Atuação fisioterapêutica em unidades de terapia intensiva neonatal do Rio Grande do Sul / Actuación de la fisioterapia en unidades de cuidados intensivos neonatales en Rio Grande do Sul / Physiotherapeutic performance in neonatal intensive care units in Rio Grande do Sul

RESUMO A unidade de terapia intensiva neonatal (UTIN) é organizada para o atendimento ao recém-nascido que tenha dificuldade de adaptação e sobrevida no ambiente extrauterino, devido à patologia perturbadora, disfunção respiratória e prematuridade. O Rio Grande do Sul (RS) detém uma alta taxa de prematuridade, acima da média nacional. Assistindo ao neonato, o fisioterapeuta executa o papel primordial de estimular as funções respiratória e motora através de técnicas específicas. Este estudo observacional descritivo objetivou identificar as técnicas fisioterapêuticas utilizadas em UTINs no estado do RS. Assim, aplicou-se um questionário on-line aos fisioterapeutas atuantes em UTINs do RS, com 32 questões sobre formação e atuação profissional, jornada de trabalho, dados da unidade, relacionamento multiprofissional e técnicas fisioterapêuticas utilizadas. Ao final, 22 profissionais responderam ao questionário, havendo prevalência do sexo feminino (100%), idade média de 30,6 anos, tempo de formação médio de 6 anos, tempo de atuação em UTIN entre 6 e 15 anos (22,7%) e com pós-graduação na área de fisioterapia neonatal (73,3%). Prematuridade foi o principal motivo de internação (100%) e as condutas fisioterapêuticas mais citadas foram: posicionamento terapêutico e aspiração (95,5%); e incentivo à linha média (90,9%). Conclui-se que as condutas fisioterapêuticas identificadas no estudo são condizentes com a recomendação na literatura, sendo pertinentes e adequadas ao tratamento do paciente neonato.

RESUMEN La unidad de cuidados intensivos neonatales (UCIN) brinda cuidados a los recién nacidos que tienen dificultad para adaptarse y sobrevivir en el ambiente extrauterino, debido a una patología perturbadora, disfunción respiratoria y prematuridad. Rio Grande do Sul (Brasil) tiene una alta tasa de prematuridad por encima de la media nacional. En la asistencia al neonato, el fisioterapeuta juega un papel clave al estimular las funciones respiratorias y motoras a través de técnicas específicas. Este estudio observacional descriptivo tuvo por objetivo identificar las técnicas fisioterapéuticas que son utilizadas en las UCIN del estado de Rio Grande do Sul. Para ello, se aplicó un cuestionario en línea a los fisioterapeutas que actúan en las UCIN de este estado, que contenía 32 preguntas sobre formación y desempeño profesional, jornada laboral, datos de la unidad, relación multidisciplinar y técnicas fisioterapéuticas utilizadas. En total 22 entrevistados respondieron al cuestionario, con predominio del sexo femenino (100%), edad media de 30,6 años, tiempo de formación promedio de 6 años, tiempo de actuación en la UCIN entre 6 y 15 años (22,7%) y con posgrado en fisioterapia neonatal (73,3%). La prematuridad fue el principal motivo de hospitalización (100%), y los procedimientos fisioterapéuticos más citados fueron la conducta terapéutica y aspiración (95,5%); e incentivo a la línea media (90,9%). Se concluye que la actuación fisioterapéutica identificada es consistente con lo que recomienda la literatura, además de ser pertinente y adecuada para el tratamiento del paciente recién nacido.

ABSTRACT The neonatal intensive care unit (NICU) is organized to care for newborns who have difficulty in adapting and surviving in the extrauterine environment, due to disturbing pathology, respiratory dysfunction, and prematurity. Rio Grande do Sul (RS) has a high rate of prematurity, above the national average. To assist the newborn, the physical therapist stimulates the respiratory and motor functions with specific techniques. This descriptive observational study aimed to identify the physiotherapeutic techniques used in NICUs in the state of RS. An online questionnaire was applied to physical therapists working in NICUs in RS, with 32 questions related to training and professional performance, working hours, unit data, multiprofessional relationship, and physiotherapeutic technique used. In total, 22 professionals answered the questionnaire, all females (100%), mean age of 30.6 years, mean period since undergraduate education of 6 years, years of professional practice in the NICU ranging from 6 to 15 years (22.7%), and with a graduate degree in the field of Neonatal Physical Therapy (73.3%). Prematurity was the main reason for hospitalization (100%) and the physiotherapeutic conduct most study participants mentioned were therapeutic positioning and aspiration (95.5%) and encouraging crossing the midline (90.9%). We concluded that the physiotherapeutic conducts in this study are consistent with the literature, being relevant and appropriate for the treatment of newborns.

Randomized trial of physiotherapy and hypertonic saline techniques for sputum induction in asthmatic children and adolescents

OBJECTIVES: This study aimed to analyze the efficiency of physiotherapy techniques in sputum induction and in the evaluation of pulmonary inflammation in asthmatic children and adolescents. Although hypertonic saline (HS) is widely used for sputum induction (SI), specific techniques and maneuvers of physiotherapy (P) may facilitate the collection of mucus in some asthmatic children and adolescents. METHODS: A randomized crossover study was performed in patients with well-controlled asthma, and 90 sputum samples were collected. Children and adolescents were assessed using spirometry and randomized at entry into one of three sputum induction techniques: (i) 3% hypertonic saline - HS technique; (ii) physiotherapy (oscillatory positive expiratory pressure, forced expiration, and acceleration of expiratory flow) - P technique; and (iii) hypertonic saline + physiotherapy - HSP technique. ClinicalTrials.gov: NCT03136042. RESULTS: The total cells (mL) and the percentage (%) of differential inflammatory cells were similar in all techniques. The sputum weight (g) in the HSP technique was significantly higher than that in the HS technique. In all techniques, the percentage of viable cells was >50%, and there was no difference between the HS and P techniques. Moreover, sputum induction did not cause any alterations in the pulmonary function of patients. CONCLUSION: The physiotherapy sputum collection technique was effective in obtaining viable cells from mucus samples and yielded the same amount of sputum as the gold standard technique (hypertonic saline). In addition, the physiotherapy maneuvers were both safe and useful for sputum induction in asthmatic children and adolescents with well-controlled asthma.

The Effect of Schroth Therapy on Thoracic Kyphotic Curve and Quality of Life in Scheuermann's Patients: A Randomized Controlled Trial

STUDY DESIGN: Randomized controlled single-blinded clinical trial. PURPOSE: To evaluate the efficacy of Schroth therapy on thoracic curve angle, pain, and self-perceived body image (SPBI) of the back in Scheuermann's patients in comparison with the efficacy of classic anti-gravitation exercises. OVERVIEW OF LITERATURE: Scheuermann disease is the most common cause of hyperkyphosis of the thoracic and thoracolumbar spine during adolescence. However, very few studies evaluated the effect of exercises on the progression of kyphosis in Scheuermann patients. Schroth three-dimensional exercise therapy was found in several studies to be effective in the treatment of adolescent scoliosis; however, we found no randomized controlled trials that evaluated the efficacy of this method in Scheuermann patients. METHODS: A total of 50 young adults (males and females) with Scheuermann's disease were randomly divided into either the experimental group (Schroth therapy treatment, n=25) or the control group (classic anti-gravitation exercises, n=25). Participants in both the groups were provided a course of individual treatment sessions during few weeks, with one appointment per week. They were required to perform the exercises daily throughout the study period (12 months) and fill their performance in a research log. We evaluated the thoracic Cobb angle (main outcome measure), pain, SPBI, flexion of the shoulder (supine), flexion of the shoulder (standing), kyphotic deformity measured using inclinometer, and L5 kyphosis apex line (L5-KAL) as well as administered the Scoliosis Research Society-22 Questionnaire for the participants before the treatment, after 6 months, and 1 year postoperatively. These results were then compared. RESULTS: In the mixed analysis of variance, the main effect of time was significant in the thoracic kyphosis (F [1]=5.72, p=0.02), and in the L5-KAL (F [1]=5.76, p=0.02). The main effect of time on the kyphotic deformity, measured using an inclinometer, did not reach the significance level; however, it showed the tendency (F [1]=2.80, p=0.07). In the group-by-time interaction, a significant difference was found in the thoracic kyphosis (F [1]=4.91, p=0.03) and in the kyphotic deformity, measured using an inclinometer (F [1]=4.05, p=0.02). Thus, the Schroth therapy group showed significantly greater improvement than the classic anti-gravitation exercises group. CONCLUSIONS: The present findings indicate that back exercises in general, and Schroth therapy in particular, is an effective treatment for preventing and significantly improving the thoracic Cobb angle and symptomatic representation in Scheuermann's patients.

THE IMPACT OF PHYSICAL THERAPY ON THE QUALITY OF LIFE OF WOMEN AFTER BREAST CANCER SURGERY / A influência da fisioterapia na qualidade de vida de mulheres após o tratamento cirúrgico do câncer de mama

Objective: To evaluate the impact of physical therapy on the quality of life of patients after breast cancer surgery. Methods: We included 16 female patients who underwent breast cancer surgery in this clinical, longitudinal, prospective, and convenience sample study. The patients underwent a mastectomy or a quadrantectomy through an axillary approach and were evaluated before and after 20 sessions of physical therapy. Quality of life was assessed by the European Organization for Research and Quality of Life Questionnaire C-30 (EORTC QLQ C-30) and the Breast Cancer Module (EORTC QLQ BR-23) questionnaire. For the statistical analysis, we used the Shapiro-Wilk test to evaluate the distribution of quality of life data. The data from before and after physical therapy was compared through the Wilcoxon test. Results: After participating in physical therapy, there was a significant improvement in physical function (p=0.023), cognitive function (p=0.033), social function (p=0.013), pain (p=0.025), fatigue (p=0.001), financial difficulty (p=0.007), and body image (p<0.001). Conclusion: According to the data presented in this study, we suggest that a physiotherapeutic approach positively impacts the quality of life of patients after breast cancer surgery.

Objetivo: Avaliar a influência da fisioterapia na qualidade de vida de pacientes após o tratamento cirúrgico do câncer de mama. Metodologia: Neste estudo clínico, longitudinal, prospectivo e de amostra por conveniência foram incluídas 16 pacientes que realizaram tratamento cirúrgico do câncer de mama, submetidas à mastectomia ou quadrantectomia, associada à abordagem axilar. Elas foram avaliadas antes e depois de 20 sessões de fisioterapia. A qualidade de vida foi examinada pelos questionários European Organization for Research and Treatment of Cancer Quality of Life Questionnaire C-30 (EORTC QLQ C-30) e Breast Cancer Module (EORTC QLQ BR-23). Para análise estatística, foi utilizado o teste de Shapiro-Wilk, para avaliação da distribuição dos dados sobre a qualidade de vida, sendo estes comparados antes e depois da fisioterapia por meio do teste de Wilcoxon. Resultados: Após a intervenção fisioterapêutica, houve melhora significativa em relação à qualidade de vida na função física (p=0,023), função cognitiva (p=0,033), função social (p=0,013), dor (p=0,025), fadiga (p=0,001), dificuldade financeira (p=0,007) e imagem corporal (p<0,001). Conclusão: De acordo com os dados apresentados no estudo, pode-se sugerir que a abordagem fisioterapêutica influencia positivamente na qualidade de vida de pacientes após o tratamento cirúrgico do câncer de mama.

Mapeamento demográfico e caracterização do perfil de assistência fisioterapêutica oferecida nas unidades de terapia intensiva neonatais do Rio de Janeiro (RJ) / Mapeo demográfico y caracterización del perfil de asistencia fisioterapéutica ofrecida en unidades de cuidados intensivos neonatales de Río de Janeiro (RJ), Brasil / Demographic mapping and characterization of physical therapy care profile offered in Neonatal Intensive Care Units in the City of Rio de Janeiro, Brazil

RESUMO Este estudo visa ao mapeamento e a caracterização do perfil da assistência fisioterapêutica oferecida em unidades de terapia intensiva (UTI) neonatais dos hospitais públicos e privados do Rio de Janeiro (RJ). Para isso, foram realizadas entrevistas com os chefes sobre as rotinas dos serviços de fisioterapia dos hospitais do Rio de Janeiro com UTI neonatais entre janeiro de 2013 e janeiro de 2015. As perguntas abordaram distribuição das horas de trabalho, organização e localização institucional, tempo de experiência na área, tipos de técnicas fisioterapêuticas e recursos utilizados. Foram incluídos 27 hospitais (17 públicos e 10 privados) da seguinte forma: 6 hospitais na Zona Sul, 8 na Zona Norte, 8 na Zona Oeste e 5 no Centro e Zona Portuária. O número total de fisioterapeutas integrantes das equipes foi de 141, sendo que 59% deles eram especialistas em terapia intensiva neonatal. No que se refere aos chefes entrevistados, 16 (59%) também eram especialistas e 21 (79%) possuíam mais de cinco anos de experiência. Foram citadas diversas técnicas fisioterapêuticas, como: fisioterapia motora, vibração torácica e reequilíbrio tóraco-abdominal. A partir do exposto, verificou-se que a assistência fisioterapêutica neonatal do Rio de Janeiro não está distribuída uniformemente no território, estando mais concentrada nas regiões Sul e Central. Além disso, falta padronização das rotinas e carga horária, sendo necessária adequação do perfil assistencial para atenção ideal e integral do recém-nascido (RN).

RESUMEN Este estudio visa el mapeo y la caracterización del perfil de la asistencia fisioterapéutica ofrecida en unidades de cuidados intensivos (UCI) neonatales de los hospitales públicos y privados de Río de Janeiro (RJ), Brasil. Para eso, fueron realizadas entrevistas con los jefes a respecto de las rutinas de los servicios de fisioterapia de los hospitales de Río de Janeiro con UCI neonatales entre enero de 2013 y enero de 2015. Las preguntas abordaron a respecto de distribición de las horas de trabajo, organización y localización institucional, tiempo de experiencia en la área, tipos de técnicas fisioterapéuticas y recursos utilizados. Fueron incluidos 27 hospitales (17 públicos y 10 privados) de la seguiente forma: 6 hospitales en Zona Sul, 8 en Zona Norte, 8 en Zona Oeste y 5 en Centro y Zona Portuaria. El número total de fisioterapeutas integrantes de los equipos fue de 141, siendo que 59% de ellos eron expertos en cuidados intensivos neonatales. En lo que se refiere a los jefes entrevistados, 16 (59%) también eron expertos y 21 (79%) poseían más de cinco años de experiencia. Fueron citadas diversas técnicas fisioterapéuticas, como: fisioterapia motora, vibración torácica y reequilibrio tóraco-abdominal. A partir del exposto, se verificó que la asistencia fisioterapéutica neonatal de Río de Janeiro não está distribuída uniformemente en el territorio, estando más concentrada en las regiones Sul y Central. Además, falta padronización de las rutinas y carga horaria, siendo necesaria adecuación del perfil asistencial para atención ideal y integral del neonato.

ABSTRACT This study aims to map and characterize the profile of physical therapy care offered in intensive care units (ICU) of public and private hospitals in the city of Rio de Janeiro. To this end, a cross-sectional study was conducted by interviews with the heads/routine chiefs of physical therapy services of the hospitals in the city of Rio de Janeiro with neonatal ICU (NICU) from January 2013 to January 2015. The questions comprised the distribution of working hours, organization and institutional location, time of experience in the area, types of physical therapy techniques and resources used. Twenty seven hospitals (17 public and 10 private) were studied as follows: 6 hospitals in the South area of the city, 8 in the North, 8 in the West and 5 in the central area and port area. The total number of physical therapists of the teams was 141, and 59% of them were experts in neonatal intensive care. With regard to the heads/routine chiefs, 16 (59%) were specialists in neonatal intensive care and 21 (79%) had more than five years of experience. Various physical therapy techniques were cited as: motor physical therapy, chest vibration and thoracic-abdominal rebalance. According to the results, there was not a single standard regarding routines, protocols, professional organization and training, and techniques used. In addition, it was found that the physical therapy in ICUs was not held full-time, neither provided the three shifts care.

Influência do número de séries e tempo de alongamento estático sobre a flexibilidade dos músculos isquiotibiais em mulheres sedentárias / Influence of the number of sets and time of static stretching on the flexibility of hamstring muscles in sedentary women

INTRODUÇÃO E OBJETIVO: Os exercícios de alongamento são frequentemente utilizados em programas de reabilitação e na área desportiva, porém, a duração ideal e o número de séries ainda não foram determinados. O objetivo do estudo foi avaliar os efeitos de 10 séries de 30 segundos e três séries de três minutos de alongamento estático passivo na flexibilidade dos músculos isquiotibiais, comparando diferentes volumes de alongamento dentro de 10 minutos. Além disso, verificar se existe diferença entre os dois programas de alongamento ao término do protocolo e após cinco meses. MÉTODOS: 25 mulheres (17 a 25 anos) foram distribuídas aleatoriamente em três grupos: grupo GC (controle), G30 e G3. O G30 alongou 10 X 30 segundos e o G3 3 X 3 minutos. O alongamento foi realizado por meio de um sistema de polias, utilizando-se 10 por cento do peso corporal da voluntária. Este protocolo durou 6 semanas. As mensurações foram feitas no início do protocolo (Av1), após seis semanas (Av2) e após cinco meses (Av3). Foi mensurada a amplitude de movimento (ADM) de extensão do joelho com 90º de flexão do quadril. A análise de variância (Anova) com dois fatores cruzados de medidas repetidas foi usada com nível de significância de 5 por cento (p < 0,05). RESULTADOS: Não houve diferença estatisticamente significante na ADM de joelho entre 30 segundos (G30) e três minutos (G3) após seis semanas (Av2) (p > 0,05) e após cinco meses (Av3) (p > 0,05). Tanto o G30 quanto o G3 apresentaram aumento da flexibilidade ao término do protocolo (Av1xAv2) (p < 0,05) e após cinco meses (Av1xAv3) (p < 0,05). CONCLUSÕES: Dez séries de 30 segundos e três séries de três minutos podem aumentar a flexibilidade dos isquiotibiais e manter a flexibilidade adquirida após cinco meses do término da intervenção.

INTRODUCTION AND OBJECTIVE: Stretching exercises are largely used in rehabilitation programs, but the ideal duration and the number of sets have not been determined yet. The purpose of this study was to evaluate the effects of 10 sets-30 seconds and 3 sets-3 minutes of static stretch on flexibility of hamstring muscles, comparing different volumes within 10 minutes. Moreover, to verify the difference between the two stretching programs. METHOD: 25 women (17 to 25 years old) were randomly assigned to one of 3 groups: group GC (control), G30 and G3. G30 stretched 10 X 30 seconds and G3 3 X 3 minutes. In all volunteers the stretching was performed by a pulley system, using weight corresponding to 10 percent of their body weight. This protocol took 6 weeks. Measurements were taken at the beginning of the protocol (Av1), after 6 weeks (Av2), and after 5 months (Av3). Flexibility of the hamstring was determined by measuring knee extension range of movement (ROM) with 90º of hip flexion. A two-way repeated measures Analysis of Variance (Anova) was used and significance level was set at 5 percent (p < 0.05). RESULTS: There was no statistically significant difference between 30 seconds (G30) and 3 minutes (G3) in knee extension ROM after 6 weeks (Av2) (p >0.05) and neither after 5 months (Av3) (p>0.05). Both the G30 as the G3 showed increasing flexibility at the end of protocol (Av1xAv2) (p<0.05) and after 5 months (Av1xAv3) (p<0.05). CONCLUSION: Stretching sets of 30 seconds and 3 minutes can increase the hamstrings flexibility and keep the flexibility obtained after 5 months from the end of intervention. There was no difference on the flexibility obtained with sets of 30 seconds or 3 minutes.

Fisioterapia na paralisia facial periférica: estudo retrospectivo / Physical therapy in peripheral facial paralysis: retrospective study

A paralisia facial periférica requer tratamento especializado. A fisioterapia tem como objetivo restabelecer a mímica facial. O objetivo deste estudo foi descrever e analisar os resultados da fisioterapia para indivíduos com paralisia facial periférica. FORMA DE ESTUDO: Retrospectivo. MÉTODO: Foi realizado um estudo retrospectivo em um Hospital Universitário, com autorização do Serviço de Atendimento Médico e Estatístico, no período de 1999 a 2003. Os dados são apresentados em forma descritiva, com utilização de média e mediana para variáveis numéricas e freqüência para variáveis categóricas. RESULTADOS: Foram analisados 23 prontuários durante quatro anos. Foi identificado o predomínio do sexo feminino e a média de idade foi de 32,3 anos (DP±16,5); 14 casos idiopáticas e cinco traumáticas; 12, com comprometimento motor total e 11, parcial; nos 12 casos com avaliação final, sete evoluíram para recuperação parcial e cinco para total. A fisioterapia utilizada foi cinesioterapia e orientações. CONCLUSÃO: Neste estudo os indivíduos são similares a outras populações. Foram tratados com cinesioterapia, como sugerido pela literatura científica e evoluíram com recuperação.

Peripheral facial paralysis requires specialized treatment. Physical therapy aims at reestablishing facial movements. The aim of this study was to describe and to analyze physical therapy results for individuals with peripheral facial paralysis. STUDY DESIGN: Retrospective study. METHOD: A retrospective study was carried out at the University Hospital, authorized by the Statistics and Medical File Services, from 1999 to 2003. Data are presented in descriptive form with mean and median values for numeric variables and frequency for categorical variables. RESULTS: Twenty-three files were analyzed during four years. Females predominated and the average age was of 32.3 years (SD±16.5); 14 idiopathic and five trauma cases; 12 with total motor deficit and 11 with partial motor deficit; in the 12 cases that underwent final evaluation, seven had partial and five had total recovery. The physical therapy program used was kinesiotherapy and patient education. CONCLUSION: In this study, individuals were similar to individuals in other populations. They were treated with kinesiotherapy, as suggested by the scientific literature and recovered.

Avaliação da expansão pulmonar por meio do teste de força muscular em paciente com espondilodiscite: relato de caso / Lung expansion evaluation by means of muscular strength test in a patient with spondylodiscitis: case report

A espondilodiscite é uma doença infecciosa incomum, autolimitada, que gera um processo inflamatório atingindo disco intervertebral e corpos vertebrais adjacentes, podendo estender-se para o espaço epidural e partes moles paravertebrais. O objetivo deste trabalho foi realizar teste de força muscular respiratória a fim de avaliar a expansibilidade da caixa torácica antes e após tratamento fisioterapêutico. Este estudo é um relato de caso de uma paciente de 37 anos, sexo feminino, internada na Santa Casa de São José do Rio Preto com diagnóstico de espondilodiscite em T10-T11 e L2-L3. Foi realizada uma avaliação fisioterapêutica e posteriormente aplicou-se um protocolo de tratamento com duração de 30 dias que consistiu de exercícios de reexpansão pulmonar (SMI, Inspiração em tempos) e incentivador inspiratório a volume Voldyne 5000. Os resultados obtidos foram por meio da mensuração de Pi Máx e Pe Máx e quantificação da intensidadede dor imediatamente antes e após a intervenção fisioterapêutica que demonstraram ao término do tratamento um aumento das pressões inspiratórias e expiratórias máximas e concomitantemente uma redução da dor. A intervenção fisioterapêutica gerou uma melhora da forçamuscular, da expansibilidade torácica e da dor do paciente com espondilodiscite.

Spondylodiscitis is an uncommon self-limited infectious disease which generates an inflammatory process affecting the intervertebral disc and adjacent vertebral bodies, sometimes extending to epidural space and paravertebral soft tissues. This work aimed at carrying out a breathing muscle strength test in order to evaluate the chest cage expansibility before and after a physiotherapy treatment. This study is a case report about a 37-year-old female patient admitted at Santa Casa de São José do Rio Preto, Hospital in São José do Rio Preto, state of São Paulo,Brazil, with diagnosis of spondylodiscitis in T10-T11 and L2-L3. A physiotherapy evaluation was accomplished and later a 30-day treatment protocol was set up, consisting of lung re-expansion exercises (SMI, Inspiration in times) and incentive spirometry with Voldyne 5000 VolumetricExerciser.The results were obtained by measuring Pi Max and Pe Max and quantifying the pain intensity immediately before and after physiotherapy intervention. At the end of the treatment, those results demonstrated an increase in maximum inspiratory and expiratory pressures and a concomitant pain reduction. Physiotherapy intervention improved muscle strength, chest cage expansibility, and relieved pain in patients with spondylodiscitis.

Clinical investigation of chemotherapy with intraperitoneal hyperthermal perfusion for malignant ascites / 国外医学(肿瘤学分册)

Objective To observe the clinical effects of chemotherapy with intraperitoneal hyper-thermal perfusion for malignant ascites. Methods 40 patients with malignant ascites were randomly divided into two groups. In the treated group, 21 patients underwent intraperitoneal hyperthermal perfusion and local thermotherapy. 19 patients in the control group received commonly intraperitoneal perfusion. Results The CR, PR patients were 6,10 and 0,7 in the treated group and control group, respectively. The efficacy rate in the treated group was significantly higher than that in the control group. 2 patients oc-cured bellyache in the treated group and 1 patient in the control group, there was no statistically significant difference between the two groups. Conclusion Chemotherapy with intraperitoneal hyperthermal perfusion can significantly improve the therapeutic effects for malignant ascites, and has no more side effects.

The Use of Elastic Adhesive Tape to Promote Lymphatic Flow in the Rabbit Hind Leg

Any method that deforms the skin of the extremities may increase lymphatic flow rate, and may be applied to treat peripheral lymphedema. This study was undertaken to investigate whether or not elastic adhesive tape with passive exercise can increase lymph flow in the rabbit hind leg by effective and periodic skin deformation. Cannulation into a pre-popliteal afferent lymphatic vessel in the lower left leg of 22 male New Zealand White rabbits was performed under a stereomicroscope. After stabilization, lymph was collected at rest or during passive exercise with an electric motor at 60 r.p.m. for 15 minutes and was then measured. Lymph flow rate was calculated and expressed as g/hour. Increase of lymph flow rate due to taping was significant only for passive exercise (p=0.0317). The lymph flow rate increased linearly as the area of tape was increased (p=0.0011), and lymph flow rates were significantly different according to site (p=0.0017). Tape on the anterior aspect of the ankle caused salient deformation and tended to increase the lymph flow rate more so than tape on the dorsum of the foot (p=0.0831). Taping with elastic adhesive tape in passive exercise increased the lymph flow rate in the rabbit hind leg by deforming the skin, which suggests a novel therapeutic method in cases of peripheral lymphedema.

Perioperative changes in systemic Inflammatory responses in patients undergoing physical cooling during the operation of acute severe cholangitis / 中华麻醉学杂志

0.05). The core temperature, levels of TNF-?,IL-6 and IL-8 were lower at t2 and t3 in group Ⅱ than those in group Ⅰ (P