The normative distribution of chest tube drainage volume after coronary artery bypass grafting

Background
Little evidence exists to describe expected volumes of chest tube (CT) drainage after coronary artery bypass grafting (CABG).

Objectives
The study objective was to map the trajectory of CT drainage volumes from insertion to removal after CABG.

Design

This was a retrospective, descriptive study.
Patients
The study included 239 patients who underwent CABG at a single metropolitan hospital in Melbourne, Australia.

Results
The sample (N = 234), aged 68.7 years (standard deviation [SD] 9.9), was predominantly male (N = 185, 79.1%). The mean duration of CT insertion was 45.2 hours (SD 26.7), and total drainage volume was 1300.6 mL (SD 763.8). Drainage volumes plateau to 31 mL per hour, 8 hours after surgery. From 24 to 48 hours, the mean drainage was 21 mL per hour. Drainage volumes varied between genders.

Conclusions
Evidence of similar drainage patterns in other populations is difficult to locate. If the pattern of drainage shown in this study is consistent, experimental intervention studies comparing standard removal time and earlier removal are recommended. If not, prospective collection of relevant preoperative, intraoperative, and postoperative factors across multiple sites is necessary to determine which patient or practice variations influence CT drainage patterns after CABG.

No difference in 1RM strength and muscle activation during the barbell chest press on a stable and unstable surface

Exercise or Swiss balls are increasingly being used with conventional resistance exercises. There is little evidence supporting the efficacy of this approach compared to traditional resistance training on a stable surface. Previous studies have shown that force output may be reduced with no change in muscle electromyography (EMG) activity while others have shown increased muscle EMG activity when performing resistance exercises on an unstable surface. This study compared 1RM strength, and upper body and trunk muscle EMG activity during the barbell chest press exercise on a stable (flat bench) and unstable surface (exercise ball). After familiarization, 13 subjects underwent testing for 1RM strength for the barbell chest press on both a stable bench and an exercise ball, each separated by at least 7 days. Surface EMG was recorded for 5 upper body muscles and one trunk muscle from which average root mean square of the muscle activity was calculated for the whole 1RM lift and the concentric and eccentric phases. Elbow angle during each lift was recorded to examine any range-of-motion differences between the two surfaces. The results show that there was no difference in 1RM strength or muscle EMG activity for the stable and unstable surfaces. In addition, there was no difference in elbow range-of-motion between the two surfaces. Taken together, these results indicate that there is no reduction in 1RM strength or any differences in muscle EMG activity for the barbell chest press exercise on an unstable exercise ball when compared to a stable flat surface. Moreover, these results do not support the notion that resistance exercises performed on an exercise ball are more efficacious than traditional stable exercises.

Development of phantom for radiographic image optimization of standard patient in the lateral view of chest and skull examination

We present the construction of a homogeneous phantom to be used in simulating the scattering and absorption of X-rays by a standard patient chest and skull when irradiated laterally. This phantom consisted of Incite and aluminium plates with their thickness determined by a tomographic exploratory method applied to the anthropomorphic phantom. Using this phantom, an optimized radiographic technique was established for chest and skull of standard sized patient in lateral view. Images generated with this optimized technique demonstrated improved image quality and reduced radiation doses. (c) 2006 Elsevier Ltd. All rights reserved.

Analysis of biological tissues in infant chest for the development of an equivalent radiographic phantom

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

Phantom development for radiographic image optimization of chest, skull and pelvis examination for nonstandard patient

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

Thermoluminescence measurements of entrance surface skin dose in exams of dog's chest in veterinary radiology

This study aims to determine the entrance surface skin doses in dogs (with suspected pulmonary metastasis) submitted to chest X-rays using the technique of thermoluminescence (TL) dosimetry. Twenty seven radiologic exams of dogs of different breed and sizes were performed. The radiation doses were assessed using thermoluminescent dosimeters of calcium sulphate doped with dysprosium (CaSO(4):Dy) produced at Instituto de Pesquisas Energeticas e Nucleares (IPEN-CNEN). The entrance surface skin dose range evaluated in this type of procedure was between 0.43 mGy to small size dogs and 4.22 mGy to big size dogs with repeated exams. The obtained results indicate that is extremely important the assessment of radiation doses involved in veterinary diagnostic radiology procedures, to evaluate the delivered doses to the animals, to be used as a parameter in the individual monitoring of pet's owners, who assist the animal positioning, and to protect occupationally exposed workers at the Veterinary Radiology Clinics. (C) 2010 Elsevier Ltd. All rights reserved.

Chest associated to motor physiotherapy acutely improves oxygen saturation, heart rate and respiratory rate in premature newborns with periventricular-intraventricular hemorrhage

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

Image quality evaluation of chest for computed radiography

The daily-to-day of medical practice is marked by a constant search for an accurate diagnosis and therapeutic assessment. For this purpose the doctor serves up a wide variety of imaging techniques, however, the methods using ionizing radiation still the most widely used because it is considered cheaper and above all very efficient when used with control and quality. The optimization of the risk-benefit ratio is considered a major breakthrough in relation to conventional radiology, though this is not the reality of computing and digital radiology, where Brazil has not established standards and protocols for this purpose. This work aims to optimize computational chest radiographs (anterior-posterior projection-AP). To achieve this objective were used a homogeneous phantoms that simulate the characteristics of absorption and scattering of radiation close to the chest of a patient standard. Another factor studied was the subjective evaluation of image quality, carried out by visual grading assessment (VGA) by specialists in radiology, using an anthropomorphic phantom to identify the best image for a particular pathology (fracture or pneumonia). Quantifying the corresponding images indicated by the radiologist was performed from the quantification of physical parameters (Detective Quantum Efficiency - DQE, Modulation Transfer Function - MTF and Noise Power Spectrum - NPS) using the software MatLab®. © 2013 Springer-Verlag.

Quantification of Biological Tissue and Construction of Patient Equivalent Phantom (Skull and Chest) for Infants (1-5 years old)

Our main purpose in this study was to quantify biological tissue in computed tomography (CT) examinations with the aim of developing a skull and a chest patient equivalent phantom (PEP), both specific to infants, aged between 1 and 5 years old. This type of phantom is widely used in the development of optimization procedures for radiographic techniques, especially in computed radiography (CR) systems. In order to classify and quantify the biological tissue, we used a computational algorithm developed in Matlab (R). The algorithm performed a histogram of each CT slice followed by a Gaussian fitting of each tissue type. The algorithm determined the mean thickness for the biological tissues (bone, soft, fat, and lung) and also converted them into the corresponding thicknesses of the simulator material (aluminum, PMMA, and air). We retrospectively analyzed 148 CT examinations of infant patients, 56 for skull exams and 92 were for chest. The results provided sufficient data to construct a phantom to simulate the infant chest and skull in the posterior anterior or anterior posterior (PA/AP) view. Both patient equivalent phantoms developed in this study can be used to assess physical variables such as noise power spectrum (NPS) and signal to noise ratio (SNR) or perform dosimetric control specific to pediatric protocols.

Analysis of acoustic frequency and wave amplitude generated by the Oscillatory Thoracic Thixotropic Device (Diottix(r)) in human chest

Diottix(r) was calibrated at 25 Hz to achieve the frequency indicated in literature as being effective to mobilize the airways secretions. However, the amplitude and frequency of the waves generated by the equipment in different regions of the chest still need to be investigated. The objective of this study was to analyze the frequency and amplitude of waves generated by Diottix(r) in chests of healthy subjects. Diottix(r) was used in the anterior and posterior regions of the chest. The mechanical waves were captured using stethoscopes connected to electret microphones, which were connected to a digital oscilloscope. Frequency and amplitude data were recorded by the stethoscope, positioned in six points in the anterior region and six in the posterior region of the chest, following the positions commonly used in pulmonary auscultation. Signals were recorded and transferred to a computer with software for their analysis. The frequency of waves did not present a significant change (from 24.9 to 26.4 Hz). The wave amplitude in the anterior versus the posterior region in each area of the lung, the upper, middle and lower, had differences. Diottix(r) produces frequencies in the chest according to the calibrated; thus, it can be a complementary resource to bronchial hygiene maneuvers. The amplitudes of waves seem to be affected by other structures like bone parts and heart.