RESUMEN
Abstract Background: Air pollution and sex independently affect cardiac autonomic control, which can be assessed by heart rate variability (HRV). The research hypothesis is that individuals exposed to low concentrations of pollution have higher cardiac autonomic modulation compared to those exposed to high concentrations and that women have better cardiac autonomic control than men. Objective: To analyze the impact of exposure to air pollutants, specifically smoke, and sex on HRV in healthy young people exposed to different concentrations of pollution over an average period of 22 years. Methods: From April to September 2011, 36 participants of both sexes (20-30 years old) were selected, grouped by levels of air pollution exposure according to indices provided by the Environmental Company of São Paulo State. The R-R intervals (R-Ri) of the electrocardiogram were captured using a heart rate monitor during supine rest. HRV was analyzed by spectral analysis and conditional entropy. The Queen's College step test was used to characterize functional capacity. A between-group comparison was performed using the two-way ANOVA statistical test (post hoc Tukey) and p<0.05. Results: Significant differences were found in mean R-Ri (p<0.01) and cardiac parasympathetic modulation between sexes in the same city (p=0.02) and between groups exposed to different air pollution concentrations (p<0.01). Conclusion: Our results suggest that long-term exposure to air pollutants, specifically smoke, has an unfavorable impact on HRV, with reduced cardiac vagal autonomic modulation in healthy young adults, especially females.
Asunto(s)
Humanos , Masculino , Femenino , Adulto , Adulto Joven , Contaminación del Aire/efectos adversos , Frecuencia Cardíaca , Sistema Nervioso Autónomo/patología , Estudios Transversales , Estudios Prospectivos , Contaminantes AtmosféricosRESUMEN
Complicações no pós-operatório de cirurgia cardíaca pediátrica são freqüentes, destacando-se a atelectasia e a pneumonia. A fisioterapia contribui significativamente no tratamento destas complicações. Desta forma, este estudo buscou agrupar e atualizar os conhecimentos da atuação fisioterapêutica no pré-operatório e nas complicações pulmonares do pós-operatório de cirurgia cardíaca pediátrica. Observou-se a eficácia do tratamento fisioterapêutico por meio de diferentes técnicas específicas e a necessidade do desenvolvimento de novas pesquisas
Lung complications during postoperative of pediatric heart surgery are frequently highlighting atelectasis and pneumonia. Physiotherapy has an important role in the treatment of these complications. We reviewed and update the physiotherapy performance in the preoperative and in the postoperative lung complication of pediatric cardiac surgery. We noted efficacy of physiotherapy treatment through different specific techniques and the need for development of new studies