Gender differences in predictors of health status in patients with COPD

Objective: To evaluate the health status (HS) of COPD patients and to identify the main predictors of HS in these patients according to gender. Methods: The study included 90 COPD patients (60 males and 30 females; mean age = 64 +/- 9 years) with a wide range of airway obstruction disorders (mean FEV(1) = 56 +/- 19% of predicted). The men were individually matched to the women by % of predicted FEV(1) (ratio: 2:1). The patients were assessed regarding body composition; six-minute walk distance; perception of dyspnea using the Modified Medical Research Council Dyspnea Scale; Saint George's Respiratory Questionnaire (SGRQ); Charlson comorbidity index; and the multidimensional Body mass index, airway Obstruction, Dyspnea, and Exercise capacity (BODE) index. Multiple linear regression analysis was performed to identify the predictors of HS by gender. Results: Impairment of HS was greater among the women than among the men for SGRQ total score and for all SGRQ domains (total: 51 +/- 18% vs. 38 19%; p = 0.002; symptoms: 61 +/- 22% vs. 42 +/- 21%; p < 0.001; activity: 62 +/- 18% vs. 49 +/- 21%; p = 0.004; and impact: 41 +/- 19% vs. 27 +/- 18%; p = 0.001). The multiple linear regression showed that age and perception of dyspnea correlated with SGRQ total score for both genders (males, r(2) = 0.42; females, r(2) = 0.70; p < 0.05). Conclusions: Our results showed an association between gender and HS in COPD patients. Age and dyspnea are determinants of HS in both genders.

Efeitos de diferentes frações inspiradas de oxigênio sobre a dinâmica respiratória em cães submetidos à infusão contínua de propofol e mantidos em ventilação espontânea

The effects of several inspired oxygen fractions (FiO 2) on the respiratory dynamics in spontaneously breathing dogs submitted to continuous infusion of propofol were evaluated. Eight adult mongrel dogs were used. Each animal underwent five anesthesias, in each procedure the patient was allowed to breath a different FiO 2, thereby resulting in five groups, namely: G100 (FiO 2 = 1), G80 (FiO 2 = 0.8), G60 (FiO 2 =0.6), G40 (FiO 2 = 0.4), and G20 (FiO 2 = 0.21). To induce anesthesia, propofol was given until the animals allowed orotracheal intubation, followed by immediate continuous infusion of drug. The initial measurement (M0) was recorded thirty minutes after the infusion of propofol has begun. Additional recordings were performed at 15 minute intervals for 60 minutes (M15, M30, M45 and M60). Numeric data were submitted to Analysis of Variance followed by Tukey Test (p<0.05). We recorded significantly lower values of SpO 2 and SaO 2 at G20, whereas PaO 2 varied according to the changes in oxygen. Regarding PaCO 2, the mean of G100 was greater than G20 at M30. However, spontaneously breathing dogs anesthetized with propofol at the rate of 0.7mg/kg/min should not be provided with 100%, 80%, and 21% oxygen owing to the significant compromise of respiratory system.

Low dose of dichloroacetate infusion reduces blood lactate after submaximal exercise in horses

The acute administration of an indirect activator of the enzyme pyruvate dehydroge-nase (PDH) in human athletes causes a reduction in blood lactate level during and after exercise. A single IV dose (2.5m.kg-1) of dichloroacetate (DCA) was administered before a submaximal incremental exercise test (IET) with five velocity steps, from 5.0 m.s-1 for 1 min to 6.0, 6.5, 7.0 and 7.5m.s-1 every 30s in four untrained mares. The blood collections were done in the period after exercise, at times 1, 3, 5, 10, 15 and 20 min. Blood lactate and glucose (mM) were determined electro-enzymatically utilizing a YSI 2300 automated analyzer. There was a 15.3% decrease in mean total blood lactate determined from the values obtained at all assessment times in both trials after the exercise. There was a decrease in blood lactate 1, 3, 5, 10, 15 and 20 min after exercise for the mares that received prior DCA treatment, with respective mean values of 6.31±0.90 vs 5.81±0.50, 6.45±1.19 vs 5.58±1.06, 6.07±1.56 vs 5.26±1.12, 4.88±1.61 vs 3.95±1.00, 3.66±1.41 vs 2.86±0.75 and 2.75±0.51 vs 2.04±0.30. There was no difference in glucose concentrations. By means of linear regression analysis, V140, V160, V180 and V200 were determined (velocity at which the rate heart is 140, 160, 180, and 200 beats/minute, respectively). The velocities related to heart rate did not differ, indicating that there was no ergogenic effect, but prior administration of a relatively low dose of DCA in mares reduced lactatemia after an IET.

Education and income distribution in urban Brazil, 1976-1996

Includes bibliography

Estimation of spontaneous blinking main sequence in normal subjects and patients with Graves' upper eyelid retraction

Purpose. We quantified the main sequence of spontaneous blinks in normal subjects and Graves' disease patients with upper eyelid retraction using a nonlinear and two linear models, and examined the variability of the main sequence estimated with standard linear regression for 10-minute periods of time. Methods. A total of 20 normal subjects and 12 patients had their spontaneous blinking measured with the magnetic search coil technique when watching a video during one hour. The main sequence was estimated with a power-law function, and with standard and trough the origin linear regressions. Repeated measurements ANOVA was used to test the mean sequence stability of 10-minute bins measured with standard linear regression. Results. In 95% of the sample the correlation coefficients of the main sequence ranged from 0.60 to 0.94. Homoscedasticity of the peak velocity was not verified in 20% of the subjects and 25% of the patients. The power-law function provided the best main sequence fitting for subjects and patients. The mean sequence of 10-minute bins measured with standard linear regression did not differ from the one-hour period value. For the entire period of observation and the slope obtained by standard linear regression, the main sequence of the patients was reduced significantly compared to the normal subjects. Conclusions. Standard linear regression is a valid and stable approximation for estimating the main sequence of spontaneous blinking. However, the basic assumptions of the linear regression model should be examined on an individual basis. The maximum velocity of large blinks is slower in Graves' disease patients than in normal subjects. © 2013 The Association for Research in Vision and Ophthalmology, Inc.

Effects of magnesium sulphate on the pharmacodynamics of rocuronium in patients aged 60 years and older: A randomised trial

BACKGROUND There is little information on the interaction between magnesium sulphate (MgSO4) and rocuronium in elderly patients. With a growing number of older patients who need surgical procedures, it is increasingly important to study this age group. OBJECTIVE To evaluate the effects of MgSO4 administration on the pharmacodynamics of rocuronium in patients aged 60 years or older. DESIGN A randomised controlled trial. SETTING A tertiary care hospital. PATIENTS Sixty-four patients, aged 60 years or older, American Society of Anesthesiologists (ASA) physical status classes I to III, scheduled for elective oncological head and neck surgery. Exclusion criteria were severe renal insufficiency (calculated creatinine clearance <30 ml min-1), preoperatorive serum magnesium concentration of more than 1.25 mmol l1 and patients receiving drugs known to affect neuromuscular function. INTERVENTIONS Patients were randomly allocated to one of two groups: in the magnesium group, patients received MgSO4 30mgkg1 intravenously, for 10 min, and then a continuous intravenous infusion at a rate of 1 g h-1. The control group received the same volume of physiological saline. Neuromuscular function was evaluated continuously in both groups. MAIN OUTCOME MEASURES Total recovery time was the primary outcome. Onset time, clinical duration, recovery index and recovery time were considered as secondary endpoints. Values are given as mean [SD]. RESULTS Total recovery time from neuromuscular block (NMB) was 113 [36] min in the magnesium group and 101 [39] min in the control group. Clinical duration was 69 [23] min in the magnesium group and 59 [28] min in the control group. Recovery index was 19 [36] min in the magnesium group and 17 [6] min in the control group. Recovery timewas 44 [22] min in the magnesium group and 42 [18] min in the control group. There were no statistically significant differences between the groups in any of the recovery indices. In the magnesium group, the mean onset time was 144 [58] s, significantly shorter than the onset time in the group that received physiological saline, which was 187 [90] s (P-0.03). Group variances were compared using an F test: onset time varied significantly less in the magnesium group (P-0.02). CONCLUSION In oncology patients of 60 or more years of age, preadministration of MgSO4, with the doses used in this study, significantly reduced the onset time of NMB induced by rocuronium. © 2013 European Society of Anaesthesiology.

Respostas neuromusculares agudas ao exercício com pesos realizado a diferentes intensidades em idosas treinadas

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Estudo comparativo entre a atropina e a hioscina na reversão da bradicardia induzida pela detomidina em equinos

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

Avaliação de diferentes frações inspiradas de oxigênio em cães anestesiados com infusão contínua de propofol e rocurônio, mantidos em ventilação controlada a pressão

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

Avaliação algimétrica por estímulo nociceptivo térmico e pressórico em cães pré-tratados com levomepromazina, midazolam e quetamina, associados ou não ao butorfanol

Pós-graduação em Medicina Veterinária - FMVZ

Efeitos hemodinâmicos, eletrocardiográficos e hemogasométricos do butorfanol em cães anestesiados pelo desfluorano

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

Perda de peso, indicadores do metabolismo de carboidratos e produção de citocinas em cães

Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)

Estudo farmacocinético e farmacodinâmico de cloridrato metadona por via oral, intramuscular e intravenosa e carreadores lipídicos nanoparticulados de metadona via oral em equinos

Pós-graduação em Anestesiologia - FMB

Influence of Different Surface Treatments on Bond Strength of Resin Composite Using the Intrinsic Characterization Technique

Objective: This study evaluated the influence of different surface treatments on the resin bond strength/light-cured characterizing materials (LCCMs), using the intrinsic characterization technique. The intrinsic technique is characterized by the use of LCCMs between the increments of resin composite (resin/thin film of LCCM/external layer of resin covering the LCCM).Materials and Methods: Using a silicone matrix, 240 blocks of composite (Z350/3M ESPE) were fabricated. The surfaces received different surface treatments, totaling four groups (n=60): Group C (control group), no surface treatment was used; Group PA, 37% phosphoric acid for one minute and washing the surface for two minutes; Group RD, roughening with diamond tip; and Group AO, aluminum oxide. Each group was divided into four subgroups (n=15), according to the LCCMs used: Subgroup WT, White Tetric Color pigment (Ivoclar/Vivadent) LCCM; Subgroup BT, Black Tetric Color pigment (Ivoclar/Vivadent) LCCM; Subgroup WK, White Kolor Plus pigment (Kerr) LCCM; Subgroup BK, Brown Kolor Plus pigment (Kerr) LCCM. All materials were used according to the manufacturer's instructions. After this, block composites were fabricated over the LCCMs. Specimens were sectioned and submitted to microtensile testing to evaluate the bond strength at the interface. Data were submitted to two-way analysis of variance (ANOVA) (surface treatment and LCCMs) and Tukey tests.Results: ANOVA presented a value of p<0.05. The mean values (+/- SD) for the factor surface treatment were as follows: Group C, 30.05 MPa (+/- 5.88)a; Group PA, 23.46 MPa (+/- 5.45)b; Group RD, 21.39 MPa (+/- 6.36)b; Group AO, 15.05 MPa (+/- 4.57)c. Groups followed by the same letters do not present significant statistical differences. The control group presented significantly higher bond strength values than the other groups. The group that received surface treatment with aluminum oxide presented significantly lower bond strength values than the other groups.Conclusion: Surface treatments of composite with phosphoric acid, diamond tip, and aluminum oxide significantly diminished the bond strength between composite and the LCCMs.

Associação do treinamento resistido e aeróbico em pacientes com doença pulmonar crônica

Introduction: The pulmonary rehabilitation (PR) is composed of aerobic and resisted exercises that improve the functional capacity to the exercise, life quality and decrease respiratory symptoms in subjects with chronic pulmonary disease. Objective: Assess the effects of a combined PR program in the cardiorespiratory function and peripheral muscle strength in subjects with chronic pulmonary disease. Method: Patients with chronic pulmonary disease were submitted to the PR program, which was developed on 24 sessions of 60 minutes (three times per week). The program was composed of aerobic exercises (two times per week) and resisted exercises (once a week). Before and after the PR the patients were submitted to manovacuometry in order to measure the maximum inspiratory pressure (MIP) and the maximum expiratory pressure (MEP), ventilometry, peek expiratory flow (PEF), six minute walking test (6MWT) and one maximum repetition (1RM). The data are presented in absolute frequency, percentage and mean±standard deviation. The t Student test was used to compare data before and after the PR and the ANOVA test to compare before, after and predicted distances in the 6MWT (p<0.05). Results: Seven patients were part of this study, 85.70% of women, 71.40% with pulmonary emphysema diagnosis. The mean age was 69.43±5.59 years old, the height was 1.61±0.07 m, the mean weight was 66.20±8.40 kg and the body mass index mean was 25.50±2.48 kg/m². From the variables assessed, the MEP increased from 79.71±13.69 to 84.42±12.83 cmH2O (p=0,03), the PEF increase from 255.71±66.3 to 320.00±93.63 l/min (p=0,03) and the distance in the 6MWT from 415.28±47.90 to 483,79±79,77 m (p=0,02). The load in the 1RM test in the reverse peck deck exercise (before - - 17.10±8.10kg; after – 210.40±9.00kg), knee in leg extension machine (before – 17.10±9.50kg; after – 26.40±13.10kg) and hip extensors (right before – 48.60±22.10kg; after – 62.90±19.30kg; and left before – 46.40±20.10kg; after – 62.10±18.20kg) increased significantly (p<0,05). Conclusion: After the PR program there was improvement in the expiratory muscular strength, in the lower limbs strength and in the functional capacity. Besides that, there was a reduction in the airflow obstruction of the subjects with chronic pulmonary disease.