Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 17 de 17
Filtrar
1.
Sensors (Basel) ; 24(5)2024 Feb 22.
Artigo em Inglês | MEDLINE | ID: mdl-38474953

RESUMO

The Bio-Radar is herein presented as a non-contact radar system able to capture vital signs remotely without requiring any physical contact with the subject. In this work, the ability to use the proposed system for emotion recognition is verified by comparing its performance on identifying fear, happiness and a neutral condition, with certified measuring equipment. For this purpose, machine learning algorithms were applied to the respiratory and cardiac signals captured simultaneously by the radar and the referenced contact-based system. Following a multiclass identification strategy, one could conclude that both systems present a comparable performance, where the radar might even outperform under specific conditions. Emotion recognition is possible using a radar system, with an accuracy equal to 99.7% and an F1-score of 99.9%. Thus, we demonstrated that it is perfectly possible to use the Bio-Radar system for this purpose, which is able to be operated remotely, avoiding the subject awareness of being monitored and thus providing more authentic reactions.


Assuntos
Radar , Sinais Vitais , Taxa Respiratória , Algoritmos , Emoções , Processamento de Sinais Assistido por Computador
2.
PeerJ ; 11: e15525, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-37397024

RESUMO

Backgorund: The production of red fruits, such as blueberry, has been threatened by several stressors from severe periods of drought, nutrient scarcity, phytopathogens, and costs with fertilization programs with adverse consequences. Thus, there is an urgent need to increase this crop's resilience whilst promoting sustainable agriculture. Plant growth-promoting microorganisms (PGPMs) constitute not only a solution to tackle water and nutrient deficits in soils, but also as a control against phytopathogens and as green compounds for agricultural practices. Methods: In this study, a metagenomic approach of the local fungal and bacterial community of the rhizosphere of Vaccinium corymbosum plants was performed. At the same time, both epiphytic and endophytic microorganisms were isolated in order to disclose putative beneficial native organisms. Results: Results showed a high relative abundance of Archaeorhizomyces and Serendipita genera in the ITS sequencing, and Bradyrhizobium genus in the 16S sequencing. Diversity analysis disclosed that the fungal community presented a higher inter-sample variability than the bacterial community, and beta-diversity analysis further corroborated this result. Trichoderma spp., Bacillus spp., and Mucor moelleri were isolated from the V. corymbosum plants. Discussion: This work revealed a native microbial community capable of establishing mycorrhizal relationships, and with beneficial physiological traits for blueberry production. It was also possible to isolate several naturally-occurring microorganisms that are known to have plant growth-promoting activity and confer tolerance to hydric stress, a serious climate change threat. Future studies should be performed with these isolates to disclose their efficiency in conferring the needed resilience for this and several crops.


Assuntos
Mirtilos Azuis (Planta) , Micorrizas , Mirtilos Azuis (Planta)/microbiologia , Rizosfera , Portugal , Micorrizas/fisiologia , Produtos Agrícolas/microbiologia , Bactérias
3.
Psychol Res ; 87(1): 108-123, 2023 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-35113209

RESUMO

Facial emotional expressions are pivotal for social communication. Their fast and accurate recognition is crucial to promote adaptive responses to social demands, for the development of functional relationships, and for well-being. However, the literature has been inconsistent in showing differentiated recognition patterns for positive vs. negative facial expressions (e.g., happy and angry expressions, respectively), likely due to affective and perceptual factors. Accordingly, the present study explored differences in recognition performance between angry and happy faces, while specifically assessing the role of emotional intensity and global/regional low-level visual features. 98 participants categorized angry and happy faces morphed between neutral and emotional across 9 levels of expression intensity (10-90%). We observed a significantly higher recognition efficiency (higher accuracy and shorter response latencies) for angry compared to happy faces in lower levels of expression intensity, suggesting that our cognitive resources are biased to prioritize the recognition of potentially harmful stimuli, especially when briefly presented at an ambiguous stage of expression. Conversely, an advantage for happy faces was observed from the midpoint of expression intensity, regarding response speed. However, when compensating for the contribution of regional low-level properties of distinct facial key regions, the effect of emotion was maintained only for response accuracy. Altogether, these results shed new light on the processing of facial emotional stimuli, emphasizing the need to consider emotional intensity and regional low-level image properties in emotion recognition analysis.


Assuntos
Ira , Emoções , Humanos , Emoções/fisiologia , Ira/fisiologia , Felicidade , Reconhecimento Psicológico , Tempo de Reação , Expressão Facial
4.
Res Dev Disabil ; 131: 104361, 2022 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-36240538

RESUMO

BACKGROUND: Autism is characterized by social and non-social alterations observed beyond the clinical diagnosis. Research analyzing the expression of autism traits in the general population helps to unravel the relationship between autism dimensions and other associated variables, such as alexithymia and anxiety. The Autism-Spectrum Quotient (AQ) was developed to assess autism traits in the general population; however, inconsistent results regarding its dimensionality have emerged. AIMS: This study aimed to extend evidence about the AQ measurement model, and explore the multivariate relationship between autism traits, alexithymia, and trait anxiety. METHODS: 292 adults of the general population were recruited. An Exploratory Factor Analysis and Confirmatory Factor Analysis were performed to assess the factorial structure of AQ. A path analysis was carried out to explore the relationship between autism traits, alexithymia, and trait anxiety. RESULTS: The results supported a three-factor model of AQ. The path analysis model showed evidence of a significant role of alexithymia as a mediator of the relationship between autism traits and anxiety. CONCLUSIONS AND IMPLICATIONS: The present study provides empirical support for a three-factor model of AQ in the general population. The association between autism traits, alexithymia, and anxiety dimensions highlights the multidimensional nature of these variables and the need to account for their distinct impact on autism-related variables.


Assuntos
Transtorno do Espectro Autista , Transtorno Autístico , Adulto , Humanos , Sintomas Afetivos/epidemiologia , Transtorno Autístico/epidemiologia , Transtorno Autístico/diagnóstico , Ansiedade/epidemiologia , Análise Fatorial , Transtornos de Ansiedade/epidemiologia , Transtorno do Espectro Autista/epidemiologia , Transtorno do Espectro Autista/diagnóstico
5.
PLoS One ; 17(1): e0262960, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35077490

RESUMO

The assessment of mal-adaptive anxiety is crucial, considering the associated personal, economic, and societal burden. The State-Trait Inventory for Cognitive and Somatic Anxiety (STICSA) is a self-report instrument developed to provide multidimensional anxiety assessment in four dimensions: trait-cognitive, trait-somatic, state-cognitive and state-somatic. This research aimed to extend STICSA's psychometric studies through the assessment of its dimensionality, reliability, measurement invariance and nomological validity in the Portuguese population. Additionally, the predictive validity of STICSA-Trait was also evaluated, through the analysis of the relationship between self-reported trait anxiety and both the subjective and the psychophysiological response across distinct emotional situations. Similarly to previous studies, results supported both a four-factor and two separated bi-factor structures. Measurement invariance across sex groups was also supported, and good nomological validity was observed. Moreover, STICSA trait-cognitive dimension was associated with differences in self-reported arousal between groups of high/low anxiety, whereas STICSA trait-somatic dimension was related to differences in both the subjective and psychophysiological response. Together, these results support STICSA as a useful instrument for a broader anxiety assessment, crucial for an informed diagnosis and practice.


Assuntos
Transtornos de Ansiedade , Cognição , Emoções , Adolescente , Adulto , Idoso , Transtornos de Ansiedade/diagnóstico , Transtornos de Ansiedade/fisiopatologia , Transtornos de Ansiedade/psicologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Portugal , Psicometria
6.
Curr Biol ; 32(2): 453-461.e4, 2022 01 24.
Artigo em Inglês | MEDLINE | ID: mdl-34856124

RESUMO

Efference copies are neural replicas of motor outputs used to anticipate the sensory consequences of a self-generated motor action or to coordinate neural networks involved in distinct motor behaviors.1 An established example of this motor-to-motor coupling is the efference copy of the propulsive motor command, which supplements classical visuo-vestibular reflexes to ensure gaze stabilization during amphibian larval locomotion.2 Such feedforward replica of spinal pattern-generating circuits produces a spino-extraocular motor coupled activity that evokes eye movements, spatiotemporally coordinated to tail undulation independently of any sensory signal.3,4 Exploiting the developmental stages of the frog,1 studies in metamorphing Xenopus demonstrated the persistence of this spino-extraocular motor command in adults and its developmental adaptation to tetrapodal locomotion.5,6 Here, we demonstrate for the first time the existence of a comparable locomotor-to-ocular motor coupling in the mouse. In neonates, ex vivo nerve recordings of brainstem-spinal cord preparations reveal a spino-extraocular motor coupled activity similar to the one described in Xenopus. In adult mice, trans-synaptic rabies virus injections in lateral rectus eye muscle label cervical spinal cord neurons closely connected to abducens motor neurons. Finally, treadmill-elicited locomotion in decerebrated preparations7 evokes rhythmic eye movements in synchrony with the limb gait pattern. Overall, our data are evidence for the conservation of locomotor-induced eye movements in vertebrate lineages. Thus, in mammals as in amphibians, CPG-efference copy feedforward signals might interact with sensory feedback to ensure efficient gaze control during locomotion.


Assuntos
Movimentos Oculares , Locomoção , Animais , Locomoção/fisiologia , Mamíferos , Camundongos , Neurônios Motores/fisiologia , Reflexo Vestíbulo-Ocular/fisiologia , Medula Espinal/fisiologia , Xenopus laevis/fisiologia
7.
Prehosp Disaster Med ; 36(5): 651-653, 2021 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-34470686

RESUMO

INTRODUCTION: The tropical cyclone Idai hit Mozambique in the city of Beira on March 15, 2019. During the following days, the Portuguese Emergency Medical Team (PT EMT) and its infrastructure deployed to Mozambique with the mission of helping local people and collaborating with the authorities. METHODS: Data analyzed were collected in the period of the deployment, from April 1-April 30, 2019. All patients admitted to PT EMT were registered through the Clinical Record of PT EMT. RESULTS: In total, 1,662 patients were admitted to PT EMT during the 30-day mission. The five most prevalent diagnoses were: 61.49% classified with "code 29" (which corresponds to "other unspecified diagnoses"), 9.15% of cases of skin disease, 8.90% of minor injuries, 6.74% of acute respiratory infection, and 3.19% of obstetric/genecology complications. DISCUSSION AND CHALLENGES: An important challenge identified was the need for a robust and effective network for transporting patients, allowing transfers between EMTs, enabling a true network response in the provision of care to disaster victims. CONCLUSIONS: The benefit of the deployment of PT EMT in Mozambique after Cyclone Idai was in line with the EMT initiative standards, allowing a direct delivery of care to the affected Mozambican population and support to the local health authorities.


Assuntos
Tempestades Ciclônicas , Missões Médicas , Etnicidade , Humanos , Moçambique , Portugal
8.
J Autism Dev Disord ; 51(7): 2338-2353, 2021 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-32964357

RESUMO

Autism Spectrum Disorders, as well as autism traits (AT), have been associated with altered sensory processing. However, the role of AT in olfactory processing is still unclear. We analyzed the impact of AT and trait anxiety (TANX), relevant in the context of autism and olfactory perception, in the olfactory abilities of a nonclinical adult sample. Participants (N = 116) completed the Autism-Spectrum Quotient (AQ), the State-Trait Inventory for Cognitive and Somatic Anxiety (STICSA) and the Sniffin' Sticks Extended Test to measure AT, TANX and olfactory abilities, respectively. A hierarchical multiple regression analysis suggested that women and higher scores on the Attention to Detail subscale of AQ were associated with better odor discrimination, and higher somatic TANX was related to poorer odor discrimination.


Assuntos
Ansiedade/psicologia , Atenção , Transtorno do Espectro Autista/psicologia , Sintomas Inexplicáveis , Percepção Olfatória , Adulto , Ansiedade/fisiopatologia , Transtorno do Espectro Autista/fisiopatologia , Feminino , Humanos , Masculino , Odorantes , Escalas de Graduação Psiquiátrica , Análise de Regressão
9.
Sci Rep ; 10(1): 20018, 2020 11 18.
Artigo em Inglês | MEDLINE | ID: mdl-33208812

RESUMO

The vestibulo-ocular reflex (VOR) and the optokinetic reflex (OKR) work synergistically to stabilize gaze in response to head movements. We previously demonstrated that a 14-day visuo-vestibular mismatch (VVM) protocol applied in freely behaving mice decreased the VOR gain. Here, we show for the first time that the OKR gain is also reduced and report on the recovery dynamics of both VOR and OKR after the end of the VVM protocol. Using sinusoidally-modulated stimulations, the decreases in VOR and OKR were found to be frequency-selective with larger reductions for frequencies < 0.5 Hz. Constant-velocity OKR stimulation tests demonstrated that the persistent components of the OKR were not modified while the transient, initial responses were. To identify the signals driving VOR and OKR reductions, we compared the responses of mice exposed to a high-contrast and no-contrast VVM. Despite being more robust in the high-contrast conditions, reductions were largely comparable and recovered with a similar time course. An analysis that directly compared VOR and OKR responses revealed that, alterations in the VOR were of significantly larger amplitude with significantly slower dynamics of recovery. Our findings are evidence for a frequency-selective influence of visual signals in the tuning of gaze stabilizing reflexes in normal mice.


Assuntos
Movimentos Oculares/fisiologia , Percepção de Movimento/fisiologia , Nistagmo Optocinético/fisiologia , Fenômenos Fisiológicos Oculares , Reflexo Vestíbulo-Ocular/fisiologia , Vestíbulo do Labirinto/fisiologia , Animais , Masculino , Camundongos , Camundongos Endogâmicos C57BL
10.
Sensors (Basel) ; 20(12)2020 Jun 21.
Artigo em Inglês | MEDLINE | ID: mdl-32575894

RESUMO

Emotional responses are associated with distinct body alterations and are crucial to foster adaptive responses, well-being, and survival. Emotion identification may improve peoples' emotion regulation strategies and interaction with multiple life contexts. Several studies have investigated emotion classification systems, but most of them are based on the analysis of only one, a few, or isolated physiological signals. Understanding how informative the individual signals are and how their combination works would allow to develop more cost-effective, informative, and objective systems for emotion detection, processing, and interpretation. In the present work, electrocardiogram, electromyogram, and electrodermal activity were processed in order to find a physiological model of emotions. Both a unimodal and a multimodal approach were used to analyze what signal, or combination of signals, may better describe an emotional response, using a sample of 55 healthy subjects. The method was divided in: (1) signal preprocessing; (2) feature extraction; (3) classification using random forest and neural networks. Results suggest that the electrocardiogram (ECG) signal is the most effective for emotion classification. Yet, the combination of all signals provides the best emotion identification performance, with all signals providing crucial information for the system. This physiological model of emotions has important research and clinical implications, by providing valuable information about the value and weight of physiological signals for emotional classification, which can critically drive effective evaluation, monitoring and intervention, regarding emotional processing and regulation, considering multiple contexts.


Assuntos
Emoções/fisiologia , Modelos Biológicos , Redes Neurais de Computação , Análise Custo-Benefício , Eletrocardiografia , Eletromiografia , Humanos
11.
Neurosci Biobehav Rev ; 116: 239-250, 2020 09.
Artigo em Inglês | MEDLINE | ID: mdl-32562688

RESUMO

Altered social cognition is a core feature of Autism Spectrum Disorders (ASD). These impairments have been explained as the consequence of compromised social motivational mechanisms that limit social interest and activate a cascade of social deficits. Following this rational, we argue that approaches capable of surpassing ASD usual restraints (e.g., deficits in verbal abilities), and able to assign social meaning, could be more effective at responding to these difficulties. In this framework, we propose that olfaction, as well as cross-modal integration strategies involving both visual and olfactory domains, may have such potential. In fact, most of socioemotional processing deficits in ASD have been shown in an uni-modal perspective, mainly with visual stimuli. However, the social environment involves other modalities and is typically multisensorial. Given the potential of olfaction as a gateway for socioemotional information in ASD, we argue in favor of studying olfactory perception, as well as visuo-olfactory integration, given the potential of these approaches to drive effective interventions and give the access to a meaningful social world in ASD.


Assuntos
Transtorno do Espectro Autista , Humanos , Olfato
12.
J Vis Exp ; (144)2019 02 20.
Artigo em Inglês | MEDLINE | ID: mdl-30855582

RESUMO

Long-term sensory conflict protocols are a valuable means of studying motor learning. The presented protocol produces a persistent sensory conflict for experiments aimed at studying long-term learning in mice. By permanently wearing a device fixed on their heads, mice are continuously exposed to a sensory mismatch between visual and vestibular inputs while freely moving in home cages. Therefore, this protocol readily enables the study of the visual system and multisensory interactions over an extended timeframe that would not be accessible otherwise. In addition to lowering the experimental costs of long-term sensory learning in naturally behaving mice, this approach accommodates the combination of in vivo and in vitro experiments. In the reported example, video-oculography is performed to quantify the vestibulo-ocular reflex (VOR) and optokinetic reflex (OKR) before and after learning. Mice exposed to this long-term sensory conflict between visual and vestibular inputs presented a strong VOR gain decrease but exhibited few OKR changes. Detailed steps of device assembly, animal care, and reflex measurements are hereby reported.


Assuntos
Comportamento Animal/fisiologia , Aprendizagem/fisiologia , Sensação/fisiologia , Animais , Camundongos , Reflexo Vestíbulo-Ocular/fisiologia , Fatores de Tempo , Vestíbulo do Labirinto/fisiologia
13.
Proc Natl Acad Sci U S A ; 114(36): 9695-9700, 2017 09 05.
Artigo em Inglês | MEDLINE | ID: mdl-28835534

RESUMO

Our understanding of the mechanisms underlying inherited forms of inner ear deficits has considerably improved during the past 20 y, but we are still far from curative treatments. We investigated gene replacement as a strategy for restoring inner ear functions in a mouse model of Usher syndrome type 1G, characterized by congenital profound deafness and balance disorders. These mice lack the scaffold protein sans, which is involved both in the morphogenesis of the stereociliary bundle, the sensory antenna of inner ear hair cells, and in the mechanoelectrical transduction process. We show that a single delivery of the sans cDNA by the adenoassociated virus 8 to the inner ear of newborn mutant mice reestablishes the expression and targeting of the protein to the tips of stereocilia. The therapeutic gene restores the architecture and mechanosensitivity of stereociliary bundles, improves hearing thresholds, and durably rescues these mice from the balance defects. Our results open up new perspectives for efficient gene therapy of cochlear and vestibular disorders by showing that even severe dysmorphogenesis of stereociliary bundles can be corrected.


Assuntos
Síndromes de Usher/genética , Síndromes de Usher/terapia , Animais , Animais Recém-Nascidos , DNA Complementar/administração & dosagem , DNA Complementar/genética , Dependovirus/genética , Modelos Animais de Doenças , Potenciais Evocados Auditivos do Tronco Encefálico , Terapia Genética/métodos , Vetores Genéticos , Células Ciliadas Auditivas/patologia , Células Ciliadas Auditivas/fisiologia , Humanos , Camundongos , Camundongos Knockout , Microscopia Eletrônica de Varredura , Proteínas do Tecido Nervoso/deficiência , Proteínas do Tecido Nervoso/genética , Síndromes de Usher/fisiopatologia , Vestíbulo do Labirinto/patologia , Vestíbulo do Labirinto/fisiopatologia
14.
eNeuro ; 4(1)2017.
Artigo em Inglês | MEDLINE | ID: mdl-28303261

RESUMO

Calibration of the vestibulo-ocular reflex (VOR) depends on the presence of visual feedback. However, the cellular mechanisms associated with VOR modifications at the level of the brainstem remain largely unknown. A new protocol was designed to expose freely behaving mice to a visuo-vestibular mismatch during a 2-week period. This protocol induced a 50% reduction of the VOR. In vivo pharmacological experiments demonstrated that the VOR reduction depends on changes located outside the flocculus/paraflocculus complex. The cellular mechanisms associated with the VOR reduction were then studied in vitro on brainstem slices through a combination of vestibular afferent stimulation and patch-clamp recordings of central vestibular neurons. The evoked synaptic activity demonstrated that the efficacy of the synapses between vestibular afferents and central vestibular neurons was decreased. In addition, a long-term depression protocol failed to further decrease the synapse efficacy, suggesting that the VOR reduction might have occurred through depression-like mechanisms. Analysis of the intrinsic membrane properties of central vestibular neurons revealed that the synaptic changes were supplemented by a decrease in the spontaneous discharge and excitability of a subpopulation of neurons. Our results provide evidence that a long-lasting visuo-vestibular mismatch leads to changes in synaptic transmission and intrinsic properties of central vestibular neurons in the direct VOR pathway. Overall, these results open new avenues for future studies on visual and vestibular interactions conducted in vivo and in vitro.


Assuntos
Tronco Encefálico/fisiopatologia , Plasticidade Neuronal/fisiologia , Reflexo Vestíbulo-Ocular/fisiologia , Percepção Visual/fisiologia , Animais , Potenciais Pós-Sinápticos Excitadores , Medições dos Movimentos Oculares , Masculino , Camundongos Endogâmicos C57BL , Atividade Motora/fisiologia , Vias Neurais/fisiopatologia , Neurônios Aferentes/fisiologia , Técnicas de Patch-Clamp , Estimulação Luminosa , Transmissão Sináptica/fisiologia , Técnicas de Cultura de Tecidos
15.
Rev. Soc. Bras. Clín. Méd ; 13(2)jun. 2015. tab
Artigo em Português | LILACS | ID: lil-749187

RESUMO

Pneumatosis intestinalis (PI) is a rare condition, especially when associated with volvulus; it is often misdiagnosed and inappropriately treated. We present the case of a 27 year-old woman suffering from an acute abdomen. An abdominal tomography was performed revealing Pneumatosis intestinalis. Once in the operating theatre sigmoid volvulus was diagnosed and Hartmann surgery performed. Histology showed intestinal ischemia. During the hospital stay, evolution was favourable. The authors present this case and a brief theoretical review, due to its rarity and clinical interest.


A pneumatose intestinal (PI) é uma condição pouco frequente, sendo ainda mais rara em associação com volvo; sendo muitas vezes mal diagnosticada e tratada inapropriadamente. Apresentamos o caso de uma mulher de 27 anos com um quadro de abdómen agudo. Realizou TAC abdominal que demonstrou pneumatose intestinal. Intra-operatoriamente foi diagnosticado volvo da sigmoideia e optado por cirurgia de Hartmann. O resultado anatomo-patológico da peça foi compatível com isquémia intestinal. Durante o internamento hospital, a doente evoluiu favoravelmente. Os autores apresentam este caso e uma breve revisão teórica, pela sua raridade e interesse clínico.


Assuntos
Humanos , Feminino , Adulto , Abdome Agudo/complicações , Pneumatose Cistoide Intestinal/diagnóstico , Pneumatose Cistoide Intestinal/etiologia , Volvo Intestinal/cirurgia , Volvo Intestinal/diagnóstico , Piperacilina/uso terapêutico
16.
Acta Med Port ; 27(2): 211-7, 2014.
Artigo em Português | MEDLINE | ID: mdl-24813489

RESUMO

INTRODUCTION: Acute Respiratory Distress Syndrome has a significant incidence and mortality at Intensive Care Units. Therefore, more studies are necessary in order to develop new effective therapeutic strategies. The authors have proposed themselves to characterize Acute Respiratory Distress Syndrome patients admitted to an Intensive Care Unit for 2 years. MATERIAL AND METHODS: This was an observational retrospective study of the patients filling the Acute Respiratory Distress Syndrome criteria from the American-European Consensus Conference on ARDS, being excluded those non invasively ventilated. Demographic data, Acute Respiratory Distress Syndrome etiology, comorbidities, Gravity Indices, PaO2/FiO2, ventilator modalities and programmation, pulmonary compliance, days of invasive mechanical ventilation, corticosteroids use, rescue therapies, complications, days at Intensive Care Unit and obits were searched for and were submitted to statistic description and analysis. RESULTS: A 40 patients sample was obtained, with a median age of 72.5 years (interquartile range = 22) and a female:male ratio of ≈1:1.86. Fifty five percent of the Acute Respiratory Distress Syndrome cases had pulmonary etiology. The mean minimal PaO2/FiO2 was 88 mmHg (CI 95%: 78.5-97.6). The mean maximal applied PEEP was 12.4 cmH2O (Standard Deviation 4.12) and the mean maximal used tidal volume was 8.2 mL/ Kg ideal body weight (CI 95%: 7.7-8.6). The median invasive mechanical ventilation days was 10. Forty seven and one half percent of the patients had been administered corticosteroids and 52.5% had been submitted to recruitment maneuvers. The most frequent complication was Ventilator Associated Pneumonia (20%). The median Intensive Care Unit stay was 10.7 days (interquartile range 10.85). The fatality rate was 60%. The probability of the favorable outcome 'non-death in Intensive Care Unit' was 4.4x superior for patients who were administered corticosteroids and 11x superior for patients < 65 years old. DISCUSSION AND CONCLUSIONS: Acute Respiratory Distress Syndrome is associated with long hospitalization and significant mortality. New prospective studies will be necessary to endorse the potential benefit of steroid therapy and to identify the subgroups of patients that warrant its use.


Introdução: A Síndrome de Dificuldade Respiratória Aguda apresenta incidência e mortalidade significativas em Cuidados Intensivos, justificando estudos adicionais, nomeadamente para definição de novas abordagens terapêuticas. Os autores propuseram-se caracterizaros casos duma Unidade de Cuidados Intensivos em dois anos.Material e Métodos: Procedeu-se a um estudo observacional retrospectivo dos casos admitidos numa Unidade de Cuidados Intensivos, cumprindo os critérios diagnósticos da American-European Consensus Conference on ARDS, tendo sido excluídos os não ventilados invasivamente. Pesquisados e submetidos a tratamento estatístico: dados demográficos, etiologia do Síndrome de Dificuldade Respiratória Aguda, comorbilidades, Índices de Gravidade, PaO2/FiO2, modalidades e parâmetros ventilatórios, compliance pulmonar, dias de ventilação mecânica invasiva, corticoterapia, terapêuticas de resgate, complicações, duração do internamento, óbitos.Resultados: Obtiveram-se 40 doentes, com uma mediana de 72,5 anos (amplitude interquartil 22) e um ratio feminino:masculino ≈1:1,86. Cinquenta e cinco por cento dos Síndrome de Dificuldade Respiratória Aguda tiveram etiologia pulmonar. A média do PaO2/ FiO2 mínimo foi 88mm Hg (IC 95%: 78,5-97,6). A média da PEEP máxima aplicada foi 12,4 cmH2O (Desvio Padrão 4,12) e a médiado Volume Corrente máximo utilizado foi 8,2 mL/Kg peso ideal (IC 95%: 7,7-8,6). A mediana dos dias de ventilação mecânica invasiva foi 10. Em 47,5% dos doentes foram administrados corticóides. Em 52,5% foi executado recrutamento alveolar. A complicação mais frequente foi a Pneumonia Associada a Ventilação (20%). A mediana da duração do internamento foi 10,7 dias (amplitude interquartil10,85). Faleceram 60% dos doentes. A probabilidade de outcome favorável 'não óbito na Unidade de Cuidados Intensivos' foi 4,4x superior nos doentes sob corticoterapia e 11x superior nos doentes com idade < 65 anos.Discussão e Conclusões: A Síndrome de Dificuldade Respiratória Aguda associa-se a internamentos prolongados e significativa mortalidade. Novos estudos prospectivos serão necessários para confirmar o benefício dos corticóides, bem como identificar o/(s) subgrupo/(s) de doentes que mais justificam a sua utilização.


Assuntos
Cuidados Críticos , Síndrome do Desconforto Respiratório/terapia , Idoso , Feminino , Humanos , Unidades de Terapia Intensiva , Masculino , Estudos Retrospectivos , Fatores de Tempo
17.
Rev Port Pneumol ; 10(4): 347-53, 2004.
Artigo em Português | MEDLINE | ID: mdl-15492879

RESUMO

Cryptogenic organizing pneumonia (COP) is one of the new recognized histological patterns of idiopathic interstitial pneumonias, in witch no cause or association is identified. Idiopathic bronchiolitis obliterans-organizing pneumonia (BOOP) is a synonymous. This rare entity is characterized by involvement of alveoli and bronchioles, which are filled by intraluminal polyps of fibroblastic tissue (Masson bodies). The clinical presentation often mimics that of community-acquired pneumonia. Persistent non-productive cough, dyspnoea with exertion and weight loss are common features, and in one-half of the cases the onset is heralded by a flu-like syndrome. Definitive diagnosis depends on histological data, and video-assisted thoracoscopic (VAT) has become the established technique. Spontaneous recovery is rare; corticosteroid therapy provides cure in two thirds of cases. The authors present a case of a patient whose lung biopsy by VAT confirmed the diagnosis. She was treated with corticoids without recurrence in a two year follow-up.


Assuntos
Pneumonia em Organização Criptogênica , Pneumonia em Organização Criptogênica/diagnóstico , Feminino , Humanos , Pessoa de Meia-Idade
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA
...