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A adoção de novas tecnologias em saúde vem se mostrando promissora durante a pandemia da COVID-19, especialmente em territórios de favela. Os objetivos do Projeto InspirAção são: orientar a população sobre a síndrome pós-COVID-19; desenvolver estratégias de telerreabilitação através de uma plataforma digital de telessaúde (SAS Brasil) simples a ser acessada por dispositivos móveis no território de favelas; organizar ações dialógicas com os indivíduos atendidos, seus familiares e uma equipe multiprofissional em saúde; estabelecer parcerias com a atenção primária à saúde; sensibilizar as secretarias públicas de saúde e contribuir para a formação de estudantes e profissionais de saúde. O programa individualizado de telerreabilitação será realizado pelo período de oito a doze semanas com encontros sincronos com o fisioterapeuta (2x/semana), e rodas de conversa virtuais quinzenais com profissional de educação em saúde para escuta ativa dos pacientes e familiares. Dentre os resultados esperados estão o treinamento em telessaúde de estudantes e profissionais da saúde; redução e controle dos sintomas respiratórios, aumento da capacidade físico-funcional, melhora da qualidade de vida e reintegração social de pessoas que apresentam a síndrome pós COVID-19. O projeto se encontra em processo de construção coletiva para aproximação e protagonismo discente e articulações com parcerias locais. Esses fluxos estão embasando as inquietações deste ensaio, sobre a inovação em saúde com a participação de moradores de favelas cariocas, criando outros percursos formativos na área da saúde, além de auxiliar nas elaborações de políticas públicas para a construção de uma sociedade menos desigual.

Gracielle Vieira Ramos, 1, 2 Ivo Vieira de Sousa Neto, 3 Alessandra Choqueta Toledo-Arruda, 4, 5 Rita de Cassia Marqueti, 3 Rodolfo P Vieira, 6– 8 Milton A Martins, 5 Tânia F Salvini, 9 João Luiz Quaglioti Durigan 10 1Physical Therapy Division, University of Brasilia, Brasília, DF, Brazil; 2Department of Physical Therapy, University Paulista, Brasília, DF, Brazil; 3Laboratory of Molecular Analysis, Graduate Program of Sciences and Technology of Health, Universidade de Brasília, Brasília, DF, Brazil; 4Faculty of Physiotherapy, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil; 5Department of Medicine Clinical (LIM 20), School of Medicine, University of São Paulo, São Paulo, Brazil; 6Universidade Brasil, Post-Graduation Program in Bioengineering, São Paulo, Brazil; 7Laboratory of Pulmonary and Exercise Immunology (LABPEI), Brazilian Institute of Teaching and Research in Pulmonary and Exercise Immunology (IBEPIPE) and Nove de Julho University (UNINOVE), São Paulo, SP, Brazil; 8Federal University of Sao Paulo, Post-Graduation Program in Sciences of Human Movement and Rehabilitation, São Paulo, Brazil; 9Department of Physical Therapy, Federal University of São Carlos, São Carlos, Brazil; 10Rehabilitation Sciences Graduation Program, University of Brasilia, Brasília, DF, BrazilCorrespondence: Gracielle Vieira RamosDepartment of Physical Therapy, University Paulista, Sgas Quadra 913, s/nº - Conjunto B - Asa Sul, Brasília, DF, Brazil, 70390-130 Email graciellevieiraramos@gmail.comBackground: Long-term cigarette smoke (CS) induces substantive extrapulmonary effects, including musculoskeletal system disorders. Exercise training seems to protect long-term smokers against fiber atrophy in the locomotor muscles. Nevertheless, the extracellular matrix (ECM) changes in response to aerobic training remain largely unknown. Thus, we investigated the effects of moderate treadmill training on aerobic performance, cross-sectional area (CSA), fiber distribution, and metalloproteinase 2 (MMP-2) activity on quadriceps muscle in mice exposed to chronic CS.Methods: Male mice were randomized into four groups: control or smoke (6 per group) and exercise or exercise+smoke (5 per group). Animals were exposed to 12 commercially filtered cigarettes per day (0.8 mg of nicotine, 10 mg of tar, and 10 mg of CO per cigarette). The CSA, fibers distribution, and MMP-2 activity by zymography were assessed after a period of treadmill training (50% of maximal exercise capacity for 60 min/day, 5 days/week) for 24 weeks.Results: The CS exposure did not change CSA compared to the control group (p> 0.05), but minor fibers in the frequency distribution (< 1000 μm 2) were observed. Long-term CS exposure attenuated CSA increases in exercise conditions (smoke+exercise vs exercise) while did not impair aerobic performance. Quadriceps CSA increased in mice nonsmoker submitted to aerobic training (p = 0.001). There was higher pro-MMP-2 activity in the smoke+exercise group when compared to the smoke group (p = 0.01). Regarding active MMP-2, the exercise showed higher values when compared to the control group (p = 0.001).Conclusion: Moderate treadmill training for 24 weeks in mice exposed to CS did not modify CSA, despite inducing higher pro-MMP-2 activity in the quadriceps muscle, suggesting limited effects on ECM remodeling. Our findings may contribute to new insights into molecular mechanisms for CS conditions.Keywords: physical exercise, chronic obstructive pulmonary disease, MMP-2, inflammation

Background Pulmonary emphysema is characterized by irreversible airflow obstruction, inflammation, oxidative stress imbalance and lung remodeling, resulting in reduced lung function and a lower quality of life. Flavonoids are plant compounds with potential anti-inflammatory and antioxidant effects that have been used in folk medicine. Our aim was to determine whether treatment with sakuranetin, a flavonoid extracted from the aerial parts of Baccharis retusa, interferes with the development of lung emphysema. Methods Intranasal saline or elastase was administered to mice; the animals were then treated with sakuranetin or vehicle 2 h later and again on days 7, 14 and 28. We evaluated lung function and the inflammatory profile in bronchoalveolar lavage fluid (BALF). The lungs were removed to evaluate alveolar enlargement, extracellular matrix fibers and the expression of MMP-9, MMP-12, TIMP-1, 8-iso-PGF-2α and p65-NF-κB in the fixed tissues as well as to evaluate cytokine levels and p65-NF-κB protein expression. Results In the elastase-treated animals, sakuranetin treatment reduced the alveolar enlargement, collagen and elastic fiber deposition and the number of MMP-9- and MMP-12-positive cells but increased TIMP-1 expression. In addition, sakuranetin treatment decreased the inflammation and the levels of TNF-α, IL-1β and M-CSF in the BALF as well as the levels of NF-κB and 8-iso-PGF-2α in the lungs of the elastase-treated animals. However, this treatment did not affect the changes in lung function. Conclusion These data emphasize the importance of oxidative stress and metalloproteinase imbalance in the development of emphysema and suggest that sakuranetin is a potent candidate that should be further investigated as an emphysema treatment. This compound may be useful for counteracting lung remodeling and oxidative stress and thus attenuating the development of emphysema. Electronic supplementary material The online version of this article (doi:10.1186/s12931-015-0233-3) contains supplementary material, which is available to authorized users.