Effects of complementary spiritual therapy on stress, anxiety, burnout syndrome and hematological parameters of professionals in a public hospital: a randomized controlled trial.

OBJECTIVES: This randomized controlled trial evaluated the stress, anxiety, and burnout of professionals exposed to complementary spiritist therapy (CST), which consists in therapeutic resources as prayer, Spiritist passe, fluidic water and spiritual education or control. METHODS: Seventy-six professionals were randomized to CST or control: to maintain the routine for 5 weeks. The ISSL scale, anxiety and depression Beck's indices, Maslach instrument, subjective well-being and WHOQOL-BREF were used at baseline and five-week. Blood count and cytokine dosage were collected at baseline, one-week and five-week. Analysis using the intention to treat approach. RESULTS: The means of variation of stress (exhaustion phase) between baseline and five-week were -1.50 ± 3.31 in the CST and 0.72 ± 3.50 in the control (p=0.036), effect size for CST group was d=0.65, which is considered medium effect. CST showed decrease in emotional exhaustion and negative affects, and increase in lymphocytes, erythrocyte parameters and platelets between the baseline and five-week (p<0.05). Reduction in IL-1ß and increase in total lymphocyte count were observed with 2-3 sessions per week, but that does not maintain when the number of sessions is decreased. Participants receiving ≥7 sessions reduced emotional exhaustion, depersonalization and stress, and improved hematological parameters throughout the study (p<0.05). CONCLUSIONS: CST may be effective in reducing stress (exhaustion phase) compared to control. Higher frequency of interventions promotes better psychic state, evidenced by large effect size for emotional exhaustion in burnout, and improves hematological parameters of professionals.

Effects of the laying on of hands on anxiety, stress and autonomic response of employees in a hospital: A double-blind randomized controlled trial.

Mental and behavioral disorders result in increased absenteeism and abandonment of work. The objective of this study was to evaluate the anxiety, stress, depression, negative and positive affects, and hematological and autonomic responses of employees in a public hospital exposed to laying on of hands with (LHS) or without Spiritual connection (control-LHW). METHODOLOGY: Eighty-four employees with anxiety/stress were enrolled and randomly allocated into two groups of intervention LHS by Spiritist "passe" and control-LHW by volunteers with healing intent. Anxiety, stress and depression were evaluated by Depression Anxiety and Stress Scale (DASS21). Negative and positive affects by Subjective Well-being Scale (SWS), cardiac autonomic modulation by heart rate variability and cytokines and blood count were assessed by blood sample. RESULTS: Our study showed a significant improvement in the neutrophils (p = 0.041; d = 0.70) and cardiac parasympathetic activity, and reduction in VLF (p < 0.005) in the LHS. There was reduction in erythrocyte parameters and interleukin 10 (p < 0.005) in the control-LHW. In both groups there was a significant reduction in anxiety, stress, depression and negative affects after one session (p < 0.005). CONCLUSION: Laying on of hands with Spiritual connection by Spiritist "passe" appears to be effective in increasing cardiac vagal activity and regulation of immune responses of employees in a public hospital with stress/anxiety.

Effect of Spiritist "Passe" on Preoperative Anxiety of Surgical Patients: A Randomized Controlled Trial, Double-Blind.

The objective of this study was to evaluate the preoperative anxiety of hospitalized patients exposed to Spiritist "passe," laying on of hand with the intention of healing (Sham) and without laying on of hand. Other variables as depression, pain, physiological parameters, muscle tension, and well-being were assessed. Patients in the Spiritist "passe" intervention group showed greater reductions in anxiety (p < 0.05) and muscle tension (p < 0.01) and increases in well-being (p < 0.01). More marked reductions in preoperative anxiety and muscle tension and improvement in well-being were observed in patients exposed to Spiritist "passe" compared to Sham or standard medical care.Trial registration: ClinicalTrials.gov Identifier NCT03356691.

Síndrome de Burnout em profissionais de enfermagem de pronto-socorro / Burnout Syndrome in emergency room nursing professionals

Objetivo: verificar o escore para a classificação da Síndrome de Burnout. Método: trata-se de um estudo quantitativo, descritivo, transversal, com 36 enfermeiros e técnicos de enfermagem do pronto-socorro de um hospital público de ensino. Coletaram-se os dados por meio do instrumento Maslach Burnout Inventory, que foram tabulados, e se realizou a análise estatística simples pelo software IBM SPSS Statistic®. Resultados: informa-se que 72,2% eram técnicos de enfermagem; 69,4%, do sexo feminino, com idade média 37 DP ± 8,76. Nota-se que, na classificação para os domínios de Síndrome de Burnout, 55,6% apresentaram moderada a alta exaustão emocional; 66,7%, moderada a alta despersonalização e 63,9%, baixa realização emocional. Ressalta-se que 13,9% apresentaram Síndrome de Burnout. Relata-se que, do total de enfermeiros, 90% apresentaram escores de exaustão emocional moderada a alta, enquanto os técnicos de enfermagem foram 42,3%. Conclusão: conclui-se que não houve associação significativa entre as variáveis sociodemográficas com a Síndrome de Burnout. Sugere-se um plano de prevenção à saúde do trabalhador individualizado.(AU)

Objective: to check the score for the classification of Burnout Syndrome. Method: this is a quantitative, descriptive, cross-sectional study with 36 nurses and nursing technicians in the emergency department of a public teaching hospital. Data was performed using the Maslach Burnout Inventory instrument, which was tabulated, and simple statistical analysis was performed using the IBM SPSS Statistic® software. Results: it is reported that 72.2% were nursing technicians; 69.4%, female, with a mean age of 37 SD ± 8.76. It is noted that, in the classification for the Burnout Syndrome domains, 55.6% had moderate to high emotional exhaustion; 66.7%, moderate to high depersonalization and 63.9%, low emotional fulfillment. It is noteworthy that 13.9% had Burnout Syndrome. It is reported that, of the total number of nurses, 90% had moderate to high emotional exhaustion scores, while nursing technicians were 42.3%. Conclusion: it is concluded that there was no significant association between sociodemographic variables and Burnout Syndrome. An individualized worker health prevention plan is suggested.(AU)

Objetivo: verificar la puntuación para la clasificación del Síndrome de Burnout. Método: este es un estudio cuantitativo, descriptivo, transversal con 36 enfermeros y técnicos de enfermería en el departamento de primeros auxilios de un hospital público de enseñanza. Los datos se recopilaron utilizando el instrumento Maslach Burnout Inventory, que se tabularon, y se realizó un análisis estadístico simple utilizando el software IBM SPSS Statistic®. Resultados: se informa que el 72.2% eran técnicos de enfermería; 69,4%, mujeres, con una edad media de 37 DE ± 8,76. Se observa que, en la clasificación para los dominios del Síndrome de Burnout, el 55.6% tenía un agotamiento emocional de moderado a alto; 66.7%, despersonalización moderada a alta y 63.9%, baja satisfacción emocional. Es de destacar que el 13,9% tenía Síndrome de Burnout. Se informa que, del número total de enfermeros, el 90% tenía puntajes de agotamiento emocional de moderados a altos, mientras que los técnicos de enfermería fueron del 42,3%. Conclusión: se concluye que no hubo asociación significativa entre las variables sociodemográficas y el Síndrome de Burnout. Se sugiere un plan individualizado de prevención de la salud de los trabajadores.(AU)

Religiosidade/espiritualidade, indicadores de saúde mental e parâmetros hematológicos de profissio-nais de enfermagem / Religiosity/spirituality, mental health indicators and hematologic parameters of nursing professionals / Religiosidad/espiritualidad, indicadores de salud mental y parámetros hematológicos de profesionales de enfermeiras

Objetivo:analisara relação entre Religiosidade e Espiritualidade,indicadores de saúde mental, parâmetros hematológicos e percepção dasaúde de profissionais deenfermagem.Método:estudo transversal com 53 funcionários. Utilizou-se Medida Multidimensional Breve de Religiosidade e Espiritualidade, Inventário Stress Lipp,Ansiedade e Depressão de Beck, Bem-Estar Subjetivo,hemograma e imunoglobulina A. Resultados:Dimensões Experiências Espirituais Diárias eAutoavaliação Global são os fatores commaior forçade relação com os índices de estresse, depressão e Bem-Estar em profissionais.Participação religiosa e comprometimento foramosfatores que influenciarammaiores valores de leucócitos,neutrófilose imunoglobulina A. Conclusão:os resultados identificaram relação entre Religiosidade e Espiritualidade, indicadores de saúde mental e parâmetros hematológicos. Profissionais de enfermagemmais religiosos e espiritualistas apresentam melhor saúde mental e maior imunidade, além de melhor percepção de saúde (AU).

Objective:to analyze the relationship between Religiosity and Spirituality, mental health indicators and haematological parameters of nurses. Method:cross-sectional study with 53 employees. It was used Brief Multidimensional Measure of Religiosity and Spirituality (BMMRS), Lipp Stress Inventory, Beck Anxiety and Depression and Subjective Wellbeing, hemogram and immunoglobulin A. Results:dimensions Daily Spiritual Experiences and Global Religiosity and Spirituality Self-evaluation are the factors that present greater strength of relation with the indices of stress, depression and Subjective Wellbeing in professionals. Religious participation and impairment were the factors that influenced higher leukocyte, neutrophil and immunoglobulin A values.Conclusion:the results identified a relation between Religiosity and Spirituality, mental health indicators and haematological parameters, demonstrating that more religious and spiritualist nurses have better mental health and immunity,as well as a better perception of health (AU).

Objetivo:analizar la relación entre Religiosidad y Espiritualidad, indicadores de salud mental y parámetros hematológicos de enfermeras. Método:estudio transversal con 53 empleados. Se utilizó Medida Multidimensional Breve de Religiosidad y Espiritualidad (BMMRS), Inventario Stress Lipp, Escalas de Ansiedad y Depresión Beck y Bienestar Subjetivo, cuestionario de clasificación de la salud,hemograma yinmunoglobulina A. Resultados:las dimensiones Experiencias Espirituales Diarias y Autoevaluación Global de Religiosidad y Espiritualidad son los factores que presentan mayor fuerza de relación con los índices de estrés, depresión y Bienestar Subjetivo en profesionales. La participación religiosa y compromiso fueron los principales factores que influyen en los valores de leucocitos, neutrófilos, y la inmunoglobulina A. Conclusión:los resultados identificaron relación entre R/E, indicadores de salud mental y parámetros hematológicos, demostrandoque enfermeras más religiosos y espiritualistas presentan mejor salud mental y mayor inmunidad, además de una mejor percepción de la salud (AU).

Pemphigus foliaceus patients (Fogo Selvagem) treated with kinesiotherapy presented lower levels of proinflammatory cytokines.

Fogo Selvagem (FS) is a rare autoimmune disease characterized by acantholysis and inflammation of the epidermis. It was evidenced in this disease the increase of proinflammatory cytokines levels which can be influenced by physical activities. Kinesiotherapy, as physiotherapeutic interventions, was associated improvement levels of the quality of live, mainly the pain. Understanding the impact of such methodology in immunology of the FS, may constitute an alternative and effective approach. We compare the levels of serum cytokines and chemokines between nine patients with FS submitted to kinesiotherapy for 12 weeks and ten patients not submitted to kinesiotherapy. The kinesiotherapy was composed by self-stretching followed by a resistance training for upper and lower limbs. The protocol was carried out in three sections of eight to ten repetitions with 70% of the maximum load measured by test maximum of ten repetitions. After strengthening period patients performed a passive stretching. The training sessions lasted 50 min and were performed 3 times a week at least 12 weeks. Cytokines and chemokines were assessed in plasma using enzyme-linked immunosorbent assay and/or cytometric bead array. Patients with FS were being kinesiotherapy presented minors levels of interferon-γ, interleukin (IL)-17, IL-22, and IL-15 when compared to those not submitted to kinesiotherapy. No differences were observed for the detection of the chemokines chemokine ligand (CCL)-2, CCL-3, CCL-5, CCL-11, C-X-C motif chemokine 8 (CXCL-8), and CXCL-10. These results suggest that kinesiotherapy had a positive impact on inflammatory markers that are associated with disease worsening in FS.

Religiousness/Spirituality, Resilience and Burnout in Employees of a Public Hospital in Brazil.

The present study aimed to determine the relation between religiousness/spirituality (R/S), resilience and burnout in employees of a public hospital. A total of 57 participants were evaluated, and the R/S Brief Multidimensional Measure, Pesce and collaborators' resilience scale and Maslach Burnout Inventory were used. Most employees (91.2%) were females. It was observed that the burnout and resilience variables showed statistically significant differences in relation to R/S dimensions. The results identified an association between R/S, resilience and burnout, demonstrating that employees who are more religious and spiritualized have greater resilience and consequently are less often affected by burnout.

Effect of Complementary Spiritist Therapy on emotional status, muscle tension, and wellbeing of inpatients with HIV/AIDS: A randomized controlled trial - single-blind.

Background Complementary Spiritist Therapy includes prayer, Spiritist "passe", fluid therapy (fluidic water or magnetized water), and spiritual education, among other therapeutic resources. The objective of this study was to evaluate the effects of Complementary Spiritist Therapy with conventional treatment on emotional status, muscle tension and wellbeing of hospitalized patients with HIV/AIDS. Methods Patients were randomly assigned into either the experimental (3 days [10 mins per day/session] of Complementary Spiritist Therapy alongside conventional treatment; n=20) or control (conventional treatment alone; n=21) group. The primary outcome were positive and negative affects evaluated by the Subjective Wellbeing Scale. The secondary outcome were muscle tension, and wellbeing were assessed by visual analogue scales. Results Significant reductions in negative effects (p=0.045), and muscle tension (p=0.022), along with significant increases in wellbeing (p=0.041) were recorded in the experimental group (Complementary Spiritist Therapy). Conclusions Reductions in negative effects and muscle tension, along with increased perceived wellbeing, were observed in hospitalized patients with HIV/AIDS exposed Complementary Spiritist Therapy combined conventional treatment compared to conventional treatment alone.

Effects of Spiritist "passe" (Spiritual healing) on stress hormone, pain, physiological parameters and length of stay in preterm newborns: a randomized, double-blind controlled trial.

Background Among the practices of complementary medicine used to treat several diseases is the Spiritist "passe (SP)." Experimental studies have demonstrated the effectiveness of this energy therapies in reducing anxiety in adults. However, studies evaluating the effects of the "passe" energy therapy on health outcomes in newborns (NBs) are lacking. The aim of this study was to evaluate the effects of SP on stress hormone levels, pain, physiological parameters and length of stay in NBs. Methods NBs were randomly allocated into two groups: intervention (3 days SP sessions, n=13) and control (3 days sham sessions, n=12). Results In the SP group, respiratory frequency (RF) was found significantly lower (p<0.05), and reduction of heart rate and length of stay were observed, without statistical differences. While in the control, there was higher tendency of cortisol levels (p=0.05). Conclusions In this pilot study, RF reduced and prevented the elevation of the salivary cortisol concentration in preterm NBs receiving the SP compared with the control group.

Efeitos do passe espírita sobre a resposta hematológica e complicações de recém-nascidos hospitalizados: ensaio clínico randomizado / Effect of the spiritist ''passe'' (spiritual healing) on the hematological response and complications of hospitalized newborns: a randomized clinical Trial / Efectos del pase espírita sobre la respuesta hematológica y complicaciones de los recién nacidos internados: ensayo clínico randomizado

Objetivo: Avaliar a resposta hematológica e complicações no período de hospitalização de recém-nascidos submetidos ao passe espírita e à imposição de mãos com intenção de cura. Método: Ensaio clínico randomizado, duplo cego. 24 recém-nascidos foram aleatoriamente designados para o grupo experimental, que recebeu passe espírita durante 10 minutos, três dias consecutivos, e grupo controle que recebeu imposição de mãos com intenção de cura, de duração igual. Os resultados foram avaliados por meio de hemograma antes e após as intervenções e complicações durante a internação hospitalar. Resultados: Nos recém-nascidos do grupo passe espírita houve diferenças significativamente menores na dosagem de eritrócitos totais, hemoglobina e níveis de neutrófilos, maiores nos valores totais e percentagem de linfócitos e nos escores de plaquetas (p<0,05). Referente às complicações, no controle 30,7% utilizaram antibiótico e 15,4% drogas vasoativas comparado com apenas 18,2% uso de antibióticos no grupo exposto ao passe espírita. Conclusões: Maior imunidade, baseado no aumento da contagem de linfócitos, e menor incidência de complicações no período de hospitalização foram observadas em recém-nascidos expostos ao passe espírita comparados à imposição de mãos com intenção de cura (AU).

Objective: To evaluate the hematological response and complications during hospitalization of newborns who were submitted to a Spiritist ''passe'' and laying on of hands aiming the healing. Method: Randomized clinical trial, double blind. 24 newborns were randomly. The experimental group was submitted to a Spiritist ''passe'' for three consecutive days, 10 minutes a day. The control group was submitted to a curative laying on of hands with the same duration. The results were evaluated using a complete blood count collected before and after the interventions, and detecting the number of complications during hospitalization. Results: The newborns who were submitted to Spiritist ''passe'' showed a smaller decrease of their microhematocrit, hemoglobin and neutrophils level, an increase of their total values and percentagem of lymphocyte and platelets (p<0,05). Concerning complications during hospitalization, in the control group 30,7% used antibiotics and 15,4% vasoactive drugs compared to only 18,2% of antibiotic use in the group exposed to Spiritist "passe". Conclusions: Increased immunity, based on increased lymphocyte count, and lower incidence of complications during the hospitalization period were observed in newborns exposed to Spiritist "passe" compared to imposing hands with intent to cure (AU).

Objetivo: Evaluar la respuesta hematológica y las complicaciones durante la internación hospitalaria de los recién nacidos sometidos a pase espírita y la imposición de manos con intención de curar. Métodos: Ensayo clínico aleatorizado, doble ciego. 24 recién nacidos fueron asignados aleatoriamente al grupo experimental, que recibió pase espírita durante 10 minutos, três días consecutivos y el grupo control que recibió la imposición de manos con la intención de curar, con la misma duración. Los resultados se evaluaron mediante hemograma antes y después de las intervenciones y complicaciones durante la internación hospitalaria. Resultados: Se encontró en el grupo experimental diferencias significativamente menores en eritrocitos totales, la hemoglobina y neutrófilos y mayores en los valores totales y en las porcentaje de linfocitos entre grupos y plaquetas (p<0,05). En el grupo control 30,7% utilizaron antibiótico y 15,4% drogas vasoactivas comparado con apenas 18,2% uso de antibióticos en el grupo expuesto al pase espírita. Conclusiones: Mayor inmunidad, basada en el aumento del recuento de linfocitos, y menor incidencia de complicaciones en el período de hospitalización fueron observadas en recién nacidos expuestos al pase espírita comparados a la imposición de manos con intención de curación (AU).

Effectiveness of Spiritist "passe" (Spiritual healing) for anxiety levels, depression, pain, muscle tension, well-being, and physiological parameters in cardiovascular inpatients: A randomized controlled trial.

BACKGROUND: Biofield therapies, such as laying on of hands, are used in association with Conventional Medicine as Spiritist "passe", among others. The aim of this study was to evaluate anxiety, depression, pain, muscle tension and well-being, as well as physiological parameters in cardiovascular inpatients submitted to the Spiritist "passe", sham, and no intervention. METHODS: In the total, 41 cardiovascular inpatients submitted to the Spiritist "passe", sham, and no intervention during a 10-min period on 3 consecutive days. They were evaluated through anxiety and depression level, pain, the perceptions of muscle tension and well-being and physiological parameters, before and after interventions. RESULTS: A significant reduction (p=0.001) in anxiety scores and muscle tension (p=0.011), improvement of well-being (p=0.003) and a significant increase in peripheral oxyhemoglobin saturation scores (p=0.028) were observed in Spiritist "passe" patients, and a significant reduction (p=0.028) of muscle tension and improvement of well-being (p=0.045) in sham patients. However, muscle tension reduction (p=0.003) and improvement of well-being (p=0.003) were more accentuated in the Spiritist "passe" compared to sham and no intervention. CONCLUSIONS: Results suggest that the Spiritist "passe" appeared to be effective, reducing anxiety level and the perception of muscle tension, consequently improving peripheral oxyhemoglobin saturation and the sensation of well-being compared to sham and no intervention in cardiovascular inpatients.

Effectiveness of Spiritist Passe (Spiritual Healing) on the Psychophysiological Parameters in Hospitalized Patients.

Context • The coexistence of affective disorders, especially anxiety and depression, with medical illness is a topic of considerable clinical and research interest. Complementary biofield modalities are therapies that involve touch or placement of the hands in or through biofields. Spiritual healing, or Spiritist passe (SP), is a kind of laying on of hands (LOH), and therefore is a biofield therapy. Objective • The current study intended to evaluate the effects of SP on psychological parameters such as anxiety and depression and on the perceptions of muscle tension and wellness as well as physiological parameters, such as pain intensity, heart rate (HR), and oxygen saturation (SpO2). Design • This study was a randomized, controlled trial. Setting • The study took place at the medical clinic of the clinical hospital of the Federal University of Triângulo Mineiro (HC/UFTM) in Uberaba, Brazil. Participants • The participants were patients aged ≥18 y who had been hospitalized in the clinic between August 2014 and June 2015. Intervention • Participants in the no-SP and SP groups were instructed to direct their thoughts to Jesus with wishes to heal during the intervention. In the SP group, the patients underwent application of the SP, and in the no-SP group, workers, students, or volunteers at the Clinical Hospital of Uberaba practiced a kind of LOH in a nonspiritual therapy with intention to healing emitting sincere wishes of improvement to the patients by thought. All procedures in those groups were carried out during a 10-min period on 3 consecutive days. In the control group, the patients lay for 10 min during the same periods on the 3 days, with no intervention occurring. Outcome Measures • The study evaluated depression and anxiety using the Hospital Anxiety and Depression (HAD) scale as well as patients' pain using a visual analog scale (VAS). The study also measured their perceptions of muscle tension and wellness and their physiological parameters: HR and SpO2. Results • Seventy-two patients consented to participate in the study. The SP group showed statistically significant reductions in anxiety (P < .001) and depression (P = .008) between baseline and postintervention, with perceptions of muscle tension significantly decreasing on day 1 (D1) and day 3 (D3) of the study (both < .001) after the interventions and wellness significantly increasing between baseline and postintervention (P = .001) and when compared with the control and no-SP groups, with P = .001. The SP group presented the smallest numbers for HR after the interventions, but no significant differences were found between groups for HR, SpO2, and pain on the VAS. Conclusions • The current research team has concluded that the SP was effective in promoting a state of muscle relaxation, reducing anxiety and depression, decreasing muscle tension, and, consequently, raising the perceptions of wellness in hospitalized patients.

Effects of Isha Hatha Yoga on Core Stability and Standing Balance.

Context • The coexistence of affective disorders, especially anxiety and depression, with medical illness is a topic of considerable clinical and research interest. Complementary biofield modalities are therapies that involve touch or placement of the hands in or through biofields. Spiritual healing, or Spiritist passe (SP), is a kind of laying on of hands (LOH), and therefore is a biofield therapy. Objective • The current study intended to evaluate the effects of SP on psychological parameters such as anxiety and depression and on the perceptions of muscle tension and wellness as well as physiological parameters, such as pain intensity, heart rate (HR), and oxygen saturation (SpO2). Design • This study was a randomized, controlled trial. Setting • The study took place at the medical clinic of the clinical hospital of the Federal University of Triângulo Mineiro (HC/UFTM) in Uberaba, Brazil. Participants • The participants were patients aged ≥18 y who had been hospitalized in the clinic between August 2014 and June 2015. Intervention • Participants in the no-SP and SP groups were instructed to direct their thoughts to Jesus with wishes to heal during the intervention. In the SP group, the patients underwent application of the SP, and in the no-SP group, workers, students, or volunteers at the Clinical Hospital of Uberaba practiced a kind of LOH in a nonspiritual therapy with intention to healing emitting sincere wishes of improvement to the patients by thought. All procedures in those groups were carried out during a 10-min period on 3 consecutive days. In the control group, the patients lay for 10 min during the same periods on the 3 days, with no intervention occurring. Outcome Measures • The study evaluated depression and anxiety using the Hospital Anxiety and Depression (HAD) scale as well as patients' pain using a visual analog scale (VAS). The study also measured their perceptions of muscle tension and wellness and their physiological parameters: HR and SpO2. Results • Seventy-two patients consented to participate in the study. The SP group showed statistically significant reductions in anxiety (P < .001) and depression (P = .008) between baseline and postintervention, with perceptions of muscle tension significantly decreasing on day 1 (D1) and day 3 (D3) of the study (both < .001) after the interventions and wellness significantly increasing between baseline and postintervention (P = .001) and when compared with the control and no-SP groups, with P = .001. The SP group presented the smallest numbers for HR after the interventions, but no significant differences were found between groups for HR, SpO2, and pain on the VAS. Conclusions • The current research team has concluded that the SP was effective in promoting a state of muscle relaxation, reducing anxiety and depression, decreasing muscle tension, and, consequently, raising the perceptions of wellness in hospitalized patients.

Evaluation of breathing exercise in hormonal and immunological responses in patients undergoing abdominal surgery.

PURPOSE: To evaluate the effects of sustained deep inspiration in the prevention of postoperative pulmonary complications, the hormonal and immunological responses in patients submitted to abdominal surgery. METHODS: This randomized clinical trial study included 75 patients submitted to abdominal surgery, of which 36 were randomly allocated in the experimental group and underwent sustained deep inspiration during five seconds, in three sets of ten repetitions per day. The others 39 patients were allocated in the control group and were not submitted to any breathing exercise. The following parameters were measured preoperatively, 24h and 48h postoperatively: chest x-ray, serum ACTH, cortisol, IL-4, IL-10, TNF-α, forced expiratory volume in first second (FEV1), forced expiratory flow 25-75% (FEF 25-75), forced vital capacity (FVC), paO2 and paCO2. RESULTS: Mean serum cortisol in patients of the experimental and control groups before surgery were 12.8 mcg/dl (4.6-50) and 10.48 mcg/dl (1-29.1), respectively (p=0.414). The experimental group had significantly increase in serum cortisol levels, 23.6 mcg/dl (9.3-45.8), especially 24h postoperatively (p=0.049). CONCLUSION: Sustained deep inspiration in patients submitted to abdominal surgery determined important changes in serum cortisol, however, without significantly influence the postoperative pulmonary complications and the endocrine and immune responses.

Evaluation of breathing exercise in hormonal and immunological responses in patients undergoing abdominal surgery

PURPOSE: To evaluate the effects of sustained deep inspiration in the prevention of postoperative pulmonary complications, the hormonal and immunological responses in patients submitted to abdominal surgery. METHODS: This randomized clinical trial study included 75 patients submitted to abdominal surgery, of which 36 were randomly allocated in the experimental group and underwent sustained deep inspiration during five seconds, in three sets of ten repetitions per day. The others 39 patients were allocated in the control group and were not submitted to any breathing exercise. The following parameters were measured preoperatively, 24h and 48h postoperatively: chest x-ray, serum ACTH, cortisol, IL-4, IL-10, TNF-α, forced expiratory volume in first second (FEV1), forced expiratory flow 25-75% (FEF 25-75), forced vital capacity (FVC), paO2 and paCO2. RESULTS: Mean serum cortisol in patients of the experimental and control groups before surgery were 12.8 mcg/dl (4.6-50) and 10.48 mcg/dl (1-29.1), respectively (p=0.414). The experimental group had significantly increase in serum cortisol levels, 23.6 mcg/dl (9.3-45.8), especially 24h postoperatively (p=0.049). CONCLUSION: Sustained deep inspiration in patients submitted to abdominal surgery determined important changes in serum cortisol, however, without significantly influence the postoperative pulmonary complications and the endocrine and immune responses.

Tabagismo não limita o incremento da força muscular respiratória em pacientes submetidos ao treinamento muscular inspiratório pré-esofagectomia / Smoking doesn't limit the increase in respiratory muscle strength in patients undergoing pre-inspiratory muscle training esophagectomy

Um programa de treinamento muscular respiratório (TMR) para pacientes tabagistas no pré-operatório ambulatorial pode melhorar a força muscular e a capacidade funcional respiratória, evitando complicações que aumentem a permanência do paciente no hospital. O objetivo deste trabalho foi avaliar a eficácia do treinamento muscular inspiratório (TMI) em pacientes tabagistas e não tabagistas que seriam submetidos à cirurgia do megaesôfago. Foram estudados 17 pessoas, divididas em dois grupos: o tabagista (GT), composto por 10 pacientes (58,82%), e o não tabagista (GNT), com 7 pacientes (41,18%). A análise dos dados relacionando os dois foi expressa da seguinte forma: os valores de idade e as medidas antropométricas foram comparadas pelo teste t de Student e os valores da pressão inspiratória máxima (PImáx) e da pressão expiratória máxima (PEmáx) pelo teste t de Student pareado. Os dados foram expressos em média±desvio-padrão quando verificada a normalidade. Consideraram-se diferenças estatisticamente significativas se p<0,05. Na análise comparativa, observou-se aumento significativo da PImáx após as 4 semanas do TMI, como se segue: PImáx no GT de -57,20±18,76 para -79,00±15,38 e no GNT de -52,00±18,76 para -72,66±19,33. A fisioterapia profilática no pré-operatório ambulatorial proporcionou aumento significativo na força dos músculos inspiratórios em ambos os grupos, evidenciada pelo acréscimo na PImáx com consequente melhora da capacidade ventilatória.

A program of muscular respiratory training to smoker patients in pre-operatory ambulatory can improve the muscle strength and the functional respiratory capacity, avoiding complications which increase the hospitalization period of the patient. The aim of this work was to evaluate the effectiveness of the inspiratory muscle training in smoker and non-smoker patients who would be submitted to a megaesophagus surgery. Seventeen patients were studied, divided into two groups: smoker (GT), composed of 10 patients (58.82%), and the non-smoker (GNT), with 7 patients (41.18%). Data analysis comparing the two groups was expressed as follows: the values of age and anthropometric measurements were compared by Student's t-test and the values of Maximal Inspiratory Pressure (MIP) and Maximal Expiratory Pressure (MEP) were compared by the paired Student's t-test. Data were expressed as mean±standard deviation when checked to normal. Differences were considered statistically significant if p<0.05. Level of significance adopted was p=0.05. Considering the comparative analysis, it was observed a significant increase of Maximal Inspiratory Pressure MIP after the 4 weeks of inspiratory muscle training (IMT), as follows: MIP in GT from -57.20±18.76 to -79.00±15.38 and in GNT from -52.00±18.76 to -72.66±19.33. The prophylactic therapy in the preoperative outpatient provides a significant increase in inspiratory muscle strength in both groups, as evidenced by the increase in MIP with consequent improvement in ventilatory capacity.

Benefícios e complicações da ventilação mecânica não-invasiva na exacerbação aguda da doença pulmonar obstrutiva crônica / Benefits and complications of noninvasive mechanical ventilation for acute exacerbation of chronic obstructive pulmonary disease

JUSTIFICATIVA E OBJETIVOS: A doença pulmonar obstrutiva crônica (DPOC) é definida como uma síndrome caracterizada por obstrução crônica ao fluxo aéreo, geralmente progressiva, podendo ser acompanhada por hiper-responsividade brônquica e ser parcialmente reversível. A ventilação mecânica não-invasiva é uma alternativa de tratamento para pacientes com exacerbação da DPOC. O objetivo deste estudo foi verificar os benefícios e as complicações da ventilação mecânica não-invasiva em pacientes com exacerbação aguda da doença pulmonar obstrutiva crônica. CONTEÚDO: Realizou-se revisão de literatura científica nacional e internacional conforme os critérios estabelecidos para a pesquisa documental nas bases de dados MedLine, LILACS, SciElo, PubMed, Cochrane, com os unitermos: doença pulmonar obstrutiva crônica, ventilação mecânica não-invasiva. Os critérios de inclusão foram artigos publicados no período de 1995-2007; nas linguagens inglesa, espanhola e portuguesa; estudos em modelo humano e sem restrição de sexo. CONCLUSÕES: A ventilação mecânica não-invasiva pode diminuir a pressão parcial de dióxido de carbono, melhorar a troca gasosa, aliviar sintomas como dispnéia ocasionada pela fadiga da musculatura respiratória, reduzir as internações hospitalares, a necessidade de intubação, o número de complicações, o tempo de internação e a mortalidade hospitalar. As principais complicações encontradas foram: eritema facial, claustrofobia, congestão nasal, dor facial, irritação nos olhos, pneumonia aspirativa, hipotensão, pneumotórax, aerofagia, hipercapnia, distensão abdominal, vômitos, broncoaspiração, dor de cabeça matinal, lesões compressivas de face, embolia gasosa e não adaptação do paciente. A ventilação mecânica não-invasiva pode ser mais efetiva em pacientes com moderada a grave exacerbação da DPOC e as complicações podem ser diminuídas pela utilização de adequada interface e experiência do fisioterapeuta.

BACKGROUND AND OBJECTIVES: Chronic obstructive pulmonary disease (COPD) is defined as a syndrome characterized by usually progressive chronic airflow limitation which is associated to a bronchial hyperresponsiveness and is partially reversible. Noninvasive mechanical ventilation is an alternative treatment for patients with COPD exacerbations. The objective of the literature reviews was to verify noninvasive mechanical ventilation benefits and complications in acute exacerbations of chronic obstructive pulmonary disease in patients. CONTENTS: This national and international's scientific literature review was developed according to criteria established for documentary research in the MedLine, LILACS, SciElo, PubMed and Cochrane, databases using the key words: chronic obstructive pulmonary disease and noninvasive mechanical ventilation. Inclusion criteria were articles published from 1995 to 2007; in English, Spanish and Portuguese; studies in the human model and with no gender restriction. CONCLUSIONS: Noninvasive mechanical ventilation can reduce partial pressure of carbon dioxide, improve gas exchange, alleviate symptoms as dyspnea caused by fatigue of the respiratory muscles, reduce duration of hospitalization, decrease need for invasive mechanical ventilation, reduce number of complications and also lessen hospital mortality. The main complications found were: facial skin erythema, claustrophobia, nasal congestion, face pain, eye irritation, aspiration pneumonia, hypotension, pneumothorax, aerophagia, hypercapnia, gastric insufflation, vomit, bronchoaspiration, morning headaches, face injuries, air embolism and, last but not least, discomfort of the patient. Noninvasive mechanical ventilation can be more effective in patients with moderate-severe exacerbations of COPD and these complications can be minimized by an adequate interface also by the contribution of the physiotherapist experience.

Ventilação mecânica não-invasiva em paciente com provável pneumonia por pneumocystis jirovecii: relato de caso / Noninvasive mechanical ventilation in patient with pneumocystis jirovecii pneumonia: case report

JUSTIFICATIVA E OBJETIVOS: A pneumonia por Pneumocystis jirovecii tem sido uma das doenças mais comuns e uma complicação infecciosa fatal em pacientes com síndrome da imunodeficiência adquirida. O objetivo deste estudo foi apresentar uma paciente com provável diagnóstico de pneumonia por Pneumocystis jirovecii que recebeu ventilação não-invasiva com pressão positiva. RELATO DO CASO: Paciente do sexo feminino, 25 anos, com diagnóstico provável de pneumonia por Pneumocystis jirovecii grave, recebeu ventilação mecânica não-invasiva com pressão positiva. CONCLUSÕES: Todos os parâmetros melhoraram progressivamente nos primeiros cinco dias. Os resultados sugeriram a eficácia desta medida para otimizar a oxigenação, reverter a hipoxemia e prevenir a intubação traqueal.

BACKGROUND AND OBJECTIVES: Pneumocystis jirovecii pneumonia has been one of the most common diseases and life-threatening infectious complications in acquired immunodeficiency syndrome patients. The objective of the case report was to present a patient with probable diagnosis of Pneumocystis jirovecii pneumonia who received noninvasive positive pressure ventilation. CASE REPORT: A female patient, 25 years old, with probable diagnosis of Pneumocystis jirovecii pneumonia received noninvasive positive pressure ventilation. CONCLUSIONS: All respiratory parameters progressively improved in the first five days. Results suggest the efficacy of this support to improve oxygenation, to revert hypoxemia and to prevent orotracheal intubation.

Benefits and complications of noninvasive mechanical ventilation for acute exacerbation of chronic obstructive pulmonary disease. / Benefícios e complicações da ventilação mecânica não-invasiva na exacerbação aguda da doença pulmonar obstrutiva crônica.

BACKGROUND AND OBJECTIVES: Chronic obstructive pulmonary disease (COPD) is defined as a syndrome characterized by usually progressive chronic airflow limitation which is associated to a bronchial hyperresponsiveness and is partially reversible. Noninvasive mechanical ventilation is an alternative treatment for patients with COPD exacerbations. The objective of the literature reviews was to verify noninvasive mechanical ventilation benefits and complications in acute exacerbations of chronic obstructive pulmonary disease in patients. CONTENTS: This national and international's scientific literature review was developed according to criteria established for documentary research in the MedLine, LILACS, SciElo, PubMed and Cochrane, databases using the key words: chronic obstructive pulmonary disease and noninvasive mechanical ventilation. Inclusion criteria were articles published from 1995 to 2007; in English, Spanish and Portuguese; studies in the human model and with no gender restriction. CONCLUSIONS: Noninvasive mechanical ventilation can reduce partial pressure of carbon dioxide, improve gas exchange, alleviate symptoms as dyspnea caused by fatigue of the respiratory muscles, reduce duration of hospitalization, decrease need for invasive mechanical ventilation, reduce number of complications and also lessen hospital mortality. The main complications found were: facial skin erythema, claustrophobia, nasal congestion, face pain, eye irritation, aspiration pneumonia, hypotension, pneumothorax, aerophagia, hypercapnia, gastric insufflation, vomit, bronchoaspiration, morning headaches, face injuries, air embolism and, last but not least, discomfort of the patient. Noninvasive mechanical ventilation can be more effective in patients with moderate-severe exacerbations of COPD and these complications can be minimized by an adequate interface also by the contribution of the physiotherapist experience.

Noninvasive mechanical ventilation in patient with pneumocystis jirovecii pneumonia: case report. / Ventilação mecânica não-invasiva em paciente com provável pneumonia por pneumocystis jirovecii: relato de caso.

BACKGROUND AND OBJECTIVES: Pneumocystis jirovecii pneumonia has been one of the most common diseases and life-threatening infectious complications in acquired immunodeficiency syndrome patients. The objective of the case report was to present a patient with probable diagnosis of Pneumocystis jirovecii pneumonia who received noninvasive positive pressure ventilation. CASE REPORT: A female patient, 25 years old, with probable diagnosis of Pneumocystis jirovecii pneumonia received noninvasive positive pressure ventilation. CONCLUSIONS: All respiratory parameters progressively improved in the first five days. Results suggest the efficacy of this support to improve oxygenation, to revert hypoxemia and to prevent orotracheal intubation.