Reference Values for 7 Different Protocols of Simple Functional Tests: A Multicenter Study.

OBJECTIVES: To establish reference values and equations (ages 20-80y) for 7 simple functional tests based on a multicenter study. DESIGN: Cross-sectional data collection in 4 research centers across different regions of a continental dimension country. SETTING: Healthy subjects from general community were assessed in different research laboratories. PARTICIPANTS: Data collection of 296 volunteer subjects (N=296; 45% men; aged 50±18y, forced expiratory volume in the first second 95±13% pred, body mass index 26.9±4.5 kg/m2) aged 20-80 years; representing both sexes; with the ability to understand and perform all proposed assessments; and with no severe and/or unstable condition that could limit functional assessments occurred simultaneously in all centers. INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: All participants randomly performed the following 7 functional tests twice: (1) the 4-meter gait speed test at usual walking speed; (2) the 4-meter gait speed test at maximal walking speed; (3) the Sit-to-Stand test performed with 5 repetitions; (4) the Sit-to-Stand test performed in 30 seconds; (5) the Sit-to-Stand test performed in 1 minute; (6) the Timed Up and Go test at usual speed; and (7) the Timed Up and Go test at maximal speed. Spirometry, quality of life, depression, anxiety, physical activity, and comorbidities were also assessed to better characterize the sample. The best performance of each test was used to propose reference values for men and women and reference equations for all. RESULTS: Participants similarly distributed by age groups from the 4 centers were included. All tests were correlated with age (0.34

Validity, Reproducibility, and Minimal Detectable Difference of the Functional Upper Extremity Function Test - Simplified Version - for Adults With Moderate to Severe Asthma and COPD.

BACKGROUND: Upper-limbs (ULs) functional tests which are valid and reliable for individuals with chronic respiratory disease (CRD) are scarce. The aim of this study was to investigate the intra-rater reproducibility, validity, minimal detectable difference (MDD), and learning effect of the Upper Extremity Function Test - simplified version (UEFT_S) functional test and to characterize its performance for adults with moderate-severe asthma and COPD. METHODS: The UEFT_S was performed twice, and the number of elbow flexions in 20 s was the outcome. In addition, spirometry, 6-min walk test (6MWT), handgrip dynamometry (HGD), and usual and maximum timed-up-and-go tests (TUG_usual and TUG_max) were also performed. RESULTS: Eighty-four individuals with moderate-severe CRD and 84 control individuals matched by anthropometric data were analyzed. Individuals with CRD presented better performance in the UEFT_S than controls (P = .023). UEFT_S correlated significantly with HGD, TUG_usual, TUG_max, and 6MWT (P < .047 for all). The test-retest intraclass correlation coefficient was 0.91 [0.86-0.94], and the MDD was 0.4%. CONCLUSIONS: The UEFT_S is a valid and reproducible tool to assess the functionality of the ULs in people with moderate-severe asthma and COPD. When applied in the modified form, the test can be considered simple, fast, and inexpensive, with an easy outcome to interpret.

Low-level laser therapy attenuates creatine kinase levels and apoptosis during forced swimming in rats.

Studies suggest that high-intensity physical exercise can cause damage to skeletal muscles, resulting in muscle soreness, fatigue, inflammatory processes and cell apoptosis. The aim of this study was to investigate the effects of low-level laser therapy (LLLT) on a decrease in creatine kinase (CK) levels and cell apoptosis. Twenty male Wistar rats were randomly divided into two equal groups: group 1 (control), resistance swimming; group 2 (LLLT), resistance swimming with LLLT. They were subjected to a single application of indium gallium aluminum phosphide (InGaAlP) laser immediately following the exercise for 40 s at an output power of 100 mW, wavelength 660 nm and 133.3 J/cm(2). The groups were subdivided according to sample collection time: 24 h and 48 h. CK was measured before and both 24 h and 48 h after the test. Samples of the gastrocnemius muscle were processed to determine the presence of apoptosis using terminal deoxynucleotidyl transferase (TdT)-mediated deoxyuridine triphosphate (dUTP) nick end labeling. (There was a significant difference in CK levels between groups (P < 0.0001) as well as between the 24 h and 48 h levels in the control group, whereas there was no significant intra-group difference in the LLLT group at the same evaluation times. In the LLLT group there were 66.3 +/- 13.2 apoptotic cells after 24 h and 39.0 +/- 6.8 apoptotic cells after 48 h. The results suggest that LLLT influences the metabolic profile of animals subjected to fatigue by lowering serum levels of CK. This demonstrates that LLLT can act as a preventive tool against cell apoptosis experienced during high-intensity physical exercise.

Effect of laser therapy (660 nm) on recovery of the sciatic nerve in rats after injury through neurotmesis followed by epineural anastomosis.

The aim of this study was to analyze the influence of aluminum gallium arsenide (AlGaAs) laser (660 nm) on the myelin sheath and functional recovery of the sciatic nerve in rats. The sciatic nerves of 12 Wistar rats were subjected to injury through neurotmesis and epineural anastomosis, and the animals were divided into two groups: group 1 was the control and group 2, underwent low-level laser therapy (LLLT). After the injury, AlGaAs laser at 660 nm, 4 J/cm(2), 26.3 mW and beam area of 0.63 cm(2) was administered to three equidistant points on the injury for 20 consecutive days. In the control group the mean area of the myelin impairment was 0.51 (+/- 0.11) on day 21 after the operation, whereas this value was 1.31 (+/- 0.22) in the LLLT group. Student's t-test revealed a P value = 0.0229 for the mean area values of the myelin sheath between the LLLT and control groups. Comparison of the sciatic functional index (SFI) showed that there was no significant difference between the pre-lesion value in the laser therapy group and the control group. The use of AlGaAs laser (660 nm) provided significant changes to the morphometrically assessed area of the myelin sheath, but it did not culminate in positive results for functional recovery in the sciatic nerve of the rats after injury through neurotmesis.

Morphometric and histological analysis of low-power laser influence on bone morphogenetic protein in bone defects repair.

Bone morphogenetic proteins (BMPs) are secreted signaling molecules belonging to the transforming growth factor-beta (TGF-beta) superfamily. The objective of this study was to determine how gallium-aluminum-arsenium (GaAlAs) 650 nm laser influenced the action of BMPs on bone defects created in rat femurs. The sample consisted of 24 male albino Wistar rats. Group 1 was composed of rats with bone defects filled with bone-inducing substance, with the application of low-power laser. Group 2 contained rats with bone defects filled with a bone-inducing substance, without the application of low-power laser. Group 3 rats had bone defects not filled with a bone-inducing substance, with the application of low-power laser. Group 4 rats had bone defects and no treatment (control group). A bone defect was produced with drills. In groups 1 and 2 the defects were filled with a bone-inducing substance. The animals were treated with GaAlAs (50 mW) laser, energy density 4 J/cm(2), for 80 ss on a 1 cm(2) area. Groups 2 and 4 were used as control. Bone samples were removed for histological procedures and morphometric analysis on the 7th, 14th and 21st days after surgery. Results obtained were subjected to statistical analysis. Rejection level for the null hypothesis was 0.05. Statistical differences were found in the comparison between group 1 (G1), G2, G3 and G4 [analysis of variance (ANOVA); P < 0.0134]. There was a statistically significant correlation between groups 1 and 4 (P < 0.01). The results of other correlations by Tukey's post-hoc test were: group 1 vs group 3 (P = 0.341), group 1 vs group 2 (P = 0.862), group 2 vs group 4 (P = 0.061), group 2 vs group 3 (P = 0.744), and group 3 vs group 4 (P = 0.249). We concluded that the association of low-power laser with a bone-inducing substance produced better results than when low-power laser or BMPs were used alone.

Experimental model of pulmonary carcinogenesis in Wistar rats.

PURPOSE: To elaborate an experimental model of pulmonary carcinogenesis in Wistar rats. METHODS: Male Rattus norvegicus albinus, Wistar lineage were carried through an intra-pulmonary instillation of the Benzo[a]pyrene (B[a]P) dilution in alcohol 70%, a polycyclic aromatic hydrocarbon widely known by its power of tumoral induction. Three experimental groups had been formed with 08 animals each: Control Group (Alcohol 70%); B[a]P Group 10 mg/kg; e B[a]P Group 20mg/kg, submitted to euthanasia 08, 10, 12 and 14 weeks after the experimental procedure. The pulmonary sections had been colored by hematoxilin-eosin (HE) and submitted to the morphometrical analysis to describe the tissue alterations. RESULTS: The presence of diffuse inflammatory alterations was observed in all groups; however, at the analysis of the pulmonary tissue of the experimental groups had been observed hyperplasic alterations (BALT hyperplasia), and in one of the animals of the experimental group 20mg/kg (12 weeks) was noticed the presence of cellular epithelial tracheal pleomorphism, suggesting the adenocarcinoma formation in situ. CONCLUSION: The main secondary alterations to the intra-pulmonary instillation of B[a]P in Wistar rats were: cellular proliferation, inflammatory alterations of several degrees and nodular lymphoid hyperplasias. The association of an activator agent of the pulmonary metabolic reply is necessary to establish the ideal reply-dose to the development of the lung cancer.

Usefulness of argyrophilic nucleolar organizer regions in detection of lung cells alterations after benzo[a]pyrene instillation.

PURPOSE: To verify the relationship between AgNOR expression and lung tissues changes of Wistar rats after pulmonary instillation of benzo[a]pyrene (B[a]P). METHODS: Male Rattus norvegicus albinus,Wistar lineage were given a single intrapulmonary instillation of B[a]P at doses of 10 and 20 mg/kg in a volume of approximately 0.3 ml. After 7 and 21 days the rats were killed and the lung slices submitted to a histological technique of AgNOR. AgNOR dots were quantified and the result analyzed by statistical tests; p < or = 0.05 was considered significant. RESULTS: The mean values of AgNOR dots for the experimental groups 10/7 (1.51+/-0.86) and 10/21 (1.84+/-0.13) were statistically different (p = 0.009). Among the groups 20/7 (1.63+/-0.11) and 20/21 (2.48+/-0.28) was observed statistically significant difference (p = 0.003). CONCLUSION: The AgNOR technique can be useful in identification of cells changes induced by B[a]P.

Pulmonary emphysema induced by methylphenidate: experimental study.

CONTEXT AND OBJECTIVE: Methylphenidate is the most widely used drug for treating attention deficit hyperactivity disorder. However, it has important side effects, such as abdominal pain, insomnia, anorexia and loss of appetite, and also some cases of early severe emphysema after drug abuse have been reported. Our aim was to investigate the development of pulmonary emphysema in rats that were subjected to different doses of methylphenidate. DESIGN AND SETTING: Experimental study carried out at the laboratory of a public university. METHODS: Eighteen male Wistar rats were divided into three groups: control (0.9% saline solution); MP 0.8 (methylphenidate, 0.8 mg/kg); MP 1.2 (methylphenidate, 1.2 mg/kg). After 90 days of daily gavage, the animals were sacrificed and lung tissue samples were prepared for analysis on the mean alveolar diameter (Lm). RESULTS: The Lm was greater in MP 0.8 (47.91 ± 3.13; P < 0.01) and MP 1.2 (46.36 ± 4.39; P < 0.05) than in the control group (40.00 ± 3.48). CONCLUSION: Methylphenidate caused an increase in the alveolar diameter of rats, which was compatible with human pulmonary emphysema.

Ischemia and reperfusion of rat small intestine using pentoxyfilline and prostaglandin E1.

PURPOSE: To investigate the small intestinal tissue alterations in rats submitted to ischemia and tissue reperfusion using pentoxyfilline or prostaglandin E1. METHODS: Thirty five Wistar rats were used, distributed into group control (A) n=10 were submitted to intestinal ischemia and reperfusion during 60 minutes and no one drug have been utilized. In the group pentoxyfilline (B) n=10 have been utilized during tissue ischemia and reperfusion as well as prostaglandin E1 (C) n=10, but separately. In the group sham (D) n=5, the animals were submitted to surgical. After euthanasia of the animals, a segment of the small intestine was cut, stained by hematoxilin-eosin and histological analysis according to Chiu criteria. RESULTS: Histological results showed that using pentoxyflline or prostaglandin E1 the results during tissue reperfusion were better, since the levels of criteria from Chiu that predominated were level 2 and 3, indicating less tissue damage in comparison to the control group (group A) that showed levels 4 and 5, what means more severe histological tissue alterations. CONCLUSION: Use of pentoxyfilline or prostaglandin E1 promoted a beneficial effect during intestinal reperfusion, demonstrated by less severe histological lesions in the small intestine mucosa of rats submitted to ischemia and tissue reperfusion when helped by the drugs.

Independência funcional de idosos submetidos à ventilação mecânica invasiva: importância para o desfecho clínico e efeitos da hospitalização / Functional independence of elderly patients who received invasive mechanical ventilation: importance for the clinical outcome and effects of hospitalization

Objetivos: Verificar a importância da medida da independência funcional (MIF) nos desfechos clínicos de idosos mecanicamente ventilados e analisar os fatores de risco associados à mortalidade. Métodos: Coorte prospectiva de pacientes submetidos a VMI, divididos em dois grupos: Grupo não sobrevivente ­ óbito na internação e Grupo sobrevivente ­ alta hospitalar. Resultados: A MIF antes da internação na UTI foi em média para o grupo não sobrevivente 94,8 e para o grupo sobrevivente 113,4 pontos (p=0,0062) e se relacionou com maior risco de óbito (p<0,0001; RR=2,37; IC 95%=1,43 a 3,93). Nos 27 pacientes avaliados após 6 meses houve recuperação da MIF a valores próximos (103,0 pontos) comparados ao momento antes da internação na UTI (113,4). Conclusões: A redução da MIF relacionou-se com maior risco de óbito. A mortalidade observada na internação foi alta com 59,0%. A MIF sofreu redução significativa após a internação na UTI e 6 meses após a alta da UTI recuperou-se a valores semelhantes se comparada a antes da internação.

Objectives: To verify the importance of Functional Independence Measure (FIM) on clinical outcomes in mechanically ventilated elderly and analyze risk factors associated with mortality. Methods: A prospective cohort of patients receiving IMV, divided into two groups: non survivor group - Hospital death and survivor Group - discharge. Results: FIM before admission to the ICU was on average for the non-survivor group 94.8 and for the surviving group 113.4 points (p=0.0062) and was associated with increased risk of death (p<0.0001, RR=2.37, 95% CI=1.43- 3.93). In the 27 patients evaluated after 6 months there was recovery of the FIM at approximate values (103.0 points) when compared to the moment before ICU admission (113.4). Conclusions: The reduction in FIM was associated with an increased risk of death. Mortality observed at admission was high at 59.0%. FIM suffered a significant reduction after admission to the ICU and 6 months after discharge from the ICU recovered to similar values when compared to before hospitalization.

Correlation between Dorsiflexion Ankle Range of Motion and Patellofemoral Pain Syndrome / Correlação Entre a Amplitude da Dorsiflexão do Tornozelo e Síndrome da Dor Patelofemoral

The change in lower extremity movement pattern has been previously associated with severe knee disorders, including anterior cruciate ligament rupture, patellar tendinopathy, iliotibial band syndrome, and patellofemoral pain (PFP). The aim of this study was to verify the clinical reliability of ankle dorsiflexion range of motion (ADROM) measurement with weight bearing (WB) using an app on the smartphone (iHand) and to verify if there is correlation between the limitation of the ADROM and the PFP. A total of 67 women, mean age 34.3 ± 2.4, height 182 ± 3.6, weight 73.7 ± 4.2, were allocated to the control group (n = 23) and the PFP group (n = 23). Two examiners evaluated the active ADROM (lunge test) in both ankles at two times to test inter-examiner and intra-examiner reliability. It was observed in the PFP group that the mean ADROM was 17.7 ± 2.5 and the control group was 35.3 ± 6.2 (right) and 17.1 ± 2.9 and 32.9 ± 5, 4 (left). It is concluded that the use of the smartphone app proved to be reliable for clinical application in the evaluation of ADROM with WB and that there is a relation between the low DFT of DFT with the presence of patellofemoral pain. (AU).

A alteração no padrão de movimento da extremidade inferior tem sido previamente associada com severas desordens do joelho, incluindo a ruptura do ligamento cruzado anterior, tendinopatia patelar, síndrome da banda iliotibial e dor patelofemoral - DPF. O objetivo do estudo foi verificar a confiabilidade clínica da mensuração da dorsiflexão de tornozelo - DFT com descarga de peso - WB utilizando um app no smartphone (iHand) e verificar se há correlação entre a limitação da DFT com a DPF. Participaram 67 mulheres, idade média 34,3±2,4, altura 182±3,6, peso 73,7±4,2, alocadas em grupo controle (n=23) e grupo DFP (n=23). Dois examinadores avaliaram a DFT ativa (lunge test) em ambos os tornozelos em dois momentos para se testar a confiabilidade inter-examinador e intra-examinador. O coeficiente de correlação intraclasse - CCI foi utilizado para a análise da confiabilidade das medidas. Observou-se alta confiabilidade (0,9965 [p<0,0001]) e (0,9949 [p<0,0001]) para tornozelo direito e esquerdo respectivamente. Observou-se no grupo DFP que a ADM média de DFT foi de 17,7±2,5 e grupo controle de 35,3±6,2 (direito) e 17,1±2,9 e 32,9±5,4 (esquerdo). Conclui-se que a utilização do app de smartphone se mostrou confiável para aplicação clínica na avaliação da DFT com WB e que há relação entre a baixa ADM de DFT com a presença de dor patelofemoral. (AU).

Effect of low-level laser therapy (660 nm) on acute inflammation induced by tenotomy of Achilles tendon in rats.

In this study, we aimed to analyze the effects of low-level laser therapy (LLLT; 660 nm) on levels of protein expression of inflammatory mediators after cutting Achilles tendon of rats. Thirty Wistar male rats underwent partial incisions of the left Achilles tendon, and were divided into three groups of 10 animals according to the time of euthanasia after injury: 6, 24 and 72 h. Each group was then divided into control group and LLLT group (treated with 100 mW, 3.57 W cm(-2), 0.028 cm(2), 214 J cm(-2), 6 J, 60 s, single point). In LLLT group, animals were treated once time per day until the time of euthanasia established for each group. The group treated with LLLT showed a significant reduction of IL-1ß compared with control groups at three time points (6 h: P=0.0401; 24 h: P=0.0015; 72 h: P=0.0463). The analysis of IL-6 showed significant reduction only in the LLLT group at 72 h compared with control group (P=0.0179), whereas IL-10 showed a significant increase in the treated group compared with control group at three experimental times (6 h: P=0.0007; 24 h: P=0.0256; 72 h: P<0.0001). We conclude that LLLT is an important modulator of inflammatory cytokines release after injury in Achilles tendon.

Lung apoptosis after intra-pulmonary instillation of Benzo(a)pyrene in Wistar rats.

PURPOSE: To evaluate the influence of pulmonary instillation of Benzo[a]pyrene in lung apoptosis of Wistar rats. METHODS: Male Rattus norvegicus albinus, Wistar lineage was carried through an intra-pulmonary instillation of the Benzo[a]pyrene (B[a]P) dilution in alcohol 70%. Three experimental groups had been formed with 08 animals each: Control Group (Alcohol 70%); B[a]P Group 40 mg/kg; e B[a]P Group 80mg/kg, submitted to euthanasia 16 and 18 weeks after the experimental procedure. The pulmonary sections had been processed by TUNEL method and submitted to the histomorphometric analysis to quantify the apoptotic cell number. RESULTS: After 16 weeks, mean of apoptotic cells number in control group (19,3 + or - 3,2) was greater than 40mg/Kg group (11,8 + or - 1,9; p<0,01) and 80mg/Kg group (7,0 + or - 1,4; p<0,01). Significant difference also observed between 40mg/Kg and 80mg/Kg (p<0,05). After 18 weeks, mean of apoptotic cells number in control group (18,0 + or - 2,2) was greater than 40mg/Kg group (8,8 + or - 1,7; p<0,01) and 80mg/Kg group (5,5 + or - 1,3; p<0,01). Significant difference wasn't observed between 40mg/Kg and 80mg/Kg (ns). CONCLUSION: Intra-pulmonary instillation of Benzo[a]pyrene induces significant decrease of apoptotic activity in lung tissue.

Ischemia and reperfusion of rat small intestine using pentoxyfilline and prostaglandin E1

PURPOSE: To investigate the small intestinal tissue alterations in rats submitted to ischemia and tissue reperfusion using pentoxyfilline or prostaglandin E1. METHODS: Thirty five Wistar rats were used, distributed into group control (A) n=10 were submitted to intestinal ischemia and reperfusion during 60 minutes and no one drug have been utilized. In the group pentoxyfilline (B) n=10 have been utilized during tissue ischemia and reperfusion as well as prostaglandin E1 (C) n=10, but separately. In the group sham (D) n=5, the animals were submitted to surgical. After euthanasia of the animals, a segment of the small intestine was cut, stained by hematoxilin-eosin and histological analysis according to Chiu criteria. RESULTS: Histological results showed that using pentoxyflline or prostaglandin E1 the results during tissue reperfusion were better, since the levels of criteria from Chiu that predominated were level 2 and 3, indicating less tissue damage in comparison to the control group (group A) that showed levels 4 and 5, what means more severe histological tissue alterations. CONCLUSION: Use of pentoxyfilline or prostaglandin E1 promoted a beneficial effect during intestinal reperfusion, demonstrated by less severe histological lesions in the small intestine mucosa of rats submitted to ischemia and tissue reperfusion when helped by the drugs.

[Influence of the breathing time increase in the pulmonary ventilation of patients submitted to mechanical ventilation in controlled pressure mode]. / Influência do aumento do tempo inspiratório na ventilação pulmonar de pacientes submetidos à ventilação mecânica na modalidade pressão controlada.

BACKGROUND AND OBJECTIVES: The mechanical ventilator support is one of the main used modalities of support in intensive therapy. In the modality of predetermined pressure, the maximum pressure is regulated, but the current volume (V T) is a complex function of the applied pressure and its speed to reach the pressure-target, of the available breathing time and the resistance to the breath. This paper has as objective to evaluate the influences of the increment of the breathing time in the pulmonary ventilation. METHODS: The study was carried through in the Adult ICU of the Regional Hospital of Mato Grosso do Sul, located in Campo Grande. They had been enclosed individuals adult, both genders, between 16 and 84 years, submitted to the mechanical ventilation in controlled pressure mode or in controlled-watched mode. The breathing time was adjusted in 1 sec, developing in 0.2 sec until the boundary-value of 1.6 sec. The tidal volume (V T) and the volume minute (V E) had been evaluated of 13 patients in the breathing times of 1s; 1.2s; 1.4s and 1.6s. RESULTS: In the mean of V T and V E an increasing increase was observed after-increment of the breathing time. We did not find in consulted literature, data which correlated the breathing time with alterations in the current volume. CONCLUSIONS: The increment of the breathing time in the ventilation for pressure control can have influence in the determination of the current volume offered to the patient.

Lung apoptosis after intra-pulmonary instillation of Benzo(a)pyrene in Wistar rats / Apoptose pulmonar após instilação intrapulmonar de Benzo(a)pireno em ratos Wistar

PURPOSE: To evaluate the influence of pulmonary instillation of Benzo[a]pyrene in lung apoptosis of Wistar rats. METHODS: Male Rattus norvegicus albinus, Wistar lineage was carried through an intra-pulmonary instillation of the Benzo[a]pyrene (B[a]P) dilution in alcohol 70 percent. Three experimental groups had been formed with 08 animals each: Control Group (Alcohol 70 percent); B[a]P Group 40 mg/kg; e B[a]P Group 80mg/kg, submitted to euthanasia 16 and 18 weeks after the experimental procedure. The pulmonary sections had been processed by TUNEL method and submitted to the histomorphometric analysis to quantify the apoptotic cell number. RESULTS: After 16 weeks, mean of apoptotic cells number in control group (19,3±3,2) was greater than 40mg/Kg group (11,8±1,9; p<0,01) and 80mg/Kg group (7,0±1,4; p<0,01). Significant difference also observed between 40mg/Kg and 80mg/Kg (p<0,05). After 18 weeks, mean of apoptotic cells number in control group (18,0±2,2) was greater than 40mg/Kg group (8,8±1,7; p<0,01) and 80mg/Kg group (5,5±1,3; p<0,01). Significant difference wasn't observed between 40mg/Kg and 80mg/Kg (ns). CONCLUSION: Intra-pulmonary instillation of Benzo[a]pyrene induces significant decrease of apoptotic activity in lung tissue.

OBJETIVO: Avaliar a influência da instilação intrapulmonar de Benzo[a]pireno na apoptose pulmonar de ratos Wistar. MÉTODOS: Rattus norvegicus albinus, linhagem Wistar machos foram submetidos à instilação intra-pulmonar da diluição em álcool 70 por cento de Benzo[a]pireno (B[a]P). Foram formados três grupos experimentais com 08 animais cada: Grupo Controle (álcool 70 por cento); Grupo B[a]P 40 mg/kg; e Grupo B[a]P 80mg/kg, submetidos a eutanásia 16 e 18 semanas após o procedimento experimental. As secções pulmonares foram processadas pelo método TUNEL e submetidas à análise histomorfométrica para quantificação do número de células apoptóticas. RESULTADOS: Após 16 semanas, a média do número de células apoptóticas do grupo controle (19,3±3,2) mostrou-se maior que o grupo 40mg/Kg (11,8±1,9; p<0,01) e 80mh/Kg (7,0±1,4; p<0,01). Diferença significante foi também observada entre os grupos 40mg/Kg e 80mg/Kg (p<0,05). Após 18 semanas, a média do número de células apoptóticas do grupo controle (18,0±2,2) mostrou-se maior que o grupo 40mg/Kg (8,8±1,7; p<0,01) e 80mh/Kg (5,5±1,3; p<0,01). Não foi observada diferença significante entre os grupos 40 e 80mg/Kg (ns). CONCLUSÃO: A instilação intrapulmonar de Benzo[a]pireno induziu diminuição significativa da atividade apoptótica em tecido pulmonar.

Experimental model of pulmonary carcinogenesis in Wistar rats

PURPOSE: To elaborate an experimental model of pulmonary carcinogenesis in Wistar rats. METHODS: Male Rattus norvegicus albinus, Wistar lineage was carried through an intra-pulmonary instillation of the Benzo[a]pyrene (B[a]P) dilution in alcohol 70 percent, a polycyclic aromatic hydrocarbon widely known by its power of tumoral induction. Three experimental groups had been formed with 08 animals each: Control Group (Alcohol 70 percent); B[a]P Group 10 mg/kg; e B[a]P Group 20mg/kg, submitted to euthanasia 08, 10, 12 and 14 weeks after the experimental procedure. The pulmonary sections had been colored by hematoxilin-eosin (HE) and submitted to the morphometrical analysis to describe the tissue alterations. RESULTS: The presence of diffuse inflammatory alterations was observed in all groups, however, at the analysis of the pulmonary tissue of the experimental groups, it had been observed hyperplasic alterations (BALT hyperplasia), and in one of the animals of the experimental group 20mg/kg (12 weeks), it was noticed the presence of cellular epithelial tracheal pleomorphism, suggesting the adenocarcinoma formation in situ. CONCLUSION: The main secondary alterations to the intra-pulmonary instillation of B[a]P in Wistar rats were: cellular proliferation, inflammatory alterations of several degrees and nodular lymphoid hyperplasias. The association of an activator agent of the pulmonary metabolic reply is necessary to establish the ideal reply-dose to the development of the lung cancer.

OBJETIVO: Elaborar um modelo experimental de carcinogênese pulmonar em ratos wistar. MÉTODOS: Rattus norvegicus albinus, linhagem Wistar foram submetidos a instilação intra-pulmonar da diluição em álcool 70 por cento de Benzo[a]pireno (B[a]P), um hidrocarboneto aromático policíclico amplamente conhecido por seu poder de indução tumoral. Foram formados três grupos experimentais com 08 animais cada: Grupo Controle (álcool 70 por cento); Grupo B[a]P 10 mg/kg; e Grupo B[a]P 20mg/kg, submetidos a eutanásia 08, 10, 12 e 14 semanas após o procedimento experimental. As secções pulmonares foram coradas por HE e submetidas a análise morfométrica para descrição das alterações teciduais. RESULTADOS: em todos os grupos observou-se a presença de alterações inflamatórias difusas, porém na análise do tecido pulmonar dos grupos experimentais, observou-se alterações hiperplásicas (hiperplasia de BALT), e em um dos animais do grupo experimental 20mg/kg (12 semanas) notou-se a presença de pleomorfismo celular epitelial traqueal, sugerindo a formação de adenocarcinoma in situ. CONCLUSÃO: as principais alterações secundárias à instilação intra-pulmonar de B[a]P em ratos Wistar foram: proliferação celular, alterações inflamatórias de diversos graus e hiperplasias nodulares linfóides. A associação de um agente ativador da resposta metabólica pulmonar pode ser necessária para estabelecimento da dose-resposta ideal ao desenvolvimento do câncer de pulmão.

Influência do aumento do tempo inspiratório na ventilação pulmonar de pacientes submetidos à ventilação mecânica na modalidade pressão controlada / Influence of the breathing time increase in the pulmonary ventilation of patients submitted to mechanical ventilation in controlled pressure mode

JUSTIFICATIVA E OBJETIVOS: O suporte ventilatório mecânico é uma das principais modalidades de apoio usadas em terapia intensiva. Na modalidade de pressão pré-determinada a pressão máxima é regulada, mas o volume corrente (V T) é uma função complexa da pressão aplicada e da sua velocidade em alcançar a pressão-alvo, do tempo inspiratório disponível e da resistência à respiração. O objetivo deste trabalho foi avaliar a influência do incremento do tempo inspiratório na ventilação pulmonar. MÉTODO: O estudo foi realizado na UTI Adulto do Hospital Regional de Mato Grosso do Sul em Campo Grande/MS. Foram incluídos pacientes adultos, de ambos os sexos, com idade entre 16 e 84 anos, submetidos à ventilação mecânica no modo pressão controlada ou assistido-controlada. Foi ajustado o tempo inspiratório em 1 seg, incrementando em 0,2 seg até o valor limite de 1,6 seg. Foram avaliados o volume-corrente (V T) e o volume-minuto (V E) de 13 pacientes nos tempos inspiratórios de 1,0s; 1,2s; 1,4s e 1,6s. RESULTADOS: Nas médias dos V T e V E observou-se um aumento crescente após o incremento do tempo inspiratório. Não foram encontrados na literatura consultada, dados que correlacionassem o tempo inspiratório com alterações no volume-corrente. CONCLUSÕES: O incremento do tempo inspiratório na ventilação por controle de pressão pode ter influência na determinação do volume-corrente ofertado ao paciente.

BACKGROUND AND OBJECTIVES: The mechanical ventilator support is one of the main used modalities of support in intensive therapy. In the modality of predetermined pressure, the maximum pressure is regulated, but the current volume (V T) is a complex function of the applied pressure and its speed to reach the pressure-target, of the available breathing time and the resistance to the breath. This paper has as objective to evaluate the influences of the increment of the breathing time in the pulmonary ventilation. METHODS: The study was carried through in the Adult ICU of the Regional Hospital of Mato Grosso do Sul, located in Campo Grande. They had been enclosed individuals adult, both genders, between 16 and 84 years, submitted to the mechanical ventilation in controlled pressure mode or in controlled-watched mode. The breathing time was adjusted in 1 sec, developing in 0.2 sec until the boundary-value of 1.6 sec. The tidal volume (V T) and the volume minute (V E) had been evaluated of 13 patients in the breathing times of 1s; 1.2s; 1.4s and 1.6s. RESULTS: In the mean of V T and V E an increasing increase was observed after-increment of the breathing time. We did not find in consulted literature, data which correlated the breathing time with alterations in the current volume. CONCLUSIONS: The increment of the breathing time in the ventilation for pressure control can have influence in the determination of the current volume offered to the patient.

Usefulness of argyrophilic nucleolar organizer regions in detection of lung cells alterations after benzo[a]pyrene instillation

PURPOSE: To verify the relationship between AgNOR expression and lung tissues changes of Wistar rats after pulmonary instillation of benzo[a]pyrene (B[a]P). METHODS: Male Rattus norvegicus albinus,Wistar lineage were given a single intrapulmonary instillation of B[a]P at doses of 10 and 20 mg/kg in a volume of approximately 0,3 ml. After 7 and 21 days the rats were killed and the lung slices submitted to a histological technique of AgNOR. AgNOR dots were quantified and the result analyzed by statistical tests; p <= 0,05 was considered significant. RESULTS: The mean values of AgNOR dots for the experimental groups 10/7 (1,51±0,86) and 10/21 (1,84±0,13) were statistically different (p = 0,009). Among the groups 20/7 (1,63±0,11) and 20/21 (2,48±0,28) was observed statistically significant difference (p = 0,003). CONCLUSION: The AgNOR technique can be useful in identification of cells changes induced by B[a]P.

OBJETIVO: Verificar a relação entre a expressão de AgNOR e alterações teciduais pulmonares em ratos Wistar após instilação pulmonar de benzo[a]pireno (B[a]P). MÉTODOS: Rattus norvegicus albinus, linhagem Wistar machos foram submetidos à instilação pulmonar única de B[a]P em doses de 10 e 20mg/kg, em um volume aproximado de 0,3 ml. Os animais foram sacrificados após 7 e 21 dias e o tecido pulmonar submetido a técnica histológica de AgNOR. Os pontos AgNOR foram quantificados e os resultados analisados estatisticamente; foram considerados significantes os valores de p <= 0,05. RESULTADOS: Os valores médios de pontos AgNOR no grupo experimental 10/7 (1,51±0,86) e 10/21 (1,84±0,13) foram estatisticamente significantes (p = 0,009). Entre os grupos 20/7 (1,63±0,11) e 20/21 (2,48±0,28) a diferença observada foi também considerada significante (p = 0,003). CONCLUSÃO: A técnica de AgNOR pode ser útil na identificação de alterações celulares induzidas pelo B[a]P.