Abstract Objectives: To analyze breathing modes with infrared thermography. Methods: Cross-sectional observational exploratory study conducted in 20 female participants with a mean age of 26.0-years. The thermograms were made following the principles of the American Academy of Thermology and the Brazilian Thermology Society. The camera FLIR A315 (FLIR Inc., Santa Barbara, CA) was used for the tests. The recordings consisted of the participants breathing normally through the nose for 2 min and simulating oral/oronasal breathing for another 2min. The thermograms were analyzed with the FLIR Tools software. An ellipse was placed between the nostrils and the lip commissures to obtain the mean temperatures. The collection was made by two independent researchers, and the normalized non-dimensional temperature was calculated. Results: The temperature in nasal breathing is higher than in oral/oronasal breathing both for inhaling and exhaling when measured in the region of the mouth. The exhaling temperatures were higher than the inhaling ones in oral/oronasal breathing (through the nose and the mouth) and nasal breathing (only through the nose). The temperature difference between exhaling and inhaling (ΔT) was greater in oral/oronasal breathing when measured in the region of the mouth. Conclusion: The thermographic assessment of breathing modes may be made by comparing the mean temperatures of the mouth, using an ellipse. Level of evidence: Study without consistently applied reference standards.

RESUMO A imobilidade pode causar várias complicações que influenciam na recuperação de doentes críticos, incluindo atrofia e fraqueza muscular esquelética. Esse efeito pode ser amenizado com a realização de mobilização precoce. Seis questões primordiais nortearam essa pesquisa: É segura? Quem é o candidato à mobilização precoce? Quais são as contraindicações? Qual a dose adequada e como defini-la? Quais os resultados obtidos? Quais os indicadores prognósticos em sua utilização? O objetivo desta diretriz foi elaborar um documento que reunisse recomendações e sugestões baseadas em níveis de evidência sobre a mobilização precoce do paciente crítico adulto, visando melhorar o entendimento sobre o tema, com impacto positivo no atendimento aos pacientes. Esta diretriz foi desenvolvida com base em uma revisão sistemática de artigos, utilizando a estratégia de busca no modelo PICO, conforme recomendado pelo Projeto de Diretrizes da Associação Médica Brasileira. Foram selecionados ensaios clínicos randomizados, estudos de coortes prognósticos, revisões sistemáticas com ou sem metanálise, sendo as evidências classificadas segundo Oxford Centre for Evidence-based Medicine - Levels of Evidence. Em todas as questões abordadas, foram encontradas evidências suficientes para a realização da mobilização precoce de forma segura e bem definida, com indicadores prognósticos que evidenciam e recomendam a técnica. A mobilização precoce está associada a melhores resultados funcionais, devendo ser realizada sempre que indicada. É segura e deve ser meta de toda equipe multidisciplinar.

ABSTRACT Immobility can cause several complications, including skeletal muscle atrophy and weakness, that influence the recovery of critically ill patients. This effect can be mitigated by early mobilization. Six key questions guided this research: Is early mobilization safe? Which patients are candidates for early mobilization? What are the contraindications? What is the appropriate dose, and how should it be defined? What results are obtained? What are the prognostic indicators for the use of early mobilization? The objective of this guideline was to produce a document that would provide evidence-based recommendations and suggestions regarding the early mobilization of critically ill adult patients, with the aim of improving understanding of the topic and making a positive impact on patient care. This guideline was based on a systematic review of articles conducted using the PICO search strategy, as recommended by the Guidelines Project of the Associação Médica Brasileira. Randomized clinical trials, prognostic cohort studies, and systematic reviews with or without meta-analysis were selected, and the evidence was classified according to the Oxford Center for Evidence-based Medicine Levels of Evidence. For all the questions addressed, enough evidence was found to support safe and well-defined early mobilization, with prognostic indicators that support and recommend the technique. Early mobilization is associated with better functional outcomes and should be performed whenever indicated. Early mobilization is safe and should be the goal of the entire multidisciplinary team.

Abstract A 32 factorial design was employed to develop an in vitro digestion method for estimation of Fe bioaccessible fractions in cooked chicken meat. The effects of sample size and the in vitro bioaccessible fractions of this essential element were evaluated. A sample preparation method employing a microwave assisted digestion with dilute nitric acid was used prior to total Fe determination. For the bioacessibility studies, the optimized procedure employed 7.5 g of sample and 6% w/v of an acid pepsin solution. This procedure was applied to two kinds of chicken meat samples: breast and liver. Flame Atomic Absorption Spectrometry was used to determine total and bioaccessible (chyme or soluble portion) levels of iron in the samples. With respect to total Fe content, the bioaccessible fractions of Fe found in these samples were around 23% and 56 %, for breast and chicken liver, respectively. The chicken liver sample showed the highest total (400 ± 10 mg kg-1) and bioaccessible Fe contents (223 ± 18 mg kg-1) and stands out as a good source of this micronutrient.

Introduction Thermography is a surface thermal radiation measurement technique whose application has been expanding in the healthcare field. The unhealed wound is a serious public health problem because it intervenes in the quality of life of patients and may cause emotional and psychological losses. The wound temperature can provide quantitative data that allow for the healing process to be monitored. The aim of this study was to verify whether thermography can be used as a method to evaluate the healing of pressure ulcers. Methods Eight participants with sacral pressure ulcers were recruited and randomly divided into two groups: A (control) and B (experimental). Both groups received standard treatment for a period of four weeks, which consisted of a daily cleaning of the pressure ulcers with physiological saline (sodium chloride 0.9%) followed by an alginate hydrogel dressing. The group B received light-emitting diode (LED) phototherapy in addition to standard treatment, three times a week, yielding a total of 12 sessions. Photographs and thermograms of each pressure ulcer were obtained in all sessions in both groups. Results Pressure ulcers treated with LED phototherapy were healed. The pressure ulcer area of group B decreased over the 12 treatment sessions, whereas the pressure ulcer area of group A increased. The ulcer temperature of group B was higher than that of group A during the treatment (temperature difference up to 7.6%). Discussion The present study suggests a relationship between the temperature and area of pressure ulcers and proposes thermography as an adjunctive method for the evaluation of healing processes.