Avaliação dos niveis de dor apos sessões de ultra-sonoterapia em pacientes cirurgicos cardiovasculares / Assessment of pain levels after ultrasound therapy sessions among postoperative cardiac patients

O ultra-som e um exemplo de recurso utilizado pelos fisioterapeutas para obtencao de analgesia em diversos casos de reabilitacao. Entretanto, na literatura nao ha um consenso quanto a real eficacia desse tipo de procdimento no processo reabilitativo. Nao foram encontrados relatos da utilizacao desse recursos no tratamento de pacientes cardiacos pos-operatorios. Objetivo: verificar a eficacia da ultra-sonoterapia na diminuicao dos niveis de dor e do tempo de permanencia pos-operatorio durante a reabilitacao de pacientes que realizaram revascularizacao do miocardio por meio da abordagem de esternotomia mediana. Metodo: a amostra foi composta por oito pacientes divididos em dois grupos? tratamento e placebo, cujo tratamento de reabilitacao consistiu de 5 procedimentos de ultra-sonoterapia em modo pulsado, com frequencia de 3MHz, intensidade de 0,2 W/cm2 regime de pulso a(20 por cento) durante 5 minutos por sessao, duas vezes por dia...

Coexistence of vessel enlargement and paradoxical constriction in a diseased left anterior descending artery: an in vivo assessment using a new system for quantitative analysis of intracoronary ultrasound.

Previous studies based on conventional two-dimensional intravascular ultrasound revealed that coronary arteries can undergo either vessel enlargement and paradoxical constriction in response to plaque growth. We report a case in which the occurrence of vessel enlargement and paradoxical constriction was documented in the same coronary artery (left anterior descending). A multiple cross-section analysis was performed, using a novel 3-D system of reconstruction of IVUS images, which provides a large number of cross-sections within the reconstructed segments.

Three-dimensional intracoronary ultrasound imaging. Methodology and clinical relevance for the assessment of coronary arteries and bypass grafts.

Three-dimensional (3-D) reconstruction of intracoronary ultrasound (ICUS) images has an increasing application as the applicability of systems of on-line analysis provides a superior guidance by coupling the advantages of a high-resolution cross-sectional imaging with an overview of stenosis and reference segments. Detection of the external contour of the vessel which is a prerequisite for measurements of coronary plaques is currently not provided by the algorithms for automated on-line analysis. Thus, off-line reconstruction is required for studies aiming at the assessment of progression/regression of atherosclerosis and of mechanisms of interventions or restenosis. Various 3-D reconstruction methods with specific advantages and limitations are able to meet the different requirements concerning applicability, quality of visualization, and accuracy of quantification. The use of 3-D ICUS in the assessment of cardiac transplant recipients permits a more reliable and accurate quantification of intimal hyperplasia as seen in cardiac allograft arteriopathy. In patients undergoing bypass surgery it may influence the therapeutic decision, since it allows to determine the longitudinal extent of calcification and frequently discovers atherosclerosis in angiographically normal segments. Vessel stenoses both of native coronary arteries and bypass grafts can be studied by 3-D ICUS and additional information can be obtained during catheter based interventions. Despite some remaining technical limitation 3-D reconstruction of ICUS images has the potential of becoming a practical tool to simplify the interpretation and quantification of ICUS images.