Efeitos da Fisioterapia Respiratória na Mecânica Respiratória de Pacientes com Acidente Vascular Encefálico Ventilados Mecanicamente

Patients who went through a Stroke may require mechanical ventilation (MV) in the acute phase of the disease and, on MV, they may show alterations in the respiratory mechanic. Physiotherapy techniques are applied in patients on MV to improve their respiratory mechanic. Thus, the purpose of this study was to evaluate the effects of the Respiratory Physiotherapy into the dynamic compliance (Cdyn), static compliance (Cst) and airway resistance (Rwa) in Stroke patients on MV. In order to do that, patients with Stroke diagnostic on MV were evaluated, before and after the use of Physiotherapy techniques (manual rib-cage compression, thoracic decompression, zero end expiratory pressure and suctioning). Cdyn, Cst and Rwa were the researched variables. Statistical Analysis was made using Paired T-Test with statistical significance with p-values no greater than 5%. Eleven patients were part of the study, with an average of 64,6±12,5 years old. Cdyn increased after physiotherapy from 29,3±16,1 ml/cmH2O to 33,8±16,7 ml/cmH2O (p=0,03). Cst also increased from 44,4±20,7 ml/cmH2O to 54,0±26,6 ml/cmH2O (p=0,024). No significant difference was detected for Rwa between the before and after moments (Before – 8,0±3,2 cmH2O/l/s, After – 7,3±2,25 cmH2O/l/s; p=0,45). It was possible to conclude that both dynamic and static compliance increased after physiotherapy, but the airway resistance did not increase in patients with stroke on mechanical ventilation.

Influência da manobra de descompressão abrupta em pacientes neurológicos

A fisioterapia respiratória em pacientes neurológicos deve ser realizada com critérios e monitorização dos parâmetros hemodinâmicos. O objetivo deste estudo foi avaliar se a fisioterapia respiratória tem efeitos na pressão arterial, pulso e saturação de oxigênio de pacientes neurológicos. Estudamos 12 pacientes com acidente vascular encefálico ou trauma crânio encefálico, independente da idade, divididos em grupos: respiração espontânea (G1) e ventilação mecânica (G2). E as variáveis foram avaliadas antes (M1) e após (M2) a Manobra de descompressão abrupta (MDA). Foram estudadas a Pressão Arterial (PA), Saturação de Oxigênio (SatO2) e Pulso (P). Na estatística foi utilizado o teste t-Student (p < 0,05). Dos pacientes estudados 9 eram do sexo masculino e 3 feminino. As variáveis em G1 e G2 não variaram de forma significativa nos momentos de estudo. Concluímos que a manobra de descompressão abrupta aplicada em pacientes neurológicos não alterou as variáveis hemodinâmicas e de troca.

Variabilidade da frequência cardíaca como recurso em fisioterapia: análise de periódicos nacionais

INTRODUCTION: The autonomic nervous system (ANS) could be investigated in a noninvasive way by the heart rate variability analysis (HRV) which has contributed to several health areas such as physiotherapy. OBJECTIVE: To gather information regarding the use of HRV on physiotherapy aims at providing an update of the findings for the area on journals of national circulation. MATERIALS AND METHODS: The journals of national circulation classified as greater than B2 or B2 and with free access and complete texts in some internet sites were searched on 21 area WebQualis resulting on selection of Revista Brasileira de Fisioterapia, Fisioterapia e Pesquisa and Fisioterapia em Movimento using the keywords: autonomic nervous system, sympathetic nervous system, physiotherapy and heart rate variability. RESULTS: The search resulted in 19 articles being 17 clinical trials and two case reports. CONCLUSION: The HRV has been used as a resource of interventions evaluation, as pathological conditions common to clinical practice investigation and to physiological conditions interpretation in physiotherapy. The HRV is principally used to the cardiorespiratory specialty of physiotherapy.

Contribuição da utrassonografia para o diagnóstico do shunt portossistêmico em câes e gatos

Portosystemic shunt, an hepatobiliary anomaly, much common in dogs and less frequent in cats, can be detected by several diagnostic methods. Among them, the one which stands out is ultrasonography due to its numerous advantages: noninvasive, quick, accessible, relatively low cost and provides useful information relating to the other systems, apart from being a highly sensitive method. Portosystemic shunt diagnosis using ultrasonography becomes highly sensitive when associated with B-mode, color Doppler and pulsed Doppler. A bibliographic survey about portosystemic shunt ultrasonographic diagnosis was carried out, and the main ultrasonographic signals were: decreased hepatic size, difficulty in blood vessels visualization, presence of an anomalous vessel, tortuous with turbulent flow and, finally, increased portal blood flow velocity near the shunting vessel

Envolvimento dos recptores purinérgicos do núcleo parabraquial lateral no controle respiratório

O núcleo parabraquial lateral (NPBL) e o núcleo Kölliker-Fuse (KF) são os mais importantes núcleos da ponte envolvidos com o controle da ventilação pulmonar (VE) e são conhecidos como grupo respiratório pontino ou centro pneumotáxico. Vários experimentos demonstraram que a estimulação ou a lesão do NPBL-KF produziram alterações nos padrões respiratórios. No entanto, ainda não estava claro qual seria a área exata (no complexo NPBL-KF) e o neurotransmissor envolvido nas alterações respiratórias. Estudos com imunohistoquímica demonstraram a presença de receptores purinérgicos (especialmente os P2X) em várias áreas envolvidas com o controle da ventilação, incluindo o NPBL. Estudos também demonstraram a presença de um denso plexo de varicosidades imunorreativas para o GABA ao longo do complexo NPB-KF, sendo que o processamento neural nessa região estaria sob forte inibição gabaérgica. No entanto, o papel dos receptores purinérgicos e gabaérgicos do NPBL na regulação da VE em ratos não anestesiados ainda não tinha sido investigado. Desta forma, no presente estudo investigamos as respostas ventilatórias após a injeção do α,β-metil-ATP (agonista purinérgico), do PPADS (antagonista purinérgico) e do muscimol (agonista GABA-A) no NPBL de ratos não anestesiados. Foram utilizados ratos com cânulas de aço inoxidável bilateralmente no NPBL, os animais foram submetidos a pletismografia de corpo inteiro para que fossem obtidas as medidas de VE. As injeções bilaterais do agonista purinérgico, α,β-metil-ATP (2 nmol/0,2 μl, n=8), no NPBL promoveu queda na freqüência respiratória (fR) (108  5 ciclos/min vs basal 137  6 ciclos/min, p = 0,005), não alterou o volume corrente (VT) (2  0,3 ml/kg vs basal 2  0,3 ml/kg, p = 0,967) e queda na VE (263  42 ml.kg-1.min-1 vs basal 325  43 ml.kg-1.min-1, p = 0,001)... (Resumo completo, clicar acesso eletrônico abaixo)

Laserterapia em lesões de coluna na Medicina Veterinária

Lasertherapy is a method of non-pharmacological treatment and surgery that can be used in several injuries and in various tissues, from bone fractures to tendonitis, skin wounds and damaged nerves, permitting the recovery of these structures and their functions without causing any side effects. Laser therapy aims to restore patients that suffered various injuries, such as bone fracture, inflammation, edema, tendon rupture, spinal cord injury, among others, without invasive intervention, and the results obtained in several studies and case reports have proven the high potential of this therapy to become an official treatment of various pathological changes

Amostragem de poluentes particulados emitidos pela queima de biomassa em correntes confinadas

It is clear today the ever-accelerating search for new fuels that will eventually replace those that will survive in our society, which are fossil fuels. For this reason, a fuel used since the dawn of humanity and much studied since then, considered the generator of clean, renewable energy, can earn more and more space in the power generation sector, which is biomass. We performed two experiments with two different types of biomass, one from the Amazon rainforest and other pine and eucalyptus as waste from the sawmill UNESP Itapeva. In the first experiment, conducted at the Laboratory of Combustion and Propulsion INPE Cachoeira Paulista were conducted three tests in a chimney with a fan creating forced ventilation, where the biomass was burned and deposited on a support beneath the hood. In the second experiment was conducted to analyze the emission of particulate matter using biomass (waste) from the sawmill on the campus of UNESP experimental Itapeva the burning of it in a burner for heating water for a wood oven. In these experiments we used a particle called DATARAM4 sampler that is capable of sampling both outdoors and inside of pipelines, which is the focus of this work. With this equipment it was possible to measure the concentration of particulate matter in all the firings as above, and compare them to levels acceptable in the current law, always trying to analyze the so-called fine particles, which are those with diameters less than 2.5 μm. Using data obtained from the equipment was also possible to evaluate the diametral distribution of particulate matter in question, and verify which phases of the flares in the concentration and the diameters of the particles are the most critical. In this work we concluded that in all firings conducted concentrations of particulate matter were higher than that allowed by the law, and the diameters were found that are more harmful to human health

Manejo no incubatório que afeta a eclodibilidade de ovos de galinha (Gallus Gallus Domesticus)

In the process of artificial incubation of fertile eggs of chicken (Gallus gallus domesticus) there are procedures that, they are not hindered the birth, they cause embryonic mortality. Handlings before incubation as disinfection and storage are capable to reduce the embryonic if accomplished of inadequate way viability. Already in the incubation process properly says, irregularities in variables as temperature, turning, humidity and ventilation in the incubator reduce the hatchability, what means that, of the total of fertile eggs there is reduction in the number of born chicks, there is like this the reduction of profit of the incubator, being necessary an analysis of which they interfered in the birth

Caracterização in vitro de técnica biomagnética empregando magnetômetros 3D para avaliar tempo de trânsito esofagiano

The biomagnetic techniques use different magnetic field detectors to measure parameters of the human physiology. Those techniques present the advantage of being noninvasive and radiation free. Among them we can show up the Superconducting Quantum Interference Device (SQUID), the Current Alternate Biosusceptometry (ACB) and, more recently, the employment of anisotropic magnetoresistive sensors. Those magnetic sensors have a low cost and good sensitivity to measure different physiological parameters using magnetic markers. The biomagnetic techniques have being used successfully through study on the characteristics of the gastrointestinal tract. Recent research, the magnetoresistors were used to evaluate the transit time and localization of magnetic sources in different parts of the gastrointestinal tract. The objective of this work is the characterization, with in vitro tests, of a biomagnetic instrumentation using two 3-axis magnetoresistors arranged in a gradiometric coplanar setup to evaluate esophageal transit time, analyze and compare the results of experimental signals and the magnetic theory, as well as evaluate the instrumentation gain with use of tri-axial sensor front to the mono-axial sensor. The instrumentation is composed by two three-axis sensing magnetometers, precision power supply and amplifier electronic circuits. The sensors fixed in a coplanar setup were separate by distance of 18 cm. The sensitivity tests had been carried through using a cylindrical magnet (ø = 4 mm and h = 4 mm) of neodymium-iron-boron (grid 35). The tests were done moving the permanent magnet on the sensors parallel axis, simulating the food transit in... (Complete abstract click electronic access below)

Estudo da viabilidade técnica/econômica no aumento da eficiência energética sustentável aplicada à residência unifamiliar

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

Avaliação do efeito da gastrectomia na motilidade e no esvaziamento gástrico em ratos por biosusceptometria de corrente alternada

The study of gastrointestinal tract (GIT) functions is necessary due to the increasing number of pathologies associated with it. Directly influencing the quality of life, the gastrointestinal tract provides a number of parameters that, when analyzed, allow us to describe its dysfunctions. Thus, many techniques can be combined to obtain these properties related to the GIT. However, these techniques are often invasive, require surgery, catheter insertion, or to build a temporal model of these functions, require the sacrifice of animals in a series of data collection. The technique used in this study has the advantage of having a low operating cost, being free of ionizing radiation, non-invasive and is known as biosusceptometry AC (BAC), used to evaluate the properties of the GI tract by monitoring the position and concentration of materials magnetically marked. The sensor consists of two pairs of coils, one reference and one for detection. A fixed base line separates the sensing and reference coils, and also functions as support for the instrumentation. It is also important to note that the detection coils are arranged in a first order (subtraction) gradiometric way. The objective of this study was to analyze the effects of gastrectomy in gastric emptying and gastrointestinal transit time of solid food in rats using a BAC system associated with magnetic markers. To realize this study was constructed a dedicated BAC sensor, built to analyze these GIT properties. Data acquisition was obtained by aligning the magnetic sensor with the stomach and colon of the animal at pre-determined intervals. Thus, when approaching the magnetic material of the sensor, the balance created between the two sides of the sensor is broken. This imbalance can be measured, digitized and acquired. Tracer was used as a ration magnetically marked with ferrite... (Complete abstract click electronic access below)

Estudo da técnica de ressonância magnética para algumas aplicações voltadas à neurologia e à neurociência

Magnetic resonance imaging (MRI), which is studied since 1938, is a technique used in medicine to produce high quality images from inside the human body. These images are produced non-invasively and without ionizing radiation. In addition, MRI is an extremely flexible technique, with which it is possible to produce images with different contrasts that provide different information about the anatomy, structure and function of the human body, and it is therefore one of the techniques preferred by radiologists. The phenomenon of MRI is based on the interaction of magnetic fields with the nuclear spins of the scanned sample. In this work a detailed study of the technique of magnetic resonance imaging is presented, with a description of the main features of the images produced by the technique and an analysis of its application to the fields of applications Neurology and Neuroscience

Biosusceptometria de corrente alternada para avaliação do trânsito gastrintestinal de alimentos líquidos em ratos

The gastrointestinal tract is the main route of nutrients absorption and drugs delivery. Is important to know the parameters related to the tract, like gastric emptying and gastrointestinal transit, in order to better understand the behavior of different kind of meals or drugs passing through the GIT. Many techniques are used to study these parameters, such as manometry, scintigraphy, phenol red, activated charcoal and carbon-13 reading. However, these methods use radiation, are invasive and require animal sacrifice. As an alternative proposal, the Alternate Current Biosusceptometry (ACB), a magnetic technique, has proved to be effective for these studies with small animals, in a noninvasive way, low cost, radiation free and avoiding the animal death. Associating the ACB to magnetic micro or nanoparticles used as tracers, it is possible to observe the meal behavior inside of the GIT. Focusing meanly on liquid meals digestion, this paper had the objective to evaluate the efficiency of the ACB technique in gastric emptying and gastrointestinal transit evaluation of liquid meals in rats. To perform the experiments, magnetic nanoparticles (ferrite, MgFe2O4) were used on a 1,5 ml solution introduced by gavage on similar weight and age rats. The sensor made by 2 pairs of coils, capable of generating and detecting magnetic fields, creates a field on the interest place and when this field is in contact with the marked meal, it changes, resulting on a variation of the measured voltage. The voltage variation is analyzed and is obtained a particle concentration on the interest region. The results showed that is possible to apply the ACB technique on the GIT evaluation of liquid particles digestion, gastric emptying and meal cecum arrival time curves were obtained and from that, is possible to observe a pattern of gastrointestinal transit. Both mean process time values were acquired, proving the technique capability of ...

Gama Câmara CZT: alteração de paradigmas em aquisição de imagens de medicina nuclear

Nuclear medicine is a medical specialty related to imagery that deals with imaging techniques, diagnosis and therapy, allowing observing the physiological state of tissues noninvasively by marking the molecules participating of these physiological processes with radioactive isotopes, thus creating the called radionuclides. The image of a radionuclide is one of the most important applications of radioactivity in nuclear medicine. The equipment’s of nuclear medicine imaging use the principle of radiation detection, turning it into an electrical signal which, through specific algorithms, allows forming tomographic images that provide information about the functional status of organs. New detection systems have been developed for tomographic acquisitions using solid state detectors. These devices use crystals of cadmium zinc telluride (CdZnTe). Some of the advantages of this detector are a significant improvement of signal to noise ratio, the increased spectral and spatial resolution, which in sum, result in greater clarity of the images obtained, opening new perspectives for imaging protocols previously unattainable. In contrast, all other gamma-cameras equipped with vacuum tubes have remained relatively unchanged for nearly fifty years. In these gamma-cameras, the images are obtained using two steps significantly less efficient: the gamma rays are converted to light through a first device, and then the light is converted into an electrical signal through a second device. One of functions the Medical Physicist is related to the quality control of equipment. This control ensures that the information and images provided are true and thus credible to be used in medical reports. To perform this type of analysis the physicist must understand the performance characteristics and operation of all equipment of the department concerned; besides, in the absence of specific legislation, proposing...(Complete abstract click electronic access below)

Ocorrência de opacidade de cápsula posterior em cães pós-facoemulsificação, com ou sem a utilização de lente intraocular dobrável e efeitos do Nd: Yag Laser

Pós-graduação em Cirurgia Veterinária - FCAV