Evaluation of sleep quality and daytime somnolence in patients with chronic obstructive pulmonary disease in pulmonary rehabilitation.

BACKGROUND: Dyspnea, fatigue, and decline in sleep quality are symptoms of chronic obstructive pulmonary disease (COPD). Pulmonary rehabilitation programs have been shown to ameliorate dyspnea and fatigue. However, only a few studies have investigated the effects of pulmonary rehabilitation on the sleep quality of COPD patients. In this study, we analyzed the benefits of a pulmonary rehabilitation program to sleep quality and daytime somnolence in COPD patients. METHODS: This study was a study of 30 moderate-severe COPD patients. All patients were evaluated by a pulmonologist and underwent polysomnography before participating in the study. For this study, we selected only ex-smokers and patients with sleep apnea were referred to the sleep clinic. These participants were prospectively recruited and not selected based on program completion. Before the start of the program, sleep quality and daytime somnolence of the participants were evaluated using the Pittsburgh Sleep Quality Index (PSQI) and the Epworth Sleepiness Scale (ESS), respectively. Rehabilitation program consisted of muscular training sessions conducted at the gym 3 times per week for 12 weeks. After rehabilitation program, the patients were reassessed and their sleep quality and daytime somnolence were reevaluated using the PSQI and the ESS, respectively. RESULTS: Before rehabilitation, PSQI evaluation revealed that 73% of the participants had poor sleep quality, and ESS evaluation showed that 86.7% of the participants experienced daytime somnolence. After pulmonary rehabilitation, the PSQI specifically improved in terms of subjective sleep quality and sleep duration (< 0.001), habitual sleep efficiency (0.001), and sleep latency and sleep alterations (0.002) and there was also improvement in the ESS (< 0.001). CONCLUSION: Pulmonary rehabilitation program of gradually increasing intensity has the potential to provide sleep-related benefits to patients with COPD who have poor sleep quality and daytime somnolence. TRIAL REGISTRATION: Registro Brasileiro de Ensaios Clínicos (ReBEC) RBR62b4z2.

Morphometry and spatial correlation of the foramen magnumand spinal cord through the magnetic resonance in normalyoung adults – anatomical and clinical aspects

to establish the spatial relationship between the surfaces of foramen magnum (FM) and spinal cord (SC) identifying how much of the FM surface is occupied by the SC. Material and methods: 40 normal adults (23 females) with a mean age of 22 yrs (18-25) were evaluated through MRI to evaluate the sagittal and transversal diameter of foramen magnum and spinal cord. The surface area of FM and spinal cord was calculated, in the craniovertebral junction. Results: the sagittal diameter was consistently greater than the transversal diameter in the FM with a mean value of 34.78 mm. On the other hand, the transversal diameter was bigger in the spinal cord, with the mean value of 12.18 mm. The spinal cord occupies 82.93% of the FM surface in the craniovertebral junction. There was no difference between sexes. Conclusions: The better knowledge of craniovertebral junction anatomy is helpful in the neurosurgical planning and in the diagnosis of diseases that present intracranial hypertension.

Características morfológicas e morfométricas da cavidade glenoidal em escápulas humanas adultas / Morphologic and morphometric characteristics of the glenoid cavity in human adult scapulae

Objetivo: Mensurar a cavidade glenoidal da escápula no que se refere aos diâmetros, profundidade e cálculo de sua área plana, além de descrever sua forma e características anatômicas. Método: Foram utilizadas 62 escápulas isoladas e seis pares (esquerdo e direito), pertencentes a esqueletos humanos adultos, no total de 74 escápulas. As medidas foram realizadas com um paquímetro digital para determinar os diâmetros e a profundidade, além de um computador para o cálculo da área plana. Esse cálculo foi possível após a obtenção das medidas dos diâmetros. Resultados: A média da área plana foi de 264,18mm2 para a cavidade glenoidal classificada como piriforme e 244,78mm2 para a cavidade glenoidal elipsóide. O valor da profundidade variou de acordo com a presença ou não do tubérculo glenoidal. Este foi observado em 47 por cento da amostra e a incisura glenoidal em 100 por cento. Nenhum outro detalhe anatômÍco foi observado. A cavidade glenoidal foi identificada como piriforme em 72 por cento e elipsóide em 28 por cento dos casos. Conclusões: Os resultados demonstraram que a área plana e a profundidade da cavidade glenoidal não apresentam diferença estatisticamente significante se comparados os lados direito e esquerdo. A forma piriforme da cavidade glenoidal foi mais freqüente que a elipsóide. A incisura glenoidal esteve presente em 100 por cento da amostra e o tubérculo glenoidal em 47 por cento