Heart failure worsens leg muscle strength and endurance in coexistence patients with COPD and heart failure reduced ejection fraction.

PURPOSE: Exercise intolerance and dyspnoea are clinical symptoms in both heart failure (HF) reduced ejection fraction (HFrEF) and chronic obstructive pulmonary disease (COPD), which are suggested to be associated with musculoskeletal dysfunction. We tested the hypothesis that HFrEF + COPD patients would present lower muscle strength and greater fatigue compared to compared to the COPD group. METHODS: We included 25 patients with HFrEF + COPD (100% male, age 67.8 ± 6.9) and 25 patients with COPD alone (100% male, age 66.1 ± 9.1). In both groups, COPD severity was determined as moderate-to-severe according to the GOLD classification (FEV1/FVC < 0.7 and predicted post-bronchodilator FEV1 between 30%-80%). Knee flexor-extensor muscle performance (torque, work, power and fatigue) were measured by isokinetic dynamometry in age and sex-matched patients with HFrEF + COPD and COPD alone; Functional capacity was assessed by the cardiopulmonary exercise test, the 6-min walk test (6MWT) and the four-minute step test. RESULTS: The COPD group exhibited reduced lung function compared to the HFrEF + COPD group, as evidenced by lower FEV1/FVC (58.0 ± 4.0 vs. 65.5 ± 13.9; p < 0.0001, respectively) and FEV1 (51.3 ± 17.0 vs. 62.5 ± 17.4; p = 0.026, respectively) values. Regarding musculoskeletal function, the HFrEF + COPD group showed a knee flexor muscles impairment, however this fact was not observed in the knee extensors muscles. Power peak of the knee flexor corrected by muscle mass was significantly correlated with the 6MWT (r = 0.40; p < 0.05), number of steps (r = 0.30; p < 0.05) and work ratepeak (r = 0.40; p < 0.05) in the HFrEF + COPD and COPD groups. CONCLUSION: The presence of HFrEF in patients with COPD worsens muscular weakness when compared to isolated COPD.

Influência do perfil clínico e sociodemográfico na qualidade de vida de cardiopatas submetidos à reabilitação cardíaca / Influence of socio-demographic and clinical profiles in quality of life of cardiac patients undergoing cardiac rehabilitation

Introdução: Programas de reabilitação cardiovascular são fundamentais para garantir uma melhor qualidade de vida (QV) em pacientes cardiopatas. Objetivos: Avaliar a QV de pacientes submetidos à reabilitação cardíaca (RC) e investigar se aspectos sociodemográficos, tipo de diagnóstico e tempo de tratamento são variáveis que influenciam a QV desses pacientes. Métodos: Realizou-se um estudo transversal com 82 pacientes, 64,52 ± 9,04 anos, que responderam dois questionários, para avaliação da QV (questionário SF-36) e para classificação do nível socioeconômico, e tiveram seu nível sociodemográfico determinado. Resultados: Maiores valores dos escores do questionário SF-36 que avaliam aspectos emocionais foram observados em todas as associações realizadas. Os aspectos do perfil da amostra abordados neste estudo não repercutiram de forma representativa na QV. Conclusão: Pacientes cardiopatas submetidos à RC apresentaram maiores valores em escores de qualidade de vida que avaliam aspectos emocionais. Os fatores estudados não influenciaram a QV desses participantes.

Introduction: Cardiovascular rehabilitation programs are fundamental to ensure a better quality of life (QL) in cardiac patients. Objective: Evaluate the QL of patients undergoing cardiac rehabilitation (CR) and investigate if demographic aspects, diagnosis and treatment time are variables that influence on these patients QL. Methods: It was conducted a cross-sectional study with 82 patients, 64,52 ± 9,04 years old, who answered two questionnaires, for QL assessment (questionnaire SF-36) and for socioeconomic level classification, and their socio-demographie profile determined. Results: Higher values of scores of SF-36 questionnaire that assess emotional aspects were observed in all associations held. The sample profile aspects addressed in this study did not represent echo in QL. Conclusion: Cardiac patients submitted to RC showed greater benefits on emotional aspects and factors studied did not influence on these patients QL.

Impacto da terapia nutricional enteral ambulatorial em pacientes oncológicos / Impact of enteral nutrition therapy in ambulatory cancer patients / Impacto de la terapia nutricional enteral ambulatoria en pacientes con cáncer

O objetivo do presente estudo foi verificar o efeito da Terapia Nutricional Enteral (TNE) no estado nutricional (EN) de pacientes oncológicos. Realizou-se estudo do tipo transversal, de natureza quantitativa retrospectiva. A população estudada constituiu-se de 95 pacientes maiores de 18 anos, em uso de TNE, atendidos ambulatorialmente no período de 01/2005 a 05/2005. Foram coletados dados de estatura, peso e percentual de perda de peso (% PP), no início e após certo tempo de TNE. O EN foi verificado através da análise concomitante do IMC e do %PP. Os programas Microsoft Excel e Statistical Package for the Social Science for Windows foram utilizados para a tabulação e análise dos dados. Obteve-se dados de 95 pacientes (H:83, M:12) com média de idade de 57,28 mais ou menos 10,61 anos com neoplasias malignas de cabeça e pescoço (58,94%), esôfago (29,47), outros (11,56%). Estavam em tratamento oncológico 73,68% destes, sendo: apenas quimioterapia (11,57%), apenas radioterapia (11,57%), quimioterapía e radioterapia (26,31%), paliativo (9,47%) e 26,31% dos pacientes não tinham tratamento identificado. Receberam dieta com proteína de origem vegetal 60% dos pacientes, animal 21% e mista 18,94%. Encontrou-se % PP significativa em 10,5% dos casos avaliados e em 47,36% verificou-se manutenção ou aumento de peso. o presente estudo reafirmou a importância do uso de TNE na manutenção do EN, demonstrando sua importância como adjuvante no tratamento oncológico.

The aim of this study was to investigate the effect of Enteral Nutrition Therapy (NET) on nutrition (EN) of cancer patients. We performed a cross-sectional study, quantitative retrospective. The study population consisted of 95 patients over 18 years, while using TNE patient clinic in the period from 01/2005 to 05/2005. Data were collected on height, weight and percentage weight loss (% PP), at baseline and after certain time of TNE. NS was determined by analyzing concurrent BMI and % PP. the Microsoft Excel and Statistical Package for Social Science for Windows were used to tabulate and analyze data. We obtained data from 95 patients (M: 83 M: 12) with a mean age of 57.28 plus or minus 10.61 years with malignant head and neck (58.94%), esophagus (29.47 ), other (11.56%). Were at 73.68% of cancer treatment, as follows: chemotherapy alone (11.57%), only radiotherapy (11.57%), quimioteraía and radiotherapy (26.31%), palliative (9.47%) and 26 31% of patients had no treatment identified. Received diets with vegetable protein 60% of patients, 21% animal and 18.94% mixed. Found % PP significantly in 10.5% of cases assessed at 47.36% and there was maintenance or weight gain. The present study reaffirmed the importance of using TNE maintenance of EN, demonstrating its importance as ajuvante in cancer treatment.

El objetivo de este estudio fue investigar el efecto de la Terapia de Nutrición Enteral (NET) en materia de nutrición (EN) de los pacientes de cáncer. Se realizó estudio transversal, retrospectivo cuantitativo. La población del estudio consistió en 95 pacientes mayores de 18 año, durante el uso de la clínica del paciente TNE en el período comprendido entre el 01/2005 al 05/2005. Se recogieron datos sobre altura, peso y porcentaje de pérdida de peso (% PP), al inicio del estudio y después de cierto tiempo de NET. NS se determinó mediante el análisis simultáneo de IMC y % PP. Microsoft Excel y Paquete Estadístico para Ciencias Sociales para Windows se utiliza para tabular y analizar datos. Se recogieron datos de 95 pacientes (M: 83 M: 12) con una edad media de 57,28 más o menos 10,61 años con la cabeza y el cuello malignos (58,94%), esófago (29.47%), otros (11,56%). Fueron a 73,68% del tratamiento del cáncer, según se indica: la quimioterapia sola (11,57%), sólo la radioterapia (11,57%), quimioteraía y radioterapia (26,31%), paliativa (9,47%) y 26 31% de los pacientes sin tratamiento identificados. Recibido dietas con proteínas vegetales 60% de los pacientes, el 21% animal y 18,94% mixtos. Se encontraron % PP significativa en el 10,5% de los casos evaluados en 47,36% y no hubo mantenimiento o aumento de peso. El presente estudio reafirma la importancia de utilizar el mantenimiento de la norma EN TNE, lo que demuestra su importancia como ajuvante en el tratamiento del cáncer.