Intubação traqueal e o paciente com o estômago cheio

A aspiração pulmonar do conteúdo gástrico, apesar de pouco frequente, exige cuidados especiais para sua prevenção. A depressão da consciência durante a anestesia predispõe os pacientes a esta grave complicação pela diminuição na função do esfíncter esofágico e dos reflexos protetores das vias aéreas. Guias de jejum pré-operatório elaborados recentemente sugerem períodos menores de jejum, principalmente para líquidos, permitindo mais conforto aos pacientes e menor risco de hipoglicemia e desidratação, sem aumentar a incidência de aspiração pulmonar perioperatória. O uso rotineiro de agentes que diminuem a acidez e volume gástrico parece estar indicado apenas para pacientes de risco. A intubação traqueal após indução anestésica por meio da técnica de sequência rápida está indicada naqueles pacientes, com risco de aspiração gástrica, em que não há suspeita de intubação traqueal difícil. A indicação correta da técnica, sua aplicação criteriosa e a utilização racional das drogas disponíveis podem promover condições excelentes de intubação, com curto período de latência, rápido retorno da consciência e da respiração espontânea, caso haja falha na intubação traqueal.O presente artigo tem como objetivo discutir os métodos atualmente utilizados para controlar o volume e o pH do conteúdo gástrico, proteger as vias aéreas durante as manobras de intubação e reduzir o refluxo gastroesofágico.

Influência da adição de níquel na síntese do SrSnO3

Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)

INJECTION OF RAMIPRIL INTO THE LATERAL VENTRICLE INTERFERES WITH THE DRINKING RESPONSE INDUCED BY PHARMACOLOGICAL AND NATURAL THIRST STIMULI

We investigated the effects of ramipril, an angiotensin I-converting enzyme (ACE) inhibitor, on water intake by male Holtzman rats (250-300 g) with cannulae implanted into the lateral ventricle. Intracerebroventricular (icv) injection of ramipril (1 mu g/mu l) significantly reduced drinking in response to subcutaneous (sc) injection of isoprenaline (100 mu g/kg) from 8.49 +/- 0.69 to 2.96 +/- 0.36 ml/2 h, polyethyleneglycol (PEG) (30% w/v, 10 ml/kg) from 9.51 +/- 2.20 to 1.6 +/- 0.34 ml/2 h or water deprivation for 24 h from 12.61 +/- 0.83 to 5.10 +/- 1.37 ml/2 h. Ramipril had no effect on water intake induced by cellular dehydration produced by sc injection of hypertonic saline (2 M NaCl). These results are consistent with the hypothesis that ramipril acts as an ACE-blocking agent in the brain. The possibility that ramipril is transformed to ramiprilat, the active drug, by the brain is suggested.

CENTRAL ANGIOTENSIN-CONVERTING ENZYME-BLOCKADE AND THIRST

1. The effect of lisinopril, a potent inhibitor of angiotensin converting enzyme (ACE), injected into the medial preoptic area (MPOA) on water intake was investigated in male Holtzman rats (200-250 g).2. Injection of lisinopril (2 mug/mul) into the MPOA abolished the water intake induced by subcutaneous (sc) injection of isoprenaline (100%) and water deprivation (90%) and drastically reduced the water intake induced by sc injection of polyethyleneglycol (60%). A small reduction of water intake induced by lisinopril was also observed 90 and 120 min after sc hypertonic saline (N = 10 for each group).3. These results suggest that central ACE activation, particularly in the MPOA, plays an important role in the dipsogenic responses induced by the agents studied.

Idazoxan and the effect of intracerebroventricular oxytocin or vasopressin on sodium intake of sodium-depleted rats

The alpha(2)-adrenergic agonist clonidine and the neuropeptide oxytocin, inhibit sodium intake when injected intracerebroventricularly (i.c.v.). The present work investigates whether (1) vasopressin also inhibits sodium intake when injected i.c.v., and (2) the effect of oxytocin and of vasopressin on sodium intake is affected by i.c.v. injection of idazoxan, an alpha(2)-adrenergic antagonist. Clonidine (30 nmol), oxytocin (40, 80 nmol) and vasopressin (40, 80 nmol) were injected i.c.v. 20 min prior to a 1.5% NaCl appetite test, in rats depleted of sodium for 24 h by a combination of a single s.c. injection of furosemide (10 mg/rat) and removal of ambient sodium. Every dose of clonidine, oxytocin and vasopressin inhibited the 1.5% NaCl intake. Seizures were observed with the higher dose of vasopressin, but not with either dose of oxytocin. The effect of i.c.v. injection of clonidine (30 nmol), oxytocin (80 nmol) or vasopressin (40 nmol) was partially inhibited by prior i.c.v. injection of idazoxan (160, 320 nmol). The results suggest that the inhibition of 1.5% NaCl intake induced by i.c.v. injection of neuropeptides in sodium-depleted rats depends, in part, on the activation of central alpha(2)-adrenoceptors. (C) 1997 Elsevier B.V. B.V. All rights reserved.

Antagonism of clonidine injected intracerebroventricularly in different models of salt intake

Clonidine, an alpha 2-adrenergic agonist, injected into the brain inhibits salt intake of animals treated by the diuretic model of sodium depletion. In the present study, we address the question of whether central injection of clonidine also inhibits salt intake in animals deprived of water or in the need-free state. Saline or clonidine (30 nmol) was injected into the anterior third ventricle of 24-h sodium-depleted (furosemide + removal of ambient sodium), of 24-h water-deprived and of normovolemic (need-free state) adult male rats, Clonidine injected intracerebroventricularly (icv) inhibited the 1.5% NaCl intake for 120 min by 50 to 90% in every model tested. Therefore, different models of salt intake are inhibited by icv injection of clonidine, Idazoxan, an alpha 2-adrenergic antagonist, injected icy at a dose of 160 nmol, inhibited the effect of clonidine only in the furosemide + removal of ambient sodium model of salt intake. This indicates that the antagonism of this effect by idazoxan is dependent on the body fluid/sodium status of the animal.

The acid-base impact of free water removal from, and addition to, plasma

Water, compared with plasma at a pH of 7.4, is a weak acid. The addition of free water to a patient should have an acidifying effect (dilutional acidosis) and the removal of it, an alkalinizing effect (concentrational alkalosis). The specific effects of free water loss or gain in a relatively complex fluid such as plasma has, to the authors' knowledge, not been reported. This information would be useful in the interpretation of the effect of changes in free water in patients. Plasma samples from goats were either evaporated in a tonometer to 80% of baseline volume or hydrated by the addition of distilled water to 120% of baseline volume. The pH and partial pressure of carbon dioxide, sodium, potassium, ionized calcium, chloride, lactate, phosphorous, albumin, and total protein concentrations were measured. Actual base excess (ABE), standard bicarbonate, anion gap, strong ion difference, strong ion gap, unmeasured anions, and the effects of sodium, chloride, phosphate, and albumin changes on ABE were calculated. Most parameters changed 20% in proportion to the magnitude of dehydration or hydration. Bicarbonate concentration, however, increased only 11% in the evaporation trial and decreased only -2% in the dehydration trial. The evaporation trial was associated with a mild, but significant, metabolic alkalotic effect (ABE increased 3.2 mM/L), whereas the hydration trial was associated with a slight, insignificant metabolic acidotic effect (ABE decreased only 0.6 mM/L). The calculated free water ABE effect (change in sodium concentration) was offset by opposite changes in calculated chloride, lactate, phosphate, and albumin ABE effects.

Solid-state compounds of 2-chlorobenzylidenepyruvate with some bivalent metal ions - Synthesis, characterization and thermal behaviour

Solid-state M-2-Cl-BP, where M stands for Mn, Fe, Co, Ni, Cu, Zn and Pb and 2-Cl-BP is 2-chlorobenzylidenepyruvate, have been synthesized. Thermogravimetry and derivative thermogravimetry (TG/DTG), simultaneous thermogravimetry and differential thermal analysis (TG-DTA), X-ray powder diffractometry, infrared spectroscopy, elemental analysis, and complexometry were used to characterize and to study the thermal behaviour of these compounds. The results led to information about the composition, dehydration, thermal stability and thermal decomposition of the isolated compounds.

Effect of chemical pretreatment on the physical properties of dehydrated grapes

The effects of chemical pretreatment and air drying temperature on drying kinetics, shrinkage, density and rehydration ratio of grapes were determined at various moisture contents. It was observed that the chemical pretreatment employed - a solution of 2% CaCO3 with 0 to 3% ethyl oleate - increased considerably the drying rate. It was established that the shrinkage increased with drying temperature between 40 to 80 degrees C and decreased with increasing concentration of ethyl oleate in the chemical pretreatment solution.

Changes of density, thermal conductivity, thermal diffusivity, and specific heat of plums during drying

The thermal properties of plums (Prunus domestica) and prunes were investigated in the moisture content of 14.2-80.4% (wet basis) near room temperature (approximately 28 degrees C). The apparent density of the fruits increased from 1042.9 to 1460.0 kg/m(3), and the bulk density increased from 706.6 to 897.5 kg/m(3) as the plums were dried, following classical empirical models as a function of moisture content. It was found that specific heat, effective thermal diffusivity, and effective thermal conductivity of the prunes increased with the moisture content of the samples, which can be represented by using different empirical models.

Synthesis, characterization and thermal behaviour of solid-state compounds of yttrium and lanthanide benzoates

Solid-state Ln(Bz)(3)center dot H(2)O compounds where Ln stands for trivalent yttrium or lanthanides and Bz is benzoate have been synthesized. Simultaneous thermogravimetry-differential thermal analysis (TG-DTA), X-ray powder diffractometry, infrared spectroscopy and chemical analysis were used to characterize and to study the thermal behaviour of these compounds. The results led to information about the composition, dehydration, thermal stability and thermal decomposition of the isolated compounds.

Effectiveness of surface protection for resin-modified glass-ionomer materials

Objective: the purpose of this study was to evaluate the effectiveness of various surface treatments for resin-modified glass-ionomer restorative materials by determining dye uptake spectrophotometrically. Method and materials: Two hundred twenty-four specimens, 4.1 mm in diameter and 2.0 mm thick, were made of 3 materials: Vitremer, Fuji II LC, and Photac-Fil Aplicap. Specimens were divided into 15 groups. The positive and negative control specimens remained unprotected, while the experimental specimens were protected with Heliobond light-activated bonding resin, Colorama nail varnish, or surface coatings indicated by the manufacturers of the glass-ionomer materials. Finishing Gloss for Vitremer, Fuji Varnish for Fuji II LC, and Ketac Glaze for Photac-Fil. The disks were immersed in 0.05% methylene blue for 24 hours except for the negative control group, which was immersed in deionized water. After 24 hours, the disks were removed, washed, and individually placed in 1 mL of 65% nitric acid for 24 hours. The solutions were centrifuged and the spectrophotometric absorbance was determined at 606 nm. The dye uptake was expressed in micrograms of dye per milliliter, and the results were analyzed with the Kruskal-Wallis test. Results: There were no differences in dye uptake among the 3 resin-modified glass-ionomer restorative materials, however, all of them required surface protection. Conclusion: the best surface protection for the 3 evaluated materials was obtained with Heliobond light-activated bonding resin.

Concentration profiles and effective diffusion coefficients of sucrose and water in osmo-dehydrated apples

The spatial distribution of water and sugars in half-fresh apples dehydrated in sucrose solutions (30% and 50% w/w, 27 degrees C) for 2, 4 and 8 h, was determined. Each half was sliced as from the exposed surface. The density, water and sugar contents were determined for each piece. A mathematical model was fitted to the experimental data of the water and sucrose contents considering the overall flux and tissue shrinkage. A numerical method of finite differences permitted the calculation of the effective diffusion coefficients as a function of concentration, using material coordinates and integrating the two differential equations (for water and sucrose) simultaneously. The coefficients obtained were one or even two orders of magnitude lower than those for pure solutions and presented unusual concentration dependence. The behaviour of the apple tissue was also studied using light microscopy techniques to obtain images of the osmotically treated pieces (20%, 30% and 50% w/w sucrose solutions for 2, 4 and 8 h). (c) 2006 Elsevier Ltd. All rights reserved.

Screening and HPLC methods for carotenoids in sweetpotato, cassava and maize for plant breeding trials

Analytical methods for sweetpotato, cassava and maize were developed. In orange and salmon-fleshed sweetpotatoes, (all-E)-beta-carotene predominated and results of spectrophotometric screening and HPLC quantification did not differ significantly. In yellow-fleshed sweetpotato and cassava, however, spectrophotometric screening overestimated the HPLC values because of the presence of several minor carotenoids. Aside from (all-E)-beta-carotene, Z-isomers were present in cassava in appreciable amounts. For both crops, extraction with acetone or tetrahydrofuran: methanol. (1: 1), using a mortar and pestle or a Polytron homogenizer, gave equivalent results. Rehydration of dry maize at room temperature for 30 min or at 85 degrees C for 5, 10 or 15 min gave equivalent results. Concentrations obtained with the C18 and C30 columns did not differ significantly for zeaxanthin, lutein, beta-cryptoxanthin and beta-carotene in the all-E-configuration, but their Z-isomers were difficult to locate in the chromatogram obtained with the C30 column. Extraction with tetrahydrofuran:methanol (1:1) gave significantly lower results for zeaxanthin and lutein. (c) 2005 Elsevier Ltd. All rights reserved.