The six-minute walk distance is a marker of hemodynamic-related functional capacity in hypertension: a case-control study.

This study investigated the association between hemodynamic variables and the 6-minute walk distance (6MWD) in adults with and without hypertension and explored the role of hemodynamic variables as predictors of 6MWD. Patients undergoing antihypertensive medication therapy (n=41) and sex-matched healthy subjects (n=41) were evaluated for their clinical status and cardiovascular risk factors. Two 6-minute walk tests were performed along an 18-m corridor with a 30-minute rest interval. The intraclass correlation (ICC) was high among patients (ICC=0.984 (0.965; 0.992), P<0.001) and controls (ICC=0.987 (0.832; 0.996), P<0.001). The patients presented 6MWD values that were significantly lower than those of healthy controls (338.8±112.8 vs. 388.0±66.7 m, P=0.010). In patients, the 6MWD was significantly and positively correlated with sex (0.737; P<0.001), height (0.502; P<0.001) and weight (0.303; P=0.027). In addition, negative and significant correlations were observed between 6MWD and the mean (-0.577; P<0.001), systolic (-0.521; P<0.001), diastolic (-0.505; P=0.001) and pulse (-0.353; P=0.015) pressures after simultaneous adjustment for age, body height and weight. The same behavior was observed in healthy controls (except for pulse pressure), albeit with lower correlation values. A regression model with sex, age, height and weight explained 52.2% (P<0.001) of the variance. The highest explained variance in patients (64.8%; P<0.001) and controls (56.5%; P<0.001) was observed after replacing the body weight with mean pressure in the model. The 6MWD is inversely associated with hemodynamic variables in both groups and is lower in patients with hypertension compared with healthy controls. Hemodynamic variables, particularly the mean pressure, should be included in prediction equations for 6MWD.

Alveolar recruitment maneuver in patients with subarachnoid hemorrhage and acute respiratory distress syndrome: a comparison of 2 approaches.

PURPOSE: The purpose of the study was to compare 2 alveolar recruitment maneuvers (ARMs) approaches in patients with subarachnoid hemorrhage (SAH) and acute respiratory distress syndrome (ARDS). MATERIAL AND METHODS: Sixteen SAH patients with ARDS were randomized in 2 similar groups. One received ARM with continuous positive airway pressure (CPAP) of 35 cm H(2)O for 40 seconds (CPAP recruitment), whereas the other received pressure control ventilation with positive-end expiratory pressure of 15 cm H(2)O and pressure control above positive end-expiratory pressure of 35 cm H(2)O for 2 minutes (pressure control recruitment maneuver [PCRM]). Intracranial pressure (ICP) and cerebral perfusion pressure (CPP) were measured before and after ARM. The ratio of arterial oxygen tension to fraction of inspired oxygen was measured before and 1 hour after the ARM. RESULTS: After ARM, ICP was higher in CPAP recruitment (20.50 ± 4.75 vs 13.13 ± 3.56 mm Hg; P = .003); and CPP was lower in CPAP recruitment (62.38 ± 9.81 vs 79.60 ± 6.8 mm Hg; P = .001). One hour after the ARM, the ratio of arterial oxygen tension to fraction of inspired oxygen increased significantly only in PCRM (108.5 to 203.6; P = .0078). CONCLUSION: In SAH patients with ARDS, PCRM did not affect ICP and decreased CPP in safe levels, besides improving oxygenation.

Manejo de uma criança de dois anos no tratamento odontológico: Relato de caso / Dental behavior management of a two-year-old child: Case report

O tratamento odontológico infantil necessita ser cuidadosamente elaborado e planejado, no qual pais e odontopediatra trabalhem juntos para o êxito do atendimento da criança. A Psicologia, enquanto ciência do comportamento, pode contribuir efetivamente para condutas bem-sucedidas em Odontopediatria. Este artigo apresenta um relato de caso visando a identificar os fatores que favoreceram a adequação do comportamento de uma criança em idade pré-escolar na situação de atendimento odontológico. Os principais fatores encontrados foram: o uso adequado de técnicas de manejo do comportamento infantil, as atitudes da mãe anteriores à situação de tratamento, a qualidade do vínculo criado entre o profissional, a criança e a mãe.

Influência do peróxido de carbamida 10 por cento na cor de resinas compostas / Influence of 10 per cent carbamide peroxide on the color of composite resins

Desde a primeira publicaçäo sobre o clareamento de dente com peróxido de carbamida, pouco foi esclarecido sobre a real alteraçäo de cor sofrida pelas restauraçöes de resinas compostas, quando expostas a esse material. O propósito deste trabalho é verificar a alteraçäo de cor das resinas compostas após sofrerem tratamento com peróxido de carbamida a 10 por cento, através do software Adobe Photoshop 4.0