THE ANALYSIS OF ACTIVITIES NOT PERFORMED BY THE NURSING TEAM REGARDING THE DIAGNOSIS OF INEFFECTIVE BREATHING PATTERN IN THE ELDERLY

The objective of this cross-sectional, descriptive study was to identify the activities of the Nursing Intervention Classification considered as priorities for an Ineffective Breathing Pattern and not performed for elderly inpatients of a teaching hospital in the state of Goias. The study participants were 43 nursing professionals, and data collection was performed in the period spanning October to December 2008, after receiving approval from the Ethics Committee. It was observed that among the 67 activities considered to be priorities for the referred diagnosis, only seven were performed by all of the participants; the other activities, with a varied frequency, were not performed, with the main reason cited being that a professional from a different area completed the activity. It is understood that the fact that the nursing staff does not perform these activities can cause lack of complete coverage in nursing care; therefore there is a need for a legal apparatus to describe the activities that comprise professional practice exclusive to nursing personnel and those activities that have an interdisciplinary nature.

The breathing pattern and the ventilatory response to aquatic and aerial hypoxia and hypercarbia in the frog Pipa carvalhoi

Anuran amphibians are known to exhibit an intermittent pattern of pulmonary ventilation and to exhibit an increased ventilatory response to hypoxia and hypercarbia. However, only a few species have been studied to date. The aquatic frog Pipa carvalhoi inhabits lakes, ponds and marshes that are rich in nutrients but low in O-2. There are no studies of the respiratory pattern of this species and its ventilation during hypoxia or hypercarbia. Accordingly, the aim of the present study was to characterize the breathing pattern and the ventilatory response to aquatic and aerial hypoxia and hypercarbia in this species. With this purpose, pulmonary ventilation (V-1) was directly measured by the pneumotachograph method during normocapnic normoxia to determine the basal respiratory pattern and during aerial and aquatic hypercarbia (5% CO2) and hypoxia (5% O-2). Our data demonstrate that P. carvalhoi exhibits a periodic breathing pattern composed of single events (single breaths) of pulmonary ventilation separated by periods of apnea. The animals had an enhanced V-1 during aerial hypoxia, but not during aquatic hypoxia. This increase was strictly the result of an increase in the breathing frequency. A pronounced increase in V-1 was observed if the animals were simultaneously exposed to aerial and aquatic hypercarbia, whereas small or no ventilatory responses were observed during separately administered aerial or aquatic hypercarbia. P. carvalhoi primarily inhabits an aquatic environment. Nevertheless, it does not respond to low O-2 levels in water, although it does so in air. The observed ventilatory responses to hypercarbia may indicate that this species is similar to other anurans in possessing central chemoreceptors. (C) 2012 Elsevier Inc. All rights reserved.

Low pressure support changes the rapid shallow breathing index (RSBI) in critically ill patients on mechanical ventilation

Background: The rapid shallow breathing index (RSBI) is the most widely used index within intensive care units as a predictor of the outcome of weaning, but differences in measurement techniques have generated doubts about its predictive value. Objective: To investigate the influence of low levels of pressure support (PS) on the RSBI value of ill patients. Method: Prospective study including 30 patients on mechanical ventilation (MV) for 72 hours or more, ready for extubation. Prior to extubation, the RSBI was measured with the patient connected to the ventilator (Drager (TM) Evita XL) and receiving pressure support ventilation (PSV) and 5 cmH(2)O of positive end expiratory pressure or PEEP (RSBI_MIN) and then disconnected from the VM and connected to a Wright spirometer in which respiratory rate and exhaled tidal volume were recorded for 1 min (RSBI_ESP). Patients were divided into groups according to the outcome: successful extubation group (SG) and failed extubation group (FG). Results: Of the 30 patients, 11 (37%) failed the extubation process. In the within-group comparison (RSBI_MIN versus RSBI_ESP), the values for RSBI_MIN were lower in both groups: SG (34.79 +/- 4.67 and 60.95 +/- 24.64) and FG (38.64 +/- 12.31 and 80.09 +/- 20.71; p<0.05). In the between-group comparison, there was no difference in RSBI_MIN (34.79 +/- 14.67 and 38.64 +/- 12.31), however RSBI_ESP was higher in patients with extubation failure: SG (60.95 +/- 24.64) and FG (80.09 +/- 20.71; p<0.05). Conclusion: In critically ill patients on MV for more than 72h, low levels of PS overestimate the RSBI, and the index needs to be measured with the patient breathing spontaneously without the aid of pressure support.

Reproductive apparatus of the male giant hermit crab Petrochirus diogenes (Anomura, Diogenidae): morphology and phylogenetic implications

We describe the male reproductive apparatus of the giant hermit crab Petrochirus diogenes, with morphological and biometric analyses of the spermatophore, the gonopore and the ultrastructure of the spermatozoa. Specimens were collected from the southern coast of Sao Paulo, Brazil. Morphological analyses were done using stereoscopic, light, transmission and scanning electron microscopy. The reproductive system of this hermit crab is composed of elongate and lobular testes followed by vasa deferentia that connect to the exterior via gonopores. The gonopores are ovoid and surrounded by setae, and each gonopore is composed of a membranous operculum that forms a depression constituting the gonopore opening. The gonopore constitutes a unique structure among the Diogenidae due to its number of setae. The spermatophores are tripartite, composed of a sperm-containing ampulla, a peduncle and a proximal foot. The spermatozoon has 3 main regions (acrosomal vesicle, nucleus and cytoplasm). The structure of the spermatophore indicates that this species can be considered an exception within Diogenidae with regard to spermatophore morphology and can therefore be used for phylogenetic inferences.

The Effect of Adenoidectomy or Adenotonsillectomy on Occlusal Features in Mouth-breathing Preschoolers

Purpose: The purpose of this study was to evaluate mouth-breathing and nasal-breathing children prior to surgical intervention and 28 months postoperatively, comparing the occlusal features obtained pre- and postoperatively through orthodontic study costs. Methods: The mouth-breathing (MB) group consists of 33 MB children who underwent surgery and presented a nasal-breathing (NB) pattern after surgery The control group comprised 22 NB children. The orthodontic examinations were accomplished prior to surgery (77) and an average of 28 months postoperatively (T2). Results: At T1, the MB and NB children presented no statistically significant difference in any analyzed occlusal features and measurements. At T2, the MB presented larger overjet comparing to NB children (P<.05). MB and NB groups presented statistically similar results (P>.05) concerning intercanine and intermolor distances, second primary molar terminal plane and canine relationship, overbite, crossbite, and open bite. From T1 to T2, the MB and NB groups showed a statistically significant difference in the molar terminal plane. Conclusion: Neither the breathing pattern nor the surgery had any effect on occlusal features in 3- to 6-year-olds. (Pediatr Dent 2012;34:10842) Received May 14, 2010 vertical bar Last Revision April 11, 2010 vertical bar Accepted April 12, 2010

A description of the nymph of Anacroneuria ofaye Froehlich (Plecoptera: Perlidae) and a apparatus for rearing Neotropical stonefly species

The Neotropical genus Anacroneuria (Perlidae) is represented by more than 300 species. Among the Brazilian Anacroneuria, only the nymphs of two species have been described. In this paper, we described the nymph of A. ofaye Froehlich and an apparatus for rearing this genus. This is the first record of A. ofaye from Parana State, Brazil.

Gross morphology and topography of the digestive apparatus in rheas (Rhea americana americana)

Rodrigues M.N., Oliveira G.B., Silva R.S.S, Tivane C.T., Albuquerque J.F.G., Miglino M.A. & Oliveira M.F. 2012. [Gross morphology and topography of the digestive apparatus in rheas (Rhea americana americana).] Macroscopia e topografia do aparelho digestorio de emas (Rhea americana americana). Pesquisa Veterinaria Brasileira 32(7):681-686. Departamento de Cirurgia, Faculdade de Medicina Veterinaria e Zootecnia, Universidade de Sao Paulo, Cidade Universitaria, Av. Prof. Dr. Orlando Marques de Paiva 87, Sao Paulo, SP 05508270, Brazil. E-mail: marcio_medvet@hotmail.com Rheas are birds belonging to the ratites group and, among ostriches and emus, are the largest birds currently alive. In this work we studied the macroscopic aspects of rheas' digestive tract in order to provide important information to a better understanding of these birds' eating habits as well their anatomy. Twenty young animals aging between two and six months from the Centre for Wild Animals Multiplication (Cemas, scientific breeding license form Ibama no.1478912) were used. After dissection it was observed that their tongue was small and presented a rhomboid form, being disposed on the oral cavity floor, and inserted in its base by a frenulum. The esophagus was a rectilinear tube with elastic aspect and longitudinal elastic fibers, without dilation, which gives it an absence of crop. The proventriculus presented a fusiform form and the gastric ventricle showed and slightly oval form when filled, and was internally coated with a thick gastric cuticle. The small intestine was composed of three distinct regions: duodenum, jejunum and ileum. The duodenum had a light gray color and showed a "U" curved shaped. The jejunum was dark green, long and composed of several short loops arranged above each other. The ileum had a gray color and was connected with the jejunum. In ventral line to the rectum and cloaca, the ileum extended cranially, dorsally to the ascending duodenum. The large intestine was composed of two caeca, one right and one left, and colon-rectum and ileum were continuous with the cloaca. The structures of the rhea digestive tract resemble those described in the literature regarding to its shape and topography, even though rhea's caeca are well developed and relatively long.

Diaphragmatic Breathing Training Program Improves Abdominal Motion During Natural Breathing in Patients With Chronic Obstructive Pulmonary Disease: A Randomized Controlled Trial

Yamaguti WP, Claudino RC, Neto AP, Chammas MC, Gomes AC, Salge TM, Moriya HT, Cukier A, Carvalho CR. Diaphragmatic breathing training program improves abdominal motion during natural breathing in patients with chronic obstructive pulmonary disease: a randomized controlled trial. Arch Phys Med Rehabil 2012;93:571-7. Objective: To investigate the effects of a diaphragmatic breathing training program (DBTP) on thoracoabdominal motion and functional capacity in patients with chronic obstructive pulmonary disease. Design: A prospective, randomized controlled trial. Setting: Academic medical center. Participants: Subjects (N=30; forced expiratory volume in Is, 4270 +/- 13% predicted) were randomly allocated to either a training group (TG) or a control group (CG). Interventions: Subjects in the TG completed a 4-week supervised DBTP (3 individualized weekly sessions), while those in the CG received their usual care. Main Outcome Measures: Effectiveness was assessed by amplitude of the rib cage to abdominal motion ratio (RC/ABD ratio) (primary outcome) and diaphragmatic mobility (secondary outcome). The RC/ABD ratio was measured using respiratory inductive plethysmography during voluntary diaphragmatic breathing and natural breathing. Diaphragmatic mobility was measured by ultrasonography. A 6-minute walk test and health-related quality of life were also evaluated. Results: Immediately after the 4-week DBTP, the TG showed a greater abdominal motion during natural breathing quantified by a reduction in the RC/ABD ratio when compared with the CG (F=8.66; P<.001). Abdominal motion during voluntary diaphragmatic breathing after the intervention was also greater in the TG than in the CG (F=4.11; P<.05). The TG showed greater diaphragmatic mobility after the 4-week DBTP than did the CG (F=15.08; P<.001). An improvement in the 6-minute walk test and in health-related quality of life was also observed in the TG. Conclusions: DBTP for patients with chronic obstructive pulmonary disease induced increased diaphragm participation during natural breathing, resulting in an improvement in functional capacity.

Development of paper based electrodes: From air-breathing to paintable enzymatic cathodes

This work presents the results from the development of bio-cathodes for the application on paper-based biofuel cells. Our main goal here is to demonstrate the possibility of using different designs of air-breathing bio-cathodes and ink-based bio-cathodes for this new type of paper based electrochemical cell. The electrochemical performance for the bio-electrocatalytic oxygen reduction reaction was studied by using open circuit voltage and amperometry measurements, as well as polarization curves to probe the four-electron reduction reaction of ambient oxygen catalyzed by bilirubin oxidase (BOx). The electrochemical measurements showed that all procedures allowed the direct electron transfer from the active site of the bilirubin oxidase to the electrode surface with a limiting current density of almost 500 mu A cm(-2) for an air-breathing BOx cathode and 150 mu A cm(-2) for an ink based BOx cathode. Under a load of 300 mV a stable current density was obtained for 12 h of continuous operation. (C) 2012 Elsevier Ltd. All rights reserved.

P2Y1 receptors expressed by C1 neurons determine peripheral chemoreceptor modulation of breathing, sympathetic activity, and blood pressure

Catecholaminergic C1 cells of the rostral ventrolateral medulla (RVLM) are key determinants of the sympathoexcitatory response to peripheral chemoreceptor activation. Overactivation of this reflex is thought to contribute to increased sympathetic activity and hypertension; however, molecular mechanisms linking peripheral chemoreceptor drive to hypertension remain poorly understood. We have recently determined that activation of P2Y1 receptors in the RVLM mimicked effects of peripheral chemoreceptor activation. Therefore, we hypothesize that P2Y1 receptors regulate peripheral chemoreceptor drive in this region. Here, we determine whether P2Y1 receptors are expressed by C1 neurons in the RVLM and contribute to peripheral chemoreceptor control of breathing, sympathetic activity, and blood pressure. We found that injection of a specific P2Y1 receptor agonist (MRS2365) into the RVLM of anesthetized adult rats increased phrenic nerve activity (≈55%), sympathetic nerve activity (38±6%), and blood pressure (23±1 mm Hg), whereas application of a specific P2Y1 receptor antagonist (MRS2179) decreased peripheral chemoreceptor–mediated activation of phrenic nerve activity, sympathetic nerve activity, and blood pressure. To establish that P2Y1 receptors are expressed by C1 cells, we determine in the brain slice preparation using cell-attached recording techniques that cells responsive to MRS2365 are immunoreactive for tyrosine hydroxylase (a marker of C1 cells), and we determine in vivo that C1-lesioned animals do not respond to RVLM injection of MRS2365. These data identify P2Y1 receptors as key determinants of peripheral chemoreceptor regulation of breathing, sympathetic nerve activity, and blood pressure.