RESUMEN

BACKGROUND: Ruminative responding involves repetitive and passive thinking about one's negative affect. This tendency interferes with initiation of goal-directed rewarding strategies, which could alleviate depressive states. Such reward-directed response selection has been shown to be mediated by ventral striatum/nucleus accumbens (VS/NAcc) function. However, to date, no study has examined whether trait rumination relates to VS/NAcc functionality. Here, we tested whether rumination moderates VS/NAcc function both in response to reward and during a ruminative state. METHODS: Trait rumination was considered dimensionally using Rumination Response Scale (RRS) scores. Our sample (N = 80) consisted of individuals from a community sample and from patients diagnosed with major depressive disorder, providing a broad range of RRS scores. Participants underwent fMRI to assess two modes of VS/NAcc functionality: 1) in response to reward, and 2) during resting-state, as a proxy for ruminative state. We then tested for associations between RRS scores and VS/NAcc functional profiles, statistically controlling for overall depressive symptom severity. RESULTS: RRS scores correlated positively with VS/NAcc response to reward. Furthermore, we noted that higher RRS scores were associated with increased ruminative-dependent resting-state functional connectivity of the VS/NAcc with the left orbitofrontal cortex. CONCLUSIONS: These findings suggest that ruminative tendencies manifest in VS/NAcc reward- and rumination-related functions, providing support for a theoretical-clinical perspective of rumination as a habitual impairment in selection of rewarding, adaptive coping strategies.

RESUMEN

Introdução: a marcha e o equilíbrio são funções motoras afetadas nos portadores da doença de Parkinson (DP). Nesse contexto, surgem os modelos de terapia com uso da realidade virtual (RV) para a melhora da capacidade motora desses indivíduos. Objetivo: analisar os efeitos da terapia com RV na marcha e no equilíbrio de pacientes com DP. Metodologia: procedeu-se a uma revisão sistemática de ensaios clínicos randomizados sobre a RV na reabilitação da marcha e do equilíbrio em pacientes com DP. A busca foi realizada através das bases de dados PubMED, LILACs, PEDro, Cochrane, SciELO em maio de 2019. Este trabalho seguiu a recomendação PRISMA de elaboração de revisão sistemática. Resultados: cinco estudos foram incluídos com um total de 233 portadores da DP. A análise mostrou que houve eficácia na utilização da RV em melhorar a marcha e o equilíbrio desses pacientes, porém não foram encontradas diferenças significativas quando comparado às terapias convencionais. Conclusão: a terapia com RV se mostra eficaz para os pacientes com DP. Os desfechos de marcha e equilíbrio tiveram melhorias consideráveis. No entanto, não se deve preconizar a utilização desse modelo de terapia em detrimento de modelos mais convencionais, devido ao fato de eles não apresentarem grandes diferenças nos resultados obtidos.

Introduction: gait and balance are motor functions affected in patients with Parkinson's disease (PD). In this context, models of therapy using virtual reality (VR) appear to improve the motor capacity of these individuals. Objective: to analyze the effects of VR therapy on gait and balance of PD patients. Methodology: systematic review of randomized clinical trials on VR in gait and balance rehabilitation in PD patients was conducted. The search was performed through the PubMED, LILACs, PEDro, Cochrane, SciELO databases in May 2019. This work followed the PRISMA recommendation for a systematic review. Results: five studies were included with a total of 233 PD patients. Analysis showed that there was efficacy in using VR to improve gait and balance of these patients, but no significant differences were found when compared to conventional therapies. Conclusion: RV therapy is effective for PD patients. Gait and balance outcomes have improved considerably. However, the use of this therapy model should not be advocated to the detriment of more conventional models, due to the fact that they do not present large differences in the results obtained.

Asunto(s)

RESUMEN

RESUMO Comparou-se a força muscular respiratória, qualidade de vida e capacidade funcional em adolescentes com fibrose cística com diferentes perfis bacteriológicos. Trata-se de um estudo transversal de caráter descritivo, em adolescentes com fibrose cística avaliados no Centro de Referência em Fibrose Cística do Hospital Especializado Octávio Mangabeira (HEOM) no período de janeiro a março de 2016, caracterizando uma amostra por conveniência. Foi realizada avaliação da força muscular com o manovacuômetro, análise da qualidade de vida por meio da aplicação do questionário de qualidade de vida com validação para pacientes com fibrose cística (QFC), análise da capacidade funcional, após a realização do teste de caminhada de seis minutos, e do perfil bacteriológico, por intermédio de resultados de exames de microbiologia. Foram avaliados 30 indivíduos com fibrose cística, em que, para Staphylococcus aureus, verificaram-se a força muscular respiratória (75,6±19,6*), a qualidade de vida QFC (59,3±3,4) e a capacidade funcional (427,8±64,6*). Para Pseudomonas aeruginosa foram analisadas a força muscular respiratória (61,4±19,1*), a qualidade de vida QFC (47,9±4,2) e a capacidade funcional (382,0±78,0*). Concluiu-se que ambos os perfis bacteriológicos comprometem a função pulmonar com ênfase para a bactéria Pseudomonas aeruginosa, que apresenta tendência à fraqueza muscular respiratória, principalmente para o sexo feminino (PImáx<60cmH2O) e baixa capacidade funcional.

RESUMEN Se comparó la fuerza muscular respiratoria, la cualidad de vida y la capacidad funcional en adolescentes con fibrosis quística con distintos perfiles bacteriológicos. Se trata de un estudio transversal de carácter descriptivo, en adolescentes con fibrosis quística que fueron evaluados en el Centro de Referencia en Fibrosis Quística del Hospital Especializado Octávio Mangabeira (HEOM) en el período de enero a marzo de 2016, caracterizando una muestra por conveniencia. Fue realizada la evaluación de la fuerza muscular con el manovacuómetro, el análisis de la cualidad de vida por medio de la aplicación del cuestionario de cualidad de vida con validación para los pacientes con fibrosis quística (CFQ), el análisis de la capacidad funcional, después de la realización de la prueba de caminata de seis minutos, y del perfil bacteriológico, por intermedio de resultados de análisis de microbiología. Fueron evaluados a 30 individuos con fibrosis quística, en que, para Staphylococcus aureus, se certificaron la fuerza muscular respiratoria (75,6±19,6*), la cualidad de vida CFQ (59,3±3,4) y la capacidad funcional (427,8±64,6*). Para Pseudomonas aeruginosa fueron analizadas la fuerza muscular respiratoria (61,4±19,1*), la cualidad de vida CFQ (47,9±4,2) y la capacidad funcional (382,0±78,0*). Se concluyó que ambos perfiles bacteriológicos comprometen la función pulmonar con énfasis para la bacteria Pseudomonas aeruginosa, que presenta tendencia a la debilidad muscular respiratoria, principalmente para el sexo femenino (PImáx<60cmH2O) y baja capacidad funcional.

ABSTRACT We compared the respiratory muscle strength, quality of life and functional capacity in adolescents with cystic fibrosis with different bacteriological profiles. This is a cross-sectional study of descriptive character on adolescents with cystic fibrosis assessed in the Reference Center for Cystic Fibrosis of the Octávio Mangabeira Specialized Hospital (HEOM) from January to March 2016, characterizing a sample for convenience. Muscle strength evaluation with the manovacuometer was performed, as well as analysis of the quality of life through the application of quality-of-life questionnaire with validation for patients with cystic fibrosis (CFQ), analysis of the functional capacity, after the six-minute walk test, and bacteriological profile, through results of microbiological tests. We evaluated 30 individuals with cystic fibrosis, in which, for Staphylococcus aureus, respiratory muscle strength (75.6±19.6*), quality of life CFQ (59.3±3.4), and functional capacity (427.8±64.6*) were verified. For Pseudomonas aeruginosa, the respiratory muscle strength (61.4±19.1*), quality of life CFQ (47.9±4.2) and the functional capacity (382.0±78.0*) were analyzed. We concluded that both bacteriological profiles impair lung function, especially the bacterium Pseudomonas aeruginosa, which has a tendency to respiratory muscle weakness, especially for women (Mip<60cmH2O) and low functional capacity.

RESUMEN

BACKGROUND: Patients with pulmonary fibrosis are living longer and present with an increasing number of comorbidities over time. Pulmonary rehabilitation, as a nonpharmacological approach, may be promising in these patients, although there is limited information on the impact of pulmonary rehabilitation on exercise tolerance and quality of life. Thus, conducting a systematic review and meta-analysis, the purpose of this study was to determine the effects of pulmonary rehabilitation on exercise tolerance and quality of life in patients with idiopathic pulmonary fibrosis. METHODS: We searched MEDLINE, Cochrane Library, Embase, Scielo, PEDro, and CINAHL (from the earliest date available to June 2016) for trials. Study selection included randomized controlled trials (RCTs) that examined the effects of pulmonary rehabilitation in patients with idiopathic pulmonary fibrosis. Two reviewers selected studies independently. Data were extracted from published RCTs. Study quality was evaluated using the PEDro scale. Weighted mean differences, standard mean differences, and 95% CIs were calculated. RESULTS: We analyzed data from 5 RCTs comparing a pulmonary rehabilitation group with a control group. Pulmonary rehabilitation improved exercise tolerance weighted mean differences (44 m; 95% CI, 5.3-82.8) compared with no exercise. The meta-analyses also showed significant improvement in symptoms, impact, and total score from the St George's Respiratory Questionnaire for participants in pulmonary rehabilitation compared with control. No serious adverse events were reported. CONCLUSION: Pulmonary rehabilitation is effective in increasing exercise tolerance and improving quality of life in patients with idiopathic pulmonary fibrosis.

Asunto(s)

RESUMEN

A fratura proximal de fêmur (FPF) está relacionada a altos índices de morbidade e a grande impacto sobre a capacidade funcional do idoso. O objetivo do estudo foi traçar o perfil funcional de pacientes idosos hospitalizados por FPF, analisando os tipos de fraturas, o mecanismo causal, e as características físicas e funcionais prévias ao evento. Trata-se de um estudo do tipo observacional, quantitativo, de corte transversal, cujos participantes eram pacientes hospitalizados por FPF. Foi utilizada uma Ficha de Registro para coletar os dados sociodemográficos. O grau de independência funcional e a capacidade de marcha prévia à FPF foram avaliados respectivamente pelo Índice de Barthel, o Questionário de Pfeffer e a Classificação Funcional da Marcha Modificada. A amostra foi constituída por 32 idosos com média de idade de 79 (± 9,5) anos e uma predominância do sexo feminino (71,8%), de cor parda (43,8%) e baixa escolaridade. A maioria não morava sozinho e faziam uso de algum medicamento. Os idosos participantes, previamente à fratura, eram independentes para as atividades básicas da vida diária (ABVD), dependentes para as atividades instrumentais da vida diária (AIVD) e não utilizam dispositivos para locomoção. A queda foi a principal causa da FPF, sendo as mais prevalentes a fratura de colo de fêmur (FCF) e a fratura transtrocantérica (FTT). As comorbidades, os medicamentos, os fatores sociodemográficos, o deficit de marcha e a dependência funcional, podem estar associados à ocorrência de FPF em idosos.

The hip fracture (HF) is related to high rates of morbidity and a major impact on the functional capacity of the elderly. The aim of the study was to outline the functional profile of elderly patients hospitalized for HF analyzing kinds of fractures, the causal mechanism and the physical and functional prior to the event. This is an observational study, quantitative, cross-sectional whose participants were patients hospitalized for FPF. A registry file was used to collect sociodemographic data. The degree of functional independence and the ability to walk prior to the HF, respectively were evaluated by the Barthel Index, the Pfeffer questionnaire and the Functional Classification of the March Modified. The sample consisted of 32 elderly people with an average age of 79 (± 9.5) years and a predominance of females (71.8%), mulatto (43.8%) and low education. Most lived alone and did not use any medication. Participants elderly, prior to fracture, were independent for basic activities of daily living (ADL), dependent for instrumental activities of daily living (IADL) and do not use for locomotion devices. Falls were the leading cause of HF, the most prevalent the femoral neck fracture (FNF) and the trochanteric fracture (TF). Comorbidities, medications, sociodemographic factors, gait impairment and functional dependency, they may be associated with occurrence of HF in the elderly.

Asunto(s)

RESUMEN

A fratura proximal de fêmur (FPF) está relacionada a altos índices de morbidade e a grande impacto sobre a capacidade funcional do idoso. O objetivo do estudo foi traçar o perfil funcional de pacientes idosos hospitalizados por FPF, analisando os tipos de fraturas, omecanismo causal, e as características físicas e funcionais prévias ao evento. Trata-se de um estudo do tipo observacional, quantitativo, de corte transversal, cujos participantes eram pacientes hospitalizados por FPF. Foi utilizada uma Ficha de Registro para coletar os dados sociodemográficos. O grau de independência funcional e a capacidade de marcha prévia à FPFforam avaliados respectivamente pelo Índice de Barthel, o Questionário de Pfeffer e a Classificação Funcional da Marcha Modificada. A amostra foi constituída por 32 idosos commédia de idade de 79 (± 9,5) anos e uma predominância do sexo feminino (71,8%), de cor parda (43,8%) e baixa escolaridade. A maioria não morava sozinho e faziam uso de algummedicamento. Os idosos participantes, previamente à fratura, eram independentes para as atividades básicas da vida diária (ABVD), dependentes para as atividades instrumentais da vida diária (AIVD) e não utilizam dispositivos para locomoção. A queda foi a principal causa da FPF, sendo as mais prevalentes a fratura de colo de fêmur (FCF) e a fratura transtrocantérica (FTT). Ascomorbidades, os medicamentos, os fatores sociodemográficos, o deficit de marcha e a dependência funcional, podem estar associados à ocorrência de FPF em idosos.(AU)

The hip fracture (HF) is related to high rates of morbidity and a major impacton the functional capacity of the elderly. The aim of the study was to outline the functional profile of elderly patients hospitalized for HF analyzing kinds of fractures, the causal mechanism and the physical and functional prior to the event. This is an observational study,quantitative, cross-sectional whose participants were patients hospitalized for FPF. A registry file was used to collect sociodemographic data. The degree of functional independence and the ability to walk prior to the HF, respectively were evaluated by the Barthel Index, the Pfeffer questionnaire and the Functional Classification of the March Modified. The sample consisted of 32 elderly people with an average age of 79 (± 9.5) years and a predominance of females (71.8%), mulatto (43.8%) and low education. Most lived alone and did not use any medication. Participants elderly, prior to fracture, were independent for basic activities of daily living (ADL), dependent for instrumental activities of daily living (IADL) and do not use for locomotion devices. Falls were the leading cause of HF, the most prevalent the femoral neck fracture (FNF) and the trochanteric fracture (TF).Comorbidities, medications, sociodemographic factors, gait impairment and functional dependency, they may be associated with occurrence of HF in the elderly.(AU)

Asunto(s)