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Avalia??o do extrato de Aroeira (Schinus terebinthifolius Raddi) no processo de cicatriza??o de gastrorrafias em ratos
Santos, Orlando José dos;Ribas Filho, Jurandir Marcondes;Czeczko, Nicolau Gregori;Castelo Branco Neto, Manoel Lages;Naufel Jr, Carlos;Ferreira, Lydia Masako;Campos, Rodrigo Peixoto;Moreira, Hamilton;Porcides, Rafael Dib;Dobrowolski, Samuel;
Acta Cirurgica Brasileira , 2006, DOI: 10.1590/S0102-86502006000800007
Abstract: purpose: to evaluate the healing process of gastric suture in rats using hydroalcoholic aroeira (schinus terebinthifolius raddi) extract. methods: forty adult male rats, divided into two groups of 20 animals were operated and named as follows: aroeira group (ga), and the control group (gc). each group was divided into two subgroups (sg) of 10 animals (sga and sgc) according to the time of provoked death (three and seven days). the same surgical procedure was performed in all animals consisting in incision and simple suture of the stomach (prolene? 6-0). the only difference was on the type of medical treatment. the aroeira group received a single 100mg/kg of aroira extract in an intraperitoneal dose and the animals from the control group received the same quantity in milliliters (ml) of the isotonic saline solution. the evaluated parameters were: macroscopic alterations, microscopic healing process and toleration to atmospheric air insufflation. results: all animals had good healing process of abdominal wall with no clinical evidence of infection, dehiscence, abscesses and peritonitis. both groups presented adherences to gastric suture line area with surrounding organs, mainly the liver, lower intestines and the abdominal wall. microscopic analysis showed only chronic inflammation significant difference between the aroeira and control groups on the third day of observation. resistance tests did not present significant statistical differences in the studied groups. conclusion: the use of aroeira (schinus terebinthifolius raddi) hydro-alcoholic extract did not alter the stomach healing process, considered on macroscopic, tensiometric and microscopic assessment.
Estudo comparativo da cicatriza??o de gastrorrafias com e sem o uso do extrato de Jatropha gossypiifolia L. (pi?o roxo) em ratos
Vale, José de Ribamar;Czeczko, Nicolau Gregori;Aquino, José Ulcijara;Ribas-Filho, Jurandir Marcondes;Bettega, Luciano;Vasconcelos, Paulo Roberto Leit?o de;Correa Neto, Mario Adolfo;Nassif, Paulo Afonso Nunes;Mazza, Marcelo;Henriques, Gilberto Simeone;
Acta Cirurgica Brasileira , 2006, DOI: 10.1590/S0102-86502006000900007
Abstract: introduction: the healing process of the gastrointestinal tract is of huge importance in the surgical field history, as well as the search for appropriate types of threads and suture techniques and the many factors that influence it. the use of phytotherapic drugs as accelerators of the healing process has been done for many years and is one of the current objectives of scientific researches trying to prove its therapeutic properties. purpose: to evaluate the use of jatropha gossypiifolia l. extract on the healing process of gastrorraphies in rats. methods: forty wistar male rats were divided in 2 groups of 20 rats, named control and jatropha groups. ten animals of each group were killed in the third day post-surgery and were named control and jatropha groups of the 3rd day. the remaining 10 animals of each group were killed in the seventh day and were named accordingly for the 7th day. in each animal, gastrostomy and gastrorraphy were performed in a single plane using polypropylene thread 6-0 (prolene). the animals from the jatropha group were given a single dose of 200 mg/kg of the jatropha gossypiifolia l. extract intraperitoneally on the same day of the procedure and the ones from the control group were given the same quantity in milliliters (ml), but of saline solution (sodium chloride 0.9%). the following parameters were evaluated: 1) macroscopic alterations; 2) the suture's resistance to atmospheric air insufflation (pressure of rupture); 3) histologic characteristics. results: no animal died during the clinical follow-up and optimal healing of the abdominal wall was seen without any signs of infection, dehiscence, abscesses or peritonitis. healing of the serous surface was considered good in all animals, without occurrence of fistulas; however, intraperitoneal adhesions occurred in 7 rats of the sub-group control and 9 of the sub-group jatropha on the 3rd day post-operative and in 9 of the sub-group control and 8 of the sub-group jatropha on the 7th day, but
Effects of laparoscopy on the cardiorespiratory system of brown brocket deer (Mazama gouazoubira) anesthetized with ketamine/ xylazine/ midazolam combination and isoflurane
Munerato, Marina Salles;Zanetti, Eveline dos Santos;Marques, José Ant?nio;Duarte, José Maurício Barbanti;
Pesquisa Veterinária Brasileira , 2008, DOI: 10.1590/S0100-736X2008001100003
Abstract: laparoscopy is not widely used as a tool to perform assisted reproduction techniques in south american cervids; thus, scarce information in literature is available regarding its effects and appropriate anesthetic protocols to perform it. this study evaluated the effect of laparoscopy on heart rate (hr), respiration rate (rr), saturation of oxyhemoglobin (spo2) and rectal temperature (rt) of six female brown brocket deer (mazama gouazoubira) anesthetized with ketamine (5mg/kg), xylazine (0.3mg/kg), midazolam (0.5mg/kg) combination i.v. and isoflurane. twelve laparoscopies were performed and each animal was used twice with a 40-day interval. after anesthetized, the animals were placed in dorsal recumbency to perform laparoscopy procedure using abdominal co2 insufflations (14.2 ± 2.39mmhg; m ± se). the main events of the laparoscopy procedure were divided into three periods: animal without (p1) and with abdominal insufflation (p2) and abdominal insufflation with the hips raised at 45o (p3). as a control, the animals were anesthetized again 40 days after the last laparoscopy, and were maintained in a dorsal recumbency for the same average duration of the previous anesthesia and no laparoscopy procedure was conducted. the period of anesthesia for the controls was also divided into p1, p2, and p3 considering the average duration of these periods in previous laparoscopies performed. data were analyzed through the (anova) variance analysis followed by tukey test and values at p<0.05 were considered significant. no significant differences were observed in the parameters evaluated at p1, p2 and p3 between the animals submitted to laparoscopy and control. however, the rr mean between p1 (38.8 ± 4.42) and p3 (32.7 ± 4.81); and the rt mean between the p1 (38.2oc ± 0.17), p2 (37.6oc ± 0.19) and p3 (37.0oc ± 0.21) varied significantly, independent of the laparoscopy. these data indicated that laparoscopy didn't cause any significant alterations in the cardiorespiratory parameters
Spirometric assessment of lung transplant patients: one year follow-up
Pêgo-Fernandes, Paulo M.;Abr?o, Fernando Conrado;Fernandes, Frederico Leon Arrabal;Caramori, Marlova L.;Samano, Marcos Naoyuki;Jatene, Fabio B.;
Clinics , 2009, DOI: 10.1590/S1807-59322009000600006
Abstract: objective: the purpose of this study was to compare spirometry data between patients who underwent single-lung or double-lung transplantation the first year after transplantation. introduction: lung transplantation, which was initially described as an experimental method in 1963, has become a therapeutic option for patients with advanced pulmonary diseases due to improvements in organ conservation, surgical technique, immunosuppressive therapy and treatment of post-operative infections. methods: we retrospectively reviewed the records of the 39 patients who received lung transplantation in our institution between august 2003 and august 2006. twenty-nine patients survived one year post-transplantation, and all of them were followed. results: the increase in lung function in the double-lung transplant group was more substantial than that of the single-lung transplant group, exhibiting a statistical difference from the 1st month in both the forced expiratory volume in one second (fev1) and the forced vital capacity (fvc) in comparison to the pre-transplant values (p <0.05). comparison between double-lung transplant and single lung-transplant groups of emphysema patients demonstrated a significant difference in lung function beginning in the 3rd month after transplantation. discussion: the analyses of the whole group of transplant recipients and the sub-group of emphysema patients suggest the superiority of bilateral transplant over the unilateral alternative. although the pre-transplant values of lung function were worse in the double-lung group, this difference was no longer significant in the subsequent months after surgery. conclusion: although both groups demonstrated functional improvement after transplantation, there was a clear tendency to greater improvement in fvc and fev1 in the bilateral transplant group. among our subjects, double-lung transplantation improved lung function.
Distensión colónica con bomba de CO2: Impacto en el disconfort del paciente en los estudios de colonoscopía virtual
Carrascosa,Patricia; Capu?ay,Carlos; Vallejos,Javier;
Revista argentina de radiolog?-a , 2011,
Abstract: objectives. to analyze the role of colonic distention with co2 and its influence on patients' discomfort and the duration of the virtual colonoscopy procedure in our daily practice. materials and methods. two hundred patients were evaluated, 50 were insufflated using room air and 150 with co2. the studies were performed with a 64-row ct scanner using 2-mm slice thickness, 120 kv and 50 mas. in all patients, scans were acquired both in prone and supine positions. we calculated the total procedure time in each group; a student's t-test was used to calculate the differences. patients completed a questionnaire about the degree of discomfort perceived. we used a scale of 0 to 3: 0- no discomfort, 1- mild, 2- moderate and 3- severe discomfort. we used a test of proportions to calculate the differences in the degree of discomfort between the two groups. results. the total procedure time was 30.5 minutes for studies performed with co2 and 35.4 minutes for those performed with room air, with a difference of -4.9 min (p =0.0003). as regards the assessment of discomfort, in the group insufflated with room air, 44% of patients reported a moderate degree of discomfort, while in the group insufflated with co2, 76% of the patients expressed no discomfort. conclusions. virtual colonoscopy performed with co2 insufflation partially reduced the total procedure time, and significantly reduced discomfort during and after the procedure.
CO insufflation for potentially difficult colonoscopies: Efficacy when used by less experienced colonoscopists
Toshio Uraoka, Jun Kato, Motoaki Kuriyama, Keisuke Hori, Shin Ishikawa, Keita Harada, Koji Takemoto, Sakiko Hiraoka, Hideyuki Fujita, Joichiro Horii, Yutaka Saito, Kazuhide Yamamoto
World Journal of Gastroenterology , 2009,
Abstract: AIM: To clarify the effectiveness of CO2 insufflation in potentially difficult colonoscopy cases, particularly in relation to the experience level of colonoscopists.METHODS: One hundred twenty potentially difficult cases were included in this study, which involved females with a low body mass index and patients with earlier abdominal and/or pelvic open surgery or previously diagnosed left-side colon diverticulosis. Patients receiving colonoscopy examinations without sedation using a pediatric variable-stiffness colonoscope were divided into two groups based on either CO2 or standard air insufflation. Both insufflation procedures were also evaluated according to the experience level of the respective colonoscopists who were divided into an experienced colonoscopist (EC) group and a less experienced colonoscopist (LEC) group. Study measurements included a 100-mm visual analogue scale (VAS) for patient pain during and after colonoscopy examinations, in addition to insertion to the cecum and withdrawal times.RESULTS: Examination times did not differ, however, VAS scores in the CO2 group were significantly better than in the air group (P < 0.001, two-way ANOVA) from immediately after the procedure and up to 2 h later. There were no significant differences between either insufflation method in the EC group (P = 0.29), however, VAS scores for CO2 insufflation were significantly better than air insufflation in the LEC group (P = 0.023) immediately after colonoscopies and up to 4 h afterwards.CONCLUSION: CO2 insufflation reduced patient pain after colonoscopy in potentially difficult cases when performed by LECs.
Overdistension in ventilated children
Véronique Nève, Francis Leclerc, Eric Dumas de la Roque, Stéphane Leteurtre, Yvon Riou
Critical Care , 2001, DOI: 10.1186/cc1023
Abstract: Analysis of respiratory V-P curves is increasingly being included in the evaluation of whether ventilator settings are suited to the mechanical properties of the respiratory system of the patient. In dynamic conditions, resistive forces, the resistance of the conducting airway and the endotracheal tube (ETT), and viscoelastic or inertial forces, adaptation to stress of units within the lung and the chest wall tissues, are measured. In order to obtain information regarding lung elastic forces, dynamic forces must be eliminated and respiratory muscles relaxed.The static V-P curve obtained in normal persons has a sigmoidal shape, with a linear segment above functional residual capacity (FRC) where tidal ventilation takes place, two inflection points, and a hysteresis curve. The lower inflection point (LIP) is observed at lung volume lower than FRC, and is therefore not observed in lungs of normal persons above relaxation volume. The upper inflection point (UIP) is observed at near total lung capacity.In patients with the acute respiratory distress syndrome (ARDS), the classical shape of the V-P curve is altered. Abnormalities include appearance of a LIP above FRC, of a UIP at lower lung volume than in normal persons, decreased slope in the linear portion, and increased hysteresis. The mechanical abnormalities are dependent on the stage of disease [1].Animal studies [2,3,4,5,6] have shown that mechanical ventilation can initiate or worsen pre-existing lung injury. Ventilator-induced lung injury (VILI) appears to result from repetitive closing and opening of collapsed alveolar units, or from pulmonary overdistension. Both of these exacerbate or initiate significant lung injury and inflammation [4,5,7]. In animal studies [5], VILI is reduced by setting the positive end-expiratory pressure (PEEP) level slightly higher than the LIP of the thoracopulmonary V-P curve, thus avoiding repetitive closing and opening of collapsed alveolar units and keeping the lung open. Also, an
Empilhamento de ar e compress?o torácica aumentam o pico de fluxo da tosse em pacientes com distrofia muscular de Duchenne
Brito, Magneide Fernandes;Moreira, Gustavo Antonio;Pradella-Hallinan, Márcia;Tufik, Sergio;
Jornal Brasileiro de Pneumologia , 2009, DOI: 10.1590/S1806-37132009001000005
Abstract: objective: to evaluate cough efficiency using two manually-assisted cough techniques. methods: we selected 28 patients with duchenne muscular dystrophy. the patients were receiving noninvasive nocturnal ventilatory support and presented fvc values < 60% of predicted. peak cough flow (pcf) was measured, with the patient seated, at four time points: at baseline, during a spontaneous maximal expiratory effort (mee); during an mee while receiving chest compression; during an mee after air stacking with a manual resuscitation bag; and during an mee with air stacking and compression (combined technique). the last three measurements were conducted in random order. the results were compared using pearson's correlation test and anova with repeated measures, followed by tukey's post-hoc test (p < 0.05). results: the mean age of the patients was 20 ± 4 years, and the mean fvc was 29 ± 12%. mean pcf at baseline, with chest compression, after air stacking and with the use of the combined technique was 171 ± 67, 231 ± 81, 225 ± 80, and 292 ± 86 l/min, respectively. the results obtained with the use of the combined technique were significantly better than were those obtained with the use of either technique alone (f[3.69] = 67.07; p < 0.001). conclusions: both chest compression and air stacking techniques were efficient in increasing pcf. however, the combination of these two techniques had a significant additional effect (p < 0.0001).
Influencia del reclutamiento alveolar sobre los efectos del surfactante exógeno
Herrera,Néstor R.; Regnicoli,Roberto N.; Silvestre Begnis,Mario; Scrigna,José; Peralta,Enzo; Quadrelli,Lisandro;
Medicina (Buenos Aires) , 2006,
Abstract: an experimental modelwas devised to study the effects of a sustained insufflation maneuver on the immediate response to exogenous surfactant administration and the effects of baseline pulmonary volume subsequently used in 20 adult albino rats. lung-injury was induced by repeated lavages with saline solution. gas exchange, hemodynamic status, lung mechanics and histopathology were assessed. the rats were divided into four experimental groups. group 1 was delivered 30 cmh2o sustained insufflation over 15 seconds prior to the surfactant. it was subsequently ventilated at positive end-expiratory pressure (peep) of 10 cm h2o. group 2 did not receive sustained insufflation and was ventilated at peep of 10 cm h2o. group 3 was delivered sustained insufflation and was ventilated with peep of 4 cm h2o; and group 4 did not receive sustained insufflation and was ventilated with peep of 4 cm h2o. the surfactant immediate effect was not modified by previous sustained insufflation administration. increased pao2 associated to high functional residual capacity (frc) (group 1 p=0.0001; group 2 p=0.0001), regardless of sustained insufflation, was observed. the use of sustained insufflation prior to surfactant administration along with high frc ventilation was associated with polymorphonuclear infiltrates beneath the bronchiolar epithelium (p=0.008). our results do not advocate the use of sustained insufflation prior to the administration of exogenous surfactant.
Colocación de sondas transpilóricas en la unidad de cuidados intensivos pediátricos: la técnica de insuflación gástrica de aire
Barrionuevo,Lucila; Eulmesekian,Pablo; Pérez,Augusto; Minces,Pablo;
Archivos argentinos de pediatr?-a , 2009,
Abstract: introduction. the aim of the study was to evaluate the success rate of transpyloric tube (tpt) placement using air gastric insufflation technique in patients hospitalized in the pediatric intensive care unit. population, materials and methods. the data were collected retrospectively from a prospective filled database. tpt positioning was defined as successful by evaluation of its distal end in the abdominal x-ray. demographic information, success rate, duration of the procedure were registered. descriptive statistics was used to analyze the data. results. there were 37 procedures in 33 patients and 84% of them were on mechanical ventilation. the percentage of success in tpt placement was 89% (33/37) and the mean duration of the procedure was 12.8 min ± 5.3. no complications were registered. conclusion. tpt placement through the insufflation of air in the stomach is a short, simple, effective, and well tolerated procedure that can be done at bedside.
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