Cánula Nasal de Alto Flujo Asimétrica: una Revisión Narrativa / Asymmetrical High Flow Nasal Cannula: a Narrative Review

Los sistemas de Cánula nasal de alto flujo (CNAF) han sido ampliamente utilizados en el campo clínico como soporte no invasivo en el manejo de la falla respiratoria aguda (sobre todo hipoxémica) y cuidados post extubación. Clínica y fisiológicamente, las cánulas nasales de alto flujo son capaces de entregar un flujo de oxigeno alto que, debido a que ese gas se encuentra optimamente humidificado y calefaccionado, permite una mejor tolerancia por parte del paciente al ser comparada con las cánulas de oxigeno tradicionales. Por otra parte, este alto. Flujo es capaz de generar una presión positiva al final de la espiración (CPAP) en la vía área y favorecer tanto en barrido de dióxido de carbono (CO2) desde la vía aérea superior, lo que disminuye el trabajo respiratorio del paciente y mejora su confort.. Sin embargo; aún existe un alto porcentaje de pacientes que fracasan la terapia con CNAF y requiere soportes mas complejos como la ventilación mecánica, ya sea imvasiva o no. Estos resultados con la terapia CNAF pueden ser influidos por aspectos técnicos como, por ejemplo, la turbulencia que pueden generar estos sistemas a nivel de la región nasal. Por esta razón se han desarrollado nuevas tecnologías en el diseño y uso de interfaces para suministrar este alto flujo. Una de estas innovaciones es el uso de cánulas asimétricas, las que potencian los beneficios fisiológicos que entrega una cánula de alto flujo convencional. La presente revisión pretende exponer las principales diferencias que presenta el sistema de alto flujo convencional versus la nueva interface asimétrica.

High-flow nasal cannula (HFNC) systems have been widely used in the clinical field as non-invasive support in the management of acute respiratory failure (especially hypoxemic) and post-extubation care. Clinically and physiologically, high flow nasal cannulas are capable of delivering a high flow of oxygen which, because this gas is optimally humidified and heated, allows better tolerance by the patient when compared to traditional oxygen cannulas. . On the other hand, this high. Flow is capable of generating positive pressure at the end of expiration (CPAP) in the airway and favoring the sweep of carbon dioxide (CO2) from the upper airway, which reduces the patient's respiratory work and improves their comfort. .. However; There is still a high percentage of patients who fail therapy with HFNC and require more complex supports such as mechanical ventilation, whether invasive or not. These results with HFNC therapy can be influenced by technical aspects such as, for example, the turbulence that these systems can generate in the nasal region. For this reason, new technologies have been developed in the design and use of interfaces to provide this high flow. One of these innovations is the use of asymmetric cannulas, which enhance the physiological benefits provided by a conventional high-flow cannula. The present review aims to expose the main differences that the conventional high flow system presents versus the new asymmetric interface.

Bases científicas del principio de curación homeopática en la farmacología moderna / Scientific bases of the homeopathic healing principle in modern pharmacology

La homeopatía emplea el denominado 'principio de similares' como método terapéutico ­ el cual consiste en administrar medicamentos que provocan ciertos síntomas en individuos sanos para tratar síntomas similares en individuos enfermos (similia similibus curantur) - para inducir una reacción curativa secundaria del cuerpo en contra de sus propios trastornos. Esta reacción secundaria (vital, homeostática o paradójica) del cuerpo se basa en el 'efecto de rebote' de los fármacos modernos, un tipo de evento adverso que se produce después de interrumpir varias clases de fármacos prescritos según el 'principio de los contrarios' (contraria contrariis curantur). Objetivo: La presente revisión ha buscado justificar científicamente el principio de curación homeopática frente a la farmacología clínica y experimental a través de un estudio sistemático del efecto de rebote de los fármacos modernos o reacción paradójica del cuerpo. Métodos: Empleando como referencia estudios y revisiones sobre el tema publicados a partir de 1998, actualizamos los datos añadiendo estudios recientes incluidos en la base de datos PubMed. Resultados: El efecto de rebote se produce después de interrumpir varias clases de fármacos con acción contraria a los síntomas de las enfermedades, exacerbándolos a niveles superiores a aquellos previos al tratamiento. Independientemente de la enfermedad, fármaco, dosis y duración del tratamiento, el fenómeno del rebote se manifiesta en una pequeña proporción de los individuos susceptibles. Siguiendo las premisas homeopáticas, los fármacos modernos también podrían usarse según el principio de la similitud terapéutica, empleando entonces el efecto de rebote (reacción paradójica) con propósito curativo. Conclusiones: Evidenciado por cientos de estudios que constatan la similitud de conceptos y manifestaciones, el efecto de rebote de los fármacos modernos justifica científicamente el principio de la cura homeopática. Aunque el fenómeno de rebote es un evento adverso estudiado por la farmacología moderna, no es conocido por los profesionales de la atención médica, lo cual priva a los médicos de un conocimiento indispensable para el manejo seguro de los fármacos.

Homeopathy employs the so-called 'principle of similars' as therapeutic method - which consists in administering medicines that cause certain symptoms in healthy individuals to treat similar symptoms in sick individuals (similia similibus curantur) - to induce a secondary and healing reaction by the body against its own disorders. This secondary (vital, homeostatic or paradoxical) reaction of the body is based on the 'rebound effect' of modern drugs, a type of adverse event that occurs following discontinuation of several classes of drugs prescribed according to the 'principle of contraries' (contraria contrariis curantur). Aim: The present review sought to scientifically substantiate the homeopathic healing principle vis-à-vis experimental and clinical pharmacology through a systematic study of the rebound effect of modern drugs or paradoxical reaction of the body. Methods: Employing as reference studies and revisions on the subject published since 1998, we updated the data adding recent studies included in database PubMed. Results: The rebound effect occurs after discontinuation of several classes of drugs with action contrary to the symptoms of diseases, exacerbating them to levels above the ones before treatment. Regardless of disease, drug, dose and duration of treatment, the rebound phenomenon manifests in a small proportion of susceptible individuals. Following the homeopathic premises, modern drugs might also be used according to the principle of therapeutic similitude, thus employing the rebound effect (paradoxical reaction) with curative intent. Conclusions: Evidenced by hundreds of studies that attest to the similarity of concepts and manifestations, the rebound effect of modern drugs scientifically substantiates the principle of homeopathic cure. Although the rebound phenomenon is an adverse event studied by modern pharmacology, it is not known by health care professionals, thus depriving doctors of knowledge indispensable for safe management of drugs.

A review of the physiological effects of Suryanamaskar in children

Increasing physical inactivity in children necessitates the exploration of physical activities that can confer health benefits. The purpose of this study was to review the literature regarding the physiological benefits of Suryanamaskar, a composite yogasana on physical fitness in children. Primary source articles in English, published between 1980 and 2020, in peer-reviewed journals were included. A literature review was carried out using PubMed, Cochrane-Library, Science Direct, and Google Scholar databases. Keywords used were “Suryanamaskar,” “physical fitness,” “sun-salutation,” “physiological effects,” “physical activity,” “health promotion,” “yoga,” and “children.” The methodological quality of the studies was assessed using the Physiotherapy Evidence Database scale. The effect of Suryanamaskar training on physical fitness components, namely flexibility, muscle strength, cardiorespiratory endurance, and cognition, was reviewed. Seven studies matched the inclusion criteria. All seven studies were randomized controlled trials. The level of evidence was of fair quality with a high risk of bias. Following Suryanamaskar intervention, improvement in musculoskeletal function—muscle strength and endurance, and the flexibility of hip joint, wrist joint, hamstrings, and dorso-lumbar fascia were reported. Improvements in cardiorespiratory variables such as peak expiratory flow rate forced vital capacity, forced expiratory volume, vital capacity, and reduction in blood pressure and heart rate are reported in children. Improvements in cognition were also observed following Suryanamaskar’s intervention. Suryanamaskar training confers health benefits and improves physical fitness components such as muscle strength, flexibility, cardiorespiratory endurance, and cognition. Suryanamaskar can emerge as a useful tool to increase physical fitness, deter physical inactivity, and promote healthy behavior (sanskar) in school-going children. High-quality longitudinal randomized control trials need to be undertaken to confirm the same.

Physiological Effects of Pulsed LED Light Added to a Task Lamp to Improve Alertness on Employees of Hospital or Shift Workers / Efectos Fisiológicos de Pulsos de Luz de Diodo Adicionados a una Lámpara de Trabajo para Mejorar el Estado de Alerta en Personal de Hospitales o Trabajadores por Turnos

Abstract The aim of this study is to investigate the effect of a continuous stream of pulses of monochromatic blue pulsed (BP) and a combination of blue and green pulsed (BGP) light-emitting diode (LED) light conditions on physiological responses. This study is an approach to clarify the most suitable LED combination and flickering frequency to evoke alertness when a continuous stream of pulsed LED light is delivered and may suggest applications of continuous pulsed light as support for task illumination for shift workers, hospital nurses, school students or office employees. Combinations were delivered by exposures of BPLED and BGPLED pulses at 100, 200, and 400 Hertz over two background light colors (BLC). Participants were exposed to 12 different light conditions in a counterbalanced procedure. By integrating measures of electroencephalogram (EEG) and pupil constriction; results suggested significant changes in responses during the interaction of BLC, LED, and EEG. Beta waves exhibited a statistically significance (p < 0.05) in arousal levels when exposed to BG light, although no active task was involved during exposure. Furthermore, pupil reacted with larger constriction towards BGPLED exposure than towards monochromatic BPLED exposure, thus demonstrating that a continuous stream of pulses can deliver the same irradiance as if delivered in a continuous flow and without affecting perception as no flickering was perceived in any of the conditions by a qualitative evaluation.

Resumen Este estudio tiene por objetivo determinar cuál es la combinación de luz LED más adecuada y la frecuencia de parpadeo que esta deba tener, para evocar un estado de alerta cuando se emite un flujo continuo de la misma al combinarla con una iluminación de ambiente; y poder sugerir aplicaciones como soporte para la iluminación de tareas para trabajadores por turnos, enfermeras, médicos, estudiantes; o en oficinas y hospitales. Es de original importancia resaltar que en el mercado no existe un producto comercial que se pueda ajustar para apoyar en el trabajo al estado de alerta, se tiene la limitante que estas son pruebas a nivel laboratorio y que posteriores pruebas serán necesarias para validar el producto final. El método usado se basó en las combinaciones que se administraron mediante exposiciones de luz azul pulsada (BPLED) y luz azul y verde combinadas (BGPLED) a frecuencias de 100, 200 y 400 Hz adicionadas a la iluminación ambiental (BLC). Los participantes fueron expuestos a 12 condiciones de luz diferentes en un experimento balanceado y contrapesado. Mediante la integración de medidas electroencefalográficas (EEG) y de constricción pupilar; los resultados sugirieron cambios significativos en las respuestas durante la interacción de BLC, LED y EEG. Las ondas beta mostraron una significancia estadística (p <0.05) en los niveles de activación cuando se expusieron a la luz BGPLED, además, la pupila reaccionó con una mayor constricción hacia la exposición a BGPLED que hacia la exposición BPLED monocromática, adicionalmente se demostró que un flujo continuo de pulsos puede proporcionar una irradiación igual a la que se emite en flujo continuo; se concluyó e identificó además la frecuencia (100 Hz) que mejor evoca estado de alerta encefalográfíca y sin afectar la percepción de los usuarios en cuanto a su percepción del ambiente de acuerdo a la evaluación cualitativa.

Effects of yogic breath regulation: A narrative review of scientific evidence

Pranayama or breath regulation is considered as an essential component of Yoga, which is said to influence the physiological systems. We present a comprehensive overview of scientific literature in thefield of yogic breathing. We searched PubMed, PubMed Central and IndMed for citations for keywords“Pranayama” and “Yogic Breathing”. The search yielded a total of 1400 references. Experimental papers,case studies and case series in English, revealing the effects of yogic breathing were included in thereview. The preponderance of literature points to beneficial effects of yogic breathing techniques in bothphysiological and clinical setups. Advantageous effects of yogic breathing on the neurocognitive, psychophysiological, respiratory, biochemical and metabolic functions in healthy individuals were elicited.They were also found useful in management of various clinical conditions. Overall, yogic breathing couldbe considered safe, when practiced under guidance of a trained teacher. Considering the positive effectsof yogic breathing, further large scale studies with rigorous designs to understand the mechanismsinvolved with yogic breathing are warranted.© 2017 Transdisciplinary University, Bangalore and World Ayurveda Foundation. Publishing Services byElsevier B.V. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/)

Physiological effects of weightlessness: countermeasure system development for a long-term Chinese manned spaceflight / 医学前沿

The Chinese space station will be built around 2020. As a national space laboratory, it will offer unique opportunities for studying the physiological effects of weightlessness and the efficacy of the countermeasures against such effects. In this paper, we described the development of countermeasure systems in the Chinese space program. To emphasize the need of the Chinese space program to implement its own program for developing countermeasures, we reviewed the literature on the negative physiological effects of weightlessness, the challenges of completing missions, the development of countermeasure devices, the establishment of countermeasure programs, and the efficacy of the countermeasure techniques in American and Russian manned spaceflights. In addition, a brief overview was provided on the Chinese research and development on countermeasures to discuss the current status and goals of the development of countermeasures against physiological problems associated with weightlessness.

A comparative study of the physiological and psychological effects of forest bathing (Shinrin-yoku) on working age people with and without depressive tendencies

BACKGROUND@#In recent years, many of Japanese workers have complained of fatigue and stress, considering them as risk factors for depression. Studies have found that "forest bathing" (Shinrin-yoku) has positive physiological effects, such as blood pressure reduction, improvement of autonomic and immune functions, as well as psychological effects of alleviating depression and improving mental health. In this study, we investigate the physiological and psychological effects of "forest bathing" on people of a working age with and without depressive tendencies.@*METHODS@#We conducted physiological measurements and psychological surveys before and after forest bathing with subjects who participated in day-long sessions of forest bathing, at a forest therapy base located in Hiroshima Prefecture. After excluding severely depressed individuals, the participants were classified into two groups: those with depressive tendencies (5 ≤ K6 ≤ 12) and those without depressive tendencies (K6 < 5) for comparative study. The evaluation indices measured were systolic blood pressure (SBP), diastolic blood pressure (DBP), pulse rate (PR), autonomic functions, and profile of mood states (POMS).@*RESULTS@#Of the 155 participants, 37% had depressive tendencies, without any differences observed between males and females. All participants showed significant decrease in SBP, DBP, and in negative POMS items after a forest bathing session. Before the session, those with depressive tendencies scored significantly higher on the POMS negative items than those without depressive tendencies. After forest bathing, those with depressive tendencies demonstrated significantly greater improvement in many of POMS items than those without depressive tendencies, and many of them no longer differed between those with and without depressive tendencies.@*CONCLUSIONS@#Examining the physiological and psychological effects of a day-long session of forest bathing on a working age group demonstrated significant positive effects on mental health, especially in those with depressive tendencies. Not applicable; this is not a report of intervention trial.

Physiological Effects of Blue Pulsed LED in an Indoor Lighting Environment / Efectos Fisiológicos de Luz LED Azul Intermitente en un Ambiente de Iluminación en Interiores

Abstract Purpose: An experiment was conducted to investigate the physiological effects of a continuous blue pulsed light emitting diode (BP-LED) added to a task lamp in an actual indoor lighting environment and its influence in alertness having as a final purpose to develop a commercial product that could be applied in situations similar to those depicted in the present work. Design methodology: Previous research studies have stated that the addition of pulsed light evokes physiological changes that may induce alertness. The participants were exposed to four different lighting conditions. Electroencephalograms (EEG), pupil sizes, heart rates (HR), performance tests, and subjective reactions were measured. Findings: Low colour temperature light and the BP-LED revealed an improved alertness according to the data from the EEG recordings. The intervention of the BP-LED in a high colour temperature ambiance was beneficial in maintaining high levels of alertness compared to the conditions where the BP-LED was not used. It was tested that the use of a BP-LED in a task lamp may be beneficial in improving or maintaining alertness levels in an indoor workplace ambiance. Originality and Value: Designing of an adequate workplace task lamp light that improves alertness for in-house, office, or classroom situations in which it is essential.

Resumen Propósito: Un experimento fue llevado a cabo para investigar los efectos fisiológicos que una luz azul LED pulsada de manera intermitente (BP-LED), adicionada a una lámpara de escritorio, y en un ambiente interior; pueda influir en el estado de alerta de una persona con la finalidad de desarrollar un producto comercial que pueda ser aplicado para los casos desarrollados y otros posibles escenarios. Metodología de Diseño: En estudios anteriores se establece que la adición de luz en pulsaciones evoca cambios fisiológicos que pueden inducir al estado de alerta. Los participantes experimentaron cuatro escenarios de iluminación. Se registraron mediciones con respecto a encefalografía (EEG), tamaño pupilar, ritmo cardiaco, prueba de performance, así como evaluación subjetiva. Hallazgos: Los datos de EEG revelaron un mayor estado de alerta durante la exposición a iluminación cálida aunado a luz BP-LED. La intervención de luz fría y BP-LED denotó ser benéfica en el nivel de estado de alerta en comparación con las condiciones donde el BP-LED no intervino. Se logró evaluar que el uso de BP-LED en una lámpara de escritorio puede ser benéfico para mejorar o mantener el estado de alerta cuando sea usado en un espacio interior. Originalidad y Valor: Propuesta para diseñar una luminaria de escritorio; para uso casero, laboral o de estudio; que mejore el estado de alerta de las personas.

Propiedades funcionales in-vitro y efectos fisiológicos in-vivo sobre ratas Holtzman de dietas con nuevas fuentes de fibra / Functional properties in vitro and physiological effects in vivo of new sources of dietary fiber in Holtzman rats

RESUMEN El endospermo de semilla de tara (EST) y polvo de las hojas de Agave americana (HAA) fueron evaluados como nuevas fuentes de fibra dietética teniendo como referencia al salvado de trigo (ST). Mediante experimentos in vitro se determinaron las propiedades funcionales y con experimentos in vivo, en ratas Holtzman, los efectos fisiológicos de las dietas alimentadas con 6% de fuente de fibra. El EST tuvo 32,2% de solubilidad; 45,0 g/g de capacidad de absorción; 47,9 g/g retención de agua y 46 ml/g de hinchamiento; valores significativamente superior al ST (p< 0,01). En cambio, el HAA presentó 6,38 g/g de capacidad de adsorción del aceite respecto al 5,27 del ST (p< 0,01). La dieta con EST, tuvieron 8,76% de grasa fecal, valor que supera al ST (p< 0,01). Sin embargo, no hubo efecto sobre el peso corporal de las ratas. El HAA incrementó el volumen fecal y redujo de 14,9 a 10,4 h el tiempo de tránsito intestinal (p< 0,01). El endospermo de semilla de tara, retiene la grasa de la dieta y la elimina a través de las heces; en cambio, el polvo de las hojas de Agave americana, reduce el tiempo de tránsito intestinal.

ABSTRACT The endosperm of tara seeds (EST) and powder from the leaves of Agave americana (HAA) were evaluated as new sources of dietary fiber, using wheat bran (ST) as a reference. In vitro experiments were carried out to determine functional properties and in vivo experiments were used to determine the physiological effects of fed Holtzman rats with diets with 6% of each fiber source. Endosperm of tara had 32.2% solubility, 45.0 and 47.9 g/g absorption and water retention capacity, respectively, and 46 ml/g swelling, values significantly higher than wheat bran (p< 0.01). On the other hand, Agave had higher adsorption capacity of oil than wheat bran (6.38 g/g vs. 5.27 g/g; p< 0.01). Diets with endosperm of tara, were 8.76% of fecal fat, a value that exceeded that of wheat bran (p< 0.01); however, there was no effect on body weight of the rats. Agave increased fecal volume and reduced (p< 0.01) intestinal transit time from 14.9 to 10.4 h. Endosperm of tara retained and eliminated fat from the diet through the feces; on the other hand, the powder of Agave leaves reduced intestinal transit time.

Fundamentação científica do princípio de cura homeopático na farmacologia moderna / Scientific basis of the homeopathic healing principle in modern pharmacology

INTRODUÇÃO: O modelo homeopático de tratamento utiliza o ‘princípio dos semelhantes’ como método terapêutico, administrando medicamentos que causam determinados sintomas em indivíduos sadios para tratar sintomas semelhantes em indivíduos doentes (similia similibus curantur), com o intuito de despertar uma reação secundária e curativa do organismo contra os seus próprios distúrbios. Essa reação secundária (vital, homeostática ou paradoxal) do organismo está embasada no ‘efeito rebote’ dos fármacos modernos, evento adverso observado após a descontinuação de diversas classes de drogas que utilizam o ‘princípio dos contrários’ (contraria contrariis curantur) como método terapêutico...

INTRODUCTION: Homeopathy employs the so-called ‘principle of similars’as therapeutic method, which consists in administering medicines thatcause certain symptoms in healthy individuals to treat similar symptomsin sick individuals (similia similibus curantur) to arouse a secondaryand healing reaction by the body against its own disorders. Thissecondary (vital, homeostatic or paradoxical) reaction of the body isbased on the ‘rebound effect’ of modern drugs, a type of adverseevent that occurs following discontinuation of several classes of drugsprescribed according to the ‘principle of contraries’ (contraria contrariiscurantur)....

Scientific basis of the homeopathic healing principle in modern harmacology

BACKGROUND: Homeopathy employs the so-called ‘principle of similars’ as therapeutic method - which consists in administering medicines that cause certain symptoms in healthy individuals to treat similar symptoms in sick individuals (similia similibus curantur) - to induce a secondary and healing reaction by the body against its own disorders. This secondary (vital, homeostatic or paradoxical) reaction of the body is based on the ‘rebound effect’ of modern drugs, a type of adverse event that occurs following discontinuation of several classes of drugs prescribed according to the ‘principle of contraries’ (contraria contrariis curantur). AIM: The present review sought to scientifically substantiate the homeopathic healing principle vis-à-vis experimental and clinical pharmacology through a systematic study of the rebound effect of modern drugs or paradoxical reaction of the body. METHODS: Employing as reference studies and revisions on the subject published since 1998, we updated the data adding recent studies included in database PubMed. RESULTS: The rebound effect occurs after discontinuation of several classes of drugs with action contrary to the symptoms of diseases, exacerbating them to levels above the ones before treatment. [...]. Following the homeopathic premises, modern drugs might also be used according to the principle oftherapeutic similitude, thus employing the rebound effect (paradoxical reaction) with curative intent. CONCLUSIONS: Evidenced by hundreds of studies that attest to the similarityof concepts and manifestations, the rebound effect of modern drugs scientifically substantiates the principle of homeopathic cure. Although the rebound phenomenon is anadverse event studied by modern pharmacology, it is not known by health care professionals, thus depriving doctors of knowledge indispensable for safe management of drugs.

Onboard physical training in weightless environment: A review / 解放军医学杂志

With the advancement of manned space science and technology,the scope of human exploration into outer space has been gradually expanded.The time and distances that astronauts flight on-board are becoming longer and longer.However,long-term microgravity can negatively affect astronauts' physical and psychological aspects,thus influencing their health and leading to the failure of work tasks,and even threatening their lives.This paper reviews USA,Russia and Europe research results in the field of astronauts on-board physical training methods and health protection measures,with the purpose of learning from their successful experience.Overall,it is suggested that for cross complementation in sport science,we should make the introduction of advanced and successful training systems to solve problems existing in astronauts on-board training,ensuring the maintenance of health.

Efeitos fisiológicos e terapêuticos da luz intensa pulsada / Physiological and therapeutic effects of intense pulsed light

Os dispositivos de luz intensa pulsada promovem o princípio básico de absorção de fótons por cromóforos endógenos ou exógenos encontrados na pele. A luz pulsada é convertida em energia calorífica, a qual coagula o alvo desejado (foto-termólise seletiva). Essa tecnologia envolve um sistema de lâmpadas paralelas de xenônio e capacitores contidos, que é aplicada diretamente à superfície da pele. Seu espectro de emissão varia de 500 a 1300 nm, apresentando assim, uma grande versatilidade de tratamentos. Para a construção deste artigo de revisão, a metodologia adotada foi uma pesquisa bibliográfica em revistas científicas da área de saúde indexadas no Pubmed (entre os anos de 1989 a 2016) que abordam os efeitos terapêuticos e fisiológicos da terapia de luz intensa pulsada. Dentre os efeitos terapêuticos aplicados à terapia com luz intensa pulsada, destacamos a remoção de pelos, tratamento de lesões pigmentadas, lesões vasculares, acnes, e rejuvenescimento da pele. Uma das maiores vantagens dos dispositivos de luz intensa pulsada é em relação à sua versatilidade e a economia. Esses dispositivos são mais vantajosos devido a sua capacidade em tratar grandes áreas de pele. No entanto, mais ensaios controlados comparativos com um período de acompanhamento estendido são necessários para determinar diferenças significativas da LIP e outras terapias. (AU)

The devices of intense pulsed light, similar to lasers, has the basic principle to absorption of photons by endogenous or exogenous chromophores in the skin. The pulsed light is converted into heat energy, which coagulates the desired target (photo-selective thermolysis). The intense pulsed light technology involves a system of parallel xenon lamps and capacitors contained in an articulated arm that is applied directly to the skin surface. Its emission spectrum ranges from 500 to 1,300 nm, thus presenting a great versatility of treatments. For the construction of this review, the methodology adopted was a literature search in scientific journals healthcare indexed in Pubmed (between the years 1989 to 2016) that address the physiological and therapeutic effects of intense pulsed light therapy. Among the therapeutic effects of the intense pulsed light therapy, we highlight hair removal, pigmented lesions, vascular lesions, acnes treatment, and finally skin rejuvenation. One of the major advantages of the intense pulsed light is in relation to its versatility and economy. Moreover, the devices of intense pulsed light are more advantageous due to their ability to treat large areas of skin. However, more comparative controlled trials with extended follow-up period are needed to determine significant differences between the intense pulsed light and other therapies. (AU)

Caracterización fisicoquímica y funcionalidad tecnológica de la fibra de banano íntegro verde (Cavendish valery) (Musa AAA cv. Musaceae)

Introducción. La zona de Urabá, en el departamento de Antioquia, Colombia, es gran productora de banano que se dedica fundamentalmente al mercado internacional. Algunos ejemplares que no dan la talla, son dedicados al mercado interno, o simplemente se desechan. Objetivo. El presente estudio buscó caracterizar una fibra de banano verde íntegro de variedad gran enano (Musa AAA cv. Musaceae) (30 %) y Valery (Cavendish valery) (70 %), proveniente de la zona de Urabá, departamento de Antioquia, Colombia. Materiales y métodos. Se realizó su análisis químico proximal, características del contenido de fibra dietaria total (FDT), fibra dietaria soluble (FDS), fibra dietaria insoluble (FDI), además del tamaño de partícula, capacidad de retención de agua (CRA), capacidad de hinchamiento (CH), capacidad de adsorción de moléculas orgánicas (CAMO) y capacidad de intercambio catiónico (CIC), para evaluar su potencial como ingrediente en productos alimenticios. Resultados y conclusión. La caracterización fisicoquímica de la fibra de banano verde íntegro arrojó un contenido de FDT de 38,7 %, FDS de 30,5 % y de FDI de 8,3 %, de proteína de 4,515 % de cenizas de 4,32 %, de grasa de 0,744 % y de humedad de 8,323 %, haciendo de esta un ingrediente que pudiera constituirse en la única fuente de fibra para un alimento.

Introduction. The Urabá zone, in Antioquia, Colombia, has a great banana production, mainly devoted to international markets. Some bananas that cannot achieve high standards are sent to domestic markets, or are simply disposed. Objective. This study aimed to characterize a green banana fiber, of the "gran enana" variety (Musa AAA cv. Musaceae), 30 % and Valery (Cavendish valery), 70 %, from Urabá, Antioquia, Colombia. Materials and methods. A proximate chemical analysis was performed, with characteristics of the total dietary fiber (TDF), soluble dietary fiber (SDF), insoluble dietary fiber (IDF), plus the particle size, water retention capacity (WRC), swelling capacity (SC), organic molecules adsorption capacity (OMAC) and cation exchange capacity (CEC), in order to assess its potential as an ingredient for food. Results and conclusion. The physical-chemical characterization of the green banana fiber had a TDF content of 38,7 %, SDF of 30,5 % and IDF of 8,3 %, 4,515 % of protein, 4,32 % of ashes, 0,744 of fat and 8,323 of humidity. Therefore, this fiber can be the only fiber source in a food product.

Introdução. A zona de Urabá, no departamento de Antioquia, Colômbia, é grande produtora de banana que se dedica fundamentalmente ao mercado internacional. Alguns exemplares que não chegam ao tamanho esperado, são dedicados aou mercado interno, o simplesmente se elimina. Objetivo. O presente estudo buscou caracterizar uma fibra de banana verde íntegro de variedade grande anão (Musa AAA cv. Musaceae) (30 %) e Valery (Cavendish valery) (70 %), proveniente da zona de Urabá, departamento de Antioquia, Colômbia. Materiais e métodos. Se realizou sua análise químico proximal, características do conteúdo de fibra dietaria total (FDT), fibra dietaria solúvel (FDS), fibra dietaria insolúvel (FDI), ademais do tamanho de partícula, capacidade de retenção de água (CRA), capacidade de expansão (CH), capacidade de adsorção de moléculas orgânicas (CAMO) e capacidade de intercambio catiônico (CIC), para avaliar seu potencial como ingrediente em produtos alimentícios. Resultados e conclusão. A caracterização físico-química da fibra de banana verde íntegro mostrou um conteúdo de FDT de 38,7 %, FDS de 30,5 % e de FDI de 8,3 %, de proteína de 4,515 % de cinzas de 4,32 %, de gordura de 0,744 % e de umidade de 8,323 %, fazendo desta um ingrediente que pudesse constituir-se na única fonte de fibra para um alimento.

Efeito rebote dos fármacos modernos: evento adverso grave desconhecido pelos profissionais da saúde / Rebound effect of modern drugs: Serious adverse event unknown by health professionals

OBJETIVO: Apoiado no aforismo hipocrático primum non nocere, o princípio bioético da não maleficência roga que o ato médico cause o menor dano ou agravo à saúde do paciente, incumbindo ao médico avaliar os riscos de determinada terapêutica por meio do conhecimento dos possíveis eventos adversos das drogas. Dentre esses, o efeito rebote representa um efeito colateral comum a inúmeras classes de fármacos modernos, podendo causar transtornos graves e fatais nos pacientes. Esta revisão tem o objetivo de esclarecer os profissionais da saúde sobre os aspectos clínicos e epidemiológicos do fenômeno rebote. MÉTODOS: Uma revisão qualitativa, exploratória e bibliográfica foi realizada na base de dados PubMed utilizando os unitermos 'rebound', 'withdrawal', 'paradoxical', 'acetylsalicylic acid', 'anti-inflammatory', 'bronchodilator', 'antidepressant', 'statin', 'proton pump inhibitor' and 'bisphosphonate' RESULTADOS: O efeito rebote ocorre após a descontinuação de inúmeras classes de fármacos com ação contrária aos distúrbios da doença, exacerbando-os a níveis superiores aos anteriores do tratamento. Independente da doença,dadrogaedaduração do tratamento, o fenômeno se manifesta numa pequena proporção de indivíduos suscetíveis. No entanto, pode causar eventos adversos graves e fatais, devendo ser considerado um problema de saúde pública em vista do enorme consumo de fármacos pela população CONCLUSÃO: Reunindo um corpo de evidências crescente e inquestionável, o médico precisa ter conhecimento das consequências do efeito rebote e de como minimizá-lo, aumentando a segurança no manejo das drogas modernas. Por outro lado, este efeito rebote pode ser utilizado de forma curativa, ampliando o espectro da terapêutica moderna.

OBJECTIVE: Supported in the Hippocratic aphorism primum non nocere, the bioethical principle of non-maleficence pray that the medical act cause the least damage or injury to the health of the patient, leaving it to the doctor to assess the risks of a particular therapy through knowledge of possible adverse events of drugs. Among these, the rebound effect represents a common side effect to numerous classes of modern drugs, may cause serious and fatal disorders in patients. This review aims to clarify the health professionals on clinical and epidemiological aspects of rebound phenomenon. METHODS: A qualitative, exploratory and bibliographic review was held in the PubMed database using the keywords 'rebound', 'withdrawal', 'paradoxical', 'acetylsalicylic acid', 'anti-inflammatory', 'bronchodilator', 'antidepressant', 'statin', 'proton pump inhibitor' and 'bisphosphonate'. RESULTS: The rebound effect occurs after discontinuation of numerous classes of drugs that act contrary to the disease disorders, exacerbating them at levels above those prior to treatment. Regardless of the disease, the drug and duration of treatment, the phenomenon manifests itself in a small proportion of susceptible individuals. However, it may cause serious and fatal adverse events should be considered a public health problem in view of the enormous consumption of drugs by population. CONCLUSION: Bringing together a growing and unquestionable body of evidence, the physician needs to have knowledge of the consequences of the rebound effect and how to minimize it, increasing safety in the management of modern drugs. On the other hand, this rebound can be used in a curative way, broadening the spectrum of the modern therapeutics.

Erlotinib Induced Trichomegaly of the Eyelashes / 결핵및호흡기질환

Epithelial growth factor receptor (EGFR) tyrosine kinase inhibitors (TKIs) have been widely used for non-small-cell lung cancer patients. Its untoward cutaneous effects are largely well known and developed in many patients treated with EGFR TKIs. However trichomegaly of eyelash is rarely reported. Although trichomegaly is not a drug-limiting side effect, it could be troublesome of continuing the treatment because of cosmetic issue or eyeball irritation by long eyelashes. Therefore clinicians are needed to pay attention to this uncommon effect. We herein describe erlotinib induced trichomegaly of eyelashes in a woman with adenocarcinoma of the lung.

Pulmonary Functions in Trained and Untrained Wind Instrument Blowers.

The present cross-sectional study was designed to ascertain whether regular and trained wind instrument blowers develop higher pulmonary functions than untrained or part time blowers. The study included 155 trained & regular blowers (Group A), 100 untrained part-time blowers (Group B) and 100 non-blowers (Group C). They were investigated by a computerized spirometer (RMS medspiror). Group A subjects showed a significantly higher (p<0.001) percentage predicted value for Forced Vital capacity (FVC), Forced expiratory volume in the 1st second (FEV1), Peak Expiratory Flow Rate (PEFR), Maximum Voluntary Ventilation (MVV), Forced Expiratory Flow at 25% & 50% of FVC (FEF25% & FEF50%), Forced Expiratory Flow between 25% & 75% of FVC (FEF 25-75%), FEF50% of FVC, than the other two groups. However, FEV1/FVC % in group A was not statistically higher than the other two groups (p=0.3699). Thus, regular training of wind instrument blowing increases the pulmonary functions which may be a physiological advantage of blowing.

Creatine Supplementation in Wistar Rats Submitted to Physical Tests of Swimming: Evaluation of the Physiological Effects through Raman Spectroscopy.

Creatine is a nitrogenous organic acid that naturally occurs in vertebrates. This compound is associated to energy supply to muscles, being that its biological synthesis occurs mainly in liver and is related to the aminoacids glycine, arginine and ornitine. Several studies have shown the benefits of creatine supplementation, such as higher muscle power, increased fat-free mass, and strength in healthy subjects. Besides, it can be applied as therapeutic agent for some diseases. In this work, the physical condition of Wistar rats that received creatine supplementation is compared with individuals without any supplementation. For this evaluation, swimming tests were developed in order to elucidate the physical condition of animals in different nutritional conditions. Indeed, swimming is considered one of the most complete exercises, since the practice of this physical activity involves great increase in the aerobic and anaerobic capability.

Novos sedativos hipnóticos / The newer sedative-hypnotics

Nas últimas décadas houve um esforço para o desenvolvimento de hipnóticos mais seguros e eficazes. Zolpidem, zaleplona, zopiclona, eszopiclona (drogas-z) e indiplona são moduladores do receptor GABA-A, os quais agem de forma seletiva na subunidade α1, exibindo, desta forma, mecanismos similares de ação, embora evidências recentes sugiram que a eszopiclona não seja tão seletiva para a subunidade α1 quanto o zolpidem. Ramelteon e tasimelteon são novos agentes crono-hipnóticos seletivos para os receptores de melatonina MT1 e MT2. Por outro lado, nos últimos anos, o consumo de drogas antidepressivas sedativas tem aumentado significativamente no tratamento da insônia. Como droga experimental, a eplivanserina tem sido testada como um potente agonista inverso do subtipo 5-HT2A da serotonina, com um uso potencial na dificuldade da manutenção do sono. Outro agente farmacológico para o tratamento da insônia é o almorexant, o qual apresenta um novo mecanismo de ação envolvendo antagonismo do sistema hipocretinérgico, desta forma levando à indução do sono. Finalmente, também discutiremos o potencial papel de outras drogas gabaérgicas no tratamento da insônia.

There has been a search for more effective and safe hypnotic drugs in the last decades. Zolpidem, zaleplon, zopiclone, eszopiclone (the z-drugs) and indiplon are GABA-A modulators which bind selectively α1 subunits, thus, exhibiting similar mechanisms of action, although recent evidence suggests that eszopiclone is not as selective for α1 subunit as zolpidem is. Ramelteon and tasimelteon are new chrono-hypnotic agents, selective for melatonin MT1 and MT2 receptors. On the other hand, the consumption of sedative antidepressant drugs is significantly increasing for the treatment of insomnia, in the last years. As an experimental drug, eplivanserin is being tested as a potent antagonist of serotonin 2-A receptors (ASTAR) with a potential use in sleep maintenance difficulty. Another recent pharmacological agent for insomnia is almorexant, which new mechanism of action involves antagonism of hypocretinergic system, thus inducing sleep. Finally we also discuss the potential role of other gabaergic drugs for insomnia.

Anti-inflamatórios não esteroides: Efeitos cardiovasculares, cérebro-vasculares e renais / Nonsteroidal anti-inflammatory drugs: cardiovascular, cerebrovascular and renal effects

Os anti-inflamatórios não esteroides (AINEs) encontram-se entre os medicamentos mais prescritos em todo o mundo. Essa classe heterogênea de fármacos inclui a aspirina e vários outros agentes inibidores da ciclo-oxigenase (COX), seletivos ou não. Os AINEs não seletivos são os mais antigos, e designados como tradicionais ou convencionais. Os AINEs seletivos para a COX-2 são designados COXIBEs. Nos últimos anos, tem sido questionada a segurança do uso dos AINEs na prática clínica, particularmente dos inibidores seletivos da COX-2. As evidências sobre o aumento do risco cardiovascular com o uso de AINEs são ainda incompletos, pela ausência de ensaios randomizados e controlados com poder para avaliar desfechos cardiovasculares relevantes. Entretanto, os resultados de estudos clínicos prospectivos e de meta-análises indicam que os inibidores seletivos da COX-2 exercem importantes efeitos cardiovasculares adversos, que incluem aumento do risco de infarto do miocárdio, acidente vascular cerebral, insuficiência cardíaca, insuficiência renal e hipertensão arterial. O risco desses efeitos adversos é maior em pacientes com história prévia de doença cardiovascular ou com alto risco para desenvolvê-la. Nesses pacientes, o uso de inibidores da COX-2 deve ser limitado àqueles para os quais não há alternativa apropriada e, mesmo assim, somente em doses baixas e pelo menor tempo necessário. Embora os efeitos adversos mais frequentes tenham sido relacionados à inibição seletiva da COX-2, a ausência de seletividade para essa isoenzima não elimina completamente o risco de eventos cardiovasculares, de modo que todos os fármacos do largo espectro dos AINEs somente devem ser prescritos após consideração do balanço risco/benefício.

The nonsteroidal anti-inflammatory drugs (NSAIDs) are among the most often prescribed drugs in the world. This heterogeneous class of drugs includes aspirin and several other selective or non-selective cyclooxygenase (COX) inhibitors. The non-selective NSAIDs are the oldest ones and are called traditional or conventional NSAIDs. The selective NSAIDs are called COX-2 inhibitors. In recent years, the safety of NSAID use in clinical practice has been questioned, especially that of the selective COX-2 inhibitors. The evidence on the increase in cardiovascular risk with the use of NSAIDs is still scarce, due to the lack of randomized and controlled studies with the capacity of evaluating relevant cardiovascular outcomes. However, the results of prospective clinical trials and meta-analyses indicate that the selective COX-2 inhibitors present important adverse cardiovascular effects, which include increased risk of myocardial infarction, cerebrovascular accident, heart failure, kidney failure and arterial hypertension. The risk of these adverse effects is higher among patients with a previous history of cardiovascular disease or those at high risk to develop it. In these patients, the use of COX-2 inhibitors must be limited to those for which there is no appropriate alternative and, even in these cases, only at low doses and for as little time as possible. Although the most frequent adverse effects have been related to the selective COX-2 inhibition, the absence of selectiveness for this isoenzyme does not completely eliminate the risk of cardiovascular events; therefore, all drugs belonging to the large spectrum of NSAIDs should only be prescribed after consideration of the risk/benefit balance.