Diss. (sammanfattning) Stockholm : Karolinska institutet, 2007. / Härtill 5 uppsatser.

Diss. (sammanfattning) Stockholm : Karolinska institutet, 2002. / Härtill 5 uppsatser.

Diss. (sammanfattning) Stockholm : Karol. inst., 2006. / Härtill 5 uppsatser.

Thesis (D.P.H.)--University of Michigan.

Thesis (D.P.H.)--University of Michigan.

Thesis--University of Oklahoma. / Bibliography: leaves 36-37.

The target of the thesis was to evaluate the risk of chemical harmful substances and dust in the working air of metal production. Four research questions were asked: {\clqq}What harmful substances are fixed in the working environment of the metal production?`` {\clqq}Are the hygienic limits of chemical substances and dust in the working environment of metal production observed?``, {\clqq}What measures were taken by the employer for the purpose of the health protection of employees?`` and {\clqq}Are the measures taken by the employer for the purpose of the health protection of employees effective?`` The thesis was treated as qualitative research. The followed file consisted of three South Bohemian companies dealing with metal production. The method of the direct, non participating and clear observation was applied for the data collection, moreover the study of documents {--} testing reports. The secondary analysis of data was performed. The results of measuring were compared with the hygienic limits fixed by the Directive of government No. 361/2007 Coll.. The evaluated professions were divided in categories pursuant the Directive No. 432/2003 Coll. In the working air of metal production, the concentration of the total dust, chromium, hexavalent chromium, carbon monoxide and ozone were followed. The last measuring in the monitored workshops proved that the hygienic limits were observed, except for two cases when the highest acceptable concentration determined for chromium and the chromium (II,III) compounds as Cr, and of the hygienic limit for welding fumes were exceeded. The most important protective measure applied by the employers on their workplaces was the reconstruction of air-conditioning, or installation of local exhausting. In view of the gradual decrease of the harmful substance in the working air in connection to the taken measures may be stated that the given measures were effective. The hypothesis {\clqq}Modernisation of operations in metal production improves the working environment of employees and in the modern operations no above-the-limit values of the most monitored harmful substances were found out. ``

Orientador: Carlos Augusto Araujo Valadão / Banca: Newton Nunes / Banca: Paulo Sérgio Patto dos Santos / Banca: Aury Nunes de Moraes / Banca: Nilson Oleskovicz / Resumo: A administração intravenosa de anestésicos voláteis halogenados pode ser considerada uma alternativa à aplicação pela via inalatória, e neste contexto, as formulações emulsificadas têm mostrado segurança, eficiência e bons planos anestésicos. Neste estudo, objetivou-se comparar os efeitos hemodinâmicos e respiratórios das administrações intravenosa e inalatória de isofluorano em cães, após a determinação da taxa de infusão intravenosa de 6,99 mL/kg/h deste halogenado em emulsão lipídica. Para tanto, foram utilizados oito cães, os quais formaram três grupos distintos: grupo IV - anestesia intravenosa por infusão de emulsão lipídica com isofluorano; grupo E - anestesia inalatória com isofluorano, associada à infusão intravenosa de emulsão lipídica sem o halogenado; e grupo IN - anestesia inalatória com isofluorano, associada à infusão intravenosa de solução de NaCl 0,9%. Foram evidenciadas diminuições da contratilidade cardíaca, índice cardíaco e pressão arterial sistêmica a partir de 10 e 40 minutos de anestesia, respectivamente, nos grupos IV e E. A hipotensão no grupo IV resultou em acidose metabólica, porém, hipoxemia não foi observada. O grupo IN apresentou manutenção do índice cardíaco, apesar de reduções do índice de resistência vascular sistêmica e pressão arterial. A taxa de infusão intravenosa determinada foi efetiva na manutenção de plano de anestesia cirúrgica em cães. As infusões intravenosas de isofluorano e emulsão lipídica causaram depressão cardíaca e hipotensão. Em relação à função respiratória, nenhum dos grupos mostrou efeitos deletérios. / Abstract: The intravenous administration of halogenated anesthetics can be considered an alternative to the application by the inhalation route, moreover, emulsified formulations have been showing safety, efficiency and appropriated anesthetic depth. The aim of this study was to compare the effects of isoflurane anesthesia by intravenous or inhalational route on hemodynamic and respiratory variables, after the determination of the intravenous infusion rate of 6.99 mL/kg/h of this anesthetic in lipid emulsion, in dogs. Therefore, eight dogs were distributed in three different protocols: IV group - intravenous anesthesia with emulsified isoflurane; E group - inhalational anesthesia with isoflurane associated to intravenous infusion of lipid emulsion; and IN group - inhalational anesthesia with isoflurane associated to intravenous infusion of 0.9% NaCl solution. The results regarding IV and EM groups revealed decreases of heart contractility, cardiac index and systemic blood pressure starting from 10 and 40 minutes of anesthesia, respectively. The hypotension in the IV group resulted in metabolic acidosis, however, hypoxemia was not observed. The IN group demonstrated maintenance of cardiac index, despite of reduction of the blood pressure and systemic vascular resistance index. The intravenous infusion rate determined was effective in the maintenance of an anesthetic depth of general anesthesia in dogs. The intravenous infusions of isoflurane and lipid emulsion caused cardiac depression and hypotension. In relation to respiratory function, the inhalational route and the intravenous infusions of isoflurane and lipid emulsion did not result in harmful effects. / Doutor

Este estudo objetivou avaliar a condição clínica pré-operatória dos cães idosos submetidos à anestesia inalatória e relacionar as alterações encontradas na avaliação pré-operatória com a ocorrência de complicações e óbito perioperatório. O estudo foi prospectivo, observacional e realizado no período de abril de 2007 a abril de 2008. Os cães idosos foram avaliados por meio de anamnese, exame físico, mensuração da pressão arterial sistólica (Doppler), eletrocardiograma (ECG) e análises laboratoriais previamente ao procedimento cirúrgico. O procedimento anestésico, cirúrgico e a ocorrência de complicações transoperatórias foram analisados pelo registro nas fichas de anestesia. Incluíram-se no estudo os animais submetidos à anestesia inalatória por no mínimo 30 minutos. As complicações pós-operatórias foram avaliadas por meio da consulta pós-operatória, do registro nos prontuários e relato dos proprietários. Os grupos foram comparados por meio do teste de Mann-Whitney. Nas variáveis categóricas foi empregado o teste do qui-quadrado ou o teste exato de Fisher. O grau de significância foi de 5%. Foram incluídos no estudo 169 cães, 97 machos e 72 fêmeas, com idade média de 10,4±2,2 anos (125,0±26,6 meses) e com peso médio de 19,8±12,3 kg. A idade e peso não apresentaram diferença entre os sexos (p>0,05). O hematócrito abaixo dos valores normais ocorreu em 16,0% (27/169) dos animais e houve associação com a ocorrência de complicações (21/169=12,43%) e óbito (4/169=2,37%) perioperatório (p<0,01). A concentração de hemoglobina abaixo dos valores normais (4/169=2,37%) e a necessidade de transfusão de hemocomponentes foram associadas com o desfecho de óbito no pós-operatório (p<0,01). Os animais classificados com categoria de risco anestésico (ASA) III (34/169=20,12%) e IV (2/169=1,18%) apresentaram maior ocorrência de complicações (p<0,05) e óbito (p<0,01) perioperatório quando comparado a ASA II (133/169=78,70%). Nos cães categorizados com risco cirúrgico médio (96/169=56,80%) e alto (9/169=5,33%) ocorreu maior morbidade e mortalidade perioperatório quando comparado ao baixo (64/169=37,87%) (p<0,01). Houve menor mortalidade com o emprego da acepromazina (89/169=52,66%) na medicação pré-anestésica (p<0,05). A hipotensão arterial foi a complicação mais frequente (78/169=46,15%) no transoperatório, mas não foi associada ao uso de acepromazina e desfecho de óbito (p>0,05). A administração de fentanil em bolus (54/169=31,95%) foi associada com a hipotensão arterial transoperatória (p<0,05). A duração do procedimento anestésico acima de 75 minutos apresentou maior ocorrência de complicações perioperatórias (p<0,01). A morbidade e mortalidade perioperatória observada nos cães idosos foi de 56,21% (IC95%: 48,38-63,82%) e 2,96% (IC95%: 0,97-6,77%), respectivamente. A partir dos resultados pode-se concluir que: o hematócrito abaixo do valor de referência indica maior ocorrência de complicações e óbito perioperatório; a concentração de hemoglobina abaixo do valor de referência e a necessidade de transfusão de hemocomponentes determinam maior mortalidade perioperatória; a classificação de risco anestésico e cirúrgico são métodos válidos na determinação dos pacientes mais propensos a ocorrência de complicações e o desfecho de óbito; a administração de acepromazina reduz a mortalidade; o procedimento anestésico superior a 75 minutos aumenta a ocorrência de complicações; e a morbidade e mortalidade perioperatória são elevadas nos cães idosos. / This study aimed to evaluate the preoperative clinical condition in elderly dogs undergoing inhalation anesthesia and relate the changes found in the preoperative evaluation with the occurrence of perioperative complications and death. This study was prospective, observational and accomplished from April 2007 to April 2008. The elderly dogs were evaluated by clinical history, physical examination, measurement of systolic blood pressure (Doppler), electrocardiogram (ECG) and laboratory tests before surgery. The anesthetic and surgical procedure and the occurrence of intraoperative complications were analyzed according to the anesthesia records. This study included the animals submitted to inhalation anesthesia for at least 30 minutes. The postoperative complications were evaluated by postoperative visit, enrollment in medical records and owners' reporting. The groups were compared using the Mann-Whitney test. For the categorical variables it was used the chi-square or Fisher's exact test. The level of significance was 5%. The study included 169 dogs, 97 males and 72 females, mean age 10.4±2.2 years old (125.0±26.6 months old) and mean weight was 19.8±12.3 kg. The age and weight did not differ between the genders (p>0.05). The hematocrit below normal values occurred in 16.0% (27/169) of the animals and was associated with the occurrence of perioperative (p<0.01) complications (21/169=12.43%) and death (4/169=2.37%). The hemoglobin concentration below normal values (4/169=2.37%) and the need for blood components transfusion were associated with the outcome of postoperative death (p<0.01). The animals classified as anesthetic risk category (ASA) III (34/169=20.12%) and IV (2/169=1.18%) had a higher perioperative complication (p<0.05) and death (p<0.01) compared to ASA II (133/169=78.70%). The dogs categorized as moderate (96/169=56.80%) and high (9/169=5.33%) surgical risk had higher perioperative morbidity and mortality when compared to low (64/169=37.87%) (p<0.01). There was a lower mortality with the use of acepromazine (89/169=52.66%) in premedication (p<0.05). Hypotension was the most frequent complication (78/169=46.15%) during surgery, but was not associated with the use of acepromazine and outcome of death (p>0.05). The administration of fentanyl (54/169=31.95%) was associated with intraoperative hypotension (p<0.05). The duration of anesthesia for over 75 minutes had a higher incidence of perioperative complications (P<0.01). The perioperative morbidity and mortality observed in older dogs was 56.21% (95% CI: 48.38-63.82%) and 2.96% (95% CI: 0.97-6.77%), respectively. According to the results it can be concluded that: the hematocrit below the reference value indicates a higher incidence of perioperative complications and death; the hemoglobin concentration below the reference value and the need for blood components transfusion determine higher perioperative mortality; the classification of anesthetic and surgical risk are valid methods in determining the most likely patients to complications and outcome of death; acepromazine administration reduces mortality; anesthesia for over 75 minutes increases the complications; and perioperative morbidity and mortality are high in elderly dogs.

Breathing is an automatic process that we hardly pay any attention to in our daily life. As a social species, we interact using body movement, speech and emotion and these actions require modification of the respiratory pattern. While we understood how the respiratory rhythm is generated, we do not have clear evidence on how higher cortical signals modulate the respiratory pattern. The deep cortical structures in the human brain are inaccessible under normal circumstances, and deep brain stimulation electrode recordings offer an opportunity to understand the neurophysiological interactions ofdeeper brain structures. In this thesis, I investigated deep brain stimulation recordings from implanted electrodes in chronic neuropathic pain subjects in the right and left anterior cingulate cortices, the ventral posterior lateral nucleus of the thalamus and periventricular gray region. The objectives of this research were to elucidate the feed-forward mechanisms of volitional breathing, cortical autonomic regulation, and to investigate whether any of the investigated nuclei haveany carbon dioxide-sensitive neurons which may encode respiratory sensation. The results show lateralisation of the cortical autonomic control whereby the left anterior cingulate exhibits increases in beta band activity (30 to 90 Hz) with cognition and vocalisation tasks. Meanwhile, right anterior cingulate activity increases with hyperoxia. Respiration using various carbon dioxide concentrations shows a constant rise in the alpha band (8 to 14 Hz) activity in the PVG which suggests a sensitive, nonspecific neuronal activity related to systemic carbon dioxide levels.