ABSTRACT
ABSTRACT Objectives: To evaluate the effectiveness of Topical Oxygen Jet Therapy (TOJT) in the treatment of surgical wounds in adult patients who has clinical signs of infection for over 30 days; and to identify the pathogens causing complicated skin and soft tissue infections. Method: Parallel, randomized clinical trials randomly divided into "Control Group" (CG) and "Treatment Group" (TG), which were followed up for 10 consecutive days. Venous antibiotics and dressings were used in both groups. In addition, TOJT were used on the wounds in the TG. The outcome criteria were based on clinical indicators: Pressure Ulcer Scale for Healing (PUSH) and Visual Analog Scale Pain (VAS). The paired t-test or Wilcoxon, chi-squared or Fisher's exact test, and Student's t-test or Mann-Whitney tests were used with a significance level of 5%. Results: 73 inpatients were included and followed up: 39 in TG and 34, CG. There were no significant differences in socio-demographic variables or of initial laboratory tests, except for blood glucose that was higher in TG than in CG (p = 0.044). Ten days into treatment, both the area of PUSH wounds (p < 0.001) and the pain scale (p = 0.029) were significantly reduced in TG. Staphylococcus aureus was the most prevalent pathogen (40%) with no significant difference between the two groups. Discussion: Although the follow-up time was of only ten days, a significant improvement was observed in TG. As a limitation of the study, the small sample size precluded the comparison of S. aureus infections between the two groups. Conclusion: TOJT accelerated the healing process, reduced pain and contributed to an improvement in the clinical status of the wounds when compared to CG. These findings demonstrate the effectiveness and relevance of the employed technique. It can be easily incorporated as a routine procedure in hospitals without extra investment.
Subject(s)
Humans , Adult , Surgical Wound/therapy , Oxygen , Staphylococcus aureus , Surgical Wound Infection , Wound HealingABSTRACT
A privação do sono é um problema sério nos tempos atuais e pode ter graves conseqüências para a fisiologia humana. De fato, a redução no tempo de sono tem sido associada a um notável aumento na incidência de hipertensão arterial, diabetes mellitus, infarto do miocárdio, acidente vascular cerebral e estresse, porém os mecanismos envolvidos são pobremente compreendidos. Objetivos: Avaliar o impacto da privação parcial do sono na função endotelial venosa e no controle autonômico cardiovascular em homens saudáveis. Métodos: Treze voluntários do sexo masculino, saudáveis e com idade média de 31±2 anos, tiveram o sono monitorado por diário de sono e actigrafia de pulso durante 12 noites consecutivas, nas quais foram divididas em 2 dois períodos. Um período de 5 noites denominado de privação parcial do sono (dormir<5h por noite) e outro de 5 noites denominado de sono controle (dormir>7h por noite). Entre estes períodos, foi interposto por 2 noites de sono irrestrito (com pelo menos de 7 horas de sono por noite). A escolha do período inicial de sono foi randomizada. Ao término de cada período de 5 dias, foi analisada a reatividade vascular venosa (com a técnica da veia do dorso da mão, Dorsal Hand Vein), a sonolência diurna excessiva (através da Escala de Sonolência de Epworth), realizada avaliação hemodinâmica e autonômica (no momento em repouso e mediante o teste de inclinação postural tilt test), exames de sangue e dosagem de norepinefrina plasmática. A freqüência cardíaca e pressão arterial de batimento a batimento na posição supina e com a manobra de "tilt test" foi monitorado com intervalo (RR) e variabilidade de pressão arterial. Resultados: Os indivíduos dormiram em média 8.0 h durante o período de sono controle e 4.5 h no período de privação parcial do sono, sendo a diferença significativa entre os mesmos (p<0.01)....
Background: Sleep curtailment is a serious and common problem in western societies and can have significant consequences in the human physiology. In fact epidemiological studies showed that sleep deprivation (reduction in sleeping time) is associated with increased blood pressure, higher incidence of diabetes mellitus, myocardial heart attack, strokes in the brain, and stress, however the mechanisms are poorly understood. Objectives: Evaluate the impact of partial sleep deprivation in the venous endothelial function and the autonomic cardiovascular autonomic control in healthy men. Methods: Thirteen healthy male volunteers (average age: 31±2 years) had their sleep monitored by sleep diary and wrist actigraphy during 12 consecutive nights, these were divided into two periods. The subjects were randomized and crossed over to 5 nights of control sleep (> 7hs) and 5 nights of partial sleep deprivation (<5hs), interposed by 2 nights of unrestricted sleep (at least 7 hours sleep per night). The choice of the initial sleeping period was randomized. At the end of each period of 5 days heart rate and beat-to-beat blood pressure in the supine position and head up tilt test maneuver were monitored with off line determination of RR-interval and blood pressure variability. In addition, serum norepinephrine and venous endothelial functions were measured by dorsal hand vein technique; also we performed the evaluation of excessive day sleepiness (evaluated through the Epworth Sleepiness Scale), hemodynamic and autonomous evaluation (during sleep and through the tilt test). Results: The subjects slept 8.0 and 4.5 hs during control and partial sleep deprivation periods, respectively (p<0.01). Sleep deprivation did not change significantly the resting heart rate and blood pressure but promoted a significant increase in the low frequency bands of heart rate and blood pressure variability as well as serum norepinephrine. Tilt test promoted a significantly greater drop...