Janice Luisa Lukrafka

Performance of the ISAAC questionnaire to establish the prevalence of asthma in adolescents: a population-based study.

Background. The epidemiology of asthma has been investigated with questionnaires, such as the International Study of Asthma and Allergies in Childhood protocol. Aim. To investigate the performance of the questions of the International Study of Asthma and Allergies in Childhood questionnaire to diagnose asthma in adolescents. Methods. This is a population-based cross-sectional study of adolescents in the Syndrome of Obesity and Risk Factors for Cardiovascular Disease study. The validity of the asthma symptoms of the International Study of Asthma and Allergies in Childhood protocol was assessed by calculating sensitivity, specificity, positive and negative posttest probabilities, and Youdens Index, taking as a gold standard the history of a medical diagnosis of asthma. Risk ratios (RRs) and 95% confidence intervals (CIs), adjusting for sex and age, were calculated using Cox regression model. Results. In total, 575 adolescents were investigated. Overall, 28.7% reported a lifetime medical diagnosis of asthma, and 40.0% reported at least one episode of wheezing. Ever wheezing had the highest sensitivity (80.6%) for the diagnosis of asthma, compared with the other ISAAC questions. Adolescents who reported ever wheezing were about 8 times more likely (adjusted RR: 8.3; 95% CI: 4.9–14.2) to have ever had asthma, independent of age and sex. Symptoms within the last 12 months (wheezing, cough without cold or respiratory infection, sleep disturbed due to wheezing, wheezing due to exercise, speech limited due to wheezing) had specificity of 92.0% or higher. Dry cough at night without cold or respiratory infection was the strongest independent predictor of asthma (adjusted RR: 8.8; 95% CI: 6.1–12.7). Conclusions. Ever wheezing is the most sensitive indicator of the diagnosis of asthma but falsely identifies a portion of adolescents as asthmatic. Symptoms of asthma in the last 12 months, such as cough without cold or respiratory infection, are rarely positive in the absence of a lifetime asthma diagnosis. The combination of ever wheezing for screening and the presence of other symptoms within the past 12 months to confirm the diagnosis could be an effective strategy to identify the prevalence of asthma in communities.

Profile and scientific output analysis of physical therapy researchers with research productivity fellowship from the Brazilian National Council for Scientific and Technological Development

OBJECTIVE To describe the profile and the scientific output of physical therapists researchers holding a research productivity fellowship (PQ) from the Brazilian National Council of Scientific and Technological Development (Conselho Nacional de Desenvolvimento Científico e Tecnológico-CNPq). METHOD This is a cross-sectional study, which has evaluated the Lattes Curriculum of all PQ physiotherapy researchers registered at CNPq holding a research productivity fellowship in the period of 2010. The variables analyzed were: gender, geographic and institutional distribution, duration since doctorate defense, research productivity fellowship level, scientific output until 2010 and the H index in Scopus(®) and ISI databases. RESULTS A total of 55 PQ from the CNPq were identified in the area of knowledge of Physical Therapy and Occupational Therapy, being 81.8% from the Southeast region of Brazil. They were predominantly female (61.8%), with research productivity fellowship level PQ2 (74.5%), and with average time since doctorate defense of 10.1 (±4.1) years. A total of 2.381 articles were published, with average of 42.5 (±18.9) articles/researcher. The average of articles published after doctorate defense was 39.40 (±18.9) articles/researchers with a mean output of 4.2 (±2.0) articles/year. We found 304 articles indexed in the Scopus(®) database with 2.463 citations, and 222 articles indexed in the Web of Science with 1.805 citations. The articles were published in 481 journals, being 244 (50.7%) of them listed on JCR-web. The researchers presented a median 5 of the H index in the Scopus(®) database, and a median 3 in ISI. CONCLUSION The scientific output of the researchers with research productivity fellowship in the field of physical therapy stands out in their indicators, since the figures are very promising for a relatively young area and as it can be observed by the amount of published articles and citations obtained by the national and international research community.

Chest physiotherapy in paediatric patients hospitalised with community-acquired pneumonia: a randomised clinical trial

Background Chest physiotherapy has been used to treat children hospitalised with pneumonia with no clear scientific evidence to support a beneficial effect. The objective of the current study was to evaluate the efficacy of chest physiotherapy as an adjuvant treatment in children hospitalised with acute community-acquired pneumonia. Methods Children (aged 1–12 years) with a clinical and confirmed radiological diagnosis of pneumonia sequentially admitted to a tertiary children hospital were eligible for this study. Participants were randomly selected to receive a standardised respiratory physiotherapy (positioning, thoracic vibration, thoracic compression, positive expiratory pressure, breathing exercises and forced exhalation with the glottis open or ‘huffing’) three times daily in the ‘intervention group’ or a non-mandatory request to breathe deeply, expectorate the sputum and maintain a lateral body position once a day in the ‘control group’. The primary outcomes were reduction in respiratory rate and severity score (respiratory rate, recession, fever, oxygen saturation and chest x-ray) from baseline to discharge. Secondary outcome was duration of hospitalisation. Results In all, 72 patients were randomly allocated to the intervention (n=35) or control (n=37) groups. There were no differences at admission on severity of pneumonia between groups. Respiratory rate and severity score significant decreased between admission to discharge within each group; however, there were no differences when comparing groups. Also, there was no significant difference in duration of hospitalisation between the control and intervention groups (6 vs 8 days, p=0.11, respectively). Conclusions This clinical trial suggests that, in children hospitalised with moderate community-acquired pneumonia, chest physiotherapy did not have clinical benefits in comparison to control group.

Chronic electroacupuncture of the ST36 point improves baroreflex function and haemodynamic parameters in heart failure rats

Electroacupuncture (EA) has been used to treat many diseases, including heart failure (HF). This study aimed to evaluate the effects of chronic stimulation in the ST36 acupuncture point on haemodynamic parameters and baroreflex function in rats with HF. Cardiovascular parameters assessed were heart rate (HR), blood pressure (BP), and the reflex cardiovascular response of HR triggered by stimulation of baroreceptors in animals with HF subsequent to acute myocardial infarction (AMI). Male Wistar rats were divided into three groups: Sham Control - animals without HF and without EA; HF Control group - animals with HF and without EA; and HF EA group - animals with HF that received the EA protocol. Six weeks after surgical induction of AMI, the EA protocol (8 weeks, 5 times a week) was performed. The protocol was applied with EA at the ST36 point, frequency of 2 Hz, pulse of 0.3 ms and intensity of 1-3 mA for 30 min. Haemodynamic parameters and baroreceptor function were assessed. There was no difference between groups in the variables HR, systolic blood pressure (SBP) and diastolic blood pressure (DBP), which were evaluated with awake animals (p>0.05). There was an increase in the mean arterial pressure (MAP) in the HF EA group compared to the HF Control group (p<0.05). The maximum gain of the baroreflex heart rate response (Gain) was higher in the HF EA group than the HF Control and Sham Control groups. Chronic EA in the ST36 point increased the MAP and baroreflex sensitivity in rats with HF.

Fatores associados ao insucesso no desmame ventilatório de crianças submetidas a cirurgia cardíaca pediátrica

OBJECTIVE To assess factors associated with failure in ventilatory weaning of children undergone surgical correction of congenital heart diseases. METHODS Cohort study with 29 children. The heart diseases were divided into cyanotic (nine children) and acyanotic (20 children). We studied children from 0 to 5 years who underwent heart surgery with invasive mechanical ventilation. RESULTS The failure group presented smaller value in SpO2 and higher values during days of stay in IMV and FiO2 when compared to the success group (P<0.05). It was observed that 4 children (14%) had failed in weaning, being necessary to return the ventilatory prosthesis before 48 hours after extubation. CONCLUSION The days of IMV, SpO2 and FiO2 were the main factors associated with failed extubation in this group of patients.

Assessment of functional capacity and pulmonary in pediatrics patients renal transplantation

INTRODUCTION Pediatric patients undergoing kidney transplantation can present changes in pulmonary function and functional capacity for exercise. OBJECTIVE To evaluate the functional capacity and pulmonary function in children and adolescents undergoing kidney transplantation. METHOD Children and adolescents aged six to 18 years of age were evaluated in Outpatient Clinic of Nephrology, Hospital da Criança Santo Antônio, Santa Casa de Porto Alegre, RS, Brazil in period the june of 2010 the march of 2011. Pulmonary capacity was assessed by spirometry and maximal respiratory pressures and functional capacity through 6-minute walk test (6MWT). RESULTS The sample comprised 25 patients, 14 (56%) males with a mean age of 13.5 ± 3.3 years. From, 19 (76%) underwent dialysis before transplantation. Mean forced vital capacity (FVC) was 97.91 + 24.32% and forced expiratory volume in one second (FEV1) 100.53 + 17.66% from predicted value. In the 6MWT, the patients walked 229.14 meters less than predicted (p < 0.001). The maximum inspiratory pressure (MIP) was significantly lower than predicted, and the difference in cmH₂O -24.63 (p = 0.03), as the maximum expiratory pressure (MEP), with a difference of 49.27 cmH₂O (p < 0.001). By correlating, functional capacity, spirometry and maximal respiratory pressures, find an association between FVC and 6MWT (r = 0.52, p = 0.01) and FVC and MIP (r = 0.54, p = 0.01). CONCLUSION Reduced functional capacity and maximum respiratory pressures were diagnosed in a small cohort of pediatric patients after kidney transplantation. Better the functional capacity and PiMáx better the FVC.

Ventilação mecânica não invasiva na bronquiolite viral aguda: estudo de coorte retrospectivo

Objetivo: Avaliar a utilizacao da ventilacao mecânica nao invasiva (VMNI) sobre parâmetros clinicos nas primeiras 24 horas em pacientes internados em uma emergencia pediatrica com diagnostico de bronquiolite viral aguda (BVA). Materiais e Metodos: Estudo de coorte retrospectivo atraves de coleta de dados de prontuarios de criancas internadas com diagnostico de BVA que fizeram uso de VMNI em uma emergencia pediatrica durante dois invernos consecutivos. Dados coletados: demograficos (sexo, idade), caracteristicas clinicas (frequencia cardiaca, frequencia respiratoria, saturacao periferica de oxigenio), tempo de uso da VMNI, internacao em UTI pediatrica e tempo de internacao. Foram utilizados testes de Friedman e Wilcoxon para comparacao de variaveis clinicas entre cada periodo de tempo, teste de Mann-Withney e ANOVA para comparacoes entre o grupo que utilizou e nao utilizou VMNI. Resultados: Amostra composta por 14 pacientes, o tipo de virus mais prevalente foi o virus sincicial respiratorio, o modo ventilatorio nao invasivo predominantemente utilizado foi o CPAP. Nao houve diferenca significativa dos sinais vitais em relacao ao momento da instalacao da VMNI, seis, 12 e 24 horas. Na utilizacao de oxigenio suplementar houve diferenca significativa entre o momento da instalacao da VMNI e apos 24 horas. Quando comparadas as caracteristicas clinicas dos pacientes que falharam na VMNI e necessitaram de suporte ventilatorio invasivo, a frequencia cardiaca diferiu significativamente tanto no momento da instalacao da VMNI como apos 6 horas. Conclusao: Houve reducao significativa da necessidade de oxigenio suplementar apos 24 horas da instalacao da VMNI. Nao foram observadas diferencas significativas nas demais caracteristicas clinicas dos pacientes.

A novel approach to the application of electroacupuncture in awake rats

The primary focus of many animal studies of electroacupuncture (EA) is on the overall effects of the treatment, without due consideration of the impact of how the needles are applied in animal models. Most experimental studies of EA use anaesthesia before needle insertion and electrical stimulation, or alternatively use restraining devices while the animals remain awake, either of which may confound the effects of the needling per se. In a recent study, Wang et al 1 reported that rats remained in a polyethylene cylinder during the application of EA, without the need for either restraints or anaesthesia. Based on this observation, and given the potential difficulties that may be encountered during the application of EA, we set out to create a novel bottle-based device to help facilitate administration of EA without the use of anaesthesia or restraints. A customised bottle device was fashioned out of a wooden board and six 500 mL polyethylene terephthalate (PET) water bottles. The necks of the bottles were cut off, fixed to the wooden surface, and used as burrows (figure 1). The cut edge of each bottleneck was covered with electrical tape to avoid any injury. Using this device it was possible to stimulate up to six conscious animals simultaneously without anaesthesia or restraints, thus …

Madurez Visomotora y Funciones Ejecutivas en Escolares

Visual-motor maturity and executive functions are closely related in the child development process. This study aimed to investigate the relation between visual-motor abilities and executive functions in 83 healthy children between 7 and 10 years old. The tools used were the Bender Gestalt Visual-Motor Test - Gradual Scoring System (B-GSS), Wisconsin Card Sorting Test (WCST), Ravens Progressive Matrices (RPM), and Rey-Osterrieth Complex Figure (ROCF). The correlation between the B-GSS and WCST scores was significantly negative ( r = -.23, p < .033), while ROCF variables, such as Total Memory and Total Copy, had a moderate, significant correlation with total B-GSS score ( r = -.55, p < .001; r = -.44, p < .001, respectively). The results empirically show the relation between executive functions and visual-motor maturity and are discussed in face of developmental neuropsychology.Visual-motor maturity and executive functions are closely related in the child development process. This study aimed to investigate the relation between visual-motor abilities and executive functions in 83 healthy children between 7 and 10 years old. The tools used were the Bender Gestalt Visual-Motor Test - Gradual Scoring System (B-GSS), Wisconsin Card Sorting Test (WCST), Ravens Progressive Matrices (RPM), and Rey-Osterrieth Complex Figure (ROCF). The correlation between the B-GSS and WCST scores was significantly negative (r = -.23, p < .033), while ROCF variables, such as Total Memory and Total Copy, had a moderate, significant correlation with total B-GSS score (r = -.55, p < .001; r = -.44, p < .001, respectively). The results empirically show the relation between executive functions and visual-motor maturity and are discussed in face of developmental neuropsychology.

Maturidade Visomotora e Funções Executivas em Escolares

Visual-motor maturity and executive functions are closely related in the child development process. This study aimed to investigate the relation between visual-motor abilities and executive functions in 83 healthy children between 7 and 10 years old. The tools used were the Bender Gestalt Visual-Motor Test - Gradual Scoring System (B-GSS), Wisconsin Card Sorting Test (WCST), Ravens Progressive Matrices (RPM), and Rey-Osterrieth Complex Figure (ROCF). The correlation between the B-GSS and WCST scores was significantly negative ( r = -.23, p < .033), while ROCF variables, such as Total Memory and Total Copy, had a moderate, significant correlation with total B-GSS score ( r = -.55, p < .001; r = -.44, p < .001, respectively). The results empirically show the relation between executive functions and visual-motor maturity and are discussed in face of developmental neuropsychology.Visual-motor maturity and executive functions are closely related in the child development process. This study aimed to investigate the relation between visual-motor abilities and executive functions in 83 healthy children between 7 and 10 years old. The tools used were the Bender Gestalt Visual-Motor Test - Gradual Scoring System (B-GSS), Wisconsin Card Sorting Test (WCST), Ravens Progressive Matrices (RPM), and Rey-Osterrieth Complex Figure (ROCF). The correlation between the B-GSS and WCST scores was significantly negative (r = -.23, p < .033), while ROCF variables, such as Total Memory and Total Copy, had a moderate, significant correlation with total B-GSS score (r = -.55, p < .001; r = -.44, p < .001, respectively). The results empirically show the relation between executive functions and visual-motor maturity and are discussed in face of developmental neuropsychology.