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INTRODUCTION: Physical exercise promotes beneficial changes in cardiac geometry, called reverse myocardial remodeling. Recent studies show that physical exercise is capable of reorganizing the cellular signal in cardiac tissue and reversing concentric hypertrophy or ventricular dilation. However, there are few reports about this in patients with Chronic Dilated Heart Failure (CHF). OBJECTIVE: To describe the effect of a Cardiovascular Rehabilitation (CR) program on the functional capacity, quality of life and myocardial geometry of a patient with chronic dilated heart failure. CASE DESCRIPTION: Woman, 67 years old, with Implantable Cardiodefibrillator, hypertensive for 30 years, dilated heart failure with reduced ejection fraction 20% (Teicholz), left bundle branch block, CHF grade III-IV (NYHA). The supervised CR program lasted twelve months, with three weekly sessions. Initially, only low-load resistive neuromuscular exercises and inspiratory muscle training were performed. Both evolved gradually, respecting the patient's clinical and functional condition. Functional exercises such as sitting and, standing and climbing stairs were later introduced. The treadmill was also introduced into the program in an interval format (three sets of 1-minute active for 2 minutes of passive rest). The work was periodized every 2 months. Drugs were not optimized during this period, and digoxin was withdrawn. RESULTS: In the pre and post-CR echocardiogram, the ejection fraction increased from 20% to 40%, the left ventricular mass from 255 g to 128 g, with a decrease in the volumes and diameters of the left ventricular cavities, showing reverse myocardial remodeling. After CR, an exercise test was performed in which the patient reached 84% of the maximum predicted frequency (6.5 METS). The patient resumed life activities that she had not previously performed, such as going shopping at the market. CONCLUSION: In this case, the CR program was important to promote improvement in functional capacity, reverse myocardial remodeling and improvement in the quality of life of a woman with Chronic Dilated Heart Failure.

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A maioria dos pacientes com obesidade apresenta resistência à insulina e hiperatividade do sistema renina-angiotensina-aldosterona, o que pode estar relacionado aos piores resultados perante infecção pelo SARS-CoV 2. Além disso, a enzima conversora de angiotensina 2 tem maior expressão no tecido adiposo quando comparado com o pulmão, sendo suscetível a invasão do vírus nos adipócitos tornando-o um importante reservatório viral permitindo propagação para demais órgãos. OBJETIVO: Identificar se a obesidade pode ser preditor de maior gravidade e pior prognóstico da Doença do Coronavírus 2019 (COVID-19). MATERIAIS E MÉTODOS: Revisão sistemática sob o código PROSPERO CRD42020200617 com estudos observacionais através das bases de dados PubMed, Portal Regional da BVS, SciELO, Science Direct e Cochrane, e buscas manuais por meio do cruzamento "Prognosis" OR "Patient Acuity" AND "Coronavirus Infections" AND "Obesity". Foram incluídos estudos observacionais que avaliaram o impacto da COVID-19 em indivíduos com obesidade de ambos os sexos que apresentaram pontuação ≥7 na escala Newcastle-Ottawa. RESULTADOS: Foram incluídos 9 estudos totalizando uma amostra de 179.047 pacientes adultos com idade entre 18 a 80 anos, com IMC mínimo <24 kg/m2 e máximo >35 kg/m2. Verificou-se que indivíduos com obesidade apresentam aumento das taxas de admissão de cuidados agudos e críticos, necessidade ventilação mecânica invasiva (VMI), pneumonia e desenvolvem COVID-19 grave, aumentando assim seu tempo de permanência hospitalar. CONCLUSÃO: Indivíduos com obesidade desenvolvem maior gravidade e pior prognóstico da COVID-19, visto que apresentam aumento das taxas de admissão de cuidados agudos e críticos, necessidade de VMI, tempo de permanência hospitalar, gravidade e letalidade.

A marked proportion of patients with obesity has insulin resistance and hyperactivity of the reninangiotensin-aldosterone system, which may be related to the worse results caused by SARS-CoV 2. In addition, the angiotensin 2-converting enzyme has greater expression in adipose tissue when compared to the lung, being susceptible to the entry of the virus in the adipocytes making it an important viral reservoir allowing the spread to too many organs. OBJECTIVE: To identify whether obesity can be a more serious predictor and worse prognosis for Coronavirus Disease 2019 (COVID-19). MATERIALS AND METHODS: Systematic review under the code CRD42020200617 with observational studies through the PubMed databases, the VHL Regional Portal, SciELO, Science Direct and Cochrane, and manual searches using the "Prognosis" OR "Patient Acuity" AND " Coronavirus Infections " AND " Obesity ". Observational studies that assess the impact of COVID-19 in common with obesity of both sexes that assess a score ≥7 on the Newcastle-Ottawa scale were included. RESULTS: 9 studies were included, totaling a sample of 179,047 adult patients aged 18 to 80 years, with a minimum BMI <24 kg / m2 and a maximum> 35 kg / m2. It was found that with obesity, he wishes to present an increase in the admission rates for acute and mandatory care, invasive mechanical necessity IMV), pneumonia and develop severe COVID-19, thus increasing their hospital stay. CONCLUSION: Individuals with obesity develop greater severity and worse prognosis for COVID-19, since there is an increase in admission rates for acute and mandatory care, need for IMV, length of hospital stay, severity and lethality.

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Um curto período de hospitalização, se acompanhado de imobilidade, pode ser capaz de promover declínio das funções musculoesqueléticas, gerando impacto negativo na funcionalidade e qualidade de vida. Com isso, tem-se tornado cada vez mais comum a adoção de estratégias terapêuticas como o uso da plataforma vibratória (PV). OBJETIVO: Sistematizar evidências sobre a funcionalidade e a segurança da aplicação da PV em pacientes adultos hospitalizados. MÉTODOS: Revisão sistemática, registrada na PROSPERO com código CRD42019119672. Desenvolvida nas bases: LILACS, SciELO, MedLine/PubMed, EBSCOhost e PEDro. Descritores e palavras-chave: "Whole body vibration", "Intensive Care Units", "hospitalization", "muscle strenght", e "functional capacity". Incluídos estudos que analisaram os efeitos e a segurança da aplicação da PV em pacientes adultos hospitalizados. A qualidade metodológica foi avaliada através da escala Downs and Black. RESULTADOS: Incluídos 2 estudos, um ensaio clínico randomizado e outro estudo de intervenção controlado. A amostra variou entre 24 e 40 sujeitos, de ambos os sexos, média de idade 52±4 anos, com diagnóstico de DPOC e condições variadas. Houve uma melhora na distância percorrida no teste de caminhada de seis minutos e diminuição no tempo do teste de sentar e levantar, aumento dos níveis de irisina e melhora na qualidade de vida, em relação aos parâmetros dos sinais vitais não teve alterações significativas. O escore metodológico foi em média 16. CONCLUSÃO: Os resultados indicam que a PV parece ser viável e segura, podendo trazer efeitos favoráveis na funcionalidade para o tratamento em pacientes adultos hospitalizados, sendo uma alternativa para a reabilitação de forma precoce.

A short period of hospitalization, if accompanied by immobility, may be able to promote a decline in musculoskeletal functions, generating a negative impact on functionality and quality of life. As a result, the adoption of therapeutic strategies such as the use of the vibrating platform (PV) has become increasingly common. OBJECTIVE: To systematize evidence on the functionality and safety of the application of PV in hospitalized adult patients. METHODS: Systematic review, registered at PROSPERO with code CRD42019119672. Developed in the bases: LILACS, SciELO, MedLine / PubMed, EBSCOhost and PEDro. Keywords and keywords: "Whole body vibration", "Intensive Care Units", "hospitalization", "muscle strength", and "functional capacity". Included studies that analyzed the effects and safety of the application of PV in hospitalized adult patients. Methodological quality was assessed using the Downs and Black scale. RESULTS: Included 2 studies, a randomized clinical trial and another controlled intervention study. The sample varied between 24 and 40 subjects, of both sexes, mean age 52 ± 4 years, with a diagnosis of COPD and varied conditions. There was an improvement in the distance covered in the six-minute walk test and a decrease in the time of the sit and stand test, an increase in irisin levels and an improvement in quality of life, in relation to the vital signs parameters, there was no significant change. The methodological score was on average 16. CONCLUSION: The results indicate that PV seems to be viable and safe, and may have favorable effects on functionality for treatment in hospitalized adult patients, being an alternative for early rehabilitation.

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INTRODUCTION: Inadequate assessment and lack of knowledge of the applicable procedures in emergencies are factors that can result in greater population morbidity and mortality. OBJECTIVE: To systematically review studies in the national literature on the knowledge of academics and health professionals in basic life support and cardiorespiratory arrest. METHODS: Systematic review of studies published in journals indexed in SciELO and LILACS databases. Search terms: "Cardiopulmonary Resuscitation", "Basic Life Support", "Cardiac Arrest", "Health Education" and "Knowledge". Complete articles published until December 2018 were included. They analyzed the knowledge of students and/or graduated health professionals about basic life support and its procedures, as well as teaching strategies. Studies with undergraduate health professionals and/or with hospital conduct and/or advanced life support were excluded. RESULTS: Searches identified 60 articles, 16 of which were included. Of these, eleven were observational and five were intervention studies. The observational studies identified the lack of knowledge of 1,178 academics and 335 professionals about the identification of cardiorespiratory arrest, the sequence of basic life support, ventilation/compression ratio, interruption of compressions and use of the automatic external defibrillator. The intervention studies, involving 24 students and 189 professionals, indicated that active learning strategies can improve knowledge. CONCLUSION: Results indicate that students and graduated health professionals have limitations in their knowledge about the cardiopulmonary arrest and basic life support, which may result in great damage and short survival to emergency patients.

INTRODUÇÃO: Avaliação inadequada e desconhecimento dos procedimentos aplicáveis em emergências são fatores que podem resultar maior morbidade e mortalidade. OBJETIVO: Revisar sistematicamente estudos da literatura nacional sobre o conhecimento de acadêmicos e profissionais da saúde em suporte básico de vida e parada cardiorrespiratória. MÉTODOS: Revisão sistemática de estudos publicados em periódicos indexados nas bases SciELO e LILACS. Descritores: "Reanimação Cardiopulmonar", "Suporte Básico de Vida", "Parada Cardíaca", "Educação em Saúde" e "Conhecimento". Foram incluídos artigos completos publicados até dezembro de 2018. Esses analisaram o conhecimento de acadêmicos e/ou profissionais da saúde sobre suporte básico de vida e seus procedimentos, assim como, estratégias de ensino. Foram excluídos estudos com profissionais de nível técnico e/ou, com condutas hospitalares e/ou suporte avançado de vida. RESULTADOS: As buscas identificaram 60 artigos, sendo 16 incluídos. Desses, onze eram observacionais e cinco de intervenção. Os estudos observacionais identificaram o desconhecimento de 1.178 acadêmicos e 335 profissionais sobre a identificação da parada cardiorrespiratória, sequência do suporte básico de vida, relação ventilação/compressão, interrupção das compressões e uso do desfibrilador externo automático. Os estudos de intervenção, envolvendo 24 estudantes e 189 profissionais, indicaram que estratégias de aprendizagem ativas podem melhorar o conhecimento. CONCLUSÃO: Os resultados indicam que acadêmicos e profissionais da saúde apresentam limitações no conhecimento sobre parada cardiorrespiratória e suporte básico de vida, o que pode implicar em maiores agravos e menor sobrevida para pacientes em emergência.

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