Eletroacupuntura na anestesia com propofol em cães

Resultados satisfatórios têm sido relatados com o emprego da eletroacupuntura (EA), como adjuvante da anestesia geral no homem e em animais. O objetivo do trabalho é avaliar a dose de indução anestésica do propofol em função do emprego da eletroacupuntura em cães. Foram utilizados 20 cães, distribuídos em dois grupos de igual número, GEA: foi realizada EA nos acupontos estômago 36 (E36), vesícula biliar 34 (VB 34) e baço-pâncreas 6 (BP 6), bilateralmente, durante 45 minutos antes da indução anestésica e GC: não foi realizada EA antes da indução anestésica. Os animais foram tranqüilizados com acepromazina intravenosa (0,05mg.kg-1) 60 minutos antes da indução anestésica, realizada com propofol na taxa de 0,2ml.kg.min-1. A análise estatística foi realizada por test t não pareado(P<0,05). Os valores foram apresentados em média±SD. Não houve diferença significativa na dose do propofol entre os grupos (5±2mg kg-1 no GC e 5,2±1,6mg kg-1 no GEA), sugerindo que a eletroacupuntura não potencializou o efeito depressor do propofol sobre o sistema nervoso central.

Injeção epidural preventiva de xilazina ou amitraz em eqüinos: efeitos clínicos e comportamentais

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Associação de cetamina S(+) e midazolam pelo método convencional de cálculo e pela extrapolação alométrica em bugios-ruivo (Alouatta guariba clamitans): resposta clínica e cardiorrespiratória

O objetivo deste estudo foi avaliar o protocolo de contenção química com cetamina S(+) e midazolam em bugios-ruivos, comparando o cálculo de doses pelo método convencional e o método de extrapolação alométrica. Foram utilizados 12 macacos bugios (Alouatta guariba clamitans) hígidos, com peso médio de 4,84±0,97kg, de ambos os sexos. Após jejum alimentar de 12 horas e hídrico de seis horas, realizou-se contenção física manual e aferiram-se os seguintes parâmetros: frequência cardíaca (FC), frequência respiratória (f), tempo de preenchimento capilar (TPC), temperatura retal (TR), pressão arterial sistólica não invasiva (PANI) e valores de hemogasometria arterial. Posteriormente, os animais foram alocados em dois grupos: GC (Grupo Convencional, n=06), os quais receberam cetamina S(+) (5mg kg-1) e midazolam (0,5mg kg-1), pela via intramuscular, com doses calculadas pelo método convencional; e GA (Grupo Alometria, n=06), os quais receberam o mesmo protocolo, pela mesma via, utilizando-se as doses calculadas pelo método de extrapolação alométrica. Os parâmetros descritos foram mensurados novamente nos seguintes momentos: M5, M10, M20 e M30 (cinco, 10, 20 e 30 minutos após a administração dos fármacos, respectivamente). Também foram avaliados: qualidade de miorrelaxamento, reflexo podal e caudal, pinçamento interdigital, tempo para indução de decúbito, tempo hábil de sedação, qualidade de sedação, e tempo e qualidade de recuperação. O GA apresentou menor tempo para indução ao decúbito, maior grau e tempo de sedação, bem como redução significativa da FC e PANI de M5 até M30, quando comparado ao GC. Conclui-se que o grupo no qual o cálculo de dose foi realizado por meio da alometria (GA) apresentou melhor grau de relaxamento muscular e sedação, sem produzir depressão cardiorrespiratória significativa.

Conteúdos lúdicos, expressivos e artísticos na educação formal

A prática de atividades lúdicas ou o incentivo ao fluir expressivo e artístico são propostas que permeiam a Educação, desde a Antiguidade Clássica. Atualmente, a necessidade premente de atentar para a inclusão contextualizada dessas práticas, vem sendo convalidada pelas diretrizes propostas pelos Parâmetros Curriculares tanto das disciplinas de Educação Física, como da Educação Artística. Entretanto esse espaço, ainda sutil, merece enfoque mais incisivo, por meio de estudos mais aprofundados acompanhados de práticas direcionadas que convalidem sua relevância. Assim, este estudo, de natureza qualitativa, objetivou investigar se essas variáveis estão disponíveis dentro dos conteúdos disseminados pelos professores e se possuem um espaço destinado ou não dentro da Educação formal. Para tanto, foi realizado um estudo exploratório com trinta professores voluntários, de ambos os sexos, pesquisados in loco, com consentimento livre e esclarecido, das disciplinas de Educação Física e Artística, utilizando como instrumento, para a coleta de dados, um questionário com perguntas mistas. Os dados foram analisados descritivamente, indicando que é possível notar a presença do lúdico e da arte, em ambas as disciplinas; mediando os processos de aprendizagem. Além disso, que os professores utilizam amplamente desses recursos, no entanto, nem sempre, de forma consciente e contextualizada, e que, apesar da implantação dos parâmetros curriculares desde 1998, esse espaço ainda não está consolidado.

A formação da identidade do médico: implicações para o ensino de graduação em Medicina

O artigo discute a constituição da identidade do médico tendo como pontos de partida sua escolha e formação profissionais. A partir da experiência das autoras no ensino médico, em especial na disciplina de Psicologia Médica, e da literatura na área são enfocadas: a idealização do papel do médico, as motivações conscientes e inconscientes na opção profissional, as dificuldades dos primeiros anos na escola médica, o início das atividades didáticas no hospital e os mecanismos psicológicos defensivos acionados no contato com pacientes. É muito importante que as Escolas Médicas e seus professores tenham conhecimento desses aspectos, devendo preocupar-se não apenas com questões curriculares e pedagógicas, mas também com o modelo de relação professor-aluno, considerando o seu papel fundamental na formação da identidade médica.

Aesthetic correction of a hypertrophic sinus frontalis: A long-term follow-up evaluation and refinement of the method

Two cases treated for hypertrophy of the frontal sinus are presented. In both patients, the excised frontal bone was inverted, and the resultant cavity was filled with either bone dust from the parietal region or Medpor. The first patient is shown with an excellent result after a follow-up period of 16 years. The second patient, who also achieved an excellent result, is presented after a follow-up period of 5 years. Using Medpor instead of bone dust resulted in the advantage that the operation could be performed with the patient under local anesthesia with sedation and prevention of an additional donor site. The use of Medpor has certain advantages over the use of hydroxyapatite, not least of which is its significant lower cost.

Enhanced pressor response to carotid occlusion in commNTS-lesioned rats: possible efferent mechanisms

Bilateral common carotid occlusion (BCO) over a period of 60 s in conscious rats produces a biphasic presser response, consisting of an early (peak) and late (plateau) phase. In this study we investigated 1) the effects of lesions of the commissural nucleus of the solitary tract (commNTS) on the cardiovascular responses produced by BCO in conscious rats and 2) the autonomic and humoral mechanisms activated to produce the presser response to BCO in sham- and commNTS-lesioned rats. Both the peak and plateau of the presser response produced by BCO increased in commNTS-lesioned rats despite the impairment of chemoreflex responses induced by intravenous potassium cyanide. In sham rats sympathetic blockade with intravenous prazosin and metoprolol, but not vasopressin receptor blockade with the Manning compound, reduced both components of BCO. In commNTS-lesioned rats the sympathetic blockade or vasopressin receptor blockade reduced both components of BCO. The results showed 1) the sympathetic nervous system, but not vasopressin, is important for the presser response to BCO during 60 s in conscious sham rats; 2) in commNTS-lesioned rats, despite chemoreflex impairment, BCO produces an increased presser response dependent on sympathetic activity associated with vasopressin release; and 3) the increment in the presser response to BCO in commNTS-lesioned rats seems to depend only on vasopressin secretion.

AORTIC BARORECEPTORS PLAY A PREDOMINANT ROLE IN THE REGULATION OF HINDLIMB VASCULAR-RESISTANCE IN RATS

In previous studies using bilateral carotid occlusion in conscious freely moving rats we suggested that aortic baroreceptors may play a more important role in the regulation of hindlimb than in renal and mesenteric vascular resistances. In the present study we performed electrical stimulation of the aortic baroreceptor nerve and analyzed the changes in mean arterial pressure and in hindlimb, renal, and mesenteric vascular resistances. All the experiments were performed under urethan anesthesia. Unilateral electrical stimulation (3 V, 2 ms, 50 Hz) of the aortic baroreceptor nerve produced a fall in arterial pressure (-27 +/- 3 mmHg) and an important reduction in hindlimb vascular resistance (-43 +/- 5%), with an increase in renal (+3 +/- 14%) and mesenteric (+48 +/- 12%) vascular resistances. Similar changes in arterial pressure as well as in the resistance of the three vascular beds studied were also observed during electrical stimulation of the aortic baroreceptor nerve in rats with bilateral carotid baroreceptor denervation or in rats treated with methylatropine. The data obtained with electrical stimulation indicated that aortic baroreceptors play a more important role in the regulation of blood flow in hindlimb than in renal and mesenteric vascular beds.

Commissural NTS contributes to pressor responses to glutamate injected into the medial NTS of awake rats

In the present study we investigated whether interruption of the chemoreceptor reflex by an electrolytic lesion of the commissural subnucleus of the nucleus tractus solitarii (commNTS) influenced presser and bradycardic responses induced by microinjection of L-glutamate (L-Glu) into the medial NTS (mNTS) of conscious rats. Seven days after sham lesions, seven rats demonstrated significant presser [change in mean arterial pressure (MAP) = +33 +/- 3 mmHg] and bradycardic [change in heart rate (HR) = -74 +/- 8 beats/min (bpm)] responses to chemoreceptor reflex activation by intravenous injection of KCN. Likewise, L-Glu (1 nmol in 100 nl) injected into the mNTS in sham rats induced presser (+29 +/- 2 mmHg) and bradycardic responses (-90 +/- 8 bpm). However, in 11 rats with lesions in commNTS, presser and bradycardic chemoreceptor reflex responses were abolished, and injection of L-Glu into the mNTS decreased MAP (-14 +/- 6 mmHg) and HR (-59 +/- 16 bpm) as is reported in anesthetized control rats. We conclude that presser responses induced by L-Glu microinjected into the baroreceptor reflex region of mNTS in conscious rats depend on the integrity of the commNTS, which plays an important role in central chemoreceptor reflex pathways.

CHANGES IN VASCULAR-RESISTANCE DURING CAROTID OCCLUSION IN NORMAL AND BARORECEPTOR-DENERVATED RATS

In the present study, we investigated changes in mesenteric, renal, and hindquarter vascular resistance during the pressor response produced by bilateral carotid occlusion (BCO) in conscious, freely moving normal and denervated (aortic, carotid, or both) rats. BCO was performed using special previously implanted cuffs. In control normal rats, the increase in mean arterial pressure (MAP) during early and late responses (37 +/- 4 and 21 +/- 2 mm Hg, respectively) was related to increased renal (125 +/- 12% and 45 +/- 10%) and mesenteric (38 +/- 13% and 41 +/- 5%) but not hindquarter (14 +/- 4% and 8 +/- 7%) vascular resistance. In aortic-denervated rats, the greater MAP increase in early and late responses (57 +/- 4 and 44 +/- 4 mm Hg, respectively) compared with normal rats was related to a marked increase in hindquarter (137 +/- 26% and 106 +/- 26%) and mesenteric (104 +/- 14% and 66 +/- 9%) vascular resistance. In carotid-denervated rats, MAP increase and change in vascular resistance were similar to those values observed in control rats. Sinoaortic-denervated rats showed a greater MAP increase (34 +/- 4 mm Hg) during late response and a reduced increase in renal vascular resistance (46 +/- 6%) during early response. The present results show that 1) the pressor response to BCO in normal rats is associated with an increase in renal and mesenteric vascular resistance, 2) the aortic baroreceptors buffer the increase in mesenteric and especially hindquarter vascular resistance during BCO, and 3) the reduced pressor response in late response is probably related to a reduced increase in renal vascular resistance during this component compared with the early response.

Assessment of electrocardiographic parameters in healthy dogs undergoing dobutamine stress testing

The electrocardiographic effects of dobutamine stress testing (10 to 40 mu g/kg/minute) were investigated in five conscious healthy dogs. We studied the changes in the duration and amplitude of P wave, PR interval, duration of QRS complex, R wave amplitude, QT interval, and heart rate. Development of arrhythmias and ST segment abnormalities were also recorded. It was observed that dobutamine significantly affects atrioventricular-nodal conduction and total electrical systole time at higher infusion rates. Only a single episode of sustained ventricular tachycardia was observed, which was promptly restored to sinus rhythm shortly after dobutamine infusion was discontinued. No ST segment abnormalities were detected. Dobutamine stress testing was concluded to play a role in some ECG parameters at higher infusion rates.

Analog Modeling of Human Cognitive Functions with Tripartite Synapses

Searching for an understanding of how the brain supports conscious processes, cognitive scientists have proposed two main classes of theory: Global Workspace and Information Integration theories. These theories seem to be complementary, but both still lack grounding in terms of brain mechanisms responsible for the production of coherent and unitary conscious states. Here we propose following James Robertson's "Astrocentric Hypothesis" - that conscious processing is based on analog computing in astrocytes. The "hardware" for these computations is calcium waves mediated by adenosine triphosphate signaling. Besides presenting our version of this hypothesis, we also review recent findings on astrocyte morphology that lend support to their functioning as Local Hubs (composed of protoplasmic astrocytes) that integrate synaptic activity, and as a Master Hub (composed, in the human brain, by a combination of interlaminar, fibrous, polarized and varicose projection astrocytes) that integrates whole-brain activity.

5-HT1A, but not 5-HT2 and 5-HT7, receptors in the nucleus raphe magnus modulate hypoxia-induced hyperpnoea

Aim: In the present study, we assessed the role of 5-hydroxytryptamine (5-HT) receptors (5-HT1A, 5-HT2 and 5-HT7) in the nucleus raphe magnus (NRM) on the ventilatory and thermoregulatory responses to hypoxia.Methods: To this end, pulmonary ventilation (V-E) and body temperature (T-b) of male Wistar rats were measured in conscious rats, before and after a 0.1 mu L microinjection of WAY-100635 (5-HT1A receptor antagonist, 3 mu g 0.1 mu L-1, 56 mM), ketanserin (5-HT2 receptor antagonist, 2 mu g 0.1 mu L-1, 36 mM) and SB269970 (5-HT7 receptor antagonist, 4 mu g 0.1 mu L-1, 103 mM) into the NRM, followed by 60 min of severe hypoxia exposure (7% O-2).Results: Intra-NMR microinjection of vehicle (control rats) or 5-HT antagonists did not affect V-E or T-b during normoxic conditions. Exposure of rats to 7% O-2 evoked a typical hypoxia-induced anapyrexia after vehicle microinjections, which was not affected by microinjection of WAY-100635, SB269970 or ketanserin. The hypoxia-induced hyperpnoea was not affected by SB269970 and ketanserin intra-NMR. However, the treatment with WAY-100635 intra-NRM attenuated the hypoxia-induced hyperpnoea.Conclusion: These data suggest that 5-HT acting on 5-HT1A receptors in the NRM increases the hypoxic ventilatory response.

Sedative and cardiorespiratory effects of acepromazine or atropine given before dexmedetomidine in dogs

To test the hypothesis that acepromazine could potentiate the sedative actions and attenuate the pressor response induced by dexmedetomidine, the effects of acepromazine or atropine were compared in six healthy adult dogs treated with this alpha(2)-agonist. In a randomised block design, the dogs received intravenous doses of either physiological saline, 0.05 mg/kg acepromazine or 0.04 mg/kg atropine, 15 minutes before an intravenous dose of 5 mu g/kg dexmedetomidine. The dogs' heart rate was reduced by 50 to 63 per cent from baseline and their mean arterial blood pressure was increased transiently from baseline for 20 minutes after the dexmedetomidine. Atropine prevented the alpha(2)-agonist-induced bradycardia and increased the severity and duration of the hypertension, but acepromazine did not substantially modify the cardiovascular effects of the a2-agonist, except for a slight reduction in the magnitude and duration of its pressor effects. The dexmedetomidine induced moderate to intense sedation in all the treatments, but the dogs' sedation scores did not differ among treatments. The combination of acepromazine with dexmedetomidine had no obvious advantages in comparison with dexmedetomidine alone, but the administration of atropine before dexmedetomidine is contraindicated because of a severe hypertensive response.

Perceptual Information Integration: Hypothetical Role of Astrocytes

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)