Fisioter Mov. 2013 set/dez;26(4):página 873-81 doi: ISSN 0103-5150 Fisioter. Mov., Curitiba, v. 26, n. 4, p. página 873-881, set./dez. 2013 Licenciado sob uma Licença Creative Commons [T] Avaliação da qualidade de vida e do tratamento fisioterapêutico em pacientes com cervicalgia crônica [I] Evaluation of quality of life and the physiotherapy treatment in patients with chronic neck pain [A] Marisa Resumo Introdução: Para analisar a efetividade do tratamento fisioterapêutico no paciente com dor crônica cervical, este trabalho teve como objetivo avaliar antes e após o tratamento fisioterapêutico: a qualidade de vida com o instrumento WHOQOL-100 e a melhora na amplitude de movimento usando um goniômetro. Borges MC, Borges CS, Silva AGJ, Castellano LRC, Cardoso FAG. 874 de alongamento melhoram de forma significativa a amplitude de movimento articular em mulheres com cervicalgia crônica. Chiu et al. (20) observaram melhora na dor crônica cervical e na limitação articular após seis semanas de tratamento com TENS e exercícios. Conclusão: O presente estudo conclui que a intervenção fisioterapêutica composta de exercícios de alongamento, técnicas de relaxamento, massagens e eletroterapia foram benéficos para melhorar a qualidade de vida e a flexibilidade nos pacientes com cervicalgia crônica. [P] Palavras-chave: Fisioterapia. Qualidade de vida. Cervicalgia. Goniometria articular.[B] AbstractIntroduction: In order to analyze the effectiveness of the physiotherapeutic treatment in patients with chronic neck pain, this work had as a goal to evaluate the period before and after the physiotherapeutic treatment: quality of life as a WHOQOL-100 tool and the improvement of the range of motion (ROM), using a goniometer. Materials and methods: 15 patients were members of this study (10 women and 5 men). Results: Level of significance adopted was p < 0.05. It was observed significant improvement after physical therapy in the domain

Background: Surgical trauma triggers an important postoperative stress response characterized by significantly elevated levels of cytokines, an event that can favor the emergence of immune disorders which lead to disturbances in the patient's body defense. The magnitude of postoperative stress is related to the degree of surgical trauma. Aim: To evaluate the expression of pro-inflammatory (TNF-α, IFN-γ, IL-1β, and IL-17) and anti-inflammatory (IL-4) cytokines in patients submitted to conventional and single-port laparoscopic cholecystectomy before and 24 h after surgery. Methods: Forty women with symptomatic cholelithiasis, ranging in age from 18 to 70 years, participated in the study. The patients were divided into two groups: 21 submitted to conventional laparoscopic cholecystectomy and 19 to single-port laparoscopic cholecystectomy. Results: Evaluation of the immune response showed no significant difference in IFN-γ and IL-1β levels between the groups or time points analyzed. With respect to TNF-α and IL-4, serum levels below the detection limit (10 pg/ml) were observed in the two groups and at the time points analyzed. Significantly higher postoperative expression of IL-17A was detected in patients submitted to single-port laparoscopic cholecystectomy when compared to preoperative levels (p=0.0094). Conclusions: Significant postoperative expression of IL-17 was observed in the group submitted to single-port laparoscopic cholecystectomy when compared to preoperative levels, indicating that surgical stress in this group was higher compared to the conventional laparoscopic cholecystectomy.

Background : Immunological and inflammatory mechanisms play a key role in the development and progression of type 2 diabetes mellitus. Aim : To raise the hypothesis that alterations in immunological parameters occur after duodenojejunal bypass surgery combined with ileal interposition without gastrectomy, and influences the insulin metabolism of betacells.Methods : Seventeen patients with type 2 diabetes mellitus under clinical management were submitted to surgery and blood samples were collected before and six months after surgery for evaluation of the serum profile of proinflammatory (IFN-γ, TNF-α, IL-17A) and anti-inflammatory cytokines (IL-4, IL-10). In addition, anthropometric measures, glucose levels and insulin use were evaluated in each patient. Results : No changes in the expression pattern of proinflammatory cytokines were observed before and after surgery. In contrast, there was a significant decrease in IL-10 expression, which coincided with a reduction in the daily insulin dose, glycemic index, and BMI of the patients. Early presentation of food to the ileum may have induced the production of incretins such as GLP-1 and PYY which, together with glycemic control, contributed to weight loss, diabetes remission and the consequent good surgical prognosis of these patients. In addition, the control of metabolic syndrome was responsible for the reduction of IL-10 expression in these patients. Conclusion : These findings suggest the presence of low-grade inflammation in these patients during the postoperative period, certainly as a result of adequate glycemic control and absence of obesity, contributing to a good outcome of surgery.

Purpose: To compare pulmonary and nutritional parameters before and after inspiratory muscle training (IMT) and enteral feeding support in patients with esophageal disease undergoing preoperative outpatient follow-up. Methods: Thirty patients with a mean age of 55.83 years, 16 men and 14 women, were included. Pulmonary assessment consisted of the measurement of MIP, MEP, and spirometry. Anthropometric measurements and laboratory tests were performed for nutritional assessment. After preoperative evaluation, inspiratory muscle training and enteral nutrition support were started. A p<0.05 was considered statistically significant. Results: After an outpatient follow-up period of 4 weeks, a significant increase in MIP (-62.20 ± 25.78 to -81.53 ± 23.09), MEP (73.4 ± 31.95 to 90.33 ± 28.39), and FVC (94.86 ± 16.77 to 98.56 ± 17.44) was observed. Regarding the anthropometric variables, a significant increase was also observed in BMI (20.18 ± 5.04 to 20.40 ± 4.69), arm circumference (23.38 ± 3.28 to 25.08 ± 4.55), arm muscle circumference (21.48 ± 3.00 to 22.07 ± 3.36), and triceps skinfold thickness (5.62 ± 2.68 to 8.33 ± 6.59). Conclusion: Pulmonary and nutritional preparation can improve respiratory muscle strength, FVC and anthropometric parameters. However, further studies are needed to confirm the effectiveness of this preoperative preparation.

Purpose: To evaluate respiratory muscle strength (PImax and PEmax) before and 24 and 48 h after conventional and single-port laparoscopic cholecystectomy. Methods: Forty women with symptomatic cholelithiasis (18 to 70 years) participated in the study. The patients were divided into two groups: 21 patients undergoing conventional laparoscopic cholecystectomy and 19 patients undergoing single-port laparoscopic cholecystectomy. Differences were considered to be significant when p<0.05. Results:The results showed a greater decline in PImax after 24 h in the group submitted to conventional laparoscopic cholecystectomy, with a significant difference between groups (p=0.0308). Conclusion: Recovery of the parameters studied was more satisfactory and respiratory muscle strength was less compromised in the group submitted to single-port laparoscopic cholecystectomy.

INTRODUÇÃO:  O treinamento muscular inspiratório (TMI) no pré-operatório pode evitar complicações pulmonares no pós-operatório (CPPO) em pacientes submetidos a esofagectomia. OBJETIVO: Avaliar a eficácia do TMI que foi realizado no período pré-operatório e seus benefícios no período pós-operatório, através da avaliação da pressão inspiratória máxima (PImáx), da pressão expiratória máxima (PEmáx), da ventilação voluntária máxima (VVM) e do pico de fluxo expiratório (PFE) e os benefícios do mesmo no pós-operatório. MATERIAIS E MÉTODOS: Foi realizado um ensaio clínico, randomizado, que foi realizado pela disciplina de Cirurgia do Aparelho Digestivo do Hospital das Clínicas da Universidade Federal do Triângulo Mineiro. Foram incluídos 26 pacientes em: Grupo Controle (GC: n=12) e Grupo Intervenção (GI: n=14). O GI realizou TMI por no mínimo 2 semanas. As avaliações foram realizadas no pré e pós-operatório. RESULTADOS:  Houve aumento da PImáx (p=0,006), da PEmáx (p=0,005) e do VVM (0,042) no GI, após o TMI realizado no pré-operatório em relação ao GC. Na avaliação do PFE não foi observada aumento após o TMI no GI em relação ao GC (p=0,63). Na alta hospitalar houve queda das variáveis avaliadas em ambos os grupos e no 30°PO ocorreu recuperação em relação aos valores iniciais. Quanto a ocorrência de CPPO não houve diferença significativa entre os grupos. CONCLUSÃO: O TMI realizado em nosso estudo melhorou a força muscular inspiratória, expiratória e a função ventilatória no pré-operatório, porém não resultou em melhor evolução no pós-operatório de pacientes submetidos a esofagectomia.

Introduction: Diabetes Mellitus (DM) is a multifactorial metabolic disorder. As considered a public health problem needing additional treatment options. Objective: This prospective study aimed at evaluating pulmonary function through spirometry, before and after metabolic surgery without gastric resection in type 2 DM patients. Methods: Sample was composed by 17 type 2 DM females. They were analyzed in pre (24 hours before surgical procedure), immediate post-operative period POST1 (24 hours after surgical procedure) and in the late postoperative period POST2 (two years after surgical procedure). Besides statistical analysis, it was evaluated the following spirometric parameters: forced vital capacity (FVC), forced expiratory volume in the first second (FEV1) and the FEV1 / FVC ratio (%). Results: Spirometric parameters showed a value increase when compared PRE and POS2 values, except for FVC and FEV1, which was not statistically significant. Conclusion: Type 2 DM women submitted to metabolic surgery without gastric resection showed spirometric value increased after two-year surgical procedure, when compared to preoperative period values. It is important additional studies about pulmonary function, diabetic patients and metabolic surgery without gastric resection.

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