Pharmacokinetics of intraosseous and central venous drug delivery during cardiopulmonary resuscitation

We compared the pharmacokinetics of intraosseous (IO) drug delivery via tibia or sternum, with central venous (CV) drug delivery during cardiopulmonary resuscitation (CPR).Methods: CPR of anesthetized KCl arrest swine was initiated 8 min post arrest. Evans blue and indocyanine green, each were simultaneously injected as a bolus with adrenaline through IO sternal and tibial needles, respectively, n = 7. In second group (n = 6) simultaneous IO sternal and IV central venous (CV) injections were made.Results: Peak arterial blood concentrations were achieved faster for sternal IO vs. tibial IO administration (53 +/- 11 s vs. 107 +/- 27 s, p = 0.03). Tibial IO dose delivered was 65% of sternal administration (p = 0.003). Time to peak blood concentration was similar for sternal IO and CV administration (97 +/- 17 s vs. 70 +/- 12 s, respectively; p = 0.17) with total dose delivered of sternal being 86% of the dose delivered via CV (p = 0.22).Conclusions: IO drug administrations via either the sternum or tibia were effective during CPR in anesthetized swine. However, IO drug administration via the sternum was significantly faster and delivered a larger dose. (C) 2011 Elsevier B.V. All rights reserved.

Simulation-based ultrasound-guided central venous cannulation training program

PURPOSE: To propose a simulation-based ultrasound-guided central venous cannulation skills' training program, during residency.METHODS: This study describes the strategies for learning the ultrasound-guided central venous cannulation on low-fidelity bench models. The preparation of bench models, educational goals, processes of skill acquisition, feedback and evaluation methods were also outlined. The training program was based on key references to the subject.RESULTS: It was formulated a simulation-based ultrasound-guided central venous cannulation teaching program on low-fidelity bench models.CONCLUSION: A simulation-based inexpensive, low-stress, no-risk learning program on low-fidelity bench models was proposed to facilitate acquisition of ultrasound-guided central venous cannulation skills by residents-in-training before exposure to the living patient.

Sobre a filosofia da mente de John Searle

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

A multidisciplinary program of preparation for childbirth and motherhood: maternal anxiety and perinatal outcomes

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Use of oocyte transfer in a commercial breeding program for mares with reproductive abnormalities

In some mares with lesions of the reproductive tract, embryo collection and survival rates are low or collection of embryos is not feasible. For these mares, oocyte transfer has been proposed as a method to induce pregnancies. In this report, a method for oocyte transfer in mares and results of oocyte transfer performed over 2 breeding seasons, using mares with long histories of subfertility and various reproductive lesions, are described.Human chorionic gonadotropin or an implant containing a gonadotropin-releasing hormone analog was used to initiate follicular and oocyte maturation. Oocytes were collected by means of transvaginal ultrasound-guided follicular aspiration. Following follicular aspiration, cumulus oocyte complexes were evaluated for cumulus expansion and signs of atresia; immature oocytes were cultured in vitro to allow maturation. The recipient's ovary and uterine tube (oviduct) were exposed through a flank laparotomy with the horse standing, and the oocyte was slowly deposited within the oviduct. Oocyte transfer was attempted in 38 mares between 9 and 30 years old during 2 successive breeding seasons. All mares had a history of reproductive failure while in breeding and embryo transfer programs. Twenty pregnancies were induced. Fourteen of the pregnant mares delivered live foals. Results suggest that oocyte transfer can be a successful method for inducing pregnancy in subfertile mares in a commercial setting..

Analysis of quality indicators of central sterile supply departments at accredited public hospitals

O objetivo do estudo foi descrever e analisar os indicadores de qualidade de Centros de Material e Esterilização de hospitais públicos acreditados do Estado de São Paulo e sua gestão pelos responsáveis do setor. Trata-se de um estudo de casos múltiplos, onde são apresentados os dados interligados de três hospitais acreditados num relatório de casos cruzados. Os dados foram coletados por entrevista semiestruturada com o responsável e por visita técnica com análise documental. Os resultados constatam a dificuldade dos responsáveis em pontuar os indicadores específicos do setor e os referidos foram os de produção e pesquisa de satisfação do cliente que não retratam a qualidade efetiva do serviço, pois são fragmentados, sem consolidação de resultados na busca de melhorias, o que sugere baixa especificidade e baixa sensibilidade dos critérios da Organização Nacional de Acreditação à realidade deste setor.

Coordinated dispersal and pre-isthmian assembly of the Central American ichthyofauna

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