Luciana Bilitário Macedo

Quality of Life of Patients After an Acute Coronary Event: Hospital Discharge

Background The acute coronary syndrome (ACS) has a high morbi-mortality rate, including physical deficiencies and functional limitations with impact on quality of life. Cardiovascular rehabilitation 1 (CVR1) should begin as early as possible, to enable improvement in functional capacity and quality of life. Previous studies have shown association of cardiovascular diseases with quality of life, in which depression and anxiety are the domains most altered. The aim of the study is to verify the impact of an acute coronary event on quality of life at the moment of hospital discharge. Methodology This was a cross-sectional study, with ACS patients hospitalized in ICU of a private hospital in the city of Salvador, Brazil, submitted to CVR1. The quality of life questionnaire Euroqol-5D was applied on discharge from hospital. Patients included in the study were those with ACV, who had medical permission to walk, had not been submitted to acute surgical treatment, were time and space oriented, and over the age of 18 years. Patients excluded from the study were those with cognitive, orthopedic and neurological problems, who used orthesis on a lower limb, and were in any condition of risk at the time of beginning with CVR1. Data were collected by a previously trained ICU team. Results Data were collected of 63 patients who revealed compromise in the domains of pain/feeling ill (20.63%) and anxiety/depression (38.09%). Statistical significance was observed in the association between sex and pain/feeling ill (P < 0.01), sex and anxiety/depression (P < 0.01), diabetes and mobility (P < 0.01), hereditary factors and anxiety/depression (p < 0.01), BMI and pain/feeling ill (P < 0.01). Conclusion In this sample of patients, on discharge from hospital after ACS, the pain/feeling ill and anxiety/depression domains were shown to be compromised.

Existe associação entre doenças venosas e nível de atividade física em jovens

INTRODUCTION: The association of the benefits of regular physical activity to health indicators is widely discussed in the literature demonstrating the relationship between a sedentary lifestyle and chronic diseases. OBJECTIVE: To describe the prevalence of venous diseases among young person and their association with physical activity. MATERIALS AND METHODS: Cross-section. Sample: young volunteers. Individuals responded to a medical record and were examined through a system of clinical classification, etiologic, anatomic and pathophysiologic (CEAP) which classifies the severity and incapacity to work of people with venous disease, and responded to the international physical activity questionnaire (IPAQ ). RESULTS: 95 subjects participated, 57.9% (55) women. Mean age of 26.12 ± 4.5 (18-35), according to the IPAQ individuals were classified in category 1 (inactive): 41.1%; category 2 (moderately active): 49.5 %; and category 3 (active): 9.5%. Difference between physical activity levels between men and women (p = 0.02). In the CEAP classification were found: class 0 = 43.2%; class 1 = 45.3%; class 2 = 11.6%; and the other classes did not appear in the sample. Women had a higher frequency of vascular disease than men (p < 0.001). Higher level of physical activity was associated with lower prevalence of peripheral venous disease (p = 0.02). CONCLUSIONS: The sample was found high prevalence of venous disease was higher among women. It was the high number of individuals considered sedentary by IPAQ, men being more active when compared to women. Individuals with higher levels of physical activity had lower prevalence of venous diseases.

Use of 50-M Walk Test as a Tool to Assess Phase-1 Cardiovascular Rehabilitation after Acute Coronary Syndrome

Introduction: In 2009, Dias and colls made a contribution to this field by applying the first functional 50-M Walk Test (50MWT) in the Coronary Intensive care Unit (CICU), being able to direct the exercise prescription as well as evaluate the response to a cardiovascular rehabilitation program during hospitalization. As the Cardiovascular Rehabilitation Program 1 (CVR1) does not yet recommend the 50 MWT in CVR1 due to safety measures and cardiovascular repercussion on the program, the inclusion of this tool is necessary as it concerns a population at risk. Objective: Compare the functional response and cardiovascular 50 MWT in patients with ACS who underwent CVR1. Methodology: Single-arm clinical trial, conducted with ACS patients admitted to the CICU of a private Hospital in Salvador - Brazil, from 24 to 48 hours post-event. The inclusion criteria consisted ACS patients with medical permission to walk, and had not been submitted to acute surgical treatments, aged ≥ 18 years who were oriented in time and space. Exclusion criteria included patients with orthopaedic problems, neurological sequelae and the inability to walk independently. Results: A total of 66 patients were gathered to compare the response to tests before CVR1 and at the time of discharge; data of systolic arterial pressure (SBP), heart rate (HR), perceived exertion rate by the Borg Scale (BS), time and speed of walking were evaluated. Measurements were obtained in the supine, seated and orthostatic positions, at the end of the walk, after 5 minutes rest, and walking duration. Statistical significance for SBP, in the time of walking and BS was observed (p ≤ 0.05). HR presented no statistical significance; predominance was shown in the absence of adverse effects in 89.4% of patients. Conclusion: This sample proved that patients who underwent CVR1 program presented an impact on functional capacity interpreted by an increase in walking speed, perceived exertion rate decreased and better blood pressure control during hospital discharge. Furthermore, 50 MWT might safely be applied as a tool before beginning CVR1, and as a method of assessing cardiovascular repercussion in the hospital phase after the program.