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Fluhr S, Andrade ADD, Oliveira EJB, Rocha T, Medeiros AIC, Couto A, Maia JN, Brandão DC. Lipoabdominoplasty: repercussions for diaphragmatic mobility and lung function in healthy women. ACTA ACUST UNITED AC 2019; 45:e20170395. [PMID: 31166554 PMCID: PMC6715028 DOI: 10.1590/1806-3713/e20170395] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2018] [Accepted: 08/12/2018] [Indexed: 11/22/2022]
Abstract
Objective: To evaluate the impact of lipoabdominoplasty on diaphragmatic mobility (DM) and lung function in healthy women. Methods: This was a prospective cohort study using high-resolution ultrasound and forced spirometry to assess DM and lung function, respectively, prior to lipoabdominoplasty, as well as on postoperative day (POD) 10 and POD 30. DM was measured under two conditions: during tidal volume breathing and during a VC maneuver. Results: The sample consisted of 20 women, with a mean age of 39.85 ± 7.52 years and a mean body mass index of 26.21 ± 2.0 kg/m2. Comparing the preoperative and postoperative periods, we found that DM and lung function values were significantly lower after lipoabdominoplasty, the mean DM on POD 10 being 17% and 15% lower during tidal volume breathing and during the VC maneuver, respectively, in comparison with the preoperative mean (p = 0.009 and p < 0.001, respectively). In addition, FEV1, FVC, and PEF were significantly lower on POD 10 than in the preoperative period (p = 0.046, p = 0.002, and p < 0.001, respectively), returning to preoperative values by POD 30. Conclusions: Lipoabdominoplasty appears to have negative short-term repercussions for DM and lung function in healthy women. However, lung function and DM are both apparently restored to preoperative conditions by POD 30. (ClinicalTrials.gov identifier: NCT02762526 [http://www.clinicaltrials.gov/])
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Affiliation(s)
- Sandra Fluhr
- . Departamento de Fisioterapia, Universidade Federal de Pernambuco, Recife (PE) Brasil
| | | | | | - Taciano Rocha
- . Departamento de Fisioterapia, Universidade Federal de Pernambuco, Recife (PE) Brasil
| | | | - Amanda Couto
- . Departamento de Fisioterapia, Universidade Federal de Pernambuco, Recife (PE) Brasil
| | - Juliana Netto Maia
- . Departamento de Fisioterapia, Universidade Federal de Pernambuco, Recife (PE) Brasil
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Rocha MRSD, Merino DFB, Souza SCD, Montebelo MIDL, Rasera Júnior I, Pazzianotto-Forti EM. Inspiratory loading exercises on respiratory muscle function in post-operative gastroplasty patients: a randomized clinical trial. FISIOTERAPIA EM MOVIMENTO 2019. [DOI: 10.1590/1980-5918.032.ao13] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Abstract Introduction: The gastroplasty post-operative period can alter respiratory mechanics and predispose patients to respiratory complications. Objective: The objective was to evaluate the effects of exercises with inspiratory load on respiratory muscle function and on the prevalence of atelectasis after gastroplasty. Method: 40 participants were randomly allocated into two groups: Control Group (CG), its members underwent conventional respiratory physical therapy (CRP) and the Inspiratory Load Group (ILG), its members performed exercises with linear inspiratory pressure load, with 40% of the maximum inspiratory pressure (MIP), associated with CRP. Therapy procedures were conducted twice during the immediate post-operative period and thrice on the first post-operative day. In addition to evaluating the MIP, the nasal inspiratory pressure (NIP) and the sustained maximum inspiratory pressure (SMIP) were evaluated before and after treatment. Analysis of variance followed by the Bonferroni correction were applied considering a 5% significance level (p < 0.05). Results: There was no significant difference in NIP and SMIP values when the pre- and post-operative periods were compared for the ILG; however, these values were significantly lower for the CG, also with intergroup differences in NIP values. Atelectasis prevalence was 5% for ILG and 15% for CG, with no intergroup difference. Conclusion: The inspiratory muscle strength and resistance of the respiratory muscles were maintained in the group that performed exercises with inspiratory load associated with CRP, with a low rate of atelectasis after gastroplasty.
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Gonçalves TCT, Londe AK, Albano RIP, de Araújo Júnior AT, de Aguiar Azeredo M, Biagioni AF, Vasconcellos THF, Dos Reis Ferreira CM, Teixeira DG, de Souza Crippa JA, Vieira D, Coimbra NC. Cannabidiol and endogenous opioid peptide-mediated mechanisms modulate antinociception induced by transcutaneous electrostimulation of the peripheral nervous system. J Neurol Sci 2014; 347:82-9. [PMID: 25282545 DOI: 10.1016/j.jns.2014.09.024] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2014] [Revised: 08/21/2014] [Accepted: 09/15/2014] [Indexed: 12/23/2022]
Abstract
Transcutaneous electrical nerve stimulation (TENS) is a non-pharmacological therapy for the treatment of pain. The present work investigated the effect of cannabidiol, naloxone and diazepam in combination with 10 Hz and 150 Hz TENS. Male Wistar rats were submitted to the tail-flick test (baseline), and each rodent received an acute administration (intraperitoneal) of naloxone (3.0mg/kg), diazepam (1.5mg/kg) or cannabidiol (0.75 mg/kg, 1.5mg/kg, 3.0mg/kg, 4.5mg/kg, 6.0mg/kg and 12.0mg/kg); 10 min after the acute administration, 10 Hz or 150 Hz TENS or a sham procedure was performed for 30 min. Subsequently, tail-flick measures were recorded over a 90-min period, at 5-min intervals. 10 Hz TENS increased the nociceptive threshold during the 90-min period. This antinociceptive effect was reversed by naloxone pre-treatment, was not altered by diazepam pre-treatment and was abolished by cannabidiol pre-treatment (1.5mg/kg). Moreover, 150 Hz TENS increased tail-flick latencies by 35 min post-treatment, which was partially inhibited by naloxone pre-treatment and totally inhibited by cannabidiol (1.5mg/kg). These data suggest the involvement of the endogenous opioid system and the cannabinoid-mediated neuromodulation of the antinociception induced by transcutaneous electrostimulation at 10 Hz and 150 Hz TENS.
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Affiliation(s)
- Thais Cristina Teixeira Gonçalves
- Laboratory of Physiology and Biophysics, Department of Medicine, Medical School of Patos de Minas Centre Universitarius (UNIPAM), Street Major Gote, 808, Patos de Minas, MG 38702-054, Brazil
| | - Anna Karla Londe
- Laboratory of Physiology and Biophysics, Department of Medicine, Medical School of Patos de Minas Centre Universitarius (UNIPAM), Street Major Gote, 808, Patos de Minas, MG 38702-054, Brazil
| | - Rafael Isaac Pires Albano
- Laboratory of Neuroanatomy and Neuropsychobiology, Department of Pharmacology, Ribeirão Preto Medical School of the University of São Paulo (USP), Av. Bandeirantes, 3900, Ribeirão Preto, SP 14049-900, Brazil
| | - Artur Teixeira de Araújo Júnior
- Laboratory of Signaling and Cell Plasticity, Department of Biotechnology, Biotechnological School of the Federal University of Rio Grande do Sul (UFRGS), Av. Bento Gonçalves, 9500, Bento Gonçalves, RS 91501-970, Brazil
| | - Mariana de Aguiar Azeredo
- Laboratory of Neuroanatomy and Neuropsychobiology, Department of Pharmacology, Ribeirão Preto Medical School of the University of São Paulo (USP), Av. Bandeirantes, 3900, Ribeirão Preto, SP 14049-900, Brazil
| | - Audrey Francisco Biagioni
- Laboratory of Neuroanatomy and Neuropsychobiology, Department of Pharmacology, Ribeirão Preto Medical School of the University of São Paulo (USP), Av. Bandeirantes, 3900, Ribeirão Preto, SP 14049-900, Brazil
| | - Thiago Henrique Ferreira Vasconcellos
- Laboratory of Psychology, Department of Psychology, Medical School of Patos de Minas Centre Universitarius (UNIPAM), Street Major Gote, 808, Patos de Minas, MG 38702-054, Brazil
| | - Célio Marcos Dos Reis Ferreira
- Laboratory of Clinical Physiotherapy, Department of Physiotherapy, School of Biological and Health Sciences of Federal University of Jequitinhonha and Mucuri Valleys (UFVJM), Motorway MGT 367, 5000, Diamantina, MG 39100-000, Brazil
| | - Dulcinéa Gonçalves Teixeira
- Laboratory of Anatomy, Department of Human Anatomy, Medical School of Patos de Minas Centre Universitarius (UNIPAM), Street Major Gote, 808, Patos de Minas, MG 38702-054, Brazil
| | - José Alexandre de Souza Crippa
- Department of Neuroscience and Behavioural Sciences, Division of Psychiatry, Ribeirão Preto Medical School of the University of São Paulo (USP), Av. Bandeirantes, 3900, Ribeirão Preto, SP 14049-900, Brazil
| | - Débora Vieira
- Laboratory of Physiology and Biophysics, Department of Medicine, Medical School of Patos de Minas Centre Universitarius (UNIPAM), Street Major Gote, 808, Patos de Minas, MG 38702-054, Brazil.
| | - Norberto Cysne Coimbra
- Laboratory of Neuroanatomy and Neuropsychobiology, Department of Pharmacology, Ribeirão Preto Medical School of the University of São Paulo (USP), Av. Bandeirantes, 3900, Ribeirão Preto, SP 14049-900, Brazil.
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Galli TT, Chiavegato LD, Santiago NR, Liebano RE. Effects of transcutaneous electrical nerve stimulation on pain, walking function, respiratory muscle strength and vital capacity in kidney donors: a protocol of a randomized controlled trial. BMC Nephrol 2013; 14:7. [PMID: 23311705 PMCID: PMC3586572 DOI: 10.1186/1471-2369-14-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2013] [Accepted: 01/10/2013] [Indexed: 11/10/2022] Open
Abstract
Background Pain is a negative factor in the recovery process of postoperative patients, causing pulmonary alterations and complications and affecting functional capacity. Thus, it is plausible to introduce transcutaneous electrical nerve stimulation (TENS) for pain relief to subsequently reduce complications caused by this pain in the postoperative period. The objective of this paper is to assess the effects of TENS on pain, walking function, respiratory muscle strength and vital capacity in kidney donors. Methods/design Seventy-four patients will be randomly allocated into 2 groups: active TENS or placebo TENS. All patients will be assessed for pain intensity, walk function (Iowa Gait Test), respiratory muscle strength (maximal inspiratory pressure and maximal expiratory pressure) and vital capacity before and after the TENS application. The data will be collected by an assessor who is blinded to the group allocation. Discussion This study is the first to examine the effects of TENS in this population. TENS during the postoperative period may result in pain relief and improvements in pulmonary tests and mobility, thus leading to an improved quality of life and further promoting organ donation. Trial registration Registro Brasileiro de Ensaios Clinicos (ReBEC), number RBR-8xtkjp.
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Affiliation(s)
- Thiago Tafarel Galli
- Physical Therapy Department, University of the City of Sao Paulo (UNICID), Sao Paulo, Brazil
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Three-armed trials including placebo and no-treatment groups may be subject to publication bias: systematic review. PLoS One 2011; 6:e20679. [PMID: 21655196 PMCID: PMC3105112 DOI: 10.1371/journal.pone.0020679] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2010] [Accepted: 05/09/2011] [Indexed: 11/29/2022] Open
Abstract
Background It has been argued that placebos may not have important clinical impacts in general. However, there is increasing evidence of a publication bias among trials published in journals. Therefore, we explored the potential for publication bias in randomized trials with active treatment, placebo, and no-treatment groups. Methods Three-armed randomized trials of acupuncture, acupoint stimulation, and transcutaneous electrical stimulation were obtained from electronic databases. Effect sizes between treatment and placebo groups were calculated for treatment effect, and effect sizes between placebo and no-treatment groups were calculated for placebo effect. All data were then analyzed for publication bias. Results For the treatment effect, small trials with fewer than 100 patients per arm showed more benefits than large trials with at least 100 patients per arm in acupuncture and acupoint stimulation. For the placebo effect, no differences were found between large and small trials. Further analyses showed that the treatment effect in acupuncture and acupoint stimulation may be subject to publication bias because study design and any known factors of heterogeneity were not associated with the small study effects. In the simulation, the magnitude of the placebo effect was smaller than that calculated after considering publication bias. Conclusions Randomized three-armed trials, which are necessary for estimating the placebo effect, may be subject to publication bias. If the magnitude of the placebo effect is assessed in an intervention, the potential for publication bias should be investigated using data related to the treatment effect.
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