OBJECTIVETo investigate the impact of intensive care unit admission during medical handover on mortality. METHODSPost-hoc analysis of data extracted from a prior study aimed at addressing the impacts ...of intensive care unit readmission on clinical outcomes. This retrospective, single-center, propensity-matched cohort study was conducted in a 41-bed general open-model intensive care unit. Patients were assigned to one of two cohorts according to time of intensive care unit admission: Handover Group (intensive care unit admission between 6:30 am and 7:30 am or 6:30 pm and 7:30 pm) or Control Group (intensive care unit admission between 7:31 am and 6:29 pm or 7:31 pm and 6:29 am). Patients in the Handover Group were propensity-matched to patients in the Control Group at a 1:2 ratio. RESULTSA total of 6,650 adult patients were admitted to the intensive care unit between June 1st 2013 and May 31st 2015. Following exclusion of non-eligible participants, 5,779 patients (389; 6.7% and 5,390; 93.3%, Handover and Control Group) were deemed eligible for propensity score matching. Of these, 1,166 were successfully matched (389; 33.4% and 777; 66.6%, Handover and Control Group). Following propensity-score matching, intensive care unit admission during handover was not associated with increased risk of intensive care unit (OR: 1.40; 95%CI: 0.92-2.11; p=0.113) or in-hospital (OR: 1.23; 95%CI: 0.85-1.75; p=0.265) mortality. CONCLUSIONIntensive care unit admission during medical handover did not affect in-hospital mortality in this propensity-matched, single-center cohort study.
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IZUM, KILJ, NUK, PILJ, PNG, SAZU, UL, UM, UPUK
RESUMO A cetamina é única entre os anestésicos e analgésicos. A droga é um anestésico geral de ação rápida que produz um estado anestésico caracterizado por analgesia profunda, reflexos ...faríngeolaríngeos preservados, tônus músculo esquelético normal ou ligeiramente aumentado, estimulação cardiovascular e respiratória e, ocasionalmente, insuficiência respiratória transitória e mínima. Estudos demonstraram a eficácia de seu uso em anestesia, na dor, em cuidados paliativos e em cuidados intensivos. Recentemente, tem sido empregada para dores pós-operatórias e crônicas, como coadjuvante em psicoterapia, como tratamento para depressão e transtorno de estresse pós-traumático, como sedativo para procedimentos cirúrgicos e como tratamento para condições clínicas respiratórias e/ou neurológicas. Apesar de ser um medicamento seguro e amplamente utilizado, muitos médicos, como intensivistas e emergencistas, não estão cientes das aplicações clínicas atuais da cetamina. O objetivo desta revisão bibliográfica narrativa é apresentar aspectos teóricos e práticos das aplicações clínicas da cetamina em ambientes de unidade de terapia intensiva e serviços de emergência.
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IZUM, KILJ, NUK, PILJ, PNG, SAZU, UL, UM, UPUK
Ketamine is unique among anesthetics and analgesics. The drug is a rapid-acting general anesthetic that produces an anesthetic state characterized by profound analgesia, preserved ...pharyngeal-laryngeal reflexes, normal or slightly enhanced skeletal muscle tone, cardiovascular and respiratory stimulation, and occasionally a transient and minimal respiratory depression. Research has demonstrated the efficacy of its use on anesthesia, pain, palliative care, and intensive care. Recently, it has been used for postoperative and chronic pain, as an adjunct in psychotherapy, as a treatment for depression and posttraumatic stress disorder, as a procedural sedative, and as a treatment for respiratory and/or neurologic clinical conditions. Despite being a safe and widely used drug, many physicians, such as intensivists and those practicing in emergency care, are not aware of the current clinical applications of ketamine. The objective of this narrative literature review is to present the theoretical and practical aspects of clinical applications of ketamine in intensive care unit and emergency department settings.
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IZUM, KILJ, NUK, PILJ, PNG, SAZU, UL, UM, UPUK
The species Lippia alba (Mill.) N. E. Brown belongs to the Verbenaceae family. It is abundant and grows spontaneously throughout the Brazilian territory. Popularly known as “erva-cidreira”, it is ...widely used because of its sedative, carminative and analgesic properties. The objective of this study was to investigate the mechanism of action of the L. alba essential oil (EOLa) and its major constituents citral and limonene, on isolated rat uterus muscle. To evaluate the EOLa, citral and limonene effect, cumulative concentrations curves for EOLa and citral (1–600 μg/mL) and for limonene (1–1200 μg/mL) were constructed from contractions of rat uterine strips under a 1 g tension. EOLa, citral and limonene dose-dependently relaxed myometrial preparations pre-contracted with 60 mM KCl, 10-2 IU/mL oxytocin, serotonin (10 μM), or ACh (10 μM). The results demonstrate that the EOLa, citral and limonene cause relaxation of the uterine smooth muscle. These results suggest that the relaxation induced by EOLa, citral and limonene is caused by inhibition of L-type VOCC, inhibiting the Ca2+ current through these channels, although other mechanisms of action are likely to contributing to relaxant activity. There was no involvement of K+ channels (BKca, KATP, KV) or cyclooxygenase on the relaxation promoted by EOLa. Then studies of the tocolytic effects of EOLa, citral and limonene may yield new insights into their therapeutic use.
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•Essential oil of the Lippia alba present major constituents as citral and limonene.•The essential oil of the Lippia alba present tocolytic activity.•The essential oil of the Lippia alba blocked contractions of rat uterine muscles.•Tocolytic action may be associated with the regulation of Ca+2 by VOOC.
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GEOZS, IJS, IMTLJ, KILJ, KISLJ, NLZOH, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UILJ, UL, UM, UPCLJ, UPUK, ZAGLJ, ZRSKP
The aim of the study was to investigate the effect of the oral administration of tucumã oil (Astrocaryum vulgare) on glucose and insulin levels, oxidative status, and pancreatic genotoxic parameters ...of alloxan-induced diabetic mice. The animals were divided into four groups (n = 6 each): control/water; control/tucumã oil; diabetic/water; diabetic/tucumã oil treated for 14 days with 5.0 mL kg−1 via oral gavage. Gas chromatograph characterization demonstrated that oleic/elaidic fatty acid is the most abundant component present in this oil, followed by palmitic and stearic fatty acids. Our results demonstrated an increase (p < 0.05) in water and food intake, blood glucose, thiobarbituric acid reactive species (TBARS) levels, damage index, and frequency of damage; conversely body weight, insulin levels, catalase (CAT) and superoxide dismutase (SOD) activities, and cell viability were decreased in the diabetic/water group compared to the control/water group. The treatment with tucumã oil prevented these alterations in the diabetic/tucumã oil group compared to the diabetic/water group, and restored these parameters near to the control/water group. In summary, our findings demonstrated that treatment with tucumã oil causes a hypoglycemic effect improving insulin levels and antioxidant/oxidant status, and has a protector effect against pancreatic damage induced by oxidative stress in alloxan-induced diabetic mice.
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•Tucumã oil significantly improves glycemic status.•Tucumã oil ameliorate enzymatic antioxidant defenses and to prevent lipid peroxidation.•Tucumã oil has hypoglycemic effect by improving insulin levels.•Oleic/elaidic fatty acid is the principal compound present in tucumã oil.•Tucumã oil may be considered an important alternative to treat hyperglycemia.
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GEOZS, IJS, IMTLJ, KILJ, KISLJ, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UL, UM, UPCLJ, UPUK, ZRSKP
As Ligas Acadêmicas são entidades criadas por acadêmicos, professores e profissionais que apresentam interesse em determinado tema. Realizam atividades extraclasse, com ações voltadas para a ...educação, e os temas abordados são relacionados ao que é estudado na sala de aula. O presente relatou a experiência da criação da Liga Acadêmica de Funcionalidade Humana (LAFUN) por estudantes do curso de Fisioterapia da Uninassau Parangaba. Foi realizado um estudo do tipo relato de experiência de caráter qualitativo, desenvolvido por estudantes e docentes que fazem parte da LAFUN, escolhendo como tema principal a funcionalidade humana. A liga foi criada com a intenção de proporcionar a importância de estudar, pesquisar e promover a funcionalidade humana nos diferentes perfis populacionais, e ademais, abordar a relação saúde e doença de acordo com o ambiente em que estão inseridos. Conclui-se que a criação e implementação da Liga Acadêmica de Funcionalidade Humana proporcionou um avanço no conhecimento e atuação docente/discente relacionado à funcionalidade humana.
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