Tempo de latencia do rocuronio e da succinilcolina e condicoes de intubacao traqueal

Background and Objectives - Pulmonary aspiration of gastric content during induction of anesthesia for emergency surgical procedures is a serious complication; fast endotracheal intubation under these circumstances is of vital importance to secure the airways. Despite its numerous side effects, succinylcholine is used for this purpose. Rocuronium is the most recently introduced aminoesteroid neuromuscular blocking drug with short onset. The objective of this study was to compare the onset time and intubating conditions of rocuronium and succinylcholine. Methods - After informed consent, forty-five patients were randomly allocated into three groups of 15: Group I (GI) = succinylcholine 1 mg.kg-1; Group II (GII) = rocuronium 0.6 mg.kg-1; Group III (GIII) = rocuronium 0.9 mg.kg-1. Every patient was premedicated with midazolam 15 mg per os and induction of anesthesia was made with fentanyl 10 μg.kg-1 and etomidate 0.3 mg.kg-1. The neuromuscular block was monitored with the TOP-Guard neuromuscular transmission monitor. The TOP-Guard neuromuscular monitor uses an accelerometer to measure the response to nerve stimulation. The stimulating electrodes were placed close to the course of the ulnar nerve at the wrist. The onset time was considered as the time between the end of neuromuscular drug injection and the twitch height (T1) decrease to 10%. Heart rate and arterial blood pressure were registered at 6 moments before and after induction of anesthesia. Results - The onset time results were: Group I, 71 s; Group II, 120 s and Group III, 70 s or GI = GIII < GII (F = 8.862; p < 0.01). There were 43 patients exhibiting excellent intubating conditions and 2 with good intubating conditions. Heart rate and arterial blood pressure showed alterations due to induction of anesthesia and intubation. Conclusions - Rocuronium 0.9 mg.kg-1 can be used in rapid sequence induction because it has a short onset time which is similar to that of succnylcholine. It is likely that rocuronium would be a good indication in patients with high intracranial pressure, burns and neuromuscular diseases.

Histological study of resection arthroplasty with and without tendon ball interposition in dogs

We studied an experimental model of resection arthroplasty with or without tendon ball interposition in the wrist of dogs. Animals were divided into two groups. Animals in group A were treated by resection of the os carpi radiale with interposition of a ball made from the tendon of the extensor carpi radialis and the group B underwent bone resection alone. Animals were assessed 1, 6, 12 and 24 weeks after operation. In all of them the wrist joint was stable and had good mobility, allowing walking supported by the operated limb. In both groups biological material filled the cavity created by bone resection. A progressive repair process resulted in fibroplasia with areas of fibrocartilaginous metaplasia. The tendon ball showed complete ischaemic necrosis at the end of the first week, which delayed the healing process. © 1999 The British Society for Surgery of the Hand.

Ulnar-to-median nerve anastomosis in the forearm. Review and report of 2 new cases

The ulnar-to-median nerve anastomosis in the forearm is a very rare occurrence, not mentioned in many anatomical text books. We found only 4 cases cited in medical literature. Here we describe 2 new cases, for which diagnosis was suspected when the compound muscle action potential of the abductor pollicis brevis muscle (APB), obtained by maximal stimulation of the median nerve at the elbow, was lower than that obtained at the wrist. The diagnosis was confirmed by stimulation of the ulnar nerve at the elbow, which evoked a compound muscle action potential of the APB with a clear negative initial deflection without volume-conducted potential.

Comparative analysis of electromyographic pattern in the forearm muscles of hemiplegic patients

It was purposed the use of electromyography (EMG) to evaluate the activation of the agonists and antagonists muscles of spastic patients, to test the viability in the development of an instrument that given quantitative data of the patient spasticity. 30 hemiplegic and 15 normal volunteers had been submitted to the EMG of flexor and extensor carpi ulnaris muscles during the flexion and extension movements of the wrist. The individuals with less severe spasticity (mAS (modified Ashworth Scale) ringing 0 to 3 degree), had presented deficit in the activation of the flexor muscles in plegic side in relation to the non plegic side and that the individuals seriously compromised by the spasticity (mAS = 4 degree) present deficit of reciprocal inhibition. One evidenced is that the non plegic member does not present a similar neuro-motor comportment when compared to the normal member. The surface electromyography is a practical clinical instrument to evaluate the patient with spasticity and the hemiplegic patient needs to be evaluated on both sides (deficient and no deficient) because the no compromised side do not show a normality standard.

Economic Survey of Latin America and the Caribbean 2009-2010: The distributive impact of public policies

Includes bibliography

Manual for completing the questionnaire on measures affecting services trade in the hemisphere

Includes bibliography

Dental age as indicator of adolescence

Aim: The purpose of the present study was to analyze the relationship between root formation of the first premolars and skeletal maturation stages identified in hand-wrist radiographs. Methods: A cross-sectional study was carried out involving the panoramic and hand-wrist radiographs obtained on the same date of 232 patients, 123 boys and 109 girls aged 4 years and 5 months to 17 years and 12 months. Root formation stages of the first premolars were related to the ossification stages of the sesamoid bone, epiphyseal stages of the phalanx of the thumb and epiphyseal stages of the radius. Results: The studied variables demonstrated statistically significant correlations. Conclusion: Roots of the lower first premolars do not reach 2/3 of their complete length before adolescence.

Livros didáticos de ensino religioso: Análise da construção da polêmica no discurso da mídia

This text aims to identify the discursive relations and the mechanisms used by sources - discourses gathered at press and specialized sites - in composing of viewpoints presented about the religious education textbooks and, a result of that, of controversial relationship built thereafter. The theoretical foundation of this work rests largely on the concepts of global semantics and constitutive intermisunderstanding (MAINGUENEAU, 1997, 2008) and discursive heterogeneity (AUTHIER-REVUZ, 1990, 1998). The research corpus consisted of four texts, three of which were published in 2010 and another in 2011, two reports and two opinion articles about the subject. From our analysis, we could see the construction of a controversial relationship between a discursive formation that challenges the teaching of religion in Brazilian public education, on the grounds that benefit the Christian faith and, moreover, one that supports the continuation of this practice and consider it important for the formation of the student and also as a promoter of diversity and equality.

Life mode of in situ Conularia in a Middle Devonian epibole

Exceptionally abundant specimens of Conularia aff. desiderata Hall occur in multiple marine obrution deposits, in a single sixth-order parasequence composed of argillaceous and silty very fine sandstone, in the Otsego Member of the Mount Marion Formation (Middle Devonian, Givetian) in eastern New York State, USA. Associated fossils consist mostly of rhynchonelliform brachiopods but also include bivalve molluscs, orthoconic nautiloids, linguliform brachiopods and gastropods. Many of the brachiopods, bivalve molluscs and conulariids have been buried in situ. Conulariids buried in situ are oriented with their aperture facing obliquely upward and with their long axis inclined at up to 87degree to bedding. Most specimens are solitary, but some occur in V-like pairs or in radial clusters consisting of three specimens, with the component specimens being about equally long or (less frequently) substantially different in length. The compacted apical end of Conularia buried in situ generally rests upon argillaceous sandstone. With one possible exception, none of the examined specimens terminates in a schott (apical wall), and internal schotts appear to be absent. The apical ends of specimens in V-like pairs and radial clusters show no direct evidence of interconnection of their periderms. The apical, middle or apertural region of some inclined specimens abuts or is in close lateral proximity to a recumbent conulariid or to one or more spiriferid brachiopods, some of which have been buried in their original life orientation. The azimuthal bearings of Conularia and nautiloid long axes and the directions in which conulariids open are nonrandom, with conulariids being preferentially aligned between 350 and 50degree and with their apertural end facing north-east, and nautiloids being preferentially aligned between 30 and 70degree. Otsego Member Conularia were erect or semi-erect, epifaunal or partially infaunal animals, the apical end of which rested upon very fine bottom sediment. The origin of V-like pairs and radial clusters remains enigmatic, but it is probable that production of schotts was not a regular feature of this animal's life history. Finally, conulariids and associated fauna were occasionally smothered by distal storm deposits, under the influence of relatively weak bottom currents. © The Palaeontological Association.

Evaluation of reusable cardboard box designs: Biomechanical and perceptual aspects

Reusable cardboard boxes can be ergonomically designed for internal transportation of dry products in industrial settings. In this study we compared the effects of handling a regular commercial box and two cardboard prototypes on upper limb postures through the evaluation of movements, myoelectrical activity, perceived grip acceptability and capacity for reuse. The ergonomic designs provided a more acceptable grip, safer wrist and elbow movements and lower wrist extensors and biceps activity. Biomechanical disadvantages were observed only for one of the prototypes when handling to high surface. The prototypes were durable and suitable for extensive reuse (more than 2000 handlings) in internal industrial transportation. Despite being slightly more expensive than regular cardboard, the prototypes showed good cost-benefit considering their high durability. Relevance to industry: Cardboard boxes can be efficiently redesigned for allowing safer upper limb movements and lower muscle workload in manual materials handling. New designs can also be extensively reused for internal industrial transportation with good cost-benefit. © 2012 Elsevier B.V.

Le capital social dans des communautés rurales en Haïti: une étude exploratoire

Inclut la bibliographie

Proposta de uma abordagem para análise dos relacionamentos em redes de ensino: uma aplicação na Faculdade de Tecnologia de Garça/SP

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Um rio entre duas mundividências: leituras do espaço em Um rio chamado tempo, uma casa chamada terra, de Mia Couto

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Morfologia das 3ª e 4ª vértebras cervicais representativa do surto de crescimento da adolescência

Pós-graduação em Odontologia - FOA

Micose fungoide: diagnóstico nas fases iniciais através da correlação clínico-morfológica e imunoistoquímica das lesões

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)