Comparison of energy expenditure of individuals with Duchenne muscular dystrophy in the sitting posture on the ground and in water.

Duchenne Muscular Dystrophy (DMD) is one of the most frequent childhood dystrophies, affecting cardiopulmonary functions and walking ability. One of the main symptoms is fatigue, which is caused by altered muscle metabolism related to energy expenditure (EE). Aquatic physiotherapy is a therapeutic modality that facilitates the maintenance of this posture because of immersion on the body. This cross-sectional observational study aimed to compare the EE on the ground and water of individuals with DMD through oxygen consumption in the maintenance of sitting posture. The individuals were in a sitting position on the ground and in the water for 20 min for the assessments. The variables peripheral oxygen saturation, heart rate, maximum expiratory pressure, maximum inspiratory pressure, forced vital capacity, respiratory quotient (RQ), and oxygen consumption per kilogram of body weight (VO2 /kg) were compared, adopting a significance of 5 %. No difference was found between medians and quartiles of RQ when comparing the two environments. The same was observed for VO2 /Kg values on the ground and in water. The data from this study demonstrate that the EE of individuals with DMD did not change when maintaining a sitting posture on the ground and in water.

Middle ear risk index (MERI) as a prognostic factor for tympanoplasty success in children.

Tympanoplasty performed in childhood has been controversial over the years because there is no clarity in determining what prognostic factors lead to surgical success. The objective of this study was to evaluate the effect of the Middle Ear Risk Index (MERI) score on the success of pediatric tympanoplasty. A retrospective case-control study was performed at a tertiary pediatric referral center. A database was created with surgical and clinical records of pediatric patients (<18 years of age) with tympanic membrane perforation, assessed and surgically managed by the same surgical team from January 2012 through March 2018. Mild MERI before tympanoplasty was found to be a protective factor against surgical failure, with an odds ratio of 0.24 (p: 0.002). The odds ratio for severe MERI in unsuccessful tympanoplasty was 5.87, with a p: 0.003, standing out as a risk factor for surgical failure. Presurgical MERI in children may be a useful tool to determine if patients are candidates for tympanoplasty, more aggressive interventions, or if medical treatment before tympanoplasty is necessary to improve prognosis. When facing a high MERI score, parents and family should be advised before surgery about the possibility of tympanoplasty failure.

Sedative and cardiorespiratory effects of detomidine constant rate infusion in sheep.

The use of sheep in experiments is widespread and is increasing worldwide, and so is the need to develop species-specific anaesthetic techniques to ensure animal safety. Previous studies have mentioned several protocols involving the administration of alpha-2 adrenergic agonists in sheep; however, assessment of the efficacy and safety of these infusion techniques is still relatively new. Thus, the aim of the present study is to assess the effectiveness of detomidine constant rate infusion (CRI) in sheep by measuring the cardiovascular and respiratory parameters, blood gas variables and sedation scores. Eight adult female Santa Inês sheep received 20 µg/kg of detomidine hydrochloride intravenously as a bolus loading dose, followed by an infusion rate of 60 µg/kg/h. The heart rates and respiratory rates changed continuously during the CRI period. No arrhythmias were observed. The reduction in arterial partial pressure of oxygen (PaO2) was not significant, but one animal showed signs of hypoxaemia (minimum PaO2 of 66.9 mmHg). The arterial partial pressure of carbon dioxide (PaCO2) increased, but the animals did not become hypercapnic. The bicarbonate (HCO3-), pH and base excess (BE) tended towards metabolic alkalosis. The cardiac output (CO), stroke volume (SV), cardiac index (CI) and ejection fraction (EF%) showed no significant changes. The fractional shortening (FS%) decreased slightly, starting at T45min. Sedation scores varied between 3 (0/10) after sedation and during recovery and 7 (0/10) during CRI. We concluded that administering detomidine at an infusion rate of 60 µg/kg/h in Santa Inês sheep is a simple technique that produces satisfactory sedation for minimally invasive procedures.