Acute and sustained effects of early administration of inhaled nitric oxide to children with acute respiratory distress syndrome

OBJECTIVE: To determine the acute and sustained effects of early inhaled nitric oxide on some oxygenation indexes and ventilator settings and to compare inhaled nitric oxide administration and conventional therapy on mortality rate, length of stay in intensive care, and duration of mechanical ventilation in children with acute respiratory distress syndrome. DESIGN: Observational study. SETTING: Pediatric intensive care unit at a university-affiliated hospital. PATIENTS: Children with acute respiratory distress syndrome, aged between 1 month and 12 yrs. INTERVENTIONS: Two groups were studied: an inhaled nitric oxide group (iNOG, n = 18) composed of patients prospectively enrolled from November 2000 to November 2002, and a conventional therapy group (CTG, n = 21) consisting of historical control patients admitted from August 1998 to August 2000. MEASUREMENTS AND MAIN RESULTS: Therapy with inhaled nitric oxide was introduced as early as 1.5 hrs after acute respiratory distress syndrome diagnosis with acute improvements in Pao(2)/Fio(2) ratio (83.7%) and oxygenation index (46.7%). Study groups were of similar ages, gender, primary diagnoses, pediatric risk of mortality score, and mean airway pressure. Pao(2)/Fio(2) ratio was lower (CTG, 116.9 +/- 34.5; iNOG, 62.5 +/- 12.8, p <.0001) and oxygenation index higher (CTG, 15.2 [range, 7.2-32.2]; iNOG, 24.3 [range, 16.3-70.4], p <.0001) in the iNOG. Prolonged treatment was associated with improved oxygenation, so that Fio(2) and peak inspiratory pressure could be quickly and significantly reduced. Mortality rate for inhaled nitric oxide-patients was lower (CTG, ten of 21, 47.6%; iNOG, three of 18, 16.6%, p <.001). There was no difference in intensive care stay (CTG, 10 days [range, 2-49]; iNOG, 12 [range, 6-26], p >.05) or duration of mechanical ventilation (TCG, 9 days [range, 2-47]; iNOG, 10 [range, 4-25], p >.05). CONCLUSIONS: Early treatment with inhaled nitric oxide causes acute and sustained improvement in oxygenation, with earlier reduction of ventilator settings, which might contribute to reduce the mortality rate in children with acute respiratory distress syndrome. Length of stay in intensive care and duration of mechanical ventilation are not changed. Prospective trials of inhaled nitric oxide early in the setting of acute lung injury in children are needed.

Effects of deltamethrin pyrethroid on the respiratory metabolism of the neotropical spirostreptid millipedes Gymnostreptus olivaceus and Plusioporus setiger

The effects of deltamethrin on the respiratory metabolism of Gymnostreptus olivaceus and Plusioporus setiger were investigated. Acetone solutions corresponding to half the LD50 values, i.e., 20 μg.g-1g for G. olivaceus and 4.40 μg.g-1 for P. setiger, were used. Metabolism was determined with a Warburg respirometer at 25°C. Respirometric measurements were performed 1, 3 and 6 hours after administration of the pyrethroid to the same groups of millipedes. After 24 hours, daily respirometric measurements lasting 1 hour each were made on different millipede groups for a period of 10 days. Significant differences were detected only between the groups treated with the pyrethroid and the two control groups. In G. olivaceus, respiratory rates increased by about 1.65-fold compared to normal immediately after administration of the pyrethroid, followed by a gradual decrease up to 72 hours and a return to normal levels thereafter. In P. setiger the increase was about 1.1-fold compared to normal, with a decrease up to 96 hours and a return to normal thereafter. Although increased oxygen consumption was observed, a detoxification process occurred in both species, so that the possible metabolism of the pyrethroid may justify the low toxicity of deltamethrin for G. olivaceus and P. setiger.

Respiratory and storage behavior of fresh cut 'Tommy Atkins' mango

The respiratory and storage behavior of fresh cut 'Tommy Atkins' mango, naturally ripened (NR) or with use of ethylene (RE), were studied. Fruits were selected, washed and disinfected (200 mgCl.L-1) and stored for 12 hours at 10°C. After this period, they were processed under hygienic conditions at 10°C, packaged in polyethylene terephthalate (PET) trays or in styrofoam trays wrapped with stretchable polyvinyl chloride (PVC) film and stored for up to 15 days at 3°C. The products were evaluated regarding the evolution of internal atmosphere in the packing (O2 and CO 2), development of weight, appearance, shelf life and consumer acceptability. The respiratory rate was measured before and after processing every two hours. The yield of 'Tommy Atkins' mango to produce fresh cut product was 48.09±0.95%. Increase of the respiration rate of both mango samples was verified one hour after the preparation (NR = 17.75 mL CO 2.kg-1.h-1; RE = 28.29 mL CO 2.kg-1.h-1), followed by stabilization at 3.76 and 8.07 mL CO2/kg.h, respectively. The percentage of O2 in packages was stable in all treatments, 15-20% in PVC trays, 18-20% in PET tray. The percentage of CO2 was steady around 1.5-2.5%. The products lost fresh mass during the storage, from 0.06% to 0.30% for PET trays and from 0.15% to 1.61% for trays covered with PVC. The appearance was considered appropriate for commercialization until the 13th day, whereas product from mangoes ripened with application of ethylene was for 11 days, presenting browning in the external surface. The naturally ripened mango presented the best flavor and consumer preference in relation to the mango ripened with application of ethylene for 11 days of storage. The control of hygienic conditions during the production and storage was good and with safety for until 10 days.

Autoregressive decomposition and pole tracking applied to vocal fold nodule signals

This letter describes a novel algorithm that is based on autoregressive decomposition and pole tracking used to recognize two patterns of speech data: normal voice and disphonic voice caused by nodules. The presented method relates the poles and the peaks of the signal spectrum which represent the periodic components of the voice. The results show that the perturbation contained in the signal is clearly depicted by pole's positions. Their variability is related to jitter and shimmer. The pole dispersion for pathological voices is about 20% higher than for normal voices, therefore, the proposed approach is a more trustworthy measure than the classical ones. © 2007.

Respiratory chemoreceptor function in vertebrates - Comparative and evolutionary aspects

The sensing of blood gas tensions and/or pH is an evolutionarily conserved, homeostatic mechanism, observable in almost all species studied from invertebrates to man. In vertebrates, a shift from the peripheral O2-oriented sensing in fish, to the central CO2/pH sensing in most tetrapods reflects the specific behavioral requirements of these two groups whereby, in teleost fish, a highly O2-oriented control of breathing matches the ever-changing and low oxygen levels in water, whilst the transition to air-breathing increased the importance of acid-base regulation and O2-related drive, although retained, became relatively less important. The South American lungfish and tetrapods are probably sister groups, a conclusion backed up by many similar features of respiratory control. For example, the relative roles of peripheral and central chemoreceptors are present both in the lungfish and in land vertebrates. In both groups, the central CO2/pH receptors dominate the ventilatory response to hypercarbia (60-80), while the peripheral CO2/pH receptors account for 20-30. Some basic components of respiratory control have changed little during evolution. This review presents studies that reflect the current trends in the field of chemoreceptor function, and several laboratories are involved. An exhaustive review on the previous literature, however, is beyond the intended scope of the article. Rather, we present examples of current trends in respiratory function in vertebrates, ranging from fish to humans, and focus on both O2 sensing and CO2 sensing. As well, we consider the impact of chronic levels of hypoxia - a physiological condition in fish and in land vertebrates resident at high elevations or suffering from one of the many cardiorespiratory disease states that predispose an animal to impaired ventilation or cardiac output. This provides a basis for a comparative physiology that is informative about the evolution of respiratory functions in vertebrates and about human disease. Currently, most detail is known for mammals, for which molecular biology and respiratory physiology have combined in the discovery of the mechanisms underlying the responses of respiratory chemoreceptors. Our review includes new data on nonmammalian vertebrates, which stresses that some chemoreceptor sites are of ancient origin.

Positive selection results in frequent reversible amino acid replacements in the G protein gene of human respiratory syncytial virus

Human respiratory syncytial virus (HRSV) is the major cause of lower respiratory tract infections in children under 5 years of age and the elderly, causing annual disease outbreaks during the fall and winter. Multiple lineages of the HRSVA and HRSVB serotypes co-circulate within a single outbreak and display a strongly temporal pattern of genetic variation, with a replacement of dominant genotypes occurring during consecutive years. In the present study we utilized phylogenetic methods to detect and map sites subject to adaptive evolution in the G protein of HRSVA and HRSVB. A total of 29 and 23 amino acid sites were found to be putatively positively selected in HRSVA and HRSVB, respectively. Several of these sites defined genotypes and lineages within genotypes in both groups, and correlated well with epitopes previously described in group A. Remarkably, 18 of these positively selected tended to revert in time to a previous codon state, producing a flipflop phylogenetic pattern. Such frequent evolutionary reversals in HRSV are indicative of a combination of frequent positive selection, reflecting the changing immune status of the human population, and a limited repertoire of functionally viable amino acids at specific amino acid sites.

Use of myoelectric signals to command mobile entertainment robot by disabled children: Design and control architecture

Severely disabled children have little chance of environmental and social exploration and discovery. This lack of interaction and independency may lead to an idea that they are unable to do anything by themselves. In an attempt to help children in this situation, educational robotics can offer and aid, once it can provide them a certain degree of independency in the exploration of environment. The system developed in this work allows the child to transmit the commands to a robot through myoelectric and movement sensors. The sensors are placed on the child's body so they can obtain information from the body inclination and muscle contraction, thus allowing commanding, through a wireless communication, the mobile entertainment robot to carry out tasks such as play with objects and draw. In this paper, the details of the robot design and control architecture are presented and discussed. With this system, disabled children get a better cognitive development and social interaction, balancing in a certain way, the negative effects of their disabilities. © 2012 IEEE.

Regulation of visfatin by microbial and biomechanical signals in PDL cells

Objectives: This in vitro study was established to examine whether visfatin thought to be a link between periodontitis and obesity is produced by periodontal ligament (PDL) cells and, if so, whether its synthesis is modulated by microbial and/or biomechanical signals. Materials and methods: PDL cells seeded on BioFlex® plates were exposed to the oral pathogen Fusobacterium nucleatum ATCC 25586 and/or subjected to biomechanical strain for up to 3 days. Gene expression of visfatin and toll-like receptors (TLR) 2 and 4 was analyzed by RT-PCR, visfatin protein synthesis by ELISA and immunocytochemistry, and NFκB nuclear translocation by immunofluorescence. Results: F. nucleatum upregulated the visfatin expression in a dose- and time-dependent fashion. Preincubation with neutralizing antibodies against TLR2 and TLR4 caused a significant inhibition of the F. nucleatum-upregulated visfatin expression at 1 day. F. nucleatum stimulated the NFκB nuclear translocation. Biomechanical loading reduced the stimulatory effects of F. nucleatum on visfatin expression at 1 and 3 days and also abrogated the F. nucleatum-induced NFκB nuclear translocation at 60 min. Biomechanical loading inhibited significantly the expression of TLR2 and TLR4 at 3 days. The regulatory effects of F. nucleatum and/or biomechanical loading on visfatin expression were also observed at protein level. Conclusions: PDL cells produce visfatin, and this production is enhanced by F. nucleatum. Biomechanical loading seems to be protective against the effects of F. nucleatum on visfatin expression. Clinical relevance: Visfatin produced by periodontal tissues could play a major role in the pathogenesis of periodontitis and the interactions with obesity and other systemic diseases. © 2013 Springer-Verlag Berlin Heidelberg.

Nucleotide and phylogenetic analysis of human papillomavirus types 6 and 11 isolated from recurrent respiratory papillomatosis in Brazil

There are few studies about the distribution of natural molecular variants of low-risk HPVs. Our aim was to evaluate the E6 early gene variability among HPV-6 and HPV-11 isolates detected in recurrent respiratory papillomatosis (RRP) samples obtained in a cohort of Brazilian patients. We also performed a phylogenetic analysis in order to compare nucleotide sequences identified in our study with previously reported isolates from different anatomic sites (laryngeal papillomas, genital warts, cervical cancer and anal swabs) obtained from other parts of the world to determine the phylogenetic relationships of variants detected in Brazil. The complete coding region of the E6 gene of 25 samples was cloned and sequenced: 18 isolates of HPV-6 (72%) and 7 isolates of HPV-11 (28%). A total of four different HPV-6 genomic variants and two HPV-11 genomic variants was identified. It was not possible to correlate specific variants with disease severity. Phylogenetic trees for both HPV types were constructed enclosing both E6 sequences detected in our study and formerly published sequences. In both phylogenetic trees, the sequences from Brazil did not group together. We could not establish a geographical association between HPV-6 or HPV-11 variants, unlike HPV-16 and HPV-18. © 2013 Elsevier B.V.

Automatic microstructural characterization and classification using artificial intelligence techniques on ultrasound signals

Secondary phases such as Laves and carbides are formed during the final solidification stages of nickel based superalloy coatings deposited during the gas tungsten arc welding cold wire process. However, when aged at high temperatures, other phases can precipitate in the microstructure, like the γ″ and δ phases. This work presents a new application and evaluation of artificial intelligent techniques to classify (the background echo and backscattered) ultrasound signals in order to characterize the microstructure of a Ni-based alloy thermally aged at 650 and 950 °C for 10, 100 and 200 h. The background echo and backscattered ultrasound signals were acquired using transducers with frequencies of 4 and 5 MHz. Thus with the use of features extraction techniques, i.e.; detrended fluctuation analysis and the Hurst method, the accuracy and speed in the classification of the secondary phases from ultrasound signals could be studied. The classifiers under study were the recent optimum-path forest (OPF) and the more traditional support vector machines and Bayesian. The experimental results revealed that the OPF classifier was the fastest and most reliable. In addition, the OPF classifier revealed to be a valid and adequate tool for microstructure characterization through ultrasound signals classification due to its speed, sensitivity, accuracy and reliability. © 2013 Elsevier B.V. All rights reserved.

The Role of Wing Pigmentation, UV and Fluorescence as Signals in a Neotropical Damselfly

Pigmentation patterns, ultraviolet reflection and fluorescent emission are often involved in mate recognition and mate quality functions in many animal taxa. We investigated the role of wing ultra-violet reflection, fluorescence emission, and pigmentation on age and sexual signals in the damselfly Mnesarete pudica. In this species, wings are sexually dimorphic in colour and exhibit age dependency: males and females show a smoky black colouration when young, turning red in mature males while it turns brown in females. First, we investigated wing UV patterns through reflectance and emission spectra. Second, behavioural experiments were undertaken to show male and female responses to manipulated wing pigmentation and experimentally reduced UV (UV-). Reflectance spectra of the wings of juvenile and mature males and females were used to show the differences between controls and individuals with manipulated colouration used in the behavioural experiment. UV-reduced, females with wings painted red, and control males and females were tethered and presented to conspecific males and females, and their behavioral responses were recorded. The male red wing pigmentation and females with red wings elicited an aggressive response in territorial males and a sexual response in females. Both males and females showed neutral responses towards individuals with reduced UV. Wing signals of juvenile individuals also provoked neutral responses. These results suggest that UV, together with pigmentation, plays a role during mate recognition in males and females. Other than butterflies and spiders, it seems that fluorescence signals and UV reflectance can also be part of communication in odonates. © 2013 Springer Science+Business Media New York.

Versão brasileira do Chronic Respiratory Questionnaire: estudo da validade de constructo e reprodutibilidade

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Lateral interactions in visual perception of temporal signals: cortical and subcortical components

The aim of this work was to isolate and investigate subcortical and cortical lateral interactions involved in flicker perception. We quantified the perceived flicker strength (PFS) in the center of a test stimulus which was simultaneously modulated with a surround stimulus (50% Michelson contrast in both stimuli). Subjects were requested to adjust the modulation depth of a separate matching stimulus that was physically identical to the center of the test stimulus but without the surround. Using LCD goggles, synchronized to the frame rate of a CRT screen, the center and surround could be presented monoptically or dichoptically. In the monoptic condition, center-surround interactions can have both subcortical and cortical origins. In the dichoptic condition, center-surround interactions cannot occur in the retina and the LGN, therefore isolating a cortical mechanism. Results revealed both a strong monoptic (subcortical plus cortical) lateral interaction and a weaker dichoptic (cortical) lateral interaction. Subtraction of the dichoptic from the monoptic data revealed a subcortical mechanism of the lateral interaction. While the modulation of the cortical PFS component showed a low-pass temporal-frequency tuning, the modulation of the subcortical PFS component was maximal at 6 Hz. These findings are consistent with two separate temporal channels influencing the monoptic PFS, each with distinct lateral interactions strength and frequency tuning characteristics. We conclude that both subcortical and cortical lateral interactions modulate flicker perception.

Uso de saponina de quilaia (Quillaja saponaria Molina) em juvenis de pacu

Pós-graduação em Aquicultura - FCAV

Cardiovascular and respiratory alterations in dogs during cervical myelography using ioversol

Subarachnoid infusion of most contrast mediums and the steps involved in performing a cervical myelography have adverse affects that can discourage its use in the radiographic diagnosis of spinal cord diseases. Thus, the cardiovascular and respiratory alterations associated with neck flexion, subarachnoid puncture, and cerebrospinal fluid drainage during subarachnoid infusion of ioversol (320mgI/mL) in dogs under general anesthesia using isoflurane were evaluated. The dogs received subarachnoid infusion of autologous cerebrospinal fluid kept at 38°C - control group (GC); ioversol 0.3mL/kg at 25°C (GI25) and ioversol 0.3mL/kg heated to 38°C (GI38). Each dog had its heart rate (HR), systolic arterial pressure (SAP), diastolic arterial pressure (DAP), respiratory rate (RR), oxyhemoglobin saturation (SaO2) and electrocardiography readings (PR and QT intervals) recorded. Group comparisons showed no statistical difference regarding neck positioning, subarachnoid puncture, and subarachnoid infusion of contrast medium on HR, RR and SaO2, cardiac rhythm or conduction. However, isoflurane significantly increased PR and QT intervals. Based on these findings, it is concluded that the steps involved in cervical myelography and the use of ioversol 320mgI/mL at 0.3mL/kg (25ºC and 38ºC) during cervical myelography did not result in relevant cardiovascular and respiratory alterations, except for an elevation in arterial pressure after injection of ioversol.