6 horas pós-admissão na unidade de terapia intensiva). Os desfechos primários analisados foram: capacidade vital no primeiro dia de pós-operatório, tempo de internamento hospitalar e na unidade de terapia intensiva. Os desfechos secundários foram reintubação, pneumonia adquirida no hospital, sepse e óbito. Resultados: Para os 223 pacientes avaliados, a capacidade vital foi menor nos Grupos 1 e 2 comparados ao Controle (p = 0,000 e p = 0,046, respectivamente). Os dias de internamento em unidade de terapia intensiva foram significativamente menores nos Grupos 1 e 2 quando comparados ao Controle (p = 0,009 e p = 0,000, respectivamente), já os dias de internamento hospitalar foram menores no Grupo 1 quando comparado ao Controle (p = 0,014). Houve associação entre a extubação na sala de operação (Grupo 1) com reintubação (p = 0,025) e complicações pós-cirúrgicas (p=0,038). Conclusão: Pacientes submetidos ao fast track com extubação em até 6 horas apresentaram menor tempo de internamento em unidade de terapia intensiva sem aumentar complicações pós-cirúrgicas e óbito. Pacientes extubados em sala de operação tiveram menor tempo de internamento hospitalar e em unidade de terapia intensiva, mas apresentaram aumento na frequência de reintubação e complicações pós-cirúrgicas.
- Published
- 2019
- Full Text
- View/download PDF
11. Thoracoabdominal asynchrony and paradoxical motion in middle stage amyotrophic lateral sclerosis
- Author
-
Sarmento, Antonio, Fregonezi, Guilherme, Dourado-Junior, Mario Emílio Teixeira, Aliverti, Andrea, de Andrade, Armele Dornelas, Parreira, Verônica Franco, and Resqueti, Vanessa
- Published
- 2019
- Full Text
- View/download PDF
12. Can diaphragmatic breathing modify chest wall volumes during inspiratory loaded breathing in patients with heart failure?
- Author
-
Lage, Susan Martins, Britto, Raquel Rodrigues, Brandão, Daniella Cunha, Pereira, Danielle Aparecida Gomes, Andrade, Armèle Dornelas de, and Parreira, Verônica Franco
- Published
- 2018
- Full Text
- View/download PDF
13. Does Valved Holding Chamber Improve Aerosol Lung Deposition with a Jet Nebulizer? A Randomized Crossover Study
- Author
-
Luciana Alcoforado, Dulciane Nunes Paiva, Arzu Ari, Jacqueline de Melo Barcelar, Simone Cristina Soares Brandão, James B. Fink, and Armele Dornelas de Andrade
- Subjects
vibrating mesh nebulizer ,jet nebulizer ,scintigraphy ,spacer ,valved holding chamber ,aerosol delivery ,Pharmacy and materia medica ,RS1-441 - Abstract
Using valved holding chambers (VHC) during aerosol therapy has been reported to improve the inhaled dose with various aerosol devices, including vibrating mesh nebulizers. The aim of this study was to quantify the pulmonary deposition of a jet nebulizer (JN) with and without a VHC, and a mesh nebulizer (MN) with a VHC in a randomized cross-over trial with seven healthy consenting adults. Our hypothesis was that the use of a VHC would improve deposition with the JN. Diethylnitriaminopentacetic acid with technetium (DTPA-Tc99m), with the activity of 1 mC with 0.9% saline solution was nebulized. The radiolabeled aerosol was detected by 2D planar scintigraphy after administration. The pulmonary deposition was greater with a JN with a VHC (4.5%) than a JN alone (3.2%; p = 0.005. However, an MN with a VHC (30.0%) was six-fold greater than a JN or JN with a VHC (p < 0.001). The extrapulmonary deposition was higher in the JN group without a VHC than in the other two modalities (p < 0.001). Deposition in the device was greater with a JN + VHC than an MN+/VHC (p < 0.001). Lower residual drug at the end of the dose was detected with an MN than either JN configuration. The exhaled dose was greater with a JN alone than either an MN or JN with VHC (p < 0.001). In conclusion, the addition of the VHC did not substantially improve the efficiency of aerosol lung deposition over a JN alone.
- Published
- 2022
- Full Text
- View/download PDF
14. Health Competency Standards in Physical Therapist Practice
- Author
-
Dean, Elizabeth, Skinner, Margot, Myezwa, Hellen, Mkumbuzi, Vyvienne, Mostert, Karien, Parra, Diana C., Shirley, Debra, Soderlund, Anne, de Andrade, Armele Dornelas, Abaraogu, Ukachukwu Okoroafor, Bruno, Selma, Clark, Diane, Gylfadottir, Sif, Jones, Alice, Veluswamy, Sundar Kumar, Lomi, Constantina, Moffat, Marilyn, Morris, David, Stensdotter, Ann-Katrin, Wong, Wai Pong, and Group, Global Health Working
- Subjects
Obesity ,Evidence-based medicine ,Hypertension ,Heart diseases ,Physical therapy ,Respiratory tract diseases ,Type 2 diabetes ,World health ,Smoking cessation ,Surgery ,Lung diseases ,Public health ,Nutrition ,Physical therapists ,Cardiovascular diseases ,Retirement benefits ,Health ,Harvard University. Harvard Medical School -- Standards ,World Health Organization -- Standards - Abstract
Although the physical therapist profession is the leading established, largely nonpharmacological health profession in the world and is committed to health promotion and noncommunicable disease (NCD) prevention, these have yet to be designated as core physical therapist competencies. Based on findings of 3 Physical Therapy Summits on Global Health, addressing NCDs (heart disease, cancer, hypertension, stroke, diabetes, obesity, and chronic lung disease) has been declared an urgent professional priority. The Third Summit established the status of health competencies in physical therapist practice across the 5 World Confederation for Physical Therapy (WCPT) regions with a view to establish health competency standards, this article's focus. Three general principles related to health-focused practice emerged, along with 3 recommendations for its inclusion. Participants acknowledged that specific competencies are needed to ensure that health promotion and NCD prevention are practiced consistently by physical therapists within and across WCPT regions (ie, effective counseling for smoking cessation, basic nutrition, weight control, and reduced sitting and increased activity/exercise in patients and clients, irrespective of their presenting complaints/diagnoses). Minimum accreditable health competency standards within the profession, including use of the WCPT-supported Health Improvement Card, were recommended for inclusion into practice, entry-to-practice education, and research. Such standards are highly consistent with the mission of the WCPT and the World Health Organization. The physical therapist profession needs to assume a leadership role vis-a-vis eliminating the gap between what we know unequivocally about the causes of and contributors to NCDs and the long-term benefits of effective, sustained, nonpharmacological lifestyle behavior change, which no drug nor many surgical procedures have been reported to match., The First and Second Physical Therapy Summits on Global Health (2007 and 2011) paved the way for the Third Summit (2015), the focus of this Perspective article, and its findings [...]
- Published
- 2019
- Full Text
- View/download PDF
15. The Manual Diaphragm Release Technique improves diaphragmatic mobility, inspiratory capacity and exercise capacity in people with chronic obstructive pulmonary disease: a randomised trial
- Author
-
Rocha, Taciano, Souza, Helga, Brandão, Daniela Cunha, Rattes, Catarina, Ribeiro, Luana, Campos, Shirley Lima, Aliverti, Andrea, and de Andrade, Armèle Dornelas
- Published
- 2015
- Full Text
- View/download PDF
16. Whole-Body Vibration Increases Cardiopulmonary Performance in the Elderly: A Randomized Double-Blind Clinical Trial
- Author
-
Pessoa, Maíra Florentino, Brandão, Daniella Cunha, de Sá, Rafaela Barros, Aguiar, Maria Inês R., de Souza, Helga Cecília Muniz, de Melo Barcelar, Jacqueline, Reinaux, Cyda Maria Albuquerque, and de Andrade, Armele Dornelas
- Published
- 2018
- Full Text
- View/download PDF
17. Intensity-dependent effects of cycling exercise on corticospinal excitability in healthy humans: a pilot study
- Author
-
Isis Suruagy, Adriana Baltar, Luis Paulo Gomes, Marina Berenguer, Armele Dornelas, and Kátia Monte-Silva
- Subjects
transcranial magnetic stimulation ,motor córtex ,motor evoked potentials ,exercise ,Sports ,GV557-1198.995 ,Sports medicine ,RC1200-1245 - Abstract
Abstract Aims the aim of this study was to verify the effects of different intensities of locomotor exercise on corticospinal excitability. Methods 18 healthy subjects (27.6 ± 6.5 years,) participated in a design study of three different exercise protocols on a cycle ergometer: (i) 10 min at 75% Wmax (high intensity); (ii) 15min at 60% Wmax (moderate intensity) or (iii) 30 min at 45% Wmax (low intensity). The protocols of lower body cycling were assigned in random order in separate sessions. A control session was done with subjects at rest. Corticospinal excitability was assessed before (baseline) and every 5 min for 15min after the end of exercise/rest (time: 0, 5, 10 and 15) by measurement of the motor evoked potential (MEP) elicited by transcranial magnetic stimulation in the relaxed first-dorsal interosseus muscle. Results Compared to the resting session, a significant decrease (64%) in the motor evoked potential amplitudes was found only in the session of exercise of high intensity. This result seems depend on the level of physical activity of subject. No change was found after rest, low and moderate exercises. Conclusions These findings suggest that changes in the corticospinal excitability depend on exercise intensity and level of physical activity of subjects.
- Published
- 2017
- Full Text
- View/download PDF
18. Impact of Gas Flow and Humidity on Trans-Nasal Aerosol Deposition via Nasal Cannula in Adults: A Randomized Cross-Over Study
- Author
-
Luciana Alcoforado, Arzu Ari, Jacqueline de Melo Barcelar, Simone Cristina S. Brandão, James B. Fink, and Armele Dornelas de Andrade
- Subjects
nasal cannula ,humidity ,aerosol ,scintigraphy ,oxygen and nebulizer ,Pharmacy and materia medica ,RS1-441 - Abstract
Background: Trans-nasal pulmonary aerosol delivery using high flow nasal cannula (HFNC) devices is described with the administration of high gas flows exceeding patient inspiratory flow (HF) and with lower flows (LF). The aim of this pilot clinical trial was to compare deposition and distribution of radiolabeled aerosol via nasal cannula in healthy adults across three rates of gas flow delivered with active heated humidification, and to further identify the impact of aerosol administration without heated humidity. Methods: Twenty-three (23) healthy adults (16F) were randomized to receive aerosol with active heated humidification or unheated oxygen at gas flows of 10 L/min (n = 8), 30 L/min (n = 7), or 50 L/min (n = 8). Diethylenetriaminepentaacetic acid labeled with 1 millicurie (37 MBq) of Technetium-99m (DTPA-Tc99m) was mixed with NaCl to a fill volume of 1 mL, and administered via mesh nebulizer placed at the inlet of the humidifier. Radioactivity counts were performed using a gamma camera and the regions of interest (ROIs) were delimited with counts from the lungs, upper airways, stomach, nebulizer, circuit, and expiratory filter. A mass balance was calculated and each compartment was expressed as a percentage of the total. Results: Lung deposition (mean ± SD) with heated humidified gas was greater at 10 L/min than 30 L/min or 50 L/min (17.2 ± 6.8%, 5.71 ± 2.04%, and 3.46 ± 1.24%, respectively; p = 0.0001). Using unheated carrier gas, a lung dose of aerosol was similar to the active heated humidification condition at 10 L/min, but greater at 30 and 50 L/min (p = 0.011). Administered gas flow and lung deposition were negatively correlated (r = −0.880, p < 0.001). Conclusions: Both flow and active heated humidity inversely impact aerosol delivery through HFNC. Nevertheless, aerosol administration across the range of commonly used flows can provide measurable levels of lung deposition in healthy adult subjects (NCT 02519465).
- Published
- 2019
- Full Text
- View/download PDF
19. Telerehabilitação e reabilitação presencial na tolerância ao exercício e qualidade de vida de sobreviventes da COVID-19: um protocolo de estudo
- Author
-
Araújo, Bruna T S, Brandão, Daniella Cunha, Barros , Ana Eugênia V R, Silva, Maria Paula dos Santos, Lopes, Samara de Menezes, Nunes, Daiara Thatiana Xavier, Leite, Jéssica Costa, Aguiar , Maria Inês Remígio de, Souza, Juliana Andrade Ferreira de, Campos, Shirley Lima, Fernandes, Juliana, and Andrade, Armele Dornelas de
- Subjects
Tolerância ao exercício ,Quality of life ,Telerrehabilitación ,Exercise Tolerance ,Calidad de vida ,Rehabilitation ,COVID-19 ,Reabilitação ,Telereahabilitation ,Qualidade de vida ,Rehabilitación ,Fadiga ,Tolerancia al ejercicio ,Telereabilitação ,Fatigue ,Fatiga - Abstract
Objective: To verify the effects of face-to-face rehabilitation and telerehabilitation on tolerance to the maximum and submaximal exercise, lung function, fatigue intensity and quality of life of survivors of COVID-19. Methodology: This is a protocol of a longitudinal study, of intervention with a sample for convenience. Adults of both sexes who have been diagnosed with COVID-19 confirmed by RT-PCR will be evaluated. After the assessment, they will receive guidance on how to perform exercises without supervision, will be referred to a face-to-face rehabilitation program or telerehabilitation, according to the results obtained in the six-minute walk test and the presence of comorbidities. Expected Results: Demonstrate the effects of exercise through face-to-face rehabilitation and telerehabilitation after being affected by COVID-19, as well as facilitating the development of treatment protocols aimed at the needs observed, aiming to reduce the repercussions caused by the disease and bring a new look to the physiotherapists who work in clinical practice. Objetivo: Verificar los efectos de la rehabilitación presencial y telerrehabilitación sobre la tolerancia al ejercicio máximo y submáximo, la función pulmonar, la intensidad de la fatiga y la calidad de vida de los supervivientes del COVID-19. Metodología: Se trata de un protocolo de estudio longitudinal, de intervención con muestra por conveniencia. Se evaluarán los adultos de ambos sexos que hayan sido diagnosticados con COVID-19 confirmado por RT-PCR. Tras la valoración, recibirán orientación sobre cómo realizar ejercicios sin supervisión, serán derivados a un programa de rehabilitación presencial o telerrehabilitación, según los resultados obtenidos en la prueba de marcha de seis minutos y la presencia de comorbilidades. Resultados Esperados: Demostrar los efectos del ejercicio a través de la rehabilitación presencial y telerrehabilitación luego de ser afectado por COVID-19, así como facilitar el desarrollo de protocolos de tratamiento dirigidos a las necesidades observadas, con el objetivo de reducir las repercusiones ocasionadas por la enfermedad y aportar una nueva mirada a los fisioterapeutas que trabajan en la práctica clínica. Objetivo: Verificar os efeitos da reabilitação presencial e da telerreabilitação na tolerância ao exercício máximo e submáximo, função pulmonar, intensidade da fadiga e qualidade de vida de sobreviventes do COVID-19. Metodologia: Trata-se de um protocolo de estudo longitudinal, de intervenção com amostra por conveniência. Serão avaliados adultos de ambos os sexos com diagnóstico de COVID-19 confirmado por RT-PCR. Após a avaliação eles receberão orientações sobre como realizar exercícios sem supervisão, serão encaminhados para um programa de reabilitação presencial ou telerreabilitação, de acordo com os resultados obtidos no teste de caminhada de seis minutos e a presença de comorbidades. Resultados Esperados: Demonstrar os efeitos do exercício físico por meio da reabilitação presencial e telerreabilitação após o acometimento pelo COVID-19, além de facilitar o desenvolvimento de protocolos de tratamento voltados às necessidades observadas, visando reduzir as repercussões causadas pela doença e trazer um novo olhar para os fisioterapeutas que atuam na prática clínica.
- Published
- 2022
20. Força muscular respiratória: comparação entre primigestas e nuligestas Respiratory muscle strength: comparison between primigravidae and nulligravidae
- Author
-
Andrea Lemos, Ariani Impieri Souza, Armele Dornelas de Andrade, José Natal Figueiroa, and José Eulálio Cabral-Filho
- Subjects
Gravidez ,Testes de função respiratória ,Força muscular ,Pregnancy ,Respiratory function tests ,Muscle strength ,Diseases of the respiratory system ,RC705-779 - Abstract
OBJETIVO: Descrever e comparar os valores de PImáx e de PEmáx em primigestas e nuligestas na faixa etária de 20-29 anos pareadas por idade. MÉTODOS: Foram estudadas 120 primigestas de baixo risco obstétrico, da 5ª a 40ª semana gestacional, e 40 nuligestas, eutróficas, não praticantes de atividade física, provenientes da região metropolitana do Recife (PE). Os valores de PImáx e PEmáx foram obtidos, respectivamente, a partir do VR e da CPT através de um manovacuômetro digital. A comparação entre os grupos foi feita pelo teste t de Student, e a relação dos fatores grupo e idade cronológica sobre as pressões foi avaliada através de regressão linear múltipla. RESULTADOS: No grupo de primigestas e nuligestas, a média de PImáx foi de, respectivamente, 88,5 ± 16,52 cmH2O e 94,22 ± 22,63 cmH2O (p = 0,08), enquanto a média de PEmáx foi de 99.76 ± 18,19 cmH2O e 98,67 ± 20,78 cmH2O (p = 0,75). Não houve correlação entre a idade gestacional e PImáx (r = -0,06; p = 0,49) ou PEmáx (r = -0,11; p = 0,22). A relação entre idade cronológica e PImáx/PEmáx não diferiu entre primigestas e nuligestas (coeficiente angular = 0,028 e 0,453, respectivamente). CONCLUSÕES: As pressões respiratórias de mulheres primigestas mantiveram-se estáveis durante o ciclo gestacional e não diferem significativamente dos valores das nuligestas na faixa etária de 20-29 anos.OBJECTIVE: To describe and to compare MIP and MEP in primigravidae and nulligravidae in the 20-29 year age bracket and paired by age. METHODS: We included 120 primigravidae with low obstetric risk (5th-40th week of gestation) and 40 nulligravidae. All of the participants were of normal weight and none exercised regularly. All were recruited from the metropolitan area of Recife, Brazil. Measurements of MIP and MEP were obtained from RV and TLC, respectively, with a digital manometer. We used Student's t-test to compare the two groups, and we used multiple linear regression in order to determine whether group or chronological age correlated with MIP or MEP. RESULTS: In the primigravida and nulligravida groups, the mean MIP values were 88.50 ± 16.52 cmH2O and 94.22 ± 22.63 cmH2O, respectively, (p = 0.08), whereas the mean MEP values were 99.76 ±18.19 cmH2O and 98.67 ± 20.78 cmH2O (p = 0.75). Gestational age did not correlate with MIP (r = -0.06; p = 0.49) or MEP (r = -0.11; p = 0.22). The relationship between chronological age and MIP/MEP did not differ between primigravidae and nulligravidae (angular coefficient = 0.028 and 0.453, respectively). CONCLUSIONS: Within this sample of women in the 20-29 year age bracket, the respiratory pressures of primigravidae remained stable during pregnancy and did not differ significantly from those of nulligravidae.
- Published
- 2011
- Full Text
- View/download PDF
21. Suplementação de antioxidantes no tratamento da lesão pulmonar aguda: meta-análise Antioxidant supplementation for the treatment of acute lung injury: a meta-analysis
- Author
-
André Martins Galvão, Armele Dornelas de Andrade, Maria Bernadete de Souza Maia, Keyla Emanuelle Ramos da Silva, Alice de Andrade Bezerra, Juliana Felix de Melo, Natalia Gomes de Morais, Thacianna Barreto da Costa, and Célia Maria Machado Barbosa de Castro
- Subjects
Antioxidantes ,Lesão pulmonar aguda ,Radicais livres ,Antioxidants ,Acute lung injury ,Free radicals ,Medical emergencies. Critical care. Intensive care. First aid ,RC86-88.9 - Abstract
OBJETIVO: A pesquisa foi conduzida de maneira a se esclarecer, através de uma meta-análise, as evidências da suplementação de antioxidantes como terapia adjuvante na prevenção dos danos oxidativos e melhora do desfecho clínico, tais como mortalidade, tempo de hospitalização e ventilação mecânica. MÉTODOS: A estratégia de busca de ensaios clínicos randomizados (ECRs) envolveu a participação de dois pesquisadores que avaliaram, de forma independente, a qualidade metodológica de cada artigo, disponível full text, nas bases de dados PubMed, ISI of Knowledge e ScienceDirect. RESULTADOS: Foram extraídos 110 estudos dos últimos 10 anos, porém somente 30 artigos preencheram os critérios metodológicos (ensaios controlados, randomizados, cego e estatisticamente significativo), totalizando 241 animais e 256 pacientes. Este trabalho encontrou um OR de 0,45 [intervalo de confiança (IC) 95%: 0,26 - 0,79] para a mortalidade na comparação do grupo experimental com placebo (6 estudos, n = 256), um OR de de 0,46 [intervalo de confiança (IC) 95%: 0,26 - 0,87] para tempo de hospitalização e um OR de 0,63 [intervalo de confiança (IC) 95%: 0,35 - 1,12] para o tempo de ventilação mecânica assistida entre os grupos. CONCLUSÃO: As evidências são conflitantes e, desta forma, ainda não é possível recomendar o uso rotineiro da suplementação com antioxidantes em pacientes criticamente enfermos.OBJECTIVE: This meta-analysis was performed to evaluate the evidence supporting antioxidant supplementation as an adjunct therapy to prevent oxidative damage and improve the clinical outcomes (mortality, length of hospital stay and duration of mechanical ventilation). METHODS: The search strategy for randomized controlled trials (RCTs) involved the participation of two researchers who independently assessed the methodological quality of each full-text article that was available in the PubMed, ISI WEB of Knowledge and ScienceDirect databases. RESULTS: We extracted 110 studies from the past 10 years, but only 30 articles met the methodological criteria (RCT, blinded and statistically significant results), for a total of 241 animals and 256 patients. This study found an odds ratio (OR) of 0.45 [95% confidence interval (CI): 0.26 to 0.79] for death in the experimental group compared with placebo (six trials, n = 256), an OR of 0.46 [95% CI: 0.26 to 0.87] for hospitalization time and an OR of 0.63 [95% CI: 0.35 to 1.12] for mechanical ventilation time between groups. CONCLUSION: Conflicting evidence makes it impossible to recommend the routine use of antioxidant supplementation in critically ill patients.
- Published
- 2011
- Full Text
- View/download PDF
22. Impact of fast-track management on adult cardiac surgery: clinical and hospital outcomes
- Author
-
Lima, Cibelle Andrade, Ritchrmoc, Maria Karoline, Leite, Wagner Souza, Silva, Diogo André Rodrigues Galdino, Lima, Wildberg Alencar, Campos, Shirley Lima, and de Andrade, Armele Dornelas
- Subjects
Vital capacity ,Intensive care units ,Airway extubation ,Length of stay ,Original Articles ,Respiration, artificial ,Cardiac surgical procedures - Abstract
Objective To compare the impact of two fast-track strategies regarding the extubation time and removal of invasive mechanical ventilation in adults after cardiac surgery on clinical and hospital outcomes. Methods This was a retrospective cohort study with patients undergoing cardiac surgery. Patients were classified according to the extubation time as the Control Group (extubated 6 hours after admission to the intensive care unit, with a maximum mechanical ventilation time of 18 hours), Group 1 (extubated in the operating room after surgery) and Group 2 (extubated within 6 hours after admission to the intensive care unit). The primary outcomes analyzed were vital capacity on the first postoperative day, length of hospital stay, and length of stay in the intensive care unit. The secondary outcomes were reintubation, hospital-acquired pneumonia, sepsis, and death. Results For the 223 patients evaluated, the vital capacity was lower in Groups 1 and 2 compared to the Control (p = 0.000 and p = 0.046, respectively). The length of stay in the intensive care unit was significantly lower in Groups 1 and 2 compared to the Control (p = 0.009 and p = 0.000, respectively), whereas the length of hospital stay was lower in Group 1 compared to the Control (p = 0.014). There was an association between extubation in the operating room (Group 1) with reintubation (p = 0.025) and postoperative complications (p = 0.038). Conclusion Patients undergoing fast-track management with extubation within 6 hours had shorter stays in the intensive care unit without increasing postoperative complications and death. Patients extubated in the operating room had a shorter hospital stay and a shorter stay in the intensive care unit but showed an increase in the frequency of reintubation and postoperative complications.
- Published
- 2019
23. Global Longitudinal Strain Predicts Poor Functional Capacity in Patients with Systolic Heart Failure
- Author
-
Maia, Rafael José Coelho, Brandão, Simone Cristina Soares, Leite, Jéssica, Parente, Giordano Bruno, Pinheiro, Filipe, Araújo, Bruna Thays Santana, Aguiar, Maria Inês Remígio, Martins, Sílvia Marinho, Brandão, Daniella Cunha, and Andrade, Armele Dornelas de
- Subjects
Heart Failure ,Torsion Abnormality ,Ventricular Dysfunction, Left ,Longitudinal Strain ,Insuficiência Cardíaca ,Torsion, Mechanical ,Torção Mecânica ,Strain Longitudinal ,Disfunção Ventricular Esquerda ,Ecocardiografia Doppler/métodos ,Echocardiography, Doppler/methods ,Anormalidade Torcional - Abstract
Background: Left ventricular global longitudinal strain value (GLS) can predict functional capacity in patients with preserved left ventricular ejection fraction (LVEF) heart failure (HF) and to assess prognosis in reduced LVEF HF. Objetive: Correlate GLS with parameters of Cardiopulmonary Exercise Test (CPET) and to assess if they could predict systolic HF patients that are more appropriated to be referred to heart transplantation according to CPET criteria. Methods: Systolic HF patients with LVEF < 45%, NYHA functional class II and III, underwent prospectively CPET and echocardiography with strain analysis. LVEF and GLS were correlated with the following CPET variables: maxVO2, VE/VCO2 slope, heart rate reduction during the first minute of recovery (HRR) and time needed to reduce maxVO2 in 50% after physical exercise (T1/2VO2). ROC curve analysis of GLS to predict VO2 < 14 mL/kg/min and VE/VCO2 slope > 35 (heart transplantation’s criteria) was performed. Results: Twenty six patients were selected (age, 47 ± 12 years, 58% men, mean LVEF = 28 ± 8%). LVEF correlated only with maxVO2 and T1/2VO2. GLS correlated to all CPET variables (maxVO2: r = 0.671, p = 0.001; VE/VCO2 slope: r = -0.513, p = 0.007; HRR: r = 0.466, p = 0.016, and T1/2VO2: r = -0.696, p = 0.001). GLS area under the ROC curve to predict heart transplantation’s criteria was 0.88 (sensitivity 75%, specificity 83%) for a cut-off value of -5.7%, p = 0.03. Conclusion: GLS was significantly associated with all functional CPET parameters. It could classify HF patients according to the functional capacity and may stratify which patients have a poor prognosis and therefore to deserve more differentiated treatment, such as heart transplantation. Resumo Fundamento: O strain longitudinal global (SLG) é capaz de predizer a capacidade funcional dos pacientes com insuficiência cardíaca (IC) e fração de ejeção do ventrículo esquerdo (FEVE) preservada, e avaliar o prognóstico na IC com FEVE reduzida. Objetivo: Correlacionar o SLG com parâmetros do teste de exercício cardiopulmonar (TECP), e avaliar se o SLG seria capaz de predizer quais pacientes com IC sistólica deveriam ser encaminhados ao transplante cardíaco de acordo com os critérios do TECP. Métodos: Os pacientes com IC sistólica com FEVE 35 (critérios para transplante cardíaco). O nível de significância adotado na análise estatística foi de p < 0,05. Resultados: Vinte e seis pacientes foram selecionados para o estudo (idade, 47±12 anos, 58% homens, FEVE média LVEF = 28 ± 8%). A FEVE correlacionou-se somente com o maxVO2 e o T1/2VO2. O SLG correlacionou-se com todas as variáveis do TECP (maxVO2: r = 0,671; p = 0,001; inclinação de VE/VCO2: r = -0,513; p = 0,007; RFC: r = 0,466; p = 0,016; e T1/2VO2: r = -0,696, p = 0,001). A área sob a curva ROC para o SLG para predizer os critérios para transplante cardíaco foi de 0,88 (sensibilidade 75%, especificidade 83%) para um ponto de corte de -5,7%, p = 0,03. Conclusão: O SLG apresentou associação significativa com todos os parâmetros funcionais do TECP. O SLG foi capaz de classificar os pacientes com IC segundo capacidade funcional e possivelmente pode identificar quais pacientes têm um prognóstico ruim e, portanto, se beneficiariam de um tratamento diferenciado, tal como o transplante cardíaco.
- Published
- 2019
24. Intensity-dependent effects of cycling exercise on corticospinal excitability in healthy humans: a pilot study
- Author
-
Armele Dornelas, Marina Berenguer, Kátia Monte-Silva, Adriana Baltar, Luis Paulo de Souza Gomes, and Isis Suruagy
- Subjects
medicine.medical_specialty ,Health (social science) ,medicine.medical_treatment ,lcsh:GV557-1198.995 ,03 medical and health sciences ,0302 clinical medicine ,Lower body ,Physical medicine and rehabilitation ,transcranial magnetic stimulation ,medicine ,lcsh:Sports medicine ,Evoked potential ,motor córtex ,lcsh:Sports ,exercise ,business.industry ,Healthy subjects ,030229 sport sciences ,General Medicine ,Intensity (physics) ,Transcranial magnetic stimulation ,medicine.anatomical_structure ,Exercise intensity ,Physical therapy ,motor evoked potentials ,lcsh:RC1200-1245 ,Cycling ,business ,030217 neurology & neurosurgery ,Motor cortex - Abstract
Aims the aim of this study was to verify the effects of different intensities of locomotor exercise on corticospinal excitability. Methods 18 healthy subjects (27.6 ± 6.5 years,) participated in a design study of three different exercise protocols on a cycle ergometer: (i) 10 min at 75% Wmax (high intensity); (ii) 15min at 60% Wmax (moderate intensity) or (iii) 30 min at 45% Wmax (low intensity). The protocols of lower body cycling were assigned in random order in separate sessions. A control session was done with subjects at rest. Corticospinal excitability was assessed before (baseline) and every 5 min for 15min after the end of exercise/rest (time: 0, 5, 10 and 15) by measurement of the motor evoked potential (MEP) elicited by transcranial magnetic stimulation in the relaxed first-dorsal interosseus muscle. Results Compared to the resting session, a significant decrease (64%) in the motor evoked potential amplitudes was found only in the session of exercise of high intensity. This result seems depend on the level of physical activity of subject. No change was found after rest, low and moderate exercises. Conclusions These findings suggest that changes in the corticospinal excitability depend on exercise intensity and level of physical activity of subjects.
- Published
- 2017
25. Bronchodilator response cut-off points and FEV0.75 reference values for spirometry in pre-schoolers
- Author
-
Burity, Edjane Figueiredo, de Castro Pereira, Carlos Alberto [UNIFESP], Jones, Marcus Herbert, Sayao, Larissa Bouwman, de Andrade, Armele Dornelas, and Amorim de Britto, Murilo Carlos
- Subjects
Child, preschool ,Spirometry ,Espirometria ,Bronchodilator agents ,Valores de referência ,Pré-escolar ,Broncodilatadores ,Reference values - Abstract
Objetivo: Determinar os pontos de corte de resposta ao broncodilatador do VEF1, VEF0,75, VEF0,5 e FEF25-75% em crianças pré-escolares saudáveis e gerar valores de referência para o VEF0,75. Métodos: Foi realizado um estudo transversal de base comunitária em crianças de 3-5 anos de idade. Pré-escolares saudáveis foram selecionados por um questionário padronizado. Foi realizada espirometria antes e depois do uso de broncodilatador. Foram definidos os pontos de corte dessa resposta como o percentil 95 de variação em cada parâmetro. Resultados: Foram recrutadas 266 crianças, e 160 (60,0%) foram capazes de gerar manobras expiratórias aceitáveis e reprodutíveis antes e depois do uso de broncodilatador. As médias de idade e estatura dos participantes foram 57,78 ± 7,86 meses e 106,56 ± 6,43 cm, respectivamente. A taxa de sucesso para o VEF0,5 foi de 35%, 68% e 70%, respectivamente, nos participantes com 3, 4 e 5 anos de idade. O percentil 95 de variação percentual do valor previsto na resposta ao broncodilatador foram, respectivamente, de 11,6%, 16,0%, 8,5% e 35,5%, para VEF1, VEF0,75, VEF0,5 e FEF25-75%. Conclusões: Nossos resultados definiram pontos de corte de resposta ao broncodilatador para o VEF1, VEF0,75, VEF0,5 e FEF25-75 em crianças pré-escolares saudáveis. Adicionalmente, foram propostas equações de referência para o VEF0,75, separadas por sexo. Os achados deste estudo podem melhorar a avaliação fisiológica da função respiratória em pré-escolares. Objective: To determine the cut-off points for FEV1, FEV0.75, FEV0.5, and FEF25-75% bronchodilator responses in healthy preschool children and to generate reference values for FEV0.75. Methods: This was a cross-sectional community-based study involving children 3-5 years of age. Healthy preschool children were selected by a standardized questionnaire. Spirometry was performed before and after bronchodilator use. The cut-off point of the response was defined as the 95th percentile of the change in each parameter. Results: We recruited 266 children, 160 (60%) of whom were able to perform acceptable, reproducible expiratory maneuvers before and after bronchodilator use. The mean age and height were 57.78 ± 7.86 months and 106.56 ± 6.43 cm, respectively. The success rate for FEV0.5 was 35%, 68%, and 70% in the 3-, 4-, and 5-year-olds, respectively. The 95th percentile of the change in the percentage of the predicted value in response to bronchodilator use was 11.6%, 16.0%, 8.5%, and 35.5% for FEV1, FEV0.75, FEV0.5, and FEF25-75%, respectively. Conclusions: Our results provide cut-off points for bronchodilator responsiveness for FEV1, FEV0.75, FEV0.5, and FEF25-75% in healthy preschool children. In addition, we proposed gender-specific reference equations for FEV0.75. Our findings could improve the physiological assessment of respiratory function in preschool children. Inst Med Integral Prof Fernando Figueira IMIP, Recife, PE, Brazil Univ Fed Sao Paulo, Escola Paulista Med, Sao Paulo, SP, Brazil Pontificia Univ Catolica Rio Grande do Sul, Escola Med, Porto Alegre, RS, Brazil Univ Fed Pernambuco, Dept Fisioterapia, Recife, PE, Brazil Univ Fed Sao Paulo, Escola Paulista Med, Sao Paulo, SP, Brazil Web of Science
- Published
- 2016
26. Trocador de calor e umidade: proteção contra infecções pulmonares? Estudo piloto Heat and moisture exchanger: protection against lung infections? Pilot study
- Author
-
Luciana Alcoforado, Daniela Paiva, Filipe Souza da Silva, André Martins Galvão, Valdecir Galindo Filho, Daniella Cunha Brandão, Heloísa Ramos Lacerda, and Armele Dornelas de Andrade
- Subjects
ventilators, mechanical ,ventiladores mecânicos ,respiratory protective devices ,lcsh:Therapeutics. Pharmacology ,respiração artificial ,dispositivos de proteção respiratória ,pneumonia, ventilator-associated ,pneumonia associada à ventilação mecânica ,lcsh:RM1-950 ,umidade ,humidity ,respiration, artificial - Abstract
O objetivo deste trabalho foi realizar um estudo bacteriológico comparativo entre os sistemas de umidificação aquoso aquecido (UAA) e filtro trocador de calor e umidade (FTCU) quanto à colonização bacteriana e a incidência de infecção respiratória em pacientes submetidos à ventilação mecânica (VM). Trata-se de uma pesquisa prospectiva, controlada e randomizada, na qual 15 pacientes internados na Unidade de Terapia Intensiva (UTI) foram distribuídos em dois grupos. O primeiro fez uso de UAA (n=7) e o outro de FTCU (n=8). Foram coletadas amostras da secreção traqueal, condensado do circuito e FTCU na admissão do paciente, no quarto e oitavo dias, e realizada análise bacteriológica dos mesmos. Quanto às características antropométricas, não observou-se diferenças entre os grupos estudados. A prevalência de pneumonia associada à ventilação (PAV) foi de 57,1% no UAA e 62,5% no FTCU. Ao realizar a análise bacteriológica quantitativa entre eles, não foram observadas variações, sugerindo não haver diferença na prevenção de PAV entre os sistemas de umidificação; porém a presença das mesmas bactérias na secreção traqueal e no condensado e ausência destas na membrana do FTCU podem indicar que a principal fonte de contaminação é o próprio paciente.The aim of this study was to conduct a bacteriological research comparing the aqueous heated humidification systems (HH) and filter heat and moisture exchanger (FHME) and to bacterial colonization and the incidence of respiratory infection in patients undergoing mechanical ventilation. It is a prospective, controlled trial, in that 15 intensive care unit (ICU) patients were divided into two groups. The first made use of HH (n=7) and the other, FHME (n=8). We collected samples of tracheal secretions, and condensate circuit FHME at admission in the fourth and eighth day and bacteriological analysis of the same place. Regarding the anthropometric characteristics, no differences were observed between the groups. The prevalence of ventilator associated pneumonia (VAP) was 57.1% in the HH and 62.5% in FHME. When performing quantitative bacteriological analysis between the group and HH and FHME, differences were not observed, suggesting no variation in the prevention of VAP between the humidification systems, but the presence of these bacteria in the tracheal and condensate and in the absence of these membrane FHME may indicate that the main source of contamination is the patient himself.
- Published
- 2012
27. Effects of inspiratory muscle training in elderly women on respiratory muscle strength, diaphragm thickness and mobility
- Author
-
Catarina Rattes, Helga Cecília Muniz de Souza, Armele Dornelas, Maíra Pessoa, Guilherme Fregonezi, Daniella Cunha Brandão, Andrea Aliverti, Shirley Lima Campos, and Taciano Rocha
- Subjects
Senescence ,Sarcopenia ,Aging ,medicine.medical_specialty ,Diaphragm ,Diaphragmatic breathing ,Double-Blind Method ,Internal medicine ,medicine ,Respiratory muscle ,Humans ,Muscle Strength ,Respiratory system ,Physical Therapy Modalities ,Aged ,Ultrasonography ,Aged, 80 and over ,business.industry ,Ultrasound ,Inspiratory muscle training ,Middle Aged ,Prognosis ,Respiratory Muscles ,Diaphragm (structural system) ,Intensity (physics) ,Physical therapy ,Cardiology ,Female ,Geriatrics and Gerontology ,business ,Muscle Contraction - Abstract
BACKGROUND Aging results in a decline in the function of the respiratory muscles. Inspiratory muscle training is emerging as a possible intervention to attenuate the decline of respiratory muscles in the elderly. The aim of this study was to evaluate the efficacy of inspiratory muscle training on respiratory strength, diaphragm thickness, and diaphragmatic mobility in elderly women. METHODS This was a controlled, randomized, and double-blind clinical trial, performed on 22 elderly women distributed in two groups, training (TG) and control (CG). Over an 8-week period a moderate intensity inspiratory muscle training protocol was followed in the TG, while CG followed a sham protocol. In addition maximum expiratory and inspiratory pressure, mobility of the diaphragm and diaphragmatic thickness were evaluated by ultrasound. RESULTS After training, in TG maximal inspiratory pressure, maximal expiratory pressure, diaphragm thickness, and mobility increased by 37%, 13%, 11%, and 9% respectively, and their values were significantly higher than CG (p < .005, p = .013, p = .001, and p = .001). CONCLUSION Inspiratory muscle training of moderate intensity improves respiratory muscle strength, diaphragm thickness, and diaphragm mobility in elderly women and it should be considered to minimize changes associated with senescence.
- Published
- 2014
28. Effects of Whole Body Vibration on Muscle Strength and Quality of Life in Health Elderly: A Meta-Analysis
- Author
-
Maíra Florentino Pessoa, Daniella Cunha Brandão, Rafaela Barros de Sá, Helga Cecília Muniz de Souza, Helen Kerlen Bastos Fuzari, and Armele Dornelas de Andrade
- Subjects
Whole Body Vibration ,Muscle Strength ,Quality of life ,Aged ,Therapeutics. Pharmacology ,RM1-950 ,Sports medicine ,RC1200-1245 - Abstract
Abstract Introduction: The literature presents different findings about the vibration training efficacy on muscle per- formance, even using protocols with similar parameters. Objective: The purpose of this systematic review was to investigate the effects of whole body vibration (WBV) on strength and quality of life in health elderly people, presenting a meta-analisys. Methods: PubMed, CINAHL, SciELO, LILACS and PEDro databases were systematically searched for studies that used WBV in healthy elderly. These searches were supplemented with material identified in references and a qualitative and quantitative analysis was performed to sum- marize the findings. The search was performed by two independent researchers with a third was selected to solve problems of search disagreement, data collection, and quality score. Results: Nine studies with strength outcome and two studies with quality of life outcome were identified, with sample ranging 21 to 220 elderly, all studies had control groups performing exercises or guidelines. Some studies have shown sig- nificant improvements in muscle strength, muscle power, vertical jump height, timed get up and go test and quality of life. Conclusion: The meta-analysis of the findings in these studies shows that WBV could benefit health elderly, increasing muscle strength and improving the quality of life mainly in functional capacity. The number of publications found in the databanks searched is small, with limitations in design of protocols with a weakness to the interpretation of the findings, suggesting the need of investigation with WBV with well-designed protocols and controlled parameters into the effects of WBV training in elderly people.
- Full Text
- View/download PDF
29. Vibrating Platform Training Improves Respiratory Muscle Strength, Quality of Life, and Inspiratory Capacity in the Elderly Adults: A Randomized Controlled Trial.
- Author
-
Pessoa, Maíra Florentino, Brandão, Daniela Cunha, de Sá, Rafaela Barros, de Melo Barcelar, Jacqueline, de Souza Rocha, Taciano Dias, de Souza, Helga Cecília Muniz, de Andrade, Armele Dornelas, Sá, Rafaela Barros de, Barcelar, Jacqueline de Melo, Rocha, Taciano Dias de Souza, Souza, Helga Cecília Muniz de, and Dornelas de Andrade, Armele
- Subjects
MUSCLE strength ,RANDOMIZED controlled trials ,AGING ,QUALITY of life ,ABDOMINAL wall ,RESPIRATORY muscle physiology ,VIBRATION therapy ,COMPARATIVE studies ,RESEARCH methodology ,MEDICAL cooperation ,QUESTIONNAIRES ,RESEARCH ,RESPIRATORY measurements ,EVALUATION research ,TREATMENT effectiveness ,BLIND experiment - Abstract
Background: Aging affects respiratory strength that could cause reduction in functional capacity and quality of life, playing a fundamental role in healthy aging and survival. To prevent these declines, the whole body vibration (WBV) has been proposed to increase strength and functional capacity. The aim of the study was to evaluate the effects of WBV on respiratory muscle strength, thoracoabdominal ventilation, and quality of life in the elderly adults.Methods: This study was a controlled, randomized double-blind clinical trial. The study included 28 elderly adults randomized into three groups: Resistance (n = 9), WBV (n = 9), or WBV + resistance exercises (n = 10), performing training, sham, or double training for 3 months, twice per week. The variables of the study were as follows: maximal inspiratory and expiratory pressures (MIP and MEP), distribution of thoracoabdominal volumes variation in optoelectronic plethysmography (pulmonary rib cage-VRCp, abdominal rib cage-VRCa, and abdomen-VAB), and quality of life.Results: After training, WBV and WBV + resistance groups increased MIP and MEP (p < .001). During inspiratory capacity maneuver, WBV groups had incremental increases in chest wall total volume (p < .001), showing a rise in pulmonary rib cage (p = .03) and abdominal rib cage (p = .04). Furthermore, WBV groups improved SF-36 scores in functional capacity, physical aspects, energy, pain, and general heath domains.Conclusions: The WBV is a training that could improve respiratory muscle strength and quality of life and promote different ventilatory strategies in chest wall and thoracoabdominal compartments in healthy elderly adults. [ABSTRACT FROM AUTHOR]- Published
- 2017
- Full Text
- View/download PDF
30. The effect of tDCS on improving physical performance and attenuating effort perception during maximal dynamic exercise in non-athletes.
- Author
-
Isis, Suruagy, Armele, Dornelas, Paulo, Gomes Luis, Raylene, Araújo, Luam, Diniz, Marina, Berenguer-Rocha, Adriana, Baltar, and Katia, Monte-Silva
- Subjects
- *
PHYSICAL mobility , *TRANSCRANIAL direct current stimulation , *RATE of perceived exertion , *TEMPORAL lobe , *MOTOR cortex , *MALE athletes - Abstract
• Effects of tDCS (transcranial direct current stimulation) tested on non-athletes submitted to maximal dynamic exercise. • Double-blind, crossover, sham-controlled study using electrode positioning. • No significant improvement of performance seen in non-athletes in a maximal dynamic exercise. This study aimed to test the effects of transcranial direct current stimulation (tDCS), using different electrode positioning and montages, on physical performance in maximum incremental tests of healthy non-athlete subjects. A double-blinded, crossover, sham-controlled study. Fifteen subjects (aged 25.8 ± 5 years, nine women) received one of five different tDCS protocols: (i) anodal tDCS on the primary motor cortex (M1) (a-tDCS/M1), (ii) anodal tDCS on the left temporal cortex (T3) (a-tDCS/T3), (iii) cathodal tDCS on M1 (c-tDCS/M1), (iv) cathodal on T3 (c-tDCS/T3), or (v) sham tDCS. The protocols were assigned in a random order in separate sessions. After tDCS, the volunteers performed the maximal incremental exercise test (MIT) on a cycle ergometer in each session. The following measures were used to evaluate physical performance (primary outcome) during MIT: time to exhaustion (TE), maximum power (MAX-P), and Borg Rating of Perceived Exertion (RPE) scale. In addition, as a secondary outcome measure, we assessed the lower-limb corticospinal excitability and electrical muscular activity. tDCS applied over T3 or M1 did not influence electrical muscular activity or increase physical performance during MIT in healthy non-athlete subjects. However, our data confirmed that a-tDCS on the M1 increases lower-limb cortical excitability. Our results suggest that tDCS is not effective in improving performance during maximal dynamic exercise in non-athletes. However, we confirmed that the a-tDCS M1 protocol used in this study might increase cortical excitability in the lower limb motor cortex. [ABSTRACT FROM AUTHOR]
- Published
- 2023
- Full Text
- View/download PDF
31. Sintomas Depressivos estão Associados a Níveis Séricos Elevados de Colesterol de Lipoproteína de Baixa Densidade em Idosos com Diabetes Mellitus Tipo 2
- Author
-
Etiene Oliveira da Silva Fittipaldi, Armele Dornelas de Andrade, Ana Célia Oliveira Santos, Shirley Campos, Juliana Fernandes, and Maria Teresa Jansen de Almeida Catanho
- Subjects
Doenças Cardiovasculares ,Diabetes Mellitus ,Hipertensão ,Dislipidemias ,Depressão ,Transtorno Depressivo ,Lipoproteinas LDL ,Diseases of the circulatory (Cardiovascular) system ,RC666-701 - Abstract
Resumo Fundamento O Diabetes Mellitus Tipo 2 (DMT2) é comum nos idosos, que também apresentam um nível elevado de fatores de risco para doenças cardiovasculares (DCVs), tais como dislipidemia. Entretanto, o papel da depressão nos pacientes com DMT2 e sua relação com fatores de risco para DCV são pouco estudados. Objetivo O objetivo do presente estudo foi investigar a relação entre sintomas depressivos (SDs) e fatores de risco cardiovascular conhecidos em idosos comunitários portadores de DMT2. Métodos Trata-se de um estudo transversal, no qual foram incluídos 85 idosos comunitários com DMT2. Os SDs foram avaliados através da Escala de Depressão Geriátrica de Yesavage, em versão reduzida (GDS-15). Os seguintes fatores de risco cardiovascular foram avaliados: pressão arterial sistólica (PAS) e diastólica (PAD), glicose plasmática em jejum (GPJ), perfil lipídico (triglicerídeos séricos (TG), colesterol total sérico (CT), colesterol sérico de lipoproteína de baixa densidade (LDL-C) e colesterol sérico de lipoproteína de baixa densidade (HDL-C)) e índice de massa corporal (IMC). A análise de regressão múltipla de Poisson foi utilizada para avaliar a associação entre os SDs e cada fator de risco cardiovascular ajustado por sexo, idade, tempo em atividades físicas moderadas e status funcional. O nível de significância adotado para a análise foi de 5%. Resultados Dentre todos os fatores de risco analisados, apenas o aumento de LDL-C apresentou uma correlação com níveis elevados de SD (RP=1,005; IC95% 1,002-1,008). Foi observada uma associação significativa entre os níveis de HDL-C (RP=0,99; IC95% 0,98-0,99) e a PAS (RP=1,009; IC95% 1,004-1,014). Conclusão Nos idosos com DMT2, a presença de SD foi associada a níveis de LDL-C, HDL-C e PAS, mesmo após o ajuste por sexo, idade, nível de atividade física e capacidade funcional. (Arq Bras Cardiol. 2020; [online].ahead print, PP.0-0)
- Full Text
- View/download PDF
32. Global Longitudinal Strain Predicts Poor Functional Capacity in Patients with Systolic Heart Failure
- Author
-
Rafael José Coelho Maia, Simone Cristina Soares Brandão, Jéssica Leite, Giordano Bruno Parente, Filipe Pinheiro, Bruna Thays Santana Araújo, Maria Inês Remígio Aguiar, Sílvia Marinho Martins, Daniella Cunha Brandão, and Armele Dornelas de Andrade
- Subjects
Heart Failure ,Longitudinal Strain ,Torsion, Mechanical ,Torsion Abnormality ,Ventricular Dysfunction, Left ,Echocardiography, Doppler/methods ,Diseases of the circulatory (Cardiovascular) system ,RC666-701 - Abstract
Abstract Background: Left ventricular global longitudinal strain value (GLS) can predict functional capacity in patients with preserved left ventricular ejection fraction (LVEF) heart failure (HF) and to assess prognosis in reduced LVEF HF. Objetive: Correlate GLS with parameters of Cardiopulmonary Exercise Test (CPET) and to assess if they could predict systolic HF patients that are more appropriated to be referred to heart transplantation according to CPET criteria. Methods: Systolic HF patients with LVEF < 45%, NYHA functional class II and III, underwent prospectively CPET and echocardiography with strain analysis. LVEF and GLS were correlated with the following CPET variables: maxVO2, VE/VCO2 slope, heart rate reduction during the first minute of recovery (HRR) and time needed to reduce maxVO2 in 50% after physical exercise (T1/2VO2). ROC curve analysis of GLS to predict VO2 < 14 mL/kg/min and VE/VCO2 slope > 35 (heart transplantation’s criteria) was performed. Results: Twenty six patients were selected (age, 47 ± 12 years, 58% men, mean LVEF = 28 ± 8%). LVEF correlated only with maxVO2 and T1/2VO2. GLS correlated to all CPET variables (maxVO2: r = 0.671, p = 0.001; VE/VCO2 slope: r = -0.513, p = 0.007; HRR: r = 0.466, p = 0.016, and T1/2VO2: r = -0.696, p = 0.001). GLS area under the ROC curve to predict heart transplantation’s criteria was 0.88 (sensitivity 75%, specificity 83%) for a cut-off value of -5.7%, p = 0.03. Conclusion: GLS was significantly associated with all functional CPET parameters. It could classify HF patients according to the functional capacity and may stratify which patients have a poor prognosis and therefore to deserve more differentiated treatment, such as heart transplantation.
- Full Text
- View/download PDF
33. Performance Comparisons of Jet and Mesh Nebulizers Using Different Interfaces in Simulated Spontaneously Breathing Adults and Children.
- Author
-
Ari, Arzu, de Andrade, Armele Dornelas, Sheard, Meryl, AlHamad, Bshayer, and Fink, James B.
- Subjects
- *
AEROSOL therapy , *RESPIRATORY therapy , *PEDIATRIC research , *SPORTS masks , *DRUG delivery devices - Abstract
Background: Different types of nebulizers and interfaces are used for the treatment of adults and children with pulmonary diseases. The purpose of this study was to determine the efficiency of a mesh nebulizer (MN) with a proprietary adapter and a jet nebulizer (JN) under different configurations in adult and pediatric models of spontaneous breathing. We hypothesize that delivery efficiency of JN and MN will differ depending on the interface used during aerosol therapy in simulated spontaneously breathing adult and pediatric models. While we expect that aerosol delivery with JN will be less efficient than MN, we also hypothesize that lung deposition obtained with the adult lung model will be more than that with the pediatric lung model in all conditions tested in this study. Methods: A lung model using a teaching manikin connected to a sinusoidal pump via a collecting filter at the level of the bronchi simulating a spontaneously breathing adult (Vt 500 mL, RR 15 bpm, I:E ratio 1:2) or pediatric patient (Vt 150 mL, RR 25 bpm, I:E ratio 1:2). Albuterol sulfate (2.5 mg/3 mL) was aerosolized with JN (Mistymax 10, Airlife) or MN (Aerogen Solo®, Aerogen) with the Adapter (Aerogen Solo® Adapter, Aerogen Ltd, Galway, Ireland) using mouthpiece, aerosol mask, and valved-mask in adults and the dragon mask, aerosol mask, and valved-mask in pediatrics ( n=3). The Adapter, specifically designed for MN, was attached to all the interfaces used in this study with supplemental oxygen of 2 lpm, and in addition, the MP was tested with no additional flow in the adult model. The JN was driven with 10 lpm based on the manufacturer's label. Drug was eluted from the filter and analyzed via spectrophotometry. Descriptive statistics, dependent t-test and one-way analysis of variance were used for data analysis. Significant level was set at 0.05. Results: In adults, delivery efficiency of JN with the valved mask was significantly greater than that with the aerosol mask ( p=0.01). Aerosol delivery of JN with the mouthpiece was not statistically significant from the valved mask ( p=0.123) and the aerosol mask ( p=0.193). Drug delivery with MN with mouthpiece (15.42±1.4%) and valved-mask (15.15±1.1%) was greater than the open aerosol mask (7.54±0.39%; p=0.0001) in the adult lung model. With no flow mouthpiece delivery increased>2 fold (34.9±3.1%; p=.0001) compared to use of 2 lpm of flow. Using the JN with the pediatric model deposition with valved-mask (5.3±0.8%), dragon mask (4.7±0.9%), and aerosol mask (4.1±0.3%) were similar ( p>0.05); while drug delivery with MN via valved-mask (11.1±0.7%) was greater than the dragon mask (6.44±0.3%; p=0.002) and aerosol mask (4.6±0.4%; p=0.002), and the dragon mask was more efficient than the open aerosol mask ( p=0.009) Conclusion: The type of nebulizer and interface used for aerosol therapy affects delivery efficiency in these simulated spontaneously breathing adult and pediatric models. Drug delivery was greatest with the valved-mouthpiece and mask with JN and MN, while the standard aerosol mask was least efficient in these simulated spontaneously breathing adult and pediatric lung models. Delivery efficiency of JN was less than MN in all conditions tested in this study except in the aerosol mask. Lung deposition obtained with the adult lung model was more than that with the pediatric lung model. [ABSTRACT FROM AUTHOR]
- Published
- 2015
- Full Text
- View/download PDF
34. Performance Comparisons of Jet and Mesh Nebulizers With Mouthpiece, Aerosol Mask, and Valved Mask in Simulated Spontaneously Breathing Adults
- Author
-
Ari, Arzu, de Andrade, Armele Dornelas, and Fink, James
- Published
- 2014
- Full Text
- View/download PDF
35. Aerosol Delivery With Jet and Mesh Nebulizers Using Different Masks in Spontaneously Breathing Infants: An In Vitro Study
- Author
-
Ari, Arzu, de Andrade, Armele Dornelas, and Fink, James
- Published
- 2014
- Full Text
- View/download PDF
36. Toward core inter-professional health promotion competencies to address the non-communicable diseases and their risk factors through knowledge translation: Curriculum content assessment.
- Author
-
Dean, Elizabeth, Moffat, Marilyn, Skinner, Margot, de Andrade, Armele Dornelas, Myezwa, Hellen, and Söderlund, Anne
- Abstract
Background: To increase the global impact of health promotion related to non-communicable diseases, health professionals need evidence-based core competencies in health assessment and lifestyle behavior change. Assessment of health promotion curricula by health professional programs is a first step. Such program assessment is a means of 1. demonstrating collective commitment across health professionals to prevent non-communicable diseases; 2. addressing the knowledge translation gap between what is known about non-communicable diseases and their risk factors consistent with ‘best’ practice; and, 3. establishing core health-based competencies in the entry-level curricula of established health professions. Discussion: Consistent with the World Health Organization’s definition of health (i.e., physical, emotional and social wellbeing) and the Ottawa Charter, health promotion competencies are those that support health rather than reduce signs and symptoms primarily. A process algorithm to guide the implementation of health promotion competencies by health professionals is described. The algorithm outlines steps from the initial assessment of a patient’s/client’s health and the indications for health behavior change, to the determination of whether that health professional assumes primary responsibility for implementing health behavior change interventions or refers the patient/client to others. An evidence-based template for assessment of the health promotion curriculum content of health professional education programs is outlined. It includes clinically-relevant behavior change theory; health assessment/examination tools; and health behavior change strategies/interventions that can be readily integrated into health professionals’ practices. Summary: Assessment of the curricula in health professional education programs with respect to health promotion competencies is a compelling and potentially cost-effective initial means of preventing and reversing non-communicable diseases. Learning evidence-based health promotion competencies within an inter-professional context would help students maximize use of non-pharmacologic/non-surgical approaches and the contribution of each member of the health team. Such a unified approach would lead patients/clients to expect their health professionals to assess their health and lifestyle practices, and empower and support them in achieving lifelong health. Benefits of such curriculum assessment include a basis for reflection and discussion within and across health professional programs that could impact the epidemic of non-communicable diseases globally, through inter-professional education and evidence-based practice related to health promotion. [ABSTRACT FROM AUTHOR]
- Published
- 2014
- Full Text
- View/download PDF
37. The First Physical Therapy Summit on Global Health: Implications and Recommendations for the 21st century.
- Author
-
Dean, Elizabeth, Al-Obaidi, Saud, De Andrade, Armele Dornelas, Gosselink, Rik, Umerah, Gloria, Al-Abdelwahab, Sami, Anthony, Joseph, Bhise, Anjali R., Bruno, Selma, Butcher, Scotty, Olsén, Monika Fagevik, Frownfelter, Donna, Gappmaier, Eduard, Gylfadóttir, Sif, Habibi, Mehrdad, Hanekom, Susan, Hasson, Scott, Jones, Alice, LaPier, Tanya, and Lomi, Constantina
- Subjects
PREVENTIVE medicine ,CONFERENCES & conventions ,HEALTH planning ,NOSOLOGY ,PHYSICAL therapy ,PRIORITY (Philosophy) ,RESEARCH evaluation ,WORLD health ,LIFESTYLES - Abstract
The First Physical Therapy Summit on Global Health was convened at the 2007 World Confederation for Physical Therapy (WCPT) Congress to vision practice in the 21st century and, in turn, entry-level education and research, as informed by epidemiological indicators, and consistent with evidence-based noninvasive interventions, the hallmark of physical therapy. The Summit and its findings were informed by WHO data and validated through national databases of the countries of the five WCPT regions. The health priorities based on mortality were examined in relation to proportions of physical therapists practicing in the areas of regional priorities and of the curricula in entry-level programs. As a validation check and to contextualize the findings, input from members of the 800 Summit participants was integrated and international consultants refined the recommendations. Lifestyle-related conditions (ischemic heart disease, smoking-related conditions, hypertension, stroke, cancer, and diabetes) were leading causes of premature death across regions. Contemporary definitions of physical therapy support that the profession has a leading role in preventing, reversing, as well as managing lifestyle-related conditions. The proportions of practitioners practicing primarily in these priority areas and of the entry-level curricula based on these priorities were low. The proportions of practitioners in priority areas and entry-level curricula devoted to lifestyle-related conditions warrant being better aligned with the prevalence of these conditions across regions in the 21st century. A focus on clinical competencies associated with effective health education and health behavior change formulates the basis for The Second Physical Therapy Summit on Global Health. [ABSTRACT FROM AUTHOR]
- Published
- 2011
- Full Text
- View/download PDF
38. Reversal of Bronchial Obstruction with Bi-level Positive Airway Pressure and Nebulization in Patients with Acute Asthma.
- Author
-
Brandão, Daniella Cunha, Lima, Vitória Maria, Filho, Valdecir Galindo, Silva, Thayse Santos, Campos, Tânia Fernandes, Dean, Elizabeth, and de Andrade, Armele Dornelas
- Subjects
ASTHMATICS ,BRONCHODILATOR agents ,AEROSOL therapy ,RESPIRATORY therapy ,RESPIRATORY insufficiency treatment ,THERAPEUTICS - Abstract
Jet nebulization (JN) and non-invasive mechanical ventilation (NIMV) through bi-level pressure is commonly used in emergency and intensive care of patients experiencing an acute exacerbation of asthma. However, a scientific basis for effect of JN coupled with NIMV is unclear. Objective. To evaluate the effect of jet nebulization administered during spontaneous breathing with that of nebulization with NIV at two levels of inspiratory and expiratory pressures resistance in patients experiencing an acute asthmatic episode. Methods. A prospective, randomized controlled study of 36 patients with severe asthma (forced expiratory volume in 1 second [FEV1] less than 60% of predicted) selected with a sample of patients who presented to the emergency department. Subjects were randomized into three groups: control group (nebulization with the use of an unpressured mask), experimental group 1 (nebulization and non-invasive positive pressure with inspiratory positive airway pressure [IPAP] = 15 cm H2O, and expiratory positive airway pressure [EPAP] = 5 cm H2O), and experimental group 2 (nebulization and non-invasive positive pressure with IPAP = 15 cm H2O and EPAP = 10 cm H2O). Bronchodilators were administered with JN for all groups. Dependent measures were recorded before and after 30 minutes of each intervention and included respiratory rate (RR), heart rate (HR), oxygen saturation (SpO2), peak expiratory flow (PEF), forced expiratory volume in 1 second (FEV1), forced vital capacity (FVC), and forced expiratory flow between 25 and 75% (FEF25 - 75). Results. The group E2 showed an increase of the peak expiratory flow (PEF), forced vital capacity (FVC), FEV1 (p < 0.03) and F25 - 75% (p < 0.000) when compared before and 30 minutes after JN+NIMV. In group E1 the PFE (p < 0.000) reached a significant increase after JN+ NIMV. RR decreased before and after treatment in group E1 only (p = 0.04). Conclusion. Nebulization coupled with NIV in patients with acute asthma has the potential to reduce bronchial obstruction and symptoms secondary to augmented PEF compared with nebulization during spontaneous breathing. In reversing bronchial obstruction, this combination appears to be more efficacious when a low pressure delta is used in combination with a high positive pressure at the end of expiration. [ABSTRACT FROM AUTHOR]
- Published
- 2009
- Full Text
- View/download PDF
39. Impact of Gas Flow and Humidity on Trans-Nasal Aerosol Deposition via Nasal Cannula in Adults: A Randomized Cross-Over Study.
- Author
-
Alcoforado, Luciana, Ari, Arzu, Barcelar, Jacqueline de Melo, Brandão, Simone Cristina S., Fink, James B., and de Andrade, Armele Dornelas
- Subjects
NASAL cannula ,GAS flow ,AEROSOLS ,SCINTILLATION cameras ,HUMIDITY ,SUMATRIPTAN - Abstract
Background: Trans-nasal pulmonary aerosol delivery using high flow nasal cannula (HFNC) devices is described with the administration of high gas flows exceeding patient inspiratory flow (HF) and with lower flows (LF). The aim of this pilot clinical trial was to compare deposition and distribution of radiolabeled aerosol via nasal cannula in healthy adults across three rates of gas flow delivered with active heated humidification, and to further identify the impact of aerosol administration without heated humidity. Methods: Twenty-three (23) healthy adults (16F) were randomized to receive aerosol with active heated humidification or unheated oxygen at gas flows of 10 L/min (n = 8), 30 L/min (n = 7), or 50 L/min (n = 8). Diethylenetriaminepentaacetic acid labeled with 1 millicurie (37 MBq) of Technetium-99m (DTPA-Tc99m) was mixed with NaCl to a fill volume of 1 mL, and administered via mesh nebulizer placed at the inlet of the humidifier. Radioactivity counts were performed using a gamma camera and the regions of interest (ROIs) were delimited with counts from the lungs, upper airways, stomach, nebulizer, circuit, and expiratory filter. A mass balance was calculated and each compartment was expressed as a percentage of the total. Results: Lung deposition (mean ± SD) with heated humidified gas was greater at 10 L/min than 30 L/min or 50 L/min (17.2 ± 6.8%, 5.71 ± 2.04%, and 3.46 ± 1.24%, respectively; p = 0.0001). Using unheated carrier gas, a lung dose of aerosol was similar to the active heated humidification condition at 10 L/min, but greater at 30 and 50 L/min (p = 0.011). Administered gas flow and lung deposition were negatively correlated (r = −0.880, p < 0.001). Conclusions: Both flow and active heated humidity inversely impact aerosol delivery through HFNC. Nevertheless, aerosol administration across the range of commonly used flows can provide measurable levels of lung deposition in healthy adult subjects (NCT 02519465). [ABSTRACT FROM AUTHOR]
- Published
- 2019
- Full Text
- View/download PDF
40. Effects of Air Stacking Maneuver on Cough Peak Flow and Chest Wall Compartmental Volumes of Subjects With Amyotrophic Lateral Sclerosis.
- Author
-
Sarmento, Antonio, Resqueti, Vanessa, Dourado-Júnior, Mario, Saturnino, Lailane, Aliverti, Andrea, Fregonezi, Guilherme, and de Andrade, Armele Dornelas
- Abstract
Objectives To assess the acute effects of air stacking on cough peak flow (CPF) and chest wall compartmental volumes of persons with amyotrophic lateral sclerosis (ALS) versus healthy subjects positioned at 45° body inclination. Design Cross-sectional study with a matched-pair design. Setting University hospital. Participants Persons (N=24) with ALS (n=12) and age-matched healthy subjects (n=12). Main Outcomes Measures CPF, chest wall compartmental inspiratory capacity, chest wall vital capacity, chest wall tidal volume and operational volumes, breathing pattern, and percentage of contribution of the compartments to the inspired volume were measured by optoelectronic plethysmography. Results Compared with healthy subjects, significantly lower CPF ( P =.007), chest wall compartmental inspiratory capacity ( P <.001), chest wall vital capacity ( P <.001), and chest wall tidal volume ( P <.001) were found in subjects with ALS. Immediately after air stacking, CPF ( P <.001) and chest wall compartmental inspiratory capacity ( P <.001) significantly increased in both groups, with values returning to basal only in healthy subjects. After air stacking, the abdominal compartment ( P =.004) was determined to be responsible for the inspired volume in subjects with ALS. Significantly higher chest wall vital capacity ( P =.05) was observed in subjects with ALS 5 minutes after air stacking, with the rib cage compartment ( P =.049) being responsible for volume change. No differences were found in chest wall vital capacity and compartmental volumes of healthy subjects. Chest wall tidal volume ( P <.001) significantly increased during the protocol in the healthy subjects, mainly because of end-inspiratory ( P <.001) and abdominal volumes ( P =.008). No significant differences were observed in percentage of contribution of the compartments to the inspired volume and end-expiratory volume of both groups. No significant differences were found in chest wall tidal volume, operational volume, and breathing pattern in persons with ALS. Conclusions Air stacking is effective in increasing CPF, chest wall compartmental inspiratory capacity, and chest wall vital capacity of persons with ALS with no hyperinflation. Differences in compartmental volume contributions are probably because of lung and chest wall physiological changes. [ABSTRACT FROM AUTHOR]
- Published
- 2017
- Full Text
- View/download PDF
41. IMPACTS OF AIR RESISTANCE IMPOSED BY RESPIRATORY FILTERS ON VOLUME AND FLOW VALUES DURING SIMULATED RESPIRATORY PATTERN.
- Author
-
Barbosa, Taiwan Roberto, de Campos, Igor Mauricio, Morais, Caio César, Leitão, Herbert Albérico de Sá, Junior, Geraldo Leite Maia, Brito, Márcio Evaristo da Cruz, Andrade, Armele Dornelas de, and Campos, Shirley Lima
- Subjects
- *
PULMONARY function tests , *RESPIRATION , *CONFERENCES & conventions , *SIMULATION methods in education , *RESPIRATORY protective devices , *RESPIRATORY mechanics - Abstract
Pulmonary function and respiratory pattern exams are essential for the diagnosis of various diseases, such as COPD and asthma. Most equipment used in these exams is not sterilized, making the use of respiratory filters necessary for biological protection of the evaluated individual. However, the use of filters with high air resistance can alter the measurement of airflow and air volume during these evaluations. Thus, analyzing the influence of this resistance is important to ensure that the results of these exams can be reliable. To analyze the influence of the resistance of a respiratory filter on the flow and volume values collected in an innovative equipment used for the examination of the human respiratory pattern. This is an experimental study. The measurement system consists of an Active Servo Lung (ASL) 5000 human breathing simulator; a respiratory filter holder for the KOKO spirometer; a respiratory filter for spirometry; and the Respiratory Diagnostic Assistant (RDA) device, developed by the LINDEF/UFPE laboratory for the evaluation of the respiratory pattern. The ASL 5000 was configured to simulate the normal respiratory pattern of a healthy adult individual. The settings were: respiratory frequency = 10 bpm; inspiratory time 2 s, expiratory time 4 s, I:E ratio = 1:2; tidal volume = 0.5L; airway resistance = 3cmH2O; lung compliance = 100mL/cmH2O; and muscle pressure = 15cmH2O. The breathing simulation was programmed to occur for 3 minutes, and thus, the ASL 5000 produced a total of 30 respiratory cycles, of which the flow and volume curves and respiratory pattern parameters were recorded by the RDA. This same procedure was performed twice, once with the presence of the filter membrane inside the filter holder, and another time without the presence of the filter membrane. The results were subsequently analyzed by the RDA Analysis software. With the addition of the filter to the system, there was a decrease from 84.46 L/min to 79.76 L/min in inspiratory flow and from 90.25 L/min to 85.76 L/min in expiratory flow, with a consequent reduction from 1323.63 mL to 1285.26 mL in inspiratory tidal volume and from 1293.73 mL to 1270.96 mL in expiratory tidal volume. By comparing the mean values of inspiratory and expiratory flow and volume in the simulation of a basal respiration, it can be inferred that the resistance imposed by the filter added to the system produced considerable decreases in inspiratory and expiratory flow and volume values. The differences obtained in this result are useful for compensation adjustments in the RDA software, aiming to correct this resistance imposed by the filter membrane, necessary during collection. Thus, this result will contribute to ensuring a respiratory pattern exam as close as possible to what the evaluated patient actually presents. It also brings reflection on the need to correct the volume and flow values obtained by other software responsible for the processing of respiratory pattern and pulmonary function data, which require the use of respiratory filters in their execution. [ABSTRACT FROM AUTHOR]
- Published
- 2024
- Full Text
- View/download PDF
42. Acapella With Nebulization in Normal Subjects
- Author
-
Armele Dornelas de Andrade
- Published
- 2010
43. Cationic liposomes containing antioxidants reduces pulmonary injury in experimental model of sepsis: Liposomes antioxidants reduces pulmonary damage.
- Author
-
Galvão, Andre Martins, Galvão, Júlia Siqueira, Pereira, Marcela Araújo, Cadena, Pabyton Gonçalves, Magalhães, Nereide Stella Santos, Fink, James B, de Andrade, Armele Dornelas, Castro, Celia Maria Machado Barbosa de, and de Sousa Maia, Maria Bernadete
- Subjects
- *
LIPOSOMES , *ANTIOXIDANTS , *LUNG injuries , *SEPSIS , *OXIDATIVE stress , *DRUG administration , *THERAPEUTICS - Abstract
Abstarct The intracellular redox state of alveolar cells is a determining factor for tolerance to oxidative and pro-inflammatory stresses. This study investigated the effects of intratracheal co-administration of antioxidants encapsulated in liposomes on the lungs of rats subjected to sepsis. For this, male rats subjected to sepsis induced by lipopolysaccharide from Escherichia coli or placebo operation were treated (intratracheally) with antibiotic, 0.9% saline and antioxidants encapsulated or non-encapsulated in liposomes. Experimental model of sepsis by cecal ligation and puncture (CLP) was performed in order to expose the cecum. The cecum was then gently squeezed to extrude a small amount of feces from the perforation site. As an index of oxidative damage, superoxide anions, lipid peroxidation, protein carbonyls, catalase activity, nitrates/nitrites, cell viability and mortality rate were measured. Infected animals treated with antibiotic plus antioxidants encapsulated in liposomes showed reduced levels of superoxide anion (54% or 7.650 ± 1.263 nmol/min/mg protein), lipid peroxidation (33% or 0.117 ± 0.041 nmol/mg protein), protein carbonyl (57% or 0.039 ± 0.022 nmol/mg protein) and mortality rate (3.3%), p value <0.001. This treatment also reduced the level of nitrite/nitrate and increased cell viability (90.7%) of alveolar macrophages. Taken togheter, theses results support that cationic liposomes containing antioxidants should be explored as coadjuvants in the treatment of pulmonary oxidative damage. [ABSTRACT FROM AUTHOR]
- Published
- 2016
- Full Text
- View/download PDF
44. Acute effects of different inspiratory efforts on ventilatory pattern and chest wall compartmental distribution in elderly women.
- Author
-
Muniz de Souza, Helga, Rocha, Taciano, Campos, Shirley Lima, Brandão, Daniella Cunha, Fink, James B., Aliverti, Andrea, and de Andrade, Armele Dornelas
- Subjects
- *
PLETHYSMOGRAPHY , *CHEST physiology , *ARTIFICIAL respiration , *HEALTH of older women , *FATIGUE (Physiology) - Abstract
It is not completely described how aging affect ventilatory kinematics and what are the mechanisms adopted by the elderly population to overcome these structural modifications. Given this, the aim was to evaluate the acute effects of different inspiratory efforts on ventilatory pattern and chest wall compartmental distribution in elderly women. Variables assessed included: tidal volume (Vt), total chest wall volume (Vcw), pulmonary rib cage (Vrcp%), abdominal rib cage (Vrca%) and abdominal compartment (Vab%) relative contributions to tidal volume. These variables were assessed during quiet breathing, maximal inspiratory pressure maneuver (MIP), and moderate inspiratory resistance (MIR; i.e., 40% of MIP). 22 young women (age: 23.9 ± 2.5 years) and 22 elderly women (age: 68.2 ± 5.0 years) participated to this study. It was possible to show that during quiet breathing, Vab% was predominant in elderly ( p < 0.001), in young, however, Vab% was similar to Vrcp% ( p = 0.095). During MIR, Vrcp% was predominant in young ( p < 0.001) and comparable to Vab% in elderly ( p = 0.249). When MIP was imposed, both groups presented a predominance of Vrcp%. In conclusion, there are differences in abdominal kinematics between young and elderly women during different inspiratory efforts. In elderly, during moderate inspiratory resistance, the pattern is beneficial, deep, and slow. Although, during maximal inspiratory resistance, the ventilatory pattern seems to predict imminent muscle fatigue. [ABSTRACT FROM AUTHOR]
- Published
- 2016
- Full Text
- View/download PDF
45. Chest wall regional volume in heart failure patients during inspiratory loaded breathing
- Author
-
Brandão, Daniella Cunha, Lage, Susan Martins, Britto, Raquel Rodrigues, Parreira, Verônica Franco, de Oliveira Jr, Wilson Alves, Martins, Sílvia Marinho, Aliverti, Andrea, de Andrade Carvalho, Larissa, do Nascimento Junior, Jasiel Frutuoso, Alcoforado, Luciana, Remígio, Inês, and de Andrade, Armele Dornelas
- Subjects
- *
HEART failure patients , *ARTIFICIAL respiration , *SPIROMETRY , *OPTOELECTRONIC devices , *PLETHYSMOGRAPHY , *DYSPNEA - Abstract
Abstract: Were evaluated individuals divided into two groups: we studied chronic heart failure (CHF) (19 patients with CHF plus cardiomegaly) and control (12 healthy volunteers) during performance of inspiratory loaded breathing (ILB). We evaluated: spirometry, functional capacity through the six-minute walk test (6MWT), and distribution of thoracoabdominal volumes via optoelectronic plethysmography (OEP), namely volume variations of pulmonary rib cage (Vrc,p), abdominal rib cage (Vrc,a), and abdomen (Vab). In each compartment, the percentage contributions of right and left sides were also calculated. During ILB, patients with heart failure were characterized by a significant reduction of the Vrc,a volume variations compared to the control group. Correlations were found between left %Vrc,a on the left side measured during ILB and left ventricular ejection fraction (r =0.468; p =0.049), and dyspnea after the 6MWT (r =−0.878; p <0.01).Then, patients with CHF and cardiomegaly are characterized by a reduced mobility in left part of the lower part of the rib cage, that contributes leading to increased perception of dyspnea during submaximal exercise. [Copyright &y& Elsevier]
- Published
- 2012
- Full Text
- View/download PDF
46. Agreement between two methods for assessment of maximal inspiratory pressure in patients weaning from mechanical ventilation.
- Author
-
Ribeiro EOS, Gosselink R, Moura LEDS, Correia RF, Leite WS, Araújo MDGR, Andrade AD, Brandão DC, and Campos SL
- Abstract
Background: Respiratory muscle strength in patients with an artificial airway is commonly assessed as the maximal inspiratory pressure (MIP) and is measured using analogue or digital manometers. Recently, new electronic loading devices have been proposed to measure respiratory muscle strength. This study evaluates the agreement between the MIPs measured by a digital manometer and those according to an electronic loading device in patients being weaned from mechanical ventilation., Methods: In this prospective study, the standard MIP was obtained using a protocol adapted from Marini, in which repetitive inspiratory efforts were performed against an occluded airway with a one-way valve and were recorded with a digital manometer for 40 seconds (MIPDM). The MIP measured using the electronic loading device (MIPELD) was obtained from repetitively tapered flow resistive inspirations sustained for at least 2 seconds during a 40-second test. The agreement between the results was verified by a Bland-Altman analysis., Results: A total of 39 subjects (17 men, 55.4±17.7 years) was enrolled. Although a strong correlation between MIPDM and MIPELD (R=0.73, P<0.001) was observed, the Bland-Altman analysis showed a high bias of -47.4 (standard deviation, 22.3 cm H2O; 95% confidence interval, -54.7 to -40.2 cm H2O)., Conclusions: The protocol of repetitively tapering flow resistive inspirations to measure the MIP with the electronic loading device is not in agreement with the standard protocol using one-way valve inspiratory occlusion when applied in poorly cooperative patients being weaned from mechanical ventilation.
- Published
- 2022
- Full Text
- View/download PDF
47. Depressive Symptoms are Associated with High Levels of Serum Low-Density Lipoprotein Cholesterol in Older Adults with Type 2 Diabetes Mellitus.
- Author
-
Fittipaldi EODS, Andrade AD, Santos ACO, Campos S, Fernandes J, and Catanho MTJA
- Subjects
- Aged, Cholesterol, HDL, Cholesterol, LDL, Cross-Sectional Studies, Humans, Risk Factors, Triglycerides, Depression etiology, Diabetes Mellitus, Type 2 complications
- Abstract
Background: Type 2 Diabetes Mellitus (T2DM) is common in older adults, who also present a high level of risk factors for cardiovascular disease (CVD), such as dyslipidemia. However, the role of depression in T2DM patients and its relationship with CVD risk factors are understudied., Objective: The present study aimed to investigate the relationship between depressive symptoms (DS) and known cardiovascular risk factors in community dwelling older adults with T2DM., Methods: This is a cross sectional study, in which 85 community-dwelling older adults with T2DM were assessed. DS was assessed using the Yesavage Geriatric Depression Scale - short version (GDS-15). The following cardiovascular risk factors were evaluated: systolic (SBP) and diastolic blood pressure (DBP), fasting plasma glucose (FPG), lipid profile (serum triglycerides - TG, serum total cholesterol - TC, serum low-density lipoprotein cholesterol - LDL-C, and serum high-density lipoprotein cholesterol - HDL-C) and body mass index (BMI). Poisson multiple regression was performed to test the association between DS and each cardiovascular risk factor adjusted by sex, age, time spent in moderate physical activity, and functional status. The significance level adopted for the analysis was 5%., Results: Among all the analyzed risk factors, only high levels of LDL-C were related to high DS (PR=1.005, CI 95% 1.002-1.008). A significant association was observed between HDL-C levels (PR=0.99, CI 95% 0.98-0.99) and SBP (PR=1.009, CI 95% 1.004-1.014)., Conclusion: In older adults with T2DM, the presence of DS was associated with LDL-C, HDL-C levels and SBP, even after adjusting for sex, age, physical activity level and functional capacity. (Arq Bras Cardiol. 2020; [online].ahead print, PP.0-0).
- Published
- 2020
- Full Text
- View/download PDF
48. Global Longitudinal Strain Predicts Poor Functional Capacity in Patients with Systolic Heart Failure.
- Author
-
Maia RJC, Brandão SCS, Leite J, Parente GB, Pinheiro F, Araújo BTS, Aguiar MIR, Martins SM, Brandão DC, and Andrade AD
- Subjects
- Adult, Cross-Sectional Studies, Echocardiography methods, Female, Heart Rate physiology, Heart Transplantation, Humans, Male, Middle Aged, Oxygen metabolism, Oxygen Consumption physiology, Prognosis, ROC Curve, Reference Values, Risk Assessment, Risk Factors, Statistics, Nonparametric, Stroke Volume physiology, Time Factors, Exercise physiology, Exercise Test methods, Heart Failure, Systolic physiopathology, Ventricular Dysfunction, Left physiopathology
- Abstract
Background: Left ventricular global longitudinal strain value (GLS) can predict functional capacity in patients with preserved left ventricular ejection fraction (LVEF) heart failure (HF) and to assess prognosis in reduced LVEF HF., Objetive: Correlate GLS with parameters of Cardiopulmonary Exercise Test (CPET) and to assess if they could predict systolic HF patients that are more appropriated to be referred to heart transplantation according to CPET criteria., Methods: Systolic HF patients with LVEF < 45%, NYHA functional class II and III, underwent prospectively CPET and echocardiography with strain analysis. LVEF and GLS were correlated with the following CPET variables: maxVO2, VE/VCO2 slope, heart rate reduction during the first minute of recovery (HRR) and time needed to reduce maxVO2 in 50% after physical exercise (T1/2VO2). ROC curve analysis of GLS to predict VO2 < 14 mL/kg/min and VE/VCO2 slope > 35 (heart transplantation's criteria) was performed., Results: Twenty six patients were selected (age, 47 ± 12 years, 58% men, mean LVEF = 28 ± 8%). LVEF correlated only with maxVO2 and T1/2VO2. GLS correlated to all CPET variables (maxVO2: r = 0.671, p = 0.001; VE/VCO2 slope: r = -0.513, p = 0.007; HRR: r = 0.466, p = 0.016, and T1/2VO2: r = -0.696, p = 0.001). GLS area under the ROC curve to predict heart transplantation's criteria was 0.88 (sensitivity 75%, specificity 83%) for a cut-off value of -5.7%, p = 0.03., Conclusion: GLS was significantly associated with all functional CPET parameters. It could classify HF patients according to the functional capacity and may stratify which patients have a poor prognosis and therefore to deserve more differentiated treatment, such as heart transplantation.
- Published
- 2019
- Full Text
- View/download PDF
49. The Second Physical Therapy Summit on Global Health: developing an action plan to promote health in daily practice and reduce the burden of non-communicable diseases.
- Author
-
Dean E, de Andrade AD, O'Donoghue G, Skinner M, Umereh G, Beenen P, Cleaver S, Afzalzada D, Delaune MF, Footer C, Gannotti M, Gappmaier E, Figl-Hertlein A, Henderson B, Hudson MK, Spiteri K, King J, Klug JL, Laakso EL, LaPier T, Lomi C, Maart S, Matereke N, Meyer ER, M'kumbuzi VR, Mostert-Wentzel K, Myezwa H, Olsén MF, Peterson C, Pétursdóttir U, Robinson J, Sangroula K, Stensdotter AK, Tan BY, Tschoepe BA, Bruno S, Mathur S, and Wong WP
- Subjects
- Humans, Global Health, Health Behavior, Health Promotion, Physical Therapy Specialty, Public Health
- Abstract
Based on indicators that emerged from The First Physical Therapy Summit on Global Health (2007), the Second Summit (2011) identified themes to inform a global physical therapy action plan to integrate health promotion into practice across the World Confederation for Physical Therapy (WCPT) regions. Working questions were: (1) how well is health promotion implemented within physical therapy practice; and (2) how might this be improved across five target audiences (i.e. physical therapist practitioners, educators, researchers, professional body representatives, and government liaisons/consultants). In structured facilitated sessions, Summit representatives (n = 32) discussed: (1) within WCPT regions, what is working and the challenges; and (2) across WCPT regions, what are potential directions using World Café(TM) methodology. Commonalities outweighed differences with respect to strategies to advance health-focused physical therapy as a clinical competency across regions and within target audiences. Participants agreed that health-focused practice is a professional priority, and a strategic action plan was needed to develop it as a clinical competency. The action plan and recommendations largely paralleled the principles and objectives of the World Health Organization's non-communicable diseases action plan. A third Summit planned for 2015 will provide a mechanism for follow-up to evaluate progress in integrating health-focused physical therapy within the profession.
- Published
- 2014
- Full Text
- View/download PDF
50. Antioxidant supplementation for the treatment of acute lung injury: a meta-analysis.
- Author
-
Galvão AM, Andrade AD, Maia MB, Silva KE, Bezerra Ade A, Melo JF, Morais NG, Costa TB, and Castro CM
- Abstract
Objective: This meta-analysis was performed to evaluate the evidence supporting antioxidant supplementation as an adjunct therapy to prevent oxidative damage and improve the clinical outcomes (mortality, length of hospital stay and duration of mechanical ventilation)., Methods: The search strategy for randomized controlled trials (RCTs) involved the participation of two researchers who independently assessed the methodological quality of each full-text article that was available in the PubMed, ISI WEB of Knowledge and ScienceDirect databases., Results: We extracted 110 studies from the past 10 years, but only 30 articles met the methodological criteria (RCT, blinded and statistically significant results), for a total of 241 animals and 256 patients. This study found an odds ratio (OR) of 0.45 [95% confidence interval (CI): 0.26 to 0.79] for death in the experimental group compared with placebo (six trials, n = 256), an OR of 0.46 [95% CI: 0.26 to 0.87] for hospitalization time and an OR of 0.63 [95% CI: 0.35 to 1.12] for mechanical ventilation time between groups., Conclusion: Conflicting evidence makes it impossible to recommend the routine use of antioxidant supplementation in critically ill patients.
- Published
- 2011
Catalog
Discovery Service for Jio Institute Digital Library
For full access to our library's resources, please sign in.