SUMMARY BACKGROUND: Patients with coronavirus disease 2019 on automatic mechanical ventilation have greater heart rate modulation with greater parasympathetic modulation. OBJECTIVE: To analyze the autonomic modulation of heart rate in critically ill patients with coronavirus disease 2019 on invasive mechanical ventilation. METHODS: A cross-section study was carried out with 36 individuals divided into two groups. The control group included patients of both genders, in orotracheal intubation with invasive mechanical ventilation under controlled assisted mode, hospitalized in the intensive care unit for another 24 h. In the non-COVID group, patients diagnosed with coronavirus disease 2019 in the same condition mentioned in the control group. RESULTS: There was a significant increase in heart rate variability (standard deviation of all normal RR intervals recorded at an interval of time; p=0.001; triangular interpolation histogram of RR intervals; p=0.048; and SD2; p=0.014) in the coronavirus disease group compared to the non-COVID group. Successively, the parameters that demonstrate parasympathetic modulation are shown to be higher in the group of patients with coronavirus disease 2019 (root mean square of the square of differences between adjacent normal RR intervals in an interval of time; p<0.001; pNN50; p<0.001; SD1; p=0.002; and high frequency; p=0.022). CONCLUSIONS: There was a greater autonomic modulation of heart rate with a greater parasympathetic modulation in patients with coronavirus disease 2019 on mechanical ventilation.

Abstract Background: The aim of this study was to evaluate the QoL of patients undergoing heart valve replacement using the SF-36 questionnaire, compare it between patients with mechanical prosthesis and patients with bioprosthesis, and correlate the results with sociodemographic variables. Objective: To assess the QoL of patients undergoing heart valve replacement and compare it between patients with bioprosthetic valves and patients with mechanical prosthetic valves. Methods: We included 36 consecutive patients (16 men) with a mean age of 51 years and six months, who underwent mitral or aortic valve replacement from September 2007 to December 2011. The study was conducted between March and May 2012 and involved the application of the SF-36 survey and a sociodemographic questionnaire. Statistical tests were performed, and data are expressed as absolute frequency and percentile, and median and interquartile range (P25 and P75) (Mann-Whitney test), considering a significance of 95%. Results: The average time of surgery was 32.5 months (8-61 months). Participants were asked about the practice of physical activity, and 41.7% were physically active. For the SF-36 domains, the highest scores were observed for the social domain whereas the lowest scores were found for mental health, with a mean of 89.25 and 54.44, respectively. In the statistical analysis, we found statistically higher values in emotional functional for patients with mechanical valve prosthesis (p = 0.0084). Conclusion: The QoL of the patients undergoing heart valve replacement improves considerably after the surgery, except for the mental health domain, probably due to the low practice of physical activity. The type of prosthesis seems not to influence the QoL or the patients in the late postoperative period.

Abstract We present a case of a female adolescent with severe acute Chagas myocarditis, acquired by oral transmission in an endemic area in the Brazilian western Amazon, who had electrocardiographic changes normalized after empirical treatment with the antiparasitic drug benznidazole combined with conventional treatment for severe heart failure.

INTRODUÇÃO: Medidas de pressão inspiratória máxima e pressão expiratória máxima são usados para avaliar a força desenvolvida pelos músculos respiratórios. Tais medidas são também utilizadas como critérios para o desmame da ventilação mecânica, para determinar as consequências funcionais de várias doenças sistêmicas e do desenvolvimento de doenças pulmonares e neuromusculares. OBJETIVO: Verificar a presença do efeito de aprendizado nas mensurações de pressão inspiratória e expiratória máximas. MÉTODO: Foram realizadas 15 medições sequenciais de pressão inspiratória máxima e 15 de pressão expiratória máxima em 71 indivíduos. Os resultados para ambas as séries foram comparados ao longo de cada série RESULTADOS: As comparações entre a primeira e as demais medidas não apresentaram diferenças estatisticamente significativas (p > 0,05). CONCLUSÃO: Não houve efeito aprendizado em 15 medidas repetidas de pressão inspiratória máxima ou pressão expiratória máxima em adultos saudáveis.

BACKGROUND: Measurements of maximal inspiratory and expiratory pressure are used to assess the pressure developed by the respiratory muscles and the passive elastic recoil of the pulmonary system. Such measurements are also used as criteria for weaning from mechanical ventilation, to determine the functional consequences of several systemic diseases and the development of lung diseases and neuromuscular disorders. The test in na outpatient setting is easy to perform, well tolerated and has predictive value OBJECTIVE: To verify the presence of a learning effect in measurements of maximal inspiratory and expiratory pressures. METHODS: We performed 15 sequential measurements of Maximal Inspiratory Pressure and 15 of Maximal Expiratory Pressure in 71 individuals. Results for both series were compared throughout each series. RESULTS: The comparison between the first and the other measurements showed no statistically significant differences. (p > 0.05). CONCLUSIONS: There was no learning effect with 15 repeated measurements of Maximal Inspiratory or Expiratory Pressure in healthy adults.