Efeito da fisioterapia respiratória convencional e da manobra de aspiração na resistência do sistema respiratório e na saturação de O2 em pacientes submetidos à ventilação mecânica

Studies about the benefits of chest physiotherapy (CP) to the treatment of bronchyectasis come from the beginning of the 20th century. Since then, a lot of work on this subject has been published about indications, techniques, risks and benefits of the CP. However, no study has been done to compare the effects of conventional CP (postural drainage, percussion and suction) to the suction manoeuvre itsef, as far as respiratory resistance is concerned. The present study was conducted in order to determine the effects of these two procedures on the airway resistance and O2 saturation (SpO2) values. Twelve patients, whose mean age was 58, admitted at the Intensive Care Unit at Botucatu University Hospital – UNESP, with respiratory failure, were studied. All patients were intubated and mechanically ventilated. Within a 4-day-period patients were submited, in turns, to suction manoeuvre, or conventional CP. Airway resistance and saturation were evaluated immediately before and after each manoeuvre. It was then noticed that there was a significant airway resistance fall (p < 0.05), after conventional CP. As to airway suction manoeuvre, the resistance values didn’t change (p > 0.05). There were no change in SpO2 with these two procedures. These results showed that conventional CP is useful to the improvement of respiratory resistance.Os primeiros relatos dos benefícios da drenagem postural no tratamento das bronquiectasias datam do início do século XX. Desde então, numerosos trabalhos têm sido publicados sobre indicações, técnicas, riscos e benefícios da fisioterapia respiratória. Entretanto, não tem sido avaliado comparativamente os efeitos da fisioterapia respiratória convencional (drenagem postural, percussão e aspiração) e da manobra de aspiração sobre a resistência do sistema respiratório, e sobre a saturação de O2 (SpO2), motivo pelo qual foi proposto neste estudo a avaliação dos efeitos da FRC e da manobra de aspiração isoladamente nos valores da resistência e SpO2. Foram investigados doze pacientes, idade média de 58 anos, internados na UTI do HC FMB– UNESP, com insuficiência respiratória em ventilação mecânica. Durante quatro dias, os pacientes foram submetidos de forma alternada a sessões de aspiração isoladamente e de FRC, documentando-se imediatamente antes e após cada procedimento os valores da resistência e da SpO2. Observou-se que houve uma diminuição significativa (p < 0,05) da resistência em todos os dias quando se utilizou a FRC. Quando o método utilizado foi o de aspiração, não houve significância estatística (p > 0,05). Os valores da SpO2 não se alteraram com o uso da FRC e da aspiração. Esses resultados demonstraram que a FRC é benéfica na melhoria da resistência do sistema respiratório

O crime organizado e as novas tecnologias : uma faca de dois gumes

O benefício que determinados Estados retiram das novas tecnologias é incalculável. Contudo, não são os únicos a tirar partido dessas vantagens. O crime organizado, e em especial o cibercrime, aproveita as vulnerabilidades dos sistemas de informação, em que as nossas sociedades estão baseadas, para lucro próprio. Apesar dos conhecimentos que já possuímos sobre este tipo de criminalidade, os nossos esforços não têm conseguido travar o número crescente de ataques cibernautas, nem evitar o aumento das perdas das empresas e dos particulares. Não devemos, no entanto, cair no erro pessimista de pensar que não existe nenhuma forma eficiente de combater o cibercrime. Existe todavia, muito trabalho por desenvolver. Desde a consciencialização da população, para os perigos inerentes à Internet, até à formação de recursos humanos mais qualificados, passando pela investigação e a cooperação entre sectores, há sem dúvida muito ainda por fazer. Adoptámos as novas tecnologias, resta-nos agora aceitar por completo as responsabilidades que elas acarretam

Transmission of signals using white LEDs for VLC applications

In this paper an integrated wavelength optical filter and photodetector for Visible Light Communication (VLC) is used. The proposed application uses indoor warm light lamps lighting using ultra-bright white LEDs pulsed at frequencies higher than the ones perceived by the human eye. The system was analyzed using two different types the white LEDs, namely, phosphor and trichromatic based LEDs. The signals were transmitted into free space and the generated photocurrent was measured by the pin-pin photodetector based on a-SiC:H/a-Si:H. This device operates in the visible spectrum, allowing thus the detection of the pulsed white light emitted by the LEDs. However, as it also works as a visible optical filter with controlled wavelength sensitivity through the use of adequate optical biasing light, it is able to detect different wavelengths. This feature allows the detection of the individual components of the tri-chromatic white LED, which enlarges the amount of information transmitted by this type of white LED, when compared to the phosphor based LED. A capacitive optoelectronic model supports the experimental results and the physical operation of the device. A numerical simulation is presented.info:eu-repo/semantics/publishedVersio

Growth and developmental outcomes of the extremely preterm infant

Objetive: To provide information for pediatricians and neonatologists to create realistic outcome expectations and thus help plan their actions. Sources of data: Searches were made of the Cochrane Library, MEDLINE, and Lilacs databases. Summary of the findings: The assessment of growth and development over the first 2-3 years must adjust chronological age with respect of the degree of prematurity. There is special concern regarding the prognoses of small for gestational age preterm infants, and for those with bronchopulmonary dysplasia. Attention must be directed towards improving the nutrition of extremely low birth weight infants during their first years of life; these infants have high prevalence levels of failure to catch-up on growth, diseases and rehospitalizations during their first 2 years. They are frequently underweight and shorter than expected during early childhood, but delayed catch-up growth may occur between 8 and 14 years. Extremely low birth weight infants are at increased risk of neurological abnormalities and developmental delays during their first years of life. Educational, psychological, and behavioral problems are frequent during school years. Teenage and adult outcomes show that although some performance differences persist, social integration is not impaired. Conclusions: The growth and neurodevelopment of all ELBW infants must be carefully monitored after discharge, to ensure that children and their families receive adequate support and intervention to optimize prognoses. Copyright © 2005 by Sociedade Brasileira de Pediatria