Evolução temporal das definições de síndrome do desconforto respiratório agudo

OBJECTIVE: to review the evolution of acute respiratory distress syndrome (ARDS) definitions and present the current definition for the syndrome. DATA SOURCE: a literature review and selection of the most relevant articles on ARDS definitions was performed using the MEDLINE®/PubMed® Resource Guide database (last ten years), in addition to including the most important articles (classic articles) that described the disease evolution. DATA SYNTHESIS: the review included the following subjects: introduction; importance of definition; description of the first diagnostic criterion and subsequently used definitions, such as acute lung injury score; definition by the American-European Consensus Conference, and its limitations; description of the definition by Delphi, and its problems; accuracy of the aforementioned definitions; description of most recent definition (the Berlin definition), and its limitations; and practical importance of the new definition. CONCLUSIONS: ARDS is a serious disease that remains an ongoing diagnostic and therapeutic challenge. The evolution of definitions used to describe the disease shows that studies are needed to validate the current definition, especially in pediatrics, where the data are very scarce.

Hemodynamic and antiarrhythmic effects of lidocaine or amiodarone in dogs anesthetized with halothane

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

Análise quantitativa da deglutição orofaríngea em indivíduo gastrostomizado com Lipofuscinose Ceróide Neuronal: relato de caso

The presence of oropharyngeal dysphagia in the pediatric population with genetic diseases it is still poorly studied. The aim of this study was to analyze the oral total transit time and pharyngeal transit time, in an individual with neuronal ceroid lipofucinosis (NCL) with severe oropharyngeal dysphagia. Individual with NCL, 3 years old, 2 years with gastrostomy and no oral feeding, weighting loss, but without pulmonary complications. Oropharyngeal swallowing was studied by videofluoroscopy and it was realized a quantitative analysis using software. Changes were observed throughout the whole biomechanics of swallowing. The quantitative analysis of total oral transit time was found 45.37 seconds (default normality in children is 4 seconds) and for pharyngeal transit time was 4.53 seconds. It was found that beside the changes in the biomechanics of oropharyngeal swallowing in the case studied, an increase in total oral transit time and pharyngeal transit time was also observed, which can significantly compromise the nutritional status and pulmonary these individuals.

Grau de comprometimento e tempo de trânsito orofaríngeo em disfagia no acidente vascular encefálico

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

Determinantes genéticos, bioquímicos e clínicos na resposta ao uso de hidroxiureia na doença falciforme

Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)

Efeitos da poluição atmosférica no sistema respiratório de indivíduos praticantes de exercício físico aeróbio em ambiente aberto e fechado

Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)

Efeitos do treinamento físico aeróbico sobre a expressão da miostatina e o trofismo de músculos esqueléticos e cardíaco de ratos espontaneamente hipertensos com insuficiência cardíaca

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

Pleuris associada à criptococose em cão: relato de caso

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

Two levels of the inspired oxygen fraction in propofol-anesthetized dogs with high intracranial pressure: cardiopulmonary function

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

The effect of sets and repetitions of the spirometer by flow in cardiorespiratory parameters

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

Interferences and interventions after acute myocardial infarction: an integrative review of the literature

Objective: to identify the interference of acute myocardial infarction (AMI) in the quality of life of affected, interventions and understanding by health professionals. Method: an integrative review, aiming to answer << What are the interference in the quality of life of post-AMI customers? >> and << What are the interventions proposed in order to minimize them? >>. We selected 12 articles available in the LILACS database, between 2000 and 2011, based on the criteria of inclusion and exclusion. Results: we have selected a total of 12 articles selected according to the inclusion and exclusion criteria pre-established. We obtained a classification into two themes (1) interference with quality of life and (2) proposals for interventions to minimize interference. Conclusions: highlights the importance of patient involvement in care plan well structured, multidisciplinary team integration and quantity of publications by heterogeneous country on the subject.

High intensity exercise training worsens alveolar destruction in pulmonary emphysema rats

OBJECTIVE: Investigation of standard intensities of physical exercise is important to better comprehend and develop rehabilitation programs for emphysema. We aimed to evaluate the effects of different intensities (moderate and high-intensity) of physical exercise on the development of a protease-induced (papain intratracheal instillation) emphysema in rats. METHODS: Male Wistar rats were randomly separated into five groups that received intratracheal instillation of papain solution or vehicle: (i) papain high intensity exercise, (ii) papain moderate exercise, (iii) saline high intensity exercise, (iv) saline sedentary and (v) papain sedentary. Forty days after intratracheal instillation, the exercise groups were submitted to an exercise-training protocol on a treadmill during 10 weeks, 5 days/week, at 0.9 km/h (Papain and saline high exercise), or at 0.6 km/h (papain moderate exercise).We measured respiratory system elastance and resistance, the collagen fiber lung parenchyma, and the pulmonary mean linear intercept. RESULTS: All animal groups that received papain instillation presented higher alveolar wall destruction compared to animals that received only saline solution. The papain high intensity exercise group presented higher values of mean linear intercept compared to emphysema groups that were trained at a moderate intensity or not submitted to exercise. CONCLUSION: High intensity exercise training worsened alveolar destruction in an experimental model of emphysema in rats when compared to moderate intensity exercise, or to no exercise.

Efeitos da exposição à sílica sobre a responsividade vascular e de vias aéreas de ratos

Silicosis, a common type of pneumoconiosis, is an occupational lung disease caused by inhalation of silica dust often with mining activity and thus reaches the miners. The fine and ultrafine silica particles deposited in the alveolar epithelium may lead to the development of progressive massive fibrosis. An increased reactive oxygen species (ROS) production has been proposed to explain the mechanism for induction of pulmonary fibrosis in silicosis. In this situation, alveolar macrophages are activated to phagocytes silica particles deposited in the alveoli. The activated macrophages secrete large amounts of ROS that in turn induce synthesis of fibrotic factors. In addition, the activity of antioxidant enzymes is impaired, which results in increased lipid peroxidation, as well as generating a local inflammatory process. Diffuse pulmonary fibrosis progresses with interstitial collagen deposition. Interstitial collagen overlies small pulmonary arteries and arterioles and thus it is associated with pulmonary hypertension in pulmonary fibrotic diseases. In addition, cytokines and silica particles passing through the respiratory membrane can reach the bloodstream. In this context, the increase in the generation of ROS in the circulation may lead to a reduction in the bioavailability of nitric oxide, an important endothelium-derived relaxing factor. A deficiency in the nitric oxide bioavailability can result in vascular endothelial dysfunction. Moreover, pro-inflammatory cytokines could contribute to the impairment of endothelial function. In the airways, pro-inflammatory cytokines can reduce the smooth muscle responsiveness to β- adrenergic agonists as isoproterenol. Thus, the aim of this study was to evaluate the effect of silica dust instillation in the function of the pulmonary artery, aorta and trachea of rats with acute silicosis. For this purpose, male Wistar rats were anesthetized... (Complete abstract click electronic access below)

Comparação do transporte mucociliar de indivíduos fumantes e abstênicos de um programa de cessação tabágica

Sabe-se que as substâncias presentes na fumaça do cigarro provocam alterações no sistema respiratório, incluindo alterações no transporte mucociliar. Objetivo: Comparar o transporte mucociliar de indivíduos tabagistas e abstênicos, e correlacioná-lo à função pulmonar e a história tabagística. Metodologia: Foram avaliados 65 indivíduos, divididos em 2 grupos, grupo abstênico (G1) e grupo controle (G2). Primeiramente, foi realizada uma entrevista inicial para obtenção de dados pessoais, antropométrico e histórico tabágístico. Após foram avaliados quanto à função pulmonar (espirometria), quantificação do monóxido de carbono no ar exalado (COex) e do transporte mucociliar nasal (tempo de trânsito de sacarina-TTS). Todas as avaliações foram realizadas após um período de doze horas, 7 e 15 e 30 dias de abstinência do cigarro. Método estatístico: A descrição dos resultados foi apresentada como média e desvio padrão. Para comparação dos grupos foi utilizado ANOVA para medidas repetidas, não paramétrico, seguido do teste Volm-hidak. O nível de significância utilizado foi de p<0.05. Resultados: Houve diferença estatística entre o TTS no grupo abstênico a partir de 15 dias em relação ao valor basal. Não houve correlação entre o transporte mucociliar basal e as variáveis. Conclusão: Indivíduos que cessam o hábito tabagístico, após 15 dias de abstinência, já é possível verificar melhora na depuração mucociliar e esta se mantém na faixa de normalidade até o 30º dia

Análise do transporte mucociliar de indivíduos fumantes em intervalos de abstinência do fumo

O transporte mucociliar é um mecanismo de defesa muito importante do trato respiratório, e é por meio deste que agentes agressores são carregados e expelidos. As substâncias presentes na fumaça do cigarro provocam mudanças no sistema respiratório, incluindo no transporte mucociliar. Objetivos: Avaliar o efeito agudo do fumo no transporte mucociliar de indivíduos tabagistas em diferentes momentos e comparar com grupo controle. Métodos: Foram avaliados 20 tabagistas (10 homens; 46 ± 13 anos; 26 ± 22 anos/maço; 19 ± 10 cigarros/dia) em quatro momentos: após 12 horas de abstinência, imediatamente, 20 minutos e 2 horas após fumar. No primeiro momento foram obtidos dados pessoais, história tabágica (anos/maço, cigarros/dia e grau de dependência de nicotina), e após 12 horas em abstinência do tabaco foi realizado o teste de função pulmonar (espirometria), quantificação do monóxido de carbono no ar exalado (COex) e mensuração do tempo de trânsito de sacarina (TTS) ...(Resumo completo, clicar acesso eletrônico abaixo)