High-flow nasal cannula oxygen therapy in acute respiratory failure due to acute exacerbation of fibrotic interstitial lung disease

High flow nasal cannula oxygen therapy (HFNC) has become frequent in the treatment of patients with acute hypoxemic respiratory failure. Methods. Eleven patients with acute exacerbation of fibrotic interstitial lung disease (ILD) were treated with HFNC after failure of conventional therapy (SatO2 < 90% offering 100% FiO2 by non-rebreathing mask or noninvasive ventilation). Ten patients had success with HFNC (not requiring orotracheal intubation) during emergency department admission. HFNC significantly improves clinical variables after 2h: respiratory rate decreased from 33 ± 6 breaths/ min to 23 ± 3 breaths/min; PaO2 increased from 48.7 (38-59) mmHg to 81.1 (76-90) mmHg; PaO2/FiO2 ratio increased from 102.4 ± 32.2 to 136.6 ± 29.4; SatO2 increased from 85 (66-92)% to 96 ± (95-97)%. HFNC could be an effective alternative in the treatment of acute respiratory failure from acute exacerbations of fibrotic ILD.(AU)

Depression, lower urinary tract symptoms and quality of life in women with multiple sclerosis: a descriptive and correlational study

Introduction: Among the most ordinary clinical manifestations of Multiple Sclerosis (MS) are depression and the presence of Lower Urinary Tract Symptoms (LUTS). Both can compromise a person's quality of life. The objective of this research was to identify the major urinary symptoms and correlate them with quality of life and with depressive symptoms in women with MS. Methods: This was an observatory, descriptive and correlational study, with nonprobabilistic sampling by convenience. This research included women over 18 years old who displayed LUT symptoms and who had been diagnosed with Relapsing-Remitting MS. Assessment consisted of an anamnesis card, the Kurtzke Expanded Disability Status Scale (EDSS), the Incontinence Impact Questionnaire-7 (IIQ-7-BR), the Urogenital Distress Inventory-6 (UDI-6-BR), the Beck Depression Inventory-2 (BDI-II) and the Multiple Sclerosis Quality of Life Questionnaire - Portuguese version (MSQOL-54). Results: 41 women participated in the study, with average age of 50.1 (± 9.45) and average of 4.11 in the EDSS. The most common urinary symptom was urinary urgency (78%). There was no correlation between the severity of the urinary symptom and quality of life. Moderate and significant negative correlation (r = -0.561 p < 0.001) was found between depression and the physical component of quality of life and strong negative correlation (r = -0.729 p < 0.001) was found between depression and the mental component. Conclusions: The most prevalent urinary symptom was urinary urgency. A strong correlation was found between symptoms of depression and quality of life and there was no correlation between urinary symptoms and quality of life.

O berçário da escola pública: aplicação de um programa de intervenção motora oportuna / The public school nursery: implementation of a timely motor intervention program

Introdução: Os programas de intervenção ofertados aos bebês potencializam o seu desenvolvimento. Objetivo: Melhorar a classificação de lactentes com atraso ou suspeita de atraso motor para bebês típicos através de um Programa de Intervenção Motora Precoce (PIMP) durante seis meses. Métodos: Participaram 15 bebês hígidos das classes B, C e D (11 meninos e 4 meninas), residentes no sul do Brasil e avaliados em três momentos: avaliação inicial (1ª avaliação), três meses (2ª avaliação) e seis meses (3ª avaliação) após o início da intervenção. Tarefas de perseguição visual, manipulação e controle postural foram realizadas, totalizando 20 minutos, três vezes por semana, por seis meses. A Alberta Infant Motor Scale (AIMS), que avalia posturas, escore total bruto e percentil e classificação de desenvolvimento, foi utilizada para avaliar as aquisições dos bebês. Foi adotado 5% para o nível de significância. Resultados: Houve diferença significativa em relação às posturas, exceto no "supino" (p = 0,428). Para "prono", "sentado" e "escore total" a diferença foi significativa da 1ª avaliação para a 2ª e 3ª, (p = 0,004), (p = 0,014), (p = 0,001) respectivamente. Na postura em pé houve diferença significativa durante o estudo (p < 0,001). Em relação ao percentil, a 3ª avaliação apresentou resultados mais significativos (p < 0,001) do que os da 1ª e 2ª avaliações, que não diferiram entre si. Conclusão: A classificação do escore AIMS apresentou aumento do percentual de normalidade nos três momentos. Todos apresentaram normalidade ao final do estudo. O efeito do programa interventivo em lactentes ao longo do tempo proporciona impacto positivo nos marcos motores.(AU)

Introduction: Intervention programs offered to babies empower their development. Aim: The goal was to improve the ranking of babies with suspicion of Delay or Motor Delay of Typical babies through an Early Motor Intervention Program (EMIP) for six months. Methods: Fifteen healthy babies' class B, C and D (11 boys and 4 girls), residents in southern Brazil and evaluated at three different points: baseline (1 st assessment), three months (2nd assessment) and six months (3rd assessment) after starting intervention. Chase visual tasks, handling and postural control were performed, 20 minutes, three times a week for six months. The Alberta Infant Motor Scale (AIMS), which evaluates postures, total gross score and percentile and development of classification, was used to evaluate the acquisitions of babies. It was adopted for the 5% level of significance. Results: There were significant differences in relation to the positions except the "supine" (p = 0.428). For "prone position", "sitting" and "total score" the difference was significant for the 1st, 2nd and 3rd assessment (p = 0.004) (p = 0.014) (p = 0.001) respectively. The standing posture significant difference was observed during the study (p < 0.001). Regarding the 3rd percentile evaluation, results showed significant (p < 0.001) than the 1st and 2nd ratings that did not differ from each other. Conclusion: The classification of AIMS score had increased the normal percentage in three stages. All had normal at the end of the study. The effect of intervening program in babies provides positive impact on the motor milestones. (AU)

Frequência semanal de um programa de intervenção motora para bebês de berçário / La frecuencia semanal de un programa de intervención motora en bebés / Weekly frequency of a motor intervention program for day care babies

RESUMO O objetivo do estudo foi comparar o efeito de um Programa de Intervenção Motora no desenvolvimento de bebês de escolas de educação infantil públicas de Porto Alegre. Participaram do estudo 59 bebês, estratificados aleatoriamente em três grupos: 18 bebês atendidos três vezes por semana (G3X); 23 bebês atendidos uma vez por semana (G1X) e 18 bebês do grupo controle (GC). Foram realizadas tarefas de perseguição visual (três minutos), manipulação de objetos (sete minutos) e força, mobilidade e estabilização (dez minutos). O instrumento utilizado foi a Alberta Infant Motor Scale (AIMS) para avaliar o desenvolvimento motor dos bebês. Os resultados do estudo mostraram que os bebês do G1X foram os que melhoraram na classificação (p=0,007); nas posturas, foram os bebês do G3X que obtiveram diferença significativa maior na postura prono, sentado e em pé, mesmo sendo mais novos. Em conclusão, os bebês que realizaram intervenção motora, uma ou três vezes por semana, obtiveram melhores resultados quando comparados ao grupo controle.

RESUMEN Este estudio tiene por objeto comparar el resultado de un programa de intervención motora en el desarrollo de bebés en un jardín de infantes públicos de la ciudad de Porto Alegre, Brasil. Del estudio, participaron 59 bebés, clasificados aleatoriamente en tres grupos: 18 bebés atendidos tres veces por semana (G3X); 23 bebés atendidos una vez por semana (G1X) y 18 bebés del grupo control (GC). Se llevaron a cabo tareas de persecución visual (tres minutos), manejo de objetos (siete minutos) y fuerza, movilidad y estabilización (diez minutos). Se empleó el Alberta Infant Motor Scale (AIMS) para análisis del desarrollo motor de los bebés. Los resultados mostraron que los del G1X fueron quienes presentaron mejoras en la clasificación (p=0,007), mientras que en las posturas, fueron los G3X quienes presentaron mayores diferencias significativas en las posturas prono, sentada y de pie, aun siendo más jóvenes que los demás. Se concluye que los bebés que realizaron intervención motora, una o tres veces por semana, presentaron mejores resultados en la comparación con los del grupo control.

ABSTRACT The main goal of this research was to compare the effect of a Motor Intervention Program (MIP) on the development of babies in public preschools in Porto Alegre. The study included 59 infants, stratified randomly into three groups: 18 infants met three times a week (3X G); 23 babies met once a week (1XG); and 18 control individuals (CG). Visual (three minutes), manipulation of objects (seven minutes) and strength, mobility, and stabilization (ten minutes) tasks were performed. The instrument used was the Alberta Infant Motor Scale (AIMS) to evaluate the babies' motor development. The study results showed an improved classification from 1XG babies (p = 0.007). The 3XG babies had the most significant difference in the prone posture, sitting and standing, despite being younger. In conclusion, the babies who underwent motor intervention one or three times a week had better results when compared to the control group.

Perfil das pacientes do ambulatório de uroginecologia de um hospital público de Porto Alegre com relação à incontinência urinária e à qualidade de vida / Profile of female patients in the urogynecology ambulatory care of a public hospital in southern Brazil regarding urinary incontinence and quality of life

Introdução: A incontinência urinária (IU) é a perda involuntária de urina e pode ser classificada de acordo com os sintomas, sendo os tipos mais comuns: IU de esforço (IUE), IU de urgência (IUU) e IU mista (IUM). Ela causa impacto físico e psicológico negativo, piorando a qualidade de vida. A fisioterapia pélvica é importante no tratamento conservador da IU, pois é segura, não invasiva e com mínimos efeitos colaterais. Objetivos: Descrever o perfil das mulheres avaliadas pela fisioterapia pélvica no Ambulatório de Uroginecologia do Hospital de Clínicas de Porto Alegre (HCPA) com relação à IU e qualidade de vida. Métodos: Estudo descritivo, transversal e retrospectivo, realizado a partir de informações dos prontuários das pacientes avaliadas pela fisioterapia pélvica no Ambulatório de Uroginecologia do HCPA, de agosto de 2013 a dezembro de 2014. Resultados: Dos 164 prontuários analisados, a média de idade das pacientes foi de 58,07 anos (±10,98), 55% realizaram parto normal, 51% fizeram episiotomia, todas eram multíparas, 60,4% apresentavam prolapso de órgão pélvico e a IUM foi a mais prevalente, sendo que 71,3% perdiam urina em jato. Quanto à força dos músculos do assoalho pélvico, a maioria apresentava grau 2 (31,1%), seguido de grau 1 (28%) e grau 3 (24,4%), conforme a Escala de Oxford Modificada, e 75,6% acionavam musculatura acessória. O International Consultation on Incontinence Questionnaire - Short Form (ICIS-SF) mostrou que o impacto da IU foi grave em 62,8%. Conclusão: Este estudo permitiu identificar as principais demandas da população feminina com IU, facilitando o delineamento de estratégias de reabilitação eficazes e compatíveis com a prática clínica (AU)

Introduction: Urinary incontinence (UI) is an involuntary loss of urine and can be classified according to its symptoms. The most common types are the following: stress UI (SUI), urge UI (UUI), and mixed UI (MUI). It causes negative physical and psychological impact and consequent deterioration in quality of life. Pelvic physical therapy plays an important role in the conservative treatment of UI, since it is noninvasive, safe, and with minimal side effects. Objectives: To describe the profile of female patients evaluated through pelvic physiotherapy at the Urogynecology Ambulatory Care of Porto Alegre Clinical Hospital (HCPA) regarding urinary incontinence and quality of life. Methods: A descriptive, cross-sectional, retrospective, documentary study that used information from the medical records of patients evaluated through pelvic physiotherapy at the Urogynecology Ambulatory Care of HCPA, from August 2013 to December 2014. Results: Of the 164 medical records analyzed, patients' average age was 58.07 years (±10.98), 55% of them underwent vaginal delivery, 51% received episiotomy, all were multiparous, 60.4% had pelvic organ prolapse, and 71.3% had urinary leakage in jets. MUI was the most prevalent type of IU. Regarding the strength of pelvic floor muscles, most patients had grade 2 (31.1%), followed by grade 1 (28%) and grade 3 (24.4%), according to the modified Oxford Grading Scale. 75.6% of the patients used some accessory musculature. Quality of life was measured by the International Consultation on Incontinence Questionnaire - Short Form (ICIQ-SF), which showed that the impact of UI was severe in 62.8% of the patients. Conclusion: The present study identified the main demands of the female population with symptoms of UI, facilitating the design of effective rehabilitation strategies which are compatible with clinical practice (AU)