Use of lung expansion techniques on drained and non-drained pleural effusion: survey with 232 physiotherapists

Introduction: Techniques for lung expansion seem to benefit patients with drained and undrained pleural effusion, but there is a lack of evidence to indicate which technique is best in each situation. Currently, the therapeutic choices of respiratory physiotherapists serving this population are not known. Objective: To know which lung expansion techniques are chosen by chest physiotherapists who assist patients with drained and non-drained pleural effusion. Method: Through the announcement of the Federal Council, 232 physiotherapists who work in hospitals in Brazil were questioned about which techniques they apply to patients with drained and non-drained effusion. Results: Initially, 512 were questioned but 232 (45.3%) answered. The physiotherapists associate more than one technique of lung expansion in both types of patients, besides walking. Deep breathing is the most used technique in patients with drained (92%) and non-drained (77%) pleural effusion. Positive pressure exercises in the airways are chosen by 60% of the physiotherapists to treat patients with drained pleural effusion and by 34% to treat patients with non-drained pleural effusion. Yet the incentive spirometry are used with 66% of patients with drained pleural effusion and 42% with non-drained ones. Conclusion: Deep breathing is the most applied lung expansion technique in the treatment of patients with drained and non-drained pleural effusion by chest physiotherapists. In addition, there is association between greatest degree and time of professional performance and the chosen techniques.

Nilai Diagnostik Adenosine Deaminase (ADA) Cairan Pleura pada Penderita Efusi Pleura Tuberkulosi

Background: Tuberculosis pleural effusion is the most common extrapulmonary TB after lymphadenitis TB. Limited diagnostic methods make TB pleural effusion hard to diagnose. Adenosine deaminase ADA is an enzyme in purin catabolism process which catalyze adenosine into inosine and deoksiadenosine into deoksiinosin. This process is important in lymphoid cell differentiation. ADA is elevated in TB pleural effusion. Method: This study was a cross sectional analytic observational. Statistic analysis was using two independent samples T test. ROC curve was used to determine cut off value of ADA. Kappa test was used to determined the level of agreement of ADA cut off value. Results: Forty eight samples were included in this study, 18 samples with TB pleural effusion and 30 samples with non TB pleural effusion. There was significant difference between pleural fluid ADA in TB and non TB. Positivity of AFB sputum and MTB culture did not show any significant differences. Cut off ADA value for TB pleural effusion diagnosis was 39,19 with sensitivity 88,9% and spesificity 90%. Conclusion: Examination of ADA level in pleural fluid is a usefull tool to diagnose TB pleural effusion.

Microwave-assisted synthesis and sublimation enthalpies of hemiporphyrazines

It was established that microwave irradiation solvent-free processing of 2,6- diaminopyridine or 1,3-phenylenediamine with phthalonitrile or 4-tert-butylphthalonitrile led to corresponding hemiporphyrazines with sufficiently high yields and a huge reduction in the time required for synthesis, from 8–12 h to 20 min. The data of IR and UV-vis spectroscopies and elemental analysis of the final products were found to be similar to those described in literature. The obtained hemiporphyrazines were characterized by 1H and [Formula: see text]C NMR data. We applied the Knudsen effusion method with mass spectrometric control of vapor composition. The mass spectrometric investigations established that the macrocyclic compounds give a stable stream of particles and their enthalpies of sublimation were estimated by the second law of thermodynamics.