OBJECTIVETo evaluate the effects of resistance exercise applied early after coronary artery bypass grafting.METHODSIt is a randomized controlled trial with 34 patients undergoing coronary artery bypass grafting between August 2013 and May 2014. Patients were randomized into two groups by simple draw: a control group (n=17), who received conventional physical therapy and an intervention group (n=17), who received, additionally, resistance exercise. Pulmonary function and functional capacity were evaluated in preoperative period and hospital discharge by spirometry and the six-minute walk test. For statistical analysis, we used the following tests: Shapiro-Wilk, Mann-Whitney, Student's t and Fisher's exact. Variables with P<0.05 were considered significant.RESULTSGroups were homogeneous in terms of demographic, clinical and surgical variables. Resistance exercise exerted no effect on pulmonary function of intervention group compared to control group. However, intervention group maintained functional capacity at hospital discharge measured by percentage of predict distance in 6MWT (54.122.7% vs. 52.515.5%, P=0.42), while control group had a significant decrease (59.211.1% vs. 50.69.9%, P<0.016).CONCLUSIONOur results indicate that resistance exercise, applied early, may promote maintenance of functional capacity on coronary artery bypass grafting patients, having no impact on pulmonary function when compared to conventional physical therapy.

IntroductionAfter removal of endotracheal tube and artificial ventilation, ventilatory support should be continued, offering oxygen supply to ensure an arterial oxygen saturation close to physiological.ObjectiveThe aim of this study was to investigate the effects of positive-end expiratory pressure before extubation on the oxygenation indices of patients undergoing coronary artery bypass grafting.MethodsA randomized clinical trial with seventy-eight patients undergoing coronary artery bypass grafting divided into three groups and ventilated with different positive-end expiratory pressure levels prior to extubation: Group A, 5 cmH2O (n=32); Group B, 8 cmH2O (n=26); and Group C, 10 cmH2O (n=20). Oxygenation index data were obtained from arterial blood gas samples collected at 1, 3, and 6 h after extubation. Patients with chronic pulmonary disease and those who underwent off-pump, emergency, or combined surgeries were excluded. For statistical analysis, we used Shapiro-Wilk, G, Kruskal-Wallis, and analysis of variance tests and set the level of significance at P<0.05.ResultsGroups were homogenous with regard to demographic, clinical, and surgical variables. There were no statistically significant differences between groups in the first 6 h after extubation with regard to oxygenation indices and oxygen therapy utilization.ConclusionIn this sample of patients undergoing coronary artery bypass grafting, the use of different positive-end expiratory pressure levels before extubation did not affect gas exchange or oxygen therapy utilization in the first 6 h after endotracheal tube removal.

No abstract

Objective: To evaluate the subjective sleep pattern in hospitalized patients. Methods: This is a cross-sectional design developed with 230 patients in a university hospital in northeastern Brazil from September 2017 to March 2018. We included patients 18 years old or older, hospitalized for a minimum of 48 hours and a maximum of five days, with stable clinical conditions and preserved guidance. For data collection, a structured questionnaire was used and the subjective sleep pattern was assessed using Visual Analog Sleep Scales. Univariate and bivariate statistics were calculated using IBM® SPSS® software, version 23.0. Results: In the hospitalization, the Disorder, Effectiveness, and Supplementation scales reached scores of 208.7 points, 353.8 points, and 62.9 points, respectively. The clinical characteristics that interfered with sleep were the practice of regular physical activity (p = 0.024) and a higher body mass index (p = 0.033). We also observed statistically significant differences between VAS scores and factors influencing sleep. Conclusion:There was a certain level of sleep disturbance during the hospitalization period, and consequently the need for sleep supplementation during the day. We also observed that some factors negatively influenced the quality of hospital sleep.

Objective To analyze the relation among insomnia, excessive daytime sleepiness and the excessive use of technologies in medical students. Methods The study was approved by the Local Ethics Committee of the institution. Students from the 1st and 2nd year of medical graduation students participated. Three questionnaires were used: Sleep Time-Related Information and Communication Technology, Insomnia Severity Index and the Epworth Sleepiness Scale. The data were described and compared by gender and year of graduation by the Students T Test, and correlated to the use of technology, insomnia and excessive daytime sleepiness by Pearsons Correlation (adopted the significance level of p <0.05). Results 106 students (41 male) participated, expressing perception of insomnia in 76.4%, 34% with excessive daytime sleepiness, and 38.3% had a high use of technology related to sleep. There was a correlation between the use of technologies both with insomnia (r = 0.393; p = < 0.001), as well as with excessive daytime sleepiness (r = 0.228; p = 0.019). Conclusion An important frequency of insomnia was found associated with the excessive use of technologies at the bed, with repercussions of daytime sleepiness. This demonstrates the importance of actions to raise awareness and education about correct sleep hygiene in medical students.

No abstract

Introdução: A DPOC é hoje um grande desafio para a saúde pública, sendo a quarta causa de morte no mundo e com projeções de torna-se a terceira. Objetivo: Avaliar a ação anti-inflamatória do laser na preservação da estrutura alveolar e diminuição dos neutrófilos. Método: Utilizaram-se cinco grupos de oito animais: grupo controle; grupo cânula; grupo laser; grupo DPOC (recebeu instilação de papaína) e grupo DPOC+laser. Para análise dos resultados foram realizados LBA e histopatológico. Resultados: Os resultados foram sub¬metidos à análise de variância (ANOVA). O LBA demonstrou um aumento significativo no número de neutrófilos no grupo DPOC, quando comparado ao controle e ao DPOC+laser. Na análise histopatológica, o DPOC apresentou elevado grau de hialinização, congestão e colabamento alveolar, o que não foi encontrado nos demais grupos. Conclusão: Os efeitos fotobiomoduladores do laser se mostraram eficazes na prevenção do enfisema pulmonar.

Estudaram-se em 6 doentes com valvulopatias reumatismais, as variações da actividade enzimática no plasma, durante e apos a cirurgia cardíaca com circulação extra-corporal, para verificar a especificidade da isoenzima MB da creatinaquinase, comparando-a com a da CK. Estudaram-se também as variações da desidrogenase láctica no mesmo período. O protocolo de colheitas escolhido, procurava dissociar as variações enzimáticas correspondentes aos tempos anteriores a miocardiotomia, das relacionadas com a lesão cirúrgica das fibras miocárdicas. Os autores verificaram existir um paralelismo evidente entre as curvas referentes a CK total e a sua isoenzima MB. Esta última elevava-se mais tardiamente, apenas durante os tempos cardíacos da intervenção, atingia o máximo no final desta e voltava mais rapidamente aos valores iniciais. A CK-MB regressava aos valores basais no 3º dia do pós-operatório e a CK-total entre o 5.° e o 7º dia. Os autores concluem que a isoenzima CK-MB é um indicador fiel e pouco sujeito a erros para detecção precoce de sofrimento das fibras musculares cardíacas. Os valores da LDH sofreram variações mais irregulares, atribuíveis a interferência de diversos factores, mas pareceram de interesse na detecção de complicações durante o pós-operatório.