Exposição de pequenos animais à hiperoxia - um modelo para estudo do papel do músculo liso na hiperreactividade brônquica

ABSTRACTExposure of small animals to high oxygen concentrations can induce morphological and functional changes usually found in the airways of patients with bronchopulmonary dysplasia and asthma. This led to the use of animal models based on exposure to high concentrations of oxygen in order to study the relation between these airway changes and the development of hyperresponsiveness. During the last ten years several studies, using in vivo and in vitro techniques, have shown a close association between cholinergic responsiveness and airway wall remodeling in rats exposed to high levels of oxygen in the inspired air. However, the comparison and interpretation of the results obtained by the various groups is often a difficult task due to the methodological differences found between the protocols. The objective of this paper is to synthesize the information concerning the hyperoxia exposure techniques, the airway challenging agents used and their methods of administration and also the parameters used to measure the responses. It is also included a review of the criteria that determined the choice of particular animal species, the stage of development more often chosen to begin the hyperoxic exposure and also its biological effects on the structure and function of the airways. It is concluded conclude that the hyperoxic rat is a suitable model to evaluate the mechanisms involved in bronchial responsiveness, in particular the contribution of the qualitative and quantitative changes occurring in the airway smooth muscle.REV PORT PNEUMOL 2002; VIII (3): 223-23

Budesonide Reverses Lung Hyperinflation in Childhood Asthma: a Controlled Study

Budesonide (800 mg bid, for 2 months) was administered to 12 asthmatic children (mean age, 11.293.3 years) with lung hyperinflation (TGV]130% predicted and:or RV]140% predicted) in a randomised, placebo controlled, double blind, crossover study. Body plethysmography (panting frequency controlled at 1·s 1) was performed at the beginning, 2 months afterwards (before crossover) and at the end of the study. Budesonide significantly reduced TGV (2.3590.90 l BTPS or 126924% predicted) compared with placebo (2.5491.08 l BTPS, P 0.014 or 140921% predicted, PB0.05). In addition, budesonide significantly increased mean specific conductance (0.0690.02 cm H2O 1 l s 1 to 0.0790.01 cm H2O 1 l s 1, PB0.05). It was concluded that budesonide reduced lung hyperinflation most likely by decreasing airway inflammation

Improvement of tensile and flexural properties of 3D printed PEEK through the increase of interfacial adhesion

The authors acknowledge Fundação para a Ciência e a Tecnologia (FCT, I.P.) for its financial support through the PhD scholarship UI/BD/151082/2021 and through UNIDEMI, project UIDB/00667/2020. The authors would also like to thank João O. Cardoso for the support provided with the DSC analysis equipment.Polyetheretherketone (PEEK) is the leading high-performance biocompatible thermoplastic for the replacement of metals in orthopaedic applications. PEEK processing using material extrusion (ME) Additive Manufacturing (AM) techniques such as Fused Filament Fabrication (FFF) highlight its potential for the manufacture of patient-specific load-bearing implantable medical devices. As a high temperature semi-crystalline polymer, the mechanical properties of PEEK 3D printed samples are significantly influenced by printing parameters, particularly the crystallinity and interfacial adhesion of 3D printed parts. Given these challenges, the printing parameters of nozzle temperature, zone heater temperature, layer height and extruder multiplier were selected and studied for their effects in the interfacial adhesion and thus consequent mechanical performance of PEEK 3D prints. Design of Experiment (DoE) studies were conducted where the Taguchi and ANOVA analysis were used to determine the optimal parameter combinations and respective contributions. Additionally, different infill configurations were used with the optimal parameters to lower the samples' void volume and increase interface bonding. Reductions of up to 65 % in void volume were obtained with an interlayer translation of the infill lines and the tested configurations yielded improvements in both the tensile and flexural properties of 3D printed PEEK. Furthermore, high-temperature annealing treatments produced further increases in the strength, stiffness and crystallinity of PEEK samples. With this, significant improvements in both the void volume and the tensile and flexural properties of PEEK prints were achieved in support of the use of 3D printed PEEK in the manufacture of custom-made and high performance implantable medical devices.publishersversionpublishe

Avaliação funcional ventilatória e dos músculos respiratórios em doentes com artrite reumatóide e sem compromisso clínico pulmonar

Arquivos de Medicina, 1994, 8 (4): 199-202São escassos os estudos relativos às alterações funcionais pulmonares encontradas em doentes com artrite reumatóide (AR) e sem envolvimento clínico do aparelho respiratório. Com o objectivo de investigar esta questão, medimos em 21 mulheres com AR, não-fumadoras, os volumes e as capacidades pulmonares pelo método do hélio em circuito fechado, os débitos expiratórios forçados por pneumotacografia e as pressões respiratórias máximas por meio de um transdutor. Em 10 doentes repetimos a avaliação dos volumes, capacidades e débitos cerca de 15 meses depois. A única alteração funcional encontrada foi uma redução do volume residual (VR), com um valor médio e respectivo desvio padrão de 68,6±15%, em relação ao valor de referência, sendo _65% em 9 doentes. Este padrão manteve-se no segundo estudo. Consideramos que a redução isolada do VR possa reflectir o aumento da tracção elástica pulmonar resultante de uma alveolite que pode acompanhar formas subclínicas de envolvimento pulmonar na AR ou então, que a alveolite seja devida à acção lesiva sobre o pulmão dos medicamentos utilizados no tratamento da grande maioria destes doentes

A Core Outcome Set for Preventive Intervention Trials in Chronic and Episodic Migraine (COSMIG):an international, consensus-derived and multistakeholder initiative

Objective Typically, migraine prevention trials focus on reducing migraine days. This narrow focus may not capture all that is important to people with migraine. Inconsistency in outcome selection across trials limits the potential for data pooling and evidence synthesis. In response, we describe the development of core outcome set for migraine (COSMIG). Design A two-stage approach sought to achieve international, multistakeholder consensus on both the core domain set and core measurement set. Following construction of a comprehensive list of outcomes, expert panellists (patients, healthcare professionals and researchers) completed a three-round electronic-Delphi study to support a reduction and prioritisation of core domains and outcomes. Participants in a consensus meeting finalised the core domains and methods of assessment. All stages were overseen by an international core team, including patient research partners. Results There was a good representation of patients (episodic migraine (n=34) and chronic migraine (n=42)) and healthcare professionals (n=33) with high response and retention rates. The initial list of domains and outcomes was reduced from >50 to 7 core domains for consideration in the consensus meeting, during which a 2-domain core outcome set was agreed. Conclusion International and multistakeholder consensus emerged to describe a two-domain core outcome set for reporting research on preventive interventions for chronic and episodic migraine: migraine-specific pain and migraine-specific quality of life. Intensity of migraine pain assessed with an 11-point Numerical Rating Scale and the frequency as the number of headache/migraine days over a specified time period. Migraine-specific quality of life assessed using the Migraine Functional Impact Questionnaire

Core outcome set for preventive intervention trials in chronic and episodic migraine (COSMIG): an international, consensus-derived and multistakeholder initiative

OBJECTIVE: Typically, migraine prevention trials focus on reducing migraine days. This narrow focus may not capture all that is important to people with migraine. Inconsistency in outcome selection across trials limits the potential for data pooling and evidence synthesis. In response, we describe the development of core outcome set for migraine (COSMIG). DESIGN: A two-stage approach sought to achieve international, multistakeholder consensus on both the core domain set and core measurement set. Following construction of a comprehensive list of outcomes, expert panellists (patients, healthcare professionals and researchers) completed a three-round electronic-Delphi study to support a reduction and prioritisation of core domains and outcomes. Participants in a consensus meeting finalised the core domains and methods of assessment. All stages were overseen by an international core team, including patient research partners. RESULTS: There was a good representation of patients (episodic migraine (n=34) and chronic migraine (n=42)) and healthcare professionals (n=33) with high response and retention rates. The initial list of domains and outcomes was reduced from >50 to 7 core domains for consideration in the consensus meeting, during which a 2-domain core outcome set was agreed. CONCLUSION: International and multistakeholder consensus emerged to describe a two-domain core outcome set for reporting research on preventive interventions for chronic and episodic migraine: migraine-specific pain and migraine-specific quality of life. Intensity of migraine pain assessed with an 11-point Numerical Rating Scale and the frequency as the number of headache/migraine days over a specified time period. Migraine-specific quality of life assessed using the Migraine Functional Impact Questionnaire

Manual therapy for chronic migraine: a pragmatic randomised controlled trial study protocol

Introduction Chronic migraine is a largely refractory condition affecting between 1 and 2.2% of the overall population worldwide, with females more affected than males. There are also high health and socioeconomic costs associated both for the individual and society. The mainstay of chronic migraine management is pharmacological, but the options available have limited efficacy and there are often unwanted side effects. There is some evidence for manual therapy as a treatment option for migraine, but its effectiveness for chronic migraine is unknown. Therefore, we have designed a pragmatic randomised control trial to investigate whether adding manual therapy to the tertiary specialist treatment of chronic migraine improves patient-reported outcomes. Methods A pragmatic, randomised controlled trial in a hospital tertiary headache clinic. Participants will be randomised into one of two groups: treatment as usual or treatment as usual plus manual therapy. The primary outcome measure will be a change in the Headache Impact Test score. Secondary outcomes will also be measured over the 12-week study period including changes in headache frequency, migraine specific quality of life and reductions in relevant medicine consumption. The manual therapy group will have five treatment sessions each lasting 30 min. The recruitment target of 64 participants will allow power at 80% with p = 0.05 using minimal clinical difference for Headache Impact Test of 3.7 and includes provision for a 10% dropout rate. Recruitment will take place between August 2018 and February 2019. The results will form part of a doctoral study and be published in peer-reviewed journals and presented at national/international conferences. Discussion Current pharmacological approaches have limited effects in the management of chronic migraine and there is a requirement to improve treatment options and reduce the health and economic burden of the condition. Manual therapy has been shown to be effective in other chronic pain conditions as well as other primary headaches. This study will explore the effectiveness of manual therapy as an adjunctive approach to the management of chronic migraine. Trial registration The trial has received a favourable opinion from the UK Health Research Authority (IRAS 228901) and is registered at ClinicalTrials.gov.number NCT03395457. Registered 1st March 2018