Efectos de la expansión rápida del maxilar sobre el flujo aéreo nasal en pacientes entre 6 y 14 años de edad, con compresión maxilar, medido a través de un flujómetro nasal portátil / Effects of rapid maxillary expansion on nasal airflow of patients between 6 and 14 years of age, with maxillary compression, measured with a portable nasal flowmeter

El objetivo de nuestro estudio de tipo longitudinal prospectivo simple de medidas repetidas fue determinar la variación del flujo aéreo nasal medido con un flujómetro nasal portátil, en niños entre 6 y 14 años de edad con compresión maxilar, después de la expansión rápida del maxilar (ERM). El trabajo constó de 16 niños diagnosticados con compresión maxilar y a quienes se les indicó una disyunción maxilar rápida. Los valores de la cantidad de expansión fueron registrados y la medición del flujo inspiratorio nasal máximo (FINM) se realizó antes de la ERM (T1), inmediatamente después (T2) y al cabo de 3 meses del período de retención (T3), manteniendo las mismas condiciones iniciales. El valor máximo y el promedio de las mediciones del FINM en T2 fueron significativamente mayores que en T1 (p-valor, 0,0056) y (p-valor 0,0062) respectivamente, mientras que entre T2 y T3 no existieron tales diferencias (p-valor: 0,3021) y (p-valor: 0,3315) respectivamente. Existe un aumento significativo en los valores del FINM inmediatamente después de la expansión rápida del maxilar que se mantienen en un período de tiempo de 3 meses.

The objective of our simple prospective longitudinal type study of repeated measures, was to determine the variation of nasal airflow measured with a portable nasal flow meter, in children between 6 and 14 years of age with maxillary compression, after rapid maxillary expansion (RME). The study consisted of 16 children diagnosed with maxillary compression and those who were identified with a rapid maxillary disjunction. The values of the amount of expansion were recorded and the measurement of the peak nasal inspiratory flow (PNIF) was performed before the ERM (T1), immediately after (T2) and after 3 months of retention period (T3), maintaining the same initial conditions. Results: the value maximum and average measurements of FINM in T2 were greater than in T1 (p-value, 0.0056) and (p-value 0.0062) respectively, while between T2 and T3 there were no differences (p value: 0.3021) and (p value: 0.3315) respectively. There is a significant increase in PNIF values immediately after rapid maxillary expansion that is in a period of 3 months.

Conhecimento sobre asma de pediatras de hospitais públicos do Rio de Janeiro / Asthma knowledge among pediatricians at public hospitals in Rio de Janeiro, Brazil

Objetivo: Avaliar o conhecimento, atitudes e práticas sobre asma de pediatras que atuavam em serviços públicos hospitalares. Métodos: Estudo descritivo transversal envolvendo 76 pediatras de quatro hospitais públicos de emergência do município do Rio de Janeiro (RJ). Foram avaliados o conhecimento global (CGA) e específico sobre asma, além de atitudes e práticas, como frequência de prescrição de ß2-agonistas através de aerossol dosimetrado (AD), encaminhamento ao especialista, uso de espaçadores e do medidor do pico de fluxo expiratório (PFE). Resultados: Em relação ao CGA, 73,7% (55/76) da amostra total obteve conceito final insuficiente. Classificação e tratamento da asma alcançaram os percentuais mais baixos de acertos, 23,7% e 14,5% respectivamente. Somente 13,2% dos participantes utilizaram o PFE frequentemente, e a prescrição de ß2-agonistas através de AD foi indicada por apenas 21,9% da amostra, porém esta prática associou-se de modo significativo com o uso frequente de espaçadores (RP = 8,75; IC 95%: 1,07-71,06; p = 0,028) e do PFE (RP = 10,80; IC 95%: 2,31-50,45; p = 0,003). Houve forte associação entre ser alergista/pneumologista pediátrico e CGA suficiente (RP = 8,28; IC 95%: 1,46-46,8; p = 0,015) e uso frequente do PFE (RP = 6,64; IC 95%: 1,22-35,95; p = 0,044). Conclusões: O nível de conhecimento sobre asma dos pediatras que atuavam nos hospitais de emergência avaliados foi insatisfatório. Houve baixa utilização do PFE e subutilização de ß2-agonistas através de AD. A especialização melhorou a compreensão global da doença. Estes resultados reforçam a necessidade de estratégias na educação médica continuada, voltada para asma infantil, nos hospitais públicos do Município do RJ.

Objective: To evaluate asthma knowledge, attitudes and practices among pediatricians working at public hospital services in Rio de Janeiro, Brazil. Methods: This cross-sectional study involved 76 pediatricians working at four publicly funded municipal emergency hospitals in Rio de Janeiro. Global knowledge on asthma (GKA) as well as specific knowledge, attitudes and practices such as frequency of prescription of inhaled ß2-agonists (in aerosol formulation), when to refer patients to specialists, use of spacers and peak expiratory flow (PEF) meters, were evaluated. Results: Regarding GKA, 73.7% of the sample (55/76) showed an insufficient final score. Asthma classification and treatment reached the lowest percentages of correct answers, with 23.7% and 14.5%, respectively. Only 13.2% of the participants used PEF meters regularly, and only 21.9% prescribed inhaled ß2-agonists; however, the latter practice was significantly associated with the use of spacers (PR = 8.75, 95%CI 1.07-71.06; p = 0.028) and PEF meters (RP = 10.80, 95%CI 2.31-50.45; p = 0.003). There was a strong association between being a pediatric allergist/ pulmonologist and having sufficient GKA knowledge (PR = 8.28, 95%CI 1.46-46.8; p = 0.015) and using a PEF meter frequently (PR = 6.64, 95%CI 1.22-35.95; p = 0.044). Conclusions: The level of asthma knowledge among pediatricians working at the emergency hospitals evaluated was unsatisfactory. There was a low frequency of use of PEF meters and also underuse of inhaled ß2-agonists. Being a specialist improved the global understanding of the illness. These results reinforce the need for continued medical education strategies focused on childhood asthma at public emergency hospitals in the city of Rio de Janeiro.

Low Concentration PM10 Had No Effect on Nasal Symptoms and Flow in Allergic Rhinitis Patients

OBJECTIVES: Since Korea is geographically close to China (the origin site for Asian sand dust [ASD]) the health influence of ASD event will be still greater in Korea. We aimed to evaluate the effect of PM₁₀ (particulate matter with aerodynamic diameter 100 μg/m³) RESULTS: There was no significant difference between group A and B in nasal symptoms and PNIF during the 120-day period. Changes in nasal symptoms and PNIF were not statistically significant before or after a PM₁₀ concentration rise above 100 μg/m³. CONCLUSION: Low concentration PM10 does not have significant effect on nasal symptoms and PNIF in AR patients.

Evaluation of Impact of Voiding Posture on Uroflowmetry Parameters in Men

PURPOSE: To evaluate the impact of voiding position on uroflowmetry parameters and to assess its potential clinical implications. MATERIALS AND METHODS: We conducted a prospective study from 2013 to 2015 and included men between 18 and 77 years old who were either healthy volunteers with an International Prostate Symptom Score (IPSS) ≤7 or men with benign prostate enlargement that were on alpha-blocker medication and had an IPSS <10. Participants underwent uroflowmetry and post-void residual urine (PVRU) measurements twice, once in a sitting position and once in a standing position. The participants were divided into 4 groups based on age (35 years or younger, 36 to 50 years, 51 to 60 years, and older than 60 years). RESULTS: A total of 740 men with a mean age of 40.35 years were evaluated. There was no significant difference in uroflowmetry parameters until the age of 50 years between the voiding positions. However, in those older than 50 years, PVRU volume was significantly lower in the sitting position than the standing position, whereas voiding time was significantly higher in the sitting position than the standing position. Other uroflowmetry parameters, including maximal and average urine flow rates, were non-significant. CONCLUSIONS: The voiding position plays an important role in the uroflowmetry parameters of elderly men. Voiding in the sitting position was found to be optimal for elderly men, whereas the role of the voiding position in healthy young men could not be determined. More research is needed to further study this issue.

Avaliação intraoperatória de contratilidade miocárdica com eletrodo decapolar / Intraoperative evaluation of myocardial contractility with decapolar catheter

Atualmente, temos a disposição modernas técnicas de mapeamento eletroanatômico gerando imagens tridimensionais da propagação do impulso nas câmaras cardíacas através de catéteres endocavitários. Apesar disso, poucos estudos estão disponíveis a respeito do mapeamento eletrofisiológico epicárdico. A avaliação intraoperatória de contratilidade miocárdica imediatamente após a revascularização miocárdica é visual e Ecocardiográfica, porém este é muito pouco utilizado para este fim. Há, portanto, a necessidade de desenvolvimento de novos métodos capazes de avaliar o impacto funcional da revascularização miocárdica. Objetivo: Avaliar a resposta intra-operatória de contratilidade miocárdica regional mediante o mapeamento epicárdico com eletrodo decapolar. Métodos: 20 pacientes serão submetidos a revascularização miocárdica e será realizado o mapeamento epicárdico com eletrodo decapolar após confecção da anastomose distal com perfusão seletiva para área revascularizada com a aorta pinçada e portanto sem perfusão para as demais artérias coronárias. Nesta análise será avaliado a duração do impulso do eletrograma...

Fluxometria intraoperatória do enxerto composto de artéria torácica interna esquerda e veia safena magna

Enxerto composto de artéria torácica interna esquerda (ATIE) e veia safena magna (VSM) na revascularização de duas ou mais artérias do sistema coronariano esquerdo (SCE)é uma técnica descrita na literatura desde a década de 1980. Apesar de recentes estudos demonstrarem que a ATIE é capaz de oferecer fluxo sanguíneo adequado, para duas ou mais artérias do SCE, tanto em situação de repouso como estresse, estudos aprofundados devem ser desenvolvidos para aprimorar esse conhecimento. O objetivo deste trabalho é analisar a dinâmica de fluxo sanguíneo neste tipo de enxerto composto, sobretudo no que concerne a adaptabilidade da ATIE eà influência da presença do segmento de VSM sobre o fluxo na ATIE.Em vinte e três pacientes foirealizadoenxerto composto em Y de ATIE e VSM, para revascularizar a artéria interventricular anterior (AIA) e outro ramo do SCE, respectivamente, sem circulação extracorpórea (CEC). O fluxo sanguíneomédio, parâmetros de perviedade do enxerto(fração diastólica e índice de pulsatilidade)e reserva de fluxo coronariano(RFC) foram avaliados por meio de fluxometria por tempo de trânsito (FMTT)em todos os segmentos do enxerto composto, ou seja, nos segmentos proximal e distal da ATIE e no segmento de VSM. As medidas foram realizadas em condição basal, e após estresse farmacológico com dobutamina, bem como sem e com clampeamento temporário a traumático dos segmentos distais do enxerto composto.Estresse farmacológico resultou em aumento dos valores do fluxo sanguíneo em todos os segmentos analisados(p<0,05)...

Composite graft of left internal thoracic artery (LITA) and great saphenous vein (GSV) in the revascularization of two or more arteries of the left coronary system (LCS) is a technique described in literature since the 1980s. Despite recent studies demonstrating that LITA is capable of providing adequate blood flow for two or more LCS arteries, both in basal condition and under stress, deeper studies must be developed to improve this knowledge. The objective of this study was to analyze blood flow dynamics in this kind of composite graft, specially in what concerns to LITA adaptability and to the influence of GSV segment on LITA flow. In 23 patients, a LITA and GVS composite Y-graft was realized to the anterior interventricular artery (AIA) and to another LCS branch, respectively, without extracorporeal circulation. Mean blood flow, as well as parameters of graft patency (diastolic fraction and pulsatile index) and coronary flow reserve(CFR)were evaluated throughtransit time flowmetry (TTFM) in all segments of the composite graft, which are LITA proximal and distal segments, and GSV segment. The measures were realized in basal condition and after dobutamine-induced pharmacological stress, as well as without and with non-traumatic temporary clamping of the distal segments of composite graft. Pharmacological stress resulted in increased values of blood flow in all analyzed segments (p<0,05)...

Effects of intraoperative diltiazem infusion on flow changes in arterial and venous grafts in coronary artery bypass graft surgery / Efeitos da infusão intraoperatória de diltiazem sobre as mudanças do fluxo em enxertos arteriais e venosos em cirurgia de revascularização do miocárdio

AbstractObjective:This study aimed to show the effects of intra-operative diltiazem infusion on flow in arterial and venous grafts in coronary artery bypass graft surgery.Methods:Hundred fourty patients with a total of 361 grafts [205 (57%) arterial and 156 (43%) venous] underwent isolated coronary surgery. All the grafts were measured by intraoperative transit time flow meter intra-operatively. Group A (n=70) consisted of patients who received diltiazem infusion (dose of 2.5 microgram/kg/min), and Group B (n=70) didn't receive diltiazem infusion.Results:Mean graft flow values of left internal mammary artery were 53 ml/min in Group A and 40 ml/min in Group B (P<0.001). Pulsatility index (PI) values of left internal mammary artery for Group A and Group B were 2.6 and 3.0 respectively (P<0.001). No statistically significant difference was found between venous graft parameters.Conclusion:We recommend an effect of diltiazem infusion in increasing graft flows in coronary artery bypass graft operations.

ResumoObjetivo:Este estudo teve como objetivo mostrar os efeitos da infusão de diltiazem intraoperatória no fluxo arterial e enxertos venosos em cirurgia de revascularização do miocárdio.Métodos:Cento e quarenta pacientes com um total de 361 enxertos [205 (57%) arteriais e 156 (43%) venosos] passaram por uma cirurgia coronária isolada. Todos os enxertos foram medidos pelo medidor de fluxo de tempo de trânsito intraoperatório. Grupo A (n=70), formado por pacientes que receberam infusão de diltiazem (dose de 2,5 micrograma/kg/min), e Grupo B (n=70), por aqueles que não receberam infusão de diltiazem.Resultados:Os valores médios de fluxo de enxerto de artéria mamária interna esquerda foram 53 ml/min no grupo A e 40 ml/min no Grupo B (P<0,001). Valores do índice de pulsatilidade da artéria mamária interna esquerda para o Grupo A e do Grupo B foram de 2,6 e 3,0, respectivamente (P<0,001). Não houve diferença estatisticamente significativa entre os parâmetros do enxerto venoso.Conclusão:Sugerimos um efeito da infusão de diltiazem em aumentar os fluxos de enxerto em operações de bypass de artéria coronária.

Discussion on testing of flow rate of infusion device about industry standard / 中国医疗器械杂志

Carried on the exploration testing of flow rate of infusion device about industry standard YY 0451-2010. Engaged in flow rate experiments adopting different method that are provided by new and old industry standard for samples of the same type. Compared with the result of the dangerous coefficient by calculating the test data, the old standard can be more sensitive to reflect the situation of product flow rate, so it can be applied to conventional control of the products. The method which provided by the new industry standard is suitable for evaluating periodicity the level of product contaminated.

Research on data acquisition of portable uroflowmeter and accuracy of measurement / 生物医学工程学杂志

This paper presents the preliminary design of data acquisition system of a portable uroflowmeter. The system uses double-hole cantilever pressure sensor. The signal is transferred to ATmega644PA microprogrammed control unit (MCU), converted by A/D (analog to digital) convertor. Then the further data are processed and get the corresponding relationship of weight-time and two curves of urine flow and urinary flow rate. In the measurement accuracy of the device about urine flow, two factors about the placement and height of the data acquisition are analyzed to show the accuracy of the equipment through the Origin 8.0 data analysis software. The design is characterized by low cost and high speed of data collection, real-time, high accuracy.

Medida do fluxo intraoperatório com fluxômetro TTFM nos enxertos coronários: resultados de amostra nacional / Intraoperative coronary grafts flow measurement using the TTFM flowmeter: results from a domestic sample

OBJETIVO: Avaliar a perviedade dos enxertos no intraoperatório e identificar enxertos com risco de oclusão precoce. MÉTODOS: Cinquenta e quatro pacientes foram submetidos à revascularização do miocárdio e foi utilizado o fluxômetro (Medtronic Medi-Stim) que utiliza o método de tempo de trânsito (TTFM) para avaliação do fluxo nos enxertos. Três pacientes tinham lesão de tronco de artéria coronária esquerda e 48 apresentavam função ventricular normal ou pouco comprometida. RESULTADOS: A mortalidade hospitalar foi de dois (3,7%) pacientes, um por trombose mesentérica e outro por choque cardiogênico. Dezessete (31,4%) pacientes foram operados sem circulação extracorpórea (CEC). O fluxo no enxerto arterial variou de 8 a 106 ml/min, com média de 31,14 ml/min, e nos enxertos venosos de 9 a 149 ml/min, com média de 50,42 ml/min. CONCLUSÃO: O fluxômetro representa maior segurança para o cirurgião e para o paciente. Até mesmo sob o aspecto legal essa documentação dos enxertos pérvios evitará questionamentos futuros.

OBJECTIVE: To evaluate intraoperative graft patency and identify grafts under risk of early occlusion. METHODS: Fifty four patients were submitted to coronary artery bypass surgery and the graft flow was assessed by the Flowmeter (Medtronic Medistim), which utilizes the TTFM method. Three patients had left main disease and 48 had normal or mildly reduced left ventricular function. RESULTS: In hospital mortality was 3.7% (two patients), one for mesenteric thrombosis and one due to cardiogenic chock. Seventeen patients (34%) were submitted to off pump CABG. Arterial Graft flow measures ranged from 8 to 106 ml/min (average 31.14 ml/min), and venous grafts flow ranged from 9 to 149 ml/min (average 50.42 ml/min). CONCLUSION: Flowmeter use represents higher safety both for patients and surgeons. Even under legal aspects, the documentation provided by the device can avoid future questionings.

Desenvolvimento e avaliação de um sistema automatizado de aquisição de dados para medição de vazão, "Auto-Venturi" / Development and evaluation of a system automated data acquisition for flow rate measurement, "Auto-Venturi"

Visando obter um instrumento, de fácil construção e baixo custo, para medição de vazão por meio de software e hardware, neste trabalho, teve-se por objetivo desenvolver e avaliar um sistema automatizado de aquisição de dados para medição de vazão por meio de um medidor Venturi com comunicação via rádio frequência. Para tal desenvolvimento, avaliou-se também a melhor forma de calibração de um transdutor utilizado em equipamentos de medição de vazão que se baseiam em diferencial de pressão. O trabalho foi realizado no Laboratório de Hidráulica, pertencente ao Departamento de Engenharia Rural da Escola Superior de Agricultura "Luiz de Queiroz", da Universidade de São Paulo, localizado no campus de Piracicaba. Utilizou-se um medidor Venturi de material acrílico que possui diâmetro maior principal (D) de 0,069 m e diâmetro menor de "garganta" (d) de 0,0352 m. Calibrou-se o transdutor diferencial de pressão utilizado de maneira estática (ausência de fluxo de água na calibração) e de maneira dinâmica, observando-se diferença significativa entre esses dois processos de calibração. Para a calibração, comunicação e transmissão dos dados desenvolveram-se rotinas computacionais em linguagem "Tbasic". Para o desenvolvimento do software denominado Auto-Venturi utilizou-se o programa computacional Delphi 3 da Borland. Os resultados obtidos mostraram que o sistema automatizado de aquisição de dados com calibração dinâmica apresentou excelentes índices de precisão e exatidão sendo indicado para esse processo. Realizando-se o processo de calibração estática, encontrou-se um excelente índice de precisão, porém um inadequado índice de exatidão, sendo sua realização não recomendada.

Asking for an instrument, of easy construction and low materials costs, to determinate flow rate by software and hardware, the aimed of this work was to project and evaluate a date acquisition automation system to estimate the flow rate existent in a Venturi instrument using frequency radio communication. This work carried out in the Hydraulic Laboratory in Rural Engineer Department in "Luiz de Queiroz" College of Agriculture at Sao Paulo University, in Piracicaba campus. It was used a Venturi instrument composed by a principal diameter (D) of 0,069 m and a lower diameter (d) of 0,0352 m. The pressure transductor calibration carried out by a static way (without flowing rate in the calibration process) and dynamic way presenting difference between these two calibration processes. Computations algorithms were developed in "Tbasic" language and the software called "Auto-Venturi" was designed using Borland Delphi 3 program. According to the results, the data acquisition automation system, with dynamic calibration, had excellent precision and accuracy indices, presenting satisfied results. However, the static calibration system had excellent precision indices and an unsatisfying accuracy isn't indicated to this process.

Estudo prospectivo e randomizado da revascularização do miocárdio minimamente invasiva com dissecção da artéria torácica interna esquerda por videotoracoscopia robótica / Robotic left internal mammary artery harvesting for single vessel minimally invasive coronary bypass: a randomized controlled trial

Objetivos: O objetivo desse estudo foi comparar a perviedade da artéria torácica interna esquerda (ATIE) dissecada por videotoracoscopia robótica para revascularização minimamente invasiva do ramo interventricular anterior (RIA) com a revascularização do miocárdio convencional. Métodos: De 2007 a 2010, 36 pacientes foram randomizados para revascularização do miocárdio minimamente invasiva (RMMI) ou revascularização do miocárdio convencional (RMC). Pacientes randomizados para o grupo RMMI foram submetidos à dissecção da ATIE por videotoracoscopia auxiliada pelo braço robótico AESOP seguida de uma minitoracotomia anterior esquerda no 4º espaço intercostal para anastomose com o RIA. Pacientes randomizados para o grupo RMC foram submetidos a revascularização do miocárdio convencional com esternotomia mediana completa, dissecção aberta da ATIE e anastomose ao RIA. Fluxometria por tempo de trânsito (FTT) foi utilizada para avaliação da perviedade da ATIE imediata. Após 24 meses uma tomografia multislice foi utilizada para avaliar a perviedade a médio prazo da ATIE. Resultados: O tempo médio de dissecção da ATIE no grupo RMMI foi de 50,1 ± 11,2 vs. 22,7 ± 3,3 min no grupo RMC. Não houve diferença significativa no fluxo médio da ATIE para o RIA entre os grupos estudados (46,17 ± 20,11 vs. 48,61 ± 23,42 mL/min, p=0,86) respectivamente. Não houve diferença significante na incidência de infecção de ferida profunda (0 vs. 2, p=0,48) e necessidade de reoperação por sangramento (0 vs. 1, p=1,00) nos grupos RMMI e RMC respectivamente. A angiotomografia mostrou perviedade da ATIE em 100% dos pacientes do grupo RMMI vs. 94,1% no grupo RMC (p=1,00). Não houve mortalidade nos grupos estudados...

Objective: The aim of this study was to compare the patency of left internal mammary artery (LIMA) robotically harvested for left anterior descendent (LAD) artery minimally invasive bypass with conventional LIMA to LAD off-pump bypass. Method: From 2007 to 2010, 36 patients were randomized to either LIMA robotically harvested to LAD artery minimally invasive bypass or standard LIMA to LAD off-pump bypass. Patients assigned to robotic group underwent robotic endoscopic harvesting of LIMA with the AESOP system followed by a small left thoracotomy in the 4th intercostal space for off-pump LAD bypass. Patients assigned to standard group underwent full median sternotomy, open LIMA harvesting followed by off-pump LAD bypass. Transit time flow measurement was used for intraoperative evaluation of LIMA to LAD patency. After a mean 24-month follow-up, Multislice Computed Tomography was used to evaluate LIMA to LAD midterm patency. Results: The mean LIMA harvesting time in robotic group was 50.1 ± 11.2 min vs. 22.7 ± 3.3 min in conventional group. There was no significant difference in intraoperative LIMA to LAD flow between robotic and conventional groups (46.17 ± 20.11 mL/min vs. 48.61 ± 23.42 mL/min, p=0.86). There were no significant differences in incidence of wound infection (0 vs. 2, p=0,48) and reoperation for bleeding (0 vs. 1, p=1.00) between robotic and conventional groups respectively. In robotic group, Multislice CT revealed patent LIMA graft in 100% patients vs. 94.1% patients in conventional group (p=1.00). There was no mortality in the study group...

Effects of Mattresses and Positioning on Interface Pressure and Skin Blood Flow

OBJECTIVE: To determine the effects of mattresses and positioning on interface pressure (IP) and skin blood flow in young healthy persons. METHOD: Ten healthy subjects were included. Three types of mattresses including standard hospital mattress, alternating pressure pump and pad, and alternating pressure air mattress (APAM) and four positions including supine, 30 degree trunk elevation, 30 degree leg elevation, and right 90 degree lateral position were evaluated. IP over the buttock was measured with force sensing array (FSA) pressure mapping system for every subjects lying in four positions on each mattresses. Skin blood flow was measured with laser doppler flowmeter probes that placed over the sacrum and right greater trochanter. RESULTS: IP was significantly lower on the APAM than on the other types of mattresses in all positions. In the right 90 degree lateral position, the IP was significantly higher on all mattresses than that in the other positions, and in the 30 degree leg elevation, the IP was significantly lower on standard hospital mattress and APAM than that in the supine position. There were significant differences in the skin blood flow over the greater trochanter between the APAM and the other types of mattresses, while there were no significant differences over the sacrum on all mattresses. CONCLUSION: APAM is likely to be the most effective as a preventive and treating measure for pressure ulcers. However, combined use of the APAMs with periodic position change might be necessary over the trochanter for effective pressure relief.

Comparison of five portable peak flow meters

OBJECTIVE: To compare the measurements of spirometric peak expiratory flow (PEF) from five different PEF meters and to determine if their values are in agreement. Inaccurate equipment may result in incorrect diagnoses of asthma and inappropriate treatments. METHODS: Sixty-eight healthy, sedentary and insufficiently active subjects, aged from 19 to 40 years, performed PEF measurements using Air Zone®, Assess®, Galemed®, Personal Best® and Vitalograph® peak flow meters. The highest value recorded for each subject for each device was compared to the corresponding spirometric values using Friedman's test with Dunn's post-hoc (p<0.05), Spearman's correlation test and Bland-Altman's agreement test. RESULTS: The median and interquartile ranges for the spirometric values and the Air Zone®, Assess®, Galemed®, Personal Best® and Vitalograph® meters were 428 (263-688 L/min), 450 (350-800 L/min), 420 (310-720 L/min), 380 (300-735 L/min), 400 (310-685 L/min) and 415 (335-610 L/min), respectively. Significant differences were found when the spirometric values were compared to those recorded by the Air Zone® (p<0.001) and Galemed ® (p<0.01) meters. There was no agreement between the spirometric values and the five PEF meters. CONCLUSIONS: The results suggest that the values recorded from Galemed® meters may underestimate the actual value, which could lead to unnecessary interventions, and that Air Zone® meters overestimate spirometric values, which could obfuscate the need for intervention. These findings must be taken into account when interpreting both devices' results in younger people. These differences should also be considered when directly comparing values from different types of PEF meters.

Influences of Chronic Indirect Cigarette Smoking on the Expression of TGF-beta1 and eNOS in Rat Vagina / 대한남성과학회지

PURPOSE: The objectives of this study were to evaluate the effects of chronic indirect cigarette smoking on vaginal blood flow and on histological change in a rat model. MATERIALS AND METHODS: Female Sprague-Dawley rats (12 weeks old, n=40) were devided into smoking and control group. For the exposure to passive smoking, the rat, in plastic enclosure, had a constant influx of cigarette smoke using a smoking generator for 8 weeks in smoking group. The experimental group was exposured to cigarette smoke for 1 hour, twice a day, daily for 8 weeks. Vaginal blood flow was measured by laser Doppler flowmeter. Serum estrogen concentration was measured using competitive radioimmunoassay. Immunohistochemistry and western blot analysis was done to observe the expression of TGF-beta1 and e-NOS. RESULTS: Mean vaginal blood flow (ml/min/100g tissue) significantly decreased in smoking group (13.4+/-1.6) compared to control (19.6+/-5.9)(p<0.05). The estimated concentration of serum estradiol (pg/ul) was similar between smoking (1.1+/-0.8) group and control (1.1+/-0.3) group. Vaginal histology of the cigarette smoking group was similar to the control. In the cigarette smoking group, the immunoreactivity of TGF-beta1 increased in the smooth muscle and fibroblasts. The protein expression of TGF-beta1 was increased in the smoking group (p<0.05). There was no significant differences in expression of e-NOS between two groups. CONCLUSIONS: A chronic indirect exposure to cigarette smoke significantly reduces vaginal blood flow and appears to cause vaginal tissue fibrosis in the female rat model. This suggest that cigarette smoking has adverse effects on female sexual functions and may cause sexual arousal disorder in women.

Ultrasonic doppler flowmeter-guided occipital nerve block / 대한마취과학회지

BACKGROUND: Greater occipital nerve block is used in the treatment of headaches and neuralgia in the occipital area. We evaluated the efficacy of ultrasonic doppler flowmeter-guided occipital nerve block in patients experiencing headache in the occipital region in a randomized, prospective, placebo-controlled study. METHODS: Twenty-six patients, aged 18 to 70, with headache in the occipital region, were included in the study. Patients received a greater occipital nerve block performed either under ultrasonic doppler flowmeter guidance using 1% lidocaine or the traditional method. Sensory examination findings in the occipital region were evaluated. RESULTS: The complete block rate of greater occipital nerve blockade in the doppler group was significantly higher than in the control group respectively (76.9% vs. 30.8%, P < 0.05). Only one patient in the control group had a complication (minimal bleeding). CONCLUSIONS: Ultrasonic doppler flowmeter-guided occipital nerve block may be a useful method for patients suffering headache in the occipital region.

Avaliação de desempenho em um medidor eletromagnético de baixo custo desenvolvido para aplicações em simulação cardiovascular / Performance evaluation on low cost electromagnetic flow meter for cardiovascular simulation system application

Técnicas cirúrgicas, próteses e dispositivos implantáveis utilizados pela cardiologia estão em constante desenvolvimento. Alguns institutos de pesquisas e universidades desenvolvem simuladores hidrodinâmicos com capacidade de reproduzir os níveis de pressão e vazão do sistema cardiovascular humano, com pistões, válvulas, câmaras de complacência, dispositivos para ajustes e medição de pressão e vazão. Este artigo apresenta o desenvolvimento e a avaliação de um fluxômetro eletromagnético (FE). O custo elevado de um fluxômetro por ultrassom (FUS) pode inviabilizar algumas pesquisas com simuladores; desta forma, uma alternativa com menor custo é apresentada neste trabalho. Baseado na indução eletromagnética para medição de vazão em um fluido iônico, o FE desenvolvido mostrou ser uma solução de baixo custo. O transdutor foi montado em um tubo de plástico com diâmetro interno de 9,5 mm, excitado por um campo magnético de 0,35 T, possui 4 eletrodos que, ligados a um circuito eletrônico, fornecem tensão elétrica proporcional à velocidade do fluido. A equação da tensão induzida, técnicas para calibração, ensaios e resultados são apresentados. Para a realização dos ensaios, foram utilizados um simulador cardiovascular e um FUS como referência. Os dados foram obtidos por hardware e software da National Instruments. Dentre os resultados, destaca-se o baixo desvio padrão de 0,043 L/min do FE para uma vazão de 3,56 L/min. O maior erro porcentual relativo foi de 1,49 ± 1,25%. Em um dos gráficos de vazão do FE observou-se um comportamento não monotônico, confirmado por uma análise da resposta em freqüência, observando-se maior amplitude na segunda, terceira e quarta harmônicas. Os resultados indicaram que o FE pode substituir o FUS em aplicações com simuladores hidrodinâmicos.

Implantable devices, prosthesis and their associated surgical techniques in cardiology are constantly under development. Many research groups have been using hydrodynamic simulators as a tool to assist the development in cardiovascular area, capable to mimic pressure and flow found in human cardiovascular system. They are made with plastic tubes, compliances chambers, valves, moving diaphragms and clamps for pressure and flow adjustments. The high cost of ultrasonic flow meters (UF) may difficult, for some research groups, the development of their own mock systems. This paper presents a simple and low cost electromagnetic flow meter (EF) useful for those cardiovascular simulation systems. EF measures flow of ionic fluids based on electromagnetic induction. A special transducer was assembled directly on a plastic tube with 9.5 mm of inner diameter. The transducer has 4 electrodes and, when excited by a magnetic field of 0.35 tesla, detects electric tension that is proportional to the fluid velocity. In this paper, induced electric potential equation, calibration techniques, performance tests and results are presented. A cardiovascular simulation system was used as test setup with an UF (Transonic Systems Inc.) as comparative flow meter. The signals were acquired by a PCI-6036E card and processed with LabView® 7.1 (National Instruments). The results from EF showed a standard deviation (SD) of 0.043 L/min for a flow of 3.56 L/min. The largest relative error was of 1.49 ± 1.25%. In one flow signal from the EF, the non monotonic behavior suggests a rich harmonic signal, which was confirmed by an analysis in the frequency domain. In vitro performance tests indicated that our EF can substitute the commercial available UF for hydrodynamic simulator application.

Status of peak expiratory flow rate [PEFR] in normal Basrah population

Measuring peak expiratory flow rate has been suggested as an important tool used to test ventilator capacity in many epidemiological surveys, for assessing the severity of asthma and bronchial hyper-reactivity management by all international guidelines. The present study was undertaken to determine the normal values of PEFR for healthy population of Basrah city, and comparison with other nations. The study was conducted in Basrah city on [649] healthy subjects of age 5- 75 years of either sex. A Wright peak flow meter was used to measure peak expiratory flow rates [PEFR]. The mean value of PEFR achieved of three successive attempts was recorded at 10 a.m. Standing height in centimeter [cm] was measured. Calculated PEFR values were also done and compare with measured values. Peak expiratory flow rate [PEFR] of Basrah subjects linearly related to height for both sex; men above 15 year were significantly higher than women. PEFR values of both sex population were significantly lower than healthy Kashmiri and Western men and women. The value of PEFR in male was higher than that of female children [5-15] and they showed lower values of PEFR in comparison to those for Iranian children. Calculated PEFR values for girls was found significantly higher than measured values. The peak expiratory flow rates for Basrah population were less than those reported from other countries, and the data from this sample size is not representative of characteristics of a region, therefore, the findings of the present study should be considered preliminary and call for further studies with a large sample size based on random selection

Feasibility study of organic matter and Ammonium removal using loofa sponge as a supporting medium in an aerated submerged fixed-film reactor (ASFFR)

Biofilm systems are efficient in the removal of organic matter and ammonium from wastewaters. In this study, loofa sponge, a natural product, was used as a supporting medium in an aerated submerged fixed-film reactor to evaluate its performance in removing organic matter and nitrogen from wastewater. Four pilot runs were performed with chemical oxygen demand (COD) concentrations of 100, 200, 300 and 400 mg l-1 to provide an organic loading rate of 0.6, 1.2, 1.8, and 2.4 kg m-3d-1 respectively. In these pilot runs, the influent ammonium nitrogen concentrations were justified to 5, 10, 15 and 20 mg l-1 as N to provide an influent nitrogen loading of 30, 60, 90 and 120 g m-3.d-1 respectively. Although soluble COD removal efficiency greater than 80 percent was achieved up to a loading rate of 2.4 kg m-3d-1, loofa deformation and clogging after 72 days of application might be considered a serious shortcoming during use in full-scale applications. Nitrogen removal efficiency decreased from 85.6 percent at an organic loading rate of 0.6 kg m-3d-1 to 56.1 percent at an organic loading rate of 2.4 kg m-3d-1.

Family Practitioners Perception of; Knowledge about and use of Peak Flow Meters in Lenasia; Lenasia South; and Soweto Community Health Clinics

Background : The purpose of this paper was to determine the availability of peak flow meters; perceptions about their usefulness and the perceptions of clinical indications for their use. Methods : A questionnaire was administered to private and public sector practitioners (n=72) working in three urban areas of greater Johannesburg. Data were collected concerning practice profiles; the characteristics of the practitioners; the extent of and indications for use; and the reasons for failure to use these meters. Results : The results showed that only 21 (29) of the practitioners advised their asthma patients to use peak flow meters for home monitoring. A scoring system (summary score); which was developed to summarise knowledge of both the indications for the use of the meters and the method of peak flow measurement; showed that only 33.3of the practitioners attained maximum or close to maximum scores (6 to 8 of an 8-point scale). Conclusion : Peak flow meters were underutilised by family practitioners. The cost of the peak flow meter was an important reported cause of underutilisation. It is recommended that the importance of the peak flow meter in the management of asthma be emphasised at the undergraduate and continuing medical education level. The findings of this study could also be used to guide the national campaign coordinators in South Africa in their strategy to improve asthma care among family practitioners. Since asthma may be under-diagnosed in the community; further research is needed to assess the effects of education in assisting people to recognise asthma. Early recognition and diagnosis of asthma; together with appropriate asthma education; may significantly reduce morbidity. The role of illiteracy and cost in limiting the use of peak flow meters warrants investigation; as does the possibility of developing suitable meters for populations with limited formal education. Doctors need to make more conscientious; concerted and informed efforts to monitor their asthma patients and to collaborate; where appropriate; with health educators to optimise the management of asthma. This could include workshops within the community and with fellow healthcare workers (doctors; primary healthcare sisters) on various aspects of asthma care; which will incorporate inhaler techniques and peak flow meter use