Competências Básicas de Investigação Científica e de Publicação

1. CompetênciasBásicas de InvestigaçãoCientífica e de Publicação Lecture 7: How to become a more successful author

2. 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?

3. 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 Ganesha Associates 2013

4. The research process Project proposal Experiment, results, analysis Write article • ? Submit to journal Rejection/ acceptance Re-submit

5. 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

6. 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

7. 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 .

8. 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 extra-cephalic allodynia vary within one month

9. Finding this information is not difficult

11. 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

15. 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

19. 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

20. 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

22. Why do papers not get cited? Ganesha Associates 2013

23. 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. Ganesha Associates 2013

24. 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. Ganesha Associates 2013

25. 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. Ganesha Associates 2013

26. Use eTBLAST to identify similar articles Ganesha Associates 2013

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28. Hunt the hypothesis Ganesha Associates 2013

29. 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 cross-sectioned 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 Ganesha Associates 2013

30. 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. Ganesha Associates 2013

31. 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. Ganesha Associates 2013

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33. Choosing the right journal Ganesha Associates 2013

34. Communities of arbuscularmycorrhizal fungi in dry tropical forests of Northeast Brazil The arbuscularmycorrhizal 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 arbuscularmycorrhizal 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. Ganesha Associates 2013

35. Using eTBLAST to find similar articles Ganesha Associates 2013

36. Other titles included Oecologia, New Phytologist… Ganesha Associates 2013

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41. Arbuscularmycorrhizal fungi in a semiarid copper mining area in Brazil There are >160 species of arbuscularmycorrhizal 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 Trufem1983; Trufem1988, 1990; Trufem et al. 1994; Gomes and Trufem1998) and Santa Catarina (Stürmer and Bellei1994). In cultivated areas there are records for the States of São Paulo (Trufem and Bononi1985; Trufem et al. 1989, 1990; Grandi and Trufem1991; Carrenho et al. 2001) and Pernambuco (Maia and Trufem1990; 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 (Nogueira1996). An excess of Zn and Cu inhibits spore germination (Hepper1979), 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. Ganesha Associates 2013

42. Arbuscularmycorrhizal fungi in a semiarid copper mining area in Brazil There are >160 species of arbuscularmycorrhizal 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. Ganesha Associates 2013

43. Communities of arbuscularmycorrhizal fungi in dry tropical forests of Northeast Brazil Arbuscularmycorrhizal 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 Caatingaharbors 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. Ganesha Associates 2013

44. Communities of arbuscularmycorrhizal fungi in dry tropical forests of Northeast Brazil Arbuscularmycorrhizal 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 Caatingaharbors 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. Ganesha Associates 2013

45. The importance of structure Title Document Summary Sections Introduction Paragraphs Results Sentences Discussion Phrases

46. 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. Ganesha Associates

47. 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. Ganesha Associates

48. 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. Ganesha Associates

49. 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 among these individuals. Ganesha Associates

50. 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. Ganesha Associates