RESUMO
The aim of this study was to establish an effective and safe protocol for in vivo oral candidiasis treatment with atmospheric plasma jets. A novel amplitude-modulated cold atmospheric pressure plasma jet (AM-CAPPJ) device, operating with Helium, was tested. In vitro assays with Candida albicans biofilms and Vero cells were performed in order to determine the effective parameters with low cytotoxicity. After the determination of such parameters, the protocol was evaluated in experimentally induced oral candidiasis in mice. AM-CAPPJ could significantly reduce the viability of C. albicans biofilms after 5 minutes of plasma exposure when compared to the non-exposed group (p = 0.0033). After this period of exposure, high viability of Vero cells was maintained (86.33 ± 10.45%). Also, no late effects on these cells were observed after 24 and 48 hours (83.24±15.23% and 88.96±18.65%, respectively). Histological analyses revealed significantly lower occurrence of inflammatory alterations in the AM-CAPPJ group when compared to non-treated and nystatin-treated groups (p < 0.0001). Although no significant differences among the values of CFU/tongue were observed among the non-treated group and the groups treated with AM-CAPPJ or nystatin (p = 0.3201), histological analyses revealed marked reduction in candidal tissue invasion. In conclusion, these results point out to a clinical applicability of this protocol, due to the simultaneous anti-inflammatory and inhibitory effects of AM-CAPPJ with low cytotoxicity.
Assuntos
Antifúngicos/uso terapêutico , Biofilmes/efeitos dos fármacos , Candida albicans/efeitos dos fármacos , Candidíase Bucal/tratamento farmacológico , Hélio/uso terapêutico , Gases em Plasma/uso terapêutico , Animais , Antifúngicos/administração & dosagem , Antifúngicos/farmacologia , Pressão Atmosférica , Candida albicans/fisiologia , Candidíase Bucal/microbiologia , Chlorocebus aethiops , Sistemas de Liberação de Medicamentos/instrumentação , Desenho de Equipamento , Hélio/administração & dosagem , Hélio/farmacologia , Camundongos , Gases em Plasma/administração & dosagem , Gases em Plasma/farmacologia , Células VeroRESUMO
OBJECTIVE: The objective of this study is to summarize the principal findings in the literature about acute asthma management in children. METHODS: Systematic reviews of randomized clinical trials (SRCTs) with or without meta-analysis in children (1-18 years) admitted to the emergency department (ED) were retrieved using five data bases. Methodological quality was determined using the AMSTAR tool. RESULTS: One hundred and three studies were retrieved. Among those, 28 SRCTs were included: seven SRCTs related to short-acting beta2-agonists (SABA), three to ipratropium bromide (IB), eight to corticosteroids, one to racemic adrenaline, one to leukotriene receptor antagonists (LTRA), four to magnesium sulfate, one to intravenous (IV) SABA, one to IV aminophylline, one to IV ketamine, and one to antibiotics. It was determined that administering SABA by MDI-VHC is superior to using a nebulizer, because it decreases the hospital admission rate, improves the clinical score, results in a shorter time in the ED, and causes fewer adverse effects. Levalbuterol and albuterol were similar. In patients with moderate to severe exacerbations, IB+SABA was superior to SABA, decreasing hospital admission and improving the clinical score. SABA heliox administered by nebulizer decreased exacerbation severity compared to oxygen. Inhaled corticosteroids (ICS), especially administered by nebulizer, showed results similar to oral corticosteroids (OCS) with respect to reducing hospital admission, unscheduled visits, and the requirement of additional systemic corticosteroids. ICS or OCS following ED discharge was similar with regard to relapse. Compared with a placebo, IV magnesium reduced hospital admission and improved lung function. CONCLUSIONS: SRCTs are useful for guiding decisions in acute asthma treatment.
Assuntos
Antiasmáticos/uso terapêutico , Asma/tratamento farmacológico , Broncodilatadores/uso terapêutico , Serviço Hospitalar de Emergência/organização & administração , Administração por Inalação , Adolescente , Corticosteroides/uso terapêutico , Agonistas de Receptores Adrenérgicos beta 2/uso terapêutico , Antiasmáticos/administração & dosagem , Broncodilatadores/administração & dosagem , Criança , Pré-Escolar , Doença Crônica , Esquema de Medicação , Quimioterapia Combinada , Hélio/uso terapêutico , Humanos , Lactente , Ipratrópio/uso terapêutico , Antagonistas de Leucotrienos/uso terapêutico , Nebulizadores e Vaporizadores , Oxigênio/uso terapêutico , Ensaios Clínicos Controlados Aleatórios como Assunto , Literatura de Revisão como AssuntoRESUMO
PURPOSE OF REVIEW: The purpose of this study is to highlight some of the recent findings related with the management of acute exacerbations in the context of the emergency department setting. RECENT FINDINGS: ß2-agonist heliox-driven nebulization significantly increased by 17% [95% confidence interval (CI) 5.2-29.4] peak expiratory flow, and decreased the rate of hospital admissions (risk ratio 0.77, 95% CI 0.62-0.98), compared with oxygen-driven nebulization. Other findings indicate that there is no robust evidence to support the use of intravenous or nebulized magnesium sulphate in adults with severe acute asthma, and that levalbuterol was not superior to albuterol regarding efficacy and safety in individuals with acute asthma. Finally, hyperlactatemia developed during the first hours of acute asthma treatment has a high prevalence, is related with the use of ß2-agonists and had no clinical consequences. SUMMARY: After a comprehensive review of the best quality pieces of literature published in the last year, it is possible to conclude that the goals of acute asthma management remain almost unchanged.
Assuntos
Agonistas de Receptores Adrenérgicos beta 1/administração & dosagem , Albuterol/uso terapêutico , Asma/tratamento farmacológico , Broncodilatadores/uso terapêutico , Hélio/uso terapêutico , Sulfato de Magnésio/uso terapêutico , Oxigenoterapia/métodos , Oxigênio/uso terapêutico , Doença Aguda , Agonistas de Receptores Adrenérgicos beta 1/efeitos adversos , Adulto , Asma/fisiopatologia , Medicina de Emergência Baseada em Evidências , Hospitalização/estatística & dados numéricos , Humanos , Hiperlactatemia/induzido quimicamente , Nebulizadores e Vaporizadores , Resultado do TratamentoRESUMO
BACKGROUND AND AIMS: The efficacy of a direct application of plasma needle to in vivo wound healing was experimentally studied in mice. This kind of plasma has achieved considerable success in blood coagulation and tissue restoration in mice. In the development of the present study, an argon plasma needle was chosen for coagulation purposes, whereas for healing purposes, a helium plasma needle was used. METHODS: Treatment was applied with a plasma needle produced by argon and helium to a wound induced in laboratory mice. Tissue regeneration was carried out by three argon plasma treatments with 0.5 SLPM flow for 1 min and three treatments of helium with 1.5 SLPM flow. Intervals between each treatment were 5 min and 60 min for argon and helium plasmas, respectively, thus completing a total treatment time of 180 min. Histological sections were performed to corroborate the internal bleeding and tissue regeneration. RESULTS: After three treatments with argon plasma, the blood produced in the wound was coagulated and protein material appeared. By means of treatment with helium plasma, an approach of the wound edges was produced until the conclusion thereof. These results were corroborated histologically. CONCLUSIONS: This type of acceleration during the skin wound healing process can be attributed to the formation of reactive species such as NO, which were increased in the helium plasma needle with respect to the argon plasma needle.
Assuntos
Argônio/farmacologia , Hélio/farmacologia , Agulhas , Gases em Plasma/administração & dosagem , Gases em Plasma/uso terapêutico , Pele/efeitos dos fármacos , Cicatrização/efeitos dos fármacos , Doença Aguda/terapia , Animais , Argônio/administração & dosagem , Argônio/uso terapêutico , Hélio/administração & dosagem , Hélio/uso terapêutico , Camundongos , Óxido Nítrico/metabolismo , Gases em Plasma/farmacologia , Dermatopatias/terapia , Fatores de Tempo , Cicatrização/fisiologiaAssuntos
Intubação Intratraqueal/métodos , Doença Pulmonar Obstrutiva Crônica/terapia , Respiração Artificial/métodos , Hélio/uso terapêutico , Humanos , Oxigênio/uso terapêutico , Doença Pulmonar Obstrutiva Crônica/fisiopatologia , Mecânica Respiratória/fisiologia , Fatores de Tempo , Desmame do Respirador/métodosRESUMO
La gingivitis crónica constituye una de las formas más frecuentes de enfermedad periodontal, caracterizada por la inflamación crónica de la encías, tumefacción, enrojecimiento y sangramiento. Su principal factor de riesgo lo constituye la microbiota del surco gingival, que resulta necesario, pero no suficiente para desencadenarla. Se realizó un ensayo clínico-terapéutico fase II, controlado, aleatorizado y a simple ciegas, para evaluar los efectos clínicos y microbiológicos del tratamiento combinado de la radiación láser helio-neón (He-Ne) con la clorhexidina al 0,2 por ciento. Todos los pacientes recibieron tratamiento inicial; al mes de finalizado este, se distribuyeron aleatoriamente en 2 grupos: un grupo estudio que recibió la combinación láser-neón y clorhexidina al 0,2 por ciento y otro grupo control que solo recibió clorhexidina al 0,2 por ciento. Se realizó una evaluación a los 15, 30 y 45 días, con criterios de eficacia clínicos y microbiológicos. Los resultados clínicos fueron satisfactorios en el grupo estudio con predominio de los morfotipos I, caracterizados por cocos gramnegativos y positivos, compatibles con un periodonto sano. Los eventos adversos detectados con esta terapéutica fueron mínimos, todos relacionados con la somnolencia(AU)
Chronic gingivitis is one of the most common periodontal diseases that is characterized by chronic inflammation, tumefaction, redness and bleeding. The main risk factor is gingival sulcus microbiota that is essential but not enough to unleash it. A phase II controlled randomized blind clinical/therapeutical assay was conducted to evaluate the clinical and microbiological effects of the combined treatment based on helium-neon laser (He-Ne) with 0.2 per cent chlorhexidine. All the patients were initially treated; after a month, they were randomly distributed into two groups, that is, the study group received a helium-neon laser plus 0.2 per cent chlorhexidine combination and the control group was treated with 0.2 per cent chlorhexidine only. They were evaluated at 15th, 30th and 45th days by using clinical and microbiological efficacy criteria. The clinical results were satisfactory in the study group where morphotypes I, characterized by Gram-negative and Gram-positive cocci and compatible with a healthy periodontium, prevailed . Adverse events were minimal, all of them related to somnolence(AU)
Assuntos
Humanos , Doenças Periodontais/etiologia , Clorexidina/uso terapêutico , Gengivite/terapia , Hélio/uso terapêutico , Lasers/efeitos adversos , Neônio/uso terapêutico , SonolênciaAssuntos
Humanos , Intubação Intratraqueal/métodos , Doença Pulmonar Obstrutiva Crônica/terapia , Respiração Artificial/métodos , Hélio/uso terapêutico , Oxigênio/uso terapêutico , Doença Pulmonar Obstrutiva Crônica/fisiopatologia , Mecânica Respiratória/fisiologia , Fatores de Tempo , Desmame do Respirador/métodosRESUMO
We determined the effects of helium-neon (He-Ne) laser irradiation on wound healing dynamics in mice treated with steroidal and non-steroidal anti-inflammatory agents. Male albino mice, 28-32 g, were randomized into 6 groups of 6 animals each: control (C), He-Ne laser (L), dexamethasone (D), D + L, celecoxib (X), and X + L. D and X were injected im at doses of 5 and 22 mg/kg, respectively, 24 h before the experiment. A 1-cm long surgical wound was made with a scalpel on the abdomens of the mice. Animals from groups L, D + L and X + L were exposed to 4 J (cm(2))-1 day-1 of He-Ne laser for 12 s and were sacrificed on days 1, 2, or 3 after the procedure, when skin samples were taken for histological examination. A significant increase of collagen synthesis was observed in group L compared with C (168 +/- 20 vs 63 +/- 8 mm(2)). The basal cellularity values on day 1 were: C = 763 +/- 47, L = 1116 +/- 85, D = 376 +/- 24, D + L = 698 +/- 31, X = 453 +/- 29, X + L = 639 +/- 32 U/mm(2). These data show that application of L increases while D and X decrease the inflammatory cellularity compared with C. They also show that L restores the diminished cellularity induced by the anti-inflammatory drugs. We suggest that He-Ne laser promotes collagen formation and restores the baseline cellularity after pharmacological inhibition, indicating new perspectives for laser therapy aiming to increase the healing process when anti-inflammatory drugs are used.
Assuntos
Anti-Inflamatórios/uso terapêutico , Dexametasona/uso terapêutico , Terapia com Luz de Baixa Intensidade , Pirazóis/uso terapêutico , Sulfonamidas/uso terapêutico , Cicatrização/efeitos da radiação , Animais , Celecoxib , Hélio/uso terapêutico , Masculino , Camundongos , Neônio/uso terapêutico , Cicatrização/efeitos dos fármacosRESUMO
We determined the effects of helium-neon (He-Ne) laser irradiation on wound healing dynamics in mice treated with steroidal and non-steroidal anti-inflammatory agents. Male albino mice, 28-32 g, were randomized into 6 groups of 6 animals each: control (C), He-Ne laser (L), dexamethasone (D), D + L, celecoxib (X), and X + L. D and X were injected im at doses of 5 and 22 mg/kg, respectively, 24 h before the experiment. A 1-cm long surgical wound was made with a scalpel on the abdomens of the mice. Animals from groups L, D + L and X + L were exposed to 4 J (cm²)-1 day-1 of He-Ne laser for 12 s and were sacrificed on days 1, 2, or 3 after the procedure, when skin samples were taken for histological examination. A significant increase of collagen synthesis was observed in group L compared with C (168 ± 20 vs 63 ± 8 mm²). The basal cellularity values on day 1 were: C = 763 ± 47, L = 1116 ± 85, D = 376 ± 24, D + L = 698 ± 31, X = 453 ± 29, X + L = 639 ± 32 U/mm². These data show that application of L increases while D and X decrease the inflammatory cellularity compared with C. They also show that L restores the diminished cellularity induced by the anti-inflammatory drugs. We suggest that He-Ne laser promotes collagen formation and restores the baseline cellularity after pharmacological inhibition, indicating new perspectives for laser therapy aiming to increase the healing process when anti-inflammatory drugs are used.
Assuntos
Animais , Masculino , Camundongos , Anti-Inflamatórios/uso terapêutico , Dexametasona/uso terapêutico , Terapia com Luz de Baixa Intensidade , Pirazóis/uso terapêutico , Sulfonamidas/uso terapêutico , Cicatrização/efeitos da radiação , Hélio/uso terapêutico , Neônio/uso terapêutico , Cicatrização/efeitos dos fármacosRESUMO
BACKGROUND: Helium and oxygen mixtures (heliox), have been used sporadically in respiratory medicine for decades. Their use in acute respiratory emergencies such as asthma has been the subject of considerable debate. Despite the lapse of more than 60 years since it was first proposed, the role of heliox in treating patients with severe acute asthma remains unclear. OBJECTIVES: To determine the effect of the addition of heliox to standard medical care on the course of acute asthma, as measured by pulmonary function testing and clinical endpoints. SEARCH STRATEGY: Randomised controlled trials were identified from the Cochrane Airways Group Specialised Register. In addition, we contacted primary authors and experts and searched reference lists of articles. Searches are current to August 2005. SELECTION CRITERIA: 1) randomised, single or double blind, controlled trials; 2) children or adults with a clinical diagnosis of acute asthma seen in emergency departments or equivalent acute care settings; and 3) compared treatment with inhaled heliox to placebo (oxygen or air). DATA COLLECTION AND ANALYSIS: Two review authors independently assessed the studies for inclusion and quality assessment; disagreement was resolved by a third review author and consensus. MAIN RESULTS: This review has been updated in 2006 to include four new trials giving atotal of ten trials involving 544 acute asthma patients. Seven studies involved adults and three studies dealt solely with children. Three were assessed as high quality (Jadad score > 3). Pulmonary function tests were recorded during heliox administration (15 to 60 min). Pooling of the eight trials contributing data to this review showed no significant group differences (standardised mean differences -0.28; 95% confidence interval (CI) -0.56 to 0.01). There was significant heterogeneity among the studies. Heliox use did improve pulmonary function only in the subgroup of patients with the most severe baseline pulmonary function impairment; however, this conclusion is based on a small number of studies. There were no significant differences between groups when adults versus children, and high versus low heliox dose studies were compared. Finally, at the end of treatment, participants treated with heliox showed no significant different risk of admission to hospital (RR 0.83 (95%CI 0.66 to 1.08, P = 0.17, I(2) = 0%). AUTHORS' CONCLUSIONS: The existing evidence does not provide support for the administration of helium-oxygen mixtures to all ED patients with acute asthma. At this time, heliox treatment does not have a role to play in the initial treatment of patients with acute asthma. Nevertheless, new evidence suggests certain beneficial effects in patients with more severe obstruction. Since these conclusions are based upon between-group comparisons and small studies, they should be interpreted with caution.
Assuntos
Asma/terapia , Hélio/uso terapêutico , Oxigênio/uso terapêutico , Doença Aguda , Adulto , Criança , Método Duplo-Cego , Combinação de Medicamentos , Humanos , Ensaios Clínicos Controlados Aleatórios como Assunto , Resultado do TratamentoRESUMO
OBJECTIVE: To determine whether noninvasive therapy using a helium-oxygen mixture reduces the use of positive-pressure ventilation in the treatment of respiratory failure caused by severe bronchiolitis. STUDY DESIGN: This was a multicenter, randomized, double-blind, placebo-controlled trial that recruited infants in 4 pediatric intensive care units (PICUs). A total of 39 nonintubated infants with severe bronchiolitis caused by respiratory syncytial virus (RSV) were randomly assigned within 8 hours of PICU admission to receive a helium-oxygen mixture (helium group) or an air-oxygen mixture (control group) through an inflatable head hood. The primary study outcome was the requirement for positive pressure mechanical ventilation. Results were compared using Fisher's exact test. RESULTS: No differences were noted between the control and helium groups with respect to age (1.0 vs 1.1 months), prematurity, or family history of asthma or smoking. Positive pressure ventilation was judged necessary for 4 of the 21 (19.0%) infants in the control group and in 4 of the 18 (22.2%) in the helium group (relative risk = 1.17; 95% confidence interval = 0.34 to 4.01). CONCLUSIONS: This study did not detect any differences between the patients in the helium group and the control group with respect to the rate of positive-pressure ventilation.
Assuntos
Bronquiolite Viral/terapia , Hélio/uso terapêutico , Oxigênio/uso terapêutico , Infecções por Vírus Respiratório Sincicial/terapia , Terapia Respiratória/métodos , Canadá , Método Duplo-Cego , Humanos , Lactente , Recém-Nascido , Respiração com Pressão Positiva , Resultado do TratamentoRESUMO
OBJECTIVE: To determine adherence to guidelines for severe asthma care and evaluate regional variability in practice among pediatric intensive care units (PICU). STUDY DESIGN: A retrospective cohort study of children treated for asthma in a PICU during 2000 to 2003. We utilized the Pediatric Health Information System (PHIS) database to identify patients and determine use of asthma therapies when patients did not improve with standard therapy (inhaled beta-agonists and systemic corticosteroids). RESULTS: Of 7125 children studied, 59% received inhaled anticholinergic medications. Use of other therapies included systemic beta-agonists (n = 1841 [26%]), magnesium sulfate (n = 1521 [21%]), methylxanthines (n = 426 [6%]), inhaled helium-oxygen gas mixture (heliox) (n = 740 [10%]), and endotracheal intubation with ventilation (n=1024 [14%]). Use of therapies varied by census region. Over half the patients (n = 524) who received ventilation did so for < or = 1 day. Adjusted for severity of illness, use of mechanical ventilation varied significantly by census division; however, much of the variation was among children ventilated for < or = 1 day. CONCLUSION: Adherence to national guidelines for use of inhaled anticholinergics among critically ill children is low, and marked variation in use of invasive ventilation exists. More explicit guidelines regarding indications for invasive ventilation may improve asthma care.
Assuntos
Asma/terapia , Cuidados Críticos , Padrões de Prática Médica , Antiasmáticos/uso terapêutico , Criança , Estudos de Coortes , Antagonistas de Aminoácidos Excitatórios/uso terapêutico , Feminino , Fidelidade a Diretrizes , Hélio/uso terapêutico , Humanos , Unidades de Terapia Intensiva Pediátrica , Ketamina/uso terapêutico , Masculino , Oxigênio/uso terapêutico , Guias de Prática Clínica como Assunto , Respiração Artificial , Estudos Retrospectivos , Índice de Gravidade de Doença , Estados UnidosRESUMO
BACKGROUND AND OBJECTIVES: The purpose of this study was to determine the role of helium-neon (He-Ne) laser random skin flap viability in rats. STUDY DESIGN/MATERIALS AND METHODS: Experimentally controlled randomized study. Forty-eight Wistar-EPM rats were used, weighed, and divided into 4 groups with 12 rats each. The random skin flap was performed measuring 10 x 4 cm, with a plastic sheet interposed between the flap and the donor site. The Group 1 (control) underwent sham irradiation with He-Ne laser. The Group 2 was submitted to laser irradiation, using the punctual contact technique on the skin flap surface. The Group 3 was submitted to laser irradiation surrounding the skin flap, and the Group 4 was submitted to laser irradiation both on the skin flap surface and around it. The experimental groups were submitted to He-Ne laser irradiation with 3 J/cm(2) energy density immediately after the surgery and for the four subsequent days. The percentage of necrotic area of the four groups was calculated at the 7th post-operative day, through a paper-template method. RESULTS: Group 1 reached an average necrotic area of 48.86%; Group 2, 38.67%; Group 3, 35.34%; and Group 4, 22.61%. After the statistic analysis, results showed that all experimental groups reached statistically significant values when compared to the control group, and Group 4 was the best one, when compared to all groups of this study (P<0.001). CONCLUSION: The He-Ne laser irradiation was efficient to increase random skin flap viability in rats.
Assuntos
Terapia com Luz de Baixa Intensidade/métodos , Pele/efeitos da radiação , Retalhos Cirúrgicos/irrigação sanguínea , Sobrevivência de Tecidos/efeitos da radiação , Animais , Hélio/uso terapêutico , Humanos , Masculino , Necrose/patologia , Necrose/prevenção & controle , Neônio/uso terapêutico , Gases Nobres/uso terapêutico , Ratos , Pele/irrigação sanguíneaRESUMO
STUDY OBJECTIVE: To determine the effect of the addition of heliox to standard medical care on the course of acute asthma. DESIGN: Systematic review of randomized and nonrandomized prospective, controlled trials of children and adults that compared heliox to placebo when used in conjunction with other standard acute treatments. MAIN OUTCOME MEASURES: Pulmonary function tests, hospital admissions, physiologic measures, side effects, and clinical outcomes. RESULTS: Seven trials were selected for inclusion, with a total of 392 patients with acute asthma. Six studies involved adults, and one study dealt solely with children. The main outcome variable was spirometric measurements (peak expiratory flow or FEV(1)) in six trials. Two studies evaluated the effect of heliox on airways resistance. No significant differences were demonstrated between heliox or oxygen/air groups (standardized mean difference [SMD], - 0.20; 95% confidence interval [CI], - 0.91 to 0.51; p = 0.6). However, the four studies that used heliox to deliver nebulized therapy showed a nonsignificant increase in pulmonary function (SMD, - 0.21; 95% CI, - 0.43 to 0.01; p = 0.06). In two studies of the same subgroup, heliox mixtures produced a significantly greater increase of heart rate than oxygen/air (weighted mean difference, 9.0; 95% CI, 1.27 to 16.8; p = 0.02). However, the four studies that used heliox to deliver nebulized therapy reported a nonsignificant difference in hospital admissions (odds ratio, 1.07; 95% CI, 0.46 to 2.48; p = 0.9). Overall, heliox appears to be safe and well tolerated. CONCLUSIONS: The existing evidence does not provide support for the administration of helium-oxygen mixtures to emergency department patients with moderate-to-severe acute asthma. However, these conclusions are based on between-group comparisons and small studies, and these results should be interpreted with caution.
Assuntos
Asma/terapia , Hélio/uso terapêutico , Oxigênio/uso terapêutico , Terapia Respiratória/métodos , Doença Aguda , Adulto , Criança , Emergências , Humanos , Estado Asmático/terapia , Resultado do TratamentoRESUMO
El objetivo del trabajo fue determinar las condiciones óptimas para una aceleración de la cicatrización en piel de conejos mediante el tratamiento de la herida con laser de helio-neón HeNe (632.8 nm). Para este fin se usaron dos grupos de 5 conejos cada uno, en uno se aplicó el tratamiento con laser y el otro sirvió de control. A los animales se les realizó un resección de piel de 2 x 5 cm. El grupo experimental se irradió con laser helio-neón con una potencia de 0.1 mW a una distancia aproximada de 3 cm, con un barrido en toda la herida, por un lapso de 5 min/día. Se tomó biopsia después de las 24 horas al primer conejo, posteriormente, cada 24 horas se tomó un conejo distinto y se realizó el análisis histológico. En el grupo experimental se observó un aumento en la actividad de los procesos de reparación, en comparación con el grupo control, como fue la proliferación de fibroblastos y el incremento en la fibras de colágena que sellaron la herida a partir del cuarto día. En las condiciones antes mencionadas se redujo el tiempo de cicatrización, por lo menos en un 40 por ciento comparado con el grupo control
Assuntos
Animais , Coelhos , Hélio/uso terapêutico , Lasers/uso terapêutico , Neônio/uso terapêutico , Cicatrização/efeitos da radiação , Modelos Biológicos , Coelhos/cirurgia , Projetos de PesquisaRESUMO
A utilizaçao da mistura de gás na qual o nitrogênio é substituído pelo hélio representa uma nova terapêutica no tratamento de pacientes com patologias que apresentam aumento da resistência de vias aéreas. Uma mistura de 80 por cento de hélio e 20 por cento de oxigênio tem propriedades físicas que aumentam o fluxo de ar e diminuem a resistência na via aérea quando utilizada como uma fraçao do gás inspirado. Nesse artigo de revisao nós discutimos a utilizaçao do heliox em crianças com várias alteraçoes respiratórias (obstruçao de vias aéreas superiores, síndrome do desconforto respiratório agudo, asma aguda, fibrose cística e nos pós-operatório de cirurgia cardíaca). Concluímos que o heliox representa no momento uma terapêutica adicional benéfica em relaçao a terapêutica convencional nas crianças criticamente enfermas com falência respiratória do tipo obstrutivo, podendo evitar a utilizaçao de ventilaçao pulmonar mecânica e portanto diminuindo a morbidade. Entretanto, sao necessárias maiores investigaçoes com utilizaçao de heliox nos pacientes pediátricos.
Assuntos
Humanos , Criança , Hélio/uso terapêutico , Pneumopatias/terapia , Oxigênio/uso terapêutico , Hélio/administração & dosagem , Oxigênio/administração & dosagemAssuntos
Antiasmáticos/uso terapêutico , Asma/terapia , Hélio/uso terapêutico , Oxigênio/uso terapêutico , Adolescente , Resistência das Vias Respiratórias , Asma/fisiopatologia , Criança , Estudos Cross-Over , Método Duplo-Cego , Dispneia/terapia , Volume Expiratório Forçado , Humanos , Pico do Fluxo Expiratório , Ensaios Clínicos Controlados Aleatórios como Assunto , Estado Asmático/fisiopatologia , Estado Asmático/terapia , Resultado do TratamentoRESUMO
Se presenta la experiencia en 123 pacientes, en quienes se efectuaron colecistostomía, herniorrafias o apendicectomía por vía laparoscópica, sin utilizar pneumoperitoneo. Esta nueva técnica es posible con el instrumento mecánico que hemos denominado Elevador Parietal de Speranza que produce la separación de la pared abdominal, obteniendo una adecuada cavidad de trabajo. Los hechos más relevantes observados fueron la ausencia de morbi-mortalidad producida por el sistema de insuflación con gas y la simpleza y facilidad de numerosas maniobras quirúrgicas. Se consiguen importantes ventajas al evitar la utilización de pneumoperitoneo: 1) se suprimen los trócares con válvulas; 2) no se utilizan los reductores de calibre; 3) aspiración intraabdominal contínua; 4) libre escape de humo fuera del abdomen; 5) colocación paralela de 2 instrumentos de menor calibre por trócar de mayor diámetro; 6) la ejecución de maniobras extracorpóreas están notoriamente simplificadas; 7) posibilita la realización de mini-laparotomías en forma simultánea; 8) menores costos de instrumental y equipamiento; 9) permite utilizar pinzas, tijeras, etc., de diseño no laparoscópico. Los pacientes fueron dados de alta dentro de las 24 horas, siendo el dolor pos-operatorio menor que con la técnica tradicional. No se produjo morbilidad ni mortalidad por la aplicación de la nueva técnica. El objetivo de este trabajo, es comunicar nuestra experiencia y hacer conocer el método con un video que documenta el procedimiento
Assuntos
Idoso , Pessoa de Meia-Idade , Adulto , Adolescente , Masculino , Feminino , Humanos , Instrumentos Cirúrgicos/normas , Laparoscopia , Pneumoperitônio Artificial/estatística & dados numéricos , Dióxido de Carbono/uso terapêutico , Hélio/uso terapêutico , Instrumentos Cirúrgicos , Laparoscopia/instrumentação , Laparoscopia/tendências , Procedimentos Cirúrgicos Operatórios , Procedimentos Cirúrgicos Operatórios/normasRESUMO
Se presenta la experiencia en 123 pacientes, en quienes se efectuaron colecistostomía, herniorrafias o apendicectomía por vía laparoscópica, sin utilizar pneumoperitoneo. Esta nueva técnica es posible con el instrumento mecánico que hemos denominado Elevador Parietal de Speranza que produce la separación de la pared abdominal, obteniendo una adecuada cavidad de trabajo. Los hechos más relevantes observados fueron la ausencia de morbi-mortalidad producida por el sistema de insuflación con gas y la simpleza y facilidad de numerosas maniobras quirúrgicas. Se consiguen importantes ventajas al evitar la utilización de pneumoperitoneo: 1) se suprimen los trócares con válvulas; 2) no se utilizan los reductores de calibre; 3) aspiración intraabdominal contínua; 4) libre escape de humo fuera del abdomen; 5) colocación paralela de 2 instrumentos de menor calibre por trócar de mayor diámetro; 6) la ejecución de maniobras extracorpóreas están notoriamente simplificadas; 7) posibilita la realización de mini-laparotomías en forma simultánea; 8) menores costos de instrumental y equipamiento; 9) permite utilizar pinzas, tijeras, etc., de diseño no laparoscópico. Los pacientes fueron dados de alta dentro de las 24 horas, siendo el dolor pos-operatorio menor que con la técnica tradicional. No se produjo morbilidad ni mortalidad por la aplicación de la nueva técnica. El objetivo de este trabajo, es comunicar nuestra experiencia y hacer conocer el método con un video que documenta el procedimiento (AU)
Assuntos
Idoso , Pessoa de Meia-Idade , Adulto , Adolescente , Masculino , Feminino , Humanos , Laparoscopia/métodos , Pneumoperitônio Artificial/estatística & dados numéricos , Instrumentos Cirúrgicos/normas , Laparoscopia/instrumentação , Laparoscopia/tendências , Procedimentos Cirúrgicos Operatórios/métodos , Procedimentos Cirúrgicos Operatórios/normas , Dióxido de Carbono/uso terapêutico , Hélio/uso terapêutico , Instrumentos Cirúrgicos/estatística & dados numéricosRESUMO
Se estudiaron 40 pacientes de uno y otro sexos con artritis reumatoide, toma articular y vírgenes de tratamiento, diagnosticados en el Instituto de Reumatología. Se aplicó laserterapia combinada helio-neón e infrarrojo en barrido y focal en 2 ciclos de 20 sesiones cada uno, separados por un período de descanso de un mes. Los pacientes se evaluaron antes del tratamiento y después de este mediante criterios clínicos (inflamación articular con cinta métrica o anillo de joyero, amplitud articular con goniómetro, tiempo de marcha -15 metros-minutos-, fuerza de puño, dolor mediante escala visual del dolor y rigidez matinal) y humorales (velocidad de eritrosedimentación, proteína C-reactiva y factor reumatoideo). Además al final del tratamiento se aplicó la escala de Long-Range (capacidad para la independencia). Se obtuvo una mejoría significativa (p<0,05) con el tratamiento lo que permitió a los pacienres mejorar tanto su disposición como su capacidad para las actividades de la vida diaria, social y laboral