RESUMO
Early mobilization is beneficial for critically ill patients because it reduces muscle weakness acquired in intensive care units. The objective of this study was to assess the effect of functional electrical stimulation (FES) and passive cycle ergometry (PCE) on the nitrous stress and inflammatory cytometry in critically ill patients. This was a controlled, randomized, open clinical trial carried out in a 16-bed intensive care unit. The patients were randomized into four groups: Control group (n=10), did not undergo any therapeutic intervention during the study; PCE group (n=9), lower-limb PCE for 30 cycles/min for 20 min; FES group (n=9), electrical stimulation of quadriceps muscle for 20 min; and FES with PCE group (n=7), patients underwent PCE and FES, with their order determined randomly. The serum levels of nitric oxide, tumor necrosis factor alpha, interferon gamma, and interleukins 6 and 10 were analyzed before and after the intervention. There were no differences in clinical or demographic characteristics between the groups. The results revealed reduced nitric oxide concentrations one hour after using PCE (P<0.001) and FES (P<0.05), thereby indicating that these therapies may reduce cellular nitrosative stress when applied separately. Tumor necrosis factor alpha levels were reduced after the PCE intervention (P=0.049). PCE and FES reduced nitric oxide levels, demonstrating beneficial effects on the reduction of nitrosative stress. PCE was the only treatment that reduced the tumor necrosis factor alpha concentration.
Assuntos
Estado Terminal/terapia , Citocinas/sangue , Terapia Passiva Contínua de Movimento/métodos , Estresse Nitrosativo/fisiologia , Respiração Artificial/métodos , Adulto , Idoso , Biomarcadores/sangue , Estado Terminal/reabilitação , Estimulação Elétrica/métodos , Feminino , Humanos , Inflamação/imunologia , Inflamação/metabolismo , Unidades de Terapia Intensiva , Masculino , Pessoa de Meia-Idade , Estresse Oxidativo/fisiologia , Músculo Quadríceps/fisiopatologiaRESUMO
Early mobilization is beneficial for critically ill patients because it reduces muscle weakness acquired in intensive care units. The objective of this study was to assess the effect of functional electrical stimulation (FES) and passive cycle ergometry (PCE) on the nitrous stress and inflammatory cytometry in critically ill patients. This was a controlled, randomized, open clinical trial carried out in a 16-bed intensive care unit. The patients were randomized into four groups: Control group (n=10), did not undergo any therapeutic intervention during the study; PCE group (n=9), lower-limb PCE for 30 cycles/min for 20 min; FES group (n=9), electrical stimulation of quadriceps muscle for 20 min; and FES with PCE group (n=7), patients underwent PCE and FES, with their order determined randomly. The serum levels of nitric oxide, tumor necrosis factor alpha, interferon gamma, and interleukins 6 and 10 were analyzed before and after the intervention. There were no differences in clinical or demographic characteristics between the groups. The results revealed reduced nitric oxide concentrations one hour after using PCE (P<0.001) and FES (P<0.05), thereby indicating that these therapies may reduce cellular nitrosative stress when applied separately. Tumor necrosis factor alpha levels were reduced after the PCE intervention (P=0.049). PCE and FES reduced nitric oxide levels, demonstrating beneficial effects on the reduction of nitrosative stress. PCE was the only treatment that reduced the tumor necrosis factor alpha concentration.
Assuntos
Humanos , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Idoso , Respiração Artificial/métodos , Terapia Passiva Contínua de Movimento/métodos , Citocinas/sangue , Estado Terminal/terapia , Estresse Nitrosativo/fisiologia , Biomarcadores/sangue , Estado Terminal/reabilitação , Estresse Oxidativo/fisiologia , Estimulação Elétrica/métodos , Músculo Quadríceps/fisiopatologia , Inflamação/imunologia , Inflamação/metabolismo , Unidades de Terapia IntensivaRESUMO
UNLABELLED: No nutritional protocol for poorly controlled diabetic patients receiving well-managed drug treatment is currently available. OBJECTIVE: Aims were to compare dietary consumption of calcium and fibers with lipid profile and glycosilated hemoglobin HbA1c. METHODOLOGY: This was a prospective observational study. Patients with poorly controlled diabetes were consecutively recruited. A food-frequency questionnaire and tests for lipid profile, HbA1c, and C reactive protein were collected, along with clinical and anthropometric assessment. RESULTS: Patients (N = 114, age 65.7 ± 6.5 years, 75.4% females, BMI 29.0 ± 5.3 kg/m²) were often insulin-dependent (32.5%) and with systemic inflammation (C-reactive protein 4.2 ± 3.9 mg/L). Diet was energy restricted (1,365 ± 565 kcal/day) and mostly adequate but with suboptimal fiber (15.4 ± 8.6 g/day) and very low calcium (592.4 ± 204.4 mg/day). Calcium and fiber in the diet correlated with serum lipids, whereas fiber alone displayed a protective association regarding diabetes (HBA1c, insulin use) and arterial hypertension. CONCLUSIONS: Calcium and fiber ingestion exhibited correlations with important markers of metabolic status and cardiovascular risk. Future studies should address enhancement of these ingredients by means of dietary changes and supplements.
Assuntos
Cálcio da Dieta/uso terapêutico , Diabetes Mellitus/dietoterapia , Fibras na Dieta/uso terapêutico , Idoso , Antropometria , Glicemia/metabolismo , Proteína C-Reativa/metabolismo , LDL-Colesterol/sangue , Diabetes Mellitus/sangue , Diabetes Mellitus/tratamento farmacológico , Dieta , Ingestão de Energia , Feminino , Hemoglobinas Glicadas/análise , Hemoglobinas Glicadas/metabolismo , Humanos , Hipoglicemiantes/administração & dosagem , Hipoglicemiantes/uso terapêutico , Insulina/administração & dosagem , Insulina/uso terapêutico , Lipídeos/sangue , Masculino , Pessoa de Meia-Idade , Estudos ProspectivosRESUMO
UNLABELLED: Low-grade inflammation adversely influences metabolism and cardiovascular prognosis, nevertheless increased intake of fruits and vegetables has rarely been studied in this context. OBJECTIVE: In a prospective controlled study, the effect on C-reactive protein (CRP) levels was assessed. METHODOLOGY: Sixty consecutive women undergoing cosmetic abdominal surgery were instructed to consume six servings each of fruits and vegetables during the first postoperative month. Detailed 24 h interviewer-administered dietary recall was conducted at baseline and at the end of the study, with weekly returns to monitor unscheduled dietary changes and compliance with the protocol. Variance (ANOVA) and covariance (ANCOVA) were evaluated to confirm significance and minimize confounding variables. RESULTS: No differences concerning age (42.2±5.3 vs 41.1±6.0 years) or BMI (25.5±3.1 vs 25.0±3.0 kg/m²) occurred. Ingestion of fruits increased to approximately 5.2 vs 3.9 and of vegetables 5.9 vs 3.4 servings/ day, respectively. CRP decreased more conspicuously in the treated group (P=0.028), and correlation between vitamin C input and CRP in supplemented participants was demonstrated (P=0.014). CONCLUSIONS: Higher intake of antioxidant foods was feasible, and an antiinflammatory effect occurred. Further studies with longer administration and follow-up period are recommended.