The COVID-19 Pandemic and Posttraumatic Stress Disorder: Emotional Impact on Healthcare Professions.

The COVID-19 pandemic, which began in March 2020, has resulted in the deaths of hundreds of thousands of people around the world in just a few months, putting at great risk the commitment of healthcare workers unprepared to manage a worldwide phenomenon at great risk. In the early stages especially, medical staff had to deal with the pandemic at the expense of their physical and mental health, putting them particularly at risk for experiencing posttraumatic stress disorder (PTSD). The study aims to analyze the psychopathological aspects associated with PTSD, focusing on the emotional impact caused by the COVID-19 pandemic on healthcare professionals compared with a control group. The sample analyzed over 2 months, from March to May 2021, included 214 participants into two groups, i.e., healthcare professionals (N = 107) and a control group (N = 107). The online assessment instrument used consisted of an anonymous questionnaire, assembled ad hoc with demographic information and different standardized assessment scales (e.g., Fear of COVID-19 scale, Profile of Mood States, and Maslach Burnout Inventory-Human Services Survey), while a further section of the survey used the DSM-5 criteria to investigate Posttraumatic stress disorder (e.g., COVID-19-PTSD). The results reported that healthcare professionals had a consistent perception of stress (mean = 26.18, SD = 14.60), but not at a level significantly higher than other categories of workers (mean = 25.75, SD = 14.65; t = 0.20, p = 0.84). However, they showed less emotional disturbance than the control sample, better anxiety management skills, and lower levels of depressive disorder and mental confusion. Specifically, the healthcare professionals showed a condition of emotional exhaustion (T = 0.64, D = 0.74, A = 0.62, S = 0.75, C = 0.64) and depersonalization (T = 0.41, D = 0.52, A = 0.49, S = 0.60, C = 0.40), which is common in the burnout syndrome. In conclusion, the results obtained are useful in understanding the determinants of the emotional involvement of healthcare professions and the risk of burnout syndrome and, therefore, for planning activities and support paths for these workers who are particularly at risk during prolonged and pervasive crises, such as the pandemic.

Radioecological studies of the main naturally occurring radionuclides in the area of Gela Phosphate Industry (Italy) through radioanalytical separation and measurement techniques.

Radioecological studies have been carried out in area of Gela Phosphate Industry. As a part of the project, some achievements have been described in the paper, including: (1) determination of the activity concentrations of 210Po, 210Pb, uranium, and radium isotopes in phosphogypsum, phosphoric acid, soil, and marine sediment, (2) inventory estimation of the NORM in the residual product and by-product, and (3) the radioecological investigation and evaluation on the NORM contamination in the sea area of Gela. The obtained data showed that the 210Po, 210Pb, uranium, and radium isotope contamination due to discharge of phosphogypsum from 1960s to 1990s is not observable through sediment analyses.

Relations Between Mood States and Eating Behavior During COVID-19 Pandemic in a Sample of Italian College Students.

The fear of contagion during the COVID-19 pandemic has been indicated as a relevant cause of psychological pathologies occurring in this period. Food represents a compensating experience, distracting from the experiences of uncertainty, fear and despair, causing alterations in eating habits and behaviors. The study aims at evaluating the relations between fear of a pandemic, mood states and eating disorders in Italian college students, taking into account gender differences. During the lockdown for the pandemic, a sample of 469 college students equally distributed by gender, was recruited online using a questionnaire including the FCV-19S for the assessment of fear of COVID-19, the profile of mood states (POMS) for the evaluation of different emotional states, the eating disorder inventory-2 (EDI-2) and the binge eating scale (BES) to evaluate the presence of the levels of eating disorders. As expected, all emotive states measured by POMS (tension, depression, anger, tiredness, confusion) resulted significantly correlated with the fear of COVID-19. Women were more exposed to fear of COVID-19 showing greater tension, fatigue, depression and confusion, and a significantly higher total mood disturbance score than males. Regarding the EDI-2 and BES variables, tension and anxiety resulted significantly correlated also with bulimic behavior, while depression with interoceptive awareness, impulsivity, and binge eating behaviors, without gender differences. In conclusion, the negative impact of the fear of COVID-19 on the emotional profile and eating behavior suggests the need to implement strategies against psychological distress during the pandemic emergency, and to design psycho-educational interventions aimed at modifying the lifestyle for preventing risks of mental disorders fostering health-oriented behaviors.

Are Future Psychologists Willing to Accept and Use a Humanoid Robot in Their Practice? Italian and English Students' Perspective.

Despite general scepticism from care professionals, social robotics research is providing evidence of successful application in education and rehabilitation in clinical psychology practice. In this article, we investigate the cultural influences of English and Italian psychology students in the perception of usefulness and intention to use a robot as an instrument for future clinical practice and, secondly, the modality of presentation of the robot by comparing oral vs. video presentation. To this end, we surveyed 158 Italian and British-English psychology students after an interactive demonstration using a humanoid robot to evaluate the social robot's acceptance and use. The Italians were positive, while the English were negative toward the perceived usefulness and intention to use the robot in psychological practice in the near future. However, most English and Italian respondents felt they did not have the necessary abilities to make good use of the robot. We concluded that it is necessary to provide psychology students with further knowledge and practical skills regarding social robotics, which could facilitate the adoption and use of this technology in clinical settings.

Determination of endogenous IAA and carbohydrates during the induction and development of protocorm-like bodies of Cattleya tigrina A. Richard / Determinação de AIA e carboidratos endógenos durante a indução e desenvolvimento deestruturas semelhantes a protocormos de Cattleya tigrina A. Richard

Tissue culture techniques have been employed for orchid mass propagation by means of themorphogenetic route of protocorm like-bodies (PLBs). This study aimed to analyze and compare Indoleaceticacid (IAA) and sugar endogenous levels in protocorm-like bodies (PLBs) induction and developmentin Cattleya tigrina, in order to better understand this process and to optimize micropropagation procedureprotocols. Leaves grown on MS (Murashige and Skoog) culture medium, suplemented with 9 μM TDZfor PLBs induction and development were collected after 0, 2, 7, 14, 30, 60 and 100 days of cultivation, forfurther analysis. Increase of IAA and reduction of sugar levels are strongly related to morphogeneticresponse, that is, PLBs formation over the preexisting ones and leaf primordia formation. Sucrose, fructoseand glucose presence in this study is related to cell signaling. Thus, hormonal signals and carbohydratesalter metabolism, triggering PLBs initiation and development in C. tigrina.

Técnicas de cultura de tecidos têm sido empregadas para a propagação em massa de orquídeaspor meio da via morfogenética de estruturas semelhantes a protocormos (ESPs). O estudo teve comoobjetivo analisar e comparar os níveis endógenos de ácido indol-3-acético (AIA) e de açúcares na indução eno desenvolvimento de estruturas semelhantes a protocormos (ESPs) em Cattleya tigrina, visando à melhorcompreensão deste processo e à otimização de protocolos de micropropagação. Folhas cultivadas em meiode cultura MS (Murashige & Skoog), suplementadas com 9 μM de TDZ para indução e desenvolvimentode ESPs foram coletadas após 0, 2, 7, 14, 30, 60 e 100 dias de cultivo, para posterior análise. O aumento dosníveis de AIA e a redução dos níveis de açúcar estão fortemente relacionados à resposta morfogenética, ouseja, à formação de ESPs sobre os pré-existentes e à formação de primórdios foliares. A presença desacarose, frutose e glicose neste estudo está relacionada à sinalização celular. Assim, sinais hormonais ecarboidratos alteram o metabolismo, desencadeando a iniciação e o desenvolvimento de ESPs em C. tigrina.

Comparison of the CBA-H and SF-36 for the screening of the psychological and behavioural variables in chronic dialysis patients.

The aim of the study was to perform an analysis of the emotional reactions, perception of stressful life and behavioural changes related to Haemodialysis (HD) in order to identify those variables that can improve lifestyle and the adherence to treatment. Some psychometric assessment, such as the Cognitive Behavioural Assessment, Hospital Form, (CBA-H) and the Health Survey (SF-36), which provides two indexes: the Physical Component Score (PCS) and the Mental Component Score (MCS), are suitable to assess a patient's psychological and behavioural style and their health-related quality of life. The study involved 37 Italian out-patients with end-stage renal disease under HD therapy. We calculated the Spearman correlation between variables of CBA-H, SF-36, age and time on HD. We also performed a multivariate linear regression using the CBA-H variables as predictors and PCS and MCS as dependent variables. From the CBA-H, 95% of participants self-reported psychological characteristics comparable to Type A personality, which identifies an anxious, hyperactive and hostile subject. Physical limitations were found to be directly proportional to the time on dialysis (rs = -0.42). The condition of perceived stress worsens the state of mental health (rs = -0.68) and general health perception (rs = -0.44). The condition of vital exhaustion correlates both the PCS and the MCS (p<0.01) with possible outcomes of physical and mental illness. The psychological wellbeing of a dialyzed patient could be due to the combination of several factors, including life parameters, the positive perception of psychosocial outcomes, and the perceived quality of life. A multidisciplinary team (neurologists, psychiatrists, psychologists, and nurses) is essential to plan effective psychological and psychotherapeutic interventions to improve a mind-body integration.

Deriving environmental quality standards for perfluorooctanoic acid (PFOA) and related short chain perfluorinated alkyl acids.

The evidence that in Northern Italy significant sources of perfluoroalkylacids (PFAA) are present induced the Italian government to establish a Working Group on Environmental Quality Standard (EQS) for PFAA in order to include some of them in the list of national specific pollutants for surface water monitoring according to the Water Framework Directive (2000/60/EC). The list of substances included perfluorooctanoate (PFOA) and related short chain PFAA such as perfluorobutanoate (PFBA), perfluoropentanoate (PFPeA), perfluorohexanoate (PFHxA) and perfluorobutanesulfonate (PFBS), which is a substitute of perfluorooctanesulfonate. For each of them a dossier collects available data on regulation, physico-chemical properties, emission and sources, occurrence, acute and chronic toxicity on aquatic species and mammals, including humans. Quality standards (QS) were derived for the different protection objectives (pelagic and benthic communities, predators by secondary poisoning, human health via consumption of fishery products and water) according to the European guideline. The lowest QS is finally chosen as the relevant EQS. For PFOA a QS for biota was derived for protection from secondary poisoning and the corresponding QS for water was back-calculated, obtaining a freshwater EQS of 0.1µgL-1. For PFBA, PFPeA, PFHxA and PFBS threshold limits proposed for drinking waters were adopted as EQS.

Lateral specialization in unilateral spatial neglect: a cognitive robotics model.

In this paper, we present the experimental results of an embodied cognitive robotic approach for modelling the human cognitive deficit known as unilateral spatial neglect (USN). To this end, we introduce an artificial neural network architecture designed and trained to control the spatial attentional focus of the iCub robotic platform. Like the human brain, the architecture is divided into two hemispheres and it incorporates bio-inspired plasticity mechanisms, which allow the development of the phenomenon of the specialization of the right hemisphere for spatial attention. In this study, we validate the model by replicating a previous experiment with human patients affected by the USN and numerical results show that the robot mimics the behaviours previously exhibited by humans. We also simulated recovery after the damage to compare the performance of each of the two hemispheres as additional validation of the model. Finally, we highlight some possible advantages of modelling cognitive dysfunctions of the human brain by means of robotic platforms, which can supplement traditional approaches for studying spatial impairments in humans.

Mixtures of chemical pollutants at European legislation safety concentrations: how safe are they?

The risk posed by complex chemical mixtures in the environment to wildlife and humans is increasingly debated, but has been rarely tested under environmentally relevant scenarios. To address this issue, two mixtures of 14 or 19 substances of concern (pesticides, pharmaceuticals, heavy metals, polyaromatic hydrocarbons, a surfactant, and a plasticizer), each present at its safety limit concentration imposed by the European legislation, were prepared and tested for their toxic effects. The effects of the mixtures were assessed in 35 bioassays, based on 11 organisms representing different trophic levels. A consortium of 16 laboratories was involved in performing the bioassays. The mixtures elicited quantifiable toxic effects on some of the test systems employed, including i) changes in marine microbial composition, ii) microalgae toxicity, iii) immobilization in the crustacean Daphnia magna, iv) fish embryo toxicity, v) impaired frog embryo development, and vi) increased expression on oxidative stress-linked reporter genes. Estrogenic activity close to regulatory safety limit concentrations was uncovered by receptor-binding assays. The results highlight the need of precautionary actions on the assessment of chemical mixtures even in cases where individual toxicants are present at seemingly harmless concentrations.

Multiple electrode whole-blood aggregometry and bleeding in cardiac surgery patients receiving thienopyridines.

BACKGROUND: Preoperative treatment with thienopyridines is associated with increased postoperative bleeding in cardiac surgery patients. Patients under treatment with thienopyridines have different levels of platelet dysfunction and the effects of discontinuation are not totally predictable. The present study aimed to determine if a preoperative assessment of platelet function in these patients could provide clinically relevant information regarding the risks of excessive postoperative bleeding and transfusion requirements. METHODS: This is a retrospective analysis of prospectively collected data. Patients (n=87) under thienopyridine treatment until at least one week before cardiac surgery were enrolled in the study. Platelet function was assessed preoperatively with multiple electrode aggregometry: the adenosine diphosphate (ADP) test and TRAP (thrombin receptor-associated peptide) test were performed for all patients. RESULTS: Univariate analysis revealed that postoperative bleeding was associated (p<0.1) with preoperative serum creatinine level, platelet count, CPB (cardiopulmonary bypass) duration, and results from the ADP test and the TRAP test. Multivariable linear regression analysis confirmed the CPB duration (p=0.049) and ADP test (p=0.007) as independently associated with postoperative bleeding. The relationship between the ADP test and postoperative bleeding was investigated with polynomial regression analysis, and a logarithmic equation provided the best fit. The accuracy of prediction was good (area under the curve 0.71, p=0.013), with a cutoff value for the ADP test at 31 U (sensitivity 72%, specificity 66%, negative predictive value 92%, and positive predictive value 29%). CONCLUSIONS: The multiple electrode aggregometry ADP test in patients under thienopyridine treatment and undergoing cardiac surgery is associated with postoperative bleeding and platelet transfusion and provides an accurate preoperative prediction of postoperative bleeding risk.

Hematocrit on cardiopulmonary bypass and outcome after coronary surgery in nontransfused patients.

BACKGROUND: Preoperative anemia and the lowest registered hematocrit value on cardiopulmonary bypass are recognized risk factors for morbidity and mortality after coronary operations. A low hematocrit often results in blood transfusions with all of the associated possible complications. The relative contribution of these three factors to long-term outcome is still not well established. This study aimed to identify the role of preoperative anemia and hemodilution during cardiopulmonary bypass as determinants of morbidity and mortality after coronary operations. METHODS: A consecutive series of 3,003 patients was analyzed. They had all undergone isolated coronary operations without receiving blood transfusions during their hospital stay. The preoperative hematocrit and the lowest hematocrit on cardiopulmonary bypass were analyzed in a multivariable model as predictors of major morbidity and operative mortality. RESULTS: After adjustment for the other explanatory variables, both the preoperative hematocrit and the lowest hematocrit on cardiopulmonary bypass were found to be independent risk factors for major morbidity, but not for operative mortality. However, low values of preoperative hematocrit were not associated with an increased morbidity, provided that the lowest hematocrit on cardiopulmonary bypass was maintained above 28%. Median values of the lowest hematocrit on cardiopulmonary bypass below 25% were associated with an increased major morbidity rate. CONCLUSIONS: Excessive hemodilution during cardiopulmonary bypass is a risk factor for major morbidity even in the absence of blood transfusions. Techniques that aim to reduce the fall in hematocrit during cardiopulmonary bypass, including blood cardioplegia, may be useful, especially in patients with a low preoperative hematocrit.

Near-infrared spectroscopy correlates with continuous superior vena cava oxygen saturation in pediatric cardiac surgery patients.

BACKGROUND: Cerebral regional oxygen saturation (rSO(2)) measured with near-infrared spectroscopy (NIRS) has a well-proven clinical utility. A goal-oriented treatment based on the rSO(2) resulted in a significant reduction in major morbidity and in a shortening of postoperative hospital stay in patients undergoing coronary revascularization. In this study, we have compared the values of superior vena cava saturation (ScvO(2)) continuously measured with a Pediasat catheter and the corresponding NIRS rSO(2) values obtained during cardiac operations in pediatric patients. METHODS: This was a prospective observational study enrolling fifteen pediatric patients (age: 6 days-7 years) undergoing cardiac operations. ScvO(2) data obtained with the Pediasat during the operation were compared with simultaneously recorded NIRS rSO(2) values. RESULTS: One hundred and seventeen matched sets of data were obtained during the operation. ScvO(2) continuously measured with the Pediasat was significantly correlated with the corresponding NIRS rSO(2) values. However, there was a constant positive bias (ScvO(2) values were higher than NIRS rSO(2) values) of 5.6%, with a precision of 10.4%. Time-related percentage changes of NIRS rSO(2) were significantly correlated with the corresponding ScvO(2) percentage changes. A decrease in ScvO(2) is predictive for a decrease in rSO(2) with a sensitivity of 73.7% and a specificity of 85.7%. CONCLUSIONS: The continuous measurement of ScvO(2) values obtained by the Pediasat may provide useful information about the metabolic conditions of the brain during cardiac operations in pediatric patients if considered as percentage changes. Absolute values of ScvO(2) tend to overestimate the correspondent rSO(2) values.

Influence of the timing of cardiac catheterization and the amount of contrast media on acute renal failure after cardiac surgery.

Postoperative acute renal failure (ARF) is not uncommon after cardiac surgery and after angiography. However, limited information exists regarding the influence of the interval between cardiac catheterization and subsequent cardiac surgery and amount of contrast agent used during this procedure on the occurrence of postoperative ARF. Data for 423 consecutive adult patients who underwent elective cardiac surgery after cardiac catheterization were examined retrospectively. The influence of interval between cardiac catheterization and cardiac surgery on postoperative ARF (defined as postoperative serum creatinine > or =2 times baseline and >2 mg/dl and/or need for renal replacement therapy) was evaluated using multivariable logistic regression. ARF occurred in 24 patients (5.7%). Median time to angiography was 2 days (interquartile range 1 to 4.5), and median dose of contrast used was 1.36 ml/kg (interquartile range 1.12 to 1.69). Surgery on the day of cardiac catheterization was independently associated with increased risk of ARF (adjusted odds ratio 3.1, 95% confidence interval 1.1 to 8.8). This risk of ARF was highest in patients who underwent surgery on the same day as angiography and with a dose of contrast higher than median (14.6%) and lowest when surgery was delayed beyond 1 day of angiography and contrast dose was median or less (2.4%; adjusted odds ratio for same-day surgery and dose higher than median 4.2, 95% confidence interval 1.2 to 14.2). Cardiac surgery performed on the day of cardiac catheterization and higher dose of contrast agent used were both independently associated with increased risk of postoperative ARF. In conclusion, these findings suggest that delaying cardiac surgery beyond 24 hours of exposure to contrast agents (when feasible) and minimizing the use of these agents have significant potential to decrease the incidence of postoperative ARF in patients undergoing elective cardiac surgery.

Efficacy and safety of recombinant activated factor vii in major surgical procedures: systematic review and meta-analysis of randomized clinical trials.

OBJECTIVE: To investigate the efficacy and safety of recombinant activated factor VII (rFVIIa) treatment in patients undergoing major surgical procedures. DATA SOURCES: Relevant studies were searched in BioMedCentral, CENTRAL, PubMed, and PubMed Central. STUDY SELECTION: Only randomized controlled trials on humans undergoing major surgery were included. Efficacy was determined as the rate of patients receiving allogeneic packed red blood cells; safety was assessed in terms of thromboembolic complications and mortality rate. DATA EXTRACTION: We followed the Cochrane Collaboration method for data extraction and internal validity procedures, as well as the Quality of Reporting of Meta-analyses statement. DATA SYNTHESIS: Seven randomized controlled trials met the inclusion criteria. Treatment with rFVIIa is associated with a reduced risk of receiving allogeneic packed red blood cells (odds ratio, 0.29; 95% confidence interval, 0.10-0.80). In a subgroup analysis, only patients receiving at least 50 mug/kg of rFVIIa had a significant benefit (odds ratio, 0.43; 95% confidence interval, 0.23-0.78). No differences in thromboembolic complications and mortality rates were observed. CONCLUSIONS: Treatment with rFVIIa is effective in reducing the rate of patients undergoing transfusion with allogeneic packed red blood cells. However, the cost-benefit ratio is favorable only in patients who need a huge number of packed red blood cell units. No safety concerns arise from the present study.

Determinants of early discharge from the intensive care unit after cardiac operations.

BACKGROUND: The length of stay in the intensive care unit is one of the factors limiting operating room utilization in cardiac surgery. We investigated the impact of a goal-oriented program aimed at discharging the patients from the intensive care unit the morning after the operation within a comprehensive model including other explanatory variables. METHODS: A multivariable predictive model for early discharge from the intensive care unit was established using a stepwise forward logistic regression. The analysis was retrospectively conducted on 9120 consecutive patients undergoing cardiac surgical procedures at our institution. RESULTS: A total of 1874 patients were discharged early from the intensive care unit. Factors associated with early discharge were ejection fraction, lowest hematocrit on cardiopulmonary bypass, lowest temperature on cardiopulmonary bypass, and the presence of the goal-oriented strategy (odds ratio, 5.5; 95% confidence interval, 4.8 to 6.3). Factors associated with late discharge were age, preoperative serum creatinine value, unstable angina, congestive heart failure, redo operation, combined operation, and cardiopulmonary bypass duration. An extubation time of 4 hours after the arrival in the intensive care unit was associated with the peak rate of early discharge. Patients being early discharged according to the goal-oriented strategy did not demonstrate a different complication rate compared with patients treated with a standard strategy. CONCLUSIONS: Early discharge from the intensive care unit depends on a combination of preoperative and intraoperative factors, but most of all on the presence of a goal-oriented strategy. A very early extubation is not required for an early discharge from the intensive care unit.

Hyperlactatemia during cardiopulmonary bypass: determinants and impact on postoperative outcome.

INTRODUCTION: Hyperlactatemia during cardiopulmonary bypass is relatively frequent and is associated with an increased postoperative morbidity. The aim of this study was to determine which perfusion-related factors may be responsible for hyperlactatemia, with specific respect to hemodilution and oxygen delivery, and to verify the clinical impact of hyperlactatemia during cardiopulmonary bypass in terms of postoperative morbidity and mortality rate. METHODS: Five hundred consecutive patients undergoing cardiac surgery with cardiopulmonary bypass were admitted to this prospective observational study. During cardiopulmonary bypass, serial arterial blood gas analyses with blood lactate and glucose determinations were obtained. Hyperlactatemia was defined as a peak arterial blood lactate concentration exceeding 3 mmol/l. Pre- and intraoperative factors were tested for independent association with the peak arterial lactate concentration and hyperlactatemia. The postoperative outcome of patients with or without hyperlactatemia was compared. RESULTS: Factors independently associated with hyperlactatemia were the preoperative serum creatinine value, the presence of active endocarditis, the cardiopulmonary bypass duration, the lowest oxygen delivery during cardiopulmonary bypass, and the peak blood glucose level. Once corrected for other explanatory variables, hyperlactatemia during cardiopulmonary bypass remained significantly associated with an increased morbidity, related mainly to a postoperative low cardiac output syndrome, but not to mortality. CONCLUSION: Hyperlactatemia during cardiopulmonary bypass appears to be related mainly to a condition of insufficient oxygen delivery (type A hyperlactatemia). During cardiopulmonary bypass, a careful coupling of pump flow and arterial oxygen content therefore seems mandatory to guarantee a sufficient oxygen supply to the peripheral tissues.

Avaliação da capacidade cardiopulmonar no pré e pós-operatório de cirurgia bariátrica: relato de um caso / Evaluation of the cardiopulmonary capacity in pre and post-operatory of bariatric surgery: a case report

A obesidade atualmente é considerada um problema de saúde pública devido à alta incidência e complicações sistêmicas. No sistema respiratório, a obesidade causa uma alteração de caráter restritivo devido à diminuição da complacência da parede torácica. A grande quantidade de tecido adiposo sobre a caixa torácica a torna mais comprimida e assim menos complacente, alterando a mecânica respiratória.São considerados obesos indivíduos com IMC entre 30 e 40 Kg/m2, e aqueles, cujo IMC é maior que 40 Kg/m2, são considerados obesos mórbidos. O objetivo desta pesquisa foi avaliar a capacidade cardiopulmonar de um indivíduo submetido à cirurgia bariátrica, por meio dos seguintes parâmetros: força muscular respiratória pelo emprego da pressão inspiratória máxima e pressão expiratória máxima, utilizando-se um manovacuômetro; permeabilidade das vias aéreas pelo pico de fluxo expiratório gerado no “peak-flow” e teste de distância percorrida durante 6 minutos. A coleta de dados foi realizada em um consultório de fisioterapia na cidade de Cascavel, Paraná, nas fases pré e pós-operatória. A freqüência de tratamento foi de três sessões por semana com duração de aproximadamente 45 minutos. Posteriormente os dados foram comparados, mostrando uma melhora da Pemáx, Pimáx, “peak-flow” e também uma melhora da freqüência respiratória e manutenção da freqüência cardíaca durante o teste de distância percorrida durante 6 minutos. Tendo em vista os resultados alcançados, conclui-se que a fisioterapia e a perda de peso após a cirurgia melhoraram a capacidade cardiopulmonar e a capacidade de exercícios, possibilitando uma melhor qualidade de vida para a paciente...