PURPOSE:To evaluate the analgesic and neuroendocrine effects of electroanalgesia in dogs undergoing ovariohysterectomy. METHODS:Eighteen dogs were randomly distributed to three groups of six animals each and received either electrical stimuli at acupuncture points (EA), at peri-incisional dermatomes (DER) and at both acupuncture points and peri-incisional dermatomes (EAD).Pre-anesthetic medication was acepromazine (0.05mg kg -1 , IV). Anesthesia was induced with propofol (4 to 5mg kg -1 , IV) and maintained with isoflurane. Postoperatively pain degree was measured using a numerical rating scale. Dogs were scored at 1, 3, 6, 12 and 24 hours postoperative. If the pain score was ≥6, supplemental morphine (0.5mg kg -1 , IM) was administered. Serum cortisol concentration was measured before pre-anesthetic medication (basal), and at 1, 12 and 24 hours postoperative. RESULTS:EA and EAD-treated dogs had lower pain scores than DER treated dogs one hour postoperatively. Fewer EA and EADtreated dogs required rescue analgesia. Serum cortisol did not differ among treatments. CONCLUSION:Preoperative application of electrical stimuli to acupuncture points isolated or in combination with periincisional dermatomes provides a reduced postoperative opioid requirement and promotes an effective analgesia in dogs undergoing ovariohyterectomy.Key words: Electroacupuncture. Analgesia. Ovary. Hysterectomy. Salpingectomy. Dogs. RESUMO OBJETIVO:Avaliar os efeitos analgésicos e neuroendócrinos da eletroanalgesia em cadelas encaminhadas para ovariossalpingohisterectomia. MÉTODOS:Foram avaliadas 18 cadelas, distribuídas aleatoriamente em três tratamentos de seis animais cada: aplicação de estímulo elétrico em pontos de acupuntura (EA), em dermátomos periincisionais (DER) e em pontos de acupuntura associados aos dermátomos periincisionais (EAD). Todos os animais foram tranquilizados com acepromazina (0,05mg kg -1 , IV), seguindo-se a indução com propofol (4 a 5mg kg -1 , IV) e manutenção anestésica com isofluorano. O grau de analgesia foi avaliado 1, 3, 6, 12 e 24 horas após a cirurgia mediante escala descritiva numérica. Animais com escores ≥6 receberam analgesia de resgate com morfina (0,5mg kg -1 , IM). A concentração sérica de cortisol foi avaliada antes da tranquilização, 1, 12 e 24 horas após a cirurgia. RESULTADOS:Escores inferiores de dor foram observados nos tratamentos EA e EAD em relação ao DER na primeira hora pós-operatória. A analgesia de resgate foi menos requerida nos animais dos tratamentos EA e EAD. O cortisol não diferiu entre os tratamentos.CONCLUSÃO: A eletroestimulação de acupontos isolados ou associados aos dermátomos periincisionais reduz o requerimento pós-operatório de opioides, bem como confere efetiva analgesia para cadelas submetidas à ovariossalpingohisterectomia.
Background: The effects of postural reeducation on low back pain (LBP) are well documented in the literature, as well as studies using manual therapy (MT). However, no studies were found that investigate the use of a protocol using both MT and postural techniques. Objective: To verify the effects of a protocol that associates the MT and postural techniques in pain symptoms and functionality of subjects with chronic non-specific LBP. Methods: The participants of this study were 09 patients from the physiotherapy outpatient clinic of a public hospital. The evaluation of the subjects was carried out with the application of the Visual Analog Scale for Pain, Oswestry Disability Index (ODI) and Pressure Algometry. Patients were treated with a protocol composed of manipulative and postural techniques performed twice a week for five weeks. Two new evaluations were performed after the 5th and 10th sessions. For statistical analysis, the ANOVA test was used followed by the Tukey post-hoc test, considering p< 0.05. Results: In all the evaluated variables it was observed a greater difference of the scores between the initial and the tenth evaluation. There was significant improvement in the pain (p = 0.0167) and in the algometry of the piriformis and quadratus lumborum. There was no significant difference in disability (p = 0.0595). Conclusion: The protocol with MT and postural techniques promoted improvement of pain and increase of pressure sensitivity threshold in patients with chronic non-specific LBP.
This integrative review seeks to present an overview of the application of machine learning (ML) tools in the assessment of the risk of falls in the elderly. We searched the CAPES and IEEE Xplore Periodical databases, articles published in English, Portuguese and Spanish, in the last eleven years. Thirteen articles were selected. Most studies use data from sensors to classify the risk of falling and compare the results obtained with results of clinical tests or history of falls. Some studies carried out the selection of characteristics of the collected signals. Research that compared CI tools and conventional scales pointed to a certain superiority of the former. In the selected articles, Multilayer Perceptron (MLP) neural networks were the most explored. It was possible to observe that the ML tools can be applied in the assessment of the risk of falls in the elderly as a classification resource, showing good results.
Introdução: Um recurso imprescindível da UTI é a ventilação mecânica invasiva (VMI), utilizada em pacientes com insuficiência respiratória grave. O processo de transição da VMI para a respiração espontânea sofre influências de diferentes sistemas biológicos que podem levar a indução da inflamação sistêmica. Objetivo: explorar se marcadores inflamatórios clinicamente acessíveis são capazes de predizer o sucesso/insucesso de extubação em pacientes adultos. Métodos: pesquisa quantitativa, retrospectiva, longitudinal e analítica realizado em duas UTI adulto em um hospital universitário. A amostra foi dividida em grupo sucesso (GS) e grupo insucesso (GI). Coletou-se os resultados de exames laboratoriais, PCR, neutrófilos, linfócitos, leucócitos, promielócitos, mielócitos, metamielócitos e bastonetes, no período de 48 e 24 horas antes, no dia, 24 e 48 horas após a extubação. Resultados: Dos 147 pacientes, 39 (27%) falharam no processo de extubação. O GI apresentou maior tempo de internação em UTI com p<0,0001 e desfecho óbito durante internamento com p=0,03 (44%). A razão neutrófilos por linfócitos no GI apresentou valores elevados no dia, 24 e 48 horas após a extubação comparados ao GS com p=0,0035, p=0,0005 e p<0,0001, respectivamente. O ponto de corte da RNL no dia da extubação para prever o insucesso foi >6,9, com sensibilidade de 74,4% (IC 95% 57,9 a 86,9), especificidade de 58,5% (IC 95% 48,5 -68,0). Conclusão: A RNL emergiu como um marcador inflamatório eficaz, simples e de fácil obtenção, sugere-se que seja considerada por profissionais da saúde no dia da extubação como potencial preditor de insucesso e avaliada nas 48 horas subsequentes ao processo.Palavras-chave: Inflamação. Mediadores inflamatórios. Extubação das vias aéreas. Desmame do Ventilador.
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