Both individuals demonstrated gains in all parameters over initial baseline and subsequent phases, with performance increases ranging from 26% to 233% when first and last assessments were compared. Significantly superior effects of treadmill training over baseline conditions on cadence were detected (P<0.05). Gains in walking speed were not significantly better during intervention, but intervention withdrawal produced deceleration of performance gains. Gains in Timed Up and Go, step length and balance were not consistent and were possibly caused by a learning effect of the association between repeated testing and treadmill training. Rivermead Visual Gait Assessment gains reached significance only for subject 2 (P<0.05), probably because of increased variability of performance of subject 1. Results suggest that the association between repeated testing and treadmill training might have been responsible for the observed gains in the two ataxic patients.
ObjectiveTo identify risk factors for extubation failure and reintubation in newborn infants subjected to mechanical ventilation and to establish whether ventilation parameters and blood gas analysis behave as predictors of those outcomes.MethodsProspective study conducted at a neonatal intensive care unit from May to November 2011. A total of 176 infants of both genders subjected to mechanical ventilation were assessed after extubation. Extubation failure was defined as the need to resume mechanical ventilation within less than 72 hours. Reintubation was defined as the need to reintubate the infants any time after the first 72 hours.ResultsBased on the univariate analysis, the variables gestational age <28 weeks, birth weight <1,000g and low Apgar scores were associated with extubation failure and reintubation. Based on the multivariate analysis, the variables length of mechanical ventilation (days), potential of hydrogen (pH) and partial pressure of oxygen (pO2) remained associated with extubation failure, and the five-minute Apgar score and age at extubation were associated with reintubation.ConclusionLow five-minute Apgar scores, age at extubation, length of mechanical ventilation, acid-base disorders and hyperoxia exhibited associations with the investigated outcomes of extubation failure and reintubation.
Incidence and primary causes of unplanned extubation in a neonatal intensive care unit Incidência e principais causas de extubação não planejada em unidade de terapia intensiva neonatal
O câncer de mama é a forma de câncer que mais causa mortes entre mulheres no Brasil. O tratamento consiste em intervenção cirúrgica, quimioterapia, hormonioterapia e radioterapia, esta última responsável por uma significativa diminuição na taxa de recorrência local do câncer, mas que pode afetar a função pulmonar. O objetivo deste estudo foi detectar alterações pulmonares funcionais decorrentes da radioterapia no tratamento do câncer de mama. Participaram do estudo 10 mulheres submetidas a tratamento do câncer de mama, avaliadas quanto à função pulmonar antes e após a radioterapia. Foram mensuradas capacidade inspiratória e capacidade vital forçada, por espirômetro de incentivo, e pressões inspiratória e expiratória máximas, por manovacuômetro. Embora tenha havido redução, em vários casos, dos valores medidos antes e depois da radioterapia, não foi encontrada diferença estatisticamente significativa. Nas pacientes avaliadas, pois, a radioterapia não parece ter prejudicado a função pulmonar.
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