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  • About
  • The Global ETD Search service is a free service for researchers to find electronic theses and dissertations. This service is provided by the Networked Digital Library of Theses and Dissertations.
    Our metadata is collected from universities around the world. If you manage a university/consortium/country archive and want to be added, details can be found on the NDLTD website.
501

Disturbances of autonomic functions in spinal cord injury: autonomic dysreflexia and thermoregulation

Kalincik, Tomas, Medical Sciences, Faculty of Medicine, UNSW January 2009 (has links)
Disorders of the autonomic nervous system constitute serious complications of spinal cord injury (SCI) and their treatment is usually highly prioritised by spinal patients. Among these, autonomic dysreflexia and impaired thermoregulation are potentially life threatening conditions and require effective management. Olfactory ensheathing cells (OECs), progenitor cells and polymeric scaffolds have been tested in animal models of SCI and some of them have been considered for clinical trials. However, evaluation of the effect of such interventions on autonomic functions has received only rudimentary attention and would require a more thorough experimental assessment before the methods are utilised in human patients. This thesis tested two potential therapeutic strategies for autonomic dysreflexia and examined disorders of thermoregulatory functions in a rat model of spinal cord transection. Magnitude and duration of autonomic dysreflexia were evaluated with radio telemetry in spinalised animals treated with (i) implants of OECs and olfactory neurosphere-derived cells seeded in poly(lactic co glycolic) porous scaffolds or with (ii) transplants of OECs alone. (iii) Effects of SCI and of OECs on the morphology of sympathetic preganglionic neurons (SPNs; which are involved in pathogenesis of autonomic dysreflexia) stained for NADPH diaphorase were examined. (iv) Doppler ultrasonography and infrared thermography were used to assess responses of tail blood flow and surface temperature to cold. Transplants of OECs alone, but not in combination with olfactory neurosphere-derived cells and polymeric scaffolds, resulted in significantly shortened episodes of autonomic dysreflexia. This may be attributed to the alterations to the morphology of SPNs adjacent to the lesion: a transient increase in the morphometric features of the SPNs was evoked by spinal cord transection and this was further altered by transplantation of OECs. The thesis also showed that local responses of tail blood flow and temperature to cold were not abolished by complete SCI suggesting that temperature homeostasis could still be maintained in response to cold. It is hypothesised that OECs facilitate improved recovery from autonomic dysreflexia through alteration of the morphology of SPNs. Furthermore, it is suggested that the role of the tail in heat conservation can be regulated by mechanisms that are independent of the descendent neural control from supraspinal centres.
502

Heart rate variability and dysrhythmogenic potential in patients admitted to psychiatric institutions

Grant, Catharina Cornelia January 2005 (has links)
Thesis (MSc. (Physiology)--Faculty of Health Sciences) - University of Pretoria, 2005. / Includes bibliographical references.
503

Avaliação dos efeitos do 2-nitrato-1,3- dibutoxipropano (NDBP) sobre o sistema cardiovascular / Evaluation of effects of the 2-nitrate-1,3-dibuthoxypropan (NDBP) on cardiovascular system

Silva, Maria do Socorro de França 03 August 2012 (has links)
Made available in DSpace on 2015-05-14T12:59:38Z (GMT). No. of bitstreams: 1 arquivototal.pdf: 2427284 bytes, checksum: d24742c1a3622f9b0122565e2537caa8 (MD5) Previous issue date: 2012-08-03 / Coordenação de Aperfeiçoamento de Pessoal de Nível Superior / Previous studies have shown that the 2-nitrate-1,3-dibuthoxypropan (NDBP), an organic nitrate synthesized from glycerin, induced vasorelaxation in mesenteric artery of rats through activation of the NO-cGMP-PKG pathway and K+ channels, in addition, caused hypotension and bradycardia in normotensive conscious rats. The current research aimed to investigate the effects of the NDBP on cardiovascular system in rats, evaluating the NO release in rat smooth muscle cell culture, the ability of NDBP to induce tolerance to vasodilatation and the effect of the acute administration of the compound on autonomic control of blood pressure and heart rate of normotensive and hypertensive rats, using in vitro and in vivo approaches. For biochemical determination aortic rat smooth muscle cell culture (ARSMC) was used and the pharmacological experiments were developed using Wistar rats or spontaneously hypertensive (SHR) and normotensive Wistar Kyoto (WKY) rats. The NDBP caused concentration-dependent increases in NO levels in ARSMC. In addition, NDBP produced no change in the vasorelaxation induced by the NDBP when the rings were pre-incubated with the NDBP (10 μM or 100 μM), suggesting that the NDBP did not induce tolerance. In vivo experiments, SHR rats were significantly hypertensive compared with WKY rats. The acute administration of the NDBP (1, 5, 10, 15 and 20 mg/kg, i.v.) caused a biphasic response: hypotension and bradycardia followed by hypertension and tachycardia in WKY and SHR rats. The blockade of muscarinic receptors with atropine (2 mg/kg) blunted the bradycardia induced by NDBP (15 mg/kg) and reduced the hypotension in WKY and SHR. However, the pressor response to the compound was potentiated. Furthermore, vagotomy almost abolished the bradycardia in WKY and SHR. Moreover, hexamethonium (30 mg/kg), a nicotinic ganglionic blocker, reduced both bradycardia and pressor response in WKY and SHR. The administration of methylene blue (4 mg/kg), a soluble guanylyl cyclase (sGC) blocker, attenuated the hypotension and bradycardia induced by the NDBP (15 mg/kg) in WKY. Similar event occurred in SHR animals. In conclusion, the NDBP releases NO in ARSMC, and was unable to induce tolerance to its vasorelaxant effect, however, the cardiovascular effects of NDBP are mainly mediated by the central action of the compound, resulting in changes on autonomic function of spontaneously hypertensive and normotensive rats. / Relatos prévios demonstraram que o 2-nitrato-1,3-dibutoxipropano (NDBP), um nitrato orgânico sintetizado a partir da glicerina, induziu vasodilatação em anéis de artéria mesentérica cranial isolada de rato mediante a ativação da via NO-GMPc- PKG, bem como dos canais para K+ e, adicionalmente, causou hipotensão e bradicardia em ratos normotensos não-anestesiados. O estudo atual teve como objetivo investigar os efeitos do NDBP sobre o sistema cardiovascular em ratos, avaliando a liberação de NO eliciada pelo NDBP em células musculares lisas vasculares, a capacidade do NDBP induzir tolerância ao vasorrelaxamento e o efeito da administração aguda do composto sobre o controle autonômico de animais normotensos e hipertensos, por meio de abordagens in vitro e in vivo. Nos experimentos bioquímicos foi utilizada a cultura de células musculares lisas de aorta de rato (CMLAR) e, nos experimentos farmacológicos foram utilizados ratos Wistar ou ratos espontaneamente hipertensos (SHR) e normotensos Wistar Kyoto (WKY). Foi observado que o NDBP causou um aumento concentração-dependente nos níveis de NO em CMLAR. Além disso, não houve alteração no efeito vasodilatador do NDBP quando os anéis de artéria mesentérica foram previamente expostos ao NDBP, nas concentrações de 10 μM ou 100 μM, sugerindo que o nitrato orgânico em estudo não induziu tolerância. Nos experimentos in vivo, foi constatado que a pressão média basal dos animais espontaneamente hipertensos foi significantemente maior que a do grupo normotenso. A administração aguda do NDBP (1, 5, 10, 15 e 20 mg/kg, i.v.) induziu uma resposta bifásica: hipotensão e bradicardia seguidas de hipertensão e taquicardia, em ratos SHR e WKY. O bloqueio dos receptores muscarínicos pela atropina (2 mg/kg) atenuou a bradicardia induzida pelo NDBP (15 mg/kg), reduzindo também a hipotensão em WKY e SHR. Entretanto, a resposta pressora ao composto foi potencializada. A secção bilateral do nervo vago praticamente aboliu a bradicardia em WKY e SHR. Adicionalmente o hexametônio (30 mg/kg), um bloqueador nicotínico ganglionar, reduziu tanto a bradicardia quanto a resposta pressora em ambos os grupos. A administração do azul de metileno (4 mg/kg), um bloqueador da ciclase de guanilil solúvel (CGs), atenuou as repostas hipotensora e bradicárdica induzida pelo NDBP (15 mg/kg) em ratos WKY. Evento similar aconteceu nos animais SHR. Esses resultados sugerem que o NDBP libera NO em CMLAR, sendo incapaz de induzir tolerância ao seu efeito vasorrelaxante, entretanto, os efeitos cardiovasculares do NDBP são mediados, principalmente, pela ação central do composto, resultando em alterações na função autonômica de ratos normotensos e espontaneamente hipertensos.
504

Neuronal control of cardiac excitability in pro-hypertensive states

Larsen, Hege Ekeberg January 2016 (has links)
Hypertension is associated with marked cardiac sympathetic over-activity and end organ hyper-responsiveness. The sympathetic dysfunction is caused by aberrant calcium (Ca<sup>2+</sup>) handling resulting in enhanced neurotransmission. However, it remains unclear whether the sympathetic neuron or the myocytes is the primary driver behind the initiation and maintenance of the autonomic phenotype. The work in this thesis characterises the Ca<sup>2+</sup> dysfunction and regulation at the membrane level. Further, it employs physiologically coupled sympathetic neurons and ventricular myocytes to determine the cellular driver of cardiac dysautonomia in the pro-hypertensive state. <b>Chapter 1</b> provides a general overview of the field of autonomic hypertension with a specific focus on the sympathetic control of cardiac excitability. In particular, the role of Ca<sup>2+</sup> and cyclic nucleotides in the facilitation of neurotransmission are explored. <b>Chapter 2</b> details the methods used in this thesis. It provides rationale for the approaches taken to record membrane Ca2+ currents, cyclic adenosine monophosphate (cAMP) levels and cAMP-activated protein kinase (PKA) activity, and the development and uses of a co-culture of coupled sympathetic neurons and ventricular myocytes. <b>Chapter 3</b> describes the successful development of an effective voltage clamp method to isolate whole cell Ca<sup>2+</sup> currents in sympathetic neurons. It details the issue of space clamp problem when using this technique on peripheral neurons and provides experimental guidance on how to quantify and limit theses issues. <b>Chapter 4</b> identifies that the pro-hypertensive four-week old neurons from the spontaneously hypertensive rat (SHR) have significantly larger whole cell Ca<sup>2+</sup> currents when compared to normotensive (Wistar Kyoto-WKY) neurons, that are largely N-type in nature. Restoring the cGMP cyclic nucleotide dysfunction seen in these cells, rescues the ion channel phenotype and bring the Ca<sup>2+</sup> down to levels seen in the normotensive WKY neuron. Further, it identifies that phosphodiesterase (PDE) 2A inhibition differentially affects the currents in the WKY and SHR, further supporting the notion of PDE2A dominance. <b>Chapter 5</b> identifies the presence and functional relevance of cGMP cross-talk with the cAMP-PKA pathway in sympathetic neurons. This cross talk is significantly altered in the pro-hypertensive state, via the differential involvement of PDEs. It functionally identifies the presence of PDE3 and PDE2A and provides further evidence that these enzymes could be dysregulated in pro-hypertensive neurons. <b>Chapter 6</b> describes the use of a co-culture model of ventricular myocytes and sympathetic neurons. Physiological stimulation of the sympathetic neuron with nicotine whilst monitoring cAMP levels in the myocytes confirms that the cellular phenotypes seen in the individual cells are functionally present in the co-culture. Using cross-cultures, it identifies the neuron as the principal driver behind the cardiac sympathetic responses observed in pro-hypertension. The results provide evidence for a dominant role played by the neuron in driving the adrenergic phenotype seen in cardiovascular disease and highlights the potential of using healthy neurons to turn down the gain of neurotransmission, akin to a smart pre-synaptic &beta;-blocker. <b>Chapter 7</b> forms the concluding discussion that summarises the main findings of this thesis and attempt to place it in a clinical context, and highlights avenues of further research. In particular, the possibility of using a cell therapeutic approach to treat sympathetic hyperactivity.
505

Variabilidade da freqüência cardíaca como ferramenta de análise da função autonômica : revisão de literatura e comparação do comportamento autonômico e metabólico em recuperação pós-exercício /

Hoshi, Rosangela Akemi. January 2009 (has links)
Orientador: Carlos Marcelo Pastre / Banca: Luiz Carlos Marques Vanderlei / Banca: Moacir Fernandes de Godoy / Resumo: O sistema nervoso autônomo (SNA) desempenha um papel importante na regulação dos processos fisiológicos do organismo humano tanto em condições normais quanto patológicas. Dentre as técnicas utilizadas para sua avaliação, a variabilidade da frequência cardíaca (VFC) tem emergido como uma medida simples e não-invasiva dos impulsos autonômicos, representando um dos mais promissores marcadores quantitativos do balanço autonômico. A VFC descreve as oscilações no intervalo entre batimentos cardíacos consecutivos (intervalos R-R), assim como oscilações entre frequências cardíacas instantâneas consecutivas. Trata-se de uma medida que pode ser utilizada para avaliar a modulação do SNA sob condições fisiológicas, tais como em situações de vigília e sono, diferentes posições do corpo, treinamento físico, e também em condições patológicas. Mudanças nos padrões da VFC fornecem um indicador sensível e antecipado de comprometimentos na saúde. Uma alta variabilidade na frequência cardíaca é sinal de boa adaptação, caracterizando um indivíduo saudável, com mecanismos autonômicos eficientes, enquanto que, baixa variabilidade é frequentemente um indicador de adaptação anormal e insuficiente do SNA, implicando a presença de mau funcionamento fisiológico no indivíduo. Diante da sua importância como um marcador que reflete a atividade do SNA sobre o nódulo sinusal e como uma ferramenta clínica para avaliar e identificar comprometimentos na saúde, este artigo revisa aspectos conceituais da VFC, dispositivos de mensuração, métodos de filtragem, índices utilizados para análise da VFC, limitações de utilização e aplicações clínicas da VFC. / Abstract: Autonomic nervous system (ANS) plays an important role in the regulation of the physiological processes of the human organism during normal and pathological conditions. Among the techniques used in its evaluation, the heart rate variability (HRV) has arising as a simple and non-invasive measure of the autonomic impulses, representing one of the most promising quantitative markers of the autonomic balance. The HRV describes the oscillations in the interval between consecutive heart beats (RR interval), as well as the oscillations between consecutive instantaneous heart rates. It is a measure that can be used to assess the ANS modulation under physiological conditions, such as wakefulness and sleep conditions, different body positions, physical training and also pathological conditions. Changes in the HRV patterns provide a sensible and advanced indicator of health involvements. Higher HRV is a signal of good adaptation and characterizes a health person with efficient autonomic mechanisms, while lower HRV is frequently an indicator of abnormal and insufficient adaptation of the autonomic nervous system, provoking poor patient's physiological function. Because of its importance as a marker that reflects the ANS activity on the sinus node and as a clinical instrument to assess and identify health involvements, this study reviews conceptual aspects of the HRV, measurement devices, filtering methods, indexes used in the HRV analyses, limitations in the use and clinical applications of the HRV. / Mestre
506

Elasticité dans le cloud computing / Elasticity in the Cloud

El Rheddane, Ahmed 25 February 2015 (has links)
Les charges réelles d'applications sont souvent dynamiques. Ainsi, le dimensionnement statique de ressources est voué soit au gaspillage, s'il est basé sur une estimation du pire scénario, soit à la dégradation de performance, s'il est basé sur la charge moyenne. Grâce au modèle du cloud computing, les ressources peuvent être allouées à la demande et le dimensionnement adapté à la variation de la charge. Cependant, après avoir exploré les travaux existants, nous avons trouvé que la plupart des outils d'élasticité sont trop génériques et ne parviennent pas à répondre aux besoins spécifiques d'applications particulières. Dans le cadre de ce travail, nous utilisons des boucles autonomiques et diverses techniques d'élasticité afin de rendre élastiques différents types d'applications, à savoir un service de consolidation, un intergiciel de messagerie et une plateforme de traitement de données en temps-réel. Ces solutions élastiques ont été réalisées à partir d'applications libres et leur évaluation montre qu'ils permettent d'économiser les ressources utilisées avec un surcoût minimal. / Real world workloads are often dynamic. This makes the static scaling of resourcesfatally result in either the waste of resources, if it is based on the estimatedworst case scenario, or the degradation of performance if it is based on the averageworkload. Thanks to the cloud computing model, resources can be provisioned ondemand and scaling can be adapted to the variations of the workload thus achievingelasticity. However, after exploring the existing works, we find that most elasticityframeworks are too generic and fail to meet the specific needs of particularapplications. In this work, we use autonomic loops along with various elasticitytechniques in order to render different types of applications elastic, namelya consolidation service, message-oriented middleware and a stream processingplatform. These elastic solutions have been implemented based on open-sourceapplications and their evaluation shows that they enable resources’ economy withminimal overhead.
507

Decentralized detection of violations f service level agreements using peer-to-peer technology

Nobre, Jéferson Campos January 2016 (has links)
Critical networked services established between service provider and customers are expected to operate respecting Service Level Agreements (SLAs). An interesting possibility to monitor such SLAs is using active measurement mechanisms. However, these mechanisms are expensive in terms of network devices resource consumption and also increase the network load because of the injected traffic. In addition, if the number of SLA violations in a given time is higher than the number of available measurement sessions (common place in large and complex network infrastructures), certainly some violations will be missed. The current best practice, the observation of just a subset of network destinations driven by human administrators expertise, is error prone, does not scale well, and is ineffective on dynamic network conditions. This practice can lead to SLA violations being missed, which invariably affect the performance of several applications. In the present thesis, we advocated the use of Peer-to-Peer (P2P) technology to improve the detection of SLA violations. Such use is described using principles to control active measurement mechanisms. These principles are accomplished through strategies to activate measurement sessions. In this context, the major contributions of this thesis are: i) An approach to improve the detection of SLA violations through the steering of the activation of active measurement sessions using local and remote past service level measurement results and resource utilization constraints; ii) The concept of destination rank as an approach to autonomically prioritize destinations for the activation of active measurement sessions using destination scores; iii) The concept of correlated peers to enable the autonomic provisioning of a P2P measurement overlay for the exchange of relevant active measurement results; iv) The concept of virtual measurement sessions to enable the sharing of measurement results among correlated peers in order to save network devices resources and to improve SLA monitoring coverage; v) The definition of decentralized strategies to steer the activation of active measurement sessions using P2P principles. The method used on the investigation started with the execution of literature reviews on the networkwide control of measurement mechanisms and the employment of P2P technology on network management. After that, the proposed principles to control active measurement mechanisms and the strategies to activate measurement sessions were described. Finally, experiments were performed to evaluate the performance as well as to highlight properties of such principles and strategies. The findings showed properties which improve the detection of SLA violations in terms of the number of detected violations and the adaptivity to network dynamics. We expect that such findings can lead to better SLA monitoring tools and methods.
508

Efeitos do treinamento resistido sobre a regulação autonômica e a função cardiovascular em indivíduos com doença de parkinson / Effects of resistance training on cardiovascular autonomic regulation and function in subjects with Parkinson\'s disease

Hélcio Kanegusuku 03 May 2016 (has links)
A doença de Parkinson (DP) caracteriza-se por alterações deletérias no controle motor e, comumente, também produz prejuízos na regulação autonômica e função cardiovascular. O treinamento resistido traz benefícios motores para estes indivíduos, mas seus efeitos autonômicos e cardiovasculares ainda são desconhecidos. Assim, esta tese avaliou os efeitos do treinamento resistido sobre a regulação autonômica e a função cardiovascular de indivíduos com DP, comparando-os a indivíduos sem DP. Para tanto, 17 indivíduos sem DP (SDP, 67±10 anos) e 27 com DP (65±8 anos, estágios II-III da escala de Hoehn e Yahr modificado, estado \"on\" da medicação) foram estudados. Os indivíduos sem DP foram avaliados uma única vez e os com DP foram divididos aleatoriamente em dois grupos, grupo controle (DPCO: n=12) e treinamento resistido (DPTR: n=15 - 2 sessões/semana, 5 exercícios, 2-4 séries, 12-6 RM), e foram avaliados no início e no final das 12 semanas do estudo. No início do estudo, os indivíduos com DP apresentaram menor modulação parassimpática e maior modulação simpática e balanço simpatovagal cardíacos em repouso, além de pior resposta cardiovascular ao teste de se levantar e à manobra de Valsalva que os indivíduos sem DP. Ademais, apresentaram maior pressão arterial na posição deitada, maior débito cardíaco e menor resistência vascular periférica na posição sentada, menor descenso noturno da pressão arterial sistólica, maior frequência cardíaca de 24 horas e sono, e respostas cardiovasculares atenuadas ao exercício máximo. O treinamento resistido, no grupo DPTR, aumentou a força dinâmica máxima (88±23 vs. 108±27 kg, P &lt; 0,05) e diminuiu a modulação simpática cardíaca (banda de baixa frequência da variabilidade da frequência cardíaca - deitado: 61±17 vs. 47±20 un; sentado: 60±11 vs. 46±15 un, P &lt; 0,05) e a queda da pressão arterial sistólica ao teste de se levantar (-14±11 vs. -6±10 mmHg, P &lt; 0,05), enquanto que nenhuma alteração foi observada no grupo DPCO. Nos demais parâmetros avaliados, não houve nenhum efeito do treinamento nos indivíduos com DP. Após as 12 semanas de estudo, o grupo DPTR apresentou modulação simpática cardíaca de repouso e resposta da pressão arterial sistólica ao teste de se levantar semelhantes aos indivíduos SDP e menores que o grupo DPCO (banda de baixa frequência da variabilidade da frequência cardíaca - deitado: 47±20 e 45±9 vs. 63±10 un e sentado: 46±15 e 49±10 vs. 61±13 un; redução da pressão arterial sistólica - 6±10 e -1±10 vs. -11±9 mmHg, respectivamente, P &lt; 0,05). Em conclusão, em indivíduos com DP, o treinamento resistido diminuiu a modulação autonômica simpática cardíaca em repouso e a redução da pressão arterial sistólica ao teste de se levantar, igualando estas respostas às de indivíduos sem DP / Parkinson\'s disease (PD) is characterized by deleterious alterations in motor control, and it usually also presents with impairments on cardiovascular autonomic regulation and function. Resistance training promotes motor benefits in individuals with PD, but its autonomic and cardiovascular effects are still unknown. Thus, this thesis evaluated the effects of resistance training on cardiovascular autonomic regulation and function in subjects with PD, comparing them with subjects without PD. Seventeen subjects without PD (WPD, 67±10 years) and 27 with PD (65±8 years, stages II-III of modified Hoehn & Yahr scale, \"on\" state of medication) were studied. The subjects without PD were evaluated only once, while the subjects with PD were randomly divided into two groups, control (PDCO: n=12) and resistance training (PDRT: n=15 - 2 sessions/week, 5 exercises, 12-6 RM), and were evaluated at the beginning and after 12 weeks of study. At the beginning of the study, the subjects with PD presented, at rest, lower cardiac parasympathetic modulation and higher cardiac sympathetic modulation and sympathovagal balance as well as worse cardiovascular response to standing test and Valsalva Manoeuvre than individuals without PD. In addition, they had higher supine blood pressure, higher seated cardiac output, lower seated peripheral vascular resistance, lower nocturnal systolic blood pressure fall, higher 24 hours and nighttime heart rate and blunted cardiovascular responses to maximal exercise. Resistance training in the PDRT group increased maximal dynamic strength (88±23 vs. 108±27 kg, P &lt; 0.05), decreased cardiac sympathetic modulation (low component of heart rate variability - supine: 61 ± 17 vs. 47 ± 20 nu and seated: 60 ± 11 vs. 46 ± 15 nu, P &lt; 0.05) and systolic blood pressure decrease to standing test (-14±11 vs. -6±10 mmHg, P &lt; 0.05), while no changes were observed in PDCO group. In the other parameters, there was no effect of training in the subjects with PD. After 12 weeks of the study, the PDRT group presented rest cardiac sympathetic modulation and systolic blood pressure response to standing test similar to WPD and lower than PDCO (low component of heart rate variability - supine: 47±20 and 45±9 vs. 63±10 nu and seated: 46±15 and 49±10 vs. 61±13 nu; systolic blood pressure reduction - -6±10 and -1±10 vs. -11±9 mmHg, respectively, P &lt; 0.05). In conclusion, in individuals with PD, resistance training decreased rest cardiac sympathetic autonomic modulation and systolic blood pressure decrease to standing test, matching these responses to the ones observed in subjects without PD
509

A respiração como ferramenta para a autorregulação psicofisiológica em crianças pré-escolares um estudo baseado na variabilidade da frequência cardíaca /

Cruz, Marina Zuanazzi. January 2016 (has links)
Orientador: Alfredo Pereira Junior / Resumo: INTRODUÇÃO: O aprendizado de habilidades de autorregulação contribui para um adequado desenvolvimento neurobiológico e psicossocial na infância. Neste estudo, investigamos a respiração como ferramenta para promover a autorregulação em crianças em idade pré-escolar. A modulação respiratória tem sido utilizada como técnica na promoção da regulação psicofisiológica, devido à sua ação benéfica sobre o funcionamento do sistema nervoso autônomo (SNA), ao seu importante papel na regulação do metabolismo e por promover o alinhamento de sistemas oscilatórios do corpo. O estudo teve como objetivos avaliar a capacidade de aprendizagem de uma técnica de respiração em crianças pré-escolares, contribuir para o entendimento de como a modulação respiratória atua sobre suas fisiologias e apoiar o desenvolvimento de estratégias educacionais e programas de intervenção em saúde que adotem a respiração como um método para promover a autorregulação psicofisiológica em crianças. MÉTODOS: Participaram do estudo 42 crianças na faixa etária entre cinco e seis anos. Todas receberam um treinamento diário, com duração de oito semanas, para a prática de uma técnica respiratória (respiração lenta, profunda, com tempos iguais de inspiração e expiração). Para a avaliação dos efeitos da respiração sobre o SNA, foram feitas análises da variabilidade da frequência cardíaca (VFC) nos domínios da coerência cardiorrespiratória, do tempo, da geometria, da frequência e do caos (não-linearidade). Dados da VFC (inter... (Resumo completo, clicar acesso eletrônico abaixo) / Doutor
510

O efeito do tubo T e da pressão suporte sobre variaveis cardiorrespiratórias e variabilidade da freqüencia cardíaca durante o desmame da ventilação mecânica

Güntzel, Adriana Meira January 2007 (has links)
Introdução: A descontinuação da ventilação mecânica (VM) e a restituição da ventilação espontânea podem acarretar importantes alterações cardiovasculares devido a modificações da pressão intratorácica. O comportamento da modulação autonômica avaliada através da variabilidade da freqüência cardíaca (VFC) durante o desmame da VM e ainda não está bem esclarecido, assim como sua repercussão nas variáveis cardiorrespiratórias. Objetivo: Verificar o efeito do tubo T (TT) e da ventilação com pressão suporte (PSV), durante o desmame da VM, sobre variáveis cardiorrespiratórias e variabilidade da freqüência cardíaca. Pacientes e Métodos: Foram avaliados 30 pacientes, em VM por ≥ 48 horas, que preencheram os critérios para desmame. Os pacientes foram submetidos aos dois modos de desmame com randomização para a escolha de uma das seqüências (basal, PSV, repouso, TT; ou, basal, TT, repouso, PSV). A VFC foi avaliada por análise espectral da freqüência cardíaca em VM, PSV, TT, com 30 minutos de duração cada uma e 30 minutos de repouso entre as intervenções. Foram analisadas no final de cada período as seguintes variáveis cardiorrespiratórias: freqüência respiratória (f), volume minuto (VE), volume corrente (VT), índice de respiração rápida e superficial (f/VT), saturação periférica de oxigênio (SpO2), freqüência cardíaca (FC) e a pressão arterial. Na VFC foi calculada a potência espectral total (PT), os componentes de baixa freqüência (BF), de alta freqüência (AF) e a razão entre os componentes de baixa/alta freqüência (BF/AF). Resultados: Durante o método TT, comparando com o período basal, ocorreu um aumento da ƒ (19 ± 4 vs 25 ± 5 rpm), f/VT (37 ± 16 vs 55 ± 23) e FC (92 ± 18 vs 98 ± 16 bpm), com redução da SpO2 (97 ± 1.7 vs 95 ± 3.1 %). Quando reduzido os valores da PSV, as variáveis cardiorrespiratórias foram semelhantes aos valores basais. Os índices da VFC não foram alterados durante o desmame da VM, independentemente do método de desmame utilizado. Conclusão: Nossos resultados sugerem que o uso de PSV durante o desmame da VM não afeta as variáveis cardiorrespiratórias estudadas, mas o uso do método TT causou alterações cardiorrespiratórias, provavelmente devido ao aumento do trabalho respiratório. A VFC permaneceu a mesma durante o desmame e o aumento da FC durante o TT provavelmente ocorreu através de mecanismos não autonômicos. / Introduction: The discontinuation of mechanical ventilation (MV) and the recovery of spontaneous breathing can lead to important cardiovascular alterations due to changes in the intrathoracic pressure. The autonomic modulation assessed through heart rate variability (HRV) during weaning from MV and its impact on cardiorespiratory variables has not been well elucidated yet. Objective: To evaluate the effect of T-tube (TT) and pressure support ventilation (PSV) during weaning from MV on cardiorespiratory variables and heart rate variability. Patients and Methods: Thirty patients who had received MV for ≥ 48 hours and who met the criteria for weaning were assessed. Two different weaning methods were used and randomization was performed to choose one of the following sequences (baseline, PSV, rest, TT; or baseline, TT, rest, PSV). HRV was assessed by heart rate spectral analysis during MV, PSV, and TT. Each intervention lasted 30 minutes and there was a 30-minute rest period between the interventions. At the end of each period of time, the following cardiorespiratory variables were analyzed: respiratory rate (f), minute ventilation (VE), tidal volume (VT), rapid shallow breathing index (f/VT), peripheral oxygen saturation (SpO2), heart rate (HR) and blood pressure. In the HRV, the total spectral power (TP), the low frequency (LF) and the high frequency (HF) components, and the ratio between the low/high frequency (LF/HF) components were calculated. Results: During TT ventilation, regarding the baseline period, there was an increase in ƒ (19 ± 4 vs 25 ± 5 breaths.min), f/VT (37 ± 16 vs 55 ± 23) and HR (92 ± 18 vs 98 ± 16 beats.min), with decrease in the SpO2 (97 ± 1.7 vs 95 ± 3.1 %). When the PSV values dropped, the cardiorespiratory variables were similar to the baseline values. The HRV values did not change during weaning from MV, regardless the weaning methods used. Conclusion: Our results suggest that using PSV during weaning from MV does not affect the cardiorespiratory variables studied, but use of TT method caused cardiorespiratory alterations, probably due to an increase in the respiratory workload. Heart rate variability remained the same during weaning and the increase in HR during TT, probably occurred through nonautonomic mechanisms.

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