Melatonin supplementation enhances pulmonary rehabilitation outcomes in COPD: a randomized, double-blind, placebo-controlled study.

Melatonin (MLT), the main product of the pineal gland, is involved in muscle tissue repair and regeneration, besides several other important physiologic functions. In COPD, MLT administration can improve lung oxidative stress and sleep quality, but its potential effects on the outcomes of pulmonary rehabilitation (PR) have not been previously investigated. A randomized controlled trial was undertaken to test the hypothesis that a combined approach of rehabilitative exercise training and MLT supplementation could maximize functional performance, health status and quality of life in patients with COPD. Thirty-nine individuals with COPD referred to a supervised PR program at the Federal University of Ceara, Brazil, were randomized to receive MLT (3 mg/day; n = 18) or placebo (n = 21). Exercise capacity (6-min walk test - 6MWT), health status (COPD assessment test), and quality of life (airways questionnaire 20) were investigated as primary outcomes. No differences were observed at baseline in demographic, anthropometric and clinical characteristics between MLT and placebo groups. At the end of PR, superiority of the MLT group was demonstrated in improvement in the distance covered in the 6MWT (71 ± 26 vs. 25 ± 36 m; p < 0.01), health status (-11 ± 6 vs. -3 ± 5; p < 0.01), and quality of life (-6.9 ± 3.0 vs. -1.9 ± 2.4; p < 0.01), compared to the placebo group. In conclusion, MLT supplementation during the course of 12 weeks of PR can improve functional capacity, health status and quality of life in patients with COPD. These findings may have significant implications for the management of this condition.

A New Full-Face Mask for Multifunctional Non-Invasive Ventilation.

Background: Noninvasive ventilation (NIV) provides positive pressure through different interfaces. A multifunctional full-face mask prototype was developed to provide NIV from three sources: ICU ventilators, portable ventilators, and high-flow medical gas pipeline systems. This study aimed to evaluate the usability of this prototype mask. Methods: This was a quantitative experimental study, conducted in two phases: the development of a full-face mask prototype NIV interface, and the evaluation of its usability by health professionals (evaluators) using a heuristic approach. The Wolf Mask prototype is a multifunctional full-face mask that makes it possible to deliver positive pressure from three different sources: microprocessor-controlled ICU ventilators, portable ventilators with single-limb circuits, and high-flow medical gas. The evaluation was conducted in three stages: presentation of the prototype to the evaluators; skills testing via simulation in a clinical environment; and a review of skills. Results: The prototype was developed by a multidisciplinary team and patented in Brazil. The evaluators were 10 health professionals specializing in NIV. Seven skills related to handling the prototype were evaluated. Three of the ten evaluators called for (non-urgent) changes to improve recognition of the components of the prototype. Only one evaluator called for (non-urgent) changes to improve recognition of the pieces, assembly, and checking the mask. Conclusions: The newly developed multifunctional full-face mask prototype demonstrated excellent usability for providing noninvasive ventilation from multiple sources. Minor modifications may further improve the design.

Nível de estresse entre acadêmicos da área da saúde e seus fatores desencadeantes

No contexto universitário, o aluno assume atividades de elevado desempenho, exigindo dele concentração e esforço contínuo. A rotina de estudos é crescente e a cada semestre, torna-se mais constante e complexa, podendo constituir-se como um fator potencialmente estressor. OBJETIVO: Avaliar o nível de estresse de acadêmicos dos cursos da área da saúde, comparando esse nível entre os alunos dos cursos de Fisioterapia, Enfermagem, Nutrição, Educação Física e Psicologia e, relacionando-os com os fatores desencadeantes do estresse. MÉTODO: Estudo de caráter descritivo, transversal e quantitativo, realizado em um Centro Universitário situado no município de Fortaleza-CE, por meio da aplicação de um questionário sociodemográfico e do Questionário de Saúde Geral (QSG), instrumento com validação de acordo com Coeficiente alfa de Cronbach (?=0,840) para os 13 itens relacionados ao estresse psíquico. RESULTADOS: Participaram do estudo 73 alunos dos cursos de Fisioterapia, Educação Física, Enfermagem, Psicologia e Nutrição, sendo analisadas as variáveis relacionadas aos dados sociodemográficos e ao QSG. De acordo com os resultados obtidos, o nível de estresse dos universitários participantes não representava risco para os mesmos, no momento da coleta de dados. CONCLUSÃO: A grande maioria das respostas obtidas no QSG apontaram para um nível de estresse dentro da média habitual. Além disso, nos resultados não foram deflagradas associações significantes entre os indicadores produzidos pelo QSG e o questionário sociodemográfico, não sendo possível, portanto, realizar associações entre os dados sociodemográficos, enquanto potenciais fatores desencadeantes de estresse no contexto analisado.