779 resultados para Prospective Randomized Trial


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Objective To compare the analgesic effect of uni- and bi-lateral electroacupuncture (EA) in response to thermal and mechanical nociceptive stimuli and to investigate the cardiorespiratory, endocrine, and behavioral changes in dogs submitted to EA.Study design Prospective, randomized cross-over experimental study.Animals Eight adult, clinically healthy, cross-breed dogs, weighing 13 +/- 4 kg.Methods Dogs underwent electrostimulation at false acupoints (T-false); bilateral EA at acupoints, stomach 36, gall bladder 34 and spleen 6 (T-EA/bil); unilateral EA at the same points (T-EA/uni) or were untreated (T-control). All animals received acepromazine (0.05 mg kg(-1)) IV; and heart rate, pulse oximetry, indirect arterial blood pressure, respiratory rate, PECO2, rectal temperature, and plasma cortisol concentration were measured before, during, and after EA. Analgesia was tested using thoracic and abdominal cutaneous thermal and mechanical stimuli, and an interdigital thermal stimulus. Behavior was classified as calm or restless. Analysis of variance for repeated measures followed by Tukey's test was used for analysis of the data.Results There were no cardiorespiratory differences among the treatments. The cutaneous pain threshold was higher after EA, compared with false points. The latency period was shorter and analgesia was more intense in T-EA/bil than T-EA/uni, when both were compared with T-false and T-control. Six out of eight animals treated with EA were calm during treatment, and 5/8 and 4/8 of the T-false and T-control animals, respectively, were restless. Latency to interdigital thermal stimulation increased in T-EA/bil compared with the others. There was no difference in plasma cortisol concentrations among the treatments.Conclusions Bilateral EA produced a shorter latency period, a greater intensity, and longer duration of analgesia than unilateral stimulation, without stimulating a stress response.Clinical relevance Bilateral EA produces a better analgesic effect than unilateral EA.

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Sintomas auditivos e ruído ambiental são freqüentemente referidos por professores, porém as aferições destes não são rotina. Forma de Estudo: Clínico prospectivo. OBJETIVOS: Estudar, em professores: os sintomas auditivos, os resultados das audiometrias e a aferição do ruído nas classes. CASUÍSTICA E MÉTODO: em dois grupos de estudo compostos por GI (40 professores) e GII (40 voluntários), estudou-se: idade, sexo, condições de trabalho, audiometrias e níveis de ruído nas classes. RESULTADOS: em GI predominaram as mulheres (86%), que atuavam em ensino fundamental (75%), em classes com 21 - 40 alunos (70%), com jornadas de trabalho de 26 a 40 horas semanais (47%), e tempo variável na profissão. 93,7% dos professores de GI referiam ruído excessivo nas classes, 65% apresentavam sintomas auditivos e 25% deles possuíam audiometrias alteradas (contra 10% de GII), predominando a gota acústica (11,25%; p<0,05). Valores de ruído de 87dBA foram aferidos em todos os níveis de ensino. CONCLUSÕES: A surdez ocupacional pode estar ocorrendo em professores, porém são necessárias pesquisas adicionais para comprovação de tal suposição.

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Plântulas de tangerina 'Cleópatra'(Citrus reshni hort. ex. Tanaka), foram utilizadas em delineamento inteiramente casualizado, com três repetições no esquema de parcelas sub-divididas, onde os tratamentos principais foram 5 concentrações de ácido giberélico: T1 = 0, T2 = 25, T3 = 50, T4 = 100 e T5 = 150 mg.L-1, parceladas em quatro pulverizações. As coletas de material foram realizadas dos 70 aos 210 dias, em intervalos de 14 dias. Pelos resultados obtidos, o fitorregulador promoveu efeito favorável com relação ao incremento do comprimento do caule, sendo que aplicações de 100 e 150 mg.L-1 foram superiores as demais. O diâmetro do caule não foi influenciado pela aplicação de ácido giberélico.

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O objetivo deste trabalho foi o de determinar a concentração hidrogeniônica (pH), acidez total titulável e tempo de redução do azul de metileno no fluido ruminal de caprinos com ou sem raça definida, mantidos em pastagens artificiais, exclusivas de gramíneas, ou em caatinga, durante as épocas chuvosa e seca do ano. O delineamento experimental foi inteiramente casualizado, sendo analisado em esquema fatorial 2³ (animais com e sem raça definida, pastagens artificiais e em caatinga, épocas chuvosa e seca do ano). O tipo de pastagem influenciou significativamente (p < 0,05) os valores encontrados para acidez total titulável. em relação ao pH, o tipo de pastagem e época do ano foram significativamente (p < 0,05) os fatores mais incisivos. A atividade microbiana, avaliada através dos parâmetros estudados, foi mais intensa na época das águas e na caatinga em relação à da seca e pastagens artificiais, respectivamente. Na avaliação dos resultados desses testes, deve-se sempre levar em consideração principalmente a época do ano e o tipo de pastagem, sem, no entanto, desprezar o fator raça.

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To evaluate the effects of acepromazine maleate on the cardiovascular changes induced by dopamine in isoflurane-anesthetized dogs.Prospective, randomized cross-over experimental design.Six healthy adult spayed female dogs weighing 16.4 +/- 3.5 kg (mean +/- SD).Each dog received two treatments, at least 1 week apart. Acepromazine (0.03 mg kg(-1), IV) was administered 15 minutes before anesthesia was induced with propofol (7 mg kg(-1), IV) and maintained with isoflurane (1.8% end-tidal). Acepromazine was not administered in the control treatment. Baseline cardiopulmonary parameters were measured 90 minutes after induction. Thereafter, dopamine was administered intravenously at 5, 10, and 15 mu g kg(-1) minute(-1), with each infusion rate lasting 30 minutes. Cardiopulmonary data were obtained at the end of each infusion rate.Dopamine induced dose-related increases in cardiac index (CI), stroke index, arterial blood pressure, mean pulmonary arterial pressure, oxygen delivery index (DO2I) and oxygen consumption index. In the control treatment, systemic vascular resistance index (SVRI) decreased during administration of 5 and 10 mu g kg(-1) minute(-1) of dopamine and returned to baseline with the highest dose (15 mu g kg (-1) minute(-1)). After acepromazine treatment, SVRI decreased from baseline during dopamine administration, regardless of the infusion rate, and this resulted in a smaller increase in blood pressure at 15 mu g kg (-1) minute(-1). During dopamine infusion hemoglobin concentrations were lower following acepromazine and this contributed to significantly lower arterial O-2 content.Acepromazine prevented the return in SVRI to baseline and reduced the magnitude of the increase in arterial pressure induced by higher doses of dopamine. However, reduced SRVI associated with lower doses of dopamine and the ability of dopamine to increase CI and DO2I were not modified by acepromazine premedication.Previous acepromazine administration reduces the efficacy of dopamine as a vasopressor agent in isoflurane anesthetized dogs. Other beneficial effects of dopamine such as increased CO are not modified by acepromazine.

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Objective To assess the brachial plexus block in chickens by an axillary approach and using a peripheral nerve stimulator.Study design Prospective, randomized, double-blinded study.Animals Six, 84-week old, female chickens.Methods Midazolam (1 mg kg(-1)) and butorphanol (1 mg kg(-1)) were administered into the pectoralis muscle. Fifteen minutes later, the birds were positioned in lateral recumbency and following palpation of the anatomic landmarks, a catheter was inserted using an axillary approach to the brachial plexus. Lidocaine or bupivacaine (1 mL kg(-1)) was injected after plexus localization by the nerve stimulator. Sensory function was tested before and after blockade (carpus, radius/ulna, humerus and pectoralis muscle) in the blocked and unblocked wings. The latency to onset of motor and sensory block and the duration of sensory block were recorded. A Friedman nonparametric one-way repeated-measures ANOVA was used to compare scores from baseline values over time and to compare the differences between wings at each time point.Results A total of 18 blocks were performed with a success rate of 66.6% (12/18). The latency for motor block was 2.8 +/- 1.1 and 3.2 +/- 0.4 minutes for lidocaine and bupivacaine, respectively. The latencies for and durations of the sensory block were 6.0 +/- 2.5 and 64.0 +/- 18.0 and 7.8 +/- 5.8 and 91.6 +/- 61.7 minutes for lidocaine and bupivacaine, respectively. There was no statistical difference between these times for lidocaine or bupivacaine. Sensory function was not abolished in nonblocked wings.Conclusions and clinical relevance The brachial plexus block was an easy technique to perform but had a high failure rate. It might be useful for providing anesthesia or postoperative analgesia of the wing in chickens and exotic avian species that have similar wing anatomy.

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Objective To compare the effect of intraperitoneal (IP) or incisional (INC) bupivacaine on pain and the analgesic requirement after ovariohysterectomy in dogs.Study design Prospective, randomized clinical study.Animals Thirty female dogs undergoing ovariohysterectomy (OHE).Methods Dogs admitted for elective OHE were anesthetized with acepromazine, butorphanol, thiopental and halothane. Animals were randomly assigned to one of three groups (n = 10 per group). The treatments consisted of preincisional infiltration with saline solution (NaCl 0.9%) or bupivacaine with epinephrine and/or IP administration of the same solutions, as follows: INC and IP 0.9% NaCl (control group); INC 0.9% NaCl and IP bupivacaine (5 mg kg(-1), IP group); INC bupivacaine (1 mg kg(-1)) and IP 0.9% NaCl (INC group). Postoperative pain was evaluated by a blinded observer for 24 hours after extubation by means of a visual analog scale (VAS) and a numeric rating scale (NRS). Rescue analgesia (morphine, 0.5 mg kg(-1), IM) was administered if the VAS was > 5/10 or the NRS > 10/29.Results At 1 hour after anesthesia, VAS pain scores were [medians (interquartile range)]: 6.4 (3.1-7.9), 0.3 (0.0-2.6) and 0.0 (0.0-7.0) in control, IP and INC groups, respectively. VAS pain scores were lower in the IP compared to the control group. Over the first 24 hours, rescue analgesia was administered to 7/10, 5/10 and 3/10 dogs of the control, INC and IP groups, respectively. Total number of dogs given rescue analgesia over the first 24 hours did not differ significantly among groups.Conclusions and clinical relevance Intraperitoneal bupivacaine resulted in lower pain scores during the first hour of the postoperative period and there was a trend towards a decreased need for rescue analgesia after OHE in dogs.

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BACKGROUNDAtherosclerotic renovascular disease (ARD) coexists with arterial obstructive disease in the coronary, cerebral, and peripheral arteries that may remain underdiagnosed and untreated.METHODSThis retrospective study compares overall survival and renal survival (i.e., time to doubling of serum creatinine or end-stage renal disease (ESRD)) over an 11-year period in 104 ARD patients of whom 68 received statin therapy (group S) because of elevated lipid levels and 36 had no statin (group NS) because of normal lipid profile at entry.RESULTSAtherosclerosis in another vascular bed was documented in 84%. Lipid profiles at end point were virtually identical in both the groups Group S had mean survival 123 months (confidence interval (CI) 113-134) with four deaths, and mean renal survival 122 months (CI 113-131). Group NS had mean survival 33 months (CI 23-42) with 13 deaths, and mean renal survival 27 months (CI 17-37).CONCLUSIONSStatin therapy was associated with lesser rate of progression of renal insufficiency (with 7.4% of S patients reaching renal end points vs. 38.9% of NS patients) and lower overall mortality (5.9% in S vs. 36.1% in NS patients), P < 0.001 for both. Although both groups received what was deemed optimal therapy, they did have other differences that may have affected the outcomes (a limitation addressed by Cox multiple regression analysis). These results suggest the need for prospective randomized controlled studies in ARD patients in order to explore potential benefits of statins that may not be attributable solely to lipid lowering.

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Objectives: To evaluate the effects of a combination of tiletamine-zolazepam-romifidine-atropine in ocelots. Design: Prospective experimental trial. Animals: Eight captive adult ocelots (three females and five males). Methods: Calculated doses of tiletamine-zolazepam (3.75 mg kg -1), romifidine (50 μg kg-1) and atropine (0.04 mg kg-1) were administered intramuscularly. After immobilization, animals were weighed and the real doses determined. Heart rate, respiratory frequency, noninvasive systolic, diastolic, and mean arterial pressure, arterial oxygen hemoglobin saturation, and rectal temperature were measured. Data were analyzed by means of ANOVA for repeated measures, followed by the Tukey test to compare values over time. Results: Doses administered were 3.4 ± 0.6 mg kg-1 of tiletamine-zolazepam, 0.04 ± 7.0 mg kg-1 of romifidine, and 0.03 ± 0.007 mg kg-1 of atropine. The mean time to recumbency and duration of immobilization were 7.0 ± 4.5 and 109.2 ± 27.9 minutes, respectively. The median times to standing and walking were 52.3 [0-90] and 2.3 [0-69.3] minutes, respectively. A decrease in heart rate was observed 45 minutes following drug administration. Arterial blood pressure was maintained during the study. Conclusions and clinical relevance: This protocol produced good immobilization in ocelots with minimal changes over time in cardiovascular parameters.

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Purpose: To present a technique for filling facial folds by using autologous orbicularis oculi muscle, based on an experimental model. Methods: two studies are presented: (1) an experimental study using 15 albino guinea-pigs from which a strip of the sural triceps muscle was removed and implanted in the subcutaneous tissue of the dorsal area. The animals were sacrificed 7, 30 and 60 days after the implantation, and the material was histologically evaluated. And (2%) an interventional prospective clinical trial carried out on 20 patients referred to blepharoplasty surgery. They received autologous preseptal orbicularis muscle for filling facial folds. The results where evaluated by patients satisfaction and clinical exam. Results: the sural tricep muscle, when implanted in the subcutaneous tissue, resulted in fibrosis. The patients whom received autologous orbicularis muscle implanted for filling facial folds showed that the procedure can be successfully carried out. Conclusions: autologous preseptal orbicularis muscle is a good material for filling facial folds. Cicatricial tissue will be formed on its implantation site, filling the tissue gap that forms the folds on the skin.

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Background & Aims Patients infected with hepatitis C virus (HCV) genotype 1, body weight <85 kg, and high baseline viral load respond poorly to standard doses of pegylated interferon (peginterferon) and ribavirin. We evaluated intensified therapy with peginterferon alfa-2a plus ribavirin. Methods This double-blind randomized trial included HCV genotype 1-infected outpatients from hepatology clinics with body weight <85 kg and HCV RNA titer <400,000 IU/mL. Patients were randomized to 180 μg/wk peginterferon alfa-2a for 48 weeks plus 1200 mg/day ribavirin (standard of care) (group A, n = 191) or 1400/1600 mg/day ribavirin (group B, n = 189). Additional groups included 360 μg/wk peginterferon alfa-2a for 12 weeks then 180 μg/wk peginterferon alfa-2a for 36 weeks plus 1200 mg/day ribavirin (group C, n = 382) or 1400/1600 mg/day ribavirin (group D, n = 383). Follow-up lasted 24 weeks after treatment. Results Sustained virologic response rates (HCV RNA level <15 IU/mL at end of follow-up) in groups A, B, C, and D were 38%, 43%, 44%, and 41%, respectively. There were no significant differences among the 4 groups or between pooled peginterferon alfa-2a regimens (A + B vs C + D: odds ratio [OR], 1.08; 95% confidence interval [CI], 0.831.39; P = .584) or pooled ribavirin regimens (A + C vs B + D: OR, 1.00; 95% CI, 0.791.28; P = .974). Conclusions In patients infected with HCV genotype 1 who are difficult to treat (high viral load, body weight <85 kg), a 12-week induction regimen of peginterferon alfa-2a and/or higher-dose ribavirin is not more effective than the standard regimen. © 2010 AGA Institute.

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Introduction: The goal of implant treatment is the formation of a direct bone-implant interface contact. Purpose: This study aimed to evaluate the possibilities of immediate loading treatment for edentulous patients rehabilitated with mandibular and maxillary overdentures. Material and methods: A literature review using the PubMed and BIREME databases between the periods of 1977 and 2011 was performed. Results: From an initial yield of 218 titles, 78 articles were selected for text analysis, finally resulting in 23 studies (16 prospective, 6 prospective randomized, and 1 prospective multicenter) that met the inclusion criteria. Conclusion: The immediate loading protocol through which the implants are subjected to occlusal function immediately after their placement was introduced to overcome this limitation. © 2013 Springer-Verlag Berlin Heidelberg.

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Pós-graduação em Pesquisa e Desenvolvimento (Biotecnologia Médica) - FMB

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Pós-graduação em Cirurgia Veterinária - FCAV