Capes / A tetraplegia é uma lesão na medula espinhal, que compromete o tronco, os membros superiores e inferiores e músculos respiratórios. Nas lesões completas, a função motora e sensorial abaixo do nível da lesão apresenta-se comprometida. Nas lesões incompletas ou parciais, ocorre a preservação da função motora e sensitiva, não havendo padrões definidos de recuperação. A estimulação elétrica já vem sendo utilizada para indução respiratória diafragmática. Neste trabalho, foram avaliados 10 indivíduos tetraplégicos, de ambos os sexos, na faixa etária de 18 á 48 anos, durante 10 sessões onde foram aplicados anamnese, avaliação inicial constando sinais vitais, cintometria, manovacuometria, oximetria, avaliação do nível da lesão, e a avaliação do déficit motor e respiratório. Aplicaram-se dois métodos utilizando o sistema de Eletroestimulação sincronizada: o primeiro com sincronização manual, FESSM (Estimulação Elétrica Funcional) e o segundo, usando o MD2, com sincronização automática. A função muscular do Diafragma foi avaliada antes e depois das aplicações de estimulação elétrica, cuja intenção era potencializar a ação, possibilitando um melhor recrutamento muscular e, conseqüentemente, uma melhor reeducação muscular respiratória. Quanto a análise comparativa entre os métodos, após a intervenção com equipamento I observou-se melhores resultados em relação aos parâmetros sinais vitais e manovacuômetria. Com a intervenção do equipamento II, observou-se melhores resultados nos parâmetros oximetria e grau de dispnéia. O equipamento I apresentou resultados satisfatórios em relação a função do sistema digestório, principalmente em pacientes com lesão medular incompleta. / The tetraplegia is an injury in the spinal cord that compromises the motor and sensitive systems commanded by the spinal cord below of that damage level. Respiratory muscles are compromises too. In complete injuries, motor and sensorial function completely damaged. In the incomplete or partial injuries, motor and sensitive function occurs, but no recovery pattern is known. The electric stimulation is used nowadays for respiratory induction. In this work, 10 tetraplegic patients had been evaluated, both gender, ages range from 18 to 48 years, during 10 sessions where anamneses were applied. Vital signals motor respiratory disfunction, and injury level were evaluated. The system of synchronized electrostimulation was applied using two methods: the first one with manual synchronization; FESSM; and the second one, using the MD2, with automatic synchronization. The muscular function of the Diaphragm was evaluated before and after the applications of electrostimulation. The comparative analysis between the two methods, had shown better results after the intervention with equipment I regarding the parameters and vital signs of manovacuometry. With the intervention of equipment II, it was observed better results in the pulse parameters and degree of dyspnea. The equipment I had shown satisfactory results for the function of the digestive system, especially in patients with incomplete spinal cord injury.

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior / Transcutaneous Electrical Nerve Stimulation (TENS) has been widely used by physical therapists for pain management, though other non-analgesic properties have been cited. A series of studies have shown that TENS acts through both central and peripheral mechanisms. However, little is known about the mechanisms of action of TENS. So, in order to improve the research on such mechanisms, this work aimed to identify brain areas activated by different protocols of TENS stimulation in non-hyperalgesic rats. Fos protein expression in neurons has been used as a marker of neural activity. A total of 15 male Wistar rats weighing between 250 to 350 g received a single administration of TENS with low (4 Hz) or high (100 Hz) frequency and sensory (absence of muscle contraction) or motor (muscle contraction) intensity of stimulation. Ninety minutes after stimulation, the animals were euthanized under general anesthesia and their encephalons were perfused and sectioned to perform the immunofluorescence for Fos technique. Then images were captured and analyzed. The animals were split into five groups (n=3, per group): control, whose animals did not received electrical stimulation, low frequency TENS at sensory level, low-frequency TENS at motor level, high frequency TENS at sensory level and high frequency TENS at motor level. After analyzing the images, a significant higher c-Fos expression was found in the electrically stimulated animals when compared to the control group at the following brain areas: preoptic area (p=0.003), insular cortex (p=0.01), motor cortex (p=0.009), prefrontal cortex (p=0.003), thalamic paraventricular nucleus (p=0.003), endopiriform cortex (p=0.01), inferior colliculus (p<0.005), entorhinal cortex (p.0.0003), secondary somatosensory cortex (p.0.0003) and olfactory tract (p.0.0003) in a manner dependent from both frequency of stimulation and intensity of current. Thus, one suggest that TENS activated several important encephalon regions, which are involved in neural function such as cognition, memory, cardiovascular regulation and motor control; however, we cannot restrict these areas as the only ones that are influenced by TENS stimulation. These results are of great relevance, because it open perspectives on new and different neurobiological actions of TENS and its possible clinical applicability and therapeutic efficacy for addressing clinical situations unrelated to analgesia, allowing wider direction for further studies. / A estimulacao eletrica nervosa transcutanea (TENS) e bastante utilizada para o controle da dor; no entanto, outras propriedades nao analgesicas tem sido citadas. Uma serie de estudos tem demonstrado que a TENS atua atraves de mecanismos perifericos e centrais. A fim de aprimorar as pesquisas sobre esses mecanismos, esse trabalho teve o objetivo de verificar as areas encefalicas ativadas pelo uso de diferentes protocolos de eletroestimulacao com TENS em ratos nao-hiperalgesicos. A imunodeteccao da proteina Fos em neuronios tem sido utilizada como marcador de atividade neural. Logo, um total de 15 ratos Wistar, pesando entre 250 a 350 g, receberam uma unica aplicacao de TENS, sendo utilizada com baixa (4 Hz) ou alta (100 Hz) frequencia de estimulacao e com intensidade em nivel sensorial (ausencia de contracao muscular) e motor (presenca de contracao muscular). Noventa minutos apos a eletroestimulacao, os animais foram eutanasiados sob anestesia e seus encefalos foram perfundidos e seccionados para realizacao de imunofluorescencia para proteina Fos. Posteriormente, imagens foram capturadas e analisadas. Os animais foram divididos em cinco grupos (n=3, por grupo): controle, cujos animais nao receberam nenhuma estimulacao eletrica; TENS de baixa frequencia em nivel sensorial, TENS de baixa frequencia em nivel motor, TENS de alta frequencia em nivel sensorial e TENS de alta frequencia em nivel motor. Apos analise das imagens, verificou-se um numero de celulas Fos positivas significativamente maior nos grupos eletroestimulados em comparacao ao grupo controle nas seguintes areas encefalicas: area preoptica (p=0,003), cortex insular (p=0,01), cortex motor (p=0,009), cortex pre frontal (p=0,003), nucleo paraventricular talamico (p=0,003), nucleo endopiriforme (p=0,01), coliculo inferior (p<0,005), cortex entorrinal (p.0,0003), cortex somatossensorial 2 (p.0,0003), nucleo supraoptico (p.0,0003) e trato olfatorio (p.0,0003). Entretanto, esta ativacao neuronal ocorreu de forma dependente da frequencia de estimulacao e da intensidade da corrente nas diferentes regioes encefalicas. Assim, conclui-se que a TENS ativou diversas regioes encefalicas importantes, associadas a funcao de cognicao, memoria, regulacao cardiovascular e controle motor; no entanto, nao se pode restringir essas areas como as unicas cujos neuronios sao ativados pela TENS. Esses resultados sao relevantes uma vez que disparam perspectivas quanto a novas e diferentes acoes neurobiologicas da TENS e sua possivel aplicabilidade e eficacia terapeutica para a abordagem de situacoes clinicas que nao relacionadas a analgesia, possibilitando a ampliacao do direcionamento para a realizacao de novos estudos.

Wheelchair-bound paraplegics are in an unnatural, almost all-day sitting position. This is physiologically disadvantageous as it may cause increased abdominal pressure, renal dysfunction, pressure sores, muscle atrophy and osteoporosis. Thus it would be beneficial, physiologically and psychologically, for a paraplegic to be able to stand for temporary periods of time. As a result of the muscle atrophy and functional degeneration that follows a spinal cord injury, it is essential for paraplegics to undergo a muscle restrengthening program, using Functional Neuromuscular Stimulation (FNS), before standing up under FNS control can be attempted. Six healthy spinal cord injured subjects with spinal lesions between CS and T9 (two tetraplegics and four paraplegics) exercised their quadriceps muscles at home using a portable two-channel FNS muscle stimulator. The muscles were exercised against an increasing load to maximise the training effect. Inclined standing exercise, under FNS control, was performed in the Inclistand. The subjects' general state of health and fitness were assessed, namely their responses during a maximal arm ergometry exercise test, arm muscle function, lung function, blood biochemistry and their dietary habits. Subjects have shown improvement in quadriceps muscle strength, fatigue resistance and muscle bulk to varying degrees - according to their individual circumstances. The tetraplegics responded in a different manner to that of the paraplegics. The muscle strength increased significantly by a mean (+SD) of 97,8 + 59,6% and 171,2 + 118,1% for the four paraplegics, left and right leg respectively. There was a mean improvement of 16% in fatigue resistance in the left leg (p=0,08), while the mean response of the right leg varied. Quadriceps muscle bulk increased by 4,43 + 3,4% (left) and 2,7 + 2,1% (right) (0,05&lt;p&lt;0,l). The amount of subcutaneous fat around the mid-thigh decreased significantly by 4,73 + 1,4% (left) and 3,43 + 1,1% (right leg). The group was in a state of general well-being, with the exception of one subject whose serum cholesterol concentration fell within the high risk category. This study therefore showed that the FNS was sucessful in improving the quadriceps muscle strength, bulk and fatigue response of the SCI people in our research group. The valuable experience gained from this FNS study will be used to improve the present program.

Este trabalho teve como objetivo realizar o processamento do gel polimérico MAGICf, irradiá-lo e caracterizá-lo com quatro métodos de leitura, uma vez que a dosimetria com gel polimérico é uma área promissora no âmbito de controle de qualidade dos tratamentos radioterápicos, pois permite a avaliação de dose tridimensionalmente. Os métodos para caracterização do gel MAGIC-f foram: Tomografia Computadorizada (TC), espectroscopia de Ressonância Magnética Nuclear (RMN), Ressonância Paramagnética Eletrônica (EPR) e espectrofotometria UV/Vis. Para a caracterização por esse último método, foi feita uma nova formulação do gel MAGIC-f adicionando fluoresceína. Os resultados da caracterização desse gel dosimétrico com tomografia computadorizada e EPR não foram satisfatórios, porém com a espectroscopia de RMN obteve-se bons resultados, assim como com a espectrofotometria UV/Vis. A nova formulação do gel para a caracterização com espectrofotometria mostrou-se ser um método inovador e bastante promissor para essa área. / This work aimed to perform the processing of the MAGIC-f polymeric gel, to irradiate it and to characterize it with four methods of reading, since the dosimetry with polymeric gel is a promising area within the scope of quality control of the radiotherapeutic treatments, because it allows dose evaluation three-dimensional. The methods for characterization of the MAGIC-f gel were: Computed Tomography (CT), Nuclear Resonance Magnetic (NMR) and Electron Paramagnetic Resonance (EPR) spectroscopy, and UV/Vis spectrophotometry. For characterization with this last method, a new MAGIC-f gel formulation was made adding fluorescein. The results of the characterization of this dosimetric gel with computed tomography and EPR were not satisfactory, but with NMR spectroscopy satisfactory results were obtained as well as UV / Vis spectrophotometry. The new gel formulation for characterization with UV / Vis spectrophotometry has proved to be an innovative and very promising method for this area.

Este trabalho teve como objetivo realizar o processamento do gel polimérico MAGICf, irradiá-lo e caracterizá-lo com quatro métodos de leitura, uma vez que a dosimetria com gel polimérico é uma área promissora no âmbito de controle de qualidade dos tratamentos radioterápicos, pois permite a avaliação de dose tridimensionalmente. Os métodos para caracterização do gel MAGIC-f foram: Tomografia Computadorizada (TC), espectroscopia de Ressonância Magnética Nuclear (RMN), Ressonância Paramagnética Eletrônica (EPR) e espectrofotometria UV/Vis. Para a caracterização por esse último método, foi feita uma nova formulação do gel MAGIC-f adicionando fluoresceína. Os resultados da caracterização desse gel dosimétrico com tomografia computadorizada e EPR não foram satisfatórios, porém com a espectroscopia de RMN obteve-se bons resultados, assim como com a espectrofotometria UV/Vis. A nova formulação do gel para a caracterização com espectrofotometria mostrou-se ser um método inovador e bastante promissor para essa área. / This work aimed to perform the processing of the MAGIC-f polymeric gel, to irradiate it and to characterize it with four methods of reading, since the dosimetry with polymeric gel is a promising area within the scope of quality control of the radiotherapeutic treatments, because it allows dose evaluation three-dimensional. The methods for characterization of the MAGIC-f gel were: Computed Tomography (CT), Nuclear Resonance Magnetic (NMR) and Electron Paramagnetic Resonance (EPR) spectroscopy, and UV/Vis spectrophotometry. For characterization with this last method, a new MAGIC-f gel formulation was made adding fluorescein. The results of the characterization of this dosimetric gel with computed tomography and EPR were not satisfactory, but with NMR spectroscopy satisfactory results were obtained as well as UV / Vis spectrophotometry. The new gel formulation for characterization with UV / Vis spectrophotometry has proved to be an innovative and very promising method for this area.

The work deals with implantable devices and possibilities of interference of elektromagnetic field. At first, the electromagnetic compatibility is discussed. Basic terms are explained, followed by insisting on resources of possible distrurbing of implantable devices and standards dealing with this issue. Furthermore, short chapter about devices affecting function of implantable devices is introduced. It means devices which patients with implantable devices may meet in common life, as well as devices used in common life, also devices used jn medical environment. In the next part, measuring process of electromamagnetic effect in working compartment of FN Brno magnetotheraphy and elektrotheraphy is devised. There is a concept of measuring card thanks to which impulses of implantable devices are measured. Finally, a description of measuring on implantable devices in FN Brno. MIKULA, D. EMD instruments and electromagnetic immunity. Brno, 2009. 74 s. Master’s thesis in Brno University of technology on faculty of elektrical engeenerig and communication. Supervisor Ing. Marie Havlíková , Ph.D.