Efeito do relaxamento muscular progressivo em adultos com sintomas de ansiedade / Effect of progressive muscle relaxation in adults with anxiety symptoms / Efecto de la relajación muscular progresiva en adultos con síntomas de ansiedad

Objetivo: avaliar a efetividade da aplicação da técnica de relaxamento muscular progressivo de Jacobson na redução de sintomas de ansiedade leves e moderados em adultos. Método: estudo quase-experimental, com amostra de 108 adultos usuários da Estratégia Saúde da Família, realizado entre março e agosto de 2019. Para análise estatística descritiva e inferencial, foram utilizados: medidas de tendência central, Teste Qui-Quadrado de Pearson, Exato de Fisher, Mann-Whitney e Wilcoxon (nível de significância de 5%). Resultados: no primeiro momento, os grupos apresentaram homogeneidade em relação às características (p= 0,707) e aos escores dos níveis de ansiedade (p=0,463). No segundo momento, mostraram heterogeneidade e independência relacionados às características (p=0,001) e aos escores (p=0,001). Conclusão: a aplicação da técnica demonstrou melhoria dos sintomas ansiosos do grupo experimental (p=0,001), com maior efetividade nos participantes com sintomas leves (p 0,010), sexo feminino, adulto jovem, histórico de situação estressora recente e com problemas com o sono (p<0,001).

Objective: to evaluate the effectiveness of applying Jacobson's progressive muscle relaxation technique in reducing mild and moderate anxiety symptoms in adults. Method: quasi-experimental study, with a sample of 108 adult users of the Family Health Strategy, carried out from March to August 2019. For descriptive and inferential statistical analysis, the following were used: measures of central tendency, Pearson's Chi-Square Test, Exact Fisher, Mann-Whitney and Wilcoxon (5% significance level). Results: at first, the groups were homogeneous in terms of characteristics (p=0.707) and anxiety levels scores (p=0.463). In the second moment, they showed heterogeneity and independence related to characteristics (p=0.001) and scores (p=0.001). Conclusion: the application of the technique showed an improvement in anxiety symptoms in the experimental group (p=0.001), with greater effectiveness in participants with mild symptoms (p=0.010), female, young adult, history of recent stressful situation and with problems with sleep (p<0.001).

Objetivo: evaluar la efectividad de la aplicación de la técnica de relajación muscular progresiva de Jacobson en la reducción de los síntomas de ansiedad leve y moderada en adultos. Método: estudio cuasiexperimental, con una muestra de 108 adultos usuarios de la Estrategia Salud de la Familia, realizado de marzo a agosto de 2019. Para el análisis estadístico descriptivo e inferencial se utilizaron: medidas de tendencia central, test Chi-Cuadrado de Pearson, Exacto de Fisher, Mann-Whitney y Wilcoxon (nivel de significancia del 5%). Resultados: en un principio, los grupos fueron homogéneos en cuanto a las características (p=0,707) y a los puntajes de niveles de ansiedad (p=0,463). En el segundo momento, mostraron heterogeneidad e independencia respecto a las características (p=0,001) y puntajes (p=0,001). Conclusión: la aplicación de la técnica mostró una mejoría en los síntomas de ansiedad en el grupo experimental (p=0,001), con mayor efectividad en los participantes con síntomas leves (p=0,010), sexo femenino, adulto joven, antecedente de situación estresante reciente y con tratornos de sueño (p<0,001).

Relaxation training effects on the muscular and technical level of athletes / Efeitos do treinamento de relaxamento a nível muscular e técnico dos atletas / Efectos del entrenamiento de relajación en el nivel muscular y técnico de los deportistas

ABSTRACT Introduction The current teaching of athletes focuses mainly on gaining their skills, often neglecting the beneficial impacts of relaxation on the overall physical quality of its students. Therefore, clarifying the relationship between muscle relaxation training and athletic performance is important. Objective Explore the effect of relaxation training on running athletes' technical and muscular levels. Methods A comparative experiment was conducted on 40 male and female runners, randomly divided into two groups. Before training, the athletes in the experimental group received relaxation training through the breath regulation method, muscle relaxation method, and independent training method, with 60 minutes in each session, for 6 months. Results Based on the assumption that there was no significant difference in the initial physical indices, the athletes in the experimental group performed better in 100m, 200m, and 300m than those in the control group, and the difference between the two groups was significant (P < 0.05). Conclusion Adequate relaxation training positively affects athletes' muscular endurance and technical level. Therefore, an adequate increase in relaxation training is shown to be conducive in improving the overall physical quality and competitive level of athletes. Level of evidence II; Therapeutic studies - investigation of treatment outcomes.

RESUMO Introdução O ensino atual dos atletas foca-se principalmente no ganho de suas habilidades, negligenciando muitas vezes os impactos benéficos do relaxamento na qualidade física geral de seus alunos. Portanto, é de grande importância esclarecer a relação entre o treinamento de relaxamento muscular e o desempenho atlético. Objetivo Explorar o efeito do treinamento de relaxamento sobre o nível técnico e muscular dos atletas de corrida. Métodos Uma experiência comparativa foi realizada em 40 corredores masculinos e femininos, divididos aleatoriamente em dois grupos. Antes do treinamento, os atletas do grupo experimental receberam treinamento de relaxamento através do método de regulação da respiração, método de relaxamento muscular e método de treinamento independente, com um total de 60 minutos de duração em cada sessão, por 6 meses. Resultados Partindo da premissa de que não houve diferença significativa nos índices físicos iniciais, os atletas do grupo experimental tiveram melhor desempenho em 100m, 200m e 300m do que os do grupo controle, e a diferença entre os dois grupos foi significativa (P < 0,05). Conclusão O treinamento de relaxamento adequado tem um efeito positivo sobre a resistência muscular e o nível técnico dos atletas. Portanto, o aumento adequado do treinamento de relaxamento mostra-se propício na melhoria da qualidade física geral e no nível competitivo dos atletas. Nível de evidência II; Estudos terapêuticos - investigação dos resultados do tratamento.

RESUMEN Introducción La enseñanza actual de los deportistas se centra principalmente en la ganancia de sus habilidades, descuidando muchas veces los impactos beneficiosos de la relajación en la calidad física general de sus alumnos. Por lo tanto, es de gran importancia aclarar la relación entre el entrenamiento de relajación muscular y el rendimiento deportivo. Objetivo Explorar el efecto del entrenamiento de relajación en el nivel técnico y muscular de los atletas que corren. Métodos Se realizó un experimento comparativo con 40 corredores masculinos y femeninos, divididos aleatoriamente en dos grupos. Antes del entrenamiento, los atletas del grupo experimental recibieron un entrenamiento de relajación mediante el método de regulación de la respiración, el método de relajación muscular y el método de entrenamiento independiente, con una duración total de 60 minutos en cada sesión, durante 6 meses. Resultados Partiendo de la base de que no había diferencias significativas en los índices físicos iniciales, los atletas del grupo experimental obtuvieron mejores resultados en 100m, 200m y 300m que los del grupo de control, y la diferencia entre los dos grupos fue significativa (P < 0,05). Conclusión Un entrenamiento de relajación adecuado tiene un efecto positivo en la resistencia muscular y el nivel técnico de los atletas. Por lo tanto, el aumento adecuado del entrenamiento de relajación se muestra propicio para mejorar la calidad física general y el nivel competitivo de los deportistas. Nivel de evidencia II; Estudios terapéuticos - investigación de los resultados del tratamiento.

The role of muscle relaxation in badminton players / O papel do relaxamento muscular em jogadores de badminton / El papel de la relajación muscular en jugadores de bádminton

ABSTRACT Introduction: In training, fatigue and recovery are antagonistic factors. Physical rehabilitation of athletes and elimination of sports fatigue have gradually become essential factors in improving competitiveness. Muscle relaxation exercises can reduce badminton players' physical effort, allowing them to recover quickly. Objective: Analyze muscle relaxation's effect on fatigue relief until the normalization of physical strength in badminton players. Methods: Twelve badminton players were grouped in cross-sectional tests. During the three weeks of physical training, players performed two training methods: muscle relaxation and complete rest. Laboratory analysis encompassed blood biomarkers such as urea and creatine kinase. Data were collected before and after the interventions, confronted, and studied mathematically and statistically. Results: The proportions of leukocytes and lymphocytes in the muscle relaxation group after resistance exercise were lower than before. The decrease of morning leukocytes in the muscle relaxation group on the second day was less than in the resting group. The recovery effect of the lymphocyte ratio was also better. After special strength training, the value of creatine kinase was significantly higher than before exercise in both the muscle relaxation group and the complete rest group. Conclusion: Muscle relaxation can reduce exercise fatigue in badminton players. Level of evidence II; Therapeutic studies - investigation of treatment outcomes.

RESUMO Introdução: No treinamento, fadiga e recuperação são fatores antagônicos. A reabilitação física dos atletas e a eliminação da fadiga esportiva tornaram-se gradualmente fatores essenciais para melhorar a competitividade. O exercício de relaxamento muscular pode reduzir o esforço físico dos jogadores de badminton, permitindo ao jogador recuperar-se rapidamente. Objetivo: Analisar o efeito do relaxamento muscular sobre o alívio da fadiga até a normalização da força física nos jogadores de badminton. Métodos: Foram agrupados 12 jogadores de badminton em testes transversais. Durante as três semanas de treinamento físico, os jogadores realizaram dois métodos de treinamento: relaxamento muscular e repouso completo. A análise laboratorial englobou biomarcadores sanguíneos, como ureia e creatina cinase. Os dados foram coletados antes e após as intervenções, confrontados e estudados de forma matemática e estatística. Resultados: As proporções de leucócitos e linfócitos no grupo de relaxamento muscular após o exercício de resistência foram menores do que antes. A diminuição dos leucócitos matinais no grupo de relaxamento muscular no segundo dia foi menor do que no grupo de repouso, e o efeito de recuperação da relação de linfócitos também foi melhor. Após o treinamento especial de força, o valor da creatina quinase foi significativamente maior do que antes do exercício tanto no grupo de relaxamento muscular quanto no grupo de repouso completo. Conclusão: O relaxamento muscular pode reduzir a fadiga do exercício nos jogadores de badminton. Nível de evidência II; Estudos terapêuticos - investigação dos resultados do tratamento.

RESUMEN Introducción: En el entrenamiento, la fatiga y la recuperación son factores antagónicos. La rehabilitación física de los atletas y la eliminación de la fatiga deportiva se han convertido gradualmente en factores esenciales para mejorar la competitividad. El ejercicio de relajación muscular puede reducir el esfuerzo físico de los jugadores de bádminton, permitiendo que el jugador se recupere rápidamente. Objetivo: Analizar el efecto de la relajación muscular en el alivio de la fatiga hasta la normalización de la fuerza física en jugadores de bádminton. Métodos: Se agruparon doce jugadores de bádminton en pruebas transversales. Durante las tres semanas de entrenamiento físico, los jugadores realizaron dos métodos de entrenamiento: la relajación muscular y el descanso completo. Los análisis de laboratorio incluían biomarcadores sanguíneos como la urea y la creatina quinasa. Los datos se recogieron antes y después de las intervenciones, se confrontaron y se estudiaron matemática y estadísticamente. Resultados: Las proporciones de leucocitos y linfocitos en el grupo de relajación muscular tras el ejercicio de resistencia fueron menores que antes. La disminución de los leucocitos matinales en el grupo de relajación muscular en el segundo día fue menor que en el grupo de reposo, y el efecto de recuperación de la proporción de linfocitos también fue mejor. Después del entrenamiento especial de fuerza, el valor de la creatina quinasa fue significativamente mayor que antes del ejercicio tanto en el grupo de relajación muscular como en el de reposo completo. Conclusión: La relajación muscular puede reducir la fatiga del ejercicio en los jugadores de bádminton. Nivel de evidencia II; Estudios terapéuticos - investigación de los resultados del tratamiento.

Core strength training impacts on the improvement of muscle coordination in sport dancers / Treinamento de força do core na melhoria da coordenação muscular em dançarinos esportivos / Entrenamiento de la fuerza del core en la mejora de la coordinación muscular en bailarines deportivos

ABSTRACT Introduction: Dance sport is an emerging sport activity. The number of college students devoted to the study of dance is increasing. Basic dance sport skills are inherent to performance. Basic skills training requires dancers to have a certain degree of flexibility, endurance, speed, etc. Currently, we know that CORE strength training can improve the physical function of athletes, but studies are scarce as to its true impact on proprioceptive skills in dance sports. Objective: The purpose of this study was to examine the effect of strengthening the CORE on muscle coordination in sport dancers. This paper examines the relationship between core strength training and dance skills in athletes. Methods: Undergraduate sport dance students were randomly and voluntarily selected. These students undergo a 4-month training protocol in CORE strengthening. The effect of this experiment was evaluated with biomarker and kinetic data collected before and after the experiment. These data were worked out statistically and the results were discussed according to the literature. Results: After the CORE training protocol, the sport dance students had significant differences in physical tests(P<0.05). Conclusion: CORE training can promote physical stability, explosive power and muscle coordination in sport dancers. Level of evidence II; Training research - outcome investigation.

RESUMO Introdução: O esporte de dança é uma atividade esportiva emergente. O número de estudantes universitários dedicados ao estudo da dança está aumentando. As habilidades básicas da dança esportiva são inerentes à performance. O treinamento de habilidades básicas exige que os dançarinos tenham um certo grau de flexibilidade, resistência, velocidade, etc. Atualmente, sabemos que o treinamento de força do core pode melhorar a função física dos atletas, porém os estudos são escassos quando ao seu verdadeiro impacto sobre as habilidades proprioceptivas na dança esportiva. Objetivo: Este estudo teve como objetivo analisar o efeito do fortalecimento do core na coordenação muscular em bailarinos esportivos. Este artigo examina a relação entre treinamento de força central e habilidades de dança em atletas. Métodos: Foram selecionados, de maneira aleatória e voluntariamente, universitários graduandos em dança esportiva. Esses alunos passam por 4 meses sob protocolo de treino em fortalecimento do core. O efeito desse experimento foi avaliado com os dados de biomarcadores e cinéticos coletados antes e após o experimento. Esses dados foram trabalhados estatisticamente e os resultados foram discutidos segundo a literatura. Resultados: Após o protocolo de treinamento do core, os alunos de dança esportiva tiveram diferenças significativas nos testes físicos (P<0,05). Conclusão: O treinamento do core pode promover estabilidade física, poder explosivo e coordenação muscular em dançarinos esportivos. Nível de evidência II; Pesquisa de treinamento - investigação de resultados.

RESUMEN Introducción: El deporte de la danza es una actividad deportiva emergente. El número de universitarios dedicados al estudio de la danza va en aumento. Las habilidades deportivas básicas de la danza son inherentes al rendimiento. El entrenamiento de habilidades básicas requiere que los bailarines tengan un cierto grado de flexibilidad, resistencia, velocidad, etc. Hoy en día, sabemos que el entrenamiento de fuerza core puede mejorar la función física de los atletas, pero los estudios son escasos sobre su impacto real en las habilidades propioceptivas en los deportes de danza. Objetivo: Este estudio tiene como objetivo analizar el efecto del fortalecimiento del core en la coordinación muscular de los bailarines deportivos. Este artículo examina la relación entre el entrenamiento de la fuerza central y las habilidades de danza en los atletas. Métodos: Se seleccionaron de forma aleatoria y voluntaria estudiantes universitarios que se graduaban en danza deportiva. Estos estudiantes pasaron 4 meses bajo el protocolo de formación en el fortalecimiento del core. El efecto de este experimento se evaluó con datos de biomarcadores y cinéticos recogidos antes y después del experimento. Estos datos se trabajaron estadísticamente y los resultados se discutieron de acuerdo con la literatura. Resultados: Tras el protocolo de entrenamiento del core, los alumnos de danza deportiva presentaron diferencias significativas en las pruebas físicas (P<0,05). Conclusión: El entrenamiento del core puede promover la estabilidad física, la potencia explosiva y la coordinación muscular en los bailarines deportivos. Nivel de evidencia II; Investigación de formación - investigación de resultados.

Effect of deImedetomidine on muscle relaIant effect of cisatracurium in patients with epilepsy / 中国临床药理学与治疗学

AIM: To determine the effect of dexmedetomidine on muscle relaxant effect of cisatracurium in patients with epilepsy. METHODS: Sixty patients undergoing elective neurosurgery, aged from 18 to 59 years old, were divided into three groups (n = 20) according to the maximum onset time of dexmedetomidine: immediate induction group after dexmedetomidine infusion (Group A), induction group 15 minutes after dexmedetomidine infusion (Group B) and normal saline infusion (Group C). The neuromuscular conduction function was monitored by muscle relaxation monitor, and the ulnar nerve was stimulated in TOF mode (frequency 2 Hz, wave width 0.2 ms, stimulation current 70 mA, string interval 12 s). Patients in group A were given dexmedetomidine 1 μg/kg after entering the room, and anesthesia induction was started immediately after 10 min pumping; Group B patients were given dexmedetomidine 1 μg/kg after entering the room, and anesthesia induction was started 15 minutes after 10 minutes of pump injection; Patients in group C began induction immediately after pumping the same milliliter of normal saline within 10 min. During anesthesia induction, 0.15 mg/kg cisatracurium was injected intravenously, and endotracheal intubation was performed when T

Movable surface models of hand joints using visible korean / Modelos de superficies móviles de articulaciones de manos utilizando visible Korean

SUMMARY: The human hand can make precise movements utilizing several joints of various articular types. To understand hand movements more accurately, it is essential to view the actual movements of bones and muscles considering the X, Y, and Z axes in the joints. This study aimed to investigate the joint movements in a hand using movable surface models, including these axes. These movable surface models of the hand will improve medical students' understanding of hand movements around the joints. To achieve this aim, 70 surface models were adopted from a Visible Korean model. Using Maya software, 20 virtual joints with X, Y, and Z axes included nine distal and proximal interphalangeal joints, five metacarpophalangeal joints, five carpometacarpal joints, and one wrist joint were created. Bone surface models were elaborately polished to maintain their original shape during movement. Muscle surface models were also processed to display the deformation of the muscle shape during movement. The surface models of the hand joints were moved by virtual control of the joints. We saved 87 movable surface models of the hand, including bones, muscles, and joint axes in stereolithography format, and compiled a Portable Document Format (PDF) file. Using the PDF file, the joint movements in a hand could be observed considering the X, Y, and Z axes alongside the stereoscopic shapes of the bones and muscles. These movable surface models of the hand will improve medical students' understanding of hand movements around the joints.

RESUMEN: La mano humana puede realizar movimientos precisos utilizando varias articulaciones de diferentes tipos articulares. Para comprender los movimientos de las manos con mayor precisión, es esencial ver los movimientos reales de los huesos y los músculos considerando los ejes X, Y y Z de las articulaciones. Este estudio tuvo como objetivo investigar los movimientos articulares en una mano utilizando modelos de superficies móviles, incluidos estos ejes. Estos modelos de superficie móvil de la mano mejorarán la comprensión de los estudiantes de medicina de los movimientos de la mano alrededor de las articulaciones. Para lograr este objetivo, se adoptaron 70 modelos de superficie de un modelo coreano visible. Con el software Maya, se crearon 20 articulaciones virtuales con ejes X, Y y Z que incluyeron nueve articulaciones interfalángicas distales y proximales, cinco articulaciones metacarpofalángicas, cinco articulaciones carpometacarpianas y una articulación de muñeca. Los modelos de superficie ósea se pulieron minuciosamente para mantener su forma original durante el movimiento. También se procesaron modelos de superficie muscular para mostrar la deformación de la forma del músculo durante el movimiento. Los modelos de superficie de las articulaciones de las manos se movieron mediante el control virtual de las articulaciones. Guardamos 87 modelos de superficies móviles de la mano, incluidos huesos, músculos y ejes articulares en formato de estereolitografía, y compilamos un archivo en formato de documento portátil (PDF). Usando el archivo PDF, los movimientos de las articulaciones en una mano se pueden observar considerando los ejes X, Y y Z junto con las formas estereoscópicas de los huesos y músculos. Estos modelos de superficie móvil de la mano mejorarán la comprensión de los estudiantes de medicina sobre los movimientos de la mano alrededor de las articulaciones.

Manejo anestésico para electroporación irreversible en el paciente pediátrico / Anesthetic management for irreversible electroporation in the pediatric patient

Resumen: Introducción: La electroporación irreversible (EIR) es una técnica conocida desde 1972; fue incorporada al ámbito oncológico en el año 2005 como técnica de ablación tumoral basada en pulsos eléctricos cortos de alto voltaje y es utilizada para introducir elementos químicos por difusión, alterar la estructura genética celular, fusionar una célula con otra (reversible) o provocarle la muerte (irreversible). Estas descargas eléctricas conllevan un riesgo asociado de arritmias cardíacas, contracciones musculares severas y convulsiones. Mantener un adecuado plano anestésico, analgesia óptima, relajación neuromuscular profunda y electrocardiograma sincronizado a los pulsos eléctricos son los objetivos principales del manejo anestésico. Objetivo: Describir las implicaciones anestésicas de la EIR en el paciente pediátrico. Material y métodos: Revisión narrativa basada en una búsqueda de artículos relacionados con la EIR en las principales bases de datos, donde la principal fuente de información son los reportes de casos y las revisiones no sistemáticas de la literatura, tanto del área de anestesiología y dolor como de ingeniería, radiología intervencionista vascular y cardiovascular, y cirugía. Resultados: Se encontraron y revisaron un total de 17 referencias bibliográficas. Conclusión: La anestesia para EIR en el paciente pediátrico debe garantizar un adecuado plano anestésico idealmente con intubación endotraqueal, analgesia óptima, relajación profunda y control de arritmias cardíacas con sincronización del electrocardiograma.

Abstract: Introduction: Irreversible electroporation (IRE) is a technique known since 1972 incorporated into the oncological field in 2005 as a tumor ablation technique based on short high-voltage electrical pulses used to introduce chemical elements by diffusion, alter the cellular genetic structure, fuse a cell with other (reversible) or cause death (irreversible). These electric shocks carry an associated risk of cardiac arrhythmias, severe muscle contractions and seizures. Maintain an adequate anesthetic plane, optimal analgesia, deep neuromuscular relaxation and an electrocardiogram synchronized to the electrical pulses are the main objectives of anesthetic management. Objective: Describe the anesthetic implications of IRE in the pediatric patient. Material and methods: Narrative review based on a search for articles related to IRE in the most important databases, where the main source of information is case reports and non-systematic reviews of the literature, both in the area of anesthesiology and pain as well as engineering, vascular and cardiovascular interventional radiology, and surgery. Results: A total of 17 bibliographic references were found and reviewed. Conclusion: The anesthesia for IRE in the pediatric patient should guarantee an adequate anesthetic plane ideally with endotracheal intubation, optimal analgesia, deep relaxation and control of cardiac arrhythmias with electrocardiogram synchronization.

Pharmacokinetics of sugammadex in reversal of postoperative residual neuromuscular blockade in obese patients / 中华麻醉学杂志

Objective:To investigate the pharmacokinetics of sugammadex in reversal of postoperative residual neuromuscular blockade in obese patients.Methods:Sixteen patients of both sexes, aged 18-65 yr, of American Society of Anesthesiologists physical statusⅠ or Ⅱ, with body mass index of ≥25 kg/m 2, scheduled for elective laparoscopic bariatric surgery, were selected.The patients were divided into 2 groups ( n=8 each) according to the degree of obesity: group O (25 kg/m 2≤BMI<40 kg/m 2) and group M (BMI≥40 kg/m 2). In group O and group M, vecuronium was administered by closed-loop muscle relaxant injection system to maintain moderate neuromuscular blockade.The administration was stopped at the end of surgery, and sugammadex 2 mg/kg was injected according to corrected body weight (CBW) of patients when the muscle relaxation monitoring T 2 recovered naturally.The recovery time of neuromuscular blockade and the occurrence of residual neuromuscular blockade within 3 h after surgery were recorded.Arterial blood samples were collected at 2, 3, 5, 10, 15, 20, 30, 60, 120, 240, 360 and 480 min after administration of sugammadex.The concentration of sugammadex in plasma was determined by ultra-performance liquid chromatography-mass spectrometry.The pharmacokinetic parameters were calculated with PKSolver software. Results:No residual neuromuscular blockade occurred, and the pharmacokinetics of sugammadex in plasma were consistent with the linear non-compartmental model in the two groups.Compared with group O, apparent clearance was increased ( P<0.05), and no significant change was found in other pharmacokinetic parameters, recovery time of neuromuscular blockade and concentrations of sugammadex in plasma at different time point ( P>0.05) in group M. Conclusion:The pharmacokinetics of sugammadex in reversal of postoperative residual neuromuscular blockade in obese patients are consistent with the linear non-compartmental model, and the clearance of sugammadex is higher in morbidly obese patients.

Cuidados de Enfermería en pacientes con ventilación mecánica invasiva en la Unidad de Cuidados Intensivos Pediátricos / Nursing Care in patients with invasive mechanical ventilation in the Pediatric Intensive Care Unit

La rehabilitación cardiometabólica es un programa multifactorial útil para el tratamiento de las principales patologías que tienen una relación directa con el sedentarismo, como patologías cardiovasculares, metabólicas y sus complicaciones. En mayo de 2004, durante la 57ª Asamblea Mundial de la Salud, se aprobó "La estrategia mundial de la Organización Mundial de la Salud (OMS) que aborda sobre el régimen alimentario, la actividad física y la salud" con la finalidad de disminuir la inactividad física, los malos hábitos de alimentación que de forma directa llevan al exceso de peso, y que están asociadas al riesgo cardiovascular (RCV), a las enfermedades cardiovasculares, a la diabetes mellitus (DM) del tipo 2 y a otras diferentes enfermedades degenerativas crónicas. En base a la cual se orienta a implementar una correcta prescripción del ejercicio tanto preventiva como terapéutica. Este protocolo de atención clínico-terapeútico va dirigido a profesionales de la salud para el control de enfermedades cardiometabólicas. Los profesionales sanitarios podrán ofertar una terapéutica integral a sus pacientes para dosificar el ejercicio de forma personalizada, a partir del estado de salud, conocimiento de patologías preexistentes, edad y condición física inicial del paciente, así como proporcionar un seguimiento mediante programas individualizados. Cuyo principal fin es mejorar la condición cardiovascular, evitar nuevas complicaciones y reducir la mortalidad.

Cardiometabolic rehabilitation is a multifactorial program useful for the treatment of the main pathologies that have a direct relationship with sedentary lifestyle, such as cardiovascular, metabolic pathologies and their complications. In May 2004, during the 57th World Health Assembly, "The World Strategy of the World Health Organization (WHO) that addresses the diet, physical activity and health" was approved in order to reduce the physical inactivity, poor eating habits that directly lead to excess weight, and that are associated with cardiovascular risk (CVR), cardiovascular diseases, diabetes mellitus type 2 and other different chronic degenerative diseases . Based on which it is oriented to implement a correct prescription of both preventive and therapeutic exercise.This protocol of clinical-therapeutic care is aimed at health professionals for the control of cardiometabolic diseases. Health professionals may offer a comprehensive therapy to their patients to dose the exercise in a personalized way, based on the state of health, knowledge of preexisting pathologies, age and initial physical condition of the patient, as well as providing follow-up through individualized programs. Whose main purpose is to improve the cardiovascular condition, avoid new complications and reduce mortality.

A study to evaluate the skeletal muscle relaxant property of Pregabalin and Gabapentin in albino rats

Background: Skeletal muscle relaxants are the drugs which reduce unwanted spasm without interfering with consciousness and voluntary movements. The centrally acting muscle relaxants like Diazepam, is known to be GABA mimetics and other antiepileptics like Gabapentin and Pregabalin also act through the release of GABA. This study is done to investigate skeletal muscle relaxant property of these drugs in comparison to Diazepam.Methods: T Models used in the experiment are Grip Strength Test, Rota Rod Method, Beam Walk Test, Photoactometer Test. Animals were divided into 6 groups of 6 rats each: Group 1: Control group treated with normal saline (0.1 ml/10gm), Group 2: Standard-15mg/kg of Diazepam, Group 3:T1-60 mg/kg of Gabapentin, Group 4:T2-10 mg/kg of Pregabalin, Group 5:T3-60 mg/kg of Gabapentin+Diazepam, Group 6:T4- 10 mg/kg of Pregabalin+Diazepam. Mean and standard deviation was calculated for each group. One way ANOVA was used for multiple group comparisons followed by post hoc Tukey’s test for statistical significance between the groups.Results: Treatment with the above test drugs produced significant muscle relaxation and caused decreased fall off, sliding time, increase climbing time and decreased locomotor activity in all models indicating motor incoordination. The results obtained from both standard and test groups showed a highly significant difference in muscle relaxation when compared with the control group.Conclusions: The test drugs showed skeletal muscle relaxant property in rats comparable to Diazepam. In view of these results, it can open a new avenue for these drugs to be used as skeletal muscle relaxants after conducting clinical trials.

Effectiveness of Progressive Muscle Relaxation in Reducing Depression, Anxiety and Stress among Haemodialysis Patients attending a Public Hospital at Central Java Indonesia

@#The increasing trend of Chronic Kidney Disease (CKD) prevalence in Indonesia is a public health concern as it increases mortality, morbidity and burden of disease that has great implication on the health economic. In addition, CKD patients who are more likely to undergo hemodialysis is commonly associated with psychological problems such as depression, anxiety and stress and these have added more to the disease burden. Immediate measures such as progressive muscle relaxation (PMR) to reduce the psychological symptoms is of great importance before the symptoms progress into psychiatric disorders. The study was aimed to evaluate the effectiveness of PMR in reducing symptoms of depression, anxiety and stress among patients undergoing hemodialysis. It was a quasi-experimental, pretest-posttest control study that recruited 60 eligible respondents who underwent hemodialysis and was randomly allocated into intervention and waitlist control groups. Respondents in the intervention group performed PMR twice a day for two weeks. Mean scores of depression, anxiety and stress of respondents were examined before and after intervention using Depression, Anxiety and Stress Scale–21 questionnaire (DASS-21). Results showed that mean scores of depression, anxiety and stress differed significantly before and after intervention between groups and within the intervention group (p<0.05). PMR was effective to reduce the psychological symptoms among patients underwent hemodialysis. This highlight the importance to screen psychological symptoms among those patients and PMR should be taught to them as one of the stress-reducing measures.

Rapid Functional Enhancement of Ankylosing Spondylitis with Severe Hip Joint Arthritis and Muscle Strain

Arthritis of hip joints deteriorates the quality of life in ankylosing spondylitis (AS) patients. Secondary to the articular inflammatory process, the shortened hip-girdle muscles contribute to the decreased joint mobility which may lead to the functional impairment. As the limitation of range of motion (ROM) usually progress slowly, clinicians regard it as a chronic condition and prescribe long-term therapy. However, by short-term intensive multimodal treatment, a 20-year-old man diagnosed as AS with severely limited hip joint ROM who relied on crutches doubled the joint angle and could walk independently only within 2 weeks. The combination included intra-articular steroid injection, electrical twitch obtaining intramuscular stimulation, extracorporeal shock wave therapy, heat, manual therapy, and stretching exercises. The management focused on the relaxation of hip-girdle muscles as well as the direct control of intra-articular inflammation. Hereby, we emphasize the effectiveness of intensive multimodal treatment in improving the function even within a short period.

Effect of co-administration of BRL-37344 and tadalafil on reduction of overactive bladder symptoms after induction of detrusor overactivity in mice

Abstract Purpose: To evaluate the impact of the combination of BRL 37344 and tadalafil (TDF) on the reduction of overactive bladder (OB) symptoms. Methods: Thirty mice were randomized into 5 groups (G) of 6 animals each. L-NAME was used to induce DO. G1: Control; G2: L-NAME; G3: L-NAME + TDF; G4: L-NAME + BRL 37344; G5: L-NAME + TDF + BRL 37344. After 30 days of treatment, the animals were submitted to cystometry to evaluate non-voiding contractions (NVC), threshold pressure (TP), baseline pressure (BP), frequency of micturition (FM) and threshold volume (TV). Differences between the groups were analyzed with ANOVA followed by the Tukey test. Results: NVC increased in G2 (4.33±2.58) in relation to G1 (1.50±0.55). NVC decreased in G3 (2.00±1.10), G4 (1.50±1.52) and G5 (2.00±1.26) compared to G2 (p<0.05). FM decreased in G3 (0.97±0.71), G4 (0.92±0.38) and G5 (1.05±0.44) compared to G2 (p<0.05). However, the combination of TDF and BRL37344 was not more effective at increasing NVC and improving FM than either drug alone. The five groups did not differ significantly with regard to TV. Conclusion: The combination of BRL 37344 and TDF produced no measurable additive effect on reduction of OB symptoms.

Effect of partial neuromuscular blockade on efficacy and safety of nerve monitoring during microvascular decompression of facial nerve / 中华麻醉学杂志

Objective To evaluate the effect of partial neuromuscular blockade (NMB) on the efficacy and safety of nerve monitoring during microvascular decompression (MVD) of facial nerve.Methods Seventy American Society of Anesthesiologists physical status Ⅰ or Ⅱ patients of both sexes,aged 39-78 yr,weighing 44-84 kg,scheduled for elective MVD,were divided into 2 groups (n=35 each) using a random number table method:control group and partial NMB group.Anesthesia was induced by intravenous injection of 3-fold ED95 cisatracurium.In control group,muscle relaxants were not used after intubation.In partial NMB group,cisatracurium was continuously infused intravenously to maintain partial NMB,and the T1/Tc ratio was maintained at 20％-40％.Intraoperative neuroelectrophysiological monitoring was performed using lateral spread response (LSR).The success rates of LSR monitoring,occurrence of body movement,requirement for anesthetics and cardiovascular agents were recorded during operation,and the patients were followed up on day 7 after surgery,and the therapeutic efficacy and occurrence of neurological complications were recorded.Results Compared with control group,the incidence of intraoperative body movement was significantly decreased,the intraoperative consumption of propofol and remifentanil was decreased,and the intraoperative requirement for vasopressors was decreased in partial NMB group (P＜0.05).There was no significant difference in the success rate of LSR monitoring,therapeutic efficacy and incidence of neurological complications between two groups (P＞0.05).Conclusion Partial NMB (T1/Tc=20％-40％) can be effectively used for MVD monitored by LSR,decrease the occurrence of the body movement,and raise the perioperative safety in patients.

Effects of different doses of mivacurium chloride on muscle relaxation time- course and hemodynamics in children with different ages / 中国医师进修杂志

Objective To observe the effect of different doses of mivacurium chloride on muscle relaxation time-course and hemodynamics in children with different ages. Methods One hundred children of selective inguinal hernia repair under general anesthesia with endotracheal intubation from January 2016 to January 2017 were enrolled, and the age was 0.5 to 6.0 years. The children were divided into low age group (0.5 to 3.0 years) and high age group (3.1 to 6.0 years) according to the age, then the children were divided into low dose group (mivacurium chloride 0.20 mg/kg) and high dose group (mivacurium chloride 0.25 mg/kg) according to the doses of mivacurium chloride. Therefore, the children were divided into low age low dose group, low age high dose group, high age low dose group and high age high dose group with 25 cases each. The mean arterial pressure (MAP) and heart rates before anesthesia (T0) and 1 min (T1), 3 min (T2), 5 min (T3), 10 min (T4) after intravenous injection of mivacurium chloride were recorded. The times of first intravenous injection of mivacurium chloride to neuromuscular block 75% (ThD75), 90% (ThD90) and maximum (ThDmax) were recorded. The recovery index (RI) was recorded. The times of last intravenous injection of mivacurium chloride to onset of muscle convulsions (Th) and muscle convulsions recovery 10% (ThR10), 25% (ThR25), 75% (ThR75), 90% (ThR90) were recorded. The times of ratio of the fourth muscle twitch to the first muscle twitch (TOFR) recovery 75% (TOFR75) and 90% (TOFR90) were recorded. Results There were no statistical difference in MAP and heart rate among 4 groups (P＞0.05). The ThD75, ThD90 and ThDmax in low age low dose group were (126 ± 40), (163 ± 59) and (192 ± 49) s, those in low age high dose group were (73 ± 15), (115 ± 41) and (142 ± 37) s, those in high age low dose group were (149 ± 38), (193 ± 44) and (221 ± 47)s, and those in high age high dose group were (105 ± 32), (138 ± 35) and (167 ± 44)s. The ThD75, ThD90 and ThDmax in low age high dose group were significantly shorter than those in low age low dose group, those in high age high dose group were significantly shorter than those in high age low dose group, those in high age low dose group were significantly longer than those in low age low dose group, those in high age high dose group were significantly longer than those in low age high dose group, and there were statistical differences (P＜0.05). There were no statistical differences in Th, ThR10, ThR25, ThD75, ThD90, RI, TOFR75 and TOFR90 among low age low dose group and low age high dose group, high age low dose group and high age high dose group (P＞0.05). Conclusions In the children of 0.5 to 3.0 years, the effect of mivacurium chloride is significantly faster than that in the children of aged 3.1 to 6.0 years. Compared with 0.20 mg/kg of mivacurium chloride, 0.25 mg/kg of mivacurium chloride has less time to display muscle relaxation effect. The recovery time is not affected by age and induction dose. Mivacurium chloride has no significant effect on hemodynamics.

Risk factors for postoperative residual paralysis in patients undergoing general anesthesia / 中华麻醉学杂志

Objective To determine the risk factors for postoperative residual paralysis in patients undergoing general anesthesia and establish the warning score system initially.Methods A total of 369 patients who underwent general anesthesia and developed residual paralysis after returning to the recovery room and 740 patients who did not developed residual paralysis were enrolled in the study.Logistic regression was used to analyze the factors of which P values were less than 0.05 to identify the independent risk factors for postoperative residual paralysis.The warning score system was established initially according to the odds ratios of each risk factor,and the area under receiver operating characteristic curve was used to evaluate the predicting ability of the system.Results Logistic regression analysis showed that the consumption of cisatracurium more than 0.4 mg · kg-1 · h-1,time from the last administration of muscle relaxants to the end of operation less than 60 min and volume of intraoperative fluid infused more than 20 ml/kg were independent risk factors for postoperative residual paralysis in patients undergoing general anesthesia.The warning score system of residual paralysis was established initially,and the area under receiver operating characteristic curve was 0.82.The best cut-off value of predicting residual paralysis was 1.5 (sensitivity 63.5％,specificity 82.7％,Youden index 0.462),and thus the risk stratification criteria were determined initially with score less than or equal to 1 predicting low risk,and score more than or equal to 2 predicting high risk.Conclusion The consumption of cisatracurium more than 0.4 mg · kg-1 · h-1,time from the last administration of muscle relaxants to the end of operation less than 60 min and volume of intraoperative fluid infused more than 20 ml/kg are independent risk factors for postoperative residual paralysis in patients undergoing general anesthesia;the initially established warning score system produces higher accuracy in predicting postoperative residual paralysis.

Influence of age on the recovery of neuromuscular function after continuous infusion of rocuronium bromide / 中华老年医学杂志

Objective To investigate the influence of age on recovery from neuromuscular blocking after continuous infusion of rocuronium bromide.Methods A total of 60 patients receiving general anesthesia were assigned to one of four groups according to age:≤44 years old group (n=12),45-59 years old group (n=18),60-74 years old group (n=15),and ≥75 years old group (n=15).Total intravenous anesthesia was used for both induction and maintenance of anesthesia.The train-of four (TOF) was applied for measuring acceleromyography.The induction of anesthesia was conducted with 0.6 mg/kg rocuronium bromide,and 0.3-0.6 mg · kg-1 · h-1 rocuronium bromide was continuously intravenouoly infused until 30 minutes before the end of operation by a micro-pump to maintain T1 between 10-20％.Recovery index (RI),recovery time of TOFr 70％ and TOFr 90％,and the average infusion rate of the four groups were collected.Results The RI,TOFr 70％ recovery time,and TOFr 90％ recovery time in the ≥75 years old group [28.9±10.0,(59.8±12.1) min,(38.6±10.6) min] were higher than those in the other three groups [≤44 years old group:21.4±7.0,(40.2±11.0) min,(27.610.0) min;the 45-59 years old group:22.8±7.0,(42.4±11.8) min,(28.7±9.2) min;the 60-74 years old group:21.1±7.9,(41.0±9.8) min,(26.1±6.7) min] (all P ＜0.05 or 0.01).The average infusion rate for the ≤44 years old group (0.41±0.1) mg·kg-1·h-1was higher than that for the 60-74 years old group (0.33±0.06) mg·kg-1·h-1(P＜0.01);The rate for the ≥75 years old group (0.32±0.06) mg·kg-1 ·h-1 was lower than that for the ≤44 years old group and that for the 45-59 years old group (0.38±0.08) mg·kg-1 ·h-1 (P＜0.05 or ＜0.01)Conclusions After continuous infusion of rocuronium bromide,patients aged 75 or over need more time to recover their myodynamia than younger people do.The myodynamia recovery time is longer after continuous bromide infusion than after a single dose injection of rocuronium bromide,but it still follows a similar pattern.For the same level of muscle relaxation in the elderly,a lower dose of rocuronium bromide is required.

The Effectiveness of Progressive Muscle Relaxation on the Postpartum Quality of Life: A Randomized Controlled Trial

PURPOSE: This study aimed to determine the effectiveness of progressive muscle relaxation (PMR) on the quality of life of women during postpartum period. METHODS: A randomized controlled trial design was used. The participants consisted of primiparous women who had experienced a vaginal birth in the obstetrics department of a hospital. Thirty women in the intervention group and 30 women in the control group were included. Data were collected using the Maternal Postpartum Quality of Life Questionnaire (MAPP-QoL) between June 2016 and April 2017. PMR was applied to the intervention group. PMR was performed as contracting a muscle group and then relaxing it, moving (or progressing) from one muscle group to another. RESULTS: The mean pretest and posttest scores of the MAPP-QoL in the intervention group were 24.43 ± 4.58 and 26.07 ± 4.58, respectively (t = −2.73, p .05), whereas the difference between the groups after PMR was found to be statistically significant (t = 3.09, p < .05). CONCLUSION: Postpartum quality of life of women was increased after PMR. It is recommended that PMR be taught to women who are admitted to obstetrics and outpatient clinics and home visits be completed to expand the use of PMR.

Progressive Muscle Relaxation Combined with Chinese Medicine Five-Element Music on Depression for Cancer Patients: A Randomized Controlled Trial / 中国结合医学杂志

<p><b>OBJECTIVES</b>To evaluate the effects of progressive muscle relaxation training (PMRT) combined with fifive elements music therapy of Chinese medicine (CM) for improving anxiety and depression of cancer patients.</p><p><b>METHODS</b>From June 2015 to March 2016, 60 cancer patients were included into the study. The patients were randomly assigned to a control group and a treatment group by envelope randomization, receiving PMRT and PMRT plus CM five elements music therapy, respectively, for 8 weeks. Hospital Anxiety and Depression Scale (HADS), Benefit Finding Scales (BFS), Functional Assessment of Chronic Illness Therapy-Spiritual (FACIT-Sp), and Intervention Expectations Questionnaire (IEQU) were adopted to assess the depression of the two groups before and after the treatment.</p><p><b>RESULTS</b>Four cases dropped out during the study, and 29 cases in the treatment group and 27 in the control group were included in the fifinal analysis. Prior to the treatments, the baselines of the 4 questionnaires in the two groups showed no difference. After the 8-week treatment, the treatment group presented better levels of HADS, BFS and FACIT-Sp scores compared with the control group (P<0.05). Among the single items of HADS, 4 items involving vexation, feeling fifidgeted, pleasure and prospecting the future in the treatment group were improved compared with the control group (P<0.05).</p><p><b>CONCLUSIONS</b>As a simple and reliable and effective intervention, PMRT combined with fifive elements music therapy mitigated anxiety and depression of cancer patients. Cancer patients have been found to respond well to psychological intervention in areas regarding stabilisation of emotions, disease awareness, and therapeutic compliance. This brings about a great difference in improving their quality of life and psychological state, offers an effective approach to better self-management in cancer treatment.</p>

Impacts Of Three Different Relaxation Techniques On Mood States Among Athletes

@#Relaxation technique is a method, process, procedure or activity that helps a person to relax. There are several methods of relaxation techniques that can be used proven beneficial to improve the individual state of relaxation. Relaxation can be performed individually or in a group. With suitable technique of relaxation, it will improve quality of life as well as emotional and physical. This study aims to investigate the impact of three different relaxation techniques, namely Autogenic (AGR), Progressive Muscle (PMR) and Music Relaxation (MR) on mood states among Universiti Sultan Zainal Abidin (UniSZA) athletes. Eighty UniSZA athletes aged between 18 to 25 years old were randomly assigned into four groups which were AGR, PMR, MR and control group. Each groups consisted of 20 subjects which were male and female athletes with multidiscipline of the sports involvement. The mood states were determined by Brunel Mood Scale (BRUMS) during pre and post-intervention. The subjects in the three intervention groups received relaxation training twice a week for four weeks, 30 minutes per sessions. While, a control group not received any relaxation training during the intervention time. Repeated measure ANOVA conducted showed that the two parameters in BRUMS significantly changes in post-intervention such vigour (F=16.083, p<0.0001) and confusion (F=3.412, p=0.022). Other negative mood scores showed no significant changes such; (anger; F=2.235, p=0.091, depression; F=0.960, p=0.416, fatigue; F=0.724, p=0.540, tension; F=16.083, p=0.913).The results of Pairwise Comparison revealed that the three types of relaxation techniques (AGR, PMR and MR) effective to enhance vigour (positive mood) score among the adult subjects. In this study, PMR was the most effective relaxation technique followed by AGR and MR to regulate the mood state among adults.