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INTRODUCTION AND OBJECTIVE: Sickle cell anemia (SCA) is a genetic condition that alters the conformation of deoxygenated red blood cells, which results in their stiffening and the occurrence of vaso-occlusive crises, endothelium damage, organ dysfunction and systemic complications. Additionally, SCA limits the participation of individuals in physical and social activities. As we consider that physical exercise promotes the recovery of functional capacity and cardiorespiratory conditioning, we aim to verify the patterns of prescription, the effects and safety of exercise for individuals with SCA. METHODOLOGY: We systematically reviewed the published literature focusing on clinical trials that correlated physical exercise with SCA patients and cross-sectional studies that applied the stress test. The data research was based on the PRISMA recommendations and the following databases were used: Medline by PubMed, Cochrane, PEDro, Scielo. RESULTS: Six studies which were based on the evaluation of 212 patients aged between 13 and 40 years, were selected from 122 identified studies. Those studies associated the individual effort tolerance improvement, its inflammatory profile adjustment and the absence of alteration in the autonomic nervous system activity to physical exercise or stress test. CONCLUSION: Low-to-moderate intensity physical exercise increased the SCA individual tolerance without causing vaso-occlusive crises, nor changes in the hemorheological and inflammatory profiles.
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Pulmonary artery aneurysm (PAA) is a rare disease, with a poorly known natural history, complex diagnosis and may evolve with serious complications, such as compression of adjacent anatomical structures. In some cases, the presence of such complications is what determines the symptoms and is the initial manifestation of the disease. This paper aims to report the case of a patient with typical angina, submitted to cardiac catheterization, which showed, among other lesions, severe left main coronary lesion with characteristics that led to the suspicion of extrinsic compression, which was identified as caused by a PAA. The treatment chosen in this case was surgical, reported concurrently with a literature review that guided the medical team in their decision-making. RELEVANCE FOR PATIENTS: Surgical correction of PAA may provide resolution of coronary symptoms in affected individuals.
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Introdução: Doenças cardiovasculares permanecem como a principal causa de morte em mulheres. Alguns recursos, como a variabilidade da frequência cardíaca (VFC), permitem predizer os riscos de intercorrências. Esta análise permite verificar de forma não invasiva as influências do sistema nervoso autônomo sobre o nodo sinusal, estando a predominância da sinalização simpática, associada a desfechos negativos. O exercício físico é a medida preventiva com melhor custo benefício para a manutenção da saúde cardiovascular e os estudos mais recentes vêm demonstrando sua capacidade em modular a atividade autonômica. Objetivo: Verificar se o exercício físico cíclico é capaz de aumentar a VFC em mulheres, independente da condição clínica. Métodos: Trata-se de uma revisão sistemática orientada pelo Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guideline. As buscas foram realizadas entre julho e agosto de 2019 nas bases de dados: Medline via Pubmed, Literatura Latino-americana e do Caribe em Ciências da Saúde (Lilacs), Scientific Electronic Library Online (Scielo), Physiotherapy Evidence Database (PEDro) e Cochrane Central Register of Controlled Trials (Cochrane Central). Resultados: Foram identificados 492 artigos, dos quais, 14 estudos participaram da seleção final, totalizando 1.579 mulheres. Condições como: gestação, pós-menopausa, diabetes mellitus tipo 2, envelhecimento, cirurgia de by-pass gástrico, fibromialgia e ovários policísticos foram abordadas. Os dois únicos estudos que se opuseram a efetividade do exercício físico apresentaram uma sessão semanal, quantidade incapaz de promover tais benefícios. Conclusão: O exercício cíclico foi capaz de aumentar a sinalização parassimpática, com consequente aumento da variabilidade da frequência cardíaca. Estes achados confirmam que o exercício prescrito corretamente é capaz de alterar positivamente a modulação autonômica cardíaca, reduzindo as chances de intercorrências. (AU)
Introduction: Cardiovascular diseases remain the leading cause of death in women. Some features, such as heart rate variability (HRV), allow to predict future risk events. This analysis aimed to verify noninvasively the influences of the autonomic nervous system on the sinus node, by sympathetic and parasympathetic afferents. The predominance of sympathetic activation is associated with negative outcomes. Exercise is the most cost-effective preventive measure for maintaining cardiovascular health. More recent studies with male and female population have demonstrated their ability to modulate autonomic activity. Objective: To verify whether cyclic exercise can increase HRV in women, regardless of clinical condition. Methods: This is a systematic review guided by the Preferred Reporting Items for Systematic Reviews and MetaAnalyzes (PRISMA) guideline. Searches were performed between July and August 2019 in the databases: Medline via Pubmed, Latin American and Caribbean Health Sciences Literature (LILACS), Scientific Electronic Library Online (Scielo), Physiotherapy Evidence Database (PEDro) and Library Central Cochrane. Results: 492 articles were identified, of which 14 studies participated in the discussion of this study, totaling 1.579 women. Conclusion: Cyclic exercise was able to increase parasympathetic signaling, with consequent increase in heart rate variability. These findings confirm that correctly prescribed exercise can positively alter cardiac autonomic modulation, reducing the chances of complications. (AU)