The role of peripheral opiate antagonists in pain medicine and perioperative care.

Background And Objectives: Pre-clinical and clinical trials of peripheral opiate antagonists have shed new light on the effects of exogenous and endogenous opioids.

Contents: This article review preclinical studies and clinical opioid bowel disfunction trials.

Conclusions: If approved these drugs may offer potential solutions to important clinical problems in pain management.

Comparison of the FiO2 delivered by seven models of the self-inflating bag-mask system.

Background And Objectives: Since resuscitators with self-inflating bag-mask systems manufactured and/or commercialized in Brazil are widely available and used in health services, both out- and intra-hospitals, the objective of this study was to determine the O2 fractions delivered by seven resuscitators receiving different O2 flows.

Methods: Seven resuscitators with self-inflating bag-mask systems were tested at the Respiratory Unit of the HC/UNICAMP. A wall O2 flowmeter was connected to the resuscitator that received an O2 flow of 1, 5, 10, and 15 L min(-1) and those were connected to a test lung.

Chronic obstructive pulmonary disease is associated with osteoporosis and low levels of vitamin D.

Unlabelled: We did a cross-sectional analysis of chronic pulmonary obstructive disease (COPD) patients without chronic use of systemic glucocorticoids (CUG). Osteoporosis was found in 51% and bone mineral density (BMD) was correlated with severity of disease. Low levels of vitamin D were found in 94%.

[The application of MELD score in patients submitted to liver transplantation: a retrospective analysis of survival and the predictive factors in the short and long term].

Background: The model for end-stage liver disease (MELD) was developed to predict short-term mortality in patients with cirrhosis. There are few reports studying the correlation between MELD and long-term posttransplantation survival.

Aim: To assess the value of pretransplant MELD in the prediction of posttransplant survival.

[Could Aleijadinho have suffered from scleroderma].

Rheumatic conditions have affected, among others, emperors, kings, politicians, religious personages and artists. Knowledge about their articular illnesses has increased with a multiplicity of source documents on these personalities: ancient texts, letters, drawings, paintings, sculptures, songs and pictures. Here the case of the most important Brazilian visual artist is described, namely the sculptor Aleijadinho (1730?-1814), who, besides suffering an extremely disability condition, did not give up performing artistic works throughout his whole life.

[Prevalence of thyroid dysfunction and antithyroid antibodies in type 1 diabetic mellitus patients and their first degree relatives].

Unlabelled: Diabetes Mellius Type 1 (DM1) is frequently associated to Autoimmune Thyroid Disease (AITD). The prevalence of AITD among diabetic patients varies between 3 to 50% and the incidence is also big among their family members, when compared to the population in general.

Objectives: To investigate the prevalence of AITD in patients with DM1; to evaluate possible differences concerning the clinical-evolutive behavior of DM1 among diabetic patients with or without AITD and to study the prevalence of AITD among the diabetes patients' relatives.

Efficacy and safety of doripenem versus piperacillin/tazobactam in nosocomial pneumonia: a randomized, open-label, multicenter study.

Objective: Doripenem is a new carbapenem that has broad-spectrum activity against bacterial pathogens commonly responsible for nosocomial pneumonia (NP). It has several advantages over currently available carbapenems and other classes of drugs used in this indication. This prospective, randomized, open-label, multicenter study was designed to establish whether doripenem was noninferior to piperacillin/tazobactam in NP.

[Comparison of pre-operative exams and per-operative findings in living donor liver transplantation].

Background: Success in living donor liver transplantation is associated to donor vascular and biliar anatomy.

Aim: Compare pre-operative and per-operative findings in living liver donors related to portal vein, hepatic artery, bile duct and hepatic venous drainage anatomy.

Methods: Donors charts of living donor liver transplants done at Clinics Hospital of the Federal University of Paraná, Curitiba, PR, Brazil, were reviewed between March 1998 and August 2005.

Functional MASP2 gene polymorphism in patients with history of rheumatic fever.

In this study we investigated whether partial or total MASP-2 deficiencies resulting from Asp105Gly mutation are associated with rheumatic fever (RF) and chronic rheumatic heart disease (RHD). The Asp105Gly MASP2 mutation (D105G) was detected by polymerase chain reaction-restriction fragment length polymorphism in 148 patients (43 men and 105 women; mean age 39.1 +/- 14.

Preparation, characterization and in vitro evaluation of 50% enantiomeric excess bupivacaine (S75-R25)-loaded microspheres.

Background And Objectives: Microspheres can be used as a controlled delivery system to prolong the duration of action of local anesthetics. The objective of this study was the preparation, characterization and analysis of the in vitro release of 50% enantiomeric excess bupivacaine (S75-R25)-loaded microspheres.

Methods: Microspheres were prepared using the copolymer of polylactide-co-glycolic acid by the spray-dryed method.

Mastopexy after massive weight loss: extended chest wall-based flap associated with a loop of pectoralis muscle.

Mammaplasty for patients who have experienced massive weight loss involves some concepts that differ from those that apply to mammaplasty for normal patients. Breast anatomic characteristics make this procedure a very challenging situation. The authors present their experience with a new mammaplasty technique using an extended thoracic wall flap associated with a loop of pectoralis.

[Hypertension associated factors and blood pressure among adolescent workers].

The aim of this study was to identify hypertension associated factors (AF) and verify blood pressure (BP) levels among adolescent workers. Interviews were conducted with 193 working adolescents--135 men and 58 women between 16 and 18 years. After five minutes in seated position, their arm circumferences were measured and their BP was determined using correct (CCW) and standard (SCW) cuff widths.

[Reliability of an instrument to assess the readiness of preterm infants for oral feeding].

Background: The transition from gastric to oral feeding of preterm infants is one of the greatest concerns of health professionals and therefore needs an objective criterion to support the beginning of this process.

Aim: To test the reliability of an instrument that assesses the readiness of preterm infants for the transition from gastric to oral feeding.

Method: The instrument is composed by the following items: corrected gestational age; behavioral state; global posture and tonus; lips and tongue posture; rooting, suck, bite and gag reflexes; tongue and jaw movements; tongue cupping; sucking strain; sucking and pause; maintenance sucking/pause; maintenance alert state and stress signs.

Acute respiratory infection by human metapneumovirus in children in southern Brazil.

Background: Human metapneumovirus (hMPV) has been described as an etiologic agent of acute respiratory infections (ARI), mainly in pediatric patients. Viral isolation is difficult and has low sensitivity, and consequently RT-PCR assays are currently used for detection.

Objectives: Detect hMPV in ARI in hospitalized children in Southern Brazil; standardize a RT-PCR for routine hMPV diagnosis; validate a positive control for molecular tests; and perform phylogenetics analyses.

[Intrusion's feeling of personal and territory space of the patient].

This study aims to identify the patients' feelings in relation to the intrusion of their personal and territorial space. It was used the Scale of Measurement of Feeling's Intrusion of the Personal and Territory Space with forty patients. The data pointed out that the patients feel more invaded in their territory space than in their personal space.

Evolutive echocardiographic study of the structural and functional heart alterations in obese individuals after bariatric surgery.

Objective: To evaluate with Doppler echocardiography the reversibility of structural and hemodynamic changes in obeses after bariatric surgery.

Methods: Twenty-three patients (19 women = 82.6%) were studied.

[Colors in the intensive therapy environment: perceptions of patients and professionals].

The use of colors in the environment of an Intensive Care Unit (ICU) may interfere in the welfare of both professionals and patients. This study is aimed at analyzing the perceptions of professionals and patients regarding the colors used in the intensive care environment, identifying those considered pleasant and unpleasant. This is a descriptive-exploratory research with a quantitative-qualitative focus.

[The nurse and the construction of professional autonomy in the care process].

This article analyses some factors that interfere in the quality of nursing practice, focusing, particularly on the professional nursing practice. It brings about a critical approach of this acting, based on the assumption that the care process is the essence of the nursing work. The nurse's professional autonomy is considered as an important issue to be renewed by a new scientific paradigm, that takes into consideration the humanistic side of health care.

[Management and care in hemodialysis units].

The study aimed at investigating a theoretical practical experience as well as the prospects concerning care management reported by nursing professionals working at hemodialysis units in Curitiba/Brazil. It is a practice-converging research; information was obtained by means of interviews, and team discussions and reflections during a workshop of educational practice. The approach of Collective Speech was used in order to organize data for the analysis.

[Variability in interventions with pulmonary artery catheter data: Brazilian experience].

Background And Objectives: Use of Pulmonary Artery Catheter (PAC) is still a debatable issue, mainly due to questions raised about its security and efficacy. This study reproduced in a sample of Brazilian physicians, another one conducted amidst American doctors, in which was pointed out the heterogeneity of clinical decisions guided by data obtained from PAC.

Methods: During the Brazilian Congress of Intensive Care Medicine (Curitiba 2004), doctors were asked to answer a survey form with three vignettes.

Therapy for severe refractory acute graft-versus-host disease with basiliximab, a selective interleukin-2 receptor antagonist.

Basiliximab is a chimeric monoclonal antibody that binds to the alpha chain of IL-2R on activated cytotoxic T-cells, inhibiting lymphocyte proliferation. We report 34 patients with refractory acute GVHD (grade III-IV) who received basiliximab from December 1998 to October 2003. Adults received 40 mg weekly (2-3 doses) and children received half of this dose.

Viral respiratory infection in Curitiba, Southern Brazil.

Objective: Viral infection is the major cause of respiratory tract pathology affecting individuals of all ages, especially children and immunocompromised patients. There is a paucity of data on etiological and epidemiological infection caused by virus, in Southern Brazil. The aim of this study was to evaluate the seasonality, and the incidence of the viruses involved in respiratory infections in Curitiba, South Brazil.