Efeitos do estímulo verbal sobre o desempenho no teste de escada e ajustes cardiorrespiratórios em sujeitos saudáveis

Esta pesquisa teve o objetivo de avaliar os efeitos do estímulo verbal (EV) no tempo do teste de escada (TEsc) e nas variáveis cardiorrespiratórias de adultos saudáveis. Trinta e um adultos saudáveis realizaram dois TEsc (com EV e sem EV). Antes e depois de cada teste, foram avaliados os sinais vitais e a Escala de Borg. Os tempos nos TEsc foram comparados por meio do Teste t de Student para amostras pareadas e as diferenças, de acordo com a ordem de realização dos testes utilizando o Teste de Mann-Whitney. Os sinais vitais e a Escala de Borg foram comparados por meio do Teste de Friedman ou ANOVA com post hoc do Teste de Tukey. As variações foram comparadas utilizando o Teste t Student para amostras independentes ou Teste de Mann-Whitney (p<0,05). O tempo no TEsc sem EV foi de 23,48±8,28 segundos, significativamente maior que o teste com EV, que foi de 21,60±7,18 segundos (p<0,05). Todas as variáveis aumentaram após os testes, e a Escala de Borg foi a única que teve maior variação no TEsc com EV, variando 2,5±1,4 no teste sem estímulo e 3,0±1,8 pontos no com estímulo (p<0,05). O estímulo verbal melhora o desempenho no TEsc e leva à maior sensação de esforço.

Anestesia para separação de gêmeos isquiópagos no período neonatal: relato de caso

JUSTIFICATIVA E OBJETIVOS: A separação de gêmeos unidos causa grande interesse devido à complexidade da anestesia e cirurgia, à raridade da patologia e às poucas chances de sobrevida. O objetivo desta descrição é o de contribuir para a literatura existente, relatando os desafios encontrados por nossa equipe no atendimento à cirurgia-anestesia de separação de gêmeos isquiópagos. RELATO do CASO: Pacientes gêmeos, nascidos a termo, de parto cesariano, pesando juntos 5.100 g, classificados como isquiópagus tetrapus. Duas equipes anestésico-cirúrgicas estavam presentes, sendo o procedimento anestésico esquematizado com aparelho de anestesia, cardioscópio, capnógrafo, oxímetro de pulso, termômetro elétrico, estetoscópio esofágico, todos em dobro. Realizou-se indução anestésica com halotano e fentanil, com os gêmeos em posição lateral e com rotação da cabeça em 45º para facilitar a intubação traqueal. Os recém-nascidos foram mantidos em ventilação controlada manualmente, utilizando o sistema de Rees-Baraka. A anestesia foi mantida com halotano, oxigênio e fentanil. Durante o per-operatório, foram encontrados órgãos abdominais duplos, com exceção do cólon, que era único. As bexigas e os ísquios estavam ligados. Ao final da cirurgia as duas crianças apresentavam-se com sinais vitais estáveis. Os gêmeos permaneceram na Unidade de Terapia Intensiva (UTI) Neonatal por quatro semanas e receberam alta em bom estado geral. CONCLUSÕES: Ressalta-se a importância do entrosamento da equipe, do estudo retrospectivo multidisciplinar, da monitorização adequada e acurada observação clínica; todos esses fatores contribuíram para a boa evolução e alta dos gêmeos.

Effect of passive pneumoperitoneum on oesophageal pressure, cardiovascular parameters and blood gas analysis in horses

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Epidemiologia e quadro clínico do botulismo epizoótico dos bovinos no Estado de São Paulo

In order to investigate epidemiological and clinical aspects of beef cattle mortalities caused by botulism, a syndrome popularly known as doença da vaca caída, studies were carried out in 32 naturally affected 4 to 9 year old cows, 27 belonging to the Nellore breed and 5 to crossbred Nellore, all from 27 farms located in municipalities near Botucatu, State of São Paulo. The epidemiological and clinical features were based, respectively, on the farm and herd managements, and on the general physical examination of the cows. Mouse bioassay and complement microfixation tests were performed to detect the presence of botulinum toxins in liver samples. The results showed that the disease occurs in beef cattle of range breeding systems, reared under inadequate mineral nutrition and deficient health management. Pregnant and milking cows represented the group at risk, and the incidence was higher during the rainy season (December to March), with morbidity and mortality rates of 3,2 ± 3,6%. Clinical examination revealed cows with no alterations of vital signs, behavior, visual and auditory acuities and skin sensation; but revealed ruminal hypomotility, anorexia, dehydration, flaccid para or tetraparesis with permanent recumbency, and a paretic or paralytic tongue. The diagnosis of botulism, involving type C and D toxins, was consistent with the epidemiological and clinical findings.

Clinical assessment of ethinylestradiol and cyproterone acetate in menstrual irregularities of hyper-androgenic origin

We report on the results of a double-blind, randomized, controlled clinical trial comparing two preparations of ethinylestradiol and cyproterone acetate in the treatment of women of reproductive age presenting menstrual irregularities of hyper-androgenic origin. After obtaining informed consent, subjects were randomized to a 4-month treatment period consisting of one daily dose of 0.035mg ethinylestradiol + 2mg cyproterone acetate. The treatment regimen cycle consisted of one pill, once daily for 21 days, followed by a 7-day pill-free period. We compared the efficacy of two presentations of the drug combination after each treatment cycle (Visits 2, 3, 4, and 5) in establishment and maintenance of menstrual regulation, intensity of menstrual flow, and dysmenorrhea, as well as a comparison of the two presentations in terms of Global Satisfaction and Drug Satisfaction assessments performed by the patients and the investigating physician. At each study visit, drug compliance and use of concomitant medications, as well as incidence, severity and duration of adverse events were recorded. A total of 86 subjects were randomized to treatment, with 43 subjects in each treatment group. At Visit 2 and each subsequent visit, all patients in both treatment groups reported an episode of withdrawal bleeding during the 7-day hormone-free period. We observed a statistically significant (p<0.0001) decrease in the incidence of dysmenorrhea at each study visit in relation to the pretreatment assessment. There was a significant reduction (p<0.0001) in the number of subjects reporting intermenstrual bleeding at each study visit in both treatment groups. Global Satisfaction scores by the patient and physician increased significantly at each successive study visit in both treatment groups. There were no clinically significant changes in vital signs, weight, and body mass index throughout the study period in either group. The number of subjects reporting adverse events at each visit did not vary between treatment groups. The combined oral contraceptive pill containing ethinylestradiol and cyproterone acetate was found to be both effective and safe in the menstrual irregularities of hyper-androgenic origin (amenorrhea, dysmenorrhea, and intermenstrual bleeding) assessed in this study. © Copyright Moreira Jr. Editora. Todos os direitos reservados.

Avaliação cardiorrespiratória e analgésica da ropivacaína isolada e associada ao fentanil ou ao tramadol, administrados pela via peridural em cães

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

Efeito do propofol associado à efedrina no tempo da latência do cisatracúrio

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Sedação consciente com midazolam, via endovenosa, para realização de tratamento odontológico em pessoas com deficiência

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Perception and Attitude About Systemic Health and Periodontal Disease Among Dentistry Undergraduates

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Compreendendo o acolhimento em uma unidade de saúde da família na perspectiva dos usuários

The present study aimed at understanding humanized reception at a Family Health Unit in a city in São Paulo state according to users’ perspectives. It is a qualitative investigation with a Case Study as its methodological framework and the Theory of Complexity (TC) as its theoretical basis. Data were collected from March to July, 2011 by means of non-directive interviews and participant observation, and the Flowchart that analyzes the care provision model in health care services was used. The discourses were analyzed according to Bardin’s thematic approach, from which two themes emerged: humanized reception as an act that precedes medical consultation and humanized reception as a solution to demands stemming from medical action. The study provided visibility to the forms how humanized reception is understood, that is, the moment that precedes medical consultation, being configured as a pre-consultation instance when punctual actions are performed, such as measuring vital signs, and when users are sure that they will be seen by a doctor, in addition to the perception that humanized reception is not part of the process to solve their need, since such result is achieved by means of medication dispensation permeated by the polite treatment given by professionals. These results show how the fragmented, reductionist and linear approach to caregiving is still present in the words, thoughts and culture of health service users as well as in those of health care team members. TC seems to shed light on these issues, and it may result in important improvement in the understanding of interactional relationships between team members and users concerning the work process in the Family Health model as the main strategy in Primary Care

Clinical Assessment of Tribulus terrestris Extract in the Treatment of Female Sexual Dysfunction

This is a qualitative-quantitative study based on hospital records of female patients of reproductive age, presenting sexual dysfunction, and treated with 250 mg Tribulus terrestris extract (1 tablet thrice daily for 90 days). Safety monitoring included vital signs, physical examination, laboratory tests, and occurrence of adverse events. Efficacy analysis included results of the Female Sexual Function Index (FSFI), dehydroepiandrosterone (DHEA) levels together with total and free testosterone, and the patient and physician assessments. There was a statistically significant improvement in total FSFI scores (P < 0.0001) post-treatment, with improvement among 106 (88.33%) subjects. There was a statistically significant (P < 0.0001) increase in the level of DHEA, while the levels of both serum testosterone (P = 0.284) and free testosterone decreased (P < 0.0001). Most adverse events recorded were related to the gastrointestinal tract. Physical examination showed no significant changes post-treatment. Based on the results, it is concluded that the T. terrestris extract is safe and effective in the treatment of female sexual dysfunction.

Evaluation of electrophoretic profile and albumin quota in the cerebrospinal fluid of dogs with distemper showing or not neurvous signs

Estudaram-se o perfil eletroforético das proteínas liquóricas e a cota de albumina em cães sem e com cinomose na fase neurológica e não-neurológica. A punção da cisterna magna para a obtenção de amostras de liquor realizou-se em 30 cães. Analisaram-se teores de proteínas totais, cota de albumina e fracionamento eletroforético das proteínas liquóricas em gel de agarose. Os resultados foram semelhantes nos cães normais e nos cães com cinomose sem sinais neurológicos e significativamente elevados no grupo de cães com cinomose apresentando sinais neurológicos. O estudo do quadro protéico do líquido cérebroespinhal foi útil e contribuiu significativamente na detecção de lesões ao sistema nervoso central e de danos à barreira hematoencefálica durante a fase neurológica da cinomose.

Molecular diagnosis of Anaplasmataceae organisms in dogs with clinical and microscopical signs of ehrlichiosis

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Analysis of cardiovascular system responses to forced vital capacity in COPD

CONTEXTUALIZAÇÃO: O teste de capacidade vital forçada (CVF) é rotineiramente realizado na avaliação da função pulmonar de pacientes com doença pulmonar obstrutiva crônica (DPOC). Entretanto, permanece pouco compreendida a influência do teste de CVF sobre o sistema cardiovascular de pacientes com DPOC. OBJETIVOS: Analisar o comportamento da frequência cardíaca (FC), pressão arterial (PA) e variabilidade da frequência cardíaca (VFC) no teste de CVF na DPOC. MÉTODOS: Dezenove homens com DPOC (72 ± 7 anos, no estágio de gravidade GOLD I=3, II=5, III=7 e IV=4 pacientes) realizaram a manobra de CVF e tiveram sua FC monitorada durante todo o exame, e a VFC analisada nos domínios do tempo (rMSSD) e da frequência (BF, AF e BF/AF) durante o repouso, antes e após a melhor manobra de CVF. A PA foi analisada no repouso, imediatamente ao final da manobra de CVF e 10 minutos após o término de todos os testes. RESULTADOS: Ao início da manobra de CVF, a FC reduziu (p<0,001) e, em seguida, aumentou progressivamente até o final do teste (p<0,001). Após término da manobra, a FC continuou a aumentar até atingir um pico (p<0,001) e depois caiu rapidamente a valores inferiores aos de repouso (p<0,001) e retornou ao seu valor basal. A PA e os índices da VFC não sofreram alterações nos períodos analisados. CONCLUSÃO: O teste de CVF influencia o comportamento da FC, sem alterar o seu controle autonômico, bem como a PA em pacientes com DPOC nos períodos analisados.

Genotyping of Toxoplasma gondii strains isolated from dogs with neurological signs

From 111 dogs with neurological signs admitted in this research in a 22-month period, brain samples of 34 animals were inoculated in mice in order to isolate Toxoplasma gondii. From these 34 dogs, 9 strains of T. gondii were isolated and the genetic characterization performed by restriction analysis (RFLP) of the SAG-2 gene. RFLP analysis showed that four of them were classified as Type I, and five as Type Ill. The present report is the first description of genotyping of T. gondii isolated from brain samples of naturally infected dogs, in Brazil. (C) 2004 Elsevier B.V. All rights reserved.