Resumo Introdução: O teste de caminhada de seis minutos (TC6min) é amplamente utilizado para avaliar a capacidade funcional em crianças. A medida do trabalho durante o TC6 poderia adicionar informações importantes à avaliação do TC6 nessa população, no que se refere à eficiência da marcha. Objetivo: Verificar os determinantes do trabalho durante o Teste de Caminhada (TC6min) em crianças em idade escolar. Método: Trata-se de um estudo transversal e exploratório que incluiu crianças saudáveis recrutadas nas escolas públicas e privadas das cidades de Belo Horizonte e Uberlândia, Brasil. Os critérios de inclusão foram: crianças de 7 a 12 anos sem diagnóstico de doença cardiorrespiratória crônica, distúrbio cognitivo, comportamental ou comprometimento da função física (informações obtidas por auto-relato dos responsáveis pelas crianças). Os critérios de exclusão foram: crianças que se recusaram a realizar o TC6; que não entenderam o TC6 ou que não responderam aos comandos de teste. Trezentos e dezenove crianças em idade escolar foram incluídas no estudo. Análises de correlação e análise de regressão linear múltipla foram utilizadas para identificar as variáveis associadas ao trabalho com TC6. Resultados: Idade, altura, estado nutricional, atividade física e frequência cardíaca apresentaram correlação significativa com o trabalho durante o TC6min (p <0,001) e explicaram 87% de sua variação (p = 0,0001). Conclusão: Idade, altura, estado nutricional e variação da frequência cardíaca são determinantes do trabalho no TC6, e portanto, devem ser considerados na avaliação da capacidade funcional de crianças em idade escolar.

Abstract Introduction: The Six-Minute Walk Test (6MWT) is widely used to assess functional capacity in children. The measure of work during 6MWT can add important information to the 6MWT assessment in this population as it relates to walking efficiency. Objective: To verify the determinants of work during the Six-Minute Walk Test (6MWTwork) in school-aged children. Method: This is a cross-sectional and exploratory study that included healthy children recruited from the public and private schools of the cities of Belo Horizonte and Uberlândia, Brazil. The inclusion criteria were: children aged 7 to 12 years without diagnosis of chronic cardiorespiratory disease, cognitive, behavioral disorder or physical function impairment (information obtained through self-report of those responsible for children). Exclusion criteria were children who refused to perform the 6MWT; who did not understand the 6MWT or who did not answer the test commands. Three hundred and nineteen school-aged children were included in the study. Correlation analyses and multiple linear regression analysis were used to identify the variables associated with the 6MWTwork. Results: Age, height, nutritional status, physical activity and heart rate showed significant correlation with 6MWTwork (p <0.001) and explained 87% of its variation (p = 0.0001). Conclusion: Age, height, nutritional status and heart rate variation are determinants of 6MWTwork that is able to evaluate functional capacity of school-aged children.

AbstractIntroduction: Excessive load on the backpacks can lead to musculoskeletal injuries and gait alterations. The objective of this study was to analyze the electromyographic (EMG) activity in association to the kinematic during the stance and balance phases of gait performed with and without the use of the backpack. Methods Twelve volunteers have executed a gait cycle in 3 tasks: without the school backpack (SM), with a backpack with load equivalent to 10% (M10) and 20% (M20) of the body weight (BW). It was evaluated the ankle, knee and hip angular excursion (AE), linear displacement (LD) of the toe and ankle, knee, hip, shoulder, head and EMG activity of the tibialis anterior (TA), vastus medialis (VM), rectus abdominis (RA), gastrocnemius lateral (GL), biceps femoris (BF) and spinal erector (EE) muscles. Results In the LD in the stance phase there was an AP increase for the toe and ankle, hip and head (p<0.043). In the balance phase for VT (vertical) direction, the shoulder presented a smaller displacement as well as the toe, ankle, knee, hip, shoulder and head in the ML direction. In the AP direction, the toe displacement was smaller as well as the ankle (p < 0.038). The AE in both phases was smaller for the hip (p <0.006). In the balance phase the IEMG was higher for the RA (p = 0.034). Conclusion These results suggest that the transport of school backpacks with loads of more than 10%BW causes changes in the kinematic and in the muscular recruitment pattern.

Abstract: Background: Low temperatures and slow blood flow may result from peripheral neuropathy caused by leprosy, and the simple detection of cold fingers could already be a preliminary classification for these patients. Objective: To investigate whether infrared thermography would be able to measure this change in temperature in the hands of people with leprosy. Method: The study assessed 17 leprosy patients who were under treatment at the National Reference Center for Sanitary Dermatology and Leprosy, Uberlândia/MG, and 15 people without leprosy for the control group. The infrared camera FLIR A325 and Therma CAM Researcher Professional 2.9 software were used to measure the temperature. The room was air-conditioned, maintaining the temperature at 25°C; the distance between the camera and the limb was 70 cm. The vasomotor reflex of patients was tested by a cold stress on the palm. Results: The study showed a significant interaction between the clinical form of leprosy and temperature, where the control group and the borderline-borderline form revealed a higher initial temperature, while borderline-lepromatous and lepromatous leprosy showed a lower temperature. Regarding vasomotor reflex, lepromatous leprosy patients were unable to recover the initial temperature after cold stress, while those with the borderline-tuberculoid form not only recovered but exceeded the initial temperature. Conclusion: Thermography proved a potential tool to assist in the early detection of neuropathies, helping in the prevention of major nerve damage and the installation of deformities and disabilities that are characteristic of leprosy.

RESUMO JUSTIFICATIVA E OBJETIVOS: Avaliar e comparar a ocorrência e dimensão da diástase dos músculos retos abdominais nos segundo e terceiro trimestres gestacionais e correlacioná-las com presença e intensidade da dor lombar. MÉTODOS: Estudo observacional do tipo transversal com 128 gestantes, divididas em dois grupos: 53 gestantes no segundo trimestre gestacional e 75 gestantes no terceiro trimestre gestacional. Utilizou-se para avaliar a dor lombar o questionário Roland Morris e a escala analógica visual da dor. A mensuração da diástase dos músculos retos abdominais foi realizada com auxílio de um paquímetro. Os dados foram analisados segundo a correlação de Spearman e teste U de Mann-Whitney. RESULTADOS: A comparação dos grupos demonstrou que as gestantes do terceiro trimestre apresentavam maior diástase abdominal, mais relatos de dor lombar intensa por meio da escala analógica visual p=0,0017 e maior impacto nas atividades da vida diária (p=0,0012). A correlação foi positiva entre a dimensão da diástase dos músculos retos abdominais e os escores obtidos no questionário Roland Morris e na escala analógica visual. CONCLUSÃO: A dimensão da diástase dos músculos retos abdominais, a intensidade da dor e a incapacidade determinadas pela lombalgia foram maiores nas gestantes do terceiro trimestre gestacional.

ABSTRACT BACKGROUND AND OBJECTIVES: To evaluate and compare the presence and size of recti abdominis diastasis in the second and third gestational trimester and to correlate them to lumbar pain incidence and intensity. METHODS: This is a cross-sectional observational study with 128 pregnant women divided in two groups: 53 pregnant women in the second gestational trimester and 75 pregnant women in the third gestational trimester. Lumbar pain was evaluated with Roland Morris questionnaire and Pain Visual Analog Scale. Recti abdominis diastasis was measured with a caliper rule. Data were analyzed according to Spearman correlation and Mann-Whitney U test. RESULTS: Comparison between groups has shown that pregnant women in the third gestational trimester had more recti abdominis diastasis, more reports of severe lumbar pain by the visual analog scale (p=0.0017) and further impact on daily life activities (p=0.0012). There has been positive correlation between recti abdominis diastasis size and scores obtained by Roland Morris questionnaire and visual analog scale. CONCLUSION: Recti abdominis diastasis size, pain intensity and incapacity determined by low back pain were more severe in pregnant women in the third gestational trimester.

INTRODUÇÃO: Crianças e adolescentes com excesso de peso apresentam maior prevalência de broncoespasmo induzido pelo exercício (BIE), quando comparados a eutróficos. A espirometria e o peak flow meter são importantes métodos avaliativos da função pulmonar. Porém, a aplicabilidade do medidor do pico de fluxo expiratório (peak flow meter) na detecção do BIE em crianças e adolescentes com excesso de peso não é conhecida, o que justifica o desenvolvimento desta pesquisa. OBJETIVOS: Avaliar e comparar o desencadeamento de broncoespasmo induzido pelo exercício (BIE) em crianças e adolescentes não asmáticos com excesso de peso, avaliados pela espirometria e pelo peak flow meter (PFE). CASUÍSTICA E MÉTODOS: Participaram do estudo 39 voluntários acima do percentil 85º (OB) e 30 eutróficos (EU), de oito a 15 anos. A avaliação da função pulmonar pré e pós-teste de broncoprovocação foi realizada pela espirometria e peak flow meter, de acordo com o protocolo de Del Río-Navarro et al., (2000). O BIE foi considerado positivo quando o voluntário apresentou uma redução > 10% do VEF1 basal ou redução > 20% do PFE PFM e/ou PFE E. RESULTADOS: Na detecção do BIE, a prevalência do grupo obeso foi de 26% avaliado pelo peak flow meter (PFEPFM) e 23% pelo VEF1. O tempo do BIE ocorreu nos primeiros 15 minutos pós-exercício em ambos os parâmetros: (PFE PFM) e VEF1. CONCLUSÃO: Os voluntários obesos apresentaram tempo e prevalências similares de BIE, quando avaliados por ambos os métodos de avaliação pulmonar. O fácil manejo e o baixo custo facilitam a maior acessibilidade para a população geral do peak flow meter, o que demonstra sua importância como parte integrante de um programa educacional no diagnóstico inicial do BIE em vias aéreas de grande calibre.

INTRODUCTION: Children and adolescents who are overweight have a higher prevalence of exercise-induced bronchospasm (EIB), as compared to eutrophics. Spirometry and peak flow meter are important evaluation methods of lung function. However, the applicability of the peak expiratory flow (peak flow meter) in the detection of EIB in children and adolescents who are overweight is not known, hence the development of this research. OBJECTIVES: To evaluate and compare the onset of exercise-induced bronchospasm (EIB) in children and adolescents non-asthmatic who are overweight, evaluated by spirometry and the peak flow meter (PEF). METHODS: The study included 39 volunteers above the 85th percentile (OB) and 30 normal weight (EU), with the age of 8 to 15 years. The evaluation of lung function before and after bronchial provocation test was performed by spirometry and peak flow meter, according to the protocol of Del Río-Navarro et al, (2000). The EIB was considered positive when the volunteer showed a reduction > 10% of baseline FEV1 or > 20% reduction in PEF PFM and / or PEFE. RESULTS: The detection of the BIE, the prevalence of obese group was 26% measured by peak flow meter (PEF PFM) and 23% for FEV1. The time of the BIE occurred with the first 15 minutes post-exercise in both parameters: (PFE PFM) and FEV1. CONCLUSION: The obese volunteers presented similar time and prevalence of EIB, when evaluated by both methods of pulmonary assessment. The easy handling and low cost from this method created greater accessibility for the general population from the peak flow meter, which shows its importance as part of an educational program in the initial diagnosis of EIB in large airway caliber.

Nosocomial pneumonia is a common complication in patients on mechanical ventilation and results in significant mortality. Diagnosis of pneumonia in patients who are intubated and under mechanical ventilation is difficult, even with the aid of clinical, laboratorial, and endoscopic tests. The objective of this study was to compare three methods of tracheal sputum collection in patients with a clinical and radiological diagnosis of pneumonia. Twenty-two patients with a clinical diagnosis of liver disease were enrolled, 18 years of age or older, 13 males and nine females, who had been mechanically ventilated over an intubation period of 5.86 ± 4.62 days. These patients were being treated in intensive care unit (ICU) of the Liver Transplantdepartment. Secretion collection was carried out according to a protocol with three distinct methods: endotracheal aspiration with a closed aspiration system, Bal cath and bronchoalveolar lavage. Of the 22 patients analyzed, 21 (95.4%) showed one or more infectious agent when the closed aspiration system was used. With the Bal cathâ collection, 19 patients (86.3%) had one or more infectious agents; in the collection by bronchoalveolar lavage, 10 patients (45.4%) presented one or more infectious agent. According to the laboratorial analysis, 14 different microorganisms were isolated, the most frequent of which were Staphylococcus aureus, Pseudomonas aeruginosa, and Klebsiella pneumoniae. We concluded that aspiration with the closed system produced the most effective results in comparison with those of bronchoalveolar lavage and the Bal cathâ, and may be an acceptable method for diagnosing hospital-acquired pneumonia when no fiberoptic technique is available.