RESUMO
The aims of this study were to analyse the occurrence of aflatoxins, aflatoxin M1 (AFM1), fumonisins, ochratoxin A (OTA), patulin (PAT), zearalenone (ZEN) and deoxynivalenol (DON) in foodstuffs consumed in Chile between 2008 and 2017 and to estimate the contribution of main contaminated foodstuff in human exposure by the probable daily intake (PDI) estimation. In 9 years of surveillance, 2020 food samples were analysed with an occurrence of 18.2% and with 2.7% of the samples being over the Chilean regulation. The occurrence of mycotoxins in food were 16% for aflatoxins, 6% for AFM1, 30% for OTA, 12% for DON, 7% for PAT, 21% for fumonisins and 2% for ZEN. The estimated median PDI of DON because of bread consumption was 129.2 ng/kg bw/day for children and 96.0 ng/kg bw/day in adults. Median PDI because of capsicum consumption was 0.006 ng/kg bw/day for OTA and 0.005 ng/kg bw/day for aflatoxins. Median PDI of aflatoxins was estimated at 0.02 ng/kg bw/day for spices and 0.04 ng/kg bw/day for nuts consumption. In children, the median PDI of AFM1 for dairy consumption was 0.07 ng/kg bw/day. The derived margin of exposure (MoE) values ranged from 1133 to 8500 suggested that aflatoxins would be of public health concern. The PDI of the other mycotoxins did not show a health risk. This is the first survey of mycotoxins in food made in Chile; further research is needed to improve surveillance and guidelines based on national risk assessments and considering sensitive population groups.
Assuntos
Aflatoxinas/análise , Análise de Alimentos , Contaminação de Alimentos/análise , Micotoxinas/análise , Adolescente , Adulto , Idoso , Criança , Pré-Escolar , Chile , Dieta , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Medição de Risco , Adulto JovemRESUMO
Caligidosis and Piscirickettsiosis are currently the most important sanitary challenges for the Chilean salmon industry. Caligidosis is caused by the ectoparasite, Caligus rogercresseyi and Piscirickettsiosis is caused by the intracellular bacterium, Piscirickettsia salmonis. Both diseases are highly prevalent and widely distributed in farming areas in Chile. The co-occurrence of the two diseases is frequently reported on salmon farms. However, there is little epidemiological evidence as to whether these two diseases are associated and generate interactive effects. This study was undertaken to evaluate the potential effects of C. rogercresseyi infestation on P. salmonis-attributed mortalities in farmed salmonids in Chile. Using a linear regression model, the potential association between the mean abundance of adult C. rogercresseyi in a period of 10 weeks and Piscirickettsiosis cumulative mortalities observed in the following 10 weeks was evaluated, while controlling for important confounders. These two 10-week windows were set around the time-point at which Piscirickettsiosis weekly mortality exceeded 0.1% for the first time in a production cycle. We found that the mean abundance of adult C. rogercresseyi was significantly associated with the Piscirickettsiosis cumulative mortality, suggesting the two diseases have a synergistic relationship. This relationship was of the same intensity in Atlantic salmon and rainbow trout. Our findings highlight the importance of taking effective control measures for C. rogercresseyi as a part of the strategies in place to reduce P. salmonis-attributed mortalities on salmon farms in Chile.
Assuntos
Doenças dos Peixes/microbiologia , Doenças dos Peixes/mortalidade , Infestações por Piolhos/veterinária , Infecções por Piscirickettsiaceae/veterinária , Salmonidae/microbiologia , Animais , Chile/epidemiologia , Doenças dos Peixes/parasitologia , Pesqueiros , Infestações por Piolhos/microbiologia , Infestações por Piolhos/mortalidade , Modelos Lineares , Ftirápteros , Piscirickettsiaceae/isolamento & purificação , Infecções por Piscirickettsiaceae/mortalidade , Infecções por Piscirickettsiaceae/parasitologiaRESUMO
In the biopharmaceutical sector, Chinese hamster ovary (CHO) cells have become the host of choice to produce recombinant proteins (r-proteins) due to their capacity for correct protein folding, assembly, and posttranslational modification. However, the production of therapeutic r-proteins in CHO cells is expensive and presents insufficient production yields for certain proteins. Effective culture strategies to increase productivity (qp) include a high glucose concentration in the medium and mild hypothermia (28-34 °C), but these changes lead to a reduced specific growth rate. To study the individual and combined impacts of glucose concentration, specific growth rate and mild hypothermia on culture performance and cell metabolism, we analyzed chemostat cultures of recombinant human tissue plasminogen activator (rh-tPA)-producing CHO cell lines fed with three glucose concentrations in feeding media (20, 30 and 40 mM), at two dilution rates (0.01 and 0.018 1/h) and two temperatures (33 and 37 °C). The results indicated significant changes in cell growth, cell cycle distribution, metabolism, and rh-tPA productivity in response to the varying environmental culture conditions. High glucose feed led to constrained cell growth, increased specific rh-tPA productivity and a higher number of cells in the G2/M phase. Low specific growth rate and temperature (33 °C) reduced glucose consumption and lactate production rates. Our findings indicated that a reduced specific growth rate coupled with high feed glucose significantly improves r-protein productivity in CHO cells. We also observed that low temperature significantly reduced qp, but not cell growth when dilution rate was manipulated, regardless of the glucose concentration or dilution rate. In contrast, we determined that feed glucose concentration and consumption rate were the dominant aspects of the growth and productivity in CHO cells by using multivariate analysis.
Assuntos
Proliferação de Células/efeitos dos fármacos , Temperatura Baixa , Glucose/farmacologia , Proteínas Recombinantes/biossíntese , Animais , Células CHO , Técnicas de Cultura de Células , Ciclo Celular/efeitos dos fármacos , Cricetulus , Humanos , Hipotermia , Análise de Componente Principal , Proteínas Recombinantes/genética , Ativador de Plasminogênio Tecidual/biossíntese , Ativador de Plasminogênio Tecidual/genéticaRESUMO
Strains of Shiga toxin-producing Escherichia coli (STEC) can cause the severe Hemolytic Uremic Syndrome (HUS). Shiga toxins are protein toxins that bind and kill microvascular cells, damaging vital organs. No specific therapeutics or vaccines have been licensed for use in humans yet. The most common route of infection is by consumption of dairy or farm products contaminated with STEC. Domestic cattle colonized by STEC strains represent the main reservoir, and thus a source of contamination. Outer Membrane Vesicles (OMV) obtained after detergent treatment of gram-negative bacteria have been used over the past decades for producing many licensed vaccines. These nanoparticles are not only multi-antigenic in nature but also potent immunopotentiators and immunomodulators. Formulations based on chemical-inactivated OMV (OMVi) obtained from a virulent STEC strain (O157:H7 serotype) were found to protect against pathogenicity in a murine model and to be immunogenic in calves. These initial studies suggest that STEC-derived OMV has a potential for the formulation of both human and veterinary vaccines.
Assuntos
Doenças dos Bovinos/prevenção & controle , Micropartículas Derivadas de Células/imunologia , Infecções por Escherichia coli/veterinária , Vacinas contra Escherichia coli/imunologia , Escherichia coli Shiga Toxigênica/imunologia , Animais , Bovinos , Composição de Medicamentos , Infecções por Escherichia coli/imunologia , Infecções por Escherichia coli/microbiologia , Infecções por Escherichia coli/prevenção & controle , Vacinas contra Escherichia coli/administração & dosagem , Camundongos Endogâmicos BALB C , Modelos AnimaisRESUMO
OBJECTIVE: To compare models of the postoperative hospital treatment phase after myocardial revascularization. DESIGN: A pilot randomized controlled trial. SETTING: Hospital patients in a hospital setting. SUBJECTS: Thirty-two patients with indications for myocardial revascularization were included between January 2008 and December 2009, with a left ventricular ejection fraction (LVEF) ≥50%, 1-second forced expiratory volume (FEV(1)) ≥60 and forced vital capacity (FVC) ≥60% of predicted value. INTERVENTIONS: Patients were randomly placed into two groups: one performed prescribed exercises according to the model proposed by the American College of Sports Medicine (ACSM) and the other according to a periodized model. MAIN MEASURES: Partial pressure of O(2) (P o (2)) and arterial O(2) saturation (Sao (2)), percentage of predicted FVC and total distance on the six-minute walking test (6MWT). RESULTS: Twenty-seven patients were re-evaluated upon release from the hospital (ACSM = 14 and PP = 13). Five patients extubated for more than 6 hours in the postoperative period were excluded from the sample. In the preoperative period the variables P o (2), Sao (2), % FVC and 6MWT were similar. In the postoperative period, a reduction was observed for all parameters in both groups. Upon comparison of the groups, a difference was observed in P o (2) (ACSM = 68.0 ± 4.3 vs. PP = 75.9 ± 4.8 mmHg; P < 0.001), Sao (2) (ACSM = 93.5 ± 1.4 vs. PP = 94.8 ± 1.2%; P = 0.018) and 6MWT (ACSM = 339.3 ± 41.7 vs. PP = 393.8 ± 25.7 m; P < 0.001). There was no difference in % FVC. CONCLUSION: Patients after myocardial revascularization following a periodized model of exercise presented a better intra-hospital evolution when compared to those using the ACSM model.
Assuntos
Terapia por Exercício/métodos , Tolerância ao Exercício , Revascularização Miocárdica/reabilitação , Idoso , Brasil , Humanos , Pacientes Internados , Pessoa de Meia-Idade , Consumo de Oxigênio/fisiologia , Projetos Piloto , Período Pós-Operatório , Espirometria , Resultado do Tratamento , Capacidade Vital/fisiologia , Caminhada/fisiologiaRESUMO
Cardiac rehabilitation protocols applied during the in-hospital phase (phaseâ I) are subjective and their results are contested when evaluated considering what should be the three basic principles of exercise prescription: specificity, overload and reversibility. In this review, we focus on the problems associated with the models of exercise prescription applied at this early stage in-hospital and adopted today, especially the lack of clinical studies demonstrating its effectiveness. Moreover, we present the concept of "periodization" as a useful tool in the search for better results.
RESUMO
OBJECTIVE: To evaluate the antioxidant effects of synovial fluid (SF) pooled from metacarpophalangeal joints of healthy horses and horses with various pathological conditions, and to compare then with the antioxidant effects of hyaluronic acid (HA) and chondroitin sulfate (CS). SAMPLE POPULATION: SF from 1 metacarpophalangeal joint was obtained from 42 horses immediately after humane slaughter. Samples were classified into 3 groups on the basis of origin: healthy joints or joints with chronically damaged cartilage or vascularly congested synovial membranes as detected via macroscopic evaluation. PROCEDURES: Antioxidant effects were evaluated by use if rat liver microsomal fractions treated with Fe(3+)-ascorbate as a free radical generator system leading to oxidative stress. Amounts of thiobarbituric-reactive substances and glutathione transferase (GSH-T) conjugation activity were measured. RESULTS: SF from healthy and chronically damaged joints inhibited microsomal lipid peroxidation, whereas SF from joints with congested synovial membranes had only a slight effect. Hyaluronic acid and CS did not inhibit microsomal lipid peroxidation. Moreover, GSH-T activity was detected in all SF samples as well as HA and CS protected rat microsomal GSH-T activity against oxidative damage. Only SF samples from joints with congested synovial membranes protected microsomal thiols against oxidation, an effect also evident with HA and CS. CONCLUSIONS AND CLINICAL RELEVANCE: The antioxidant mechanisms associated with the response to metacarpophalangeal joint damage in horses appeared to act on different targets, depending on whether the damage was acute or chronic.
Assuntos
Sulfatos de Condroitina/farmacologia , Cavalos/fisiologia , Ácido Hialurônico/farmacologia , Microssomos Hepáticos/metabolismo , Líquido Sinovial/fisiologia , Animais , Antioxidantes/metabolismo , Antioxidantes/farmacologia , Glutationa Transferase/metabolismo , Peroxidação de Lipídeos/efeitos dos fármacos , Masculino , Ratos , Ratos Sprague-DawleyRESUMO
Glutathione S-transferases (GSTs) are isoenzymes occurring in the cytoplasm and as integral membrane proteins. In addition to their role in drug metabolism by conjugating electrophilic and lipophilic compounds with glutathione (GSH), these enzymes display multiple functions in cells, including antioxidant action. It has been generalized that reactive oxygen species (ROS) inhibit cytosolic GSTs and activate microsomal GSTs; some evidence shows, however, that different ROS-generating systems can inhibit microsomal GST activity. We therefore tested the effect of Fe3+/ascorbate, another ROS-generating system, on cytosolic and microsomal GST activities from rat liver cytosol and microsomes, respectively, and compared it to that of hydrogen peroxide (H2O2). We found that, while both agents displayed similar inhibitory effects on cytosolic GST activity, they promoted opposite effects on microsomal GST activity. Using specific antioxidant enzymes, we corroborated that the effect of Fe3+/ascorbate involves generation of O2(.-) without dismutation into H2O2. Since these ROS have physicochemical properties and redox potentials that are very distinct, their reactivity is different, and their oxidative action is likely to have different targets. We discuss how these properties are related with the oxidative potency of ROS, especially those of O2(.-) and H2O2.
Assuntos
Citosol/enzimologia , Glutationa Transferase/metabolismo , Peróxido de Hidrogênio/farmacologia , Fígado/enzimologia , Microssomos Hepáticos/enzimologia , Oxidantes/farmacologia , Superóxidos/farmacologia , Animais , Citosol/efeitos dos fármacos , Citosol/metabolismo , Masculino , Microssomos Hepáticos/efeitos dos fármacos , Microssomos Hepáticos/metabolismo , Ratos , Ratos Sprague-Dawley , Espécies Reativas de Oxigênio/metabolismoRESUMO
Immunomodulatory effects of chemicals adsorbed to particles with aerodynamic diameter below 0.49 microm (PM(0.5)) collected in winter 2001 at three sampling points (industrial area [LPIn], traffic-influenced urban area [LPCi], and control area [LPCo]) of La Plata, Argentina, were investigated. The sampling of particulate matter was carried out with high-volume collectors using cascade impactors. PM(0.5)-adsorbed compounds were hexane-extracted by accelerated solvent extraction. For immunological investigations, human peripheral blood lymphocytes were activated by phytohemagglutinin and exposed to dimethyl-sulfoxide dilutions of PM(0.5)-extracts for 24h. Vitality/proliferation was quantified using MTT, released interferon-gamma (IFN-gamma) and interleukin-4 (IL-4) by ELISA. Cytokine production but not vitality/proliferation was significantly suppressed by all of the highest extract concentrations. Generally, suppression of IFN-gamma by PM(0.5)-extracts was stronger than those of IL-4. Based on administered mass of PM(0.5), all extracts suppressed IFN-gamma production nearly uniform. Contrary, LPCi-extracts exerted maximum IFN-gamma suppression based either on air volume or regarding PM(0.5)-adsorbed PAH. Also the ranking of PM(0.5)-associated effects on IL-4 production differs in dependence of the chosen reference points, either mass or [microg/ml] or air volume [m(3)/ml] related dust quantities in cell culture. Based on the corresponding air volume, LPCi-extracts inhibited IL-4 production to the maximum extend, whereas suppression of IL-4 was comparable based on concentrations. This indicates that not only the disparate PM(0.5)-masses in air cause varying impacts, but also that disparities in PM(0.5)-adsorbed chemicals provoke different effects on immune responses and shifts in the regulatory balance that might have implications for allergy and cancer development.
Assuntos
Poluentes Ocupacionais do Ar/toxicidade , Poluentes Atmosféricos/toxicidade , Fatores Imunológicos , Nanopartículas/toxicidade , Argentina , Citocinas/biossíntese , Relação Dose-Resposta a Droga , Poeira/análise , Ensaio de Imunoadsorção Enzimática , Humanos , Imunidade Celular/efeitos dos fármacos , Interferon gama/biossíntese , Interleucina-4/biossíntese , Monócitos/efeitos dos fármacos , Tamanho da Partícula , Fito-Hemaglutininas/farmacologia , Hidrocarbonetos Policíclicos Aromáticos/análise , Hidrocarbonetos Policíclicos Aromáticos/toxicidade , Saúde da População Rural , Espectrometria de Fluorescência , Linfócitos T Auxiliares-Indutores/efeitos dos fármacos , Linfócitos T Auxiliares-Indutores/metabolismo , Sais de Tetrazólio , Tiazóis , Saúde da População UrbanaRESUMO
BACKGROUND: Epidemiologic studies show statistical associations between levels of air pollutants and respiratory outcomes. OBJECTIVE: We sought to determine the effects of exposure to petrochemical pollution on the respiratory health of children. METHODS: Children aged 6 to 12 years living close to the petrochemical plants in La Plata, Argentina (n = 282), were compared with those living in a region with exposure to heavy traffic (n = 270) or in 2 relatively nonpolluted areas (n = 639). Parents answered a validated questionnaire providing health and demographic data. A random sample (n = 181) had lung function measured. Particulate matter and outdoor and indoor volatile organic compound levels were measured during 4-week study periods and reported as overall means for each study area. RESULTS: Children living near the petrochemical plant had more asthma (24.8% vs 10.1% to 11.5%), more asthma exacerbations (6.7 vs 2.9-3.6 per year), more respiratory symptoms (current wheeze, dyspnea, nocturnal cough, and rhinitis), and lower lung function (>13% decrease in FEV(1) percent predicted) than those living in other regions. Length of residence in the area was a significant risk factor, but age, sex, body mass index, proximity to busy roads and other nonpetrochemical industries, length of breast-feeding, and socioeconomic and demographic characteristics of children or their families were not. CONCLUSION: Exposure to particulate matter and volatile organic compounds arising from petrochemical plants but not from high traffic density was associated ith worse respiratory health in children.
Assuntos
Poluição do Ar , Asma/fisiopatologia , Petróleo/toxicidade , Alcanos/toxicidade , Argentina/epidemiologia , Asma/epidemiologia , Criança , Cicloparafinas/toxicidade , Feminino , Humanos , Hidrocarbonetos Aromáticos/toxicidade , Masculino , Inquéritos e QuestionáriosRESUMO
El impacto de la exposición a contaminantes ambientales sobre la salud humana ha sido ampliamente investigado, encontrándose que muchos problemas de salud están relacionados con la contaminación del aire. En el presente trabajo se analizan los resultados obtenidos de un relevamiento empleando cuestionarios epidemiológicos a niños en edad pre-escolar de la ciudad de La Plata, capital de la Provincia de Buenos Aires, Argentina, y sus alrededores. Para el estudio se consideraron cuatro zonas, una típicamente urbana, otra con influencia industrial, otra de característica semi-rural y una residencial. Los resultados obtenidos evidencian, en cuanto a las enfermedades asociadas a las zonas en estudio, correlaciones significativas entre la zona industrial y dos tipos de afecciones: bronquitis crónica y piel fotosensible. Estos resultados están en concordancia con el elevado nivel de partículas, compuestos orgánicos asociados con las mismas y compuestos orgánicos volátiles hallados en la zona industrial en comparación con las zonas control. Otras correlaciones significativas encontradas se refieren a mayor predisposición a padecer bronquitis en la población que utiliza querosén como combustible para cocinar y calefacción doméstica y el desarrollo de bronquiolitis en zonas con tránsito vehicular congestionado. Estos resultados contribuyen con información de base de gran utilidad para contextualizar futuros estudios epidemiológicos en la región.
The influence of air pollution on human health has been studied during the last decades. In this sense, several epidemiological studies have shown an association between air pollutants and various diseases. In the present study an epidemiological questionnaire was applied to a population of children between 3 and 6 years of La Plata and its neighbouring areas, in Buenos Aires, Argentina. Four different areas were considered: urban, industrial, semi-rural and residential. Results show significant correlations between industrial area and chronic bronchitis and skin photosensitivity. These results depend on the high levels of particles, organic compounds bound to particles and volatile organic compounds found in the industrial area compared to control zones. Other significant correlations are related to the use of kerosene for heating and cooking, and a predisposition to develop bronchitis. Besides, the analyses of questionnaires show a correlation between bronchiolitis and heavy traffic. This investigation contributes with preliminary information to future epidemiological studies in the region.
Assuntos
Humanos , Masculino , Feminino , Pré-Escolar , Saúde Ambiental , Poluição do Ar/estatística & dados numéricos , Poluentes Ambientais/efeitos adversos , Argentina , Pólen , Bronquite/epidemiologia , Bronquiolite/epidemiologia , Poluição do ArRESUMO
BACKGROUND: Pulmonary complications are important causes of morbidity and fatalities among patients subject to cardiac surgery. The respiratory physiotherapy has been aiding in the recovery of these patient ones. OBJECTIVE: To evaluate the physiotherapeutic effect of intermittent positive pressure breathing (IPPB) and incentive spirometry (IS) in patients submitted to myocardial revascularization surgery. METHODS: Forty patients were divided in two groups: one was submitted to IPPB (n=20) and the other to IS (n=20). The patients were evaluated at the preoperative period and 24, 48 and 72 hours postoperatively, with the resources being applied in the postoperative period. The following parameters were analyzed: oxygen saturation (SpO2), respiratory frequency (RF), minute volume (MV), current volume (CV), maximum inspiratory pressure (Ip max) and maximum expiratory pressure (Ep max). RESULTS: The groups were considered homogeneous regarding the demographic and clinical variables. In the group submitted to IPPB, an increase in SpO2 was observed 48 (p=0.007) and 72 h (p=0.0001) after surgery, when compared to the IS group. As for the RF, MV and CV variables, there were no statistically significant differences between the groups. The group submitted to IS showed a significant increase in the Epmax 24 (p=0.02) and 48 (p=0.01) h after surgery. CONCLUSION: Aiming at reversing hypoxemia earlier, IPPB showed to be more efficient when compared to IS; however, IS was more effective in improving respiratory muscle strength.
Assuntos
Respiração com Pressão Positiva Intermitente , Revascularização Miocárdica , Espirometria/métodos , Feminino , Humanos , Hipóxia/terapia , Masculino , Pessoa de Meia-Idade , Revascularização Miocárdica/efeitos adversos , Oxigênio/sangue , Período Pós-Operatório , Cuidados Pré-Operatórios , Pressão , Estudos Prospectivos , Respiração , Músculos Respiratórios/fisiopatologia , Estatísticas não Paramétricas , Fatores de TempoRESUMO
FUNDAMENTO: As complicações pulmonares são causas freqüentes do aumento de morbi-mortalidade nos pacientes submetidos à cirurgia cardíaca. A fisioterapia respiratória tem auxiliado na recuperação destes pacientes. OBJETIVO: Analisar o efeito fisioterapêutico da aplicação da pressão positiva intermitente (RPPI) e do incentivador respiratório (IR) em pacientes submetidos a cirurgia de revascularização do miocárdio. MÉTODOS: Quarenta pacientes foram divididos em dois grupos: um submetido à aplicação do RPPI (n=20) e o outro ao IR (n=20). Os pacientes foram avaliados nos momentos: pré-operatório, 24ª, 48ª e 72ª horas de pós-operatório, sendo aplicados os recursos no período pós-operatório. Analisaram-se os seguintes parâmetros: saturação de oxigênio (SpO2), freqüência respiratória (FR), volume minuto (VM), volume corrente (VC), pressão inspiratória máxima (Pi máx) e pressão expiratória máxima (Pe máx). RESULTADOS: Nas variáveis demográficas e clínicas os grupos foram considerados homogêneos. No grupo submetido à aplicação com o RPPI identificou-se aumento da SpO2 na 48ª (p=0,007) e na 72ª horas (p=0,0001) quando comparado ao grupo IR. Nos parâmetros: FR, VM e VC na comparação entre os grupos não foram encontradas diferenças estatisticamente significativas. No grupo submetido ao IR a Pe máx na 24ª (p=0,02) e na 48ª (p=0,01) horas apresentaram um aumento significativo. CONCLUSÃO: Com o objetivo de reverter mais precocemente a hipoxemia, o RPPI mostrou-se mais eficiente em comparação ao IR; entretanto, para melhorar a força dos músculos respiratórios, o IR foi mais efetivo.
BACKGROUND: Pulmonary complications are important causes of morbidity and fatalities among patients subject to cardiac surgery. The respiratory physiotherapy has been aiding in the recovery of these patient ones. OBJECTIVE: To evaluate the physiotherapeutic effect of intermittent positive pressure breathing (IPPB) and incentive spirometry (IS) in patients submitted to myocardial revascularization surgery. METHODS: Forty patients were divided in two groups: one was submitted to IPPB (n=20) and the other to IS (n=20). The patients were evaluated at the preoperative period and 24, 48 and 72 hours postoperatively, with the resources being applied in the postoperative period. The following parameters were analyzed: oxygen saturation (SpO2), respiratory frequency (RF), minute volume (MV), current volume (CV), maximum inspiratory pressure (Ip max) and maximum expiratory pressure (Ep max). RESULTS: The groups were considered homogeneous regarding the demographic and clinical variables. In the group submitted to IPPB, an increase in SpO2 was observed 48 (p=0.007) and 72 h (p=0.0001) after surgery, when compared to the IS group. As for the RF, MV and CV variables, there were no statistically significant differences between the groups. The group submitted to IS showed a significant increase in the Epmax 24 (p=0.02) and 48 (p=0.01) h after surgery. CONCLUSION: Aiming at reversing hypoxemia earlier, IPPB showed to be more efficient when compared to IS; however, IS was more effective in improving respiratory muscle strength.
Assuntos
Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Respiração com Pressão Positiva Intermitente , Revascularização Miocárdica , Espirometria/métodos , Hipóxia/terapia , Revascularização Miocárdica/efeitos adversos , Oxigênio/sangue , Período Pós-Operatório , Cuidados Pré-Operatórios , Pressão , Estudos Prospectivos , Respiração , Músculos Respiratórios/fisiopatologia , Estatísticas não Paramétricas , Fatores de TempoRESUMO
OBJECTIVE: To compare the effect of the use of intermittent and continuous positive airway pressure in postoperative patients undergoing coronary artery bypass grafting. METHODS: This study included forty patients divided into two groups: one undergoing continuous positive airway pressure (CPAP Group), and the other undergoing intermittent pressure (Müller Resuscitator Group). The patients were evaluated in relation to the several study variables at the following time points: preoperative, 3rd, 24th, and 48th hours. RESULTS: The patient groups were homogeneous in relation to the several demographic and clinical variables. The values of pO2, pCO2 and sO2 were within normal limits and no significant differences were found between the groups. Regarding respirometry, the groups showed significant differences in the tidal volume and respiratory rate at the 48th postoperative hour. Dyspnea and use of accessory muscle in postoperative assessments were found with a significantly higher frequency in patients undergoing CPAP. Patients undergoing Müller Resuscitator had a normal chest radiograph more frequently than did patients undergoing CPAP. CONCLUSION: Both devices were shown to be able to keep pO2, pCO2, and sO2 values within normal limits. However, when the objective was pulmonary reexpansion with less imposed workload, the Müller Resuscitator was more effective because of its prompter action and consequently lower levels of dyspnea, respiratory rate (RR) and use of accessory muscle were observed.
Assuntos
Pressão Positiva Contínua nas Vias Aéreas/normas , Ponte de Artéria Coronária , Respiração com Pressão Positiva Intermitente/normas , Desmame do Respirador/normas , Pressão Positiva Contínua nas Vias Aéreas/efeitos adversos , Feminino , Humanos , Concentração de Íons de Hidrogênio , Respiração com Pressão Positiva Intermitente/efeitos adversos , Masculino , Pessoa de Meia-Idade , Período Pós-Operatório , Estudos Prospectivos , Estatísticas não Paramétricas , Volume de Ventilação Pulmonar , Fatores de TempoRESUMO
OBJETIVO: Comparar o efeito da aplicação da pressão positiva intermitente e contínua em pacientes no pós-operatório de cirurgia de revascularização do miocárdio. MÉTODOS: Neste estudo foram considerados quarenta pacientes, divididos em dois grupos: um submetido a pressão positiva contínua (Grupo CPAP), e outro submetido a pressão intermitente (Grupo Reanimador de Müller). Os pacientes foram avaliados nos momentos: pré-operatório, 3ª, 24ª e 48ª horas, em relação às diversas variáveis do estudo. RESULTADOS: Os grupos de pacientes eram homogêneos em relação a diversas variáveis demográficas e clínicas. Os valores gasométricos de PO2, PCO2 e SO2 estiveram dentro dos parâmetros de normalidade e não foram encontradas diferenças significantes entre os grupos. Na ventilometria os grupos apresentaram diferenças significativas no volume corrente e freqüência respiratória no pós-operatório de 48 horas. A dispnéia e a participação da musculatura acessória, nas avaliações do pós-operatório, foram encontradas com freqüência significativamente maior nos pacientes submetidos ao CPAP. Pacientes submetidos ao Reanimador de Müller apresentaram radiografia de tórax normal com maior freqüência do que pacientes submetidos ao CPAP. CONCLUSÃO: Observou-se que ambos os recursos foram capazes de manter valores de PO2, PCO2 e SO2 dentro da normalidade. Porém, quando se busca a reexpansão pulmonar, com menor carga de trabalho imposta, o Reanimador de Müller foi mais efetivo pela forma mais rápida de ação e, conseqüentemente, apresentou menores índices de dispnéia, freqüência respiratória (FR) e atividade de musculatura acessória.
Assuntos
Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Ponte de Artéria Coronária , Pressão Positiva Contínua nas Vias Aéreas/normas , Respiração com Pressão Positiva Intermitente/normas , Desmame do Respirador/normas , Pressão Positiva Contínua nas Vias Aéreas/efeitos adversos , Concentração de Íons de Hidrogênio , Respiração com Pressão Positiva Intermitente/efeitos adversos , Período Pós-Operatório , Estudos Prospectivos , Estatísticas não Paramétricas , Volume de Ventilação Pulmonar , Fatores de TempoRESUMO
This study takes into consideration an analysis of the chemical polycyclic aromatic hydrocarbon (PAH) profile and its distribution in inhalable and respirable particulate matter in urban and industrial areas in La Plata, Argentina, and Leipzig, Germany. Representative samples from three locations in La Plata (industrial, traffic influenced and control area) and two locations in Leipzig (traffic influenced and control area) were obtained in summer and winter. The sampling of particulate matter was carried out with high volume collectors using cascade impactors to separate six size fractions. PAHs were extracted with hexane through a solid-liquid equilibrium extraction and analysed by HPLC/UV/fluorescence detection. The results showed a PAH seasonal behaviour in both regions, with lower contents in summer and higher ones in winter. Highest concentrations of total PAHs were found in the industrial area in La Plata. The size distribution of particles demonstrates the greater relevance of smaller particles. More than 50% of PAHs were associated with particles of less than 0.49 microm. Moreover, this particle size fraction was associated with traffic, whereas other sources of combustion were related also to particles between 0.49 and 0.95 microm. Considering the ratio of benzo(ghi)perylene (BgP)/benzo(a)pyrene (BaP) as an indicator for traffic influence, it was observed that La Plata City was more affected than Leipzig by the same proportion in summer and in winter. The BgP/InP (indeno(123-cd)pyrene) ratio was lower in winter than in summer in both places and indicates the presence of domestic combustion sources. It is important to point out the significance of using fingerprint compound ratios to identify possible sources of pollution with PAHs bound to particles.
Assuntos
Poluentes Atmosféricos/análise , Poeira/análise , Hidrocarbonetos Policíclicos Aromáticos/análise , Argentina , Cidades , Monitoramento Ambiental , Alemanha , Calefação , Indústrias , Tamanho da Partícula , Petróleo , Centrais Elétricas , Estações do Ano , Emissões de VeículosRESUMO
O Reanimador de Muller foi por nós desenvolvido na Santa Casa de Misericórdia de Curitiba em 1991, após vivenciarmos ano á ano as dificuldades respiratórias em pacientes portadores das mais diversas afecçöes pulmonares. O Reanimador de Muller passou entäo a se constituir em mais um recurso em nosso serviço, e com o passar do tempo se tornou um recurso indispensável em nossa rotina diária, principalmente em pacientes em pós operatório de cirurgia cardíaca que comumente apresentam distúrbios ventilatórios. Este artigo aborda a descriçäo do aparelho e suas formas de aplicaçäo
Assuntos
Especialidade de Fisioterapia , Terapia RespiratóriaRESUMO
As autoras deste trabalho, visam a apresentar aspectos básicos da atuaçäo dos diuréticos, com ênfase especial no seu poder natriurético e sua influência nas secreçöes mucociliares. O interesse gerou a necessidade de abordar detalhadamente a fisiologia das secreçöes mucociliares, aparelho mucociliar, sua funçäo e completando com a fisiologia respiratória. O objetivo deste estudo é estimular o desenvolvimento de novas pesquisas que promovam a qualidade da assistência na fisioterapia respiratória
Assuntos
Adolescente , Adulto , Pessoa de Meia-Idade , Humanos , Masculino , Feminino , Depuração Mucociliar , Diuréticos/efeitos adversos , Especialidade de Fisioterapia , Fator Natriurético Atrial , RespiraçãoRESUMO
A equipe de Fisioterapia da Irmandade Santa Casa de Misericórdia de Curitiba, Paraná, através de uma grande clientela de pacientes diabéticos, com complicaçöes sistêmicas, devido ao näo controle da doença, tentou desenvolver um estudo sobre o programa de exercícios em fase hospitalar e domiciliar. Ainda em andamento e necessários de maiores recursos englobaremos neste artigo nossos avanços sobre esta área
Assuntos
Diabetes Mellitus/terapia , Exercício Físico , Especialidade de Fisioterapia , Terapia por Exercício/métodos , Insulina/efeitos adversos , Insulina/uso terapêutico , Especialidade de Fisioterapia/efeitos adversos , Especialidade de Fisioterapia/estatística & dados numéricosRESUMO
A equipes de Fisioterapia da Irmandade Santa Casa de Misericórdia de Curitiba, Estado do Paraná, através da observaçäo de uma grande clientela de pacientes hepatopatas cirróticos-ascíticos, procurou desenvolver um protocolo de atendimento para solucionar as dificuldades de tratamento durante a fase hospitalar. Ainda em andamento e necessitando de maiores comprovaçöes estatísticas damos continuidade aos estudos apesar dos sucessos já conseguidos