Correlation between intra-abdominal pressure and pulmonary volumes after superior and inferior abdominal surgery

OBJECTIVE: Patients undergoing abdominal surgery are at risk for pulmonary complications. The principal cause of postoperative pulmonary complications is a significant reduction in pulmonary volumes (FEV1 and FVC) to approximately 65-70% of the predicted value. Another frequent occurrence after abdominal surgery is increased intra-abdominal pressure. The aim of this study was to correlate changes in pulmonary volumes with the values of intra-abdominal pressure after abdominal surgery, according to the surgical incision in the abdomen (superior or inferior). METHODS: We prospectively evaluated 60 patients who underwent elective open abdominal surgery with a surgical time greater than 240 minutes. Patients were evaluated before surgery and on the 3rd postoperative day. Spirometry was assessed by maximal respiratory maneuvers and flow-volume curves. Intra-abdominal pressure was measured in the postoperative period using the bladder technique. RESULTS: The mean age of the patients was 56±13 years, and 41.6% 25 were female; 50 patients (83.3%) had malignant disease. The patients were divided into two groups according to the surgical incision (superior or inferior). The lung volumes in the preoperative period showed no abnormalities. After surgery, there was a significant reduction in both FEV1 (1.6±0.6 L) and FVC (2.0±0.7 L) with maintenance of FEV1/FVC of 0.8±0.2 in both groups. The maximum intra-abdominal pressure values were similar (p = 0.59) for the two groups. There was no association between pulmonary volumes and intra-abdominal pressure measured in any of the groups analyzed. CONCLUSIONS: Our results show that superior and inferior abdominal surgery determines hypoventilation, unrelated to increased intra-abdominal pressure. Patients at high risk of pulmonary complications should receive respiratory care even if undergoing inferior abdominal surgery. .

Efeitos dos exercícios resistidos sobre o equilíbrio e a funcionalidade de idosos saudáveis: artigo de atualização / Effects of resistance training on balance and functional ability in healthy elderly: an update

A diminuição da força muscular com o envelhecimento e os baixos níveis de atividade física contribuem para défices funcionais e de equilíbrio. Esta revisão sistemática teve como objetivo analisar os estudos que correlacionaram o treino resistido (TR) isolado, o equilíbrio e a função de idosos saudáveis. A busca nas bases do Google Acadêmico e na BVS levou à seleção de 35 estudos controlados. O TR isolado mostrou ser relevante para a função dos idosos (90% dos estudos) devido sobretudo ao ganho de força e mobilidade. Exercícios de baixa e moderada intensidade tiveram melhores resultados sobre a função de idosas, frágeis e sedentários. Em relação ao equilíbrio, apesar da inconsistência dos dados, o TR parece exercer efeitos positivos, sobretudo devido a fatores neuromusculares. Estudos com parâmetros de treino e amostra uniformes são necessários para melhor comparação dos resultados, sobretudo em idosos com padrão funcional elevado.

Muscle strength decrease in aging and low physical activity levels may be an indicator of balance deficits and functional limitations. The purpose of this systematic review was to assess the effects of resistance training (RT) alone on balance performance and functional capacity in healthy elderly. The search in Google Scholar and BVS led to selecting 35 controlled trials. The RT alone showed to have positive effects (90% of the studies) on functional tasks in elderly, associatedwith increases in strength and mobility. Moderate and low-intensity exercise could produce functional capacity benefits in older women, frail and sedentary elderly. Despite the inconsistency of data, resistance training appears to exert positive effects on balance, especially through neuromuscular factors. Standardization of methodology and homogeneity of sampling may ensure greater comparability of results, especially among elderly with high physical functional level.

Efeito da atividade física sobre a evolução do enfisema pulmonar: um estudo experimental em ratos Wistar / Effects of physical activity on the development pulmonar emphysema in rats: experimental study in rats Wistar

O propósito da presente investigação foi avaliar o papel da atividade física no desenvolvimento de enfisema induzido por papaina em ratos. Para tanto, ratos Wistar foram radomicamente divididos em quatro grupos (n = 10 para cada grupo) que receberam, respectivamente, infusão intra-traqueal de papaína (6 mg em 1 ml de NaCI 0,9 por cento) ou veículo e foram submetidos ou não ao protocolo de exercício em uma esteira ergométrica. Os ratos exercitaram-se a 13,3 m/min, 6 dias por semana, durante 9 semanas (o tempo de exercício foi aumentado gradualmente, de 10 a 35 min) / The purpose of the present study was to evaluate the role of exercise trainning on the development of papain-induced emphysema in rats. Wistar rats were randomly assigned to four groups (n = 10 for each group) that receiveid, respectively, intratracheal infusion of papain (6 mg in 1 ml NaCI 0,9 per cent) or vehicle and were submitted or not to a protocol of exercise on a treadmill...