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Artigo Blockchain in health information systems: a systematic review(International Journal of Environmental Research and Public Health, 2024-11-14) Fonsêca, Aleika Lwiza Alves; Barbalho, Ingridy Marina Pierre; Fernandes, Felipe Ricardo dos Santos; Arrais Júnior, Ernano; Nagem, Danilo Alves Pinto; Cardoso, Pablo Holanda; Veras, Nícolas Vinícius Rodrigues; Farias, Fernando Lucas de Oliveira; Lindquist, Ana Raquel; Santos, João Paulo Queiroz dos; Morais, Antonio Higor Freire de; Henriques, Jorge; Lucena, Marcia Jacyntha Nunes Rodrigues; Valentim, Ricardo Alexsandro de MedeirosAbstract: (1) Background: With the increasing digitalization of healthcare systems, data security and privacy have become crucial issues. In parallel, blockchain technology has gradually proven to be an innovative solution to address this challenge, as its ability to provide an immutable and secure record of transactions offers significant promise for healthcare information management. This systematic review aims to explore the applications of blockchain in health information systems, highlighting its advantages and challenges. (2) Methods: The publications chosen to compose this review were collected from six databases, resulting in the initial identification of 4864 studies. Of these, 73 were selected for in-depth analysis. (3) Results: The main results show that blockchain has been used mainly in electronic health records (63%). Furthermore, it was used in the Internet of Medical Things (8.2%) and for data sharing during the COVID-19 pandemic (6.8%). As advantages, greater security, privacy, and data integrity were identified, while the challenges point to the need for standardization and regulatory issues. (4) Conclusions: Despite the difficulties encountered, blockchain has significant potential to improve healthcare data management. However, more research and continued collaboration between those involved are needed to maximize its benefitsArtigo Impactos da covid-19 no trabalho colaborativo na atenção primária à saúde(2023) Almeida Júnior, José Jailson de; Xavier, Pedro Bezerra; Silva, Ísis de Siqueira; Magalhães, Adriana Gomes; Guedes, Dimitri TaurinoO estudo tem como tema o impacto da pandemia no trabalho colaborativo na Atenção Primária à Saúde. O objetivo é analisar os impactos da pandemia da COVID-19 no trabalho colaborativo na Atenção Primária à Saúde. Trata-se de um estudo exploratório, descritivo de abordagem qualitativa, tendo como campo de investigações as Unidades Básicas de Saúde da Família do município de Campina Grande, Paraíba. A amostra do estudo foi composta por profissionais de saúde vinculados à Estratégia Saúde da Família. Entre as equipes selecionadas, foram entrevistados 31 participantes. Os resultados evidenciam que a pandemia da COVID-19 causou impactos significativos em diversas ações de saúde, especialmente aquelas relacionadas às interações em grupos, como prevenção e vigilância em saúde. A dinâmica do trabalho das equipes foi alterada, diante da necessidade de reorganização das atividades, afetando diretamente o trabalho interprofissional e as práticas colaborativas em saúde. Os achados deste estudo também apontaram que antes do advento da pandemia, o trabalho interprofissional já estava sofrendo modificações, influenciado principalmente pelo cenário político. Conclui-se que há a necessidade da reorganização dos papéis de cada membro da equipe da APS, para alcançar o domínio e a execução das práticas colaborativas, fundamentais para promover o cuidado em sua integralidade. Esses resultados são relevantes, e poderão contribuir para as decisões futuras acerca da temática, este estudo revela ações, que foram prejudicadas durante a pandemia, e que necessitam de maior atenção e fortalecimento no atual momentoArtigo Urinary incontinence in physically active older women of northeast Brazil(International Journal Of Environmental Research And Public Health, 2021) Souza, Dyego Leandro Bezerra de; Guedes, Thais Sousa Rodrigues; Guedes, Marcello Barbosa Otoni Gonçalves; Oliveira, Hévila Kilvia Miguel de; Soares, Rodrigo Lopes; Cunha, Vitor Leandro da; Lopes, Johnnatas Mikael; Oliveira, Nayara Priscila Dantas de; Roig, Javier Jerez; https://orcid.org/0000-0001-8426-3120Low- and moderate-impact physical activity (PA) is associated with the prevention of urinary incontinence (UI). The objective of the cross-sectional study presented herein is to analyze the factors associated with UI in physically older active women who participate in senior community groups. The variable UI was measured by the International Consultation Incontinence Questionnaire Short Form (ICIQ-SF). Socioeconomic variables were also collected, along with data on life habits and clinical history. The multivariate analysis employed Poisson’s Regression with robust variance for factors associated with UI. Of the 106 participants evaluated, 54.7% presented UI, of which stress incontinence was more frequent, with 40.6%. UI presented a statistically significant association with dizziness/loss of balance during Activities of Daily Living (ADL) (prevalence ratio-PR 1.48; 95% CI 1.06–2.07) and nocturia (PR 1.63; 95% CI 1.05–2.55). Despite PA being a protection factor, UI presented an elevated prevalence in the older population, and therefore, other biological, social, and cultural aspects could also contribute to the occurrence of UI in this age group. Moreover, physically active older women with UI presented nocturia and dizziness/loss of balance during ADL, regardless of education levels and the number of births. These findings can help improve multi-professional programs aimed at promoting, preventing, and managing UI in the publicArtigo Sexual dysfunction in women with cancer: a systematic review of longitudinal studies(International Journal Of Environmental Research And Public Health, 2022) Souza, Dyego Leandro Bezerra de; Guedes, Thais Sousa Rodrigues; Guedes, Marcello Barbosa Otoni Gonçalves; Santana, Rebeca de Castro; Silva, José Felipe Costa da; Dantas, Amanda Almeida Gomes; Monllor, Marc Terradas; Roig, Javier Jerez; https://orcid.org/0000-0001-8426-3120Abstract: Background: Several factors affect sexual function, including cancer development and treatment. This study summarized the risk of women with cancer of developing sexual dysfunctions. Methods: This systematic review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). We searched the EMBASE, PubMed, LILACS, SciELO, CINAHL, Scopus, and Web of Science databases using the descriptors cancer, neoplasms, sexual dysfunction, sexual function, and women. The Quality Assessment Tool for Observational Cohort and Cross-Sectional Studies assessed the quality of studies. Results: Sixteen studies were included in this review. Women with cancer presented sexual dysfunctions in 14 out of 16 included studies. The incidence of sexual dysfunctions ranged from 30% to 80%, while the risk of developing sexual dysfunction increased 2.7- and 3.5-fold in women with cervical and breast cancer, respectively. Conclusion: Different cancer treatments increase the risk of developing sexual dysfunction in women, especially desire, arousal, and orgasm, leading to biopsychosocial changes in the health of this populationArtigo Confiabilidade do teste da caminhada de seis minutos em pacientes com miastenia gravis generalizada(Fisioterapia e Pesquisa, 2009) Dourado Junior, Mário Emílio Teixeira; Resqueti, Vanessa Regiane; Oliveira, Georges Willeneuwe de Sousa; Andrade, Armèle Dornelas de; Casan, Pere; Fregonezi, Guilherme Augusto de Freitas; https://orcid.org/0000-0002-9462-2294Este estudo objetivou determinar a confiabilidade do teste da caminhada de seis minutos (TC6M) como um teste de capacidade funcional em pacientes com miastenia gravis generalizada (MG). Foram selecionados 11 pacientes com MG - 5 homens, 6 mulheres - com idade de 55±9 anos, avaliados inicialmente quanto à função fulmonar, que se submeteram a três TC6M em dias diferentes. Durante e/ou após cada teste foram medidas freqüência cardíaca e saturação de oxigênio (por oxímetro portátil), sensação de dispnéia (pela escala de Borg) e distância percorrida. Nos três testes as distâncias percorridas foram 498 m, 517 m e 520 m (respectivamente 99%, 103% e 104% do valor predito). Em média, a freqüência cardíaca, dispnéia e saturação de oxigênio mostraram comportamento constante nos três testes. Foram encontradas alta confiabilidade relativa, com coeficiente de correlação interclasse maior que 0,90 entre os testes (TC6M1-TC6M2, 0,960; TC6M1-TC6M3, 0,945; e TC6M2-TC6M3, 0,970) e confiabilidade absoluta de 4%, 3,5% e 4,8%, com reprodutibilidade de 11%, 9,8% e 13,4%, respectivamente para o primeiro, segundo e terceiro testes. Os limites superiores e inferiores de concordância e o valor médio das médias das diferenças (bias) calculados pelo teste de Bland-Altman mostraram-se clinicamente aceitáveis. Conclui-se que o TC6M se mostrou seguro, confiável e reprodutível, podendo ser aplicado para avaliação e seguimento da tolerância ao exercício em pacientes com MG generalizada.Artigo Effects of respiratory muscle training on respiratory muscle strength and heart rate variability in myotonic dystrophy patients type 1(Journal of Respiratory and CardioVascular Physical Therapy, 2012) Dourado Junior, Mário Emílio Teixeira; Araújo, Thayse Lucena; Resqueti, Vanessa Regiane; Lima, Illia Nadinne Dantas Florentino; Fregonezi, Guilherme; https://orcid.org/0000-0002-9462-2294Introduction: Myotonic dystrophy (MD) is a multisystemic neuromuscular disease responsible for causing progressive respiratory muscle weakness. Respiratory muscle training (MRT) has been shown to be effective in several diseases; however, its effects on respiratory and cardiac functions in MD are still inconsistent. Objective: Assess the effects of MRT on respiratory muscle strength and heart rate variability in patients with type 1 myotonic dystrophy. Methods: The sample was composed of 6 individuals of both sexes. The following was assessed: respiratory muscle strength, before and after training (sessions 1-4) and heart rate variability before and after sessions 2 and 3. The group submitted to MRT used the Threshold IMT device, adapted for inspiratory and expiratory training, three times a week, once at an outpatient facility and twice at home. Results were expressed as median and interquartile ranges for pulmonary function variables, and the Friedman and Wilcoxon tests were applied to compare heart rate variability. Results: respiratory muscle strength significantly improved expiratory and inspiratory muscles (33% and 20%, respectively), considering training sessions 1-4. With respect to variability, there was a 102% increase in sympathetic activity, reflected by low frequency and 194% increase in vagal tonus, represented by high frequency. Conclusions: Preliminary study results demonstrate that a partial home-based respiratory muscle-training program is feasible, in addition to improving strength and heart rate variability in patients with MD.Artigo Variabilidade da frequência cardíaca em pacientes com distrofia miotônica tipo 1(Arquivos Brasileiros de Cardiologia, 2012) Dourado Junior, Mário Emílio Teixeira; Fregonezi, Guilherme Augusto de Freitas; Araújo, Thaise Lucena; Sa, Joceline Cassia Ferezini de; Resqueti, Vanessa Regiane Resqueti; Silva, Ester; https://orcid.org/0000-0002-9462-2294FUNDAMENTO: O envolvimento cardíaco é comum em pacientes com Distrofia Miotônica (DM). A Variabilidade da Frequência Cardíaca (VFC) é uma técnica simples e confiável que pode ser útil para estudar a influência do sistema nervoso autonômico sobre o coração. OBJETIVO: Estudar a variabilidade da frequência cardíaca em pacientes com DM tipo 1. MÉTODOS: Estudamos a VFC durante registros de 5 minutos em pacientes com DM em um grupo controle saudável. Analisamos os domínios da frequência (BF e AF) em unidades normalizadas (un) e balanço simpático-vagal, na posição sentada e em decúbito dorsal. RESULTADOS: Dezessete pacientes (10 homens e 7 mulheres) e dezessete indivíduos pareados saudáveis (10 homens e 7 mulheres) foram estudados. As modulações simpática e parassimpática do coração elevadas em pacientes do sexo masculino com DM da posição em decúbito dorsal para a posição sentada em 19% da AFun e a razão BF/AF aumentaram 42,3%. Na posição sentada, os pacientes do sexo masculino com DM apresentaram balanços simpático-vagal significativamente mais elevados em 50,9% em comparação com indivíduos controles saudáveis. A VFC foi influenciada tanto pelo sexo quanto pela enfermidade apresentada. O sexo influenciou a AFun na posição em decúbito dorsal, enquanto a razão BF/AF e AFun foi afetada em ambas as posições. Análises post hoc mostraram que o sexo afeta significativamente pacientes com DM e indivíduos saudáveis de diferentes maneiras (p < 0,01). O domínio de baixa frequência na posição sentada (AFun) foi significativamente influenciado pela enfermidade. CONCLUSÃO: Os resultados deste estudo sugerem que o estímulo simpático em pacientes de meia-idade do sexo masculino com DM que não está gravemente comprometido e apresenta duração moderada da doença parece ser maior do que em indivíduos saudáveis pareados.Artigo Força muscular respiratória e perfil postural e nutricional em crianças com doenças neuromusculares(Fisioterapia em Movimento, 2012) Dourado Junior, Mário Emílio Teixeira; Pontes, Jaqueline Fernandes; Ferreira, Gardenia Maria Holanda; Fregonezi, Guilherme; Evangelista, Karine Cavalcanti Maurício de Sena; https://orcid.org/0000-0002-9462-2294As doenças neuromusculares infantis são crônicas, degenerativas e determinam alterações funcionais, musculares e nutricionais. OBJETIVOS: Avaliar sistematicamente a força muscular respiratória e o perfil postural e nutricional de crianças com doenças neuromusculares em seguimento multidisciplinar institucional. MATERIAIS E MÉTODOS: Foram estudados pacientes com diferentes doenças neuromusculares por meio da verificação da força muscular respiratória, da avaliação nutricional de massa muscular, do índice de massa corpórea e da porcentagem (%) de gordura corporal, além de avaliação postural e dos padrões de movimento. RESULTADOS: Foram avaliados 41 sujeitos. As crianças do sexo masculino predominaram na população em estudo, sendo 82,9% dela (n = 34), e os outros 17,1% (n = 7) eram do sexo feminino. A média de idade encontrada foi de 9,65 ± 3,11 anos. O principal diagnóstico encontrado foi Distrofia Muscular de Duchenne, 43,9% (n = 18), seguido de Atrofia Muscular Espinhal, 9,75% (n = 4), Distrofia Congênita, 7,31% (n = 3), Distrofia Muscular de Cinturas, Polineuropatia e Miopatia Congênita, todos com 4,9% (n = 2), além de Distrofia Muscular Progressiva, Miastenia Grávis, Charcoot Marie Toot, Emery Dreifuss, encontrados em 2,43% (n = 1). Foi verificada uma diminuição da força muscular respiratória (PImáx = 81 ± 24,3 cmH2O, 91% predito e PEmáx = 70 ± 29,6 cmH2O, 72% predito), mais evidente nos músculos expiratórios. A Hiperlordose lombar foi encontrada em 26 pacientes (64%) e 9 pacientes (22%) já haviam perdido a capacidade de deambular. Em relação ao perfil nutricional, 90% dos pacientes (n = 30) mostraram uma alta incidência de perda de reserva muscular e 52% deles (n = 13) apresentaram a porcentagem de gordura corporal abaixo do aceitável. CONCLUSÃO: A avaliação multidisciplinar das doenças neuromusculares pediátricas podem auxiliar no estabelecimento de tratamento precoce da Fisioterapia para melhorar a qualidade de vida dos pacientes e cuidadores.Artigo Monitoring respiratory muscle strength assists in early diagnosis of respiratory dysfunction as opposed to the isolated use of pulmonary function evaluation in amyotrophic lateral sclerosis(Arquivos de Neuro-Psiquiatria, 2013-03) Dourado Junior, Mário Emílio Teixeira; Fregonezi, Guilherme; Araújo, Paloma Russelly Saldanha; Macêdo, Tathiana Lindemberg Ferreira; Resqueti, Vanessa Regiane; Andrade, Armele de Fátima Dornelas de; https://orcid.org/0000-0002-9462-2294Objetivo: Estudar a relação entre a força dos músculos respiratórios e a capacidade vital forçada (CVF) em pacientes com esclerose lateral amiotrófica (ELA) e sujeitos saudáveis. Métodos: Avaliamos a função pulmonar e a força dos músculos respiratórios [pressão inspiratória (PImax), pressão expiratória (PEmax) e pressão inspiratória nasal de sniff (SNIP)] utilizando pontos de corte estabelecidos na literatura para diagnóstico de fraqueza muscular respiratória. Resultados: Foram estudados 28 pacientes com ELA e 28 sujeitos saudáveis. Encontramos sensibilidade e especificidade para PImax, PEmax e SNIP de 75/58%, 81/67% e 75/67%. A curva ROC (Receiver Operating Characteristic) indicou que as variáveis PImax, PEmax e SNIP podem identificar diferenças na força dos músculos respiratórios em pacientes com ELA versus sujeitos saudáveis em 0,89, 0,9 e 0,82 respectivamente. Foi encontrada uma correlação positiva entre CVF (%) e SNIP, PImax e PEmax. Conclusão: Em pacientes com ELA, o monitoramento da força muscular respiratória auxilia no diagnóstico precoce da disfunção em detrimento do uso da CVF isolada.Artigo Muscle impairment in neuromuscular disease using an expiratory/inspiratory pressure ratio(Respiratory Care, 2015) Dourado Junior, Mário Emílio Teixeira; Fregonezi, Guilherme; Azevedo, Ingrid G; Resqueti, Vanessa R; Andrade, Arme`le D De; Gualdi, Lucien P; Aliverti, Andrea; Parreira, Veronica F; https://orcid.org/0000-0002-9462-2294Neuromuscular diseases (NMDs) lead to different weakness patterns, and most patients with NMDs develop respiratory failure. Inspiratory and expiratory muscle strength can be measured by maximum static inspiratory pressure (PImax) and maximum static expiratory pressure (PEmax), and the relationship between them has not been well described in healthy subjects and subjects with NMDs. Our aim was to assess expiratory/inspiratory muscle strength in NMDs and healthy subjects and calculate PEmax/PImax ratio for these groups. METHODS: Seventy (35 males) subjects with NMDs (amyotrophic lateral sclerosis, myasthenia gravis, and myotonic dystrophy), and 93 (47 males) healthy individuals 20 – 80 y of age were evaluated for anthropometry, pulmonary function, PImax, and PEmax, respectively. RESULTS: Healthy individuals showed greater values for PImax and PEmax when compared with subjects with NMDs. PEmax/PImax ratio for healthy subjects was 1.31 0.26, and PEmax%/PImax% was 1.04 0.05; for subjects with NMDs, PEmax/PImax ratio was 1.45 0.65, and PEmax%/PImax% ratio was 1.42 0.67. We found that PEmax%/PImax% for myotonic dystrophy was 0.93 0.24, for myasthenia gravis 1.94 0.6, and for amyotrophic lateral sclerosis 1.33 0.62 when we analyzed them separately. All healthy individuals showed higher PEmax compared with PImax. For subjects with NMDs, the impairment of PEmax and PImax is different among the 3 pathologies studied (P < .001). CONCLUSIONS: Healthy individuals and subjects with NMDs showed higher PEmax in comparison to PImax regarding the PEmax/PImax ratio. Based on the ratio, it is possible to state that NMDs show different patterns of respiratory muscle strength loss. PEmax/PImax ratio is a useful parameter to assess the impairment of respiratory muscles in a patient and to customize rehabilitation and treatment.Artigo Effects of air stacking maneuver on cough peak flow and chest wall compartmental volumes of subjects with amyotrophic lateral sclerosis(Elsevier, 2017) Dourado Junior, Mário Emílio Teixeira; Sarmento, Antonio; Resqueti, Vanessa Resqueti; Saturnino, Lailane; Aliverti, Andrea; Fregonezi, Guilherme; Andrade, Armele Dornelas de; https://orcid.org/0000-0002-9462-2294Objectives To assess the acute effects of air stacking on cough peak flow (CPF) and chest wall compartmental volumes of persons with amyotrophic lateral sclerosis (ALS) versus healthy subjects positioned at 45° body inclination. Design Cross-sectional study with a matched-pair design. Setting University hospital. Participants Persons (N=24) with ALS (n=12) and age-matched healthy subjects (n=12). Main Outcomes Measures CPF, chest wall compartmental inspiratory capacity, chest wall vital capacity, chest wall tidal volume and operational volumes, breathing pattern, and percentage of contribution of the compartments to the inspired volume were measured by optoelectronic plethysmography. Results Compared with healthy subjects, significantly lower CPF (P=.007), chest wall compartmental inspiratory capacity (P<.001), chest wall vital capacity (P<.001), and chest wall tidal volume (P<.001) were found in subjects with ALS. Immediately after air stacking, CPF (P<.001) and chest wall compartmental inspiratory capacity (P<.001) significantly increased in both groups, with values returning to basal only in healthy subjects. After air stacking, the abdominal compartment (P=.004) was determined to be responsible for the inspired volume in subjects with ALS. Significantly higher chest wall vital capacity (P=.05) was observed in subjects with ALS 5 minutes after air stacking, with the rib cage compartment (P=.049) being responsible for volume change. No differences were found in chest wall vital capacity and compartmental volumes of healthy subjects. Chest wall tidal volume (P<.001) significantly increased during the protocol in the healthy subjects, mainly because of end-inspiratory (P<.001) and abdominal volumes (P=.008). No significant differences were observed in percentage of contribution of the compartments to the inspired volume and end-expiratory volume of both groups. No significant differences were found in chest wall tidal volume, operational volume, and breathing pattern in persons with ALS. Conclusions Air stacking is effective in increasing CPF, chest wall compartmental inspiratory capacity, and chest wall vital capacity of persons with ALS with no hyperinflation. Differences in compartmental volume contributions are probably because of lung and chest wall physiological changes.Artigo Multiparametric analysis of sniff nasal inspiratory pressure test in middle stage amyotrophic lateral sclerosis(Frontiers in Neurology, 2018-05-02) Dourado Junior, Mário Emílio Teixeira; Sarmento, Antonio; Aliverti, Andrea; Marques, Layana; Pennati, Francesca; Fregonezi, Guilherme; Fregonezi, Vanessa Regiane Resqueti; https://orcid.org/0000-0002-9462-2294The relaxation rates and contractile properties of inspiratory muscles are altered with inspiratory muscle weakness and fatigue. This fact plays an important role in neuromuscular disorders patients and had never been extensively studied in amyotrophic lateral sclerosis (ALS). In this cross-sectional study, these parameters were investigated non-invasively through nasal inspiratory sniff pressure test (SNIP) in 39 middle stage spinal onset ALS subjects and compared with 39 healthy controls. ALS patients were also divided into three subgroups according to a decline in their percentage of predicted forced vital capacity (FVC%pred) as well as a decline in the ALS functional rating scale score and its respiratory subscore (R-subscore) in order to determine the best parameter linked to early respiratory muscle weakness. When compared with healthy subjects, middle stage ALS subjects exhibited a significantly lower (p < 0.0001) maximum relaxation rate and maximum rate of pressure development (MRPD), as well as a significantly higher (p < 0.0001) tau (τ), contraction time, and half-relaxation time. The results from receiver operating characteristic curves showed that MRPD (AUC 0.735, p < 0.001) and FVC%pred (AUC 0.749, p = 0.009) were the best discriminator parameters between ALS patients with ≤30 and >30 points in the ALS functional rating scale. In addition, 1/2RT (AUC 0.720, p = 0.01), FVC%pred (AUC 0.700, p = 0.03), τ (AUC 0.824, p < 0.0001), and MRPD (AUC 0.721, p = 0.01) were the parameters more sensitive in detecting a fall of three points in the R-subscore. On the other hand, MRPD (AUC 0.781, p < 0.001), τ (AUC 0.794, p = 0.0001), and percentage of predicted of SNIP (AUC 0.769, p = 0.002) were the parameters able to detect a fall in 30% of the FVC%pred in middle stage ALS patients. The contractile properties and relaxation rates of the diaphragm are altered in middle stage spinal onset ALS when compared with healthy subjects. These parameters are able to discriminate between those middle stage ALS subjects with early decline in inspiratory muscle function and those who not.Artigo Thoracoabdominal asynchrony and paradoxical motion in middle stage amyotrophic lateral sclerosis(Elsevier, 2019) Dourado Junior, Mário Emílio Teixeira; Sarmento, Antonio; Fregonezi, Guilherme; Aliverti, Andrea; Andrade, Armele Dornelas de; Parreira, Verônica Franco; Resqueti, Vanessa; https://orcid.org/0000-0002-9462-2294Aim: To assess thoracoabdominal asynchrony (TAA) and the presence of paradoxical motion in middle stage amyotrophic lateral sclerosis (ALS) and its relationships with chest wall tidal volume (VT,CW), breathing pattern and cough peak flow (CPF). Methods: Phase angle (θ) between upper (RCp) and lower ribcage (RCa) and abdomen (AB), as well as percentage of inspiratory time for the lower ribcage (IPRCa) and abdomen (IPAB) moving in opposite directions were quantified using optoelectronic plethysmography in 12 ALS patients during quiet breathing and coughing. Paradoxical motion of the compartments was based on threshold values of θ and IP, obtained in twelve age and sex matched healthy persons. Results: During quiet breathing, significantly higher RCa and AB θ (p < .05), IPRCa (p = 0.001) and IPAB (p < 0.05) were observed in ALS patients as compared to controls. In ALS patients, correlations between RCa and AB θ with forced vital capacity (FVC) (r=–0.773, p < 0.01), vital capacity (r=–0.663, p < 0.05) and inspiratory capacity (IC) (r=–0.754, p < 0.01), as well as between RCp and RCa θ with FVC (r=–0.608, p < 0.05) and CPF (r=–0.601, p < 0.05) were found. During coughing, correlations between RCp and AB θ with CPF (r=–0.590, p < 0.05), IC (r=–0.748, p < 0.01) and VT,CW (r=–0.608, p < 0.05), as well as between RCa and AB θ with CPF (r=–0.670, p < 0.05), IC (r=–0.713, p < 0.05) and peak expiratory flow (r=–0.727, p < 0.05) were also observed in ALS patients. ALS patients with paradoxical motion presented lower vital capacity and FVC%pred (p < 0.05) compared to those without paradoxical motion. Conclusions: Middle stage ALS patients exhibit TAA and paradoxical motion during quiet spontaneous breathing and coughing. In addition, diaphragmatic weakness (i.e. decrease in excursion of the RCa and AB compartments) was observed earlier in the lower ribcage rather than the abdominal compartment in this population.Artigo Effects of positioning on cough peak flow and muscular electromyographic activation in duchenne muscular dystrophy(Respiratory Care, 2020) Dourado Junior, Mário Emílio Teixeira; Marques, Layana; Santos, Ilsa Priscila; Marcelino, Ana Aline; Fonseca, Jessica Danielle Medeiros da; Aliverti, Andrea; Sarmento, Antonio; Resqueti, Vanessa Regiane; Fregonezi, Guilherme Augusto de Freitas; https://orcid.org/0000-0002-9462-2294Advanced stages of Duchenne muscular dystrophy (DMD) result in muscle weakness and the inability to generate an effective cough. Several factors influence the effectiveness of cough in patients with DMD. The aim of this study was to assess whether differences in positioning affect cough peak flow (CPF) and muscular electromyographic activation in subjects with DMD compared with paired healthy subjects. METHODS: Optoelectronic plethysmography and surface electromyography were used to assess chest wall volumes, chest wall inspiratory capacity, CPF, breathing pattern, and electromyographic activity of sternocleidomastoid, scalene, rectus abdominis, and external oblique muscles during inspiratory and expiratory cough phases in the supine position, supine position with headrest raised at 45 , and sitting with back support at 80 in 12 subjects with DMD and 12 healthy subjects. RESULTS: Subjects with DMD had lower CPF (P < .01) in comparison to control subjects in all positions; the DMD group also exhibited lower CPF (P 5 .045) in the supine position versus 80 . Moreover, the relative volume contributions of the rib cage and abdominal compartments to tidal volume modified significantly with posture. The electromyographic activity during inspiratory and expiratory cough phases was lower in subjects with DMD compared to healthy subjects for all evaluated muscles (P < .05), but no significant differences were observed with posture change. CONCLUSIONS: In subjects with DMD, posture influenced CPF and the relative contribution of the rib cage and abdominal compartments to tidal volume. However, muscular electromyographic activation was not influenced by posture in subjects with DMD and healthy subjects.Artigo Thoracoabdominal asynchrony and paradoxical motion in Duchenne muscular dystrophy and healthy subjects during cough: a case control study(Wiley, 2021) Dourado Junior, Mário Emílio Teixeira; Marques, Layana; Fregonezi, Guilherme Augusto de Freitas; Marcelino, Ana Aline; Sarmento, Antonio; Pennati, Francesca; Aliverti, Andrea; Resqueti, Vanessa Regiane; https://orcid.org/0000-0002-9462-2294Objective:To assess thoracoabdominal asynchrony (TAA) and inspiratory para-doxical motion at different positionings in subjects with Duchenne muscular dys-trophy (DMD) versus healthy subjects during quiet spontaneous breathing (QB) andcough.Methods:This is a case control study with a matched‐pair design. We assessed 14DMD subjects and 12 controls using optoelectronic plethysmography (OEP) duringQB and spontaneous cough in 3 positions: supine, supine with headrest raised at45°, and sitting with back support at 80°. The TAA was assessed using phase angle(θ) between upper (RCp) and lower rib cage (RCa) and abdomen (AB), as well as thepercentage of inspiratory time the RCp (IPRCp), RCa (IPRCa), and AB (IPAB) moved inopposite directions.Results:During cough, DMD group showed higher RCp and RCaθ(p< .05), RCp andABθ(p< .05) in supine and 45° positions, and higher RCp and Rcaθ(p= .006) only insupine position compared with controls. Regarding the intragroup analysis, duringcough, DMD group presented higher RCp and ABθ(p= .02) and RCa and ABθ(p= .002) in supine and higher RCa and ABθ(p= .002) in 45° position when com-pared to 80°. Receiver operating characteristic curve analyzes were able to dis-criminate TAA between controls and DMD in RCa supine position (area under thecurve: 0.81, sensibility: 78.6% and specificity: 91.7%,p= .001).Conclusion:Subjects with DMD yields TAA with insufficient deflation of chest wallcompartments and rib cage distortion during cough, by noninvasive assessment.Artigo Motor neuroprosthesis for promoting recovery of function after stroke(Stroke, 2020-06-05) Mendes, Luciana de Andrade; Lima, Illia Nadinne Dantas Florentino; Souza, Túlio Oliveira de; Nascimento, George Carlos do; Resqueti, Vanessa Regiane Resqueti; Fregonezi, Guilherme Augusto de FreitasMotor neuroprosthesis (MN) involves electrical stimulation of neural structures to increase the activities and participation of people with stroke in the natural environment in which people live, as an orthosisArtigo Qualidade de vida e aspectos psicossociais da síndrome dos ovários policísticos: um estudo quali-quantitativo(Thieme Open, 2013-11) Moreira, Simone da Nóbrega Tomaz; Sá, Joceline Cássia Ferezini de; Costa, Eduardo Caldas; Azevedo, George Dantas deObjetivos: avaliar a qualidade de vida das mulheres com síndrome dos ovários policísticos (SOP) e compreender a experiência vivida por essas mulheres diante dos sintomas que apresentam. Métodos: este estudo compreendeu duas abordagens metodológicas - quantitativa e qualitativa, de forma complementar. Foi avaliada a qualidade de vida de 213 mulheres (abordagem quantitativa) por meio do SF-36, sendo 109 com SOP (Grupo Caso: 26,8±5,4 anos) e 104 mulheres saudáveis (Grupo Controle: 23,9±6,7 anos). A análise estatística compreendeu a utilização dos testes t de Student e qui-quadrado, além dos testes de correlação de Pearson. O nível de significância adotado foi de 5%. Das mulheres do Grupo SOP, 15 participaram do estudo qualitativo, tendo sido entrevistadas mediante uso de roteiro semiestruturado. Os dados qualitativos foram analisados por meio da técnica análise de conteúdo temática categorial. Resultados: mulheres com SOP apresentaram comprometimento na qualidade de vida quando comparadas ao Grupo Controle (capacidade funcional: 76,5±20,5 e 84,6±15,9, respectivamente; aspectos físicos: 56,4±43,3 e 72,6±33,3; estado geral de saúde: 55,2±21,0 e 62,5±17,2; vitalidade: 49,6±21,3 e 55,3±21,3; aspectos sociais: 55,3±32,4 e 66,2±26,7; aspectos emocionais: 34,2±39,7 e 52,9±38,2; saúde mental: 50,6±22,8 e 59,2±20,2). Em relação aos dados qualitativos, a análise temática categorial aponta que sentimentos de "anormalidade", tristeza, medo e ansiedade estiveram associados aos principais sintomas da SOP: hirsutismo, irregularidade menstrual, infertilidade e obesidade. Esses sintomas repercutiram na vida social, na esfera profissional e no relacionamento conjugal dessas mulheres. Conclusão: a SOP compromete a qualidade de vida das mulheres, levando-as a se sentirem diferentes das outras mulheres. Por causa disso, a mulher com SOP não necessita apenas de tratamento médico para as repercussões reprodutivas, estéticas e metabólicas, mas de atendimento multiprofissionalArtigo Variabilidade da frequência cardíaca como método de avaliação do sistema nervoso autônomo na síndrome dos ovários policísticos(Thieme Open, 2013-09) Sá, Joceline Cássia Ferezini de; Costa, Eduardo Caldas; Silva, Ester da; Azevedo, George Dantas deA síndrome dos ovários policísticos (SOP) é uma condição endócrina que está associada a diversos fatores de risco cardiometabólico, tais como obesidade central, resistência à insulina, diabetes tipo 2, síndrome metabólica e hipertensão arterial. Esses fatores estão associados à hiperatividade adrenérgica, que é um importante fator prognóstico para o desenvolvimento de distúrbios cardiovasculares. Nos últimos anos, diante das alterações cardiometabólicas comuns na SOP, estudos têm investigado o controle autonômico cardíaco dessas pacientes, principalmente empregando-se a variabilidade da frequência cardíaca (VFC). Nesse sentido, nesta revisão, discorreremos sobre os achados recentes dos estudos que buscaram investigar a VFC em mulheres com SOP, assim como os métodos não invasivos de análise do controle autonômico a partir de índices básicos relacionados a essa metodologia de investigaçãoArtigo Affect-regulated exercise: an alternative approach for lifestyle modification in overweight/obese women with polycystic ovary syndrome(Taylor and Francis, 2015-09-25) Costa, Eduardo Caldas; Sá, Joceline Cássia Ferezini de; Costa, Ingrid Bezerra Barbosa; Meireles, Rodrigo da Silva Rosa Veleda; Lemos, Telma Maria Araújo Moura; Elsangedy, Hassan Mohamed; Krinski, Kleverton; Azevedo, George Dantas deObjective: affect-regulated exercise (‘‘ARE’’) is an alternative approach to guide exercise intensity based on feeling of pleasure. The aim of this study was to analyze if overweight/obese women with polycystic ovary syndrome (PCOS) meet the American College of Sports Medicine (ACSM) recommendation regarding to exercise intensity to improve health status during a single bout of ‘‘ARE". Methods: a sample of 14 overweight/obese women with PCOS (18–34 years) performed a single bout of ‘‘ARE’’ (40 min of aerobic exercise on outdoor track). The Feeling Scale (FS) was used to guide ‘‘ARE’’ intensity/pace maintaining an affective valence between ‘‘good’’ and ‘‘very good’’ during all time. Heart rate (HR), speed, % of HR at first and second ventilatory threshold (VT1 and VT2) and time spent at moderate (64–76% of HRmax) and vigorous (77–95% of HRmax) intensity during ‘‘ARE’’ were measured with a global positioning system (GPS) device. Results: volunteers exercised at 73% (68–78%) of HRmax, 5.8 (5.2–6.2) km/h, 93.4% of HR at VT1 (89.3–98.2) and 80.5% of HR at VT2 (75.3–84.6) and spent 480% of time at moderate intensity. Conclusions: overweight/obese women with PCOS met the ACSM recommendation regarding exercise intensity to improve health status when exercised between ‘‘good’’ and ‘‘very good’’ of FS. Thus, ‘‘ARE’’ may be an interesting approach to be used in clinical practice regarding to exercise prescription and/or physical activity adviceArtigo Tradução, adaptação e validação da versão brasileira do questionário Utian Quality of Life para avaliação da qualidade de vida no climatério(Thieme Open, 2015-11) Lisboa, Lilian Lira; Utian, Wulf; Fonseca Filho, Gentil Gomes da; Azevedo, George Dantas deObjetivo: traduzir, realizar a equivalência e validar o questionário Utian Quality of Life (UQOL) para a população brasileira. Métodos: participaram do estudo mulheres selecionadas aleatoriamente, na fase do climatério, residentes na cidade de Natal, Rio Grande do Norte, localizada na região do nordeste brasileiro. Foram utilizados os questionários UQOL e SF-36, sendo a fase da tradução realizada da língua inglesa para o português por três professores, enquanto que a fase de adaptação da versão traduzida foi feita através da aplicação do questionário a 35 mulheres, que poderiam marcar a opção de resposta “não compreendi a questão”; e para a validação foram usadas as medidas de reprodutibilidade (teste-reteste) e validade de construto, seguindo as normas metodológicas padronizadas internacionalmente. Resultados: a versão brasileira foi reconhecida plenamente pela população-alvo, que foi composta por 151 mulheres, devido a nenhuma questão apresentar percentual de “não compreensão” igual ou superior a 20%. Os resultados obtidos para a reprodutibilidade intra e interobservador demonstraram concordância significativa em todos os itens do questionário. Essa versão apresentou consistência acima do critério requerido (>70), demonstrando sua precisão, enquanto que a validade de construto foi obtida através de correlações estatisticamente significativas entre os domínios ocupação, saúde e emocional do UQOL com os domínios do SF-36. O coeficiente alfa de Cronbach para o instrumento como um todo foi de 0,82, representando boa precisão. Análise da correlação item-total demonstrou a homogeneidade da escala. Conclusão: a partir das etapas realizadas, o questionário UQOL foi traduzido e adaptado para aplicação no Brasil, apresentando alta reprodutibilidade e validade. Dessa forma, pode ser incluído e utilizado em estudos brasileiros que visem avaliar a qualidade de vida durante a peri e pós-menopausa