Camilly Enes Ferreira

Bronchiectasis (BC) is a multidimensional and etiologically diverse disease and, therefore, no single parameter can be used to determine its overall severity and prognosis. In this regard, two different validated scores are currently used to assess the severity of non-cystic fibrosis bronchiectasis (NCFB): the FACED score and the Bronchiectasis Severity Index (BSI). To describe the etiology of NCFB and compare the results of the assessment of NCFB severity obtained via FACED and BSI scores. Retrospective study of demographic and clinical data of a convenience sample of NCFB patients attending the Functional Breathing Re-adaptation appointment at the Pneumology B Unit, University Hospital Center of Coimbra. All patients underwent evaluation of the variables incorporated in the FACED score (FEV1% predicted, age, chronic colonization by Pseudomonas aeruginosa, radiological extent of the disease, and dyspnea) and in the BSI (age, body mass index, FEV1% predicted, hospitalization and exacerbations before study, dyspnea, chronic colonization by P. aeruginosa and other microrganisms, and radiological extent of the disease). Statistical analysis of the data was performed using Microsoft Excel® and IBM SPSS® v23. The sample included 40 patients, 22 females and 18 males, aged 39–87 years. Regarding the etiology of NCFB, we found: idiopathic (60%), post-infectious (20%), sequelae of pulmonary tuberculosis (12.5%) and primary immunodeficiency related (7.5%). According to the FACED score we found 20 patients (50%) with mild BC, 15 patients (37.5%) with moderate and 5 patients (12.5%) with severe BC. The frequency of patients with low, intermediate and high BSI was 13 (32.5%), 13 (32.5%) and 14 (35%), respectively in relation to derived BSI, Moreover, we observed a weak but statistically significant association between FACED and BSI scores: Fisher's exact test (p = 0.004), tau-b de Kendall (0.469; p = 0.001). The Kappa test (0.330; p = 0.002) also shows us that there is 55% agreement between the two scales. There is a small but significant correlation between the two scales: a tendency is observed for patients to be classified with a higher BSI compared to the FACED score. This can be explained by the fact that BSI (and not FACED) evaluates parameters including BMI, hospitalization and exacerbations before study, chronic colonization by other microorganisms and development of cystic bronchiectasis. Further studies should address how these scores may impact clinical practice.

Case report of a 49-year old male patient who presented with signs and symptoms in agreement with Cushing's Syndrome, the etiology of which was shown to be an ACTH-independent macronodular hyperplasia. In such cases, the therapeutical choice is bilateral adrenalectomy which was adopted by us using a posterior approach. The relevance of the clinical diagnosis and therapeutical aspects of this condition are reviewed.

Background: The combination of aerobic exercise and transcutaneous microcurrent electrical stimulation (MES) application was shown to have a positive effect on localized abdominal adiposity (LAA) reduction. However, the effect of the combination of MES and high-intensity interval training (HIIT) is still unknown. Objective: This study aimed to evaluate the effect of combination of MES and HIIT on LAA reduction. Methods: 39 sedentary women with LAA, distributed in a control group (CG), an exercise group (EG), and a MES plus exercise group (MEG) participated in this randomized clinical trial. The CG was not submitted to intervention. The EG was submitted to a HIIT protocol (80% of heart rate max in a functional circuit) and MEG was submitted to abdominal transcutaneous application of MES prior to HIIT, 2x/week, during 5 weeks. The outcomes were collected by a blind evaluator and measured in three moments (before the 1st intervention, and after the 5th and 10th intervention), based on body composition parameters, anthropometric data, physical activity level (PAL), body satisfaction, quality of life (QOL), and lumbar functionality. Results: After 10 interventions, MEG showed significant improvement in skinfolds, QOL, and body satisfaction, but no significant difference compared to EG or CG. Regarding PAL, MEG differed significantly in relation to CG, but not in relation to EG. Conclusion: The combination of MES and HIIT in 10 interventions did not show satisfactory results for LAA reduction compared to HIIT, but the increase in PAL and the improvement in lumbar functionality may provide positive effects in the medium-term, although further studies are required.

The analysis of the presence of hypertension and diabetes and falls in the elderly seeks to determine arelationship between these variables, aiming to develop and advance prevention and awarenessmechanisms regarding this problem that persists in the lives of the elderly. The objective of this studywas to determine the prevalence of falls among community-dwelling elderly individuals who havehypertension and diabetes mellitus. The study consists of a data snapshot, in a descriptive andquantitative cross-sectional manner, where economic and sociodemographic aspects, general health,level of frailty, and functional autonomy of the elderly were evaluated. Elderly individuals aged 60 orolder, with hypertension and diabetes mellitus, were included in the study. The sample consisted of onehundred and ten elderly individuals (n = 110) who met the inclusion criteria and agreed to participate. Itwas found that 38.2% (n=42) of the elderly with hypertension and diabetes mellitus had falls in the lasttwelve months, and 21.8% (n=24) reported having had only one fall in the last twelve months. Theresults also indicate that 36.84% of the elderly with diabetes mellitus and 50% of the elderly withhypertension reported having fallen in the last 12 months, demonstrating a considerable prevalence ofthese occurrences in this group. Although preventive actions have reduced the number of falls, it isimportant to continue focusing on strategies to further decrease this prevalence and improve the qualityof life for the elderly.

The assessment of the functional autonomy of the elderly aims to determine their ability to take care of themselves, perform basic and instrumental daily living activities, as well as analyze how they behave in the environment they live in. This study aims to analyze the levels of functional autonomy of elderly individuals in a long-term care institution (ILPI) in the municipality of Rio Verde - GO. The study consists of a cross-sectional quantitative analysis of secondary data, where sociodemographic and economic aspects, general health, institutionalization, and functional autonomy (Functional Autonomy Measurement System) were evaluated. Those elderly individuals who were over 60 years old and had been institutionalized for more than six months at the time of data collection were included in the study. Seventy-five elderly individuals met the inclusion criteria. The participants had an average age of 76.3±8.0 years, and the majority were male (n=54; 72.0%), between 60 and 79 years old (n=52; 69.3%), without a partner (n=57; 76.0%), without formal education (n=50; 64.0%), retired (n=68; 90.7%), using more than 5 medications (n=41; 54.7%), and having more than 3 comorbidities (n=63; 84.0%). It was found that 28.0% of the evaluated elderly presented as dependent, representing the lowest level of functional autonomy, indicating significant challenges for maintaining independence and quality of life, such as specific interventions like rehabilitation programs, exercises, and environments that encourage independence.