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Search Results: 1 - 10 of 11197 matches for " Sara Nunes "
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Avalia??o dos parametros derivados do eletroencefalograma durante administra??o de diferentes concentra??es de óxido nitroso
Cavalcante, Sara Lúcia;Nunes, Rogean Rodrigues;
Revista Brasileira de Anestesiologia , 2003, DOI: 10.1590/S0034-70942003000100001
Abstract: background and objectives: spectral electroencephalography has been used to measure anesthetic depth, hypnosis and sedation levels induced by different anesthetic agents. this study aimed at evaluating the effects of n2o on electroencephalographic (eeg) variables and sedation levels according to observer assessment of alertness/sedation (oaa/s) scale, as well as on hemodynamic and respiratory parameters. methods: thirty adult patients from both genders, physical status asa i, aged 20 and 40 years, were submitted to the following protocol: after 10 minutes of relaxation, spontaneously breathing with eyes close, patients were given 30% and 50% n2o concentrations under face mask. data were collected in three moments: m1- before n2o administration; m2 - 30% n2o in o2; m3 - 50% n2o in o2. data for m2 and m3 were collected 15 minutes after stabilization of 30% and 50% n2o expired fractions (fen2o), respectively, with a 5-minute interval between fractions. the following parameters were evaluated: electroencephalographic: bis, sef1, sef2, power energy (pe) and burst suppression (bs); hemodynamic: heart rate (hr), systolic blood pressure (sbp), diastolic blood pressure (dbp); respiratory: oxygen hemoglobin saturation (spo2), carbon dioxide expired pressure (petco2), minute ventilation and respiratory rate; clinical: patients were rated in a descending order (5, 4, 3, 2 and 1) according to oaa/s scale. results: n2o administrated at 30% and 50% concentrations has statistically changed bis, sef1, sef2, pe and oaa/s level of sedation in the studied moments. no clinically important changes were observed, as all patients were cooperative and slightly sedated, though sef1 and sef2 indications of deep hypnosis. hemodynamic and respiratory parameters changes were not statistically significant. conclusions: n2o at 30% and 50% concentrations in non-premedicated patients has induced mild sedation according to oaa/s scale. there has been correspondence with bis, but not with sef1 and sef
Influência da dexmedetomidina na concentra??o expirada do sevoflurano: avalia??o pelo índice bispectral, taxa de supress?o e análise espectral da potência do eletroencefalograma
Nunes, Rogean Rodrigues;Cavalcante, Sara Lúcia;
Revista Brasileira de Anestesiologia , 2002, DOI: 10.1590/S0034-70942002000200001
Abstract: background and objectives: dexmedetomidine, an a2-adrenergic agonist, has been described as being able to decrease the demand for both venous and inhalational agents. this study aimed at evaluating the influence of dexmedetomidine upon sevoflurane end-expiratory concentration (ec) with monitoring the depth of anesthesia. methods: participated in this study 40 female adult patients, physical status asa i, submitted to gynecological laparoscopy under general anesthesia maintained with sevoflurane, who were randomly divided in two groups: group i (n=20), without dexmedetomidine; and group ii (n=20), with dexmedetomidine, in continuous infusion, as follows: rapid phase (1 μg.kg-1 in 10 min-1) 10 minutes before anesthesia induction, followed by a maintenance phase (0,4 μg.kg-1.h-1) throughout the surgery. the following parameters were analyzed: bp, hr, bis, sef 95%, d%, suppression rate (sr), rso2, ce, spo2 and petco2, in the following moments: m1 - before dexmedetomidine or 0.9% saline infusion; m2 - prior to intubation; m3 - following intubation; m4 - before incision; m5 - following incision; m6 - before co2 inflation; m7 - following co2 inflation; m8 - 10 min after co2 inflation; m9 - 10 min after m8; m10 - 20 min after m8; m11 - 30 min after m8; m12 - 40 min after m8; and m13 - at emergence. time for emergence and hospital discharge were also recorded. results: dexmedetomidine has decreased sevoflurane end-expiratory concentration from m4 to m13 (p<0.05) when comparing group i and group ii. no clinically significant changes were observed in hemodynamic parameters. time for emergence in groups i and ii was 11 ± 0.91 min. and 6.35 ± 0.93 min., respectively (p < 0.05). time for hospital discharge was 7.45 ± 0.69 h in group i and 8.37 ± 0.88 h in group ii (p < 0.05). conclusions: dexmedetomidine was effective in decreasing sevoflurane end-expiratory concentration while maintaining hemodynamic stability without impairing time for hospital discharge, in addition to promoti
Avalia o dos parametros derivados do eletroencefalograma durante administra o de diferentes concentra es de óxido nitroso
Cavalcante Sara Lúcia,Nunes Rogean Rodrigues
Revista Brasileira de Anestesiologia , 2003,
Abstract: JUSTIFICATIVA E OBJETIVOS: A análise espectral do eletroencefalograma vem sendo usada como medida da profundidade anestésica, nível de hipnose e seda o de diversos agentes anestésicos. O objetivo deste estudo foi avaliar os efeitos do N2O sobre os parametros derivados do eletroencefalograma, nível de seda o pela Escala Analógica de Alerta e Seda o (EAS), variáveis hemodinamicas e ventilatórias. MéTODO: Participaram do estudo 30 pacientes adultos, de ambos os sexos, estado físico ASA I, com idades entre 20 e 40 anos, que se submeteram ao seguinte protocolo: respirar espontaneamente e relaxar de olhos fechados durante dez minutos, sendo coletados dados em três momentos: M1 - antes da oferta de N2O; M2 - N2O a 30% em O2; M3 - N2O a 50% em O2. A coleta dos dados de M2 e M3 foi realizada após quinze minutos da estabiliza o das fra es expiradas de N2O (FeN2O) em 30% e 50% respectivamente, com o tempo de 5 minutos entre as fra es. Os parametros estudados foram os seguintes: eletroencefalográficos: BIS, SEF1, SEF2, potência total (PT) e taxa de supress o (TS); hemodinamicos: freqüência cardíaca (FC), press o arterial sistólica (PAS), press o arterial diastólica (PAD); ventilatórios: SpO2, P ET CO2, ventila o minuto e freqüência respiratória; clínicos: os pacientes foram classificados numericamente em ordem decrescente (5, 4, 3, 2 e 1) quanto ao seu estado de alerta, pela EAS. RESULTADOS: O N2O a 30% e a 50% modificou estatisticamente o BIS, SEF1, SEF2, PT e o grau de seda o pela EAS, ao longo dos momentos estudados. N o foram observadas modifica es clinicamente importantes, pois todos os pacientes mostraram-se cooperativos e levemente sedados, apesar das varia es do SEF1 e SEF2 indicarem valores compatíveis com estágio de hipnose profunda. As varia es estatísticas nos parametros hemodinamicos e ventilatórios n o foram clinicamente significativas. CONCLUS ES: O N2O a 30% e a 50%, em pacientes sem medica o pré-anestésica, induzem a um leve estado de seda o avaliado pela EAS, havendo correspondência com o BIS, o mesmo n o ocorrendo com SEF1 e SEF2.
Efeitos da seda??o produzida pela associa??o midazolam e cetamina S(+) sobre as variáveis eletroencefalográficas
Nunes, Rogean Rodrigues;Cavalcante, Sara Lúcia;Franco, Suyane Benevides;
Revista Brasileira de Anestesiologia , 2011, DOI: 10.1590/S0034-70942011000300005
Abstract: background and objectives: ketamine s(+) is important in pain modulation in surgical patients. the objective of the present study was to evaluate the relationship between the levels of sedation produced by low doses of ketamine s(+), as well as encephalographic variables: bis, sef 95%, pemg, suppression rate, and presence of burst-suppression. methods: thirty patients of both sexes, aged 25-50 years, were randomized into three groups. group g1 (10) received intravenous ketamine s(+) 0.050 mg,kg-1; group g2 (10) intravenous ketamine s(+) 0.125 mg.kg-1; and group g3 (10) intravenous ketamine s(+) 0.250 mg.kg-1. all patients received 0.08 mg.kg-1 of intravenous midazolam 10 minutes before administration of ketamine s(+). in each group, two moments were evaluated: m1, before ketamine s(+) administration; and m2, after ketamine s(+) administration. sedation levels and encephalographic variables: bis, sef 95%, pemg, suppression rate, and the presence of burst-suppression were evaluated in all patients before and after ketamine s(+) administration. anova was used for repeated measurements and the p-value was adjusted for multiple comparisons by tukey's test. results: a decrease in alertness-sedation scale scores was observed in all three groups in moment m2. electroencephalographic variables showed significant variation in all three groups when moments m1 and m2 were compared, both in pemg and bis (p < 0.05). conclusions: sedation levels showed significant correlation with the increase in ketamine s(+) dosage. however, increased bis levels may have reflected increased pemg induced by ketamine s(+).
Vessel Arterial-Venous Plasticity in Adult Neovascularization
Sara S. Nunes, Harish Rekapally, Carlos C. Chang, James B. Hoying
PLOS ONE , 2011, DOI: 10.1371/journal.pone.0027332
Abstract: Objective Proper arterial and venous specification is a hallmark of functional vascular networks. While arterial-venous identity is genetically pre-determined during embryo development, it is unknown whether an analogous pre-specification occurs in adult neovascularization. Our goal is to determine whether vessel arterial-venous specification in adult neovascularization is pre-determined by the identity of the originating vessels. Methods and Results We assessed identity specification during neovascularization by implanting isolated microvessels of arterial identity from both mice and rats and assessing the identity outcomes of the resulting, newly formed vasculature. These microvessels of arterial identity spontaneously formed a stereotypical, perfused microcirculation comprised of the full complement of microvessel types intrinsic to a mature microvasculature. Changes in microvessel identity occurred during sprouting angiogenesis, with neovessels displaying an ambiguous arterial-venous phenotype associated with reduced EphrinB2 phosphorylation. Conclusions Our findings indicate that microvessel arterial-venous identity in adult neovascularization is not necessarily pre-determined and that adult microvessels display a considerable level of phenotypic plasticity during neovascularization. In addition, we show that vessels of arterial identity also hold the potential to undergo sprouting angiogenesis.
Regular physical exercise training assists in preventing type 2 diabetes development: focus on its antioxidant and anti-inflammatory properties
Edite Teixeira-Lemos, Sara Nunes, Frederico Teixeira, Flávio Reis
Cardiovascular Diabetology , 2011, DOI: 10.1186/1475-2840-10-12
Abstract: Our previous work showed, in an animal model of obese type 2 diabetes, the Zucker Diabetic Fatty (ZDF) rat, that regular and moderate intensity physical exercise (training) is able, per se, to attenuate insulin resistance and control glycaemia, dyslipidaemia and blood pressure, thus reducing cardiovascular risk, by interfering with the pathophysiological mechanisms at different levels, including oxidative stress and low-grade inflammation, which are key features of diabesity.This paper briefly reviews the wide pathophysiological pathways associated with Type 2 diabetes and then discusses in detail the benefits of training therapy on glycaemic control and on cardiovascular risk profile in Type 2 diabetes, focusing particularly on antioxidant and anti-inflammatory properties. Based on the current knowledge, including our own findings using an animal model, it is concluded that regular and moderate intensity physical exercise (training), due to its pleiotropic effects, could replace, or at least reduce, the use of anti-diabetic drugs, as well as of other drugs given for the control of cardiovascular risk factors in obese type 2 diabetic patients, working as a physiological "polypill".Type 2 diabetes mellitus (T2DM) achieved proportions of a real epidemic and, according to the International Diabetes Federation (IDF), the disease now affects 246 million people worldwide and is expected to affect about 380 million by 2025 [1]. This panorama is even more dramatic if considered that over the past 20 years its prevalence has increased dramatically among children and adolescents. As such, the incidence/prevalence of serious diabetic complications (which includes cardiovascular disease, kidney failure, blindness and amputations) as well as the premature death, will unequivocally deteriorate life quality and exacerbate health costs, unless more effective primary and secondary pharmacological and non-pharmacological (lifestyle interventional) strategies become more widely availa
Eletroencefalograma processado em crian?as anestesiadas com sevoflurano. é possível?
Nunes, Rogean Rodrigues;Cavalcante, Sara Lúcia;Gemal, Alberto Esteves;Amorim, Domingos Gerson de Sabóia;
Revista Brasileira de Anestesiologia , 2003, DOI: 10.1590/S0034-70942003000300001
Abstract: background and objectives: eeg-derived bispectral index (bis), has been indicated as a major substrate for measuring hypnotic effects of anesthetic drugs. however, there are only limited data on the use of eeg in anesthetized children. this study aimed at evaluating changes in bis, sef95%, relative delta band frequency amplitude (d%) and suppression rate (sr) in children, correlating these changes with sevoflurane pharmacodynamic variables (ec and ec/mac) as compared to adults. methods: participated in this study 100 patients of both genders, aged 0 to 40 years, physical status asa i and ii. all patients were induced with sevoflurane followed by neuromuscular blocker at bis 30. patients were distributed in 5 groups: gi (20) - 0 to 6 months; gii (20) > 6 months to 2 years; giii (20) > 2 to 12 years; giv (20) > 12 to 18 years and gv (20) > 18 to 40 years. five moments were evaluated for each group: m1 (awaken); m2 (bis 60); m3 (bis 50); m4 (bis 40) and m5 (emergence). the following parameters were recorded for all moments: sbp, dbp, hr, bis, sef95%, d%, suppression rate, ec and ec/mac. results: both bis and sef95% values for all age groups directly correlated to sevoflurane?s ec/mac at bis values of 40, 50, 60 and at emergence, considering mac values for age (p > 0.05). d% values in gi were higher than in any other group during all five moments (p < 0.05). conclusions: unlike d%, the variations of which seem brain maturation-related, bis and sef95% may be used to monitor sevoflurane?s anesthetic depth in children aged 0 to 12 years, observing the parameters suggested for adults.
Derrame pleural complicado na crian?a: Abordagem terapêutica
Martins,Sara; Valente,Sandra; David,Teresa Nunes; Pereira,Luísa; Barreto,Celeste; Bandeira,Teresa;
Revista Portuguesa de Pneumologia , 2007,
Abstract: pediatric management of complicated pleural effusion (cpe) remains controversial. different approaches include antibiotics and chest tube drainage alone or the use of fibrinolitics, videothorascoscopy (vtc) and surgical decortication through thoracotomy. the aim of the present study was to review, evaluate and update technical approach to cpe. we retrospectively reviewed the clinical files of children admitted to the pediatric respiratory ward between 1992 and 2003 with the diagnosis of cpe. twenty-five patients were included [15 male (60%)]. mean (±sd) age was 37,4 (±37,0) months. bacteria were identified in 17/25 (68%) [s. aureus in 6/17 (35%), st. pneumoniae in 5/17 (29%)], 16/17 (94%)in the pleural fluid. twenty-five children were treated with antibiotics and thoracocentesis (100%). chest tube drainage was required in 22/25 (88%) with mean (±dp) duration of 14,2 (±7,8) days. fibrinolitics were employed in 1 only case and surgical decortication in 11/25 (44%). one patient (4%) was submitted to primary vtc. median length of stay was 30,4 (±15,1) days and no deaths were recorded. center skills in cpe management are critical on the choice of the technique and the timing of approach. this seems to influence immediate prognosis
Auditory evoked potentials in peripheral vestibular disorder individuals
Matas, Carla Gentile,Silva, Sara Manami,Wen, Débora Dong Mei,Nunes, Cristiane da Silva
International Archives of Otorhinolaryngology , 2011,
Abstract: Introduction: The auditory and vestibular systems are located in the same peripheral receptor, however they enter the CNS and go through different ways, thus creating a number of connections and reaching a wide area of the encephalon. Despite going through different ways, some changes can impair both systems. Such tests as Auditory Evoked Potentials can help find a diagnosis when vestibular alterations are seen. Objective: describe the Auditory Evoked Potential results in individuals complaining about dizziness or vertigo with Peripheral Vestibular Disorders and in normal individuals having the same complaint. Methods: Short, middle and long latency Auditory Evoked Potentials were performed as a transversal prospective study. Conclusion: individuals complaining about dizziness or vertigo can show some changes in BAEP (Brainstem Auditory Evoked Potential), MLAEP (Medium Latency Auditory Evoked Potential) and P300.
Eletroencefalograma processado em crian as anestesiadas com sevoflurano. é possível?
Nunes Rogean Rodrigues,Cavalcante Sara Lúcia,Gemal Alberto Esteves,Amorim Domingos Gerson de Sabóia
Revista Brasileira de Anestesiologia , 2003,
Abstract: JUSTIFICATIVA E OBJETIVOS: O índice bispectral (BIS) tem sido indicado como um substrato importante na mensura o do efeito hipnótico de drogas anestésicas. No entanto, existem apenas dados limitados do uso do EEG em crian as durante anestesia. O objetivo deste estudo é avaliar, em crian as, as mudan as no BIS, SEF95%, amplitude relativa na banda de freqüência delta (d%) e taxa de supress o de surtos (TS), correlacionando com variáveis farmacodinamicas do sevoflurano (CE e CE/CAM), comparando-as com o adulto. MéTODO: Participaram do estudo, 100 pacientes de ambos os sexos, com idades entre 0 e 40 anos, estado físico ASA I e II. Todos os pacientes foram induzidos com sevoflurano, sendo utilizado bloqueador neuromuscular quando o BIS atingiu 30, sendo estratificados em 5 grupos: GI (20) - idade entre 0 e 6 meses; GII (20) - idade > 6 meses até 2 anos; GIII (20) - idade > 2 anos até 12 anos; GIV (20) - idade > 12 anos até 18 anos e GV (20) - idade > 18 anos até 40 anos. Em cada grupo, 5 momentos foram avaliados: M1 (alerta); M2 (BIS 60); M3 (BIS 50); M4 (BIS 40) e M5 (despertar), sendo, em todos os momentos, anotados os seguintes parametros: PAS, PAD, FC, BIS, SEF95%, d%, taxa de supress o de surtos, CE e CE/CAM. RESULTADOS: Os valores de BIS e SEF95% apresentaram correla o direta com a CE/CAM do sevoflurano a valores de BIS de 40, 50, 60 e despertar, respeitando-se a CAM para idade p > 0,05). A d%, no GI, apresentou valores superiores a todos os outros grupos, nos cinco momentos (p < 0,05). CONCLUS ES: O BIS e SEF95% podem ser utilizados na monitoriza o da profundidade da anestesia com sevoflurano em crian as de 0 a 12 anos observando-se os mesmos parametros sugeridos para adultos. O mesmo n o acontece com a d%, a qual mostrou varia es dependentes, provavelmente, da matura o cerebral.
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