RESUMO
INTRODUCTION: Physical inactivity in hemodialysis patients is associated with increased mortality. The objective of this study was evaluated the effect of an intradialytic resistance exercise program on chronic kidney disease (CKD) patients on hemodialysis. METHODS: One hundred seven patients were included in the study. They were aged 18-60 years, of both sexes, had undergone hemodialysis treatment for at least 1 year, sedentary. Patients were randomly divided into two groups: stretching (STG) and resistance exercise (REG). Intervention programs were performed for 8 weeks, three times a week. The evaluations were performed before and after the training programs. The primary outcome was functional capacity using the 6-minute walk test (6MWT). Secondary outcomes were peripheral muscle strength, respiratory muscle strength, spirometric respiratory function, and laboratory data. FINDINGS: Comparisons between groups revealed the following clinically relevant results in favor of REG: lower limb muscle strength (mean difference [MD] = -1.99, 95% confidence interval [CI] = -2.77 to -1.21; d = -0.53), distance walked in the 6MWT (MD = -26.27, 95% CI = -45.40 to -7.14; d = -0.46), creatinine (MD = -1.52, 95% CI = -2.49 to -0.54; d = -0.66), and calcium (MD = -0.44, 95% CI = -0.78 to -0.10; d = -0.49). DISCUSSION: CKD patients on hemodialysis have reduced functional capacity compared to healthy sedentary individuals. In turn, this reduction appears to be associated with a lower survival rate and affects the performance of their daily living activities. Thus, resistance exercise performed in the intradialytic phase is an effective therapeutic strategy for CKD patients, mainly because it increases functional capacity and lower limb muscle strength.
RESUMO
An autochthonous case of paracoccidioidomycosis was reported in a city of north Iran. This condition is a well-known endemic fungal infection highly prevalent in Latin American countries, with an incidence of 1 to 3.7 cases per 100.000 annually in Brazil. The classical features are cutaneous lesions, lymph node, and pulmonary involvements, while typical oral changes are superficial ulcers with hemorrhage and moriform aspect. Herein is reported an adult male patient with characteristic oral and pulmonary lesions. Rural environment, male gender, cigarette smoking, and alcohol abuse were risk factors; and clinical history, imaging studies, and histopathologic data established the diagnosis. The patient improved well by administration of sulfamethoxazole plus trimethoprim. The aim of this case study is to enhance the awareness of generalists about this mycosis.
