Competências Básicas de Investigação
Científica e de Publicação
Lecture 7: How to become a more
successful author
You…
• How can we improve our research outputs?
– Quantity
– Quality
• How can we avoid rejection?
• How can we increase citation rates?
• How can we publish in quality journals?
Main opportunities for success - 2013
• Start with a well-defined hypothesis that has
its foundations firmly rooted in the
international literature.
• Have a clear message
• Develop a well-structured writing style
• Understand the publishing process
• Choose the right journal at the beginning of
the project
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The research process
Project
proposal
Experiment,
results,
analysis
Write article
?
Submit to
journal
Rejection/
acceptance
Re-submit
Project titles – the problem starts here
• Análise dos limiares de sensibilidade à pressão e
à corrente elétrica em acupontos em indivíduos
com e sem migrânea
• Frequência, localização anatômica e limiar de
percepção dolorosa em pontos gatilhos
miofasciais na cabeça e pescoço em mulheres
com migrânea.
• Ultrassonografia e eletromiografia de superfície
dos músculos flexores cervicais em mulheres com
migrânea e cefaleia do tipo tensional
Titles are easily improved – focus on
outcomes rather than methods
• DIAPHRAGM RELEASE MANUAL TECHNIQUE
EFFECTS ON DIAPHRAGMATIC MOBILITY,
RESPIRATORY MUSCLE STRENGTH AND
EXERCISE PERFORMANCE IN COPD PATIENTS:
A RANDOMIZED CONTROLLED TRIAL.
• MANUAL DIAPHRAGM RELEASE TECHNIQUE
INCREASES TIDAL VOLUME IN ELDERLY COPD
PATIENTS
Frequência, localização anatômica e limiar de percepção
dolorosa em pontos gatilhos miofasciais na cabeça e pescoço em
mulheres com migrânea.
Context: Migraine is a very common pain syndrome and the mechanisms that
can cause or aggravate the pain and the consequences of its chronicity are
still not completely understood. Studies have shown that migraine is
associated with a central sensitization phenomena in which noxious stimuli
cause changes in the central nervous system , sensitizing cranial nociceptors
and reducing their activation threshold . In this context , the constant
peripheral nociceptive input due to myofascial trigger points in the muscles of
the head and neck may be associated with the onset of the migraine attack .
The elucidation of the role of trigger points in migraine is essential in order to
establish and direct physical therapy through tools useful for patients with
myofascial disorders associated with migrainous framework .
Objective: To evaluate and compare differences in the frequency , anatomical
location and sensory threshold pressure of the trigger points of the trapezius
( descending fibers ) , masseter , sternocleidomastoid , in women with and
without migraine .
Hypotheses – mechanism not
measurement
• Patients with migraine have a higher amount
of myofascial trigger points in the temporalis,
masseter, sternocleidomastoid and
descending trapezius muscles.
• Patients with migraine have a low threshold
for pain sensation in these points.
• Cutaneous mechanical cephalic and extracephalic allodynia vary within one month
Finding this information is not difficult
Top ten journals in this field
1. Headache Total score: 1.46
2. Pain Total score: 1.24
3. Current pain and headache reports Total score: 0.91
4. Cephalalgia : an international journal of headache Total score: 0.71
5. The journal of pain : official journal of the American Pain Soc Total score: 0.51
6. European journal of neurology : the official journal of the Eur Total score: 0.47
7. Medical hypotheses Total score: 0.41
8. Brain : a journal of neurology Total score: 0.41
9. Chinese medicine Total score: 0.39
10. Neurology Total score: 0.39
Hypotheses - 2
• Women with migraine and tension-type
headache have a smaller cross-sectional area
of the flexor neck and greater activation and
fatigue of the sternocleidomastoid muscle,
than women without migraine.
• Ten references, eight before 2010
Conclusions
• Make sure your hypothesis is firmly rooted in
the current literature
• Identify at least one journal that is publishing
work based on similar hypotheses
• If your reference list does not contain many
recently published articles, you have a
problem
Measuring performance
The h-index is an index that attempts to
measure both the productivity and impact of
the published work of a scientist or scholar.
The index is based on the set of the scientist's
most cited papers and the number of citations
that they have received in other publications
Fisioterapia - departmental performance
8
7
6
H-index
5
4
3
2
1
0
0
5
10
15
Article output 2008-2013
20
25
Why do papers not get cited?
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Echocardiography evaluations for
asymptomatic patients with severe obesity
Abstract
Objective: To study the systolic and diastolic function of asymptomatic patients with
severe obesity using a Doppler echocardiography. Methods: Thirty candidates for
bariatric surgery, with an average BMI of 49.2 ± 8.8 Kg/m2 and no previous history of
heart disease were evaluated through transthoracic echocardiography. Results:
Enlarged left chambers were observed in 42.9% of the sample, diastolic dysfunction in
54.6% and left ventricular hypertrophy in 82.1%, of which 50% of the cases presented
the geometric pattern of eccentric hypertrophy. Indexation of left ventricular mass to
height resulted in a significantly higher number of diagnoses for hypertrophy than
indexation to body surface area (p = 0.0053), demonstrating that this index is more
appropriate to determine ventricular hypertrophy in obese people. Correlations
between left ventricular hypertrophy with obesity duration and pressure levels were
positive as well as correlations between body mass index and diastolic dysfunction
indicators. Conclusion: This study demonstrated that echocardiograms performed on
asymptomatic severely obese patients can detect alterations in the cardiac structure
that are common in cases of obesity cardiomyopathy and can be associated with the
development of heart failure, arrhythmias and sudden death, enabling the
identification of patients with greater cardiovascular risk.
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Echocardiography evaluations for
asymptomatic patients with severe obesity
• Objective: To study the systolic and diastolic function of
asymptomatic patients with severe obesity using a
Doppler echocardiography.
• Conclusion: This study demonstrated that
echocardiograms performed on asymptomatic severely
obese patients can detect alterations in the cardiac
structure that are common in cases of obesity
cardiomyopathy and can be associated with the
development of heart failure, arrhythmias and sudden
death, enabling the identification of patients with
greater cardiovascular risk.
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Echocardiography identifies obese patients
at risk of cardiovascular complications
• Objective: Can echocardiograms be used to
identify patients at risk of cardiovascular
complications?
• Conclusion: Echocardiograms detect common
alterations in the cardiac structure in
asymptomatic severely obese patients. These
changes are associated with the development of
heart failure, arrhythmias and sudden death.
Thus, echocardiograms can be used to identify
patients at risk of cardiovascular complications.
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Use eTBLAST to identify similar articles
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Hunt the hypothesis
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Do malnutrition and fluoxetine neonatal treatment
program alterations in heart morphology?
Abstract: Growth and development events are observed in all organisms and
can be modified by exogenous factors such as nutritional changes. Drastic
morphological and functional alterations may occur during a vulnerable stage
of development. The aim of this study was to investigate if malnutrition
and/or fluoxetine neonatal treatment program alterations in heart
morphology during the postnatal period. The sample consisted of 48 albino
Wistar male rats. The rats were divided into two groups: nourished and
malnourished. Pharmacologic manipulation was performed during the
suckling period. The animals of each group were divided into two subgroups:
saline-nourished and saline-malnourished, treated with sodium chloride
solution, and fluoxetine-nourished and fluoxetine-malnourished, treated with
fluoxetine. Half of the individuals in each subgroup were weighed and
sacrificed on day 30 and the other half on day 71. Myocardial perfusion was
performed and the heart subsequently weighed. The ventricles were crosssectioned into two parts, which were fixed, dehydrated and sectioned. There
were differences in body weight, heart weight, cross-sectional area and
perimeter of the heart and in the cross-sectional area and perimeter of the
cardiac cells among the groups at the different ages. Malnutrition appears to
program alterations in heart morphology. However, malnourished animals
that had undergone drug treatment did not exhibit the same changes
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Introduction
Long-term consequences in adult life dependent on environmental stimuli during critical periods of development (fetal, neonatal or infancy) have
been evidenced by epidemiological and animal studies (Hales and Barker, 1992, Ozanne et al., 1998 and Lopes de Souza et al., 2008). The mechanism
associated with these effects is called “programming”, whereby environmental aggression during a critical period of development would have
permanent effects on the structure and function of the organs (Lucas, 1991). Nutritional status during the critical period of development has been
considered an important inducer of programming in both animals and humans. A growth rate deficit, increased oxidative damage and changes in
glucose/insulin metabolism have been observed in rats submitted early in life to either a maternal dietary-protein restriction (40–50% of normal
intake) or to low-protein diet throughout gestation and lactation (Desai et al., 1996, Ozanne et al., 1998 and Toscano et al., 2008). In humans, a
number of epidemiological studies have provided support to the association between low birth weight and metabolic diseases in adult life (Hales and
Barker, 1992 and Ravelli et al., 1998). The effects of early malnutrition on cardiac development have been investigated.
Malnutrition prevents growth and causes an overall deterioration of tissue, especially a severe loss of muscular tissue, including cardiac muscle
(Bergman et al., 1988, Almeida and Mandarim-de-Lacerda, 2005 and Toscano et al., 2008). During its development, the heart is damaged by the
adverse effects of malnutrition (Fioretto et al., 2002). Animal studies show that malnutrition reduces heart cell mass proportionally to weight loss
(Alden et al., 1987, Pissaia et al., 1980, Vandewoude and Buyssens, 1992 and Webb et al., 1986).
The interference in the growth and development processes caused by malnutrition is also seen in the balance of neurotransmitter systems. Regarding
the serotonergic system, malnutrition in early life in rats reduces serotonergic fibers and serotonin (5-HT) reuptake sites in the hippocampus (Blatt et
al., 1994). Even after short periods of food restriction, metabolic 5-HT changes and also changes in the levels of other substances, such as dopamine,
were noted in rat pups (Ishida et al. 1997). It is well known that protein malnutrition early in life promotes an increase of 5-HT and norepinephrine
levels in rat brain (Sobotka et al., 1974, Stern et al., 1975 and Resnick et al., 1979). There is also evidence that norepinephrine is increased in the heart
of malnourished rats (Pissaia et al., 1980).
Besides its action as a neurotransmitter, 5-HT plays a role in regulating the growth of neural and non-neural tissues (Buznicov et al., 2001). Serotonin is
believed to act as a morphogenetic signal in rat embryos, possibly regulating the action or expression of other growth regulatory molecules (Yavarone
et al., 1993). Manipulation of the serotonergic system may affect cardiovascular morphogenesis (Negibil et al., 2001) as well as regulating heart cell
growth (Yavarone et al., 1993).
According to these hypotheses, optimal serotonin levels may be mitogenic, although high concentrations of this amine seem to be inhibitory
(Yavarone et al., 1993). The use of 5-HT reuptake inhibitors (SSRI) during development of the embryo decreased the cell proliferation in the
myocardium, cardiac mesenchyma and endothelium growth (Yavarone et al., 1993). Fetal and early infancy environmental exposure can impair
cardiovascular health and functioning (Mone et al., 2004). Among the cardiovascular problems that may be caused by environmental exposure is
abnormal anatomic development (Mone et al., 2004). Therefore there is increasing evidence that the cardiovascular system is susceptible to external
influences throughout gestation and after birth (Mone et al., 2004). Considering the nutritional and the neurotransmitters influences on body and
heart development it would be very opportune to compare the consequences of the early malnutrition and 5-HT pharmacological manipulations on
body and heart growth. The aim of this study was therefore to investigate if malnutrition and/or fluoxetine neonatal treatment program alterations in
heart morphology.
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Introduction
Considering the nutritional and the
neurotransmitters influences on body and
heart development it would be very
opportune to compare the consequences
of the early malnutrition and 5-HT
pharmacological manipulations on body
and heart growth. The aim of this study
was therefore to investigate if malnutrition
and/or fluoxetine neonatal treatment
program alterations in heart morphology.
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Choosing the right journal
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Communities of arbuscular mycorrhizal fungi in
dry tropical forests of Northeast Brazil
The arbuscular mycorrhizal association is one of the important
strategies used by plants in arid and semiarid regions to support water
scarcity and soil nutrient deficiency. In this study the diversity and
activity of arbuscular mycorrhizal fungi (AMF) were investigated in two
types of dry tropical forest. Soil and roots samples were collected in
areas of thorny dry woody savanna (TDWS) and in areas of mixed
savanna and montane deciduous shrub (SMDS) in Pernambuco State,
Brazil. Twenty seven species from 10 genera of Glomeromycota were
identified, and Acaulospora was the most representative. An average
of 50 spores per 100 g of soil was recovered from the two areas. The
infection potential of the AMF was determined using colonized root
fragments and extraradical mycelium and demonstrated the
importance of these propagules for the colonization of roots. Under the
same semiarid conditions, the two tropical dry forests studied harbored
distinct AMF communities indicating that the soil and vegetation type
are the key influencers of the composition and activity of these fungi in
the studied areas.
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Using eTBLAST to find similar articles
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Other titles included Oecologia, New Phytologist…
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EDANZ Journal Selector
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Arbuscular mycorrhizal fungi in a semiarid
copper mining area in Brazil
There are >160 species of arbuscular mycorrhizal fungi (AMF), whose taxonomic history is recent. Based on their symbiotic
habit and morphology, Morton and Benny (1990) included all of the AMF in the order Glomales, with three families
(Acaulosporaceae, Gigasporaceae and Glomaceae) and six genera ( Acaulospora, Entrophospora , Gigaspora , Glomus ,
Sclerocystis and Scutellospora). However, Redecker et al. (2000), using phylogenetic information obtained from morphological
and molecular data, transferred the species of Sclerocystis to Glomus, reinforcing the proposal of Almeida and Schenck (1990).
Morton and Redecker (2001) created two new families, Archaeosporaceae and Paraglomaceae, respectively, typified by the
genera Archaeospora and Paraglomus, and currently the AMF are included in a new phylum: Glomeromycota (Schüssler et al.
2001).
The distribution of AMF in natural Brazilian ecosystems has not been well studied: Trufem (1996) mentioned some species in
the Amazon and Atlantic provinces, as well as in cerrado areas, without records for other important areas (caatinga in the
northeast and pampas in the south). Taxonomic inventories of AMF in undisturbed areas were done in São Paulo (Bononi and
Trufem 1983; Trufem 1988, 1990; Trufem et al. 1994; Gomes and Trufem 1998) and Santa Catarina (Stürmer and Bellei 1994).
In cultivated areas there are records for the States of São Paulo (Trufem and Bononi 1985; Trufem et al. 1989, 1990; Grandi and
Trufem 1991; Carrenho et al. 2001) and Pernambuco (Maia and Trufem 1990; Melo et al. 1997).
The excess of heavy metals in soils has a direct toxic effect on plants, being deleterious to the AMF and having an impact on
plant and microbial communities (Valsecchi et al. 1995). Various heavy metals are fungitoxic, reducing spore germination,
mycelial growth and, consequently, mycorrhizal colonization (Nogueira 1996). An excess of Zn and Cu inhibits spore
germination (Hepper 1979), while colonization can be reduced in the presence of high levels of Zn, Cu, Ni, and Cd (Gildon and
Tinker 1983).
There are apparently no papers that mention species of AMF in areas in Brazil that have been degraded by mining. However,
taxonomic surveys in these areas are important to provide information regarding environmental impact and also about the
AMF species that are adapted to this stress condition, and would be useful for revegetation programs.
This paper deals with the identification of AMF species that occur in areas affected by copper mining, relating the presence of
such species to the levels of environmental impact found in the areas and comparing the occurrence of these fungi with the
local
plant diversity.
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Arbuscular mycorrhizal fungi in a
semiarid copper mining area in Brazil
There are >160 species of arbuscular mycorrhizal fungi (AMF), whose
taxonomic history is recent.
The distribution of AMF in natural Brazilian ecosystems has not been well
studied:
The excess of heavy metals in soils has a direct toxic effect on plants, being
deleterious to the AMF and having an impact on plant and microbial
communities (Valsecchi et al. 1995).
There are apparently no papers that mention species of AMF in areas in Brazil
that have been degraded by mining
This paper deals with the identification of AMF species that occur in areas
affected by copper mining, relating the presence of such species to the levels
of environmental impact found in the areas and comparing the occurrence of
these fungi with the local plant diversity.
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Communities of arbuscular mycorrhizal fungi in
dry tropical forests of Northeast Brazil
Arbuscular mycorrhizal fungi (AMF) live in symbiosis with the roots of most terrestrial plants (Smith and Read, 2008, Willis et al.,
2013). These fungi provide better conditions for the establishment of the host plant, especially under stress situations such as
nutrient deficiency (Smith and Smith, 2012), drought (Cavalcante et al., 2001), soil degradation (Mergulhão et al., 2010) and the
attack of plant pathogens (Sikes, 2010).
Plants in arid and semiarid environments are exposed to high temperatures, soils with low fertility and long drought periods
(Menezes et al., 2012). Water scarcity is considered the most important abiotic factor that limits the growth and productivity of
plants in such ecosystems (Almeselmani et al., 2012). Thus, the mycorrhizal association is probably an essential condition for
establishment, maintenance and productivity of plants in arid and semiarid environments .
Most of the Northeast region of Brazil is characterized by a semiarid climate, with annual high temperatures ranging from 23 to
27ºC and low rainfall. In many areas the average annual rainfall is lower than 1000 mm (Menezes et al., 2012). This region is
marked by torrential though extremely irregular rains, followed by periods of six to nine months of drought. The thorny dry
woody savanna, composed of plants with adaptations to withstand drought (Giulietti et al., 2006) is the predominant
vegetation type in this region and characterizes the biome known as Caatinga, which covers 844.453 km2 and represents 70%
of the Northeast region (MMA, 2011).
The Caatinga harbors a high biological diversity but is poorly studied. Furthermore, it is suffering from anthropic activity and
the resultant loss of native fauna and flora (Albuquerque et al., 2012) with areas of preserved vegetation reduced to small
fragments.
Studies on the ecology of AMF have been conducted in this biome (Carneiro et al., 2012; Mello et al., 2012; Mergulhão et al.,
2010), and 79 species of the group have already been recorded (Goto et al., 2010). However, more research is needed,
especially in areas as yet not studied, to improve our knowledge about community structure for these important plant
symbionts and the role they play in the Brazilian semiarid.
New data on the occurrence and distribution of organisms in the Caatinga are essential not only to broaden the understanding
about biological diversity of this and other semi-arid biomes but also because they constitute an important tool for its
conservation. Thus, in this study we investigated the composition of AMF species, their infectivity potential, and the mycorrhizal
conditions of the plants, analyzing the influence of environmental factors on these variables.
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Ganesha Associates 2013
Communities of arbuscular mycorrhizal fungi in
dry tropical forests of Northeast Brazil
Arbuscular mycorrhizal fungi (AMF) live in symbiosis with the roots of most terrestrial
plants (Smith and Read, 2008, Willis et al., 2013).
Plants in arid and semiarid environments are exposed to high temperatures, soils with
low fertility and long drought periods (Menezes et al., 2012).
Most of the Northeast region of Brazil is characterized by a semiarid climate, with
annual high temperatures ranging from 23 to 27ºC and low rainfall.
The Caatinga harbors a high biological diversity but is poorly studied.
Studies on the ecology of AMF have been conducted in this biome (Carneiro et al.,
2012; Mello et al., 2012; Mergulhão et al., 2010), and 79 species of the group have
already been recorded (Goto et al., 2010)
New data on the occurrence and distribution of organisms in the Caatinga are
essential not only to broaden the understanding about biological diversity of this and
other semi-arid biomes but also because they constitute an important tool for its
conservation.
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The importance of structure
Title
Document
Summary
Sections
Introduction
Paragraphs
Results
Sentences
Discussion
Phrases
Bird odour predicts reproductive success
Abstract: Although the importance of chemical communication in birds has
long been overlooked or doubted, volatile compounds in avian preen
secretions have been shown to covary with traits including species, sex and
breeding condition, and thus may be useful mate recognition cues. Here we
demonstrate for the first time that these compounds may reliably predict
reproductive success in a North American songbird, the dark-eyed junco,
Junco hyemalis. Several compounds associated with sex differences in this
species varied with reproductive success, such that females with a more
‘female-like’ volatile profile and males with a more ‘male-like’ profile
produced more genetic offspring. A male's preen oil volatile compounds also
predicted his success in rearing offspring in his home nest: males with a
higher abundance of ‘male-like’ compounds had more surviving nestlings,
including offspring sired by extrapair males. Finally, males with a higher
abundance of ‘female-like’ compounds had more extrapair offspring in their
home nests. Our results suggest that odours correlate with reproductive
success and thus have qualities that could allow them to serve as reliable
mate assessment cues in birds.
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Bird odour predicts reproductive success
Introduction: The previously described relationships between preen oil volatile compounds and individual variation,
these compounds have the qualities required to serve as species recognition cues (they are highly divergent among
species: Haribal et al., 2005 and Mardon et al., 2010) and as mate recognition cues (the concentration of these
compounds differs between the sexes and with breeding condition: Soini et al., 2007, Whittaker et al.,
2010 and Whittaker et al., 2011b). Mate assessment cues must advertise the sender's individual identity and quality,
and be highly variable among individuals (Johansson & Jones 2007).
In the present study, we examined whether volatile compounds in preen gland secretions covary with individual
quality and thus could serve as reliable mate assessment cues. Definitions of individual quality vary, but are generally
based on phenotypic characters that correlate with fitness (Lailvaux & Kasumovic 2011), although some studies imply
that quality and fitness are interchangeable (Wilson & Nussey 2010). In this study, we chose to test whether these
potential cues correlated with reproductive success, defined as the number of surviving offspring produced.
We tested whether measurements of preen oil volatile compounds collected early in the breeding season predicted
genetic and social reproductive success in the same season. Our study organism is the dark-eyed junco, Junco
hyemalis, a songbird that has recently been the subject of avian chemical communication studies ( Soini et al., 2007,
Whittaker et al., 2009, Whittaker et al., 2010, Whittaker et al., 2011a and Whittaker et al., 2011b).
For comparison, we also tested whether visual cues, including plumage traits and morphological measurements, could
predict reproductive success in these birds, or whether chemical signals might be a more reliable predictor.
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Bird odour predicts reproductive success
Introduction: The previously described relationships between preen oil volatile compounds and
individual variation, these compounds have the qualities required to serve as species recognition cues.
In the present study, we examined whether volatile compounds in preen gland secretions covary with
individual quality and thus could serve as reliable mate assessment cues.
We tested whether measurements of preen oil volatile compounds collected early in the breeding
season predicted genetic and social reproductive success in the same season.
For comparison, we also tested whether visual cues, including plumage traits and morphological
measurements, could predict reproductive success in these birds, or whether chemical signals might be
a more reliable predictor.
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Ganesha Associates
REGIONAL LUNG VENTILATION DISTRIBUTION AMONG INDIVIDUALS WITH
CHRONIC HEART FAILURE AFTER AN INSPIRATORY MUSCLE TRAINING
PROGRAME: A RANDOMIZED CONTROLLED CLINICAL TRIAL
Introduction: Chronic heart failure (CHF) is a complex syndrome caused by functional or structural cardiac abnormalities, leading to defects in
ventricular filling/ejection. As a result, the heart is unable to adequately supply the blood demand of tissues.1,2
The main symptoms of CHF are dyspnea and fatigue,3,4 caused by a physiopathological interaction beyond the hemodynamic disorder itself.3-6
Research shows that the lungs, with the exception of possible pulmonary function damage, are not responsible for reduced functional capacity in
patients with chronic heart failure (CHF).4 Since hemodynamic and pulmonary limitations do not sufficiently explain the appearance of fatigue and
dyspnea in CHF sufferers, several studies suggest that skeletal muscle abnormalities may contribute to these symptoms among subjects with CHF.6,7
Fatigue and dyspnea hamper performance in activities of daily living and exercise among patients with CHF.8 These symptoms are caused by skeletal
muscle atrophy, lower percentages of type I fibers in relation to type II, a decline in oxidative enzymes with rapid depletion of glycolytic mechanisms,
as well as a decrease in the size and number of mitochondria.9 In addition, respiratory muscle weakness may be involved in increased breathing
effort during hyperpnea required to perform activities with greater energy expenditure.10
Inspiratory muscle dysfunction is characterized by a reduction in their ability to generate pressure and force. This decreased strength is the result of
histological and biochemical changes. Based on diaphragm biopsies of individuals with CHF, histological studies recorded an increase in type I fibers,
suggesting a compensatory mechanism for the ventilation overload of these muscles. 11 Moreover, weakness in these muscles can also be explained
by the reduced diameter of muscular fibers, causing mechanical alterations.12 Clinically, this dysfunction may lead to limited exercise ability and
diminished quality of life, as well as a less favorable prognosis among individuals affected.10
In an attempt to reduce respiratory muscle dysfunction in CHF sufferers, several investigations have demonstrated the effects of Inspiratory Muscle
Training (IMT). 8,10,13 Inspiratory muscles, particularly the diaphragm, exhibit plasticity and are therefore susceptible to the principles of training.14 In
accordance with the specificity of training, IMT improves respiratory function in daily activities with regard to the type of muscle recruitment pattern
required during exercise or activities of daily living of patients. 15
A recent study by Chiappa et al 13, recorded a 72% increase in MIP among individuals who underwent IMT and suffered from CHF related to
inspiratory muscle weakness, compared to patients not submitted to training. Using ultrasound testing, the investigation also found that IMT
provoked notable diaphragmatic hypertrophy.
Another clinically significant aspect in CHF sufferers is the presence of cardiomegaly in some patients. In this condition expansion of the chest wall is
limited and extrapulmonary restriction, caused by competition between the lungs and heart for space inside the chest, may occur. As the disease
advances and worsens, in association with cardiomegaly, episodes of dyspnea become more frequent and severe with minimal effort and muscle
fatigue sets in progressively sooner.14-15
Thus, the present study aims to assess regional lung ventilation distribution in patients with CHF after completing an inspiratory muscle training
program
and correlate it with functional capacity and quality of life
amongAssociates
these individuals.
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Ganesha
REGIONAL LUNG VENTILATION DISTRIBUTION AMONG INDIVIDUALS WITH
CHRONIC HEART FAILURE AFTER AN INSPIRATORY MUSCLE TRAINING
PROGRAME: A RANDOMIZED CONTROLLED CLINICAL TRIAL
Introduction: Chronic heart failure (CHF) is a complex syndrome caused by functional or structural cardiac
abnormalities, leading to defects in ventricular filling/ejection.
The main symptoms of CHF are dyspnea and fatigue,3,4 caused by a physiopathological interaction beyond the
hemodynamic disorder itself.3-
Fatigue and dyspnea hamper performance in activities of daily living and exercise among patients with CHF.8
Inspiratory muscle dysfunction is characterized by a reduction in their ability to generate pressure and force.
In an attempt to reduce respiratory muscle dysfunction in CHF sufferers, several investigations have demonstrated
the effects of Inspiratory Muscle Training (IMT). 8,10,13
A recent study by Chiappa et al 13, recorded a 72% increase in MIP among individuals who underwent IMT and
suffered from CHF related to inspiratory muscle weakness, compared to patients not submitted to training. Using
ultrasound testing, the investigation also found that IMT provoked notable diaphragmatic hypertrophy.
Another clinically significant aspect in CHF sufferers is the presence of cardiomegaly in some patients.
Thus, the present study aims to assess regional lung ventilation distribution in patients with CHF after completing an
inspiratory muscle training program and correlate it with functional capacity and quality of life among these
individuals.
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Ganesha Associates
REGIONAL LUNG VENTILATION DISTRIBUTION AMONG INDIVIDUALS WITH
CHRONIC HEART FAILURE AFTER AN INSPIRATORY MUSCLE TRAINING
PROGRAME: A RANDOMIZED CONTROLLED CLINICAL TRIAL
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REGIONAL LUNG VENTILATION DISTRIBUTION AMONG INDIVIDUALS WITH
CHRONIC HEART FAILURE AFTER AN INSPIRATORY MUSCLE TRAINING
PROGRAME: A RANDOMIZED CONTROLLED CLINICAL TRIAL
Introduction: The main symptoms of chronic heart failure (CHF) are dyspnea and fatigue,3,4 Several
studies suggest that skeletal muscle abnormalities may contribute to these symptoms. 6,7 Diaphragm
biopsies of individuals with CHF show an increase in type I fibers, suggesting a compensatory
mechanism for the ventilation overload of these muscles. 11 Moreover, weakness in these muscles can
also be explained by the reduced diameter of muscular fibers, causing mechanical alterations. 12
Clinically, this dysfunction may lead to limited exercise ability and diminished quality of life, as well as a
less favorable prognosis among individuals affected.10 Some CHF patients have cardiomegaly. Expansion
of the chest wall is limited and extra-pulmonary restriction, caused by competition between the lungs
and heart for space inside the chest, may occur. As the disease advances episodes of dyspnea become
more frequent and muscle fatigue sets in progressively sooner.14-15
In an attempt to increase respiratory muscle function in CHF sufferers, several investigations have
demonstrated the positive effects of Inspiratory Muscle Training (IMT). 8,10,13 IMT improves respiratory
function in daily activities with regard to the type of muscle recruitment pattern required during
exercise or activities of daily living of patients. 15 For example, a recent study by Chiappa et al 13,
recorded a 72% increase in MIP in CHF patients who underwent IMT. Using ultrasound testing, the
investigation also found that IMT provoked notable diaphragmatic hypertrophy.
Here we show that IMT improved muscle strength, functional capacity and quality of life in CHS
patients. We also analyzed the distribution behavior of lung volumes for the thoracoabdominal system
in this population and found that larger abdominal rib cage and abdomen volumes may result in more
effective diaphragmatic contraction.
18/10/2013
Ganesha Associates
INSPIRATORY MUSCLE TRAINING IMPROVES REGIONAL LUNG VENTILATION
DISTRIBUTION IN CHRONIC HEART FAILURE PATIENTS: A RANDOMIZED
CONTROLLED CLINICAL TRIAL
Introduction: The main symptoms of chronic heart failure
(CHF) are dyspnea and fatigue.
Clinically, this dysfunction may lead to limited exercise ability
and diminished quality of life, as well as a less favourable
prognosis among individuals affected.
In an attempt to increase respiratory muscle function in CHF
sufferers, several investigations have demonstrated the
positive effects of Inspiratory Muscle Training (IMT).
Here we show that IMT improved muscle strength, functional
capacity and quality of life in CHS patients.
18/10/2013
Ganesha Associates
Conclusions
• Hypothesis quality needs to improve
• Authors can always make a better job of
presenting their findings
• Always aim for an international journal, just
makes sure it is the right one
• Structured Portuguese gives birth to structured
English
02/10/2013
Ganesha Associates 2013