Introduction: Imbalance in autonomic cardiovascular function increases the risk for sudden death in patients with coronary artery disease (CAD), but the time course of the impact of coronary artery bypass grafting (CABG) on autonomic function has been little studied. Thus, the purpose of the present study was to determine the effects of the CABG on the cardiovascular autonomic function. Methods: Patients undergoing CABG (n = 13) and two matched control groups (patients with CAD who refused surgical treatment [n = 9], and healthy volunteers [n = 9]) underwent a prospective longitudinal study consisting of autonomic evaluation before and after (3, 6, 15, 30, 60, and 90 days) surgery, including measurement of heart rate variability (HRV), respiratory sinus arrhythmia (RSA), and Valsalva maneuver. Results: After CABG there was a decrease in, and a later recovery of, (1) the HRV in the time domain and in the frequency domain, (2) RSA, and (3) Valsalva maneuver. Conclusions: CABG caused an impairment, reversible after 60 days, of cardiovascular autonomic function, with a maximal decrease on about the sixth day after surgery.

Background: The treatment of coronary artery disease (CAD) seeks to reduce or prevent its complications and decrease morbidity and mortality. For certain subgroups of patients, coronary artery bypass graft surgery (CABG) may accomplish these goals. The objective of this study was to assess the pulmonary function in the CABG postoperative period of patients treated with a physiotherapy protocol. Methods: Forty-two volunteers with an average age of 63 ± 2 years were included and separated into three groups: healthy volunteers (n = 09), patients with CAD (n = 9) and patients who underwent CABG (n = 20). Patients from the CABG group received preoperative and postoperative evaluations on days 3, 6, 15 and 30. Patients from the CAD group had evaluations on days 1 and 30 of the study, and the healthy volunteers were evaluated on day 1. Pulmonary function was evaluated by measuring forced vital capacity (FVC), maximum expiratory pressure (MEP) and Maximum inspiratory pressure (MIP). Results: After CABG, there was a significant decrease in pulmonary function (p < 0.05), which was the worst on postoperative day 3 and returned to the preoperative baseline on postoperative day 30. Conclusion: Pulmonary function decreased after CABG. Pulmonary function was the worst on postoperative day 3 and began to improve on postoperative day 15. Pulmonary function returned to the preoperative baseline on postoperative day 30.

The purpose of this study was to determine the effect of respiratory muscle fatigue on intercostal and forearm muscle perfusion and oxygenation in patients with heart failure. Five clinically stable heart failure patients with respiratory muscle weakness (age, 66±12 years; left ventricle ejection fraction, 34±3%) and nine matched healthy controls underwent a respiratory muscle fatigue protocol, breathing against a fixed resistance at 60% of their maximal inspiratory pressure for as long as they could sustain the predetermined inspiratory pressure. Intercostal and forearm muscle blood volume and oxygenation were continuously monitored by near-infrared spectroscopy with transducers placed on the seventh left intercostal space and the left forearm. Data were compared by two-way ANOVA and Bonferroni correction. Respiratory fatigue occurred at 5.1±1.3 min in heart failure patients and at 9.3±1.4 min in controls (P0.05). Respiratory fatigue in heart failure reduced intercostal and forearm muscle blood volume (P<0.05) along with decreased tissue oxygenation both in intercostal (heart failure, -2.6±1.6%; controls, +1.6±0.5%; P<0.05) and in forearm muscles (heart failure, -4.5±0.5%; controls, +0.5±0.8%; P<0.05). These results suggest that respiratory fatigue in patients with heart failure causes an oxygen demand/delivery mismatch in respiratory muscles, probably leading to a reflex reduction in peripheral limb muscle perfusion, featuring a respiratory metaboreflex.

Introdução: Este estudo enfoca o envelhecimento como um processo natural, acompanhado de mudanças físicas e aumento do risco de doenças crônicas, ressaltando a importância de estratégias para combater o etarismo e promover uma longevidade saudável. Objetivo: Analisar os desafios relacionados ao envelhecimento, considerando fatores biológicos, psicológicos, sociais e econômicos que influenciam a inclusão social dos idosos. Métodos: Realizou-se uma revisão narrativa, analisando estudos que construíram uma narrativa abrangente e integrativa do conhecimento disponível sobre o tema. A conexão entre diferentes estudos e ideias permitiu identificar informações relevantes. Emerge como fator determinante a desigualdade social em relação ao bem-estar e à participação social, prejudicando a qualidade de vida dos idosos. A discriminação por idade também contribui para sua exclusão, impactando negativamente sua autoestima e bem-estar. Para combater o etarismo e promover uma sociedade mais inclusiva, é fundamental criar consciência sobre esse problema e educar as pessoas sobre a importância de valorizar e respeitar todas as faixas etárias. Portanto, as políticas públicas são necessárias para garantir que os direitos das pessoas idosas sejam protegidos e que tenham acesso a serviços de qualidade em todas as áreas da vida. Somente com esforços coletivos poderemos construir uma sociedade que valorize e respeite todas as gerações. Nesse contexto, os programas governamentais de ginástica voltados para essa faixa etária têm se mostrado eficazes na promoção da inclusão e bem-estar dessa população. Além de oferecerem atividades físicas adequadas à idade, incentivam a interação social e a integração na comunidade, melhorando a qualidade de vida e combatendo a solidão. Essas iniciativas são desenvolvidas em parceria com diversas organizações e instituições, permitindo acesso a recursos e conhecimentos especializados, o que aumenta sua eficácia. Cidades como São Paulo, Belo Horizonte, Curitiba, Rio de Janeiro e Niterói têm implementado com sucesso esses programas. Conclusão: Conclui-se que promover a inclusão social dos idosos demanda esforços conjuntos de governos, instituições, sociedade civil e comunidade. Investir em programas de ginástica e atividades físicas é um passo significativo nessa direção, contribuindo para um envelhecimento digno e uma melhor qualidade de vida. O aprimoramento contínuo e a expansão desses programas são essenciais para que todos os idosos, independentemente de sua situação socioeconômica, possam desfrutar de uma vida mais saudável e participativa na sociedade.

Air pollution is one of the major global environmental challenges, particularly in urban and industrial areas, where multiple sources emit pollutants that compromise air quality and threaten human health. This study aims to analyze the effects of air pollution on the health of vulnerable urban populations, emphasizing monitoring techniques for key pollutants and comparing national and international air quality standards through a literature review. It also discusses the implications of these pollutants considering the 2030 Agenda, highlighting environmental education as a strategy for pollution mitigation, public awareness, and strengthening air quality policies. A qualitative and descriptive methodology was adopted, based on national and international research publications between 2005 and 2023, using databases such as PubMed, Scopus, Web of Science, LILACS, and Google Scholar, with descriptors including “Air Pollution,” “Industrialization,” “Public Health,” and “Environmental Education.” The results indicate that industrial and transportation activities are the main sources of air pollution, contributing to an increase in cases of asthma, lung cancer, and cardiovascular diseases, as well as negatively impacting ecosystems and the economy. Even when pollutant levels comply with legal standards, vulnerable populations experience higher morbidity and mortality rates, highlighting the need for more stringent protection policies. Comparisons between the standards of the World Health Organization (WHO), the European Union (EU), the United States Environmental Protection Agency (EPA), and the National Council for the Environment (CONAMA) reveal significant disparities in exposure limits. The WHO and the EU, aligned with Sustainable Development Goals (SDGs) 3 and 13, advocate for stricter limits, while EPA and CONAMA regulations remain less stringent. This gap emphasizes the importance of internationally harmonized, evidence-based, and equitable air quality policies. Combating air pollution requires an integrated approach that combines stricter regulations, continuous monitoring, emissions control strategies, and environmental education. Promoting environmental awareness among children and young people can encourage behavioral changes and civic engagement. Environmental education, along with political and social responsibility, remains a fundamental path to mitigating health impacts and promoting sustainable development, in line with the 2030 Agenda.