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Caribbean Region↗
Biomedical subjects
F Simini
Publications and source records attributed to F Simini.
Oro-naso-pharyngeal suction at birth: effects on respiratory adaptation of normal term vaginally born infants.
The effect of oro-naso-pharyngeal suction at birth on pulmonary mechanics is described in a random assigned controlled study of 40 normal term vaginally born infants. Twenty cases had their oro-naso-pharynx suctioned immediately after birth (S Group), whereas 20 were not suctioned in the neonatal period (NS Group). A computerized pneumotachographic system (MECVENT) was used for the assessment of respiratory mechanics (Dynamic Compliance (C. Dyn.) and Total Pulmonary Resistance (R) in inspiration and expiration at 10, 30 and 120 minutes after birth. In both groups the C. Dyn increased during the study period whereas the R decreased, mainly in the initial 30 minutes. No significant differences were observed between S and NS groups for any of the parameters of respiratory mechanics. The results obtained in this study provide no physiological basis to recommend routine airway suction at birth in normal, term, vaginally born infants.
Adaptation, Physiological↗
Electroencephalogram in vitro and cortical transmembrane potentials in the turtle Chrysemys d'orbigny.
An experimental stable model of an in vitro turtle brain (Chrysemys d'orbigny) was developed in order to compare electrographic activity (EEG) with transmembrane potentials. Two preparations were used: a whole intact hemisphere and a whole open hemisphere. The latter permitted easier impalement of cortical neurons through the ependymal surface. The EEG characteristics were similar to those described in turtles in vivo. The EEG was nonrhythmic (rhythmicity coefficient less than 0.40). The power spectrum presented a high energy band between 1 and 3 Hz, decreasing progressively towards the higher frequencies. Total power of the EEG was one order of magnitude greater than the system noise. Random large amplitude sharp waves (22-300 microV, 500-1,900 ms) were recorded spontaneously. Hypoxia produced an increase in frequency and amplitude of the large sharp waves, without modification of either EEG background activity or membrane potentials. Physostigmine provoked the disappearance of the large sharp waves, an effect reversed by atropine. The addition of TTX to the medium provoked the abolition of the EEG, although spikes and plateaus determined by Ca2+ conductances persisted. The power spectra band of maximum relative potency was 0.8-2.5 Hz for both EEG and slow membrane potentials.
Animals↗
Assessment of pulmonary dynamics in normal newborns: a pneumotachographic method.
A pneumotachographic method for assessment of pulmonary dynamics in critically ill newborns in an intensive care setting was developed in our laboratory. Before the results obtained with this method could be applied, the normal range of values were determined in 48 normal term and preterm newborns. Their body weight ranged between 1200 and 4100 g, and postnatal ages between 24 hours and 21 days. In three infants, two determinations were performed after an interval of 7 days. The studies were performed with a pneumotachograph applied to the upper airway by means of an inflatable face mask or latex nasal prongs. The air flow signal was electronically integrated to time to produce a volume signal. Airway pressure was determined proximal to the pneumotachograph. Esophageal pressure was determined with a water filled catheter placed in the lower third of the esophague. Tidal volume (VT), minute ventilation (V), Dynamic compliance (Cdyn), total pulmonary resistance (R), total pulmonary work (Wt), Elastic work (We), and flow resistive work (Wv), were determined. A significant linear correlation was found between Cdyn and body weight (r = 0.50, p less than 0.01) whereas no significative correlation was found between body weight and VT, V or R. Values for VT, V and Cdyn were corrected for body weight and means (X), standard deviation (SD) so as 10th and 90th percentiles are shown in table III. X, SD and percentiles for R were shown in table III. Wt, We and Wv were corrected for V, and X, SD and percentiles shown in table III. Values of VT/Kg, Cdyn/Kg and R are similar to those found by other authors with pneumotachography and plethysmography. The V/Kg values obtained by us were higher than those reported by other authors, which together with the lack of correlation of VT and V with body weight, question the reliability of V values in our study. This could be explained by: 1) excessive increase in dead space in cases in which a face mask was used; 2) nocioceptive stimulus produced by face mask or nasal prongs; 3) inadequate selection of the moment at which the record was obtained. Whichever the explanation, our values of V cannot be considered as basal, and should be interpreted with caution. The results obtained allow us to continue with our program and apply this method to the study of newborn infants with RDS.
Airway Resistance↗
Cesarean section odds ratios.
Cesarean section (CS) rates for primiparas, multiparas with and without previous CS were investigated in seven obstetrical settings. Despite the great diversity of global CS rates (5.3 to 17.4%), common CS odds ratios of 3.0 and 37 have been found for primiparas and multiparas with previous CS, respectively. Internal links between CS odds ratios have also been investigated for some anomalies associated with CS (fetal distress, non-vertex presentation, hypertension, dystocia, small for dates new born and prematurity), suggesting that perinatal services may be evaluated on CS aspects according to a single general interventionist/conservative clinical attitude. Data from two additional obstetrical settings were used to verify the findings in terms of perinatal evaluation.
Cesarean Section↗