Point-of-care ultrasound (POCUS) is a fast-growing clinical utility and is becoming an essential clinical skill for all practitioners attending to critically ill patients. Ultrasound equipment is now smaller, more affordable and readily available in clinical work areas. POCUS is performed by a non-cardiologist physician at the patient's bedside as an adjunct to the physical examination. It is easily taught, non-invasive and allows for real-time clinical information. Bedside use of ultrasound imaging aids with rapid diagnosis of severe and life-threatening pathological conditions. It can be repeated, may change clinical management, and impact on patient outcome. POCUS has a broad clinical use, including, but not limited to, focused assessed transthoracic echocardiography (FATE), lung ultrasound imaging, extended focused assessment with sonography for trauma (e-FAST), vascular access and regional blocks. It may also be extended to detect endotracheal intubation and the estimation of intracranial pressure. Assessment of cardiac pathology by POCUS, performed by a novice examiner, has been shown to compare with the gold standard of an expert. Training is paramount. The physician should know his limitations and always relate the information back to the clinical scenario and context. By incorporating POCUS as part of our armamentarium and into our daily medical practice, we might see it reach its full clinical potential, optimising patient care and improving patient outcomes.

CONTEXTUALIZAÇÃO: A literatura demonstra o efeito benéfico da terapia ultra-sônica de baixa intensidade sobre o processo de cicatrização de vários tecidos. OBJETIVO: Avaliar o efeito do ultra-som contínuo (USC) sobre a dinâmica hematológica do processo inflamatório agudo de lesão muscular iatrogênica. MÉTODOS: Foram utilizados 16 ratos da raça Wistar (350 a 400g), divididos em grupo controle (GC=8) e grupo experimental (G1=8), submetidos à incisão cirúrgica na face lateral do membro posterior direito, onde o músculo bíceps femoral foi lesionado transversalmente. O USC (1MHz) foi aplicado sobre o local da lesão a uma intensidade de 0,4W/cm², durante três minutos, na 1ª, 8ª e 24ª hora após a lesão. Nestes períodos, foram realizadas as coletas de sangue por punção venosa do plexo retroorbital para as análises sangüíneas das séries brancas e vermelhas. RESULTADOS: O USC diminui 8% dos eritrócitos na primeira coleta (9,9±0,1 versus 7,8±0,1; x10(5)/mm³, p<0,001); dobrou os neutrófilos segmentados na segunda coleta (3.166,8±161,4 versus 6.426,2±306,0; x10³/mm³ p=0,008) e os eosinófilos na terceira coleta (2.883,6±99,0 versus 4.714,4±275,2; x10³/mm³ p=0,011) em relação ao GC. Não se observaram diferenças entre os grupos no hematócrito, leucócitos totais, neutrófilos bastonetes, monócitos e linfócitos, nos três momentos estudados. CONCLUSÕES: A aplicação do USC no tratamento agudo de lesão muscular é contra-indicada nesta condição, pois promove a redução dos eritrócitos, aumento dos neutrófilos segmentados e dos eosinófilos, favorecendo a hemorragia e o aumento do processo inflamatório.

BACKGROUND: The literature shows the beneficial effects of low-intensity ultrasound therapy on the healing process of several biological tissues. OBJECTIVE: To evaluate the effects of continuous ultrasound (CUS) on the hematological dynamics of an acute inflammatory process in iatrogenic muscle injuries. METHODS: Sixteen Wistar rats (350 to 400g) were divided into a control group (CG=8) and an experimental group (G1=8). The rats were submitted to a surgical incision on the lateral aspect of the right hind limb, in which the biceps femoris muscle was transversally injured. The CUS (1MHz) was applied to the injury site at an intensity of 0.4W/cm², for three minutes, in 1, 8 and 24 hour after the injury. At these times, blood was drawn by venipuncture of the retroorbital plexus, for analysis of red and white blood cells. RESULTS: The CUS reduced erythrocytes in 8% at the first blood collection (9.9±0.1 versus 7.8±0.1; x10(5)/mm³; p<0.001); it doubled the number of segmented neutrophils at the second collection (3,166.8±161.4 versus 6,426.2±306.0; x10³/mm³; p=0.008) and the eosinophils at the third collection (2,883.6±99.0 versus 4,714.4±275.2; x10³/mm³; p=0.011), in relation to the CG. No differences between the groups were seen with regard to hematocrit, total leukocytes, rod neutrophils, monocytes or lymphocytes at the three times studied. CONCLUSIONS: Application of CUS for acute treatment of muscle injuries is contraindicated under this condition, because it promotes reductions in erythrocytes and increases in segmented neutrophils and eosinophils, thus favoring hemorrhage and increasing inflammatory process.

Fusion cross section excitation functions were measured for the 6;7Li+59Co systems (12 < Elab < 26 MeV)aiming the investigation of the effect of the breakup process on the fusion cross section. The experimental method consisted on the detection of gamma-rays from the evaporation residues. Coupled channels calculations have been performed for both systems. The comparison to the experimental results support the conclusion that there is neither supression nor enhancement at energies above the coulomb barrier. A slight enhancement at energies below the barrier is observed for the 6Li+59Co cross section over the one for 7Li+59Co. In order to better quantify the effect of the breakup process, coincidence measurements for the breakup products are being performed.