Development of a low-cost congenital abdominal wall defect simulator (wall-go) for undergraduate medical education: a validation study.

BACKGROUND: Congenital Anomalies were responsible for 303,000 deaths in the neonatal period, according to the WHO, they are among the world's top 20 causes of morbidity and mortality. Expensive simulators demonstrate several diseases, but few are related to congenital anomalies. This study aims to develop, validate, and evaluate low-cost simulator models (WALL-GO) of the most common abdominal wall defects, gastroschisis, and omphalocele, to enable diagnosis through an accessible tool with study value and amenable to replication. METHODS: Market research was conducted to find materials to build low-cost models. The researchers built the model and underwent validation assessment of the selected experts who scored five or more in the adapted Fehring criteria. The experts were assessed through a 5-point Likert scale to 7 statements (S1-7). Statements were assigned values according to relevance in face and transfer validities. Concomitantly, the model was also evaluated by students from 1st to 5th year with the same instruments. Content Validity Indexes (CVIs) were considered validated between groups with concordance greater than 90%. Text feedback was also collected. Each statement was subjected to Fisher's Exact Test. RESULTS: Gastroschisis and omphalocele model costs were US $15 and US $27, respectively. In total, there were 105 simulator evaluators. 15 experts were selected. Of the 90 students, there were 16 (1st year), 22 (2nd), 16 (3rd), 22 (4th), and 14 (5th). Students and experts obtained CVI = 96.4% and 94.6%, respectively. The CVIs of each statement were not significantly different between groups (p < 0,05). CONCLUSIONS: The WALL-GO models are suitable for use and replicable at a manufacturable low cost. Mannequins with abdominal wall defects are helpful in learning to diagnose and can be applied in teaching and training health professionals in developing and low-income countries.

Metagenomic analysis reveals novel dietary-related viruses in the gut virome of marmosets hybrids (Callithrix jacchus x Callithrix penicillata), Brazil.

Viral metagenomics has contributed enormously to the characterization of a wide range of viruses infecting animals of all phyla in the last decades. Among Neotropical primates, especially those introduced, knowledge about viral diversity remains poorly studied. Therefore, using metagenomics based on virus enrichment, we explored the viral microbiota present in the feces of introduced common marmosets (Callithrix sp.) in three locations from the Silva Jardim region in the State of Rio de Janeiro, Brazil. Fecal samples were collected from nine marmosets, pooled into three sample pools, and sequenced on Illumina MiSeq platform. Sequence reads were analyzed using a viral metagenomic analysis pipeline and two novel insect viruses belonging to the Parvoviridae and Baculoviridae families were identified. The complete genome of a densovirus (Parvoviridae family) of 5,309 nucleotides (nt) was obtained. The NS1 and VP1 proteins share lower than 32% sequence identity with the corresponding proteins of known members of the subfamily Densovirinae. Phylogenetic analysis suggests that this virus represents a new genus, provisionally named Afoambidensovirus due to its discovery in the Brazilian Atlantic Forest. The novel species received the name Afoambidensovirus incertum 1. The complete circular genome of a baculovirus of 107,191 nt was also obtained, showing 60.8% sequence identity with the most closely related member of the Baculoviridae family. Phylogenetic analysis suggests that this virus represents a new species in the Betabaculovirus genus, provisionally named Betabaculovirus incertum 1. In addition, sequences from several families of arthropods in the three pools evaluated were characterized (contigs ranging from 244 to 6,750 nt), corroborating the presence of possible insect hosts with which these new viruses may be associated. Our study expands the knowledge about two viral families known to infect insects, an important component of the marmosets' diet. This identification in hosts' feces samples demonstrates one of the many uses of this type of data and could serve as a basis for future research characterizing viruses in wildlife using noninvasive samples.

Tracing and analyzing COVID-19 dissemination using knowledge graphs.

The COVID-19 (SARS-CoV-2) spread around the globe could have been halted if we had had a better understanding of the situation and applied more restrictive measures for travel adapted to each country. This is due to a lack of efficient tools to visualize, analyze and control the virus dissemination. In the context of virus proliferation, analyzing flight connections between countries and COVID-19 data seems helpful to understand spatial and temporal information about the virus and its possible spread. To manage these complex, massive, and heterogeneous data, we propose a methodology based on knowledge graphs models. Several analyses and visualization tools can be applied, and our results show that these knowledge graph models may be a promising way to study the dissemination of any virus. These graphs can also be easily enriched with additional information that could be useful in the future to analyze or predict other interesting indicators.

Discovery of two novel Torque Teno viruses in Callithrix penicillata provides insights on Anelloviridae diversification dynamics.

The development of high-throughput sequencing (HTS) technologies and metagenomics protocols deeply impacted the discovery of viral diversity. Moreover, the characterization of novel viruses in the Neotropical primates (NP) is central for the comprehension of viral evolution dynamics in those hosts, due to their evolutionary proximity to Old World primates, including humans. In the present work, novel anelloviruses were detected and characterized through HTS protocols in the NP Callithrix penicillata, the common black-tufted marmoset. De novo assembly of generated sequences was carried out, and a total of 15 contigs were identified with complete Anelloviridae ORF1 gene, two of them including a flanking GC-rich region, confirming the presence of two whole novel genomes of ~3 kb. The identified viruses were monophyletic within the Epsilontorquevirus genus, a lineage harboring previously reported anelloviruses infecting hosts from the Cebidae family. The genetic divergence found in the new viruses characterized two novel species, named Epsilontorquevirus callithrichensis I and II. The phylogenetic pattern inferred for the Epsilontorquevirus genus was consistent with the topology of their host species tree, echoing a virus-host diversification model observed in other viral groups. This study expands the host span of Anelloviridae and provides insights into their diversification dynamics, highlighting the importance of sampling animal viral genomes to obtain a clearer depiction of their long-term evolutionary processes.

Experiências anômalas e dissociativas em contexto religioso: uma abordagem autoetnográfica / Anomalous and dissociative experiences in a religious context: an autoethnographic approach / Experiencias anómalas y disociativas en un contexto religioso: un enfoque autoetnografico

A presente pesquisa investigou as características fenomenológicas das experiências anômalas (EAs) relatadas em contextos mediúnicos umbandistas, a partir de uma comparação entre EAs reportadas durante rituais envolvendo o uso da substância Ayahuasca e rituais sem o uso dessa substância. Para tanto, comparamos indivíduos com diferentes graus de envolvimento com as práticas mediúnicas umbandistas, tendo por base uma abordagem autoetnográfica. A perspectiva metodológica adotada nos permitiu confrontar os dados subjetivos com o conhecimento disponível na literatura acadêmica acerca das EAs, dos fenômenos dissociativos e estados alterados de consciência, tendo sido fundamental para uma compreensão mais sensível das nuances e características dessas experiências. Os relatos analisados atestam uma semelhança significativa entre as experiências vivenciadas com e sem o uso de Ayahuasca em contextos mediúnicos. Em ambos os casos, os experienciadores puderam reconhecer similaridades no que diz respeito à redução do controle motor, às alterações perceptivas e mnêmicas experimentadas, à comunicabilidade da experiência, à recepção anômala de informação e a um aumento da sensibilidade interpessoal. Os resultados indicam a viabilidade metodológica da autoetnografia como recurso para um aprofundamento de aspectos das EAs e outras experiências subjetivas usualmente de difícil investigação por outros métodos.

The present study explored the phenomenological characteristics of anomalous experiences (AEs) reported during Umbanda rituals, a mediumistic Brazilian religion, with the aim of comparing AEs reported during rituals involving the use of Ayahuasca (an entheogen frequently used in some Umbanda contexts) and rituals without the use of this substance. In order to do so, we compared individuals with different levels of involvement with the mediumistic practices. The study was based on an auto-ethnographic approach. This methodological perspective allowed us to confront subjective data with the available knowledge in the scientific literature about AEs, dissociative phenomena and altered states of consciousness and was of fundamental importance for a more sensitive understanding of the nuances and characteristics of these experiences. The results attest to a significant similarity between the experiences reported with and without the use of Ayahuasca in mediumistic contexts. In both groups, the experiencers were able to identify certain similarities in their experiences regarding a reduction of voluntary motor control, changes in memory and perception, communicability and accessibility of experiences, anomalous information reception and increases in interpersonal sensitivity. The results support the methodological feasibility of autoethnography as a research tool and point to its relevance to a deeper understanding of AEs and other subjective experiences usually of difficult investigation by other research methods.

En la presente investigación se analiso las características fenomenológicas de experiencias anómalas (EAs) relatadas en contextos mediúmnicos umbandistas por medio de una comparación entre EAs reportadas durante rituales con el uso de la sustancia Ayahuasca y rituales sin el uso de esa sustancia. Para alcanzar ese objectivo, comparamos algunas caracteristicas de individuos con diferentes grados de involucracion con las prácticas mediúmnicas. Utilizamos un enfoque autoetnográfico. La perspectiva metodológica adoptada nos permitió evaluar los datos subjetivos con el conocimiento disponible en la literatura académica acerca de las EAs, de los fenómenos disociativos y los estados alterados de conciencia. Este acercamiento metodológico fue fundamental para una comprensión más sensible de los matices y características de las experiencias investigadas. Los relatos analizados atestiguan una similitud significativa entre las experiencias vivenciadas con y sin el uso de Ayahuasca en contextos mediúmnicos. En ambos casos, los participantes reconoceran similitudes en lo que se refiere a la reducción del control motor, a las alteraciones perceptivas y mnémicas experimentadas, a la comunicabilidad de la experiencia, a la recepción anómala de información, y un aumento de la sensibilidad interpersonal. Los resultados indican la viabilidad metodológica de la autoetnografía como recurso para una compreension profunda de aspectos de las EAs y otras experiencias subjetivas usualmente de difícil investigación por otros métodos.

Definição de Experiência Fora do Corpo a partir de Relatos de Experiências Similares / Out-of-Body Experience Definition by Reports about Similar Experiences

Resumo Diversas abordagens foram utilizadas para entender as Experiências Fora do Corpo (EFC), contudo, não há consenso sobre sua etiologia, definição e características constitutivas. Este artigo buscou comparar definições de EFC com experiências semelhantes, não consideradas como EFC por seus protagonistas. Treze participantes narraram experiências durante entrevistas semiestruturadas, as quais foram submetidas à análise de conteúdo. Três participantes descreveram experiências que se enquadram a três categorias de EFCs distintas. O não reconhecimento da experiência como EFC esteve relacionado à atribuição de causalidade e crenças paranormais e religiosas. Tais dados sugerem a necessidade de separação entre a definição da experiência e sua atribuição de causalidade, bem como uma abordagem multietiológica e fenomenológica no estudo de EFC.

Abstract Several approaches have been used to understand out-of-body experiences (OBE); however, there is no consensus about its etiology, definition and constitutive characteristics. This study aimed to compare the definition of OBE with experiences similar to OBE but not classified as such by its experiencers. Thirteen respondents reported their experiences in a semistructured interview, which was analyzed using content analysis. Three of them described experiences that fit into three different categories of OBEs. Failure to recognize the experience as OBE was related to causal attributions and paranormal and religious beliefs. These data suggest the need for a separation of the definition of experience from its causal attribution as well as a multi-etiologic and phenomenological approach in the study of OBE.

Contemporaneidade e experiências anômalas: dimensões psicossociais de vivências culturalmente limítrofes / Contemporaneity and anomalous experiences: psychosocial dimensions of culturally frontier experiences / Contemporaneidad y experiencias anómalas: dimensiones psicosociales de experiencias culturalmente marginales

Ao longo da história, sempre foram reportadas experiências pessoais "extraordinárias", relacionadas ao "paranormal". Contudo, tais experiências podem confrontar referenciais hegemônicos em dado contexto, além de conduzir à estigmatização de seus protagonistas, o que levanta questionamentos sobre que fatores e processos propiciam seu verificado crescimento. Para investigar variáveis psicossociais que intermedeiam relações entre crenças/experiências anômalas e cultura em contexto brasileiro, foram entrevistadas 46 pessoas que reportam contatos diretos com alegados "alienígenas", além de 35 que não as reportam, para comparação. A coleta e a análise dos dados delinearam uma pesquisa qualitativa-fenomenológica. Através da Teoria da Atribuição de Causalidade, averiguou-se que as experiências adquirem sentido sob uma mescla caracteristicamente contemporânea de referenciais científicos, esotéricos e religiosos tradicionais, o que permite seu fortalecimento mesmo diante da estigmatização que seus protagonistas sofrem na macrocultura enquanto insanos, mentirosos, ignorantes ou endemoninhados.

Throughout history, "extraordinary" experiences have always been reported, somehow related to the "paranormal". However, such experiences may confront hegemonic thinking in a given context, and lead to stigmatization of their protagonists, which raises questions about its growing. In order to investigate psychosocial variables that mediate the relation between beliefs/anomalous experiences and culture in the Brazilian context, 46 people were interviewed about their alleged contacts with aliens, such as 35 people that did not report such experiences, for comparison. Data gathering and analysis delineated a qualitative-phenomenological research. Using the Theory of Attribution of Causality, it was found that the experiences acquire meaning under a characteristically contemporary combination of scientific, esoteric and traditional religious references, allowing their strength even in face of the stigmatization that protagonists suffer in macroculture while insane, liars, ignorant or possessed.

Por la historia, siempre se registraron experiencias extraordinarias relacionadas con el "paranormal". Sin embargo, estas experiencias pueden entrar en conflicto con referencias culturales hegemónicas en una cultura, y conducir a la estigmatización de sus protagonistas, lo que plantea interrogantes sobre su crecimiento. Para investigar las variables psicosociales que median las relaciones entre las creencias/experiencias anómalas y la cultura en el contexto brasileño, fueron entrevistados 46 personas que reportaron el contacto directo con supuestos "extraterrestres" y 35 que no reportaron para comparación. La recolección y análisis de datos definen una investigación cualitativa fenomenológica. A través de la Teoría de la Atribución de la Causalidad, se ha encontrado que las experiencias adquieren sentido en una mezcla propiamente contemporánea de referencias científicas, esotéricas y religiosas tradicionales, lo que permite su fortalecimiento, incluso contra el estigma de que sus protagonistas sufren en la macrocultura como locos, mentirosos, ignorantes o que éste posea.

Educação permanente em saúde mental: relato de experiência / Lifelong education on mental health: experience report / Educación permanente en salud mental: relato de una experiencia

Este artigo relata o desenvolvimento do curso-piloto de formação em Saúde Mental, Doutor, eu sou normal? Reuniu usuários, técnicos e gestores do Núcleo de Atenção Psicossocial de Santos I (NAPS I). O projeto objetivava, com as temáticas propostas, analisar sua aplicação teórico-metodológica e refletir sobre o cuidado em Saúde Mental, com os diferentes atores envolvidos. A análise da aplicação indicou importantes problemáticas do campo da saúde mental: o processo de medicalização, a produção da loucura, o apagamento das subjetividades e o controle dos sujeitos. Assim, proporcionou reflexões sobre o protagonismo dos participantes, os processos histórico-sociais relacionados às terapêuticas e saberes sobre o sofrimento psíquico, e, ao mesmo tempo, despertou importantes reflexões sobre a dimensão ético-política do cuidado.

This paper describes the development of the Mental Health pilot-course called Doctor, Am I normal?, gathering users, technicians and managers of the Psychosocial Care Center of Santos I (NAPS I). The project aimed to analyze the theoretical and methodological application in order to reflect on the care in mental health with the participation of the different actors involved. The application of the analysis showed important issues pertaining to the field of mental health: the medicalization process, the production of madness, the erasure of subjectivity and the subjects’ control. Thus, it provided reflections about the leading roles of the participants, the historical and social processes related to the therapeutics, the lore about psychic suffering and, at the same time, it aroused important reflections about the ethical and political dimension of care.

Este artículo relata el desarrollo del curso-piloto de fornación en Salud Mental, Doctor, soy normal?, que reunió a los usuarios , técnicos y directivos del Centro de Atención Psicosocial de Santos I (NAPS I). El objetivo del proyecto fue analizar su aplicación teórico-metodológica y reflexionar sobre el cuidado de la salud mental junto a los diferentes actores involucrados. El análisis de la aplicación indicó temas que son de importancia para el campo de la salud mental: el proceso de medicalización, la producción de la locura, la supresión de las subjetividades y el control de los sujetos. Por lo tanto, promovió reflexiones sobre el papel de los participantes, los procesos históricos y sociales relacionados con el tratamiento y el conocimiento sobre el sufrimiento psíquico y, al mismo tiempo, despertó importantes reflexiones sobre la dimensión ética y política del cuidado.

Fenomenologia da percepção extracorpórea: análise de experiências fora do corpo / Phenomenology of extracorporeal perception: analysis of out-of-body experiences / Fenomenología de la percepción extracorpórea: análisis de experiencias fuera del cuerpo

Diversos autores apontam conceitos e etiologias para o fenômeno de Experiências Fora do Corpo (EFC). O presente artigo objetivou descrever e analisar as EFC a partir da experiência do vivido, elencando diferentes experiências denominadas EFC, comparando-as entre si e com o conceito científico de EFC, e investigando os sentidos dados a estas, bem como seu papel na vida cotidiana daqueles que alegam praticá-las, de modo a explorar as variedades de experiências rotuladas como EFC. Treze sujeitos foram entrevistados quanto a suas experiências, crenças e a consequência das EFC em suas vidas. Utilizou-se a análise de conteúdo, adotando Merleau-Ponty como principal referencial teórico para a interpretação dos dados. Os relatos de EFC foram divididos em dois grupos: aqueles que têm convicção da natureza espiritual destas - e que, assim, relataram experiências com presença de seres espirituais que os auxiliaram - e aqueles ressabiados de suas percepções - que se mantiveram céticos e, quando em EFC, permaneceram nos cômodos onde estavam fisicamente. Contudo, em ambos os casos, a experiência possuía um papel importante no entendimento e no modo de ser no mundo de tais sujeitos, sendo utilizada como coping para questões desde doenças crônicas, com risco de morte; ao desinteresse pela vida.

Several authors point out concepts and causes for the phenomenon of Out of Body Experiences (OBE). This article aimed to describe and analyze the OBE from the experience of the lived, listing different experiences called EFC, comparing them with each other and with the scientific concept of OBE, and investigating the meanings given to them, and their role in everyday life of those who claim to practice them in order to explore the variety of experiences named as OBE. Thirteen people were interviewed about their experiences, beliefs and consequence of OBE in their lives. We used content analysis, adopting Merleau-Ponty as the main theoretical framework for the interpretation of data. Reports of OBE were divided into two groups: those who have belief in the spiritual nature of such experiences - and thus reported experiences with the presence of spiritual beings who helped them - and those distrustful of their perceptions - who were skeptical and when in OBE, remained in the rooms where they were physically. However, in both cases, the experience had an important role in the understanding and being in the world of the experient, and is used as coping for questions from chronic diseases; life-threatening; to the lack of interest in life.

Varios autores señalan conceptos y las causas del fenómeno de Experiencias fuera del cuerpo (EFC). Este artículo tiene como objetivo describir y analizar el EFC de la experiencia de lo vivido, enumerando las diferentes experiencias llamadas EFC, comparándolos entre sí y con el concepto científico de EFC, y la investigación de los significados que se les da, así como su papel en la vida cotidiana de aquellos que dicen practicarlas; con el fin de explorar la variedad de experiencias etiquetadas como EFC. Fueron entrevistados trece sujetos acerca de sus experiencias, creencias y consecuencia de la EFC. Se utilizó el análisis de contenido, la adopción de Merleau-Ponty como el principal marco teórico para la interpretación de los datos. Informes de EFC se dividieron en dos grupos: aquellos que tienen fe en la naturaleza espiritual de estos - y por lo tanto las experiencias reportadas con la presencia de los seres espirituales que les ayudaron - y los que desconfían de su percepción - que eran escépticos y cuando en EFC, se quedaron en las habitaciones donde estaban físicamente. Sin embargo, en ambos casos, la experiencia tuvo un papel importante en la comprensión y ser en el mundo de tales sujetos, siendo utilizados como un afrontamiento para las cuestiones de las enfermedades crónicas, el riesgo de muerte; la falta de interés en la vida.

Fenomenologia da percepção extracorpórea: análise de experiências fora do corpo / Phenomenology of extracorporeal perception: analysis of out-of-body experiences / Fenomenología de la percepción extracorpórea: análisis de experiencias fuera del cuerpo

Diversos autores apontam conceitos e etiologias para o fenômeno de Experiências Fora do Corpo (EFC). O presente artigo objetivou descrever e analisar as EFC a partir da experiência do vivido, elencando diferentes experiências denominadas EFC, comparando-as entre si e com o conceito científico de EFC, e investigando os sentidos dados a estas, bem como seu papel na vida cotidiana daqueles que alegam praticá-las, de modo a explorar as variedades de experiências rotuladas como EFC. Treze sujeitos foram entrevistados quanto a suas experiências, crenças e a consequência das EFC em suas vidas. Utilizou-se a análise de conteúdo, adotando Merleau-Ponty como principal referencial teórico para a interpretação dos dados. Os relatos de EFC foram divididos em dois grupos: aqueles que têm convicção da natureza espiritual destas - e que, assim, relataram experiências com presença de seres espirituais que os auxiliaram - e aqueles ressabiados de suas percepções - que se mantiveram céticos e, quando em EFC, permaneceram nos cômodos onde estavam fisicamente. Contudo, em ambos os casos, a experiência possuía um papel importante no entendimento e no modo de ser no mundo de tais sujeitos, sendo utilizada como coping para questões desde doenças crônicas, com risco de morte; ao desinteresse pela vida.(AU)

Several authors point out concepts and causes for the phenomenon of Out of Body Experiences (OBE). This article aimed to describe and analyze the OBE from the experience of the lived, listing different experiences called EFC, comparing them with each other and with the scientific concept of OBE, and investigating the meanings given to them, and their role in everyday life of those who claim to practice them in order to explore the variety of experiences named as OBE. Thirteen people were interviewed about their experiences, beliefs and consequence of OBE in their lives. We used content analysis, adopting Merleau-Ponty as the main theoretical framework for the interpretation of data. Reports of OBE were divided into two groups: those who have belief in the spiritual nature of such experiences - and thus reported experiences with the presence of spiritual beings who helped them - and those distrustful of their perceptions - who were skeptical and when in OBE, remained in the rooms where they were physically. However, in both cases, the experience had an important role in the understanding and being in the world of the experient, and is used as coping for questions from chronic diseases; life-threatening; to the lack of interest in life.(AU)

Varios autores señalan conceptos y las causas del fenómeno de Experiencias fuera del cuerpo (EFC). Este artículo tiene como objetivo describir y analizar el EFC de la experiencia de lo vivido, enumerando las diferentes experiencias llamadas EFC, comparándolos entre sí y con el concepto científico de EFC, y la investigación de los significados que se les da, así como su papel en la vida cotidiana de aquellos que dicen practicarlas; con el fin de explorar la variedad de experiencias etiquetadas como EFC. Fueron entrevistados trece sujetos acerca de sus experiencias, creencias y consecuencia de la EFC. Se utilizó el análisis de contenido, la adopción de Merleau-Ponty como el principal marco teórico para la interpretación de los datos. Informes de EFC se dividieron en dos grupos: aquellos que tienen fe en la naturaleza espiritual de estos - y por lo tanto las experiencias reportadas con la presencia de los seres espirituales que les ayudaron - y los que desconfían de su percepción - que eran escépticos y cuando en EFC, se quedaron en las habitaciones donde estaban físicamente. Sin embargo, en ambos casos, la experiencia tuvo un papel importante en la comprensión y ser en el mundo de tales sujetos, siendo utilizados como un afrontamiento para las cuestiones de las enfermedades crónicas, el riesgo de muerte; la falta de interés en la vida.(AU)

A model-Driven Approach to Customize the Vocabulary of Communication Boards: Towards More Humanization of Health Care.

OBJECTIVE: This work presents a Modeling Language and its technological infrastructure to customize the vocabulary of Communication Boards (CB), which are important tools to provide more humanization of health care. METHOD: Using a technological infrastructure based on Model-Driven Development (MDD) approach, our Modelin Language (ML) creates an abstraction layer between users (e.g., health professionals such as an audiologist or speech therapist) and application code. Moreover, the use of a metamodel enables a syntactic corrector for preventing creation of wrong models. RESULTS: Our ML and metamodel enable more autonomy for health professionals in creating customized CB because it abstracts complexities and permits them to deal only with the domain concepts (e.g., vocabulary and patient needs). Additionally, our infrastructure provides a configuration file that can be used to share and reuse models. This way, the vocabulary modelling effort will decrease our time since people share vocabulary models. CONCLUSION: Our study provides an infrastructure that aims to abstract the complexity of CB vocabulary customization, giving more autonomy to health professionals when they need customizing, sharing and reusing vocabularies for CB.

Oxygen desaturation during the six-minute walk test in COPD patients.

OBJECTIVE: To evaluate the behavior of oxygen saturation curves throughout the six-minute walk test (6MWT) in patients with COPD. METHODS: We included 85 patients, all of whom underwent spirometry and were classified as having moderate COPD (modCOPD, n = 30) or severe COPD (sevCOPD, n = 55). All of the patients performed a 6MWT, in a 27-m corridor with continuous SpO2 and HR monitoring by telemetry. We studied the SpO2 curves in order to determine the time to a 4% decrease in SpO2, the time to the minimum SpO2 (Tmin), and the post-6MWT time to return to the initial SpO2, the last designated recovery time (RT). For each of those curves, we calculated the slope. RESULTS: The mean age in the modCOPD and sevCOPD groups was 66 ± 10 years and 62 ± 11 years, respectively. At baseline, SpO2 was > 94% in all of the patients; none received supplemental oxygen during the 6MWT; and none of the tests were interrupted. The six-minute walk distance did not differ significantly between the groups. The SpO2 values were lowest in the sevCOPD group. There was no difference between the groups regarding RT. In 71% and 63% of the sevCOPD and modCOPD group patients, respectively, a ≥ 4% decrease in SpO2 occurred within the first minute. We found that FEV1% correlated significantly with the ΔSpO2 (r = -0.398; p < 0.001), Tmin (r = -0.449; p < 0.001), and minimum SpO2 (r = 0.356; p < 0.005). CONCLUSIONS: In the sevCOPD group, in comparison with the modCOPD group, SpO2 was lower and the Tmin was greater, suggesting a worse prognosis in the former.

Oxygen desaturation during the six-minute walk test in COPD patients / Análise da dessaturação de oxigênio durante o teste de caminhada de seis minutos em pacientes com DPOC

Objective: To evaluate the behavior of oxygen saturation curves throughout the six-minute walk test (6MWT) in patients with COPD. Methods: We included 85 patients, all of whom underwent spirometry and were classified as having moderate COPD (modCOPD, n = 30) or severe COPD (sevCOPD, n = 55). All of the patients performed a 6MWT, in a 27-m corridor with continuous SpO2 and HR monitoring by telemetry. We studied the SpO2 curves in order to determine the time to a 4% decrease in SpO2, the time to the minimum SpO2 (Tmin), and the post-6MWT time to return to the initial SpO2, the last designated recovery time (RT). For each of those curves, we calculated the slope. Results: The mean age in the modCOPD and sevCOPD groups was 66 ± 10 years and 62 ± 11 years, respectively. At baseline, SpO2 was > 94% in all of the patients; none received supplemental oxygen during the 6MWT; and none of the tests were interrupted. The six-minute walk distance did not differ significantly between the groups. The SpO2 values were lowest in the sevCOPD group. There was no difference between the groups regarding RT. In 71% and 63% of the sevCOPD and modCOPD group patients, respectively, a ≥ 4% decrease in SpO2 occurred within the first minute. We found that FEV1% correlated significantly with the ΔSpO2 (r = −0.398; p < 0.001), Tmin (r = −0.449; p < 0.001), and minimum SpO2 (r = 0.356; p < 0.005). Conclusions: In the sevCOPD group, in comparison with the modCOPD group, SpO2 was lower and the Tmin was greater, suggesting a worse prognosis in the former. .

Objetivo: Avaliar o comportamento da curva de saturação de oxigênio durante o teste de caminhada de seis minutos (TC6) em pacientes com DPOC. Métodos: Incluímos 85 pacientes e todos realizaram espirometria, sendo classificados como portadores de DPOC moderada (DPOCm, n = 30) ou grave (DPOCg, n = 55). Todos os pacientes realizaram TC6 em um corredor de 27 m com monitoramento contínuo da SpO2 e FC por telemetria. A partir das curvas de SpO2, foram analisados os tempos para atingir a queda de 4% da SpO2, para atingir a SpO2 mínima (Tmin) e para a recuperação da SpO2 após o TC6 (TR). Foram calculadas as inclinações dessas curvas. Resultados: A média de idade nos grupos DPOCm e DPOCg foi de 62 ± 11 anos e 66 ± 10 anos, respectivamente. Todos os pacientes iniciaram o teste com SpO2 > 94%, nenhum recebeu suplementação de oxigênio durante o TC6, e não houve interrupções. A distância percorrida no TC6 não apresentou diferença significativa entre os grupos. Os menores valores da SpO2 ocorreram no grupo DPOCg. Não houve diferença no TR entre os grupos, e 71% e 63% dos pacientes nos grupos DPOCg e DPOCm, respectivamente, apresentaram queda de SpO2 ≥ 4% até o primeiro minuto. O VEF1% apresentou correlações significativas com ΔSpO2 (r = −0,398; p < 0,001), Tmin (r = −0,449; p < 0,001) e SpO2 mínima (r = 0,356; p < 0,005). Conclusões: As curvas dos pacientes do grupo DPOCg em relação às do grupo DPOCm apresentaram valores menores de SpO2 e maior Tmin, sugerindo um pior prognóstico nos primeiros. .