• Refine Query
  • Source
  • Publication year
  • to
  • Language
  • 14
  • Tagged with
  • 14
  • 14
  • 14
  • 14
  • 13
  • 13
  • 7
  • 5
  • 5
  • 5
  • 4
  • 3
  • 3
  • 3
  • 3
  • About
  • The Global ETD Search service is a free service for researchers to find electronic theses and dissertations. This service is provided by the Networked Digital Library of Theses and Dissertations.
    Our metadata is collected from universities around the world. If you manage a university/consortium/country archive and want to be added, details can be found on the NDLTD website.
11

For?a e endurance muscular inspirat?ria em crian?as e adolescentes com fibrose c?stica : compara??o com indiv?duos saud?veis

Vendrusculo, Fernanda Maria 05 March 2014 (has links)
Made available in DSpace on 2015-04-14T13:33:08Z (GMT). No. of bitstreams: 1 456334.pdf: 876900 bytes, checksum: 9a3a16228d37d2decb9f9e991320abe6 (MD5) Previous issue date: 2014-03-05 / Objectives : To evaluate inspiratory muscle strength and endurance in children and adolescents with cystic fibrosis (CF) in comparison with healthy subjects. Methods : This cross-sectional observational study evaluated CF patients (6 to 18 years old) and healthy subjects paired in a 1:2 proportion, for sex, age, height and weight. Spirometry, impulse oscillometry, plethysmography, manovacuometry and a protocol of inspiratory muscle endurance were performed. Data were analyzed using Student s t test and Pearson correlation coefficient. Results : Thirty four patients with CF were included in the study with a mean age of 12.6?2.9 years and twenty of them were boys (58.8%). The mean percentage of maximal inspiratory pressure (MIP%) was 118.5?25.8 and the endurance (percentage of MIP) was 60.9?13.3. Sixty eight healthy subjects were included and they presented a mean MIP% of 105.8?18.0 and an endurance of 65.3?12.3 of. CF patients had higher MIP% than healthy subjects and no significant difference in the endurance was shown. When restricting the analysis to CF patients without colonization by Pseudomonas aeruginosa and with forced expiratory volume in one second (FEV1) greater than 80% of predicted values, MIP% values were significantly higher and inspiratory muscle endurance was lower, in comparison with the control group. MIP correlated more significantly with forced vital capacity (r=0.44, p=0.01) and FEV1 (r=0.41, p=0.01), while endurance correlated better with total airway resistance (r=0.35, p=0.04) and with central airway resistance (r=0.48, p=0.04). Conclusion : Children and adolescents with CF present changes in inspiratory muscle strength and endurance that are associated differently with levels of pulmonary impairment. Furthermore, the significant strength associations are better related to pulmonary function parameters, while endurance is to airway resistance. / M?todos : Estudo observacional, transversal, em pacientes com FC (6 a 18 anos) e indiv?duos saud?veis pareados na propor??o de 1:2 por sexo, idade, altura e peso. Foram realizados espirometria, oscilometria de impulso, pletismografia, manovacuometria e protocolo de endurance muscular inspirat?ria. Para an?lise de dados utilizou-se os testes t de student e a correla??o linear de Pearson. Resultados : Foram inclu?dos 34 pacientes com FC, m?dia de idade de 14,0?2,7, sendo 20 pacientes (58,8%) do sexo masculino, com m?dia de press?o inspirat?ria m?xima percentual (PIMAX%) de 118,5?25,8 e de endurance (percentual da PIMAX) de 60,9?13,3. Tamb?m foram inclu?dos 68 indiv?duos saud?veis com m?dia de PIMAX% de 105,8?18,0 e de endurance de 65,3?12,3. Os pacientes com FC apresentaram maior PIMAX% do que os saud?veis e n?o apresentaram diferen?a significativa na endurance. Ao analisar separadamente os pacientes com FC sem coloniza??o por Pseudomonas aeruginosa e com volume expirat?rio for?ado no primeiro segundo (VEF1) maior do que 80% do previsto a PIMAX% foi significativamente maior nos pacientes com FC e a endurance muscular inspirat?ria foi menor em compara??o com os saud?veis. A PIMAX se correlacionou com capacidade vital for?ada (r=0,44; p=0,01) e com VEF1 (r=0,41; p=0,01) e a endurance se correlacionou com resist?ncia total das vias a?reas (r=0,35; p=0,04) e com a resist?ncia central das vias a?reas (r=0,48; p=0,04). Conclus?o : Crian?as e adolescentes com FC apresentam altera??es da for?a e da endurance muscular inspirat?ria que s?o distintas em diferentes n?veis de comprometimento pulmonar. Al?m disso, a for?a parece estar mais relacionada com par?metros da fun??o pulmonar e a endurance com a resist?ncia das vias a?reas.
12

Fisioterapia respirat?ria, capacidade de exerc?cio e predi??o de mortalidade em pacientes com fibrose c?stica

Vendrusculo, Fernanda Maria 09 March 2018 (has links)
Submitted by PPG Pediatria e Sa?de da Crian?a (pediatria-pg@pucrs.br) on 2018-04-27T17:58:37Z No. of bitstreams: 1 Tese de doutorado corrigida Fernanda.pdf: 4883244 bytes, checksum: b51a91fe19e35875a088cb500cc4add5 (MD5) / Approved for entry into archive by Caroline Xavier (caroline.xavier@pucrs.br) on 2018-05-14T11:21:02Z (GMT) No. of bitstreams: 1 Tese de doutorado corrigida Fernanda.pdf: 4883244 bytes, checksum: b51a91fe19e35875a088cb500cc4add5 (MD5) / Made available in DSpace on 2018-05-14T11:25:06Z (GMT). No. of bitstreams: 1 Tese de doutorado corrigida Fernanda.pdf: 4883244 bytes, checksum: b51a91fe19e35875a088cb500cc4add5 (MD5) Previous issue date: 2018-03-09 / Conselho Nacional de Pesquisa e Desenvolvimento Cient?fico e Tecnol?gico - CNPq / Introduction: Cystic fibrosis (CF) is a genetic, multisystemic disease characterized by progressive loss of lung function and airway obstruction. Thus, airflow limitation and dynamic hyperinflation may limit exercise capacity of these patients. In addition, exercise capacity has correlated with survival in children and adults with CF. Objective: To evaluate the effect of respiratory physiotherapy on exercise capacity and the role of maximal oxygen consumption as a predictor of mortality in CF patients. Methods: This thesis is divided into two articles. Article 1 was a prospective randomised, cross-over pilot study performed on children diagnosed with CF, aged >9 years and >128 cm tall. Two visits were performed with one month of interval, one with respiratory physiotherapy using positive expiratory pressure and autogenic drainage, before spirometry, plethysmography and the cardiopulmonary exercise test (CPET), and another without respiratory physiotherapy. The CPET was performed on a cycle ergometer using the Godfrey protocol. All tests followed international recommendations. Article 2 consisted of systematic review and meta-analysis, in which an online search was performed in PubMed, Embase, LILACS and SciELO databases. Were included cohort studies that assessed mortality rates after maximal oxygen uptake (VO2peak) measurements during CPET. The quality analysis of the selected articles was performed using the Newcastle-Ottawa scale. The main outcome evaluated was the mortality of CF patients. Whenever possible, and if appropriate, a random effect meta-analysis was performed. Results: Study 1 included 12 patients with CF with mean age of 12.83?1.85 years, body mass index in Z score was 0.08?0.82 and 75% of them presented at least one allele ?F508. No significant differences were found in maximal oxygen consumption with respiratory physiotherapy. However, there was a significant decrease in minute ventilation (VE) and ventilatory equivalents for oxygen consumption (VEVO2) and for carbon dioxide production (VEVCO2) at lactate threshold when respiratory physiotherapy was performed prior to CPET. The mean VE (L.min-1) was 26.67? 5.49 vs 28.92?6.30 (p=0.05), VEVO2 (L.min-1) was 24.5?1.75 vs 26.05?2.50 (p=0.03) and VEVCO2 (L.min-1) was 26.58?2.41 vs 27.98?2.11 (p=0.03). In study 2, six cohort studies were included, totaling 551 participants. Five studies were classified with high methodological quality. Two different analyzes were carried out to evaluate the influence of VO2peak on mortality. The significant standardized total difference between the VO2peak averages in the survival or non-survival groups was -0.606 (95%CI= -0.993 ? -0.219; p=0.002). In addition, patients with lower VO2peak were associated with a significantly higher mortality risk (RR: 4.896; 95%CI= 1.086 ? 22.072; p=0.039). Conclusion: The results suggest that the performance of respiratory physiotherapy prior to exercise may lead to improved ventilatory dynamics during exercise in CF patients. In addition, the systematic review with meta-analysis has shown that low levels of maximal oxygen uptake are associated with an increase of 4.8 in the risk of mortality, indicating that VO2peak could also be an important follow-up variable. / Introdu??o: A fibrose c?stica (FC) ? uma doen?a gen?tica, multissist?mica, caracterizada pela perda progressiva da fun??o pulmonar e obstru??o das vias a?reas. Assim, a limita??o ao fluxo a?reo e a hiperinsufla??o din?mica podem limitar da capacidade de exerc?cio desses pacientes. Al?m disso, a capacidade de exerc?cio t?m se correlacionado com a sobrevida de crian?as e adultos com FC. Objetivo: Avaliar o efeito da fisioterapia respirat?ria sobre a capacidade de exerc?cio e o papel do consumo m?ximo de oxig?nio como preditor de mortalidade em pacientes com FC. M?todos: Est? tese est? dividida em dois artigos. O artigo 1 foi um estudo piloto, prospectivo, randomizado e cross-over realizado em crian?as com diagn?stico de FC, com idade >9 anos e >128 cm de altura. Foram realizadas duas visitas com um m?s de intervalo, sendo uma com a realiza??o da fisioterapia respirat?ria utilizando press?o expirat?ria positiva e drenagem autog?nica, antes da espirometria, pletismografia e do teste de exerc?cio cardiopulmonar (TECP), e outra sem a realiza??o da fisioterapia respirat?ria. O TECP foi realizado no ciclo erg?metro com a utiliza??o do protocolo de Godfrey. Todos os testes seguiram as recomenda??es internacionais. O artigo 2 consistiu em uma revis?o sistem?tica e meta-an?lise, no qual foi realizada uma pesquisa on-line nas bases de dados PubMed, Embase, LILACS e SciELO. Foram inclu?dos estudos de coorte que avaliaram as taxas de mortalidade ap?s medi??es do consumo m?ximo de oxig?nio (VO2pico) durante um TECP. A an?lise de qualidade dos artigos selecionados foi realizada com a escala Newcastle-Ottawa. O principal desfecho avaliado foi a mortalidade de pacientes com FC. Sempre que poss?vel, e se apropriado, foi realizada uma meta-an?lise de efeito aleat?rio. Resultados: No estudo 1 foram inclu?dos 12 pacientes com FC com m?dia de idade de 12,83?1,85 anos, o ?ndice de massa corporal em escore Z foi 0,08?0,82 e 75% deles apresentavam um alelo ?F508. N?o foram encontradas diferen?as significativas no consumo m?ximo de oxig?nio com a realiza??o da fisioterapia respirat?ria. No entanto, houve uma diminui??o significativa na ventila??o minuto (VE) e nos equivalentes ventilat?rios para o consumo de oxig?nio (VEVO2) e para a produ??o de g?s carb?nico (VEVCO2) no limiar anaer?bico quando realizaram fisioterapia respirat?ria antes do TECP. A m?dia da VE (L.min-1) foi 26,67?5,49 vs 28,92?6,30 (p=0,05), VEVO2 (L.min-1) foi 24,5?1,75 vs 26,05?2,50 (p=0,03) e VEVCO2 (L.min-1) foi 26,58?2,41 vs 27,98?2,11 (p=0,03). No estudo 2 foram inclu?dos seis estudos de coorte, totalizando 551 participantes. Cinco estudos foram classificados com alta qualidade metodol?gica. Foram realizadas duas an?lises diferentes para avaliar a influ?ncia do VO2pico sobre a mortalidade. A diferen?a total padronizada significativa entre as m?dias do VO2pico nos grupos sobrevivente ou n?o-sobrevivente foi -0,606 (IC95%= -0,993 ? -0,219; p=0,002). Al?m disso, os pacientes com menor VO2pico foram associados a um risco de mortalidade significativamente maior (RR: 4,896; IC95%= 1,086 ? 22,072; p=0,039). Conclus?o: Os resultados obtidos sugerem que a realiza??o de fisioterapia respirat?ria antes do exerc?cio pode levar a uma melhora da din?mica ventilat?ria durante o exerc?cio em pacientes com FC. Al?m disso, a revis?o sistem?tica com meta-an?lise demonstrou que baixos n?veis de absor??o m?xima de oxig?nio est?o associados a um aumento de 4,8 vezes no risco de mortalidade na FC, indicando que o VO2pico tamb?m pode ser uma importante vari?vel de acompanhamento.
13

Associa??o entre as altera??es da via a?rea superior e marcadores de progress?o da doen?a em pacientes com fibrose c?stica

Steffen, Luciane Mazzini 22 March 2017 (has links)
Submitted by PPG Pediatria e Sa?de da Crian?a (pediatria-pg@pucrs.br) on 2018-07-12T11:24:06Z No. of bitstreams: 1 Disserta??oLu SteffenVers?oFinal.pdf: 1086203 bytes, checksum: 9b8f206613da0e87460cd6110bcec5ac (MD5) / Approved for entry into archive by Sheila Dias (sheila.dias@pucrs.br) on 2018-07-17T11:24:05Z (GMT) No. of bitstreams: 1 Disserta??oLu SteffenVers?oFinal.pdf: 1086203 bytes, checksum: 9b8f206613da0e87460cd6110bcec5ac (MD5) / Made available in DSpace on 2018-07-17T11:32:31Z (GMT). No. of bitstreams: 1 Disserta??oLu SteffenVers?oFinal.pdf: 1086203 bytes, checksum: 9b8f206613da0e87460cd6110bcec5ac (MD5) Previous issue date: 2017-03-22 / Coordena??o de Aperfei?oamento de Pessoal de N?vel Superior - CAPES / Introduction: Cystic Fibrosis is a disease characterized by recurrent infections and chronic inflammation of the respiratory system that lead to irreversible pulmonary complications. Infections are mainly caused by Staphilococcus aureos(SA) and Pseudomonas aeruginosa (PA). Early diagnosis for identification of colonizing germs is an important challenge. Guidelines suggest the use of swab cultures of the oropharynx or sputum. However, studies on molecular testing, or alternative methods of collection are still unconclusive. The involvement of the upper airway (nasopharynx and paranasal sinuses) has been cited as the primary source of infection. The present study aims to describe and compare the most frequent findings and pathogens in the nasal tract in patients with cystic fibrosis and to correlate findings with markers of severity and progression of lung disease. Methods: This is a retrospective study, which included patients with a diagnosis of Cystic Fibrosis (CF) who are followed up at the Multidisciplinary Outpatient Clinic of the Pediatric Pulmonology Unit of the Hospital S?o Lucas (Pontifical Catholic University of Rio Grande do Sul - PUCRS). Patients who have performed otorhinolaryngological evaluation (ENT) in the last two years (2015-2016) were included. The video naso endoscopy and nasal swab collection were part of the ENT evaluation. Results: 48 patients with CF were included, of which 30 (62.5%) were male. The mean age was 12.15 years ?6.60, and the mean predicted forced expiratory volume in the first second (FEV1%) was 83.36 ?30.04. When evaluating the presence and characteristic of nasal secretion, only 9 patients (18.7%) presented purulent secretion. Twenty-six patients (54.2%) presented grade 1 tonsils and 12 (25%) grade 2 or 3 patients. Nasal swab bacteriology was positive in 26 (54.1%) patients, from which 22 presented Staphylococcus aureos, 2 Pseudomonas aeruginosa, 1 Pseudomonas cepacea and 1 Stenotrophomonas maltophila (SM). In 22 patients (45.8%) the result of the culture was negative. In this study, patients who presented positive colonization by the traditional method (oropharynx / sputum) had a statistically significant chance of being identified also by nasal cavity culture (p<0.001). However, the association was not perfect, and showed a low correlation for the detection of gram negative germs. Nasal polyps were observed in 9 participants. When polyp is used as a marker of disease in nasal endoscopy, a strong association is observed between the presence of polyps and lower Shwachman-Kulczycki clinical score (p <0.001). Conclusions: the results of the culture obtained by collection of the nasal cavity were similar to those found by the standardized collection methods as markers of colonization of the inferior airway. In addition, nasal swabs is characterized as a non-invasive technique and showed to be sensitive to the identification of relevant pathogens in CF, especially SA. In addition, the presence of the polyp in the nasal cavity was shown to be associated with prognostic markers as Shwachman-Kulczycki clinical score. / Introdu??o: a fibrose c?stica ? uma patologia caracterizada por infec??es recorrentes e inflama??o cr?nica do sistema respirat?rio que levam a complica??es pulmonares, por vezes, irrevers?veis. As infec??es s?o causadas, principalmente pelos microorganismos Staphilococcusaureos(SA) e Pseudomonas aeruginosa(PA). O diagn?stico precoce para identifica??o dos germes colonizadores ? ainda um desafio. Consensos sugerem o uso de culturas de swab da orofaringe ou escarro. No entanto, pesquisa por testes moleculares como op??o, ou formas alternativas de coleta ainda s?o inconclusivos. O comprometimento da via a?rea superior (nasofaringe e seios paranasais) tem sido citada como fonte prim?ria de infec??o. O presente estudo tem por objetivo descrever e comparar as altera??es e os pat?genos mais frequentes no trato nasal em pacientes com fibrose c?stica e correlacionar os achados com marcadores de gravidade e progress?o da doen?a pulmonar. M?todos: este ? um estudo retrospectivo, que incluiu pacientes com diagn?stico de Fibrose C?stica (FC) que s?o acompanhados no Ambulat?rio Multidisciplinar de FC do Servi?o de Pneumologia Pedi?trica do Hospital S?o Lucas da Pontif?cia Universidade Cat?lica do Rio Grande do Sul (PUCRS), e que tenham realizado avalia??o otorrinolarigol?gica (ORL) entre os anos de 2015 e 2016. A videonasoendoscopia e a coleta de material da fossa nasal com o uso do swab fizeram parte da avalia??o ORL. Os marcadores de gravidade e progress?o da doen?a foram: ?ndice de massa corporal (IMC), volume expirat?rio for?ado no primeiro segundo(VEF1%) e o escore cl?nico de Shwachman-Kulczycki(S-K). Resultados: foram inclu?dos 48 pacientes com FC, sendo 30 (62,5%) do g?nero masculino. A m?dia de idade foi 12,15 anos ? 6,60, e a m?dia do percentual do valor previsto de volume expirat?rio for?ado no primeiro segundo (VEF1%) foi de 83,36 ? 30,04. Ao avaliar a presen?a e caracter?stica da secre??o nasal, apenas 9 pacientes (18,7%) apresentavam secre??o purulenta. Com rela??o as tonsilas far?ngeas, 26 pacientes (54,2%) apresentavam tonsilas grau 1 e 12 pacientes (25%) grau 2 ou 3. A bacteriologia do swab nasal foi positiva em 26 (54,1%) pacientes, onde 22 apresentavam Staphylococcus aureos, 2 Pseudomonas aeruginosa, 1 Pseudomonas cepacea e 1 Stenotrophomonas maltophila(SM). Em 22 pacientes (45,8%) o resultado da cultura foi negativo. Neste estudo, os pacientes que apresentavam coloniza??o positiva pelo m?todo tradicional (orofaringe/escarro), tinham uma chance estatisticamente significativa de serem identificados tamb?m pela cultura da cavidade nasal (p<0,001). Por?m a associa??o n?o ? perfeita, e demonstrou baixa correla??o para detec??o de germes gram negativos. Foram observados p?lipos nasais em 9 participantes. Quando utilizada a presen?a de p?lipo como marcador de doen?a na endoscopia nasal, observa-se uma forte associa??o entre a presen?a de p?lipos e o redu??o dos valores no escore cl?nico de Shwachman-Kulczycki (p<0,001). Conclus?es: os resultados da cultura obtidos pela coleta da fossa nasal foram semelhantes aos encontrados pelos m?todos de coleta padronizados como marcadores de coloniza??o da via a?rea inferior. Al?m de caracterizar-se como uma t?cnica pouco invasiva, o swab nasal mostra-se sens?vel ? identifica??o de pat?genos relevantes na FC, especialmente SA. Al?m disso, a presen?a do p?lipo na cavidade nasal mostrou ser um dado associado a marcadores de progn?stico medido pelo escore cl?nico de Shwachman-Kulczycki.
14

Avalia??o da aptid?o f?sica, for?a muscular perif?rica, atividade f?sica habitual e uso de antibi?ticos em pacientes com fibrose c?stica

Bueno, Gabriela Sabino 14 March 2018 (has links)
Submitted by PPG Pediatria e Sa?de da Crian?a (pediatria-pg@pucrs.br) on 2018-08-30T19:16:33Z No. of bitstreams: 1 DISSERTA??O Gabi Sabino 06FEV_.pdf: 1617758 bytes, checksum: 39ce4905f97356a47c068acdadc8690f (MD5) / Approved for entry into archive by Sheila Dias (sheila.dias@pucrs.br) on 2018-08-31T13:28:07Z (GMT) No. of bitstreams: 1 DISSERTA??O Gabi Sabino 06FEV_.pdf: 1617758 bytes, checksum: 39ce4905f97356a47c068acdadc8690f (MD5) / Made available in DSpace on 2018-08-31T13:41:55Z (GMT). No. of bitstreams: 1 DISSERTA??O Gabi Sabino 06FEV_.pdf: 1617758 bytes, checksum: 39ce4905f97356a47c068acdadc8690f (MD5) Previous issue date: 2018-03-14 / Coordena??o de Aperfei?oamento de Pessoal de N?vel Superior - CAPES / INTRODUCTION: Cystic fibrosis (CF) is an autosomal recessive genetic disease with chronic inheritance and systemic manifestations that compromises the normal function of several organs and systems, including the respiratory system. Thus, the progression of lung disease is still the factor of greater morbidity, leading to the reduction of exercise capacity. OBJECTIVES: To evaluate the physical and muscular performance of individuals with cystic fibrosis. METHODS: This is an observational cross-sectional study performed at a cystic fibrosis center. The sample was selected by convenience, including patients with clinical diagnosis of CF (sweat test and/or genetic evaluation) of both genders and aged ? 6 years. Patients were referred to perform the cardiopulmonary exercise test (CPET). In addition, demographic data (age and sex), anthropometric data (weight, height and BMI), pulmonary function (spirometry), genetic mutation and clinical information (pancreatic insufficiency and chronic colonization by Pseudomonas aeruginosa) were collected. At the end of the visit, the peripheral muscle strength test and the physical activity questionnaire were performed. Finally, the total number of days of antibiotic use (oral and intravenous) was recorded in the period of one year following CPET evaluation. RESULTS: Thirty-five patients with CF were evaluated. In general, pulmonary function data (% of predicted) were within the limits of normality, obtaining a mean of 83.1 for the forced expiratory volume in the first second (FEV1) and 90.4 for the forced vital capacity (FVC). Only 15 and 10 subjects presented FEV1 and FVC scores below normal, respectively. Regarding CPET, the mean maximum oxygen consumption (VO2max) (%) in the anaerobic threshold was 67.3, heart rate (bpm) was 154.3 and maximum ventilation (L/min) was 30.8. At peak exercise, we found a mean HRmax (% predicted maximum) of 90.2, a respiratory exchange coefficient of 1.1 and VO2max (% predicted) of 102.3, indicating the performance of a maximum test. Only 5 participants presented VO2max results below normal. No subjects had desaturation during and/or after the test. In the evaluation of the peripheral muscle strength (Kgf), we found an average around 20, for both biceps and quadriceps isometric strength. Regarding the physical activity questionnaire, we found habitual levels below recommended, obtaining a median of 30 and 102.5 minutes for moderate and vigorous activities, respectively. Of these, 10/24 were classified as inactive through this instrument. Although there were no correlations between FEV1 (p=0.063) and the use of antibiotic therapy with VO2max at peak exercise, there were weak and significant correlations of FVC with VO2max. Similarly, although there were no VO2max correlations at peak exercise with peripheral muscle strength data, we found moderate and significant correlations of VO2 at the anaerobic threshold with biceps and quadriceps isometric strength. No correlation was found between this variable and the strength of the hamstrings. Finally, subjects with a higher ventilatory reserve and lower resting heart rate did not require the use of antibiotics (ATB) one year after CPET. There was no significant differences FEV1 data were compared. CONCLUSION: The findings of the study demonstrated significant correlations of VO2 at the anaerobic threshold with peripheral muscle strength, showing that the higher the level of physical conditioning, the greater the results of peripheral muscle strength. It was also found that after one year of the proposed evaluations, those who had lower resting heart rate and greater ventilatory reserve in CPET did not require antibiotic therapy. / INTRODU??O: A fibrose c?stica (FC) ? uma doen?a gen?tica, de heran?a autoss?mica recessiva, com manifesta??es sist?micas que comprometem a fun??o normal de diversos ?rg?os e sistemas, dentre eles o respirat?rio. Assim, a progress?o da doen?a pulmonar ainda ? o fator de maior morbidade, levando ? redu??o da capacidade de exerc?cio. OBJETIVOS: Avaliar o desempenho f?sico e muscular de indiv?duos com fibrose c?stica. METODOS: Trata-se de um estudo observacional, do tipo transversal, realizado em um centro de fibrose c?stica. A amostra foi selecionada por conveni?ncia, incluindo pacientes com diagn?stico cl?nico de FC (teste do suor e/ou avalia??o gen?tica), de ambos os sexos e com idade ? 6 anos. Os pacientes foram encaminhados para realizar o teste de exerc?cio cardiopulmonar (TECP). Ainda, foram coletados os dados demogr?ficos (idade e sexo), antropom?tricos (peso, altura e IMC), de fun??o pulmonar (espirometria), gen?ticos (muta??o gen?tica) e as informa??es cl?nicas (insufici?ncia pancre?tica e coloniza??o cr?nica por Pseudomonas aeruginosa). No final da consulta, foram realizados o teste de for?a muscular perif?rica e o question?rio de atividade f?sica. Por fim, foi registrado o total de dias de uso de antibi?ticos (oral e endovenoso) no per?odo de um ano subsequente ? avalia??o do TECP. RESULTADOS: Foram avaliados 35 pacientes com diagn?stico de FC. De maneira geral, os dados de fun??o pulmonar (% do previsto) encontraram-se dentro dos limites da normalidade, obtendo-se uma m?dia de 83,1 de volume expirat?rio for?ado no primeiro segundo (VEF1) e de 90,4 de capacidade vital for?ada (CVF). Somente 15 e 10 sujeitos apresentaram resultados de VEF1 e CVF abaixo da normalidade, respectivamente. Quanto ao TECP, a m?dia do consumo m?ximo de oxig?nio (VO2m?x) (%) no limiar anaer?bio foi de 67,3, da frequ?ncia card?aca (bpm) de 154,3 e da ventila??o m?xima (L/min) de 30,8. No pico do exerc?cio, encontrou-se uma m?dia de 90,2 de FCm?x (% da m?xima prevista), de 1,1 para o coeficiente de troca respirat?ria e de 102,3 para o VO2m?x (% do previsto), indicando ser um teste de desempenho m?ximo. Apenas 5 participantes apresentaram resultados de VO2m?x abaixo da normalidade. Nenhum sujeito apresentou dessatura??o durante e/ou ap?s a realiza??o do teste. Na avalia??o da for?a muscular perif?rica (Kgf), encontrou-se uma m?dia em torno dos 20, tanto para a for?a isom?trica do b?ceps, quanto do quadr?ceps. J? quanto ao question?rio de atividade f?sica, foram encontrados n?veis habituais abaixo do recomendado, obtendo-se uma mediana de 30 e de 102,5 minutos para atividades moderadas e vigorosas, respectivamente. Destes, 10/24 foram classificados como inativos atrav?s desse instrumento. Embora n?o houve correla??es do VEF1 (p=0,063) e do uso de antibioticoterapia com o VO2m?x no pico do exerc?cio, encontrou-se correla??es fracas e significativas da CVF com o VO2m?x no TECP. Da mesma forma, apesar de n?o haver correla??es do VO2m?x no pico do exerc?cio com os dados de for?a muscular perif?rica, encontrou-se correla??es moderadas e significativas do VO2 no limiar anaer?bio com a for?a isom?trica do b?ceps e quadr?ceps. N?o foi encontrada correla??o dessa vari?vel com a for?a dos isquiotibiais. Por fim, os sujeitos com maior reserva ventilat?ria e menor frequ?ncia card?aca de repouso n?o necessitaram do uso de antibi?tico (ATB) um ano depois da realiza??o do TECP. N?o houve diferen?a significativa na compara??o dos dados quanto ao VEF1. CONCLUS?O: Os achados do estudo demonstraram correla??es significativas do VO2 no limiar anaer?bico com os dados de for?a muscular perif?rica, mostrando que quanto maior ? o n?vel de condicionamento f?sico, maior s?o os resultados de for?a muscular perif?rica. Constatou-se ainda que ap?s um ano das avalia??es propostas aqueles que possu?am frequ?ncia card?aca de repouso mais baixa e maior reserva ventilat?ria no TECP n?o necessitaram de antibioticoterapia.

Page generated in 0.0651 seconds