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Introduction: Chagas cardiomyopathy (ChC) is highly stigmatized, and the presence of depressive symptoms may be a common feature. However, its determinants remain unclear. Therefore, the present study aimed to verify the prevalence of depression and the clinical, echocardiographic, functional, and quality of life factors associated with depressive symptoms in patients with ChC and predominantly preserved cardiac function. Methods: Thirty-five patients with ChC (aged 40 to 60 years, 66% men, NYHA I-III) were evaluated by echocardiography, cardiopulmonary exercise testing, 6-minute walk test (6MWT), and Mini-Mental State Examination. Physical activity level was assessed using the Human Activity Profile (HAP) and health-related quality of life was assessed using the Short-Form Health Survey (SF-36). Depressive symptoms were evaluated using the Beck Depression Inventory. A cutoff point greater than 9 was indicative of depression. Results: Depression was detected in 13 patients (37%). In the univariate analysis, female sex, NYHA functional class, body mass index, HAP score, mental summary of SF-36, peak oxygen uptake, and 6MWT distance were associated with depressive symptoms. The final model showed that only the HAP score (B =-0.533; 95% confidence interval [CI]:-0.804 to-0.262) and SF-36 mental summary (B =-0.269; 95% CI:-0.386 to-0.153) remained as independent predictors of depressive symptoms in patients with ChC. Conclusions: Depression was prevalent in patients with ChC and predominantly preserved cardiac function. Physical activity and mental health were independent risk factors for depressive symptoms.

The results of the present study suggest that the presence of a chest tube is a factor significantly associated with postoperative pain and functional limitation in patients submitted to pulmonary resection.

Introduction: Chronic kidney disease consists in the slow, progressive and irreversible loss in renal function and it is considered a social and economic problem worldwide, since it is linked to numerous diseases, as well as to higher public health spending. It is known that dialysis patients undergo a long period of restricted physical activity reflects in dysfunctions in various organical systems and in the quality of their lives. Objective: To verify the results of physical therapy intervention in patients on hemodialysis, for respiratory muscle function, grip strength and quality of life. Methodology: Experimental, nonrandomized, quantitative and qualitative of a sample of 13 patients, 43.69 ± 9.28 years, on hemodialysis in the hospital Santa Casa de Diamantina/MG, selected by convenience. All patients were evaluated for maximal respiratory pressures (PI max e PE max ) and peak expiratory flow (PFE), before and after physiotherapy, which consisted of 3 sessions per week for a period of 2 months weeks: exercises for upper limbs, with technique PNF and breathing diaphragmatic; strengthening exercises for lower limbs and use of exerciser ball. Statistical analysis was performed using the student-t test and significance value at p < 0.05.

Patients with Chagas cardiomyopathy (ChC) usually progress with fatigue and dyspnea. Exercise tests are valuable for the functional evaluation of these patients. However, information about the applicability of the exercise tests is scattered, and no studies have systematically reviewed the results. Thus, the present review explored the general aspects and prognostic value of exercise tests in patients with ChC. A literature search of the MEDLINE, Web of Science, CINAHL, Scopus, and LILACS databases was performed to identify relevant studies. There were no data restrictions, and articles that met the objective of the study were selected. Articles written in English, Portuguese, and Spanish were considered, and 25 articles were finally included. The peak oxygen uptake (VO2peak) was correlated with demographic and echocardiographic variables. Echocardiographic features of the left ventricular diastolic function and right ventricular systolic function appeared to be determinants of functional capacity, in addition to age and sex. VO2peak was associated with higher mortality, especially in patients with dilated ChC. The minute ventilation/carbon dioxide production slope (VE/VCO2 slope) was a strong predictor of survival; however, more studies are needed to verify this observation. Field tests showed moderate to strong correlation with VO2peak and thus may be inexpensive tools for the functional evaluation of patients with ChC. However, few studies have verified their prognostic significance. While exercise tests are useful tools for functional assessment, information is scarce regarding further considerations, and many of the criteria are based on guidelines for other heart diseases.

This study aimed to investigate the efficacy of whole-body vibration training (WBVT) on blood brain-derived neurotrophic factor (BDNF) levels and determine the clinical and functional outcomes in patients with fibromyalgia syndrome (FMS). Thirty-two women with FMS were randomized into an intervention group (IG), receiving 6 weeks of WBVT, or a control group (CG) with no intervention. The outcomes at the baseline and follow-up in both groups included blood BDNF levels, sit-to-stand test (STS), 6-minute walk test (6MWT), Fibromyalgia Impact Questionnaire (FIQ), Pittsburgh Sleep Quality Index (PSQI), Beck Depression Inventory (BDI), and visual analogue scale (VAS). WBVT resulted in a group-by-time interaction effect. Thus, after the intervention time, the IG had increased blood BDNF levels ( p = 0.045 ), a higher number of repetitions on the STS test ( p = 0.011 ), and increased walking distance on the 6MWT ( p = 0.010 ), compared to CG. Moreover, there was a reduction in the scores of the FIQ ( p = 0.001 ), the PSQI ( p = 0.001 ), the BDI ( p = 0.017 ), and pain assessed using VAS ( p = 0.008 ) in IG. The results demonstrate that WBVT promotes an increase in blood BDNF levels, with concomitant improvement in lower limb muscle strength, aerobic capacity, clinical symptoms, and quality of life in women with FMS. This trial is registered with Brazilian Clinical Trials Registry (REBEC; RBR-38nbbx) (https://ensaiosclinicos.gov.br/rg/RBR-38nbbx).

Background Bronchopulmonary dysplasia (BPD) is a chronic lung disease that affects the premature lung, and to reduce its incidence has been used non-invasive ventilatory support, such as continuous positive airway (CPAP) and high-flow nasal cannula (HFNC). Thus, the objective of this review was to assess whether the use of high flow nasal cannula (HFNC) compared to continuous positive airway pressure (CPAP) decreases the risk of bronchopulmonary dysplasia (BPD) in premature newborns. Methods The protocol was registered (Prospero: CRD42019136631) and the search was conducted in the MEDLINE, PEDro, Cochrane Library, CINAHL, Embase, and LILACS databases, and in the clinical trials registries, until July 2020. We included randomized clinical trials comparing HFNC versus CPAP use in premature infants born at less than 37 weeks of gestational age. The main outcome measures were the development of BPD, air leak syndrome, and nasal injury. The methodological quality of the included studies was assessed using the Cochrane risk of bias tool and the GRADE system was used to summarize the evidence recommendations. Meta-analyses were performed using software R. Results No difference was found between HFNC or CPAP for the risk of BPD (RR: 1.10; 95% CI: 0.90–1.34), air leak syndrome (RR: 1.06; 95% CI: 0.52–2.14), and nasal trauma (RR: 2.00; 95% CI: 0.64–6.25), with a very low level of evidence. Conclusion(s) The HFNC showed similar results when compared to CPAP in relation to the risk of BPD, air leak syndrome, and nasal injury. In the literature, no randomized clinical trial has been found with BPD as the primary outcome to support possible outcomes.

ObjectiveTo compare the effect of Whole-Body Vibration Exercise (WBVE) applied in push-up modified and half-squat positions, on handgrip strength (HS) and on the electromyography registry (EMGrms) of the flexor digitorum superficialis muscle (FDSM) of the dominant hand.MethodsNineteen healthy women (age 23.40 ± 4.03 years, bodyweight: 58.89 ± 9.87 kg), performed in a randomized order five different tests: (S1) Control; (S2) Push-up modified; (S3) Push-up placebo; (S4); Half-squatting; (S5) Half-squatting placebo. The HS and the EMGrms were assessed at baseline and immediately after the tests. ANOVA two-way design mixed test, with Tukey post hoc, was used to evaluate the HS, EMGrms and the ratio between EMGrms and HS, i.e., neural ratio (NR). Thus, the lower NR represents the greater neuromuscular modifications. The statistical significance level was set up at p &lt; 0.05.ResultsWBVE on S2 increased HS compared to the stimulus applied to the S4 (p = 0.0001). The increase in HS was associated with a reduction in the EMGrms of the FDSM (p &lt; 0.001) and a lower NR (p &lt; 0.0001), i.e., greater neuromuscular modifications, in the S2 compared to the S4 after the tests.ConclusionThe distance of the stimulus and the positioning on the vibratory platform influence the maximum muscular strength due to neuromuscular modifications of hands in healthy women.