Efeito de um programa regular de exercício físico sobre a proteína C-reativa de indivíduos com risco de doenças cardiovasculares / Effect of a Regular Aerobic Exercise Program on C-Reactive Protein among People at Risk for Cardiovascular Disease

Fundamentos: Estudos observacionais sugerem que exercício físico possui efeito anti-inflamatório, no entanto essa hipótese não está definitivamente confirmada por ensaios clínicos randomizados.Objetivo: Verificar o efeito da atividade física aeróbica sobre o processo inflamatório sistêmico em indivíduos com risco cardiovascular. Métodos: Ensaio clínico randomizado, em que foram incluídos indivíduos sedentários, com pelo menos dois fatores de risco para doença coronariana ou doença cardiovascular estabelecida. Os voluntários foram randomizados para três meses de treinamento aeróbico supervisionado (grupo-treino) ou apenas aconselhamento quando a hábitos de vida saudáveis (grupo-controle). Proteína C-reativa (PCR) foi mensurada por método de alta sensibilidade antes e após a intervenção. Resultados: Avaliados 68 indivíduos. Os grupos treino e controle apresentaram características basais semelhantes. Houve melhora da capacidade funcional apenas nos pacientes do grupo-treino. Observou-se aumento de PCR após três meses no grupo-controle, cuja mediana evoluiu de 2,2 mg/L (IIQ =1,0 mg/L - 4,3 mg/L)para 3,2 mg/L (IIQ =2,4 mg/L - 5,5 mg/L), p=0,006.Esse fenômeno não foi observado no grupo-treino,que apresentou mediana basal de 1,7 mg/L(IIQ =0,97 mg/ L - 4,8 mg/L), estatisticamente semelhante ao valor final de 2,5 mg/L (1,0 mg/L - 4,7 mg/L), p=0,46.Quando a variação percentual da PCR foi comparada entre os grupos, houve maior incremento no grupo controle(+58,0 %; IIQ =11,0 % - 151,0 %), comparado ao grupo-treino (+17,0 %; IIQ =-36,0 % - 79,0 %),p intergrupo=0,046.

Background: Although observational studies suggest that exercise has anti-inflammatory effects, this possibility has not been confirmed definitively through randomized clinical trials. Objective: To assess the effects of aerobic activities on systemic inflammatory processes among people at cardiovascular risk. Methods: A randomized clinical trial encompassing sedentary subjects with at least two risk factors for heart disease or established cardiovascular disease. These volunteers were assigned randomly to three months of supervised aerobic training (training group) or just counseling on healthy lifestyle habits (control group). C-reactive protein (CRP) was measured by a highly sensitive method before and after these interventions. Results: Assessing 68 subjects. The training and control groups had similar baseline characteristics. There was improvement in functional capacity among only the training group patients. After three months, an increase in the CRP was noted in the control group, whose median rose from 2.2mg/L(IQR=1.0 to 4.3mg/L) to 3.2mg/L (IQR=2.4 to5.5mg/L) - p=0.006. This phenomenon was not found in the training group, which presented a baseline median of 1.7mg/L (IQR =0.97 to 4.8mg/L),statistically similar to the final value of 2.5mg/L(1.0 to 4.7mg/L) - p=0.46. When the percentage variation in the CRP was compared for these groups, there was a greater increase in the control group (+58%, IQR=11% to 151%), compared to the training group (+17%, IQR= -36% to 79%) - intergroupp=0.046.

Satisfacción y retención de los contenidos del Curso Agentes Físicos del Diplomado en Rehabilitación / Satisfaction and retention of the contents of the course on Physical Agents given in the Diploma Course on Rehabilitation

Se realizó una investigación educacional para identificar la satisfacción de residentes y profesores de la especialidad en Medicina Física y Rehabilitación con el Curso Agentes Físicos (AF) impartido en el Diplomado de Rehabilitación en la Atención Primaria de Salud y evaluar la retención de los contenidos recibidos, así como la necesidad de abordarlos nuevamente en el programa de la especialidad, por su importancia. Para medir la satisfacción se aplicaron encuestas a los 23 residentes de segundo año de la especialidad y a 16 profesores, que impartieron clases en el curso. Se aplicó un examen teórico a todos los residentes, para evaluar la retención de dichos contenidos. Para el análisis de la información se procesaron los datos mediante frecuencias y porcentajes y se presentaron en tablas, para darles significación se realizó una triangulación de los datos con elementos teóricos. Los resultados mostraron satisfacción baja respecto a los contenidos de agentes físicos del diplomado, los que son insuficientes, no están actualizados y presentan dificultades con su profundización y aplicación, por lo que deben ser abordados nuevamente y con mayor profundidad en el programa de la especialidad. Los residentes demostraron no tener suficiente dominio de los contenidos recibidos

An education research was conducted to identify the satisfaction of residents and professors of the specialty of Physical Medicine and Rehabilitation with the course on Physical Agents given in the Diploma Course on Rehabilitation in Primary Health Attention and evaluate retention of the contents studied as well as the need to deal with these contents again, because of their importance, in the course design of the specialty. To measure the level of satisfaction, inquiries were applied to the 23 second year residents of the specialty and 16 professors who gave lessons in the course. A theory exam was applied to all residents to evaluate retention of the above contents. For information analysis, all data were processed by means of frequencies and percentages, they were shown in tables and, to emphasize their importance, a triangulation of data with theoretical elements was presented. The results showed low satisfaction with the contents on physical agents given in the Diploma Course which are not sufficient; they are not updated and present difficulties in their depth and application what means that they should be undertaken again in depth in the course design of the specialty. Residents showed not to have enough knowledge of the contents received

Prevention-of-impairment-and-disabilities activities in leprosy after integration: role for physical medicine and rehabilitation personnel.

Referral options for specialist care for prevention of impairment and disabilities are imperative in order to make an integrated leprosy control system work. This requires an understanding of the disease, in addition to the special skills for managing specific disabilities. Physical medicine and rehabilitation (PMR) personnel are better equipped to handle leprosy-related disabilities. They are well versed with biomechanical aspects of deformities, and are competent to provide splints, orthoses, etc. to the needy persons, and they can assess sensory motor functions and deformities. If PMR personnel can be trained in deformity correction they can become valuable resource persons for secondary and tertiary care of leprosy-affected persons. PMR persons, therefore, have the opportunity to volunteer themselves for this job to fill the void created by the fading out of leprosy surgeons. They will also have to bear additional responsibility to train general health care workers so as to empower them to look after the needs of those disabled by leprosy, many of whom will continue to be available for a number of years to come.

Bacharelado em física: ênfase física médica / Phisics bachelor: medical phisics enphasis

O presente trabalho visa descrever as etapas de implantação, bem como, os primeiros resultados referentes a formação de alunos de graduação no curso de Bacharelado de Física, com ênfase na área médica. Os resultados apresentados demonstram a perfeita integração dos egressos com o curriculo desenvolvido, da mesma maneira que, com as atividades extracurriculares realizadas na área hospitalar.

Abstract - This paper describes the implementation steps of student's graduation who's taking a Phisics couse bachelor enphassissing medical area. showing it's first results. Our analisyss show us a perfect integration between students, an advanced curriculum course and at the same time extra activities developed at hospital's major

Formacion en el Pregrado de Medicina sobre rehabilitacion y medicina fisica / Undergraduate teaching of reabilitation and physical medicine

Se encuesto a un grupo de 100 alumnos de Internado Rotatorio de la Carrera de Medicina de La Paz, en base a las preguntas referidas a criterios sobre incapacidad, su prevencion, el tratamiento, pronostico y la medicina fisica y rehabilitacion. Los resultados demostraron una total falta de conocimiento en estos aspectos que no estan incluidos en los planes de estudio. Asimismo, pusieron en evidencia la gran confusion existente en relacion a todos los aspectos del campo de la rehabilitacion y el uso de medicos fisicos en el tratamiento. Se econcluye en la necesidad de incorporar a los planes de estudio de la materia de Medicina Fisica y Rehabilitacion en concordancia con recomendaciones de instituciones nacionales como internacionales.

Prospectives and retrospectives: a glimpse of the future of physiatry

Brevemente se ha presentado un vistazo hacia el futuro cercano y lejano de la Medicina Física y el Fisiatra. Siempre habrá una gran cantidad de pacientes envejecientes, crónicamente enfermos, impedidos, incapacitados y con limitaciones. El cuidado a pacientes cambiará constantemente para incorporar adelantos en a tecnología biomédica y de rehabilitación como también por restricciones por control de costos. Los derechos humanos prevalecerán no sólo por razones humanitarias, sino porque los ciudadanos con limitaciones se unirán y cabildearán en las legislaturas para aprobar leyes que mejorarán l calidad de sus vidas

Rehabilitación médica integral / Medical and integral rehabilitation

La rehabilitación médica, como filosofía es la restauración de los individuos impedidos hacia un estudio físico, mental, social y económico útil; es un proceso creativo, en donde se emplean técnicas especiales para desarrollar la incapacidad residual al último grado de efectividad. El presente documento constituye una preocupación docente en el campo de la rehabilitación médica, considerando que existe poca literatura tanto para la docencia en pregrado, como en postgrado. Comprende 14 capítulos básicos que abarcan desde los conceptos, la filosofía, organización, docencia, rehabilitación profesional y legislación venezolana de protección al impedido. Asimismo se analízan las medidas rehabilitadoras en la etapa curativa y crónica