Mechanisms of edema formation

Edema is defined as liquid accumulation in the interstitial space. In this review, the mechanisms of localized and generalized edema formation were discussed as well as semiologic aspects used in approach to its differential diagnosis. The pathophysiologic mechanisms of the cardiac, cirrhotic and renal (nephritic and nephrotic syndromes) edemas were detailed highlighting the alterations of the mechanisms of control of the effective arterial volume.Edema é definido como acúmulo de fluido no espaço intersticial. Nesta revisão, discutem-se os mecanismos formadores de edemas localizados e dos grandes edemas (generalizados), assim como aspectos semiológicos, empregados em seu diagnóstico diferencial. São detalhados os mecanismos patofisiológicos dos edemas cardíaco, cirrótico e renal (síndromes nefrítica e nefrótica) com destaque para as alterações dos mecanismos de controle do volume arterial efetivo

Optimização de stocks bloqueados

Estágio realizado na Bosch Termotecnologia SA e orientado pelo Lino Sérgio Ferreira da Silva CastroTese de mestrado integrado. Engenharia Electrotécnica e de Computadores - Major Automação. Faculdade de Engenharia. Universidade do Porto. 200

A comparison between sphygmomanometer-based and ambulatory blood pressure monitoring in acute salt loading and depletion protocol

INTRODUCTION: Ambulatory blood pressure monitors have been used in salt loading and depletion protocols. However, the agreement between measurements made using ambulatory blood pressure monitors and those made with the sphygmomanometer has not been evaluated. OBJECTIVE: The objective of this study was to compare the concordance of the two methods of blood pressure measurements in protocols of acute salt loading and depletion. METHOD: Systolic blood pressure was measured using a sphygmomanometer at the completion of salt infusion (2 L NaCl 0.9%, 4 h) and salt depletion (furosemide, 120mg/day, p.o.) in 18 volunteers. Using the Pearson correlation coefficient (ρ), these readings were compared with the mean systolic blood pressure measured using the ambulatory blood pressure monitoring device during the following periods: 4 h of saline infusion and 12 h of salt depletion; 4 h of saline infusion and the last 6 h of salt depletion; 12 h of salt loading and the last 6 h of depletion; 12 h of salt loading and 12 h of depletion. Salt sensitivity was defined by a difference in the systolic blood pressure between salt loading and salt depletion greater than 10 mmHg when measured with the sphygmomanometer, and the Kappa analysis of concordance (K) was used with a significance level of

Hypertensive urgencies and emergencies

Introdução - A Urgência e a Emergência Hipertensiva são ocorrências clínicas, que podem representar mais de 25% dos atendimentos de urgência médica, devendo o médico deve estar apto a diferenciá-las, visto que o prognóstico e o tratamento são distintos. Métodos - Foram pesquisados, no site www.ncbi.nlm.nih.gov/PUBMED os artigos referentes ao termo “Crise Hipertensiva” tendo sido selecionadas dezenove publicações, que foram analisadas nesta revisão. Resultados - A Emergência Hipertensiva resulta de elevação abrupta da pressão arterial, com sintomas que sugerem lesões de órgãos-alvo, necessitando de internação hospitalar,em ambiente de terapia intensiva e tratamento com Nitroprussiato de Sódio e/ou Urapidil. Na Urgência Hipertensiva,ocorre aumento da pressão arterial, sem sinais e sintomas de lesão de órgãosalvo, podendo ser ambulatorial o tratamento, com medicamentos por administração oral. Discussões sobre diagnóstico, fisiopatologia e, sobretudo, tratamento apropriado são apresentados. Conclusões - Urgência Hipertensiva é caracterizada por elevação da pressão sem sintomas e/ou lesões em órgãos-alvo, necessitando de redução da pressão arterial em até 24 h. A Emergência Hipertensiva configura-se como elevação significativa da pressão, com sintomas e risco de vida, necessitando de tratamento e redução imediata da pressão.Introduction - The Urgency and Hypertensive Emergency are clinical occurrences that may represent more than 25% of the medical urgency treatments, due to the fact that the doctor must be able to tell them apart, once that prognosis and treatment are distinct. Methods - The articles referring to the term “Hypertensive crisis” were researched at the www.ncbi.nlm.nih.gov/ PUBMED Website, where 19 publications have been closen and will thus be analysed in this review. Results - The Hypertensive Emergency results in the sudden elevation of the arterial pressure with symptoms that suggest target-organ lesions,making hospital commitment necessary, in an intensive theraphy facility and Sodium Nitroprussiatum treatment and /or Urapidil. In the hypertensive urgency, the arterial pressure elevation occurs, with no signals and targetorgan damage symptoms, thus being possible of ambulatorial treatment with oral medication. Discussions on diagnosis, physiopathology and, above all, appropriate treatment are presented. Conclusions - Hypertensive Urgency is characterized by the pressure elevation without symptoms and/or target-organ damage, making necessary the arterial pressure reduction up to 24 hours. The Hypertensive Emergency means a significant pressure elevation with symptoms and risk of dead, what brings the need of treatment and immediate pressure reduction

Assessment of quality of prescription by dental students

Objective: The main objective of this study was to evaluate changes in prescribing pattern of Dentistry students throughout academic course. Methods: A case of non-complicated dental extraction was presented to all students that had completed their pharmacology coursework (from 4th semester to the last semester). The students were grouped according to year of study and were asked to prescribe paracetamol for pain control. A maximal score of 5 points was calculated from three subscores for identification of professional and patient (1.0 point), drug concentration, dosage, and quantity (1.5 points); and drug information, instructions, and warnings (2.5 points). The data were expressed as medians [95% confidence intervals (CIs)] and were compared using the Kruskal-Wallis test followed by Dunn's post hoc test. A

Hipertensão arterial sistêmica primária

Hipertensão Arterial Sistêmica (HAS) é doença de alta prevalência e determinante de alta morbidade e mortalidade senão adequadamente diagnosticada e apropriadamente tratada.O diagnóstico depende da medida correta da pressão arterial (PA), utlizando-se atualmente métodos alternativos à medida convencional de consultório como a Monitorização Ambulatorial da Pressão Arterial (MAPA) ou a Monitorização Residencial da Pressão Arterial (MRPA).Uma adequada estratificação do risco adicional ao valor da PA obtido é indispensável para uma planificação do tratamento e o alcance das metas desejadas para cada grupo de indivíduos.Manter os pacientes sob o tratamento é necessário e desejável para que os benefícios auferidos com o tratamento, medicamentoso e não medicamentoso, sejam obtidos.Systemic Arterial Hypertension (SAH) is a highly prevalent disease causing high morbidity and mortality if not adequately diagnosed and properly treated.The diagnosis depends on a correct measurement of arterial blood pressure (ABP), with alternative methods to the conventional office measurement being currently used, such as Ambulatory Blood Pressure Monitoring (ABPM) or Home Blood Pressure Monitoring (HBPM).An appropriate stratification of the additional risk besides the ABP value is essential for treatment planning and for archieving the desired goals for each group of individuals. It is necessary and desirable to maintain the patients under treatment in order to obtain the benefits derived from pharmacological or non-pharmacological treatment

Drilling dimension effects in early stages of osseointegration and implant stability in a canine model

Background: This study histologically evaluated two implant designs: a classic thread design versus another specifically designed for healing chamber formation placed with two drilling protocols. Material and Methods: Forty dental implants (4.1 mm diameter) with two different macrogeometries were inserted in the tibia of 10 Beagle dogs, and maximum insertion torque was recorded. Drilling techniques were: until 3.75 mm (regular-group); and until 4.0 mm diameter (overdrilling-group) for both implant designs. At 2 and 4 weeks, samples were retrieved and processed for histomorphometric analysis. For torque and BIC (bone-to-implant contact) and BAFO (bone area fraction occupied), a general-linear model was employed including instrumentation technique and time in vivo as independent. Results: The insertion torque recorded for each implant design and drilling group significantly decreased as a function of increasing drilling diameter for both implant designs ( p <0.001). No significant differences were de - tected between implant designs for each drilling technique ( p >0.18). A significant increase in BIC was observed from 2 to 4 weeks for both implants placed with the overdrilling technique ( p <0.03) only, but not for those placed in the 3.75 mm drilling sites ( p >0.32). Conclusions: Despite the differences between implant designs and drilling technique an intramembranous-like healing mode with newly formed woven bone prevaile

Investigation of Galactic open cluster remnants: The case of NGC 7193

Galactic open clusters (OCs) that survive the early gas-expulsion phase are gradually destroyed over time by the action of disruptive dynamical processes. Their final evolutionary stages are characterized by a poorly populated concentration of stars called an open cluster remnant (OCR). This study is devoted to assessing the real physical nature of the OCR candidate NGC 7193. GMOS/Gemini spectroscopy of 53 stars in the inner target region were obtained to derive radial velocities and atmospheric parameters. We also employed photometric and proper motion data. The analysis method consists of the following steps: (i) analysis of the statistical resemblance between the cluster and a set of field samples with respect to the sequences defined in color-magnitude diagrams (CMDs); (ii) a 5-dimensional iterative exclusion routine was employed to identify outliers from kinematical and positional data; (iii) isochrone fitting to the Ks × (J-Ks) CMD of the remaining stars and the dispersion of spectral types along empirical sequences in the (J-H) × (H-Ks)diagram were checked. A group of stars was identified for which the mean heliocentric distance is compatible with that obtained via isochrone fitting and whose metallicities are compatible with each other. Fifteen of the member stars observed spectroscopically were identified together with another 19 probable members. Our results indicate that NGC 7193 is a genuine OCR, of a once very populous OC, for which the following parameters were derived: d = 501±46 pc, t = 2.5±1.2Gyr, 〈[Fe/H]〉 = -0.17±0.23 and E(B-V) = 0.05±0.05. Its luminosity and mass functions show depletion of low mass stars, confirming the OCR is in a dynamically evolved state.Fil: de Souza Angelo, Mateus. Universidade Federal de Minas Gerais; BrasilFil: Coelho Dos Santos, Joao Francisco. Universidade Federal de Minas Gerais; BrasilFil: Barbosa Corradi, Wagner José. Universidade Federal de Minas Gerais; BrasilFil: De Souza Maia, Francisco Ferreira. Universidade Federal de Minas Gerais; BrasilFil: Piatti, Andres Eduardo. Universidad Nacional de Córdoba. Observatorio Astronómico de Córdoba; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Córdoba; Argentin