Genetic Aspects of Glaucoma: An Updated Review.

Glaucoma is a group of diverse diseases characterized by cupping of the optic nerve head due to the loss of retinal ganglion cells. It is the most common cause of irreversible blindness throughout the word; therefore, its timely diagnosis and early detection through an ophthalmological examination are very important. We, herein, present the information on the epidemiology, pathophysiology, clinical diagnosis, and treatment of glaucoma. We also emphasize the investigations of the last decades that have allowed identifying numerous genes and susceptible genetic factors. We have also described in detail the genes whose mutations cause or contribute to the development of the disease.

Evaluation of a Plant-Based Infant Formula Containing Almonds and Buckwheat on Gut Microbiota Composition, Intestine Morphology, Metabolic and Immune Markers in a Neonatal Piglet Model.

A controlled-neonatal piglet trial was conducted to evaluate the impact of a plant-based infant formula containing buckwheat and almonds as the main source of protein compared to a commercially available dairy-based formula on the gut health parameters. Two day old piglets were fed either a plant-based or a dairy-based formula until day 21. Gut microbiome, cytokines, growth and metabolism related outcomes, and intestinal morphology were evaluated to determine the safety of the plant-based infant formula. This study reported that the plant-based formula-fed piglets had a similar intestinal microbiota composition relative to the dairy-based formula-fed group. However, differential abundance of specific microbiota species was detected within each diet group in the small and large intestinal regions and fecal samples. Lactobacillus delbrueckii, Lactobacillus crispatus, and Fusobacterium sp. had higher abundance in the small intestine of plant-based formula-fed piglets compared to the dairy-based group. Bacteroides nordii, Enterococcus sp., Lactobacillus crispatus, Prevotella sp., Ruminococcus lactaris, Bacteroides nordii, Eisenbergiella sp., Lactobacillus crispatus, Prevotella sp., and Akkermansia muciniphila had greater abundance in the large intestine of the plant based diet fed piglets relative to the dairy-based diet group. In the feces, Clostridiales, Bacteroides uniformis, Butyricimonasvirosa, Cloacibacillus porcorum, Clostridium clostridioforme, and Fusobacterium sp. were abundant in dairy-based group relative to the plant-based group. Lachnospiraceae, Clostridium scindens, Lactobacillus coleohominis, and Prevetolla sp. had greater abundance in the feces of the plant-based group in comparison to the dairy-based group. Gut morphology was similar between the plant and the dairy-based formula-fed piglets. Circulatory cytokines, magnesium, triiodothyronine (T3), thyroxine (T4), thyroid stimulating hormone (TSH), vitamin D, vitamin K, and IgE levels were similar among all piglets independent of dietary group. Overall, the present study demonstrated that a plant-based formula with buckwheat and almonds as the primary source of protein can support similar gut microbiota growth and health outcomes compared to a dairy-based infant formula.

Evaluation of the Safety of a Plant-Based Infant Formula Containing Almonds and Buckwheat in a Neonatal Piglet Model.

A randomized neonatal piglet trial was conducted to evaluate the safety and the effects of a plant-based formula containing almonds and buckwheat as the main ingredients on growth and plasma parameters. From postnatal day (PND) 2 to 21, the piglets were fed a dairy-based milk formula (Similac Advance) or a plant-based formula (Else Nutrition) and all piglets were euthanized at day 21. No diarrhea was observed after PND 8 and all the piglets completed the trial. Body growth, kcal intake, the complete plasma count parameters and hematological parameters were within the reference range in both groups. Organ growth and development was similar between the two groups. Plasma glucose was higher in the dairy-based-fed piglets relative to the plant-based at 2 weeks of age. Liver function biomarkers levels were greater in the plasma of the plant-based compared to the dairy-based fed group. In addition, calcium levels were higher in the plant-based fed piglets at 1 week of age. Thus, the plant-based formula tested in this study was well tolerated by the piglets and supported similar growth compared to dairy-based milk formula. Therefore, the results support the safety of the tested plant-based infant formula during the neonatal period in comparison to the dairy-based formula fed group.

Effects of 2,4-thiazolidinedione (TZD) on milk fatty acid profile and serum vitamins in dairy goats challenged with intramammary infusion of Streptococcus uberis.

The study included two experiments. In the first, 24 lactating Saanen dairy goats received low-energy diet without vitamin supplements. Twelve goats received a daily IV injection of 2,4- thiazolidinedione (TZD), others received saline injection. A week later, 6 goats from each treatment were challenged with intramammary infusion (IMI) of saline (CTRL) or Streptococcus uberis. In the second experiment, 12 Saanen lactating dairy goats received supplemental vitamins to reach NRC recommendation level. Six goats in each group were injected with TZD or saline daily, and 14 d later received Streptococcus uberis IMI in the right half of the udder. The hypotheses were (1) TZD does not affect the level of retinol in blood, and (2) the fatty acid profile is affected by the interaction between mammary infection and TZD in dairy goats. In the first experiment blood samples were collected on d -7, -2, 1, 2, 12 and milk samples were collected on d -8, 1, 4, 7, and 12, both relative to IMI. In the second experiment, blood samples were collected on d -15, 0, 1, and 10 relative to IMI. Milk and serum samples were analyzed for retinol, α-tocopherol and fatty acid profile. Serum retinol and ß-carotene concentrations were higher in the second experiment compared to the first. Serum ß-carotene and α-tocopherol were greater in TZD than CTRL and there was a TZD × time interaction in the first experiment. In addition, the TZD × time interaction showed that the milk fatty acid were reduced in C16 : 0 while C18 : 3 n3 while total omega 3 fatty acids were increased, as well as with minor effect on preventing a transient increase in α-tocopherol in milk. Overall, the TZD may affect the lipid-soluble vitamins and fatty acid profile, potentially altering immune responses, during mastitis in dairy goats.

2,4-Thiazolidinedione in Well-Fed Lactating Dairy Goats: II. Response to Intra-Mammary Infection.

In a prior experiment, treatment of goats with the putative PPARγ agonist 2,4-thiazolidinedione (2,4-TZD) ameliorated the response to intramammary infection without evidence of PPARγ activation. The lack of PPARγ activation was possibly due to deficiency of vitamin A and/or a poor body condition of the animals. Therefore, the present study hypothesized that activation of PPARγ by 2,4-TZD in goats supplemented with adequate amounts of vitamin A can improve the response to sub-clinical mastitis. Lactating goats receiving a diet that met National Research Council requirements, including vitamin A, were injected with 8 mg/kg BW of 2,4-TZD (n = 6) or saline (n = 6; control (CTR)) daily. Two weeks into treatment, all goats received Streptococcus uberis (IMI) in the right mammary gland. Blood biomarkers of metabolism, inflammation, and oxidative status plus leukocytes phagocytosis were measured. Mammary epithelial cells (MEC) and macrophages were isolated from milk and liver tissue collected for gene expression analysis. Milk fat was maintained by treatment with 2,4-TZD, but decreased in CTR, after IMI. Haptoglobin was increased after IMI only in 2,4-TZD without any effect on negative acute phase proteins, indicating an improved liver function. 2,4-TZD vs. CTR had a greater amount of globulin. The expression of inflammation-related genes was increased by IMI in both macrophages and MEC. Except for decreasing expression of SCD1 in MEC, 2,4-TZD did not affect the expression of measured genes. Results confirmed the successful induction of sub-clinical mastitis but did not confirm the positive effect of 2,4-TZD on the response to IMI in well-fed goats.

Avaliação de sintomas psicofuncionais em bebês: revisão crítica da literatura sobre o uso do symptom checklist / Evaluation of psychofunctional symptoms in infants: a critical review of the literature on the use of the symptom checklist / Evaluación de síntomas psicofuncionales en los bebés: revisión crítica de la literatura sobre el uso de symptom checklist

Esse trabalho objetivou apresentar os estudos que utilizaram o Symptom Checklist (SCL) para avaliar sintomas psicofuncionais em bebês. Foram detalhados os países em que os trabalhos foram realizados, o delineamento dos estudos e as principais variáveis associadas. Para tanto, foi realizada uma revisão crítica da literatura, considerando trabalhos que utilizaram o SCL. Identificou-se que a prevalência de sintomas psicofuncionais em bebês ainda é um dado desconhecido tanto no Brasil quanto no exterior, ainda que exista um predomínio de estudos europeus. Embora o SCL possa ser usado em pesquisas com diversos tipos de delineamentos, destacaramse estudos longitudinais. Os achados também permitiram problematizar as propriedades psicométricas do instrumento. Sugere-se a realização de novos estudos, bem como uma ampliação no uso e na divulgação do SCL, uma vez que o instrumento permite uma avaliação compreensiva e detalhada da saúde e do desenvolvimento infantil.

This study aimed to present the studies that used the Symptom Checklist (SCL) to evaluate psychofunctional symptoms infants. Were detailed the countries that the studies were carried out, the design of the articles and the main variables associated. Therefore, a critical review of the literature was performed, considering works that used the SCL instrument. It was found that the prevalence of symptoms of infants, is still unknown in Brazil and abroad, although there is a predominance of studies in the European context. Although the SCL can be used in various types of research designs, longitudinal studies were predominant. The findings also allowed to question the psychometric properties of the instrument. It is suggested to carry out new studies, as well as an expansion in the use and divulgation of SCL, since the instrument allows a comprehensive and detailed assessment of health and child development.

Esta investigación tuvo como objetivo presentar los estudios que utilizaron el Symptom Checklist (SCL) para evaluar los síntomas psicofuncionales en bebés. Fueron detallados los países en los que el trabajo se lleva a cabo, el diseño de los estudios y las principales variables asociada. Por lo tanto, se realizó una revisión crítica de la literatura, teniendo en cuenta los estudios que utilizaron el SCL. Se encontró que la prevalencia de síntomas en los bebés psicofuncionales sigue siendo una incógnita tanto en Brasil como en el extranjero, aunque hay un predominio de los estudios europeos. Aunque el SCL se puede utilizar en la investigación de varios tipos de diseños, se destacaron estudios longitudinales. Los resultados también permiten a cuestionar las propiedades psicométricas del instrumento. Se sugiere conducir nuevos estudios, así como una expansión en el uso y divulgación de SCL, ya que el instrumento permite una evaluación completa y detallada de salud y desarrollo infantil

Phytochemical Compounds and Antioxidant Capacity of Tucum-Do-Cerrado (Bactris setosa Mart), Brazil's Native Fruit.

This study identified major phenolic compounds of the tucum-do-cerrado (Bactris setosa) peel, as well as antioxidant activity and total phytochemical compound concentration of different extracts of the peel and pulp of this fruit. Phenolic compounds of the different extracts of tucum-do-cerrado peel were identified and quantified using a high-performance liquid chromatography system coupled to a diode array detector (DAD). Total phytochemical compound content was determined by spectrophotometric assays and the antioxidant activity by ferric reducing antioxidant power and ß-carotene/linoleic assays. Total phenolic, flavanols, total anthocyanins and yellow flavonoids concentration of tucum-do-cerrado were 122-, 14-, 264- and 61-fold higher in the peel than in the pulp, respectively. The aqueous, methanolic and ethanolic extracts of the tucum-do-cerrado peel exhibited higher antioxidant activity compared to its pulp. Flavanols, anthocyanins, flavones, phenolic acids and stilbenes were the main phenolic classes identified in the tucum-do-cerrado peel extracts. Results suggest that the antioxidant capacity and the phytochemical compound content of the tucum-do-cerrado are mainly associated with the peel. Although flavonoids are the main compounds identified in tucum-do-cerrado peel, other phenolics identified in minor amounts, such as phenolic acids and stilbenes, may be responsible for the high antioxidant capacity of the fruit.

Estudo da emissão de luz por diodoinfravermelho na dor neuropática em ratos / Study of infrared light emitting diodes infraredon neuropathic pain in rats

Introdução: A lesão nervosa periférica pode causar alteraçõesfuncionais tanto sensitivas quanto motoras, podendo promoverimportantes comprometimentos, especialmente a dor neuropática.Dentre os vários tratamentos propostos está o emprego da luz monocromáticade baixa intensidade, como o diodo de emissão de luz(LED). Objetivo: Avaliar o efeito analgésico do LED no espectroinfravermelho em modelo experimental de dor neuropática porconstrição do nervo ciático em ratos. Material e métodos: Foramutilizados 24 ratos machos Wistar, randomizados em 4 grupos (n =6). Grupo I: animais neuropáticos e tratados com LED; grupo II:animais neuropáticos e tratados com o LED desligado (placebo);grupo III: animais Sham e tratados com LED; grupo IV: animaisSham e tratados com LED desligado (placebo). Para avaliar a eficáciado tratamento, foram empregados parâmetros de nocicepção comoalodínia mecânica estática, dinâmica e térmica ao frio; hiperalgesiatérmica ao calor e nocicepção espontânea. Resultados: Os animaisneuropáticos desenvolveram alodínia e hiperalgesia ao estímulomecânico, térmico e nocicepção espontânea em 7 dias (Tempo 0)contados a partir da indução da neuropatia, mantendo essas manifestaçõesaté o 14º dia. Conclusão: O tratamento contínuo com LED noespectro infravermelho promoveu efeito analgésico em um modeloexperimental de dor neuropática em ratos. Os resultados obtidosneste estudo sugerem que esse recurso físico pode ser utilizado notratamento de pacientes com dor neuropática.

Introduction: The peripheral nerve injury can cause sensory andmotor functional changes, promoting important damages, especiallyneuropathic pain. The use of monochromatic light of low intensity,such as light-emitting diode (LED) is among different treatmentsoptions. Objective: This study proposes an evaluation of analgesiceffect of LED in the infrared spectrum in experimental model ofneuropathic pain induced by constriction of the sciatic nerve in rats.Methods: We used 24 male Wistar rats randomized into 4 groups (n= 6). Group I: neuropathic animals, treated with LED; group II:neuropathic animals, treated with LED (placebo); group III: Shamanimals treated with LED, group IV: Sham animals treated withLED turned off (placebo). We used nociception parameters suchas static mechanical allodynia, thermal (cold) dynamics, thermal(heat) hyperalgesia and spontaneous nociceptive in order to evaluatetreatment efficacy. Results: All animals developed neuropathicallodynia and hyperalgesia to mechanical stimulation, thermal andspontaneous nociception in 7 days (time 0), starting on inductionof neuropathy, maintaining these conditions until the 14th day.Conclusion: Continuous LED treatment with infrared spectrumpromotes analgesic effect in experimental model of neuropathic painin rats. The results of this study suggest that this treatment may beused to treat patients with neuropathic pain.

A novel, potent, oral active and safe antinociceptive pyrazole targeting kappa opioid receptors.

Pyrazole compounds are an intriguing class of compounds with potential analgesic activity; however, their mechanism of action remains unknown. Thus, the goal of this study was to explore the antinociceptive potential, safety and mechanism of action of novel 1-pyrazole methyl ester derivatives, which were designed by molecular simplification, using in vivo and in vitro methods in mice. First, tree 1-pyrazole methyl ester derivatives (DMPE, MPFE, and MPCIE) were tested in the capsaicin test and all presented antinociceptive effect; however the MPClE (methyl 5-trichloromethyl-3-methyl-1H-pyrazole-1-carboxylate) was the most effective. Thus, we selected this compound to assess the effects and mechanisms in subsequent pain models. MPCIE produced antinociception when administered by oral, intraperitoneal, intrathecal and intraplantar routes and was effective in the capsaicin and the acetic acid-induced nociception tests. Moreover, this compound reduced the hyperalgesia in diverse clinically-relevant pain models, including postoperative, inflammatory, and neuropathic nociception in mice. The antinociception produced by orally administered MPClE was mediated by κ-opioid receptors, since these effects were prevented by systemically pre-treatment with naloxone and the κ-opioid receptor antagonist nor-binaltorphimine. Moreover, MPCIE prevented binding of the κ-opioid ligand [(3)H]-CI-977 in vitro (IC50 of 0.68 (0.32-1.4) µM), but not the TRPV1 ([(3)H]-resiniferatoxin) or the α2-adrenoreceptor ([(3)H]-idazoxan) binding. Regarding the drug-induced side effects, oral administration of MPClE did not produce sedation, constipation or motor impairment at its active dose. In addition, MPCIE was readily absorbed after oral administration. Taken together, these results demonstrate that MPClE is a novel, potent, orally active and safe analgesic drug that targets κ-opioid receptors.

Identification of the plant steroid α-spinasterol as a novel transient receptor potential vanilloid 1 antagonist with antinociceptive properties.

The transient receptor potential vanilloid 1 (TRPV1) receptor is relevant to the perception of noxious information and has been studied as a therapeutic target for the development of new analgesics. The goal of this study was to perform in vivo and in vitro screens to identify novel, efficacious, and safe TRPV1 antagonists isolated from leaves of the medicinal plant Vernonia tweedieana Baker. All of the fractions and the hydroalcoholic extract produced antinociception in mice during the capsaicin test, but the dichloromethane fraction also had antioedematogenic effect. Among the compounds isolated from the dichloromethane fraction, only α-spinasterol reduced the nociception and edema induced by capsaicin injection. Moreover, α-spinasterol demonstrated good oral absorption and high penetration into the brain and spinal cord of mice. α-Spinasterol was able to displace [3H]resiniferatoxin binding and diminish calcium influx mediated by capsaicin. Oral administration of the dichloromethane fraction and α-spinasterol also produced antinociceptive effect in the noxious heat-induced nociception test; however, they did not change the mechanical threshold of naive mice. The treatment with α-spinasterol did not produce antinociceptive effect in mice systemically pretreated with resiniferatoxin. In addition, α-spinasterol and the dichloromethane fraction reduced the edema, mechanical, and heat hyperalgesia elicited by complete Freund's adjuvant paw injection. The dichloromethane fraction and α-spinasterol did not affect body temperature or locomotor activity. In conclusion, α-spinasterol is a novel efficacious and safe antagonist of the TRPV1 receptor with antinociceptive effect.

Fibrose cística: uma abordagem clínica e nutricional / Cystic fibrosis: a clinical and nutritional approach

A fibrose cística é a doença genética letal mais comum em populações caucasianas e é caracterizada por infecções crônicas e recorrentes do pulmão, insuficiência pancreática e elevados níveis de cloro no suor. É uma doença de herança autossômica recessiva causada pela mutação no gene do Regulador da Condutância Transmembrana da Fibrose Cística, que induz o organismo a produzir secreções espessas e viscosas que obstruem os pulmões, o pâncreas e o ducto biliar. Muitos pacientes apresentam insuficiência pancreática, que leva a má-absorção de nutrientes especialmente de proteínas e lipídeos e a complicações gastrintestinais tais como prolapso retal, síndrome da obstrução intestinal, constipação e cirrose hepática. A fibrose cística normalmente é diagnosticada na infância, pelos programas de triagem neonatal ou pelo teste do suor. Devido aos vários sistemas envolvidos e à variabilidade e cronicidade da doença, uma abordagem multidisciplinar é essencial para auxiliar o paciente e sua família a compreenderem a doença e aderirem ao tratamento. A terapia atual da fibrose cística inclui a manutenção do estado nutricional, a remoção das secreções das vias aéreas com fisioterapia e mucolíticos, o uso de antibióticos para prevenção e tratamento de infecções, a prescrição de suplementos energéticos, dietas hiperlípidicas e hiperprotéicas, bem como a suplementação de minerais e vitaminas lipossolúveis. O objetivo deste trabalho foi realizar breve revisão de literatura sobre os aspectos clínicos e nutricionais da fibrose cística.

Cystic fibrosis is the most common, lethal, genetic disease in Caucasian populations and is characterized by chronic and recurrent lung infections, pancreatic insufficiency and high sweat chloride levels. It is an autosomal recessive hereditary disease caused by a mutation in the cystic fibrosis transmembrane conductance regulator gene which induces the body to produce thick and viscous mucus secretions that obstruct the lungs, pancreas and bile duct. Many patients have pancreatic insufficiency which leads to malabsorption of nutrients, especially proteins and fats and to gastrointestinal complications such as rectal prolapse, intestinal obstruction syndrome, constipation and hepatic cirrhosis. Cystic fibrosis is usually diagnosed during childhood by neonatal screening programs or sweat test. Because of the multiple systems involved and the variability and chronicity of the disease, a multidisciplinary team is essential to help patients and their families understand the disease and adhere to treatment. Current cystic fibrosis therapy includes maintaining the nutritional status, clearing the airways with physiotherapy and mucolytics, preventing and treating infections with antibiotics and prescribing energy supplements, high-fat and high-protein diets, as well as minerals and fat-soluble vitamins. The purpose of this study was to present a brief literature review of the clinical and nutritional aspects of cystic fibrosis.

Comportamento da mecânica pulmonar após a aplicação de protocolo de fisioterapia respiratória e aspiração traqueal em pacientes com ventilação mecânica invasiva / Behavior of the lung mechanics after the application of protocol of chest physiotherapy and aspiration tracheal in patients with invasive mechanical ventilation

JUSTIFICATIVA E OBJETIVOS: A fisioterapia respiratória (FR) em pacientes submetidos a suporte ventilatório invasivo, atua diretamente no sistema ventilatório podendo alterar a mecânica pulmonar através da complacência pulmonar dinâmica (Cdyn) e da resistência do sistema respiratório (Rsr). Porém, as alterações descritas após a realização de FR permanecem controversas. O objetivo deste estudo foi avaliar as alterações da mecânica pulmonar em pacientes em ventilação mecânica invasiva (VMI). MÉTODO: Foi realizado estudo prospectivo e aleatório, controlado do tipo cruzado, incluindo pacientes com mais de 48 horas em VMI. Os protocolos de fisioterapia respiratória (PF) e de aspiração traqueal isolada (PA) foram aleatorizados para a ordem de aplicação, com intervalo de 24 horas entre eles. Dados da mecânica pulmonar e das variáveis cardiorrespiratórias foram coletados antes da aplicação do protocolo, imediatamente após; 30 minutos e 120 minutos após a aplicação dos protocolos. RESULTADOS: Doze pacientes completaram o estudo. A pneumonia foi a causa mais comum de insuficiência respiratória (IRpA). Não houve diferença estatisticamente significativa entre os grupos em relação à Cdyn, volume de ar corrente (VAC) e volume-minuto (VM). A Rsr diminuiu de forma significativa imediatamente após (de 10,4 ± 3 cmH2O/L/seg para 8,9 ± 2 cmH2O/L/seg; p < 0,02), 30 minutos após (de 10,4 ± 3 cmH2O/L/seg para 9 ± 2 cmH2O/L/seg; p < 0,01) e 120 min após (de 10,4 ± 3 cmH2O/L/seg para 9 ± 2 cmH2O/L/seg; p < 0,03) a aplicação do protocolo de fisioterapia respiratória. Quando comparado com o protocolo de aspiração traqueal isolada foi significativamente menor nos momentos 30 (9 ± 2 cmH2O/L/seg versus 10,2 ± 2 cmH2O/L/seg; p < 0,04) e 120 minutos (9 ± 2 cmH2O/L/segundo versus 10,4 ± 3 cmH2O/L/seg; p < 0,04). CONCLUSÕES: O protocolo de fisioterapia respiratória foi eficaz na diminuição da Rsr quando comparado com o protocolo de aspiração. Essa diminuição manteve-se...

BACKGROUND AND OBJECTIVES: The chest physiotherapy (CP) in patients submitted to invasive support ventilation acts directly in the breathing system, and it could alter the lung mechanics through the dynamic lung compliance (DynC) and resistance of the breathing system (Rbs). However the alterations after the accomplishment of CP are still controversy. The objective of this study was to evaluate the alterations of the lung mechanics in patients in invasive mechanical ventilation (IMV). METHODS: It was a prospective, randomized, and controlled and crossover study, with patient with more than 48 hours in IMV. The protocol of chest physiotherapy and isolated tracheal aspiration they were randomized for the application order with a window of 24 hours among them. Data of lung mechanics and its varied cardiorespiratory were collected moments before the protocol, immediately after the application of the protocol, 30 minutes and 120 minutes after the application of the protocols. RESULTS: Twelve patients completed the study. Pneumonia was the mean cause respiratory failure (RF). There was not statistical difference among the groups in relation to Cdyn, volume tidal (Vt) and volume minute (Ve). Rbs decreased in a significant way immediately after (of 10.4 ± 3 cmH2O/L/seg for 8.9 ± 2 cmH2O/L/seg; p < 0.02), 30 minutes after (of 10.4 ± 3 cmH2O/L/seg for 9 ± 2 cmH2O/L/seg; p < 0.01) and 120 minutes after (of 10.4 ± 3 cmH2O/L/seg for 9 ± 2 cmH2O/L/seg; p < 0.03) application the protocol of chest physiotherapy. When compared with the protocol of isolated tracheal aspiration it was significantly smaller in the 30 (9 ± 2 cmH2O/L/seg versus10.2 ± 2 cmH2O/L/seg; p < 0.04) and 120 minutes (9 ± 2 cmH2O/L/seg versus 10.4 ± 3 cmH2O/L/seg; p < 0.04). CONCLUSIONS: The protocol of chest physiotherapy was effective in the decrease of Rsr when compared with the aspiration protocol. That decrease was maintained for two hours after its application, what did not happen...

[Optimizing exercise performance with a continuously paced shuttle walk test for patients with chronic obstructive pulmonary disease]. / Optimización de la capacidad de realización de ejercicio físico mediante una prueba de la lanzadera por tramos con estimulación auditiva continua en pacientes con EPOC.

BACKGROUND: A continuously paced shuttle walk test (SWTp) was developed to test the hypothesis that speed and rhythm could be more optimally imposed by an easier-to-follow sound stimulus at every step. The objective of this study was to assess the reproducibility of the SWTp and to compare the performance of patients with chronic obstructive pulmonary disease (COPD) on the conventional and optimally paced forms of the test. PATIENTS AND METHODS: The walk test results of 24 COPD patients were studied. All patients completed 2 SWTp sessions and a conventional SWT in random order, after an initial practice test for each. A portable device was used to measure peak oxygen uptake (VO2) in 6 patients. RESULTS: The intraclass correlation coefficient (Cronbach's alpha) was 0.95 for the STWp. The Pearson correlation coefficient between distance walked and peak VO2 in the SWTp was 0.86 (P < .02). Better performance was achieved during the SWTp (peak VO2, 3.30 mL/kg/min; P < .01; distance walked, 32 m, P < .001) than during the conventional SWT. The SWTp showed excellent reproducibility. CONCLUSIONS: COPD patients can achieve better performance with the stimuli provided in the SWTp than on the SWT.

Optimización de la capacidad de realización de ejercicio físico mediante una prueba de la lanzadera por tramos con estimulación auditiva continua en pacientes con EPOC / Optimizing exercise performance with a continuously paced shuttle walk test for patients with Chronic Obstructive Pulmonary Disease

Objetivo: Se ha desarrollado una prueba de lanzadera por tramos (SWT, de shuttle walk test) con estimulación auditiva continua (SWTp, paced shuttle walk test) para comprobar la hipótesis de que es posible que los pacientes consigan una velocidad y un ritmo mejores mediante la aplicación de un estímulo sonoro, de seguimiento más fácil por ellos y correspondiente a cada paso que realizan en la prueba. El objetivo de este estudio ha sido evaluar la reproducibilidad de la SWTp y comparar el rendimiento de los pacientes con enfermedad pulmonar obstructiva crónica (EPOC) en la SWT con estimulación sonora convencional y en la SWTp con estimulación sonora óptima. Pacientes y métodos: Se han evaluado los resultados obtenidos por 24 pacientes con EPOC en la prueba de ejercicio de caminar. Todos los pacientes completaron 2 sesiones de SWTp y una sesión de SWT convencional, tras su distribución aleatoria a los grupos y después de efectuar una sesión inicial de práctica con cada una de las pruebas. Se utilizó un dispositivo portátil para determinar el consumo de oxígeno (VO2) máximo en 6 pacientes. Resultados: El coeficiente de correlación intraclase (alfa de Cronbach) fue de 0,95 para la STWp. El coeficiente de correlación de Pearson entre la distancia recorrida en la prueba y el VO2 máximo respecto a la SWTp fue de 0,86 (p < 0,02). Se consiguió un rendimiento mejor durante la SWTp (VO2 máximo de 3,30 ml/kg/min, p < 0,01; distancia recorrida de 32 m, p < 0,001), en comparación con la SWT convencional. La SWTp se acompañó de una reproducibilidad excelente. Conclusiones: Los pacientes con EPOC pueden alcanzar un rendimiento mayor con el estímulo auditivo proporcionado en la SWTp que con el correspondiente a la SWT

Background: A continuously paced shuttle walk test (SWTp) was developed to test the hypothesis that speed and rhythm could be more optimally imposed by an easier-to-follow sound stimulus at every step. The objective of this study was to assess the reproducibility of the SWTp and to compare the performance of patients with chronic obstructive pulmonary disease (COPD) on the conventional and optimally paced forms of the test. Patients and methods: The walk test results of 24 COPD patients were studied. All patients completed 2 SWTp sessions and a conventional SWT in random order, after an initial practice test for each. A portable device was used to measure peak oxygen uptake (VO2) in 6 patients. Results: The intraclass correlation coefficient (Cronbach's alpha) was 0.95 for the STWp. The Pearson correlation coefficient between distance walked and peak VO2 in the SWTp was 0.86 (P<.02). Better performance was achieved during the SWTp (peak VO2, 3.30 mL/kg/min; P<.01; distance walked, 32 m, P<.001) than during the conventional SWT. The SWTp showed excellent reproducibility. Conclusions: COPD patients can achieve better performance with the stimuli provided in the SWTp than on the SWT