The effect of intracuff alkalinized 2% lidocaine on emergence coughing, sore throat, and hoarseness in smokers

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

Production of bacteriocin-like inhibitory substances (BLIS) by Streptococcus salivarius strains isolated from the tongue and throat of children with and without sore throat

Cepas de Streptococcus salivarius, isoladas de crianças com e sem dor de garganta, foram testadas quanto à produção de bacteriocina contra Streptococcus pyogenes. Os resultados mostraram que as crianças que não tinham dor de garganta possuiam, na boca, cepas de bactérias produtoras de substâncias inibidoras semelhantes à bacteriocina contra S. pyogenes.

Prevalence and microscopic features of enamel pearls from permanent human molars

Enamel pearls are ectopic structures observed mainly on the roots of permanent teeth and could be related to periodontal diseases. Aim: To evaluate the prevalence of enamel pearls in extracted human molars and characterize their structures using light and scanning electron microscopy. Methods: The study comprised 2,201 extracted human permanent molars. The teeth were analyzed and classified according to morphological features. The presence, location and shape of enamel pearls were investigated. Fifteen human molars with enamel pearls were embedded in acrylic resin and observed by light microscopy. Results: Seventy-one enamel pearls were identified on third molar root. Microscopically, most pearls were composed of prismatic irregular enamel and normal dentin. The dentinoenamel junction presented an irregular course. The number of dentinal tubules was normal and they presented curvature to continue within the root dentin of the carrier tooth. Dentinal tubules below the enamel pearls were closer to each other. Conclusions: Scanning electron microscopic analysis revealed that the enamel pearls were similar to coronal enamel.

Efeitos genéticos e ambientais sobre a idade à primeira concepção de fêmeas suínas

The genetic and environmental factors that affect age at first conception (AFC) of gilts were evaluated, using 466 observations of Dalland animals (C-40). The software program MTDFREML was used to assess the genetic parameters on an animal model that included as fixed effect, contemporary group and, as random effects, the additive genetic, the common litter and the error. Mean value of AFC was 241.12±25.9 days, with CV of 8.5 %. Variance analysis showed that year (P<0.01), season (P<0.01) and herd effects (P<0.01) were important sources of variation of AFC. The throat effect (P=0.34) was not important for the AFC, but the mother of the gilts (P<0.01) was an important source of variation. The heritability estimate was 0.44±0.14 that this trait would yield genetic gain as a response to the selection.

Does sealing endotracheal tube cuff pressure diminish the frequency of postoperative laryngotracheal complaints after nitrous oxide anesthesia?

Study Objectives: To study endotracheal tube (ETT) cuff pressures during nitrous oxide (N2O) anesthesia when the cuffs are inflated with air to achieve sealing pressure, and to evaluate the frequency of postoperative laryngotracheal complaints.Design: Prospective, randomized, blind study.Setting: Metropolitan teaching hospital.Patients: 50 ASA physical status I and II patients scheduled for elective abdominal surgery.Interventions: Patients received standard general anesthesia with 66% N2O in oxygen. In 25 patients, the ETT cuff was inflated with air to achieve a sealing pressure (P-seal group). In 25 patients, the ETT cuff was inflated with air to achieve a pressure of 25 cm H2O (P-25 group).Measurements and Main Results: ETT intracuff pressures were recorded before (control) and at 30, 60, 90, 120, and 150 minutes during N2O administration. We investigated the frequency and intensity of sore throat, hoarseness, and dysphagia in patients in the Post-Anesthesia Care Unit (PACU) and 24 hours following tracheal extubation. The cuff pressures in the P-seal group were significantly lower than in the P-25 group at all time points studied (p < 0.001), with a significant increase with time in both groups (p < 0.001). The cuff pressures exceeded the critical pressure of 30 cm H2O only after 90 minutes in the P-seal group and already by 30 minutes in the P-25 group. The frequency and intensity of sore throat, hoarseness, and dysphagia were similar in both groups in the PACU and 24 hours after tracheal extubation (p > 0.05).Conclusions: Minimum ETT sealing cuff pressure during N2O anesthesia did not prevent, but instead attenuated, the increase in cuff pressure and did not decrease postoperative laryngotracheal complaints. (C) 2004 by Elsevier B.V.

Emergence agitation in pediatric anesthesia: current features

Objective: Postoperative agitation in children is a well-documented clinical phenomenon with incidence ranging from 10% to 67%. There is no definitive explanation for this agitation. Possible causes include rapid awakening in unfamiliar settings, pain (wounds, sore throat, bladder distension, etc.), stress during induction, hypoxemia, airway obstruction, noisy environment, anesthesia duration, child's personality, premedication and type of anesthesia. The purpose of this paper is to discuss the possible causes of postoperative agitation in children, providing a foundation for better methods of identifying and preventing this problem.Sources: MEDLINE and PubMed were searched using the following words: emergence, agitation, incidence, etiology, diagnosis, treatment, children, pediatric, anesthesia.Summary of the findings: This study includes a review of potential agitation trigger factors and a proposal for a standardized diagnostic score system, in addition to measures to improve prevention and treatment.Conclusion: No single factor can identified as the cause of postoperative agitation, which should therefore be considered a syndrome made up of biological, pharmacological, psychological and social components, and which anesthesiologists and pediatric intensive care specialists should be prepared to identify, prevent and intervene appropriately as necessary.

Effectiveness and safety of endotracheal tube cuffs filled with air versus filled with alkalinized lidocaine: a randomized clinical trial

CONTEXTO E OBJETIVO: Os tubos traqueais são dispositivos utilizados para manutenção da ventilação. A hiperinsuflação do balonete do tubo traqueal, causada pela difusão do óxido nitroso (N2O), pode determinar lesões traqueais, que se manifestam clinicamente como odinofagia, rouquidão e tosse. A lidocaína, quando injetada no balonete do tubo traqueal, difunde-se através de sua parede, determinando ação anestésica local na traquéia. O objetivo foi avaliar a efetividade e a segurança do balonete do tubo traqueal preenchido com ar comparado com o balonete preenchido com lidocaína, considerando os desfechos: sintomas cardiovasculatórios (HAS, taquicardia); odinofagia, tosse, rouquidão e tolerância ao tubo traqueal. TIPO DE ESTUDO E LOCAL: Estudo clínico prospectivo, realizado no Departamento de Anestesiologia da Faculdade de Medicina da Unesp, campus de Botucatu. MÉTODOS: A pressão do balonete do tubo traqueal foi medida, entre 50 pacientes, antes, 30, 60, 90 e 120 minutos após o início da inalação de N2O anestésico. As pacientes foram distribuídas aleatoriamente em dois grupos: Air, em que o balonete foi inflado com ar para obtenção de pressão de 20 cm H2O, e Lido, em que o balonete foi preenchido com lidocaína a 2% mais bicarbonato de sódio a 8,4% para obtenção da mesma pressão. O desconforto antes da extubação, e manifestações clínicas como dor de garganta, rouquidão e tosse foram registrados no momento da alta da unidade de cuidados pós-anestésicos, e dor de garganta e rouquidão foram avaliadas também 24 horas após a anestesia. RESULTADOS: Os valores da pressão no balonete em G2 foram significativamente menores do que os de Air em todos os tempos de estudo, a partir de 30 minutos (p < 0,001). A proporção de pacientes que reagiu ao tubo traqueal no momento da desintubação foi significantemente menor em Lido (p < 0,005). A incidência de odinofagia foi significantemente menor em Lido no primeiro dia de pós-operatório (p < 0,05). A incidência de tosse e rouquidão não diferiu entre os grupos. CONCLUSÕES: Durante ventilação artificial, empregando-se a mistura de oxigênio e N2O, a insuflação do balonete com lidocaína 2% alcalinizada impede que ocorra aumento significante da pressão no balonete e determina maior tolerância ao tubo traqueal e menor incidência de odinofagia no pós-operatório, podendo então ser considerada mais segura e com maior efetividade.

Avaliação cefalométrica do perfil mole de pacientes face longa submetidos à cirurgia ortognática: estudo retrospectivo

OBJETIVO: o presente trabalho propôs-se a comparar o perfil tegumentar pós-operatório de pacientes Classe II, Padrão Face Longa, submetidos ao tratamento ortodôntico-cirúrgico, com os parâmetros descritos na análise cefalométrica de Legan e Burstone. METODOLOGIA: 32 telerradiografias pós-cirúrgicas, com um mínimo de 6 meses de acompanhamento, foram submetidas a traçado manual (repetido 4 vezes) e digitalização (também repetida 4 vezes) no programa DFPlus para análise cefalométrica. RESULTADOS: os resultados permitiram verificar que 9 das 11 medidas avaliadas encontravam-se estatisticamente diferentes da norma avaliada; contudo, ao se verificar o desvio padrão permitido na norma, os achados deste trabalho situam-se dentro da mesma, com exceção do ângulo mentocervical. CONCLUSÃO: as condições experimentais deste estudo permitiram concluir que, embora a população estudada tenha obtido resultados estéticos-funcionais satisfatórios, não se enquadrou nas normas da análise de Legan e Burstone, o que indica que a avaliação após a cirurgia ortognática deve ser principalmente clínica e que a estética facial não está totalmente relacionada com as medidas préestabelecidas na análise cefalométrica.

Redescription of Physalaemus barrioi (Anura: Leiuperidae)

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

Principais preocupações dos pacientes sobre as complicações mais frequentes na sala de recuperação pós-anestésica

JUSTIFICATIVA E OBJETIVOS: Eventos considerados menores têm assumido papel fundamental na determinação da qualidade do serviço prestado na área da Anestesiologia. O objetivo do presente estudo foi avaliar as principais preocupações dos pacientes em relação ao período pós-anestésico e testar a hipótese de que os efeitos mais indesejados podem ser influenciados por características demográficas. MÉTODO: Um questionário foi respondido por 440 pacientes imediatamente antes da avaliação pré-anestésica. Foram listados os possíveis efeitos indesejáveis no período pós-operatório imediato, baseados em levantamento a partir de dados disponíveis na literatura e considerando o critério de frequência, mas não o de gravidade. Foram avaliados os dados demográficos e pesquisadas as nove preocupações mais frequentemente citadas. As informações coletadas a partir da análise dos questionários preenchidos pelos entrevistados foram relacionadas com seus dados antropométricos, socioeconômicos e educacionais, com o objetivo de avaliar a influência dessas variáveis no perfil das respostas. RESULTADOS: Entre os efeitos indesejados, o temor de acordar intubado foi o mais frequentemente citado como o mais importante, seguido de dor forte no local da cirurgia e acordar durante a cirurgia. A análise dos três efeitos mais indesejados em relação aos dados demográficos não evidenciou diferença estatística significativa, com exceção do item dor no local da cirurgia (menos citada entre pacientes do sexo masculino). CONCLUSÕES: As principais preocupações dos pacientes em relação ao período pós-anestésico são: acordar com um tubo na garganta, dor forte no local da cirurgia e a lembrança de estar acordado durante a cirurgia. A idade, o grau de escolaridade e a renda familiar não determinaram diferenças nas preocupações dos pacientes.

3 CHAMAEZA ANTTHRUSHES IN EASTERN BRAZIL (FORMICARIIDAE)

There are three, not two, sibling antthrushes of the genus Chamaeza (Formicariidae) in eastern Brazil. One is the short-tailed, large, pale-billed, lower montane C. campanisona, with a spotted throat, dark forehead, and a long song ending in several grunts. The second is the long-tailed, small, dark-billed, montane and southern C. ruficauda, with barred undertail coverts and a short upscale song. The third is medium-tailed, small, dark-billed, midmontane, with a long upscale song like that of midmontane so-called ruficauda in Colombia and Venezuela. This northern group is like the third Brazilian species in proportions but not in coloration, so is considered to be the separate species C. turdia. The third Brazilian bird is probably C. meruloides Vigors 1825, based on an 1826 color plate; type specimens were sold at auction and have disappeared. It has a reddish crown and olive-brown back as in C. campanisona but reddish forehead and tail as in C. ruficauda; the throat is unspotted but the rest of the underparts are as in C. campanisona. C. meruloides and C. turdina form a vocally similar superspecies.

Scent-marking behaviour in free-ranging golden-faced saki monkeys, Pithecia pithecia chrysocephala: Sex differences and context

Scent-marking behaviour of golden-faced saki monkey, Pithecia pithecia chrysocephala, was observed intermittently between 1987 and 1990 for a family group in a Central Amazonian forest fragment. of 95 scent-marking events (during 275.5 hours of observation), throat-and-chest rubbing accounted for all except one anogenital rubbing. Nine of the throat-and-chest markings also involved touching groin with hands and eight markings (including the anogenital), urinating on the marked branch. Marking behaviour is strongly sex related, with the adult male making 88.4% of the markings. Scent-marking frequency by the adult male increased during breeding periods. Scent-marking behaviour seems related to courtship, and possibly stimulates sexual behaviour. All regularly marked spots consisted of horizontal branches on commonly travelled routes. Eleven occurred in feeding trees and lianas, but none in sleeping trees. Scent-marking behaviour in the monkeys studied here was not related to intergroup encounters and probably did not have a territorial function, although it may do so where different groups interact.

The gas flow rate increase obtained by an oscillating piezoelectric actuator on a micronozzle

Micronozzles with piezoelectric actuator were fabricated and investigated. The micronozzles were fabricated in glass substrates using a powder-blasting technique, and the actuator is a bimorph structure made from a piezoelectric polymer. The actuator was located at the nozzle outlet, and was driven in an oscillating mode by applying an alternating voltage across the actuator electrodes. With a pressure difference between inlet and outlet, the gas flow rate through the device was increased. This effect was quantified, and compared to a similar micronozzle with no actuator. The increase in the flow rate was defined as the gas flow through the micronozzle with actuator oscillating minus the gas flow without actuator, was found to depend on the inlet pressure, the pressure ratio, and the nozzle throat diameter. (C) 2008 Elsevier B.V. All rights reserved.

REFLUXO GASTROESOFAGICO E SINTOMAS OTORRINOLARINGOLOGICOS

Gastroesophageal reflux and other gastroesophageal diseases produce symptoms in head and neck region leading individuals to search for ear nose and throat consultation. Otolaryngologist may incorporate investigation of reflux in your daily practice. Comments of gastroesophageal reflux and head and neck complaints are done. To illustrate handling of patients suspected of reflux authors relates a case of a dysphagia patient. Close relationship between otolaryngologist and gastroenterologist in reflux investigation is emphasized.

Development of microvalves for gas flow control in micronozzles using PVDF piezoelectric polymer

This work describes a fabrication and test sequence of microvalves installed on micronozzles. The technique used to fabricate the micronozzles was powder blasting. The microvalves are actuators made from PVDF (polivinylidene fluoride), that is a piezoelectric polymer. The micronozzles have convergent-divergent shape with external diameter of 1mm and throat around 230μm. The polymer have low piezoelectric coefficient, for this reason a bimorph structure with dimensions of 2mm width and 4mm of length was build (two piezoelectric sheets were glued together with opposite polarization). Both sheets are recovered with a conductor thin film used as electrodes. Applying a voltage between the electrodes one sheet expands while the other contracts and this generate a vertical movement to the entire actuator. Appling +300V DC between the electrodes the volume flux rate, for a pressure ratio of 0.5, was 0.36 sccm. Applying -200V DC between the electrodes (that means it closed) the volume flux rate was 0.32 sccm, defining a possible range of flow between 0.32 and 0.36 sccm. The third measurement was performed using AC voltage (200V AC with frequency of 1Hz), where the actuator was oscillating. For pressure ratio of 0.5, the flow rate was 0.62 sccm. © 2008 IOP Publishing Ltd.