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[PMID]:29293261
[Au] Autor:Gibbons C; Pagnini F; Friede T; Young CA
[Ad] Endereço:The Primary Care Unit, University of Cambridge, Forvie Site, Robinson Way, Cambridge, Cambridgeshire, UK, CB2 0SR.
[Ti] Título:Treatment of fatigue in amyotrophic lateral sclerosis/motor neuron disease.
[So] Source:Cochrane Database Syst Rev;1:CD011005, 2018 Jan 02.
[Is] ISSN:1469-493X
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Amyotrophic lateral sclerosis (ALS), also known as motor neuron disease (MND), is terminal, progressive neurological condition for which there are no curative treatments. Among people with ALS/MND, fatigue is a common and debilitating symptom, which is characterised by reversible motor weakness and whole-body tiredness that is only partially relieved by rest. The effectiveness of pharmacological or non-pharmacological treatments for fatigue in ALS/MND is not yet established. OBJECTIVES: To assess the effects of pharmacological and non-pharmacological interventions for fatigue in ALS/MND. SEARCH METHODS: We searched the following databases on 5 September 2017: Cochrane Neuromuscular Specialised Register, CENTRAL, MEDLINE, Embase, PsycINFO, CINAHL Plus, and ERIC. We also searched two clinical trials registries. SELECTION CRITERIA: We selected randomised and quasi-randomised controlled trials of any intervention which sought to reduce fatigue for people with ALS/MND. We included studies if reduction in fatigue was a primary or secondary outcome of the trial. DATA COLLECTION AND ANALYSIS: We used the standard methodological procedures expected by Cochrane. MAIN RESULTS: We included one pharmacological (modafinil) study and three non-pharmacological studies (resistance exercise, respiratory exercise, and repetitive transcranial magnetic stimulation (rTMS)), involving a total of 86 participants with ALS/MND. None of the included studies were free from risk of bias. Since there was only one trial for each intervention, no meta-analysis was possible. All studies assessed fatigue using the Fatigue Severity Scale (FSS; scale from 9 to 63, higher scores indicate more fatigue). Information for assessing bias was often lacking in study reports, making the risk of bias unclear across several domains in all trials. Blinding of participants was not possible in exercise trials, but the outcome assessment was blinded.We found very low-quality evidence suggesting possible improvements in fatigue for modafinil treatment versus placebo (MD -11.00, 95% CI -23.08 to 1.08), respiratory exercise versus a sham intervention (MD -9.65, 95% CI -22.04 to 2.73), and rTMS versus sham rTMS (data not provided), which warrant further investigation to clarify the efficacy of these treatments for fatigue in ALS/MND. We found no clear improvements in fatigue for resistance exercise versus usual care (MD 0.20, 95% CI -10.98 to 11.38; very low-quality evidence).Three participants in the modafinil group dropped out of the modafinil study, two citing issues with headache and one with chest tightness; other adverse effects were anxiety, nausea, dizziness, and sialorrhoea (probably ALS-related). The trials reported no adverse effects of exercise or rTMS.We cannot be certain about the effects of any of the interventions studied because of imprecision (small numbers of participants, wide CI), and possible study limitations. AUTHORS' CONCLUSIONS: It is impossible to draw firm conclusions about the effectiveness of interventions to improve fatigue for people with ALS/MND as there are few randomised studies, and the quality of available evidence is very low.
[Mh] Termos MeSH primário: Esclerose Amiotrófica Lateral/complicações
Compostos Benzidrílicos/uso terapêutico
Exercícios Respiratórios/métodos
Fadiga/terapia
Treinamento de Resistência/métodos
Estimulação Magnética Transcraniana/métodos
[Mh] Termos MeSH secundário: Fadiga/etiologia
Seres Humanos
Ensaios Clínicos Controlados Aleatórios como Assunto
[Pt] Tipo de publicação:JOURNAL ARTICLE; REVIEW
[Nm] Nome de substância:
0 (Benzhydryl Compounds); R3UK8X3U3D (modafinil)
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180226
[Lr] Data última revisão:
180226
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:180103
[St] Status:MEDLINE
[do] DOI:10.1002/14651858.CD011005.pub2


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[PMID]:29254301
[Au] Autor:Shu M; Wang BY; Zhang J; Guo CY; Wang XH
[Ad] Endereço:Orthopedic Surgery Section 4, the 2nd Affiliated of Harbin Medical University, Harbin, China.
[Ti] Título:Analysis of specialized nursing on respiratory functions in thoracotomy patients.
[So] Source:J Biol Regul Homeost Agents;31(4):971-976, 2017 Oct-Dec.
[Is] ISSN:0393-974X
[Cp] País de publicação:Italy
[La] Idioma:eng
[Ab] Resumo:To analyze the nursing effect on the respiratory function of thoracotomy patients, sixty thoracotomy hospitalized patients were studied. The subjects were divided into a normal group (A) and an observation group (B). The patients in group A received routine nursing only, while those in group B received chest physiotherapy as well as routine nursing. Afterwards, the respiratory function indicators of the two groups were compared and a data analysis was performed. The results showed that the partial pressure of oxygen (PO2) value of the patients in group B was greater than that of the patients in group A while the partial pressure of carbon dioxide (PCO2) value in group B was smaller than that in group A, and there was a significant difference between the two groups (p less than 0.05). The vital capacity under normal circumstances and forced breathing of group B were greater than that of group A and the difference was statistically significant (p less than 0.05). The incidence of complications (atelectasis, respiratory infections, pleural effusion) was statistically significant between the two groups (p less than 0.05). The degree of autonomic respiratory dysfunction in group B was lower than that in group A, and there was a significant difference (p less than 0.05), suggesting that the respiratory function in patients receiving chest physiotherapy improved significantly.
[Mh] Termos MeSH primário: Exercícios Respiratórios/métodos
Drenagem Postural/métodos
Enfermagem em Pós-Anestésico/métodos
Enfermagem em Reabilitação/métodos
Toracotomia/reabilitação
[Mh] Termos MeSH secundário: Adulto
Feminino
Seres Humanos
Masculino
Massagem/métodos
Meia-Idade
Derrame Pleural/etiologia
Derrame Pleural/prevenção & controle
Atelectasia Pulmonar/etiologia
Atelectasia Pulmonar/prevenção & controle
Respiração
Testes de Função Respiratória
Infecções Respiratórias/etiologia
Infecções Respiratórias/prevenção & controle
Toracotomia/efeitos adversos
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180222
[Lr] Data última revisão:
180222
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171220
[St] Status:MEDLINE


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[PMID]:29267988
[Au] Autor:Rietberg MB; Veerbeek JM; Gosselink R; Kwakkel G; van Wegen EE
[Ad] Endereço:Department of Rehabilitation Medicine, Amsterdan Movement Sciences, MS Center Amsterdam, VU University Medical Center, De Boelelaan 1118, Amsterdam, Netherlands, 1007 MB.
[Ti] Título:Respiratory muscle training for multiple sclerosis.
[So] Source:Cochrane Database Syst Rev;12:CD009424, 2017 Dec 21.
[Is] ISSN:1469-493X
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Multiple sclerosis (MS) is a chronic disease of the central nervous system, affecting approximately 2.5 million people worldwide. People with MS may experience limitations in muscular strength and endurance - including the respiratory muscles, affecting functional performance and exercise capacity. Respiratory muscle weakness can also lead to diminished performance on coughing, which may result in (aspiration) pneumonia or even acute ventilatory failure, complications that frequently cause death in MS. Training of the respiratory muscles might improve respiratory function and cough efficacy. OBJECTIVES: To assess the effects of respiratory muscle training versus any other type of training or no training for respiratory muscle function, pulmonary function and clinical outcomes in people with MS. SEARCH METHODS: We searched the Trials Register of the Cochrane Multiple Sclerosis and Rare Diseases of the Central Nervous System Group (3 February 2017), which contains trials from the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, Embase, CINAHL, LILACS and the trial registry databases ClinicalTrials.gov and WHO International Clinical Trials Registry Platform. Two authors independently screened records yielded by the search, handsearched reference lists of review articles and primary studies, checked trial registers for protocols, and contacted experts in the field to identify further published or unpublished trials. SELECTION CRITERIA: We included randomized controlled trials (RCTs) that investigated the efficacy of respiratory muscle training versus any control in people with MS. DATA COLLECTION AND ANALYSIS: One reviewer extracted study characteristics and study data from included RCTs, and two other reviewers independently cross-checked all extracted data. Two review authors independently assessed risk of bias with the Cochrane 'Risk of bias' assessment tool. When at least two RCTs provided data for the same type of outcome, we performed meta-analyses. We assessed the certainty of the evidence according to the GRADE approach. MAIN RESULTS: We included six RCTs, comprising 195 participants with MS. Two RCTs investigated inspiratory muscle training with a threshold device; three RCTs, expiratory muscle training with a threshold device; and one RCT, regular breathing exercises. Eighteen participants (˜ 10%) dropped out; trials reported no serious adverse events.We pooled and analyzed data of 5 trials (N=137) for both inspiratory and expiratory muscle training, using a fixed-effect model for all but one outcome. Compared to no active control, meta-analysis showed that inspiratory muscle training resulted in no significant difference in maximal inspiratory pressure (mean difference (MD) 6.50 cmH O, 95% confidence interval (CI) -7.39 to 20.38, P = 0.36, I = 0%) or maximal expiratory pressure (MD -8.22 cmH O, 95% CI -26.20 to 9.77, P = 0.37, I = 0%), but there was a significant benefit on the predicted maximal inspiratory pressure (MD 20.92 cmH O, 95% CI 6.03 to 35.81, P = 0.006, I = 18%). Meta-analysis with a random-effects model failed to show a significant difference in predicted maximal expiratory pressure (MD 5.86 cmH O, 95% CI -10.63 to 22.35, P = 0.49, I = 55%). These studies did not report outcomes for health-related quality of life.Three RCTS compared expiratory muscle training versus no active control or sham training. Under a fixed-effect model, meta-analysis failed to show a significant difference between groups with regard to maximal expiratory pressure (MD 8.33 cmH O, 95% CI -0.93 to 17.59, P = 0.18, I = 42%) or maximal inspiratory pressure (MD 3.54 cmH O, 95% CI -5.04 to 12.12, P = 0.42, I = 41%). One trial assessed quality of life, finding no differences between groups.For all predetermined secondary outcomes, such as forced expiratory volume, forced vital capacity and peak flow pooling was not possible. However, two trials on inspiratory muscle training assessed fatigue using the Fatigue Severity Scale (range of scores 0-56 ), finding no difference between groups (MD, -0.28 points, 95% CI-0.95 to 0.39, P = 0.42, I = 0%). Due to the low number of studies included, we could not perform cumulative meta-analysis or subgroup analyses. It was not possible to perform a meta-analysis for adverse events, no serious adverse were mentioned in any of the included trials.The quality of evidence was low for all outcomes because of limitations in design and implementation as well as imprecision of results. AUTHORS' CONCLUSIONS: This review provides low-quality evidence that resistive inspiratory muscle training with a resistive threshold device is moderately effective postintervention for improving predicted maximal inspiratory pressure in people with mild to moderate MS, whereas expiratory muscle training showed no significant effects. The sustainability of the favourable effect of inspiratory muscle training is unclear, as is the impact of the observed effects on quality of life.
[Mh] Termos MeSH primário: Exercícios Respiratórios/métodos
Esclerose Múltipla/complicações
[Mh] Termos MeSH secundário: Tosse/fisiopatologia
Expiração/fisiologia
Seres Humanos
Inalação/fisiologia
Ensaios Clínicos Controlados Aleatórios como Assunto
Músculos Respiratórios
[Pt] Tipo de publicação:JOURNAL ARTICLE; META-ANALYSIS; REVIEW
[Em] Mês de entrada:1801
[Cu] Atualização por classe:180123
[Lr] Data última revisão:
180123
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171222
[St] Status:MEDLINE
[do] DOI:10.1002/14651858.CD009424.pub2


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[PMID]:28471492
[Au] Autor:Morrison L; Innes S
[Ad] Endereço:West of Scotland Adult CF Unit, Queen Elizabeth University Hospital (The Southern General Hospital), 1345 Govan Road, Glasgow, UK, G51 4TF.
[Ti] Título:Oscillating devices for airway clearance in people with cystic fibrosis.
[So] Source:Cochrane Database Syst Rev;5:CD006842, 2017 05 04.
[Is] ISSN:1469-493X
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Chest physiotherapy is widely prescribed to assist the clearance of airway secretions in people with cystic fibrosis. Oscillating devices generate intra- or extra-thoracic oscillations orally or external to the chest wall. Internally they create variable resistances within the airways, generating controlled oscillating positive pressure which mobilises mucus. Extra-thoracic oscillations are generated by forces outside the respiratory system, e.g. high frequency chest wall oscillation. This is an update of a previously published review. OBJECTIVES: To identify whether oscillatory devices, oral or chest wall, are effective for mucociliary clearance and whether they are equivalent or superior to other forms of airway clearance in the successful management of secretions in people with cystic fibrosis. SEARCH METHODS: We searched the Cochrane Cystic Fibrosis and Genetic Disorders Group Trials Register comprising references identified from comprehensive electronic database searches and hand searches of relevant journals and abstract books of conference proceedings. Latest search of the Cystic Fibrosis Trials Register: 27 April 2017.In addition we searched the trials databases ClinicalTrials.gov and the WHO International Clinical Trials Registry Platform. Latest search of trials databases: 26 April 2017. SELECTION CRITERIA: Randomised controlled studies and controlled clinical studies of oscillating devices compared with any other form of physiotherapy in people with cystic fibrosis. Single-treatment interventions (therapy technique used only once in the comparison) were excluded. DATA COLLECTION AND ANALYSIS: Two authors independently applied the inclusion criteria to publications and assessed the quality of the included studies. MAIN RESULTS: The searches identified 76 studies (302 references); 35 studies (total of 1138 participants) met the inclusion criteria. Studies varied in duration from up to one week to one year; 20 of the studies were cross-over in design. The studies also varied in type of intervention and the outcomes measured, data were not published in sufficient detail in most of these studies, so meta-analysis was limited. Few studies were considered to have a low risk of bias in any domain. It is not possible to blind participants and clinicians to physiotherapy interventions, but 11 studies did blind the outcome assessors.Forced expiratory volume in one second was the most frequently measured outcome. One long-term study (seven months) compared oscillatory devices with either conventional physiotherapy or breathing techniques and found statistically significant differences in some lung function parameters in favour of oscillating devices. One study identified an increase in frequency of exacerbations requiring antibiotics whilst using high frequency chest wall oscillation when compared to positive expiratory pressure. There were some small but significant changes in secondary outcome variables such as sputum volume or weight, but not wholly in favour of oscillating devices. Participant satisfaction was reported in 15 studies but this was not specifically in favour of an oscillating device, as some participants preferred breathing techniques or techniques used prior to the study interventions. The results for the remaining outcome measures were not examined or reported in sufficient detail to provide any high level evidence. AUTHORS' CONCLUSIONS: There was no clear evidence that oscillation was a more or less effective intervention overall than other forms of physiotherapy; furthermore there was no evidence that one device is superior to another. The findings from one study showing an increase in frequency of exacerbations requiring antibiotics whilst using an oscillating device compared to positive expiratory pressure may have significant resource implications. More adequately-powered long-term randomised controlled trials are necessary and outcomes measured should include frequency of exacerbations, individual preference, adherence to therapy and general satisfaction with treatment. Increased adherence to therapy may then lead to improvements in other parameters, such as exercise tolerance and respiratory function. Additional evidence is needed to evaluate whether oscillating devices combined with other forms of airway clearance is efficacious in people with cystic fibrosis.There may also be a requirement to consider the cost implication of devices over other forms of equally advantageous airway clearance techniques. Using the GRADE method to assess the quality of the evidence, we judged this to be low or very low quality, which suggests that further research is very likely to have an impact on confidence in any estimate of effect generated by future interventions.
[Mh] Termos MeSH primário: Oscilação da Parede Torácica/instrumentação
Fibrose Cística/complicações
Pneumopatias Obstrutivas/terapia
Depuração Mucociliar
Muco/secreção
Vibração/uso terapêutico
[Mh] Termos MeSH secundário: Adolescente
Adulto
Exercícios Respiratórios
Criança
Fibrose Cística/fisiopatologia
Progressão da Doença
Fluxo Expiratório Forçado
Volume Expiratório Forçado
Seres Humanos
Pneumopatias Obstrutivas/etiologia
Meia-Idade
Satisfação do Paciente
Ensaios Clínicos Controlados Aleatórios como Assunto
Escarro/secreção
[Pt] Tipo de publicação:JOURNAL ARTICLE; META-ANALYSIS; REVIEW
[Em] Mês de entrada:1708
[Cu] Atualização por classe:180116
[Lr] Data última revisão:
180116
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170505
[St] Status:MEDLINE
[do] DOI:10.1002/14651858.CD006842.pub4


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[PMID]:28756753
[Au] Autor:Sugimura A; Ando S; Tamakoshi K
[Ad] Endereço:Doctoral Program, Fundamental and Clinical Nursing, Department of Nursing, Nagoya University Graduate School of Medicine (Health Sciences) Nagoya, Japan.
[Ti] Título:Palliative care and nursing support for patients experiencing dyspnoea.
[So] Source:Int J Palliat Nurs;23(7):342-351, 2017 Jul 02.
[Is] ISSN:1357-6321
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:To investigate the association between the type of support provided by nurses for dyspnoea and palliative care practice in Japan, a cross-sectional questionnaire survey was conducted in 2015. Of the 535 questionnaires sent to nurses working at 22 designated cancer hospitals, 344 were returned. The questionnaire assessed the demographic characteristics of the nurses, nursing support for dyspnoea, and palliative care practice measured by the 'Palliative care self-reported practices scale'. Multivariate analysis showed that the domains of palliative care practice influenced the provision of nursing support for patients with dyspnoea. In conclusion, palliative care practice is important for supporting patients with dyspnoea, and nurses should possess the requisite knowledge and skills to deliver this care appropriately.
[Mh] Termos MeSH primário: Exercícios Respiratórios
Institutos de Câncer
Dispneia/enfermagem
Enfermagem de Cuidados Paliativos na Terminalidade da Vida
Neoplasias Pulmonares/enfermagem
Posicionamento do Paciente
[Mh] Termos MeSH secundário: Adulto
Estudos Transversais
Dispneia/etiologia
Análise Fatorial
Seres Humanos
Japão
Neoplasias Pulmonares/complicações
Meia-Idade
Análise Multivariada
Padrões de Prática em Enfermagem
Inquéritos e Questionários
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1709
[Cu] Atualização por classe:170926
[Lr] Data última revisão:
170926
[Sb] Subgrupo de revista:N
[Da] Data de entrada para processamento:170801
[St] Status:MEDLINE
[do] DOI:10.12968/ijpn.2017.23.7.342


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[PMID]:28714735
[Au] Autor:Kaminsky DA; Guntupalli KK; Lippmann J; Burns SM; Brock MA; Skelly J; DeSarno M; Pecott-Grimm H; Mohsin A; LaRock-McMahon C; Warren P; Whitney MC; Hanania NA
[Ad] Endereço:1 Department of Medicine, Division of Pulmonary and Critical Care, University of Vermont College of Medicine , Burlington, VT.
[Ti] Título:Effect of Yoga Breathing (Pranayama) on Exercise Tolerance in Patients with Chronic Obstructive Pulmonary Disease: A Randomized, Controlled Trial.
[So] Source:J Altern Complement Med;23(9):696-704, 2017 Sep.
[Is] ISSN:1557-7708
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:OBJECTIVE: Pulmonary rehabilitation improves exercise tolerance in patients with chronic obstructive pulmonary disease (COPD). However, many patients do not have access to pulmonary rehabilitation programs. We hypothesized that an alternative to pulmonary rehabilitation to improve exercise tolerance is the practice of pranayama, or yoga breathing, which could be done independently at home. We also sought to determine whether yoga nonprofessionals could adequately teach pranayama to patients. DESIGN: Proof-of-concept, randomized, double-blind, controlled pilot trial. SETTINGS/LOCATION: Two academic pulmonary practices. SUBJECTS: Forty-three patients with symptomatic, moderate-to-severe COPD. INTERVENTIONS: Twelve weeks of pranayama plus education versus education alone. Two yoga professionals trained the research coordinators to conduct all pranayama teaching and monitored the quality of the teaching and the practice of pranayama by study participants. OUTCOME MEASURES: The primary outcome was a change in the 6-min walk distance (6MWD). Secondary outcomes included changes in lung function, markers of oxidative stress and systemic inflammation, and measures of dyspnea and quality of life. RESULTS: The 6MWD increased in the pranayama group (least square mean [95% confidence interval] = 28 m [-5 to 61]) and decreased in the control group (-15 m [-47 to 16]), with a nearly significant treatment effect (p = 0.06) in favor of pranayama. Pranayama also resulted in small improvements in inspiratory capacity and air trapping. Both groups had significant improvements in various measures of symptoms, but no overall differences in respiratory system impedance or markers of oxidative stress or systemic inflammation. CONCLUSION: This pilot study successfully demonstrated that pranayama was associated with improved exercise tolerance in patients with COPD. Lay personnel were able to adequately teach patients to practice pranayama. These results suggest that pranayama may have significant clinical benefits for symptomatic patients with COPD, a concept that needs to be confirmed in future, larger clinical trials.
[Mh] Termos MeSH primário: Exercícios Respiratórios/métodos
Tolerância ao Exercício/fisiologia
Doença Pulmonar Obstrutiva Crônica/reabilitação
Ioga
[Mh] Termos MeSH secundário: Idoso
Feminino
Seres Humanos
Masculino
Meia-Idade
[Pt] Tipo de publicação:JOURNAL ARTICLE; RANDOMIZED CONTROLLED TRIAL
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171024
[Lr] Data última revisão:
171024
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170718
[St] Status:MEDLINE
[do] DOI:10.1089/acm.2017.0102


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[PMID]:28685539
[Au] Autor:Liu L; Liu DZ; Wang QP; Zhu ZL; Li HM; Lu XY
[Ad] Endereço:Xinxiang Central Hospital, Xinxiang City, China.
[Ti] Título:Respiratory training during rehabilitation of acute organic fluorine-poisoned patients treated by non-invasive positive pressure ventilation.
[So] Source:J Biol Regul Homeost Agents;31(2):371-376, 2017 Apr-Jun.
[Is] ISSN:0393-974X
[Cp] País de publicação:Italy
[La] Idioma:eng
[Ab] Resumo:This paper aimed to analyze the effects of respiratory training on pulmonary function during the rehabilitation period for acute organic fluorine-poisoned patients treated by non-invasive positive pressure ventilation (NIPPV). Sixty-two acute organic fluorine-poisoned patients admitted to the Xinxiang Central Hospital, Xinxiang City, China, from May 2012 to March 2016 were selected and randomly divided into an observation group and a control group, with 31 cases in each. Both groups received NIPPV. The patients in the control group exercised daily, while the patients in the observation group received contracting lips-abdominal breathing training. The therapeutic effects, pulmonary ventilation function, serum levels of α-antitrypsin1 (α-AT1), surfactant protein D (SP-D), neutrophil elastase (NE), transforming growth factor beta 1 (TGF-ß1), and quality of life were analyzed and compared between the two groups both before and after the administration of treatment. The total effective rate of the observation group was 93.55%, which was significantly higher when compared with the control group (74.19%) (P less than 0.05). The levels of forced expiratory volume in one second (FEV1), FEV1/FVC ratio, vital capacity (VC), carbon monoxide diffusion capacity (DLco), and maximal voluntary ventilation (MVV) of the observation group were better when compared with the control group and had statistical significance (P less than 0.05). Before treatment, the serum levels of α-AT1, SP-D, NE, and TGF-ß1, and quality of life had no statistical significance in either group (P>0.05); after treatment, these indexes and the quality of life for the observation group were significantly higher when compared with the control group, with statistical significance (P less than 0.05). The respiratory training in acute organic fluorine-poisoned patients treated by NIPPV can improve the serum indexes, dilute toxicity, and recover pulmonary function, which play key roles in improving the therapeutic effects and quality of life of patients, and is worthy of clinical promotion.
[Mh] Termos MeSH primário: Exercícios Respiratórios
Hidrocarbonetos Fluorados/envenenamento
Elastase de Leucócito/sangue
Respiração com Pressão Positiva
Proteína D Associada a Surfactante Pulmonar/sangue
Fator de Crescimento Transformador beta1/sangue
alfa 1-Antitripsina/sangue
[Mh] Termos MeSH secundário: Adulto
Feminino
Seres Humanos
Masculino
Meia-Idade
[Pt] Tipo de publicação:CLINICAL TRIAL; JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Hydrocarbons, Fluorinated); 0 (Pulmonary Surfactant-Associated Protein D); 0 (TGFB1 protein, human); 0 (Transforming Growth Factor beta1); 0 (alpha 1-Antitrypsin); EC 3.4.21.37 (Leukocyte Elastase)
[Em] Mês de entrada:1708
[Cu] Atualização por classe:170814
[Lr] Data última revisão:
170814
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170708
[St] Status:MEDLINE


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[PMID]:28539142
[Au] Autor:Lomax M; Massey HC; House JR
[Ti] Título:Inspiratory Muscle Training Effects on Cycling During Acute Hypoxic Exposure.
[So] Source:Aerosp Med Hum Perform;88(6):544-549, 2017 Jun 01.
[Is] ISSN:2375-6314
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:INTRODUCTION: Hypoxic environments increase the physiological demands of exercise. Inspiratory muscle training can reduce the demands of exhaustive exercise in this environment. This study examined the impact of inspiratory muscle training on moderate intensity hypoxic cycling exercise. METHODS: There were 17 healthy adult men who undertook 4 wk of inspiratory muscle training (N = 8) or 4 wk of sham inspiratory muscle training (N = 9). Subjects completed four fixed intensity (100 W) and duration (10 min) cycle ergometry tests. Two were undertaken breathing normoxic ambient air and two breathing a hypoxic gas mixture (14.6% oxygen, balance nitrogen). One normoxic and hypoxic test occurred before, and one after, inspiratory muscle training. RESULTS: Inspiratory muscle training increased maximal inspiratory mouth pressure by 21 ± 16 cmH2O. Arterial oxygen saturation and its ratio to minute ventilation also increased after inspiratory muscle training during hypoxic exercise from 83 ± 4% to 86 ± 3% (approximately 3%) and 2.95 ± 0.48 to 3.52 ± 0.54% · L · min-1(approximately 21%), respectively. In addition, minute ventilation and carbon dioxide output fell by 12-13% after inspiratory muscle training during hypoxic exercise. DISCUSSION: Inspiratory muscle training reduced the physiological demand of moderate intensity exercise during acute hypoxic, but not normoxic, exercise. It may therefore be of benefit in adults exercising in a hypoxic environment.Lomax M, Massey HC, House JR. Inspiratory muscle training effects on cycling during acute hypoxic exposure. Aerosp Med Hum Perform. 2017; 88(6):544-549.
[Mh] Termos MeSH primário: Exercícios Respiratórios/métodos
Dióxido de Carbono/metabolismo
Exercício/fisiologia
Hipóxia/metabolismo
Consumo de Oxigênio/fisiologia
Oxigênio/metabolismo
Ventilação Pulmonar
Músculos Respiratórios
[Mh] Termos MeSH secundário: Teste de Esforço
Voluntários Saudáveis
Seres Humanos
Masculino
Nitrogênio
Oximetria
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE; RANDOMIZED CONTROLLED TRIAL
[Nm] Nome de substância:
142M471B3J (Carbon Dioxide); 37291-87-5 (nitrox); N762921K75 (Nitrogen); S88TT14065 (Oxygen)
[Em] Mês de entrada:1707
[Cu] Atualização por classe:170731
[Lr] Data última revisão:
170731
[Sb] Subgrupo de revista:IM; S
[Da] Data de entrada para processamento:170526
[St] Status:MEDLINE
[do] DOI:10.3357/AMHP.4780.2017


  9 / 2887 MEDLINE  
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[PMID]:28502461
[Au] Autor:Zou Y; Zhao X; Hou YY; Liu T; Wu Q; Huang YH; Wang XH
[Ad] Endereço:Division of Cardiology, The First Affiliated Hospital of Soochow University, Suzhou, China; School of Nursing, Soochow University, Suzhou, China.
[Ti] Título:Meta-Analysis of Effects of Voluntary Slow Breathing Exercises for Control of Heart Rate and Blood Pressure in Patients With Cardiovascular Diseases.
[So] Source:Am J Cardiol;120(1):148-153, 2017 Jul 01.
[Is] ISSN:1879-1913
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Rising heart rate (HR) and elevated blood pressure (BP) cause a greater frequency of cardiovascular events. Many patients cannot maintain target HR and BP using pharmacological therapies. To evaluate the effectiveness of voluntary slow breathing exercises in reducing resting HR and BP, we searched Embase (1974 to April 2016), PubMed (1966 to April 2016), the Cochrane Central Register of Controlled Trials (issue 4, April 2016), and PEDro (www.pedro.org.au; 1999 to April 2016). The primary outcome was the mean change in HR at rest. Secondary outcomes included changes in systolic blood pressure (SBP) and diastolic blood pressure (DBP) as well as compliance with the breathing training. Finally, we included 6 studies consisting of 269 subjects. Practice of the breathing exercises resulted in statistically significant HR reduction (mean difference: -1.72 beats/min, 95% CI -2.70 to -0.75). Reductions were seen in SBP (mean difference: -6.36 mm Hg, 95% CI -10.32 to -2.39) and DBP (mean difference: -6.39 mm Hg, 95% CI -7.30 to -5.49) compared with the controls. Trial durations ranged from 2 weeks to 6 months. In conclusion, the existing evidence from randomized controlled trails demonstrates that short-term voluntary slow breathing exercises can reduce resting HR, SBP, and DBP for patients with cardiovascular diseases.
[Mh] Termos MeSH primário: Pressão Sanguínea/fisiologia
Exercícios Respiratórios/métodos
Doenças Cardiovasculares/terapia
Frequência Cardíaca/fisiologia
[Mh] Termos MeSH secundário: Doenças Cardiovasculares/fisiopatologia
Seres Humanos
[Pt] Tipo de publicação:JOURNAL ARTICLE; META-ANALYSIS; REVIEW
[Em] Mês de entrada:1708
[Cu] Atualização por classe:170809
[Lr] Data última revisão:
170809
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170516
[St] Status:MEDLINE


  10 / 2887 MEDLINE  
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[PMID]:28492791
[Au] Autor:Jaenisch RB; Bertagnolli M; Borghi-Silva A; Arena R; Lago PD
[Ad] Endereço:Laboratory of Experimental Physiology, Post-Graduation Program in Health Sciences, Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA), Porto Alegre, RS, Brazil.
[Ti] Título:Respiratory Muscle Training Improves Diaphragm Citrate Synthase Activity and Hemodynamic Function in Rats with Heart Failure.
[So] Source:Braz J Cardiovasc Surg;32(2):104-110, 2017 Mar-Apr.
[Is] ISSN:1678-9741
[Cp] País de publicação:Brazil
[La] Idioma:eng
[Ab] Resumo:INTRODUCTION:: Enhanced respiratory muscle strength in patients with heart failure positively alters the clinical trajectory of heart failure. In an experimental model, respiratory muscle training in rats with heart failure has been shown to improve cardiopulmonary function through mechanisms yet to be entirely elucidated. OBJECTIVE:: The present report aimed to evaluate the respiratory muscle training effects in diaphragm citrate synthase activity and hemodynamic function in rats with heart failure. METHODS:: Wistar rats were divided into four experimental groups: sedentary sham (Sed-Sham, n=8), trained sham (RMT-Sham, n=8), sedentary heart failure (Sed-HF, n=7) and trained heart failure (RMT-HF, n=7). The animals were submitted to a RMT protocol performed 30 minutes a day, 5 days/week, for 6 weeks. RESULTS:: In rats with heart failure, respiratory muscle training decreased pulmonary congestion and right ventricular hypertrophy. Deleterious alterations in left ventricular pressures, as well as left ventricular contractility and relaxation, were assuaged by respiratory muscle training in heart failure rats. Citrate synthase activity, which was significantly reduced in heart failure rats, was preserved by respiratory muscle training. Additionally, a negative correlation was found between citrate synthase and left ventricular end diastolic pressure and positive correlation was found between citrate synthase and left ventricular systolic pressure. CONCLUSION:: Respiratory muscle training produces beneficial adaptations in the diaphragmatic musculature, which is linked to improvements in left ventricular hemodynamics and blood pressure in heart failure rats. The RMT-induced improvements in cardiac architecture and the oxidative capacity of the diaphragm may improve the clinical trajectory of patients with heart failure.
[Mh] Termos MeSH primário: Exercícios Respiratórios/métodos
Citrato (si)-Sintase/metabolismo
Diafragma/enzimologia
Insuficiência Cardíaca/enzimologia
Insuficiência Cardíaca/fisiopatologia
Hemodinâmica/fisiologia
[Mh] Termos MeSH secundário: Animais
Pressão Sanguínea/fisiologia
Diafragma/fisiologia
Masculino
Modelos Animais
Infarto do Miocárdio/fisiopatologia
Ratos Wistar
Mecânica Respiratória/fisiologia
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
EC 2.3.3.1 (Citrate (si)-Synthase)
[Em] Mês de entrada:1708
[Cu] Atualização por classe:170828
[Lr] Data última revisão:
170828
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170512
[St] Status:MEDLINE



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