Análisis comparativo de meningiomas cerebrales Grado I vs Grado II en una serie retrospectiva de 63 pacientes operados

PubMed Central

Coppola, Federico; Campbell, Juan Iaconis; Herrero, Juan Manuel; Volpe, Emilio; Cersosimo, Tito

2017-01-01

Resumen Introducción: Los meningiomas Grado II tienen un comportamiento biológico más agresivo que los Grado I. A partir del año 2007, con los nuevos criterios de clasificación, la incidencia de meningiomas atípicos reportada aumentó hasta un 35%. Objetivo: Establecer diferencias entre los Meningiomas Grado I y II de la clasificación de la OMS, en lo que respecta a: grados de resección de Simpson, localización tumoral, necesidad de reintervención, tratamiento adyuvante, evolución y mortalidad. Métodos: Estudio retrospectivo de 63 pacientes operados entre el periodo 2009-2015. Variables analizadas: sexo, edad, grado histológico, localización, grado de resección quirúrgica, radioterapia adyuvante, mortalidad y evolución. Resultados: Se analizaron 63 pacientes: 51 Grado I y 12 Grado II de la clasificación de la OMS. La distribución por sexo no mostró diferencias entre meningiomas benignos y atípicos. Tampoco el grupo etario de presentación; mediana de 57 años. Un 55% de los meningiomas benignos se localizaron fuera de la base del cráneo versus el 91,6% de los meningiomas atípicos (P = 0.02). En el 74,5% de los meningiomas benignos se logró una resección total (Simpson I-II-III) versus el 58.3% para los atípicos (P = 0.3). Se reintervinieron el 33,3% de meningiomas atípicos en comparación con el 9.8% de los benignos (P = 0.03). Tuvieron una buena evolución el 86,2% de los benignos vs el 53,8% de los GII (P = 0.01). Realizaron radioterapia adyuvante el 33,3% de los meningiomas Grado II vs el 1,9% de los Grado I. Conclusiones: Los meningiomas atípicos cerebrales tienen peor pronóstico evolutivo que los Grado I de la OMS. Presentan una mayor tasa de reintervención y se localizan más frecuentemente fuera de la base del cráneo. La localización pareciera ser un factor de riesgo para el desarrollo de meningiomas atípicos. PMID:29142779

Confirmatory factor analysis of the Appraisal of Self-Care Agency Scale - Revised.

PubMed

Stacciarini, Thaís Santos Guerra; Pace, Ana Emilia

2017-01-30

to analyze the factor structure of the Appraisal of Self-Care Agency Scale-Revised (ASAS-R), adapted for Brazil. methodological study conducted with 150 individuals with diabetes mellitus cared for by the Family Health Strategy, most of whom are elderly with low educational levels. The test of the hypothesis concerning the confirmatory factor composition of the ASAS-R was performed using latent variables structural equations. the model's goodness-of-fit indexes were satisfactory (χ2 = 259.19; χ2/g.l = 2.97, p < 0.001; GFI = 0.85; RMR = 0.07; RMSEA = 0.09); the factor loads were greater than 0.40; and most item-to-factor-correlations presented moderate to strong magnitude (0.34 to 0.58); total alpha value was 0.74, while the alpha of the three factors were 0.69, 0.38 and 0.69, respectively. the scale's factor structure presented satisfactory validity and reliability results, with the exception of one factor. Application of this scale to samples of the general population is desirable in order to strengthen analyses of internal consistency and the dimensionality of the factor structure. This study is expected to contribute to further studies addressing the self-care agency construct and the development of the ASAS-R. analisar a estrutura fatorial da escala de avaliação da capacidade de autocuidado, Appraisal of Self Care Agency Scale-Revised (ASAS-R), adaptada no Brasil. estudo metodológico conduzido em 150 usuários com diabetes mellitus, maioria idosos e com baixa escolaridade, em seguimento na Estratégia Saúde da Família. O teste de hipótese da composição fatorial confirmatória da escala ASAS-R foi realizado via modelo de equações estruturais para variáveis latentes. os valores dos índices de ajuste do modelo foram satisfatórios (χ2 de 259,19; χ2/g.l de 2,97, p < 0,001; GFI = 0,85; RMR = 0,07; RMSEA = 0,09), as cargas fatoriais foram superiores a 0,40, maioria das correlações item e fator foi de moderada a forte magnitude (0,34 a 0,58) e os

Immediate reconstruction with autologous fat grafting: influence in breast cancerregional recurrence.

PubMed

Stumpf, Camile Cesa; Biazus, Jorge Villanova; Zucatto, Fernando Schuh Ângela Erguy; Cericatto, Rodrigo; Cavalheiro, José Antônio Crespo; Damin, Andrea Pires Souto; Melo, Márcia Portela

2017-01-01

to evaluate local and systemic recurrence of breast cancer in patients submitted to autologous fat grafting in the immediate reconstruction after conservative surgery for breast cancer. this is a historical cohort study comparing 167 patients submitted to conservative surgery without reconstruction (conservative surgery group) with 27 patients submitted to conservative treatment with immediate graft reconstruction, following the Coleman's technique (lipofilling group). All patients had invasive carcinoma and were operated by a single surgeon from 2004 to 2011. The postoperative follow-up time was 36 months. the overall incidence of local recurrence was 2.4%. No patient in the lipofilling group had local recurrence during the study period. For systemic recurrence, the rates obtained were 3.7% (one patient) for the fat grafting group and 1.8% (three patients) for the conservative surgery group without reconstruction. there was no significant difference for local or systemic recurrence in the groups studied. Immediate autologous fat grafting appears to be a safe procedure. avaliar recorrência local e sistêmica do câncer de mama em pacientes submetidas ao enxerto autólogo de gordura na reconstrução imediata após cirurgia conservadora para o câncer de mama. estudo de coorte histórica em que foram comparadas 167 pacientes submetidas à cirurgia conservadora sem reconstrução com 27 pacientes submetidas ao tratamento conservador com reconstrução imediata do enxerto, seguindo técnica de Coleman. Todas as pacientes eram portadoras de carcinoma invasor e foram operadas por um único cirurgião, no período de 2004 a 2011. O tempo de acompanhamento pós-operatório foi 36 meses. a incidência global de recidiva local foi 2,4%. Nenhuma paciente do grupo de lipoenxertia apresentou recorrência local durante o período do estudo. Para recorrência sistêmica, as taxas obtidas foram de 3,7% (uma paciente) para o grupo lipoenxertia e 1,8% (três pacientes) para grupo

Attitude and knowledge about foot health: a spanish view.

PubMed

López-López, Daniel; García-Mira, Ricardo; Palomo-López, Patricia; Sánchez-Gómez, Rubén; Ramos-Galván, José; Tovaruela-Carrión, Natalia; García-Sánchez, Matilde

2017-04-06

to explore attitudes towards patients' self-reported data about foot health-related beliefs from a behavioural and attitudinal perspective. a sample of 282 participants of a mean age of 39.46 ± 16.026 came to a health centre where self-reported demographic, clinical characteristics and beliefs relating to foot health data were registered, informants' completed all the stages of the research process. the results of the analysis revealed an 8-factor factorial structure based on (1) podiatric behaviours, (2) the intention to carry out protective behaviour, (3) attitudinal beliefs, (4) normative beliefs, (5) needs, (6) apathy, (7) self-care, and (8) the general perception of foot health. They all explained 62.78% of the variance, and were considered as independent variables in a regression analysis to determine which provided the best explanations for the importance attributed to foot health. the participants in the study revealed a positive attitude in relation to foot health care and responsible behaviour. explorar as atitudes em relação aos dados auto-relatados dos pacientes sobre crenças relacionadas à saúde do pé, desde uma perspectiva comportamental e atitudinal. uma amostra de 282 participantes com idade média de 39,46 ± 16,026 chegaram a um centro de saúde onde foram registradas características demográficas, clínicas e crenças auto-relatadas referentes a dados de saúde do pé, os quais completaram todas as fases do processo de pesquisa. os resultados da análise revelaram uma estrutura fatorial de 8 fatores baseada em (1) comportamentos podiátricos, (2) a intenção de realizar comportamentos protetores, (3) crenças atitudinais, (4) crenças normativas, (6) apatia, (7) autocuidado, e (8) a percepção geral da saúde do pé. Todos eles explicaram 62,78% da variância e foram considerados como variáveis ​​independentes em uma análise de regressão para determinar quais forneceram as melhores explicações para a importância atribuída �

Foraminotomia cervical posterior en el tratamiento de conflictos foraminales

PubMed Central

Campero, Álvaro; Barrera, Ramiro; Ajler, Pablo

2012-01-01

Introducción: La foraminomotima cervical posterior es un procedimiento utilizado para la descompresion radicular por via posterior y constituye una alternativa a la via clásica anterior. En este trabajo evaluamos nuestra serie de pacientes tratados por esta via. Método: Desde enero de 2008 a diciembre de 2011, 17 pacientes (18 foraminotomías) fueron operados por presentar cervicobraquialgia a causa de un conflicto foraminal, realizando un foraminotomía cervical posterior. Los pacientes fueron evaluados en el postoperatorio inmediato, al mes y a los 3 meses de la cirugía. Los parámetros para valorar los resultados fueron la Escala Análoga del Dolor (VAS), la Neck Disability Index y los criterios de Odom. Resultados: El dolor radicular por conflicto foraminal secundario a hernia de disco cervical fue el síntoma y la patología predominante. El nivel más afectado fue C5-C6. La resolución completa del dolor radicular se observó en casi todos los pacientes. La VAS preoperatoria en promedio fue de 8.8 (mínimo 8 – máximo 10), con una franca mejoría en todos los casos (0.4 en el último control). La media en la Neck Disability Index al inicio fue de 35.3 (mínimo 32 – máximo 45), con una evolución favorable en la evaluación final (0.6). Los Criterios de Odom para la evaluación de pacientes operados de columna cervical fueron satisfactorios con un promedio de 1.17. Se observaron complicaciones en 4 pacientes (23%), todas tuvieron una evolución favorable. No hubo infecciones, discitis ni empeoramiento de los síntomas preexistentes en ningún paciente. Conclusión: La foraminotomía cervical posterior es un procedimiento efectivo para el tratamiento del dolor radicular en los conflictos foraminales PMID:23596556

Prevalencia y factores de riesgo para infecciones del tracto urinario de inicio en la comunidad causadas por Escherichia coli productor de betalactamasas de espectro extendido en Colombia

PubMed Central

Blanco, Victor M.; Maya, Juan J.; Correa, Adriana; Perenguez, Marcela; Muñoz, Juan S.; Motoa, Gabriel; Pallares, Christian J.; Rosso, Fernando; Matta, Lorena; Celis, Yamile; Garzon, Martha; Villegas, y María V.

2016-01-01

RESUMEN Introducción Las infecciones del tracto urinario (ITU) son frecuentes en la comunidad. Sin embargo, la información de aislamientos resistentes en este contexto es limitada en Latinoamérica. Este estudio tiene como objetivo determinar la prevalencia y los factores de riesgo asociados con ITU de inicio en la comunidad (ITU-IC) causadas por Escherichia coli productor de betalactamasas de espectro extendido (BLEE) en Colombia. Materiales y métodos Entre agosto y diciembre de 2011 se realizó un estudio de casos y controles en 3 instituciones de salud de tercer nivel en Colombia. Se invitó a participar a todos los pacientes admitidos a urgencias con diagnóstico probable de ITU-IC, y se les pidió una muestra de orina. En los aislamien-tos de E. coli se realizaron pruebas confirmatorias para BLEE, susceptibilidad antibiótica, caracterización molecular (PCR en tiempo real para genes bla, repetitive element palindromic PCR [rep-PCR], multilocus sequence typing [MLST] y factores de virulencia por PCR). Se obtuvo información clínica y epidemiológica, y posteriormente se realizó el análisis estadístico. Resultados De los 2.124 pacientes seleccionados, 629 tuvieron un urocultivo positivo, en 431 de estos se aisló E. coli, 54 fueron positivos para BLEE y 29 correspondieron a CTX-M-15. La mayoría de los aislamientos de E. coli productor de BLEE fueron sensibles a ertapenem, fosfomicina y amikacina. La ITU complicada se asoció fuertemente con infecciones por E. coli productor de BLEE (OR = 3,89; IC 95%: 1,10–13,89; p = 0,03). E. coli productor de CTX-M-15 mostró 10 electroferotipos diferentes; de estos, el 65% correspondieron al ST131. La mayoría de estos aislamientos tuvieron 8 de los 9 factores de virulencia analizados. Discusión E. coli portador del gen blaCTX-M-15 asociado al ST131 sigue siendo frecuente en Colombia. La presencia de ITU-IC complicada aumenta el riesgo de tener E. coli productor de BLEE, lo cual debe tenerse en cuenta para ofrecer

Zero Calcium Score as a Filter for Further Testing in Patients Admitted to the Coronary Care Unit with Chest Pain.

PubMed

Correia, Luis Cláudio Lemos; Esteves, Fábio P; Carvalhal, Manuela; Souza, Thiago Menezes Barbosa de; Sá, Nicole de; Correia, Vitor Calixto de Almeida; Alexandre, Felipe Kalil Beirão; Lopes, Fernanda; Ferreira, Felipe; Noya-Rabelo, Márcia

2017-06-12

), na qual a probabilidade pré-teste de DAC é maior do que em outras populações. Pacientes foram submetidos a tomografia computadorizada para quantificar o escore de cálcio, DAC obstrutiva foi definida por uma estenose mínima de 70% na cineangiocoronariografia invasiva. Um escore clínico para estimar a probabilidade pré-teste de DAC obstrutiva foi criado em amostra de 370 pacientes, usado para definir subgrupos na definição de valores preditivos negativos do escore zero. Em 146 pacientes estudados, a prevalência de DAC foi 41% e o escore de cálcio zero foi demonstrado em 35% deles. A sensibilidade e a especificidade para escore de cálcio zero resultaram numa razão de verossimilhança negativa de 0,16. Após ajuste com um escore clínico com a regressão logística para a probabilidade pré-teste, o escore de cálcio zero foi preditor independente associado a baixa probabilidade de DAC (OR = 0,12, IC95% = 0,04-0,36), aumentando a área abaixo da curva ROC do modelo clínico de 0,76 para 0,82 (p = 0,006). Considerando a probabilidade de DAC < 10% como ponto de corte para alta precoce, o escore de cálcio aumentou a proporção de pacientes para alta precoce de 8,2% para 25% (NRI = 0,20; p = 0,0018). O escore de cálcio zero apresentou valor preditivo negativo de 90%. Em pacientes com probabilidade pré-teste < 50%, o valor preditivo negativo foi 95% (IC95% = 83%-99%). O escore de cálcio zero reduz substancialmente a probabilidade pré-teste de DAC obstrutiva em pacientes internados em UCI com dor torácica aguda. (Arq Bras Cardiol. 2017; [online].ahead print, PP.0-0).

[Panorama of self-management initiatives in Spain].

PubMed

Nuño-Solinis, Roberto; Rodríguez-Pereira, Carolina; Piñera-Elorriaga, Koldo; Zaballa-González, Irune; Bikandi-Irazabal, Javier

2013-01-01

To describe the current situation of self-management initiatives in Spain. We performed a descriptive study of self-management support initiatives in Spain from the perspective of the patient as expert. Three databases were searched in October 2010 (Pubmed, Scientific Electronic Library Online [SCIELO] and Indice Médico Español [IME]), using the following Keywords «paciente experto» (expert patient), «paciente activo» (active patient) and «apoyo al autocuidado» (self-management support). Web sites were also consulted, using the same key words. Of the initiatives found, we selected those with the most advanced development and continuity, using the perspective of the expert patient (in which patients have an active role) and with a systematic format and methodology. A questionnaire was designed and was sent to the heads of the selected initiatives in the last quarter of 2010. To update the information, the questionnaire was sent again between August and September, 2012. Subsequently, the web sites were visited to review their contents and presence in social networks. Seven initiatives were identified in the autonomous regions of Murcia, Andalusia, Galicia, Castile-La Mancha, Basque Country, and Catalonia. These initiatives used distinct methodologies, formats and assessment systems. In Spain, there is increasing interest in the development of self-management support programs, although their scope is limited and their impact is mostly unknown, except for patient satisfaction. There is a need for studies on results assessment to identify the impact of these initiatives in our setting, as well as for studies on their implementation to encourage the introduction of patient activation initiatives in routine clinical practice. Copyright © 2012 SESPAS. Published by Elsevier Espana. All rights reserved.

Avaliação da influência de alterações cardíacas na ultrassonografia vascular periférica de idosos

PubMed Central

Ribeiro, Alcides José Araújo; Ribeiro, Andréa Campos de Oliveira; Rodrigues, Márcia Marisia Maciel; Negreiros, Sandra de Barros Cobra; Nogueira, Ana Cláudia Cavalcante; Almeida, Osório Luís Rangel; Silva, José Carlos Quináglia e; de Paula, Ana Patrícia

2016-01-01

Resumo Contexto As cardiopatias podem causar alterações no formato das ondas da ultrassonografia vascular (UV) em vasos periféricos. Essas alterações, tipicamente bilaterais e sistêmicas, são pouco conhecidas e estudadas. Objetivo Avaliar as ondas periféricas da UV de pacientes idosos para identificar alterações decorrentes de cardiopatias. Métodos Foram estudados 183 pacientes idosos submetidos a UV periférica no ano de 2014. Resultados Foram avaliados 102 mulheres (55,7%) e 81 homens (44,3%) com idade entre 60 e 91 anos (média de 70,4±7,2 anos). Encontraram-se alterações pela UV em 84 pacientes (45,9%). Foram identificadas 138 alterações de oito dos 13 tipos descritos na literatura: arritmia, onda bisferiens de pico sistólico, baixa velocidade de pico sistólico, pulsatilidade em veias femorais, bradicardia, taquicardia, onda de pulso parvus tardus e onda de pulso alternans. Houve baixa concordância entre a presença e a não presença de alterações na UV e na avaliação cardiológica. Na análise específica das alterações, os exames tiveram uma concordância variável, que foi boa para o achado de taquicardia, moderada para arritmia e baixa para bradicardia. Não houve concordância entre a UV e os exames cardiológicos para as demais alterações. Conclusões É possível identificar determinadas alterações cardíacas em idosos por meio da análise do formato das ondas periféricas da UV. É importante reconhecer e relatar a presença dessas alterações, pela possibilidade de alertar para um diagnóstico ainda não identificado nesses pacientes. Entretanto, mais estudos são necessários para que seja definida a importância das alterações no formato das ondas Doppler periféricas no reconhecimento de cardiopatias. PMID:29930591

Generating para-water from para-hydrogen: A Gedankenexperiment.

PubMed

Ivanov, Konstantin L; Bodenhausen, Geoffrey

2018-07-01

A novel conceptual approach is described that is based on the transfer of hyperpolarization from para-hydrogen in view of generating a population imbalance between the two spin isomers of H 2 O. The approach is analogous to SABRE (Signal Amplification By Reversible Exchange) and makes use of the transfer of spin order from para-hydrogen to H 2 O in a hypothetical organometallic complex. The spin order transfer is expected to be most efficient at avoided level crossings. The highest achievable enrichment levels of para- and ortho-water are discussed. Copyright © 2018 Elsevier Inc. All rights reserved.

Examining adherence among challenging patients in public and private HIV care in Argentina

PubMed Central

Jones, Deborah; Cook, Ryan; Cecchini, Diego; Sued, Omar; Bofill, Lina; Weiss, Stephen; Waldrop-Valverde, Drenna; Lopez, Maria R; Spence, Andrew

2015-01-01

Treatment engagement, retention and adherence to care are required for optimal HIV outcomes. Yet, patients may fall below the treatment recommendations for achieving undetectable viral load or not be retained in care. This study examined the most challenging patients in Buenos Aires, Argentina, those non-adherent to HIV care. Men (n = 61) and women (n = 59) prescribed antiretrovirals (ARVs) and non-adherent to treatment in the prior 3 to 6 months were enrolled and assessed regarding adherence, knowledge, motivation and attitudes regarding treatment. Private clinic patients had lower viral load and higher self-reported adherence than public clinic patients. Motivations to be adherent and positive beliefs regarding ARVs were associated with increased adherence in public clinic participants. Increased self-efficacy was associated with increased adherence among participants from both clinics. Results support patient and provider interventions that strengthen the characteristics supporting adherence, engagement and retention in public and private clinic settings. Resumen El compromiso, la retención en el cuidado y adherencia al tratamiento son esenciales para el manejo óptimo del paciente con VIH. Sin embargo, muchos pacientes con VIH no siguen las el tratamiento para lograr tener una carga viral indetectable, o no permanecen bajo cuidado médico. Este estudio examina los pacientes más difíciles de retener en el cuidado médico en Buenos Aires, Argentina. Hombres (n = 61) y mujeres (n = 59) a los que se les habían recetado antiretrovirales pero seguían el tratamiento en los últimos 3 - 6 meses participaron en el estudio. Adherencia, conocimiento, motivación y actitudes frente al tratamiento fueron evaluados. Los pacientes en la clínica privada tenían menor carga viral y mejor adherencia que los de la clínica pública. Motivación y pensamientos positivos con respecto a antiretrovirales estaban asociados con mejor adherencia en los pacientes de la clínica p

PubMed

Barrantes-Monge, Melba; Rodríguez, Eduardo; Lama, Alexis

2009-01-01

Existen prejuicios en relación con la vejez, incluso entre los profesionales que se dedican a la gerontología. Uno común y peligroso es considerar que los viejos son todos enfermos o discapacitados.La relación médico-paciente es la piedra angular de la práctica y ética médicas. Para alcanzar el respeto por los adultos mayores es necesaria una medicina prudente, basada en una práctica en la cual la reflexión ética y clínica pueda contribuir. Esto último es posible si se hacen valer los derechos del adulto mayor, en particular como paciente para la toma de decisiones.

PubMed

Real Delor, Raúl Emilio

2018-04-23

Se presenta caso de paciente obesa a quien se le realiza endoscopía digestiva alta por disfagia tras ingesta accidental de hueso de pollo. Se constata leve esofagitis de reflujo y atrofia duodenal. La biopsia intestinal informa atrofia intestinal con infiltrado inflamatorio. Los autoanticuerpos para enfermedad celiaca resultan positivos. La paciente nunca presentó síntomas digestivos. Se confirma enfermedad celiaca silente e inicia dieta sin gluten.

Simulating Asymmetric Top Impurities in Superfluid Clusters: A para-Water Dopant in para-Hydrogen.

PubMed

Zeng, Tao; Li, Hui; Roy, Pierre-Nicholas

2013-01-03

We present the first simulation study of bosonic clusters doped with an asymmetric top molecule. The path-integral Monte Carlo method with the latest methodological advance in treating rigid-body rotation [Noya, E. G.; Vega, C.; McBride, C. J. Chem. Phys.2011, 134, 054117] is employed to study a para-water impurity in para-hydrogen clusters with up to 20 para-hydrogen molecules. The growth pattern of the doped clusters is similar in nature to that of pure clusters. The para-water molecule appears to rotate freely in the cluster. The presence of para-water substantially quenches the superfluid response of para-hydrogen with respect to the space-fixed frame.

Planificación Neuroquirúrgica con Software Osirix

PubMed Central

Jaimovich, Sebastián Gastón; Guevara, Martin; Pampin, Sergio; Jaimovich, Roberto; Gardella, Javier Luis

2014-01-01

Introducción: La individualidad anatómica es clave para reducir el trauma quirúrgico y obtener un mejor resultado. Actualmente, el avance en las neuroimágenes ha permitido objetivar esa individualidad anatómica, permitiendo planificar la intervención quirúrgica. Con este objetivo, presentamos nuestra experiencia con el software Osirix. Descripción de la técnica: Se presentan 3 casos ejemplificadores de 40 realizados. Caso 1: Paciente con meningioma de la convexidad parasagital izquierda en área premotora; Caso 2: Paciente con macroadenoma hipofisario, operada previamente por vía transeptoesfenoidal en otra institución con una resección parcial; Caso 3: Paciente con lesiones en pedúnculo cerebeloso medio bilateral. Se realizó la planificación prequirúrgica con el software OsiriX, fusionando y reconstruyendo en 3D las imágenes de TC e IRM, para analizar relaciones anatómicas, medir distancias, coordenadas y trayectorias, entre otras funciones. Discusión: El software OsiriX de acceso libre y gratuito permite al cirujano, mediante la fusión y reconstrucción en 3D de imágenes, analizar la anatomía individual del paciente y planificar de forma rápida, simple, segura y económica cirugías de alta complejidad. En el Caso 1 se pudo analizar las relaciones del tumor con las estructuras adyacentes para minimizar el abordaje. En el Caso 2 permitió comprender la anatomía post-operatoria previa del paciente, para determinar la trayectoria del abordaje transnasal endoscópico y la necesidad de ampliar su exposición, logrando la resección tumoral completa. En el Caso 3 permitió obtener las coordenadas estereotáxicas y trayectoria de una lesión sin representación tomográfica. Conclusión: En casos de no contar con costosos sistemas de neuronavegación o estereotáxia el software OsiriX es una alternativa a la hora de planificar la cirugía, con el objetivo de disminuir el trauma y la morbilidad operatoria. PMID:25165617

Perfil das alterações vasculares periféricas em dependentes de crack acompanhados em Centro de Atenção Psicossocial para Álcool e Drogas (CAPS-AD)

PubMed Central

da Costa, Antônio Fagundes; Baldaçara, Leonardo Rodrigo; da Silva, Sílvio Alves; Tavares, Ana Célia de Freitas Ramos; Orsolin, Ederson de Freitas; Prehl, Vinícius Barros; Gondo, Fernando Hirohito Beltran; Santana, Hernani Lopes

2016-01-01

Resumo Contexto O consumo de crack é um dos grandes desafios em saúde pública, e o uso dessa droga tem efeitos diretos na saúde de seus usuários. Objetivos Avaliar o perfil das alterações vasculares em pacientes com dependência de crack em Centro de Atenção Psicossocial para Álcool e Drogas (CAPS-AD) e observar os possíveis efeitos vasculares periféricos. Métodos Trata-se de um estudo observacional, descritivo, de corte transversal. Os pacientes da amostra foram submetidos a um questionário objetivo para avaliar questões demográficas, padrão de uso da droga, coexistência de diabetes melito, hipertensão arterial ou tabagismo, exame físico e ecográfico. Os dados foram sumarizados e analisados estatisticamente com teste qui-quadrado ou teste exato de Fisher. Resultados A média de idade da amostra foi de 33,29 (±7,15) anos, e 74% eram do gênero masculino. A média de idade de início de uso da droga foi de 23,4 (±7,78) anos, com tempo médio de uso de 9,58 (±5,64) anos. O consumo médio diário de pedras de crack foi de 21,45 (±8,32) pedras. A alteração de pulsos em membros inferiores foi mais frequente em mulheres. A prevalência do espessamento da parede arterial nos membros inferiores foi de 94,8%. O tempo de uso da droga apresentou associação estatística (p = 0,0096) com alteração do padrão de curva espectral das artérias dos membros inferiores. Conclusões Há alterações vasculares periféricas em usuários de crack. O tempo de uso da droga exerceu um maior impacto nesse sistema, o que sugere associação entre o uso do crack e a diminuição de fluxo arterial.

Dobutamine Stress Echocardiography Safety in Chagas Disease Patients.

PubMed

Rassi, Daniela do Carmo; Vieira, Marcelo Luiz Campos; Furtado, Rogerio Gomes; Turco, Fabio de Paula; Melato, Luciano Henrique; Hotta, Viviane Tiemi; Nunes, Colandy Godoy de Oliveira; Rassi, Luiz; Rassi, Salvador

2017-02-01

A few decades ago, patients with Chagas disease were predominantly rural workers, with a low risk profile for obstructive coronary artery disease (CAD). As urbanization has increased, they became exposed to the same risk factors for CAD of uninfected individuals. Dobutamine stress echocardiography (DSE) has proven to be an important tool in CAD diagnosis. Despite being a potentially arrhythmogenic method, it is safe for coronary patients without Chagas disease. For Chagas disease patients, however, the indication of DSE in clinical practice is uncertain, because of the arrhythmogenic potential of that heart disease. To assess DSE safety in Chagas disease patients with clinical suspicion of CAD, as well as the incidence of arrhythmias and adverse events during the exam. Retrospective analysis of a database of patients referred for DSE from May/2012 to February/2015. This study assessed 205 consecutive patients with Chagas disease suspected of having CAD. All of them had their serology for Chagas disease confirmed. Their mean age was 64±10 years and most patients were females (65.4%). No patient had significant adverse events, such as acute myocardial infarction, ventricular fibrillation, asystole, stroke, cardiac rupture and death. Regarding arrhythmias, ventricular extrasystoles occurred in 48% of patients, and non-sustained ventricular tachycardia in 7.3%. DSE proved to be safe in this population of Chagas disease patients, in which no potentially life-threatening outcome was found. Até poucas décadas atrás, os pacientes chagásicos eram predominantemente trabalhadores rurais, com baixo perfil de risco para doença obstrutiva coronária. Com a crescente urbanização, passaram a ter os mesmos fatores de risco para doença aterosclerótica que indivíduos não infectados. O ecocardiograma sob estresse com dobutamina (EED) é uma importante ferramenta no diagnóstico de coronariopatia. É referido, porém, como um método potencialmente arritmogênico, mas

Número de ganglios linfáticos metastásicos como determinante de los resultados después de prostatectomía radical de rescate para el cáncer de próstata de radiación recurrente

PubMed Central

Gugliemetti, G; Sukhu, R; Conca Baenas, M A.; Meeks, J; Sjoberg, D D.; Eastham, J A.; Scardino, P T.; Touijer, K

2017-01-01

Resumen Antecedentes La presencia de metástasis en los ganglios linfáticos (MGL) en la prostatectomía radical de rescate (PRs) se asocia con un mal pronóstico. Los factores predictivos de resultados en este contexto siguen siendo indeterminados. El objetivo fue evaluar el papel de número de ganglios linfáticos positivos sobre el resultado de los pacientes con MGL después de PRs y para el cáncer de próstata de radio-recurrente. Material y métodos Se analizaron los datos de una cohorte consecutiva de 215 hombres tratados con PRr en una sola institución. Se utilizaron los modelos de regresión de riesgos proporcionales de Cox univariante para la recurrencia bioquímica (RBQ) y los resultados metastásicos, con el antígeno prostático específico, la puntuación de Gleason, la extensión extraprostática, la invasión de vesículas seminales, el tiempo entre la terapia de radiación y PRr y el número de ganglios positivos como factores predictivos. Resultados De los 47 pacientes con MGL, 37 desarrollaron RBQ, 11 desarrollaron metástasis a distancia y 4 fallecieron con una mediana de seguimiento de 2,3 años para los supervivientes. El riesgo de metástasis aumentó con mayores niveles preoperatorios de PSA (HR 1,19 por 1 ng/ml; IC del 95%: 1,06, 1,34; p = 0,003). Los factores predictivos restantes no alcanzaron niveles convencionales de significación. Sin embargo, la eliminación de 3 o más ganglios linfáticos positivos demostró una asociación positiva, como se esperaba, con enfermedad metastásica (HR 3,44, IC: 0,91, 13,05; p = 0,069) en comparación con uno o dos ganglios positivos. Del mismo modo, la presencia de extensión extraprostática, invasión de vesículas seminales y grado de Gleason superior a 7 también demostraron una asociación positiva con un mayor riesgo de metástasis, con índices de riesgo de 3,97 (IC del 95% 0,50; 31,4; p = 0,2), 3,72 (IC 95% 0,80, 17,26; p = 0,1) y 1,45 (IC del 95% 0,44, 4,76; p = 0,5), respectivamente

[Not Available].

PubMed

Vio, Fernando; Lera, Lydia; Salinas, Judith

2016-07-19

Objetivo: mediante la técnica de consenso Delphi, conocer la opinión de un grupo de expertos en nutrición, educación y gastronomía para buscar consenso sobre metodologías educativas en alimentación saludable, alumnos de tercero a quinto año básico, sus familias y profesores.Métodos: con los resultados de encuestas y grupos focales realizados previamente a niños, padres y profesores, se elaboró un cuestionario que fue enviado a 51 expertos en nutrición, educación y gastronomía en una primera ronda. Los resultados fueron analizados y reenviados en una segunda ronda con las preguntas no consensuadas, obteniendo 38 respuestas.Resultados: hubo consenso en que se pueden cambiar hábitos en escuelas mediante talleres de cocina con chefs o monitores, educación activo-participativa y huertos escolares. Padres y profesores deben tener habilidades culinarias saludables para educar a los niños. Estos deben hacer uso racional del dinero en la escuela. Para ello es necesario cambiar la oferta del kiosko hacia alimentos saludables, o suprimirlo si no es saludable. Los profesores deben capacitarse con talleres de autocuidado y vida sana para educar en alimentación saludable a los niños en horarios de clase con material educativo, talleres de cocina con recetas y aprovechar horarios de desayuno y almuerzo para actividades educativas. Los padres deben participar en talleres para escoger alimentos saludables en lugares de venta y preparar menús saludables. Los niños deben aprender habilidades culinarias simples, preparando y degustando alimentos saludables. Conclusiones: estos resultados son fundamentales para diseñar materiales educativos en alimentación saludable que cambien los malos hábitos alimentarios actuales.

PubMed

Benítez Brito, Néstor; Oliva García, José Gregorio; Delgado Brito, Irina; Pereyra-García Castro, Francisca; Suárez Llanos, José Pablo; Leyva González, Francisco Gustavo; Palacio Abizanda, José Enrique

2016-11-29

Introducción: la alimentación constituye el pilar fundamental del soporte nutricional de los pacientes hospitalizados. Evaluar el grado de aceptación de la dieta es imprescindible en aras de combatir la desnutrición hospitalaria.Objetivos: a) determinar el grado de satisfacción de los pacientes en relación con las dietas; y b) analizar posibles variables asociadas a un grado de satisfacción mayor (apetito y tipo de dieta).Material y métodos: estudio descriptivo de corte transversal. Se emplea una encuesta de 17 preguntas con datos sociodemográficos, datos cualitativos, así como la valoración general del paciente. Se comparó el grado de satisfacción global en función del apetito y el tipo de dieta (terapéutica vs.basal; con sal vs.sosa) (Test no paramétric o Krustal-Wallis y T-Student para muestras independientes, respectivamente).Resultados: mil cuatrocientos trece pacientes. Edad: 53,9 ± 19 años; 51,3% mujeres. Dieta terapéutica (34,9%). Solo el 39,4% tomó dieta con sal. El 66,8% refirió ingresos previos. La alimentación del hospital para un 43% de pacientes fue ''como esperaba'', mientras que para un 44,1% fue ''mejor de lo que esperaba''. El horario de comidas era adecuado (89,1%) y el tiempo para comer, suficiente (96,4%). En cuanto a las características de la comida servida, consideraron como buenas o muy buenas la misma el porcentaje reflejado: sabor/gusto (56.3%), olor (65,5%), cocinado (69,2%), presentación (80,4%), tamaño de ración (75,9%), calidad (73%), cantidad (77,9%), variedad (67,6%), temperatura (70,4%). La valoración global de la alimentación en una escala de 1 a 10 fue de 6,8 ± 2,3. El apetito se asoció a un aumento significativo de la satisfacción global alimentaria del paciente (p < 0,01). El tipo de dieta o la presencia de sal en la misma no se asociaron a un aumento significativo de la satisfacción con la dieta de los pacientes (p = 0,99 y 0,35, respectivamente).Conclusiones: aunque el grado de satisfacción de

Bladder Control Problems

MedlinePlus

... del Instituto Nacional de la Diabetes y las Enfermedades Digestivas y Renales (NIDDK, por sus siglas en ... para incrementar el conocimiento de salud y las enfermedades entre pacientes, profesionales de la salud y el ...

The culture of patient safety from the perspective of the pediatric emergency nursing team.

PubMed

Macedo, Taise Rocha; Rocha, Patricia Kuerten; Tomazoni, Andreia; Souza, Sabrina de; Anders, Jane Cristina; Davis, Karri

2016-01-01

To identify the patient safety culture in pediatric emergencies from the perspective of the nursing team. A quantitative, cross-sectional survey research study with a sample composed of 75 professionals of the nursing team. Data was collected between September and November 2014 in three Pediatric Emergency units by applying the Hospital Survey on Patient Safety Culture instrument. Data were submitted to descriptive analysis. Strong areas for patient safety were not found, with areas identified having potential being: Expectations and actions from supervisors/management to promote patient safety and teamwork. Areas identified as critical were: Non-punitive response to error and support from hospital management for patient safety. The study found a gap between the safety culture and pediatric emergencies, but it found possibilities of transformation that will contribute to the safety of pediatric patients. Nursing professionals need to become protagonists in the process of replacing the current paradigm for a culture focused on safety. The replication of this study in other institutions is suggested in order to improve the current health care scenario. Identificar a cultura de segurança do paciente em emergências pediátricas, na perspectiva da equipe de enfermagem. Pesquisa quantitativa, tipo survey transversal. Amostra composta por 75 profissionais da equipe de enfermagem. Dados coletados entre setembro e novembro de 2014, em três Emergências Pediátricas, aplicando o instrumento Hospital Survey on Patient Safety Culture. Dados submetidos à análise descritiva. Não foram encontradas áreas de força para a segurança do paciente, sendo identificadas áreas com potencial de assim se tornarem: Expectativas e ações do supervisor/chefia para promoção da segurança do paciente e Trabalho em equipe. Como área crítica identificaram-se: Resposta não punitiva ao erro e Apoio da gestão hospitalar para segurança do paciente. O estudo apontou distanciamento

Cirugía transnasal endoscópica para tumores de hipófisis

PubMed Central

Ajler, Pablo; Hem, Santiago; Goldschmidt, Ezequiel; Landriel, Federico; Campero, Alvaro; Yampolsky, Claudio; Carrizo, Antonio

2012-01-01

Introducción: Exponer la técnica utilizada y los resultados obtenidos en los primeros 52 pacientes portadores de tumores hipofisarios tratados por la vía endoscópica transnasal en el Hospital Italiano de Buenos Aires Métodos: Se llevó a cabo un análisis retrospectivo de 52 cirugías endoscópicas transnasales utilizadas en el tratamiento de tumores hipofisários. Las mismas fueron realizadas en el Hospital Italiano de Buenos Aires durante el período junio del 2011 a junio del 2012. Se analizaron las características demográficas de los pacientes, la patología de base y la morbimortalidad asociada a la cirugía. Resultados: La edad media de los pacientes fue de 41,52 años con un rango de 18-79. La distribución fue similar entre hombres y mujeres. Las patologías más frecuentes fueron: adenomas no funcionantes (40.4%), tumores productores de GH/Acromegalia (25%) y tumores productores de ACTH/Enfermedad de Cushing (23.1%). Aproximadamente el 70 % correspondieron a macroadenomas. Sólo un paciente presentó complicaciones. No se registro ningún óbito. Conclusión: Si bien podremos objetivar fehacientemente resultados más concluyentes en futuros trabajos, podemos decir a priori que, en la endoscopía el detalle anatómico es claramente superior al microscópico y que la posibilidad de la introducción del endoscopio en la silla turca permite la visualización directa de remanentes tumorales, de sitios de fístula y como así también de la glándula normal, ventajas que potencialmente podrían permitir obtener mejores resultados quirúrgicos, en términos de control de la enfermedad y tasa de complicaciones. PMID:23596553

INFLUENCE OF HEPATOCELLULAR CARCINOMA ETIOLOGY IN THE SURVIVAL AFTER RESECTION.

PubMed

Lopes, Felipe de Lucena Moreira; Coelho, Fabricio Ferreira; Kruger, Jaime Arthur Pirolla; Fonseca, Gilton Marques; Araujo, Raphael Leonardo Cunha de; Jeismann, Vagner Birk; Herman, Paulo

2016-01-01

Hepatocellular carcinoma (HCC) is the most frequent type of primary liver cancer and its incidence is increasing around the world in the last decades, making it the third cause of death by cancer in the world. Hepatic resection is one of the most effective treatments for HCC with five-year survival rates from 50-70%, especially for patients with a single nodule and preserved liver function. Some studies have shown a worse prognosis for HCC patients whose etiology is viral. That brings us to the question about the existence of a difference between the various causes of HCC and its prognosis. To compare the prognosis (overall and disease-free survival at five years) of patients undergoing hepatectomy for the treatment of HCC with respect to various causes of liver disease. Was performed a review of medical records of patients undergoing hepatectomy between 2000 and 2014 for the treatment of HCC. They were divided into groups according to the cause of liver disease, followed by overall and disease-free survival analysis for comparison. There was no statistically significant difference in the outcomes of the groups of patients divided according to the etiology of HCC. Overall and disease-free survival at five years of the patients in this sample were 49.9% and 40.7%, respectively. From the data of this sample, was verified that there was no prognostic differences among the groups of HCC patients of the various etiologies. O carcinoma hepatocelular (CHC) é o mais frequente tipo de câncer primário do fígado e a sua incidência vem aumentando nas últimas décadas, tornando-o hoje a terceira causa de morte por câncer no mundo. A ressecção hepática é um dos tratamentos mais eficazes para ele com taxas de sobrevida em cinco anos de 50-70%, especialmente para pacientes com nódulo único e função hepática preservada. Alguns estudos mostraram pior prognóstico para os pacientes com CHC cuja causa é a infecção por vírus B ou C. Isso leva à questão sobre a

[Cambios en la salud sexual de los pacientes obesos tras cirugía bariátrica].

PubMed

Pomares-Callejón, María A; Ferrer-Márquez, Manuel; Solvas-Salmerón, María J

2018-01-01

Los objetivos del estudio fueron: 1) evaluar la salud sexual en pacientes con obesidad grave/mórbida candidatos a cirugía bariátrica; y 2) valorar la evolución de la salud sexual tras 12 meses de la cirugía. Estudio descriptivo, prospectivo desde febrero de 2011 hasta junio de 2014. Se valoró la actividad sexual en los hombres a través del cuestionario EVAS-H y la función sexual en la mujer a través de la escala FSM (44 pacientes). Durante el estudio basal en los hombres, un 21% de la muestra presentó disfunción sexual en diferentes dimensiones, mientras que un 43% presentó problemas de eyaculación precoz. Tras 12 meses de la intervención, se observó un incremento de la actividad sexual global (p = 0.026). En torno al 70-89% de las mujeres, previamente a la cirugía, no presentaban trastorno. En la evolución no se observaron cambios medios relevantes (p > 0.05). Los pacientes con obesidad grave/mórbida candidatos a cirugía bariátrica presentan alteraciones considerables en diversas dimensiones de la salud sexual. Después de 12 meses de seguimiento, la salud sexual parece mejorar en los hombres. The aims of the study were: 1) to assess sexual health patients severe/morbid obesity patients candidates for bariatric surgery; and 2) to assess sexual health evolution after 12 months of surgery. Descriptive, prospective study from February 2011 to June 2014. Sexual activity in men was valued through EVAS-H questionnaire and through FSM scale on women (44 patients). During the basal study in men, a 21% of the sample showed sexual disfunction in different dimensions, while a 43% showed problems with premature ejaculation. 12 months after surgery, global sexual activity was improved significantly (p = 0,026). Approximately 70-89% of women presented no disturbance before surgery. No average relevant changes were observed within the evolution (p > 0.05). Morbid/severe obesity patients candidates to bariatric surgery, show considerable alterations on diverse

Diagnosis and medical treatment of neuropathic pain in leprosy.

PubMed

Arco, Rogerio Del; Nardi, Susilene Maria Tonelli; Bassi, Thiago Gasperini; Paschoal, Vania Del Arco

2016-08-08

to identify the difficulties in diagnosing and treating neuropathic pain caused by leprosy and to understand the main characteristics of this situation. 85 patients were treated in outpatient units with reference to leprosy and the accompanying pain. We used a questionnaire known as the Douleur Neuropathic 4 test and we conducted detailed neurological exams. As a result, 42 patients were excluded from the study for not having proved their pain. Out of the 37 patients that experienced pain, 22 (59.5%) had neuropathic pain (or a mixture of this pain and their existing pain) and of these 90.8% considered this pain to be moderate or severe. 81.8% of the sample suffered with this pain for more than 6 months. Only 12 (54.5%) of the patients had been diagnosed with neuropathic pain and in almost half of these cases, this pain had not been diagnosed. With reference to medical treatment (n=12) for neuropathic pain, 5 (41.6%) responded that they became better. For the other 7 (58.4%) there were no changes in relation to the pain or in some cases the pain worsened in comparison to their previous state. Statistical analysis comparing improvements in relation to the pain amongst the patients that were treated (n=12) and those that were not, showed significant differences (value p=0.020). we noted difficulties in diagnosing neuropathic pain for leprosy in that almost half of the patients that were studied had not had their pain diagnosed. We attributed this to some factors such as the non-adoption of the appropriate protocols which led to inadequate diagnosis and treatment that overlooked the true picture. identificar as dificuldades em diagnosticar e tratar a dor neuropática causada pela hanseníase, bem como determinar as características principais dessa situação. examinaram-se 85 pacientes tratados no ambulatório de referência para hanseníase e referiam dor. Aplicou-se questionário, o teste Douleur Neuropathic 4, e criterioso exame neurológico pelo qual exclu

Profilaxia da trombose venosa profunda em cirurgia bariátrica: estudo comparativo com doses diferentes de heparina de baixo peso molecular

PubMed Central

Goslan, Carlos José; Baretta, Giórgio Alfredo Pedroso; de Souza, Hemuara Grasiela Pestana; Orsi, Bruna Zanin; Zanoni, Esdras Camargo A.; Lopes, Marco Antonio Gimenez; Engelhorn, Carlos Alberto

2018-01-01

Resumo Contexto A cirurgia bariátrica é considerada a melhor opção para o tratamento da obesidade, cujos pacientes são considerados de alto risco para fenômenos tromboembólicos. Objetivos Comparar o uso de doses diferentes de heparina de baixo peso molecular (HBPM) na profilaxia da trombose venosa profunda (TVP) em pacientes candidatos à cirurgia bariátrica em relação ao risco de TVP, alteração na dosagem do fator anti-Xa e sangramento pré ou pós-operatório. Métodos Estudo comparativo transversal em pacientes submetidos à cirurgia bariátrica distribuídos em dois grupos, que receberam doses de HBPM de 40 mg (grupo controle, GC) e 80 mg (grupo de estudo, GE). Foram avaliados por ultrassonografia vascular e dosagem de KPTT, TAP, plaquetas e fator anti-Xa. Resultados Foram avaliados 60 pacientes, sendo 34 no GC e 26 no GE. Foi observada diferença significativa somente no peso (p = 0,003) e índice de massa corporal (p = 0,018) no GE em relação ao GC. Não houve diferença na dosagem de KPTT, TAP, plaquetas e fator anti-Xa entre os grupos. Não foram detectados TVP ou sangramentos significativos em ambos os grupos. Conclusões Não houve diferença estatisticamente significativa na utilização de doses maiores de HBPM na profilaxia da TVP em pacientes candidatos à cirurgia bariátrica em relação ao risco de TVP, dosagem do fator anti-Xa e sangramento pré ou pós-operatório.

Superoxide reaction with tyrosyl radicals generates para-hydroperoxy and para-hydroxy derivatives of tyrosine.

PubMed

Möller, Matías N; Hatch, Duane M; Kim, Hye-Young H; Porter, Ned A

2012-10-10

Tyrosine-derived hydroperoxides are formed in peptides and proteins exposed to enzymatic or cellular sources of superoxide and oxidizing species as a result of the nearly diffusion-limited reaction between tyrosyl radical and superoxide. However, the structure of these products, which informs their reactivity in biology, has not been unequivocally established. We report here the complete characterization of the products formed in the addition of superoxide, generated from xanthine oxidase, to several peptide-derived tyrosyl radicals, formed from horseradish peroxidase. RP-HPLC, LC-MS, and NMR experiments indicate that the primary stable products of superoxide addition to tyrosyl radical are para-hydroperoxide derivatives (para relative to the position of the OH in tyrosine) that can be reduced to the corresponding para-alcohol. In the case of glycyl-tyrosine, a stable 3-(1-hydroperoxy-4-oxocyclohexa-2,5-dien-1-yl)-L-alanine was formed. In tyrosyl-glycine and Leu-enkephalin, which have N-terminal tyrosines, bicyclic indolic para-hydroperoxide derivatives were formed ((2S,3aR,7aR)-3a-hydroperoxy-6-oxo-2,3,3a,6,7,7a-hexahydro-1H-indole-2-carboxylic acid) by the conjugate addition of the free amine to the cyclohexadienone. It was also found that significant amounts of the para-OH derivative were generated from the hydroxyl radical, formed on exposure of tyrosine-containing peptides to Fenton conditions. The para-OOH and para-OH derivatives are much more reactive than other tyrosine oxidation products and may play important roles in physiology and disease.

Use of black vulture (Coragyps atratus) in complementary and alternative therapies for cancer in Colombia: A qualitative study

PubMed Central

2012-01-01

Background Although Coragyps atratus has been used as a traditional therapy for patients with cancer, the scientific literature does not contain enough information on how this therapy is used or the mechanisms that explain this therapeutic practice. Objectives To understand the methods of use and the reasons given by patients and caregivers for the use of Coragyps atratus in cancer treatment. Methods This study used a qualitative design based on twenty in-depth interviews of patients with cancer or caregivers of patients with the disease. The analysis of the text was based on an inductive thematic approach. Results Resistance to disease and immune enhancement are properties attributed to Coragyps atratus when used for cancer treatment. The most recommended method of use is fresh blood ingestion, and the associated mechanism of action is transfer of immune factors to the individual who consumes it. Conclusions Use of Coragyps atratus as a treatment for cancer is a popular alternative therapy in Colombia. More studies are needed to understand the clinical effects of this intervention in cancer patients. Spanish abstract Introducción Aunque Coragyps atratus se usa tradicionalmente como terapia para pacientes con cáncer, no existe suficiente información en la literatura científica sobre su forma de utilización ni sobre los mecanismos explicativos que subyacen a esta práctica terapéutica. Objetivos Conocer métodos de utilización y mecanismos explicativos dados por los pacientes y cuidadores de pacientes sobre el uso de Coragyps atratus en el tratamiento del cáncer. Materiales y métodos Diseño cualitativo basado en veinte entrevistas en profundidad de pacientes con cáncer o cuidadores de pacientes con esta enfermedad. Análisis de texto basado en enfoque temático inductivo. Resultados Al Coragyps atratus se le atribuyen propiedades de resistencia y fortalecimiento del sistema inmune de personas enfermas de cáncer. La forma de utilización mas común es la

Medicina integrativa en América: De qué forma se está practicando la medicina integrativa en los centros clínicos en los Estados Unidos

PubMed Central

Horrigan, Bonnie; Lewis, Sheldon; Abrams, Donald I.; Pechura, Constance

2012-01-01

RESUMEN EJECUTIVO El impulso para desarrollar e implementar estrategias de medicina integrativa está enraizado en el deseo de mejorar la atención al paciente. The Bravewell Collaborative, una organización sin ánimo de lucro dedicada a la mejora de la atención sanitaria, define la medicina integrativa como “un enfoque de la medicina que coloca al paciente en el centro y se dirige al conjunto completo de influencias físicas, emocionales, mentales, sociales, espirituales y ambientales que afectan a la salud de la persona. Con una estrategia personalizada que considera las condiciones, necesidades y circunstancias únicas del paciente, utiliza las intervenciones más apropiadas de una variedad de disciplinas científicas para curar la afección y la enfermedad y ayudar a las personas a recobrar y mantener una salud óptima”. En las pasadas dos décadas, se ha documentado un número creciente de centros clínicos que proporcionan medicina integrativa, el número de facultades y escuelas médicas que enseñan estrategias integrativas, el número de investigadores que estudian intervenciones integrativas, y el número de pacientes que solicitan cuidados integrativos. Pero se desconocía si la medicina integrativa se estaba ofreciendo de manera igual, similar, o dispar. Además, mientras que los estudios anteriores se centraban en la prevalencia y el uso de la medicina complementaria o alternativa (MCA) por parte de los pacientes1,2 o de los médicos en hospitales3, enumerando la utilización de terapias MCA individuales, se había recogido muy poca información con respecto a la práctica real de la medicina integrativa que, por definición, trata a la persona en su conjunto. En 2011, The Bravewell Collaborative encargó una encuesta para determinar la forma en que la medicina integrativa se estaba practicando en los Estados Unidos: (1) describiendo las poblaciones de pacientes y las afecciones sanitarias tratadas más habitualmente; (2) definiendo las pr

DISYUNTIVAS EN LAS CONCEPCIONES SOBRE AUTONOMÍA Y BENEFICENCIA QUE AFECTAN LA TERAPÉUTICA DEL INTENTO SUICIDA1

PubMed Central

Mondragón, Liliana; Monroy, Zuraya; Ito, Ma. Emily; Medina-Mora, Dra. Ma. Elena

2010-01-01

El objetivo del trabajo es conocer las disyuntivas entre los principios de beneficencia y autonomía, que se presentan en la relación médico-paciente, durante la terapéutica del intento de suicidio. La investigación se realizó en dos hospitales psiquiátricos de la Ciudad de México. La muestra incluyó a tres sujetos con intento de suicidio, mayores de 18 años, que eran atendidos en consulta externa a causa de una lesión autoinfligida en el último año, y a tres psiquiatras que trataban a estos pacientes. La información se obtuvo previo consentimiento informado en entrevistas individuales. Se llevó a cabo un análisis de discurso argumentado para encontrar los significados que los participantes otorgaron a los principios bioéticos y las posibles disyuntivas entre éstos. Las discordancias entre la beneficencia y la autonomía estuvieron relacionadas con el beneficio del tratamiento, el respeto por los valores y las creencias de los pacientes, entre otros. Este trabajo presenta consideraciones éticas relevantes en el escenario clínico, al ofrecer al psiquiatra un análisis bioético que le permita actuar de acuerdo con la beneficencia y respetando la autonomía del paciente frente a casos de intento de suicidio y, de esta forma procurar una mejor atención para ellos. PMID:20830214

DISYUNTIVAS EN LAS CONCEPCIONES SOBRE AUTONOMÍA Y BENEFICENCIA QUE AFECTAN LA TERAPÉUTICA DEL INTENTO SUICIDA.

PubMed

Mondragón, Liliana; Monroy, Zuraya; Ito, Ma Emily; Medina-Mora, Dra Ma Elena

2010-06-01

El objetivo del trabajo es conocer las disyuntivas entre los principios de beneficencia y autonomía, que se presentan en la relación médico-paciente, durante la terapéutica del intento de suicidio.La investigación se realizó en dos hospitales psiquiátricos de la Ciudad de México. La muestra incluyó a tres sujetos con intento de suicidio, mayores de 18 años, que eran atendidos en consulta externa a causa de una lesión autoinfligida en el último año, y a tres psiquiatras que trataban a estos pacientes. La información se obtuvo previo consentimiento informado en entrevistas individuales. Se llevó a cabo un análisis de discurso argumentado para encontrar los significados que los participantes otorgaron a los principios bioéticos y las posibles disyuntivas entre éstos.Las discordancias entre la beneficencia y la autonomía estuvieron relacionadas con el beneficio del tratamiento, el respeto por los valores y las creencias de los pacientes, entre otros. Este trabajo presenta consideraciones éticas relevantes en el escenario clínico, al ofrecer al psiquiatra un análisis bioético que le permita actuar de acuerdo con la beneficencia y respetando la autonomía del paciente frente a casos de intento de suicidio y, de esta forma procurar una mejor atención para ellos.

Desenvolvimento de modelo clínico para predição da possibilidade de identificação da artéria de Adamkiewicz por angiotomografia

PubMed Central

Amato, Alexandre Campos Moraes; Parga, José Rodrigues; Stolf, Noedir Antônio Groppo

2018-01-01

Resumo Contexto Diferenças morfológicas da artéria de Adamkiewicz (AKA) entre a população portadora e não portadora de doença aórtica têm importância clínica, influenciando as complicações neuroisquêmicas da medula espinhal em procedimentos operatórios. Ainda não é conhecida a correlação entre parâmetros clínicos e a previsibilidade da identificação dessa artéria pela angiotomografia. Objetivo Desenvolver um modelo matemático que, através de parâmetros clínicos correlacionados com aterosclerose, possa prever a probabilidade de identificação da AKA em pacientes submetidos a angiotomografias. Método Estudo observacional transversal utilizando banco de imagens e dados de pacientes. Foi feita análise estatística multivariada e criado modelo matemático logit de predição para identificação da AKA. Variáveis significativas foram utilizadas na montagem da fórmula para cálculo da probabilidade de identificação. O modelo foi calibrado, e a discriminação foi avaliada pela curva receiver operating characteristic (ROC). A seleção das variáveis explanatórias foi guiada pela maior área na curva ROC (p = 0,041) e pela significância combinada das variáveis. Resultados Foram avaliados 110 casos (54,5% do sexo masculino, com idade média de 60,97 anos e etnia com coeficiente B -2,471, M -1,297, N -0,971), com AKA identificada em 60,9%. Índice de massa corporal: 27,06 ± 0,98 (coef. -0,101); fumantes: 55,5% (coef. -1,614/-1,439); diabéticos: 13,6%; hipertensos: 65,5% (coef. -1,469); dislipidêmicos: 58,2%; aneurisma aórtico: 38,2%; dissecção aórtica: 12,7%; e trombo mural: 24,5%. Constante de 6,262. Fórmula para cálculo da probabilidade de detecção: (e−(Coef. Etnia+(Coef. IMC×IMC)+Coef.fumante+Coef.HAS+Coef.dislip+Constante)+1)−1 . O modelo de predição foi criado e disponibilizado no link https://vascular.pro/aka-model . Conclusão Com as covariáveis etnia, índice de massa corporal, tabagismo, hipertens

[Anorexia nervosa as a cause of acute liver failure. Report of a case].

PubMed

Voltas-Arribas, Beatriz; Artero-Fullana, Ana; Ferrer-García, Juan Carlos; Sánchez-Juan, Carlos; Marco-Alacid, Cristian; Sanz-Revert, Pablo; García-Blasco, Lourdes

2018-01-10

Caso clínico: presentamos una paciente de 33 años con anorexia nerviosa de 15 años de evolución con uno de los pocos casos reportados de fallo hepático agudo severo secundario a la desnutrición.Discusión: tras el soporte nutricional protocolizado para evitar el síndrome de realimentación y un adecuado manejo multidisciplinar, la paciente evoluciona favorablemente logrando normalizar los electrolitos, la función hepática y las alteraciones en la coagulación.

Lesiones subcutáneas dolorosas en paciente con melanoma metastásico: un caso de paniculitis linfocítica asociado a vemurafenib.

PubMed

Benavente-Villegas, Felipe; Ferrando-Roca, Francisco; Dolz-Gaitón, Raquel; Royo-Peiró, María

2017-10-15

Vemurafenib ha probado ser una herramienta útil en el tratamiento de melanoma metastásico con mutación BRAF-V600E. Los efectos adversos incluyen artralgias, fatiga y toxicidad cutánea, siendo infrecuente la paniculitis. Presentamos el caso de una paciente de 43 años con melanoma metastásico que desarrolla lesiones subcutáneas dolorosas en miembros inferiores y superiores, asociadas a clínica sistémica después de 2 semanas de inicio de tratamiento con Vemurafenib + Cobimetinib. La histología demostró paniculitis linfocitaria septal y lobulillar. La paciente tuvo mala tolerancia al tratamiento anti diana a dosis plenas, requiriendo su ajuste, generando una corticodependencia para controlar sintomatología, y que finalmente obligó a la descontinuación de la terapia dirigida contra melanoma.  A la fecha, se han descrito 29 casos en la literatura de paniculitis asociada a vemurafenib, siendo la mayoría paniculitis neutrofílicas con adecuado control de sintomatología asociando antiinflamatorios no esteroidales y/o corticoides orales sin requerir en su mayoría modificación de la terapia contra melanoma; sin embargo hay que tener presente que pueden haber casos con mala evolución que obligan a la reducción de dosis de vemurafenib y descontinuar el tratamiento, como ha ocurrido en nuestro reporte.Vemurafenib has proven to be a useful tool in the treatment of metastatic melanoma with BRAF-V600E mutation. Adverse effects include arthralgia, fatigue, and skin toxicity; panniculitis is a rare complication. We present the case of a 43-year-old patient with metastatic melanoma who developed painful subcutaneous nodules of the lower and upper limbs and associated systemic clinical symptoms after 2 weeks of treatment with vemurafenib plus cobimetinib. Histology showed a septal and lobular lymphocytic panniculitis.The patient had poor tolerance of the full-dose treatment, requiring its adjustment. Systemic corticosteroids were required to control symptomatology

Effects of zinc supplementation on fatigue and quality of life in patients with colorectal cancer.

PubMed

Ribeiro, Sofia Miranda de Figueiredo; Braga, Camila Bitu Moreno; Peria, Fernanda Maris; Martinez, Edson Zangiacomi; Rocha, José Joaquim Ribeiro da; Cunha, Selma Freire Carvalho

2017-01-01

To investigate the effects of oral zinc supplementation on fatigue intensity and quality of life of patients during chemotherapy for colorectal cancer. A prospective, randomized, double-blinded, placebo-controlled study was conducted with 24 patients on chemotherapy for colorectal adenocarcinoma in a tertiary care public hospital. The study patients received zinc capsules 35mg (Zinc Group, n=10) or placebo (Placebo Group, n=14) orally, twice daily (70mg/day), for 16 weeks, from the immediate postoperative period to the fourth chemotherapy cycle. Approximately 45 days after surgical resection of the tumor, all patients received a chemotherapeutic regimen. Before each of the four cycles of chemotherapy, the Functional Assessment of Chronic Illness Therapy-Fatigue scale was completed. We used a linear mixed model for longitudinal data for statistical analysis. The scores of quality of life and fatigue questionnaires were similar between the groups during the chemotherapy cycles. The Placebo Group presented worsening of quality of life and increased fatigue between the first and fourth cycles of chemotherapy, but there were no changes in the scores of quality of life or fatigue in the Zinc Group. Zinc supplementation prevented fatigue and maintained quality of life of patients with colorectal cancer on chemotherapy. Investigar os efeitos da suplementação oral de zinco sobre a intensidade da fadiga e a qualidade de vida de pacientes durante a quimioterapia para neoplasia colorretal. Estudo prospectivo, randomizado, controlado e duplo-cego conduzido em um hospital universitário público terciário, com 24 pacientes em regime quimioterápico para adenocarcinoma colorretal. Os pacientes receberam cápsulas de zinco 35mg (Grupo Zinco, n=10) ou placebo (Grupo Placebo, n=14) por via oral, duas vezes ao dia (70mg/dia), durante 16 semanas, desde o período pós-operatório imediato até o quarto ciclo de quimioterapia. Todos os pacientes receberam quimioterapia por

Impaired pulmonary function after treatment for tuberculosis: the end of the disease?

PubMed

Chushkin, Mikhail Ivanovich; Ots, Oleg Nikolayevich

2017-01-01

To evaluate the prevalence of pulmonary function abnormalities and to investigate the factors affecting lung function in patients treated for pulmonary tuberculosis. A total of 214 consecutive patients (132 men and 82 women; 20-82 years of age), treated for pulmonary tuberculosis and followed at a local dispensary, underwent spirometry and plethysmography at least one year after treatment. Pulmonary impairment was present in 102 (47.7%) of the 214 patients evaluated. The most common functional alteration was obstructive lung disease (seen in 34.6%). Of the 214 patients, 60 (28.0%) showed reduced pulmonary function (FEV1 below the lower limit of normal). Risk factors for reduced pulmonary function were having had culture-positive pulmonary tuberculosis in the past, being over 50 years of age, having recurrent tuberculosis, and having a lower level of education. Nearly half of all tuberculosis patients evolve to impaired pulmonary function. That underscores the need for pulmonary function testing after the end of treatment. Avaliar a prevalência de alterações da função pulmonar e investigar os fatores que afetam a função pulmonar em pacientes tratados para tuberculose pulmonar. Um total de 214 pacientes consecutivos (132 homens e 82 mulheres; 20-82 anos de idade), tratados para tuberculose pulmonar e acompanhados em um dispensário local, foi submetido a espirometria e pletismografia pelo menos um ano após o tratamento. O comprometimento pulmonar estava presente em 102 (47,7%) dos 214 pacientes avaliados. A alteração funcional mais comum foi o distúrbio ventilatório obstrutivo (observado em 34,6%). Dos 214 pacientes, 60 (28,0%) apresentaram função pulmonar reduzida (VEF1 abaixo do limite inferior de normalidade). Os fatores de risco para função pulmonar reduzida foram tuberculose pulmonar com cultura positiva no passado, idade acima de 50 anos, recidiva de tuberculose e menor nível de escolaridade. Quase metade de todos os pacientes com tuberculose

[An automated registry program for nosocomial infections].

PubMed

Castañón-González, Jorge Alberto; Polanco-González, Carlos; Samaniego-Mendoza, José Lino; Buhse, Thomas

2014-12-01

Las infecciones nosocomiales presentan un gran reto para la medicina hospitalaria, en general, y para las Unidades de Cuidados Intensivos, en particular. Su elevada prevalencia, la gran morbilidad y mortalidad asociadas, el incremento de la estancia hospitalaria y, en consecuencia, los costos de la atención médica han hecho que los programas de vigilancia, control y prevención de infecciones nosocomiales sean una parte toral de los protocolos de seguridad para el paciente y un indicador de calidad de la atención médica.

Assessment of fatigue using the Identity-Consequence Fatigue Scale in patients with lung cancer.

PubMed

Nogueira, Ingrid Correia; Araújo, Amanda Souza; Morano, Maria Tereza; Cavalcante, Antonio George; Bruin, Pedro Felipe de; Paddison, Johana Susan; Silva, Guilherme Pinheiro da; Pereira, Eanes Delgado

2017-01-01

. Estudo transversal com pacientes com CP, atendidos em um hospital-escola no Brasil, que preencheram a EICF. Pacientes com doenças cardíacas crônicas (DCC) e controles saudáveis, pareados por idade e sexo, também preencheram a escala. Inicialmente, uma versão brasileira da escala foi aplicada a 50 pacientes com CP por dois entrevistadores independentes; para testar a reprodutibilidade, ela foi reaplicada aos mesmos pacientes. No momento basal, os pacientes com CP realizaram espirometria e teste de caminhada de seis minutos, bem como preencheram a Epworth Sleepiness Scale (ESS), Hospital Anxiety and Depression Scale (HADS), Medical Outcomes Study 36-item Short-Form Health Survey (SF-36) e Fatigue Severity Scale (FSS). O estado inflamatório foi avaliado pelos níveis de proteína C reativa (PCR) no sangue. Para validar a EICF, avaliamos as correlações entre as pontuações na mesma e essas variáveis. A amostra foi composta por 50 pacientes em cada grupo (CP, DCC e controle). No grupo CP, os coeficientes de correlação intraclasse para confiabilidade intra e interobservador para as variáveis resumidas da EICF variaram de 0,94 a 0,76 e de 0,94 a 0,79, respectivamente. A EICF apresentou excelente consistência interna, e as disposições gráficas de Bland-Altman demonstraram boa confiabilidade teste-reteste. A EICF apresentou correlações significativas com as pontuações na FSS, HADS e SF-36, bem como com os níveis de PCR. As médias das pontuações na EICF do grupo CP diferiram significativamente das dos grupos DCC e controle. A EICF é um instrumento válido e confiável para a avaliação de pacientes com CP, nos quais depressão, qualidade de vida e níveis de PCR parecem estar significativamente associados à fadiga.

[Not Available].

PubMed

Pérez-Flores, Juan Emmanuel; Chávez-Tostado, Mariana; Larios-Del-Toro, Youné Elizabeth; García-Rentería, Jesús; Rendrón-Félix, Jorge; Salazar-Parra, Marcela; Irusteta-Jiménez, Leire; Michel-Espinoza, Luis Rodrigo; Márquez-Valdez, Aída Rebeca; Cuesta-Márquez, Lisbeth; Álvarez-Villaseñor, Andrea Socorro; Fuentes-Orozco, Clotilde; González Ojeda, Alejandro

2016-07-19

Introducción: la desnutrición intrahospitalaria se ha descrito hace más de 70 años como un problema frecuente. En México se reportan cifras de entre el 20% al 50%; sin embargo no se ha estudiado su prevalencia ni su asociación con la morbilidad y mortalidad hospitalaria.Objetivos: evaluar el estado nutricional y su relación con la morbimortalidad hospitalaria en pacientes mexicanos.Métodos: cohorte prospectiva de pacientes que ingresaron en un hospital de referencia para una estancia hospitalaria mayor de 5 días. Se capturó peso, talla, índice de masa corporal (IMC), estado nutricional de acuerdo con la valoración global subjetiva (VGS) a su ingreso y egreso hospitalario, así como diagnóstico médico, complicaciones y mortalidad. Los datos fueron analizados mediante la prueba T de Student, prueba Chi-cuadrado y prueba Exacta de Fisher.Resultados: se incluyeron 610 pacientes en total, con un promedio de edad de 50,8 ± 17,32 años, 267 mujeres (43,8%) y 343 hombres (56,2%). Del total, 154 fueron catalogados con sospecha de desnutrición o desnutrición (pacientes expuestos, 25,2%) y 456 bien nutridos (pacientes no expuestos, 74,8%), con una relación de 1 a 3. La morbilidad total de la cohorte tuvo un RR = 2,70, IC 95 % (2,06-3,55) y la mortalidad con un RR = 2,64, IC 95% (1,74-4,0), siendo ambas estadísticamente significativas (p = 0,001).Conclusiones: el diagnóstico de desnutrición al ingreso hospitalario constituye un factor de riesgo para el desarrollo de complicaciones y mortalidad. Este padecimiento al ingreso en comparación con el paciente que no presenta desnutrición incrementó el riesgo de mortalidad hasta en 2.64 veces.

[Not Available].

PubMed

Chivu, Elena Cristina; Artero-Fullana, Ana; Alfonso García, Antonio; Sánchez Juan, Carlos

2016-07-19

Introducción: conociendo la elevada prevalencia de la desnutrición hospitalaria, se hace necesaria su detección precoz. Cuando, por diversos motivos, no es posible realizar una valoración completa del estado nutricional, se recomienda el empleo de herramientas validadas de cribado nutricional. Estas ayudarían a detectar de forma rápida a aquellos pacientes que necesiten de un tratamiento nutricional.Objetivos: determinar la prevalencia del riesgo de desnutrición, en el Hospital General Universitario de Valencia, empleando para ello la herramienta de cribado nutricional HEMAN y comprobar si la implementación de esta herramienta en la práctica clínica, sería lo más adecuado.Métodos: estudio transversal, realizado sobre una muestra de 1.099 pacientes ingresados en un hospital terciario. A todos ellos se les realizó el cribado nutricional HEMAN a las 24-48 horas del ingreso. Las variables cualitativas se compararon mediante Chi-cuadrado, y las cuantitativas mediante el test t de Student.Resultados: la prevalencia del riesgo de desnutrición fue del 33,5%. Los pacientes que resultaron positivos en el cribado (HEMAN ≥ 3), tenían mayor edad que los pacientes normonutridos, referían pérdidas de peso entre el 5-10%, el 55,2% disminuyó su ingesta a menos del 50% de la habitual. Además, ingresaron con patologías consideradas de leves a moderadas. La utilización del método HEMAN como herramienta de cribado, resultó ser práctica y efectiva, y ayudó a disminuir el tiempo empleado con cada paciente encuestado evaluado.Conclusiones: se detectó una elevada prevalencia de riesgo de desnutrición entre los pacientes evaluados, por lo tanto se hace imprescindible la utilización de métodos de cribado nutricional en la rutina diaria del hospital, para ello recomendamos especialmente la utilización del método HEMAN.

PubMed

De Abajo Larriba, Ana Beatriz; Méndez Rodríguez, Enrique; González-Gallego, Javier; Capón Álvarez, Jessica; Díaz Rodríguez, Ángel; Peleteiro Cobo, Beatriz; Mahmoud Atoui, Omar; De Abajo Olea, Serafín; Martínez de Mandojana Hernández, Juan; Lumbreras González, Víctor

2016-11-29

Objetivos: estimar el porcentaje de pacientes con EPOC adiestrados en la consulta para el manejo de inhaladores en la provincia de León.Métodos: estudio epidemiológico, transversal, multicéntrico (30 centros de salud de la provincia de León). Incluyó pacientes mayores de 35 años diagnosticados y tratados de EPOC. Variables a estudio: edad, sexo, hábitat, datos antropométricos, estado nutricional, tabaquismo, espirometría postboroncodilatadora, disnea (mMRC), reagudizaciones, gravedad (Índice Bodex), hospitalizaciones, tratamiento, seguimiento y caracterización del fenotipo (GesEOPC 2014). Los resultados se expresan con sus IC al 95,5%.Resultados: se incluyeron 833 pacientes, el 85,8% varones, con edad media de 64,69 (53,66-75,61) años y 20,65 (4,47-36,8) años evolución de la EPOC. Empleaban 1,88 (1,64-2,16) dispositivos inhaladores de media, p = 0,006, (57% de forma correcta, 23% regular y el 20% incorrecta). El 20,9% no recibieron adiestramiento para usar inhaladores frente al 79,1% adiestrados, p < 0,001, (9,4% por neumólogos, 20,3% enfermeras y 43,5% médicos familia, p = 0,002). Los pacientes bien adiestrados realizan mejor el tratamiento, en el 60,60% (58,91-62,29), p = 0,002. No hubo diferencias significativas en el adiestramiento por tabaquismo, gravedad, ingresos hospitalarios, ni calidad de vida, obteniendo una reducción significativa del número de agudizaciones, siendo de 1,59 (1,12-2,15) reagudizaciones medias en el grupo adiestrado frente a 3,29 (2,50-4,11) en los no adiestrados, p = 0,002.Conclusiones: el nivel de adiestramiento en el uso de inhaladores en los pacientes con EPOC es insuficiente en nuestro medio. La mejor formación de los profesionales y la simplificación de los dispositivos contribuirán a que un mayor número de pacientes realicen el tratamiento de forma adecuada.

Instruments used in the assessment of expectation toward a spine surgery: an integrative review.

PubMed

Nepomuceno, Eliane; Silveira, Renata Cristina de Campos Pereira; Dessotte, Carina Aparecida Marosti; Furuya, Rejane Kiyomi; Arantes, Eliana De Cássia; Cunha, Débora Cristine Prévide Teixeira da; Dantas, Rosana Aparecida Spadoti

2016-01-01

To identify and describe the instruments used to assess patients' expectations toward spine surgery. An integrative review was carried out in the databases PubMed, CINAHL, LILACS and PsycINFO. A total of 4,402 publications were identified, of which 25 met the selection criteria. Of the studies selected, only three used tools that had confirmed validity and reliability to be applied; in five studies, clinical scores were used, and were modified for the assessment of patients' expectations, and in 17 studies the researchers developed scales without an adequate description of the method used for their development and validation. The assessment of patients' expectations has been methodologically conducted in different ways. Until the completion of this integrative review, only two valid and reliable instruments had been used in three of the selected studies. Identificar e descrever os instrumentos usados para avaliar a expectativa dos pacientes diante do tratamento cirúrgico da coluna vertebral. Revisão Integrativa realizada nas bases de dados PubMed, CINAHL, LILACS e PsycINFO. Identificamos 4.402 publicações, das quais 25 atenderam aos critérios de seleção. Dos estudos selecionados, apenas em três os autores utilizaram instrumentos que possuíam validade e confiabilidade confirmadas para serem aplicados; em cinco estudos foram utilizados escores clínicos, modificados para a avaliação das expectativas dos pacientes, e em dezessete os pesquisadores elaboraram escalas sem adequada descrição do método usado para o seu desenvolvimento e validação. A avaliação das expectativas dos pacientes tem sido metodologicamente conduzida de diferentes maneiras. Até a finalização desta revisão integrativa, apenas dois instrumentos, válidos e confiáveis, haviam sido utilizados em três dos estudos selecionados.

Assessment scale of risk for surgical positioning injuries.

PubMed

Lopes, Camila Mendonça de Moraes; Haas, Vanderlei José; Dantas, Rosana Aparecida Spadoti; Oliveira, Cheila Gonçalves de; Galvão, Cristina Maria

2016-08-29

to build and validate a scale to assess the risk of surgical positioning injuries in adult patients. methodological research, conducted in two phases: construction and face and content validation of the scale and field research, involving 115 patients. the Risk Assessment Scale for the Development of Injuries due to Surgical Positioning contains seven items, each of which presents five subitems. The scale score ranges between seven and 35 points in which, the higher the score, the higher the patient's risk. The Content Validity Index of the scale corresponded to 0.88. The application of Student's t-test for equality of means revealed the concurrent criterion validity between the scores on the Braden scale and the constructed scale. To assess the predictive criterion validity, the association was tested between the presence of pain deriving from surgical positioning and the development of pressure ulcer, using the score on the Risk Assessment Scale for the Development of Injuries due to Surgical Positioning (p<0.001). The interrater reliability was verified using the intraclass correlation coefficient, equal to 0.99 (p<0.001). the scale is a valid and reliable tool, but further research is needed to assess its use in clinical practice. construir e validar escala de avaliação de risco para lesões decorrentes do posicionamento cirúrgico em pacientes adultos. pesquisa metodológica, conduzida em duas etapas: construção e validação de face e de conteúdo da escala e pesquisa de campo, com a participação de 115 pacientes. a Escala de Avaliação de Risco para o Desenvolvimento de Lesões Decorrentes do Posicionamento Cirúrgico contém sete itens, sendo que cada um apresenta cinco subitens. A pontuação dessa escala varia de sete a 35 pontos, quanto maior o escore maior o risco do paciente. O Índice de Validade de Conteúdo da escala foi de 0,88. Por meio da aplicação do teste t de Student, para igualdade de médias, constatou-se validade de crit

Family caregiver burden: the burden of caring for lung cancer patients according to the cancer stage and patient quality of life.

PubMed

Borges, Eliana Lourenço; Franceschini, Juliana; Costa, Luiza Helena Degani; Fernandes, Ana Luisa Godoy; Jamnik, Sérgio; Santoro, Ilka Lopes

2017-01-01

Patients with lung cancer experience different feelings and reactions, based on their family, social, cultural, and religious backgrounds, which are a source of great distress, not only for the patients but also for their family caregivers. This study aimed to evaluate the impact that lung cancer stage and quality of life (QoL) of lung cancer patients have on caregiver burden. This was a prospective cross-sectional study. Consecutive patient-caregiver dyads were selected and asked to complete the Hospital Anxiety and Depression Scale and the Medical Outcomes Study 36-item ShortForm Health Survey (SF-36). Family caregivers also completed the Caregiver Burden Scale. Group-based modeling was used in order to identify patients with early- or advanced-stage cancer (IA to IIIA vs. IIIB to IV) plus non-impaired or impaired QoL (SF36 total score > 50 vs. ≤ 50). Patient-caregiver dyads were stratified into four groups: early-stage cancer+non-impaired QoL; advanced-stage cancer+non-impaired QoL; early-stage cancer+impaired QoL; and advanced-stage cancer+impaired QoL. We included 91 patient-caregiver dyads. The majority of the patients were male and heavy smokers. Family caregivers were younger and predominantly female. The burden, QoL, level of anxiety, and level of depression of caregivers were more affected by the QoL of the patients than by their lung cancer stage. The family caregivers of the patients with impaired QoL showed a higher median burden than did those of the patients with non-impaired QoL, regardless of disease stage. Caregiver burden is more affected by patient QoL than by lung cancer stage. Pacientes com câncer de pulmão vivenciam diferentes sentimentos e reações, dependendo de sua formação familiar, social, cultural e religiosa, que são fonte de grande sofrimento, não só para os pacientes mas também para seus cuidadores familiares. Este estudo objetivou avaliar o impacto do estágio do câncer de pulmão e da qualidade de vida (QV) dos

[Not Available].

PubMed

Fort Casamartina, Eduard; Arribas Hortiguela, Lorena; Bleda Pérez, Carmen; Muñoz Sánchez, Carme; Peiro Martínez, Imma; Perayre Badía, María; Clopés Estela, Ana

2016-06-03

Durante la última década, el conocimiento de nuevos mecanismos implicados en el desarrollo del cáncer ha permitido el diseño de nuevos fármacos para su tratamiento y la mayor parte de ellos son fármacos que se administran por vía oral. Uno de los principales problemas de los pacientes oncohematológicos es la desnutrición, que suele tener causas multifactoriales (de la propia enfermedad, de los pacientes y de los diferentes tratamientos administrados). Para minimizar el impacto de la desnutrición es necesaria una intervención nutricional, ya sea adaptando la dieta o mediante la instauración de soporte nutricional artificial, en función de la gravedad de cada caso. En cualquier paciente que esté recibiendo un tratamiento oncológico hay que evaluar las posibles interacciones que pueden existir con el soporte nutricional instaurado, ya sea dieta oral, suplementación oral o nutrición enteral. Estas interacciones pueden disminuir la eficacia, aumentar la toxicidad de los tratamientos o producir déficits nutricionales. Se detallan las principales interacciones que se pueden producir, las interacciones entre los tratamientos oncológicos y el soporte nutricional.

[Not Available].

PubMed

Torres Díaz, Cristina V; Martín Peña, Gonzalo; Ezquiaga, Elena; Navas García, Marta; García de Sola, Rafael

2016-07-19

Gracias a los avances técnicos en técnicas neuroquirúrgicas, y debido a que el diagnóstico y la clasificación de las enfermedades psiquiátricas han evolucionado significativamente a lo largo de las últimas décadas, se están desarrollando tratamientos a nivel experimental para aquellos pacientes resistentes al manejo conservador.La anorexia nerviosa es una enfermedad de prevalencia creciente, con la tasa de mortalidad más elevada dentro de los trastornos psiquiátricos, y con aproximadamente un 20% de pacientes que presentan una evolución tórpida. Para estos pacientes que no responden a manejo conservador, la estimulación cerebral profunda ha surgido como una alternativa terapéutica, si bien la literatura especializada al respecto es escasa.A continuación presentamos una revisión de la fisiopatología de la anorexia nerviosa, así como de los distintos tratamientos neuroquirúrgicos realizados a lo largo de la historia. Se detalla la perspectiva de tratamiento quirúrgico actual, así como los aspectos éticos que se han de considerar en relación con el surgimiento de estas nuevas terapias.

Producing and quantifying enriched para-H2.

PubMed

Tom, Brian A; Bhasker, Siddhartha; Miyamoto, Yuki; Momose, Takamasa; McCall, Benjamin J

2009-01-01

The production of enriched para-H(2) is useful for many scientific applications, but the technology for producing and measuring para-H(2) is not yet widespread. In this note and in the accompanying auxiliary material, we describe the design, construction, and use of a versatile standalone converter that is capable of producing para-H(2) enrichments of up to > or = 99.99% at continuous flow rates of up to 0.4 SLM. We also discuss para-H(2) storage and back conversion rates, and improvements to three techniques (thermal conductance, NMR, and solid hydrogen impurity spectroscopy) used to quantify the para-H(2) enrichment.

CORRELATION OF NON-ALCOHOLIC FATTY LIVER DISEASE AND FEATURES OF METABOLIC SYNDROME IN MORBIDLY OBESE PATIENTS IN THE PREOPERATIVE ASSESSMENT FOR BARIATRIC SURGERY.

PubMed

Barros, Fernando de; Setúbal, Sergio; Martinho, José Manoel; Ferraz, Loraine; Gaudêncio, Andressa

2016-01-01

Obesity is an epidemic and chronic disease that can bring other comorbidities to the patient. Non-alcoholic fatty liver disease is present in up to 90% of these patients and can progress to hepatitis and hepatocarcinoma. The relationship of this liver disease and obesity is already well known; however, it is possible that some parameters of the comorbidities are more related than others in the pathophysiology of the disease. Was analyzed the relationship between non-alcoholic fatty liver disease (NAFLD) and the comorbidities of metabolic syndrome in morbidly obese patients. Was involved ultrasonography and laboratory assessment of obese patients before bariatric surgery. NAFLD was assessed using the same sonography parameters for all patients. Based on the results, the patients were divided into groups with and without NAFLD. Comparisons between them involved clinical and laboratory variables such as fasting blood glucose, insulin, HOMA-IR (homeostasis model assessment - insulin resistance), glycated hemoglobin, total cholesterol and fractions, triglycerides, alanine aminotransferase, aspartate aminotransferase, gamma glutamyl transferase, C-reactive protein, albumin and ferritin. Patients who reported alcohol abuse (defined as the consumption of >14 drinks per week) or who had hepatitis were excluded. Eighty-two patients (74 women and 8 men) were studied, of whom 53 (64.6%) had NAFLD and 29 (35.4%) did not. The levels of glycated hemoglobin (p=0.05) and LDL cholesterol (p=0.01) were significantly altered in patients with NAFLD. However, weight, body mass index and excess weight did not differ significantly between the groups (p=0.835, p=0.488 and p=0.727, respectively). Altered LDL cholesterol and glycated hemoglobin levels were related to the presence of NAFLD. A obesidade é doença epidêmica e crônica que pode trazer outras comorbidades ao paciente. A doença hepática gordurosa não alcoólica está presente em até 90% desses pacientes e pode evoluir para

Ortho-para-hydrogen equilibration on Jupiter

NASA Technical Reports Server (NTRS)

Carlson, Barbara E.; Lacis, Andrew A.; Rossow, William B.

1992-01-01

Voyager IRIS observations reveal that the Jovian para-hydrogen fraction is not in thermodynamic equilibrium near the NH3 cloud top, implying that a vertical gradient exists between the high-temperature equilibrium value of 0.25 at depth and the cloud top values. The height-dependent para-hydrogen profile is obtained using an anisotropic multiple-scattering radiative transfer model. A vertical correlation is found to exist between the location of the para-hydrogen gradient and the NH3 cloud, strongly suggesting that paramagnetic conversion on NH3 cloud particle surfaces is the dominant equilibration mechanism. Below the NH3 cloud layer, the para fraction is constant with depth and equal to the high-temperature equilibrium value of 0.25. The degree of cloud-top equilibration appears to depend on the optical depth of the NH3 cloud layer. Belt-zone variations in the para-hydrogen profile seem to be due to differences in the strength of the vertical mixing.

PubMed

Contreras, Kateir; Vargas, María José; García, Paola; González, Camilo A; Rodríguez, Patricia; Castañeda-Cardona, Camilo; Otálora-Esteban, Margarita; Rosselli, Diego

2018-03-15

Introducción. El citomegalovirus es la causa más frecuente de infección en pacientes con trasplante renal. Existen dos estrategias de similar efectividad para prevenirlo: la profilaxis universal con valganciclovir durante 90 días o el tratamiento anticipado verificando la carga viral semanal y aplicándolo solo si esta es positiva.Objetivo. Determinar cuál de estas dos estrategias sería más costo-efectiva en pacientes de riesgo intermedio en Colombia.Materiales y métodos. Se diseñó un árbol de decisiones bajo la perspectiva del tercer pagador considerando únicamente los costos médicos directos en pesos colombianos (COP) del 2014 durante un periodo de un año en una población de pacientes con riesgo intermedio para citomegalovirus (donante positivo y receptor positivo, o donante negativo y receptor positivo). Las probabilidades de transición se extrajeron de los estudios clínicos y se validaron con expertos mediante el método Delphi.Los costos de los procedimientos se basaron en el manual tarifario ISS 2001, con un incremento del 33 % a partir del índice de precios al consumidor (IPC) en salud de 2014, en tanto que los de los medicamentos se extrajeron de las circulares del Ministerio de Salud y del Sistema de Información de Medicamentos (Sismed).Resultados. La profilaxis universal con valganciclovir resultó ser menos costosa y se asoció con una menor probabilidad de infección. El costo promedio del primer año de tratamiento anticipado sería de COP$ 30'961.290, mientras que el universal sería de COP$ 29'967.834, es decir, un costo 'incremental' de COP$ 993.456.Conclusiones. Para los pacientes de riesgo intermedio con trasplante renal en Colombia, la profilaxis universal es la mejor estrategia por ser menos costosa y reducir el riesgo de infección.

Patient safety in organizational culture as perceived by leaderships of hospital institutions with different types of administration.

PubMed

Silva, Natasha Dejigov Monteiro da; Barbosa, Antonio Pires; Padilha, Kátia Grillo; Malik, Ana Maria

2016-01-01

To identify the perceptions of leaderships toward patient safety culture dimensions in the routine of hospitals with different administrative profiles: government, social and private organizations, and make correlations among participating institutions regarding dimensions of patient safety culture used. A quantitative cross-sectional study that used the Self Assessment Questionnaire 30 translated into Portuguese. The data were processed by analysis of variance (ANOVA) in addition to descriptive statistics, with statistical significance set at p-value ≤ 0.05. According to the participants' perceptions, the significant dimensions of patient safety culture were 'patient safety climate' and 'organizational learning', with 81% explanatory power. Mean scores showed that among private organizations, higher values were attributed to statements; however, the correlation between dimensions was stronger among government hospitals. Different hospital organizations present distinct values for each dimension of patient safety culture and their investigation enables professionals to identify which dimensions need to be introduced or improved to increase patient safety. Identificar percepções das lideranças sobre as dimensões da cultura de segurança do paciente no cotidiano de hospitais de diferentes perfis administrativos: públicos, organizações sociais e privados, e realizar correlação entre as instituições participantes, de acordo com as dimensões da cultura de segurança do paciente utilizadas. Estudo transversal de aspecto quantitativo obtido por meio da aplicação do instrumento Self Assessment Questionnaire 30, traduzido para a língua portuguesa. Os dados foram tratados com análise de variância (ANOVA), além das estatísticas descritivas, considerando como de significância estatística valores de p-valor ≤ 0,05. Segundo a percepção dos participantes do estudo, as dimensões significativas para a cultura de segurança do paciente foram Ambiente de

Comunicación de pareja y VIH en mujeres en desventaja social

PubMed Central

Rosina Cianelli, A.; Lilian Ferrer, L.; Margarita Bernales, S.; Natalia Villegas, R.

2009-01-01

Introducción La epidemia de VIH y SIDA se ha diseminado rápidamente a nivel mundial tendiendo a la feminización, pauperización y heterosexualización. La comunicación de pareja en torno el VIH es descrita como uno de los factores protectores en la adquisición de esta enfermedad, favoreciendo la adopción de conductas sexuales seguras tales como la negociación de pareja y la utilización de preservativo, consideróndose como un pilar fundamental en la incorporación de medidas de autocuidado en la sexualidad femenina. Objetivo Determinar el nivel de comunicación de pareja en torno al VIH en mujeres chilenas en desventaja social. Metodología Cuatrocientas noventa y seis mujeres contestaron la entrevista inicial de la investigación “Testing an HIV/AIDS Prevention Intervention for Chilean Women” (RO1 TW 006977 PI Cianelli). Se utilizó la escala “Health protective sexual communication scale (HPC)” (0–10 puntos). Se realizó un análisis descriptivo utilizando el programa SPSS 16.0. Resultados El promedio del nivel de comunicación de pareja fue de 3,26 ± 2,7 puntos con la pareja principal, de 2,52 ± 2,48 puntos con una segunda pareja y de 0 puntos con una tercera pareja. Los temas de menor comunicación entre las parejas fueron el uso de preservativo y la realización del test para VIH antes de tener relaciones sexuales. Conclusión Las mujeres de la muestra presentan bajos niveles de comunicación de pareja en relación a VIH con todas sus parejas sexuales. Son necesarias estrategias que potencien este tópico dentro de las intervenciones de prevención de VIH y SIDA de manera de fortalecer la adopción de conductas de autocuidado en torno al tema. PMID:19936328

Reliability and construct validity of the Instrument to Measure the Impact of Valve Heart Disease on the Patient's Daily Life.

PubMed

Anjos, Daniela Brianne Martins Dos; Rodrigues, Roberta Cunha Matheus; Padilha, Kátia Melissa; Pedrosa, Rafaela Batista Dos Santos; Gallani, Maria Cecília Bueno Jayme

2016-12-19

evaluate the practicality, acceptability and the floor and ceiling effects, estimate the reliability and verify the convergent construct's validity with the instrument called the Heart Valve Disease Impact on daily life (IDCV) of the valve disease in patients with mitral and or aortic heart valve disease. data was obtained from 86 heart valve disease patients through 3 phases: a face to face interview for a socio-demographic and clinic characterization and then other two done through phone calls of the interviewed patients for application of the instrument (test and repeat test). as for the practicality and acceptability, the instrument was applied with an average time of 9,9 minutes and with 110% of responses, respectively. Ceiling and floor effects observed for all domains, especially floor effect. Reliability was tested using the test - repeating pattern to give evidence of temporal stability of the measurement. Significant negative correlations with moderate to strong magnitude were found between the score of the generic question about the impact of the disease and the scores of IDCV, which points to the validity of the instrument convergent construct. the instrument to measure the impact of valve heart disease on the patient's daily life showed evidence of reliability and validity when applied to patients with heart valve disease. avaliar a praticabilidade, aceitabilidade e os efeitos teto e chão, estimar a confiabilidade e verificar a validade de construto convergente do Instrumento para Mensuração do Impacto da Doença no Cotidiano do Valvopata em pacientes com valvopatia mitral e/ou aórtica. dados foram obtidos junto a 86 pacientes valvopatas por meio de três etapas: uma entrevista presencial para caracterização sociodemográfica e clínica e as duas outras realizadas por meio de contato telefônico para as aplicações do instrumento (Teste e teste de repetição). quanto à praticabilidade e aceitabilidade, o instrumento foi aplicado com tempo m

Tiempo para un cambio

NASA Astrophysics Data System (ADS)

Woltjer, L.

1987-06-01

En la reunion celebrada en diciembre dei ano pasado informe al Consejo de mi deseo de terminar mi contrato como Director General de la ESO una vez que fuera aprobado el proyecto dei VLT, que se espera sucedera hacia fines de este aAo. Cuando fue renovada mi designacion hace tres aAos, el Consejo conocia mi intencion de no completar los cinco aAos dei contrato debido a mi deseo de disponer de mas tiempo para otras actividades. Ahora, una vez terminada la fase preparatoria para el VLT, Y habiendose presentado el proyecto formalmente al Consejo el dia 31 de marzo, y esperando su muy probable aprobacion antes dei termino de este ano, me parece que el 10 de enero de 1988 presenta una excelente fecha para que se produzca un cambio en la administracion de la ESO.

[What can doctors do to moderate healthcare costs?

PubMed

Lifshitz, Alberto; Celis, Miguel Ángel; Moreno, Mucio; Gas, Héctor Aguirre; Halabe, José; Jasso, Luis; Arrieta, Óscar; Burgos, Rubén; Campillo, Carlos; de la Llata, Manuel; Domínguez, Judith; Islas, Sergio; Plancarte, Ricardo; Reyes, Alejandro; Soda, Antonio; Verásteguio, Emma; Sotelo, Julio

Los costos de la atención médica pueden alcanzar niveles tales que marginen a algunos pacientes de los beneficios del avance científico y tecnológico. Las razones de estos elevados costos son diversas y en la mayoría de los casos no está en manos de los médicos moderarlos. En este escrito se proponen algunas acciones que los médicos podemos realizar para disminuir los costos de la atención médica. La magnitud del ahorro que se puede alcanzar con estas medidas es modesta, puesto que la mayor parte de los costos no dependen de los médicos, pero se trata de ofrecer nuestra contribución. Evitar todo lo superfluo: no más medicamentos ni estudios que los estrictamente necesarios, sin medicina defensiva; y no ceder ante la presión de pacientes y familiares para que se prescriban pruebas o medicamentos inútiles.

Nonclassical and semiclassical para-Bose states

NASA Astrophysics Data System (ADS)

Huerta Alderete, C.; Villanueva Vergara, Liliana; Rodríguez-Lara, B. M.

2017-04-01

Motivated by the proposal to simulate para-Bose oscillators in a trapped-ion setup [C. Huerta Alderete and B. M. Rodríguez-Lara, Phys. Rev. A 95, 013820 (2017), 10.1103/PhysRevA.95.013820], we introduce an overcomplete, nonorthogonal basis for para-Bose Hilbert spaces. The states spanning these bases can be experimentally realized in the trapped-ion simulation via time evolution. The para-Bose states show both nonclassical and semiclassical statistics on their Fock state distribution, asymmetric field quadrature variances, and do not minimize the uncertainty relation for the field quadratures. These properties are analytically controlled by the para-Bose order and the evolution time; both parameters might be feasible for fine tuning in the trapped-ion quantum simulation.

Syntax Score and Major Adverse Cardiac Events in Patients with Suspected Coronary Artery Disease: Results from a Cohort Study in a University-Affiliated Hospital in Southern Brazil.

PubMed

Fuchs, Felipe C; Ribeiro, Jorge P; Fuchs, Flávio D; Wainstein, Marco V; Bergoli, Luis C; Wainstein, Rodrigo V; Zen, Vanessa; Kerkhoff, Alessandra C; Moreira, Leila B; Fuchs, Sandra C

2016-09-01

sistema de escore que estima a extensão anatômica da doença arterial coronariana (DAC). Sua capacidade para predizer desfechos com base na cineangiocoronariografia diagnóstica de base ainda não foi testada. Avaliar o desempenho do SXescore para predizer eventos cardíacos adversos maiores (MACE) em pacientes encaminhados para cineangiocoronariografia diagnóstica. Coorte prospectiva de 895 pacientes com suspeita de DAC encaminhados para cineangiocoronariografia diagnóstica eletiva de 2008 a 2011, em hospital universitário no Brasil. Os pacientes tiveram seus SXescores calculados e foram estratificados em três categorias: 'sem DAC significativa' (n = 495); SXescoreBAIXO-INTERMEDIÁRIO: < 23 (n = 346); e SXescoreALTO: ≥ 23 (n = 54). O desfecho primário foi composto de morte cardíaca, infarto do miocárdio e revascularização tardia. Os desfechos secundários foram MACE e morte por todas as causas. Em média, os pacientes foram acompanhados por 1,8 ± 1,4 anos. Desfecho primário ocorreu em 2,2%, 15,3% e 20,4% nos grupos 'sem DAC significativa', SXescoreBAIXO-INTERMEDIÁRIO e SXescoreALTO, respectivamente (p < 0,001). Morte por todas as causas foi significativamente mais frequente no grupo de SXescoreALTO comparado ao grupo 'sem DAC significativa', 16,7% e 3,8% (p < 0,001), respectivamente. Após ajuste para fatores de confusão, todos os desfechos permaneceram associados com o SXescore. O SXescore prediz independentemente MACE em pacientes submetidos a cineangiocoronariografia diagnóstica. Seu uso rotineiro nesse contexto poderia identificar pacientes de pior prognóstico.

Nursing care missed in patients at risk of or having pressure ulcers.

PubMed

Valles, Jonathan Hermayn Hernández; Monsiváis, María Guadalupe Moreno; Guzmán, Ma Guadalupe Interial; Arreola, Leticia Vázquez

2016-11-21

to determine the nursing care missed as perceived by the nursing staff and its relation with the nursing care missed identified in the assessment of patients at risk of or having pressur ulcers. descriptive correlation study. The participants were 161 nurses and 483 patients from a public hospital. The MISSCARE survey was used in combination with a Nursing Care Assessment Form for Patients at Risk of or having pressure ulcers. For the analysis, descriptive and inferential statistics were used. the nursing staff indicated greater omission in skin care (38.5%), position change (31.1%) and the registration of risk factors for the development of pressure ulcers (33.5%). The nursing care missed identified in the assessment related to the use of pressure relief on bony prominences and drainage tubes interfering in the patient's movements (both with 58.6%) and the use of pneumatic mattresses (57.6%). a high percentage of nursing care missed was found according to the staff's perception. Nevertheless, the assessment of the nursing care missed was much higher. No significant relation was found between both. Therefore, it is a priority to reflect on the importance of objective patient assessments. determinar o cuidado de enfermagem omitido percebido pela equipe de enfermagem e sua relação com o cuidado omitido identificado na avaliação de pacientes com risco ou com de úlceras por pressão. estudo descritivo correlacional. Participaram 161 enfermeiras e 483 pacientes de um hospital público. Foram utilizados o levantamento MISSCARE e um Formulário de Avaliação de Cuidados de Enfermagem em Pacientes com Risco ou com úlceras por pressão. Para a análise foi utilizada estatística descritiva e inferencial. a equipe de enfermagem assinalou que há maior omissão no cuidado da pele (38,5%), reposicionamento (31,1%) e no registro de fatores de risco para o aparecimento de úlceras por pressão (33,5%). Os cuidados de enfermagem omitidos identificados na avaliação foram

Incidence and factors related to delirium in an intensive care unit.

PubMed

Mori, Satomi; Takeda, Juliana Rumy Tsuchihashi; Carrara, Fernanda Souza Angotti; Cohrs, Cibelli Rizzo; Zanei, Suely Sueko Viski; Whitaker, Iveth Yamaguchi

2016-01-01

To identify the incidence of delirium, compare the demographic and clinical characteristics of patients with and without delirium, and verify factors related to delirium in critical care patients. Prospective cohort with a sample made up of patients hospitalized in the Intensive Care Unit (ICU) of a university hospital. Demographic, clinical variables and evaluation with the Confusion Assessment Method for Intensive Care Unit to identify delirium were processed to the univariate analysis and logistic regression to identify factors related to the occurrence of delirium. Of the total 149 patients in the sample, 69 (46.3%) presented delirium during ICU stay, whose mean age, severity of illness and length of ICU stay were statistically higher. The factors related to delirium were: age, midazolam, morphine and propofol. Results showed high incidence of ICU delirium associated with older age, use of sedatives and analgesics, emphasizing the need for relevant nursing care to prevent and identify early, patients presenting these characteristics. Identificar a incidência de delirium, comparar as características demográficas e clínicas dos pacientes com e sem delirium e verificar os fatores relacionados ao delirium em pacientes internados em Unidade de Terapia Intensiva (UTI). Coorte prospectiva, cuja amostra foi constituída de pacientes internados em UTI de um hospital universitário. Variáveis demográficas, clínicas e da avaliação com o Confusion Assessment Method for Intensive Care Unit para identificação de delirium foram processadas para análise univariada, e regressão logística para identificar fatores relacionados à ocorrência do delirium. Do total de 149 pacientes da amostra, 69 (46,3%) apresentaram delirium durante a internação na UTI, observando-se que a média da idade, o índice de gravidade e o tempo de permanência nas UTI foram estatisticamente maiores. Os fatores relacionados ao delirium foram: idade, midazolam, morfina e propofol. Os

Effectiveness of a nursing intervention in decreasing the anxiety levels of family members of patients undergoing cardiac surgery: a randomized clinical trial.

PubMed

Hamester, Letícia; Souza, Emiliane Nogueira de; Cielo, Cibele; Moraes, Maria Antonieta; Pellanda, Lúcia Campos

2016-08-15

ário IDATE. foram incluídos 210 sujeitos, 105 em cada grupo, com idade média de 46,4±14,5 anos, sendo 69% do sexo feminino e 41% filhos dos pacientes. Na avaliação da ansiedade, o escore médio para o grupo intervenção foi de 41,3±8,6 pontos e, para o grupo controle, 50,6±9,4 pontos (p<0,001). a intervenção de enfermagem voltada à orientação de familiares, no momento que antecede a primeira visita no pós-operatório imediato de cirurgia cardíaca, contribui para possível redução da ansiedade dos acompanhantes, contribuindo para que se sintam mais preparados para esse momento. Registro Brasileiro de Ensaios Clínicos (ReBEC) e The Universal Trial Number (UTN), sob o número U1111-1145-6172. verificar la efectividad de las orientaciones de enfermería - dadas a familiares de pacientes en el posoperatorio inmediato de cirugía cardíaca, antes de la primera visita, en la sala de recuperación postanestésica - en los niveles de ansiedad, comparados con la orientación de rutina de la unidad. ensayo clínico aleatorio, realizado con familiares abordados en la sala de espera, antes de la primera visita en el posoperatorio inmediato. Familiares designados para el grupo intervención recibieron orientaciones audiovisuales sobre las condiciones en que el paciente se encontraba en aquel momento, y el grupo control recibió las orientaciones de rutina de la unidad. El resultado ansiedad fue evaluado por el inventario IDATE. fueron incluidos 210 sujetos, 105 en cada grupo, con edad promedio de 46,4±14,5 años, siendo 69% del sexo femenino y 41% eran hijos de los pacientes. En la evaluación de la ansiedad, el puntaje promedio para el grupo intervención fue de 41,3±8,6 puntos y, para el grupo control, 50,6±9,4 puntos (p<0,001). la intervención de enfermería dirigida a orientar a familiares, en el momento que antecede a la primera visita en el posoperatorio inmediato de cirugía cardíaca, induce una posible reducción de la ansiedad de los acompa

Angiolymphatic invasion as a prognostic fator in resected N0 pancreatic adenocarcinoma.

PubMed

Almeida, Ricardo Vitor Silva de; Pacheco, Adhemar Monteiro; Silva, Rodrigo Altenfelder; Moricz, André de; Campos, Tércio de

2017-01-01

Pancreatic adenocarcinoma remains one of the worst digestive cancers. Surgical resection is the main target when treating a patient with curative intent. To assess angiolymphatic invasion as a prognostic factor in resected pN0 pancreatic cancer. Thirty-eight patients were submitted to pancreatoduodenectomy due to head pancreatic cancer. Tumor size, margins, lymph nodes, pTNM staging, angiolymphatic and perineural invasion were described in the pathologists' reports. Most patients were female. Overall median survival was 13 months. Gemcitabine was the regimen of choice for chemotherapy in selected patients; however, it did not improve overall survival. pR0 resection had better survival compared with pR1. Within the pN0 group, survival was significantly better in patients without angiolymphatic invasion. Angiolymphatic invasion in N0 pancreatoduodenectomy can be demonstrated by the Hematoxylin-Eosin stain and may predict a poor prognosis factor for those patients. Adenocarcinoma pancreático continua sendo um dos piores cânceres do aparelho digestivo. A ressecção cirúrgica é o principal objetivo quando se trata de intenção curativa. Avaliar a invasão angiolinfática como um fator prognóstico no câncer da cabeça do pâncreas ressecado pN0. Trinta e oito pacientes foram submetidos a duodenopancreatectomia por câncer da cabeça do pâncreas. Tamanho do tumor, margens, linfonodos, estadiamento pTNM, invasão angiolinfática e perineural foram descritos nos laudos anatomopatológicos. A maioria foi de mulheres. A sobrevida mediana global foi de 13 meses. Gencitabina foi a droga de escolha para quimioterapia nos pacientes selecionados, entretanto não aumentou a sobrevida global. Pacientes com ressecção pR0 tiveram sobrevida global superior quando comparados com ressecção pR1. Dentro do grupo de pacientes com pN0, a sobrevida foi significativamente melhor no grupo de pacientes que não apresentavam invasão angiolinfática. A invasão angiolinfática da

The para-HK/QK correspondence

NASA Astrophysics Data System (ADS)

Dyckmanns, Malte; Vaughan, Owen

2017-06-01

We generalise the hyper-Kähler/quaternionic Kähler (HK/QK) correspondence to include para-geometries, and present a new concise proof that the target manifold of the HK/QK correspondence is quaternionic Kähler. As an application, we construct one-parameter deformations of the temporal and Euclidean supergravity c-map metrics and show that they are para-quaternionic Kähler.

PubMed

Alvarez Padilla, Facundo Nicolás; Schiavoni, Emiliano Nestor; Bustos, Mario Eduardo Francisco

2018-04-20

INTRODUCCIONEl derrame pleural neoplásico (DPN) implica una enfermedad oncológica avanzada. La biopsia pleural por cirugía torácica endoscópica permite el diagnóstico en más del 90% de los casos y la instrumentación del espacio pleural complicado, mejorando los resultados de la técnica.MATERIAL Y METODOSe realizó un análisis retrospectivo de pacientes con DPN operados para la realización de una pleurodesis química con talco. Se formaron dos grupos, uno con derrame pleural neoplásico complicado (DPNC) y otro con derrame pleural neoplásico no complicado (DPNNC). En el grupo con DPNC se realizó "maniobras de liberación - expansión". Se compararon las variables entre ambos grupos para el análisis pertinente.RESULTADOSSe analizaron 28 pacientes con DPN tratados con pleurodesis química por cirugía torácica endoscópica. La edad promedio fue de 62,64 años. El compromiso pleural por patología mamaria fue la forma más frecuente (46,4%). No se hubo diferencia en cuanto a complicaciones (p= 0,31) y riesgo de defunción a los 30 días (p=1,09) con el manejo agresivo del espacio pleural. La demora en la indicación de pleurodesis se relacionó con un mayor índice de complicaciones (p=0,002) y mayor probabilidad de defunción dentro de los 30 días (p=0,008). La mayoría de pacientes se reinsertó a sus tareas diarias, con buena tolerancia a la disnea luego del procedimiento.  CONCLUSIONEn los pacientes con DPNC, las "maniobras de liberación - expansión pulmonar" descriptas, aumentarían las chances de mejorar los resultados con bajo riesgo. La pleurodesis química temprana mejora la calidad de vida de los pacientes portadores de un DPN.

ESTIMATING BASAL ENERGY EXPENDITURE IN LIVER TRANSPLANT RECIPIENTS: THE VALUE OF THE HARRIS-BENEDICT EQUATION.

PubMed

Pinto, Andressa S; Chedid, Marcio F; Guerra, Léa T; Álvares-DA-Silva, Mario R; Araújo, Alexandre de; Guimarães, Luciano S; Leipnitz, Ian; Chedid, Aljamir D; Kruel, Cleber R P; Grezzana-Filho, Tomaz J M; Kruel, Cleber D P

2016-01-01

Reliable measurement of basal energy expenditure (BEE) in liver transplant (LT) recipients is necessary for adapting energy requirements, improving nutritional status and preventing weight gain. Indirect calorimetry (IC) is the gold standard for measuring BEE. However, BEE may be estimated through alternative methods, including electrical bioimpedance (BI), Harris-Benedict Equation (HBE), and Mifflin-St. Jeor Equation (MSJ) that carry easier applicability and lower cost. To determine which of the three alternative methods for BEE estimation (HBE, BI and MSJ) would provide most reliable BEE estimation in LT recipients. Prospective cross-sectional study including dyslipidemic LT recipients in follow-up at a 735-bed tertiary referral university hospital. Comparisons of BEE measured through IC to BEE estimated through each of the three alternative methods (HBE, BI and MSJ) were performed using Bland-Altman method and Wilcoxon Rank Sum test. Forty-five patients were included, aged 58±10 years. BEE measured using IC was 1664±319 kcal for males, and 1409±221 kcal for females. Average difference between BEE measured by IC (1534±300 kcal) and BI (1584±377 kcal) was +50 kcal (p=0.0384). Average difference between the BEE measured using IC (1534±300 kcal) and MSJ (1479.6±375 kcal) was -55 kcal (p=0.16). Average difference between BEE values measured by IC (1534±300 kcal) and HBE (1521±283 kcal) was -13 kcal (p=0.326). Difference between BEE estimated through IC and HBE was less than 100 kcal for 39 of all 43patients. Among the three alternative methods, HBE was the most reliable for estimating BEE in LT recipients. Estimativa confiável do metabolismo basal em pacientes transplantados de fígado é necessária para adaptar os requerimentos energéticos, melhorar o estado nutricional e prevenir ganho de peso. Calorimetria indireta (CI) é o padrão-ouro para a medição do metabolismo basal. No entanto, ele pode ser estimado utilizando-se métodos alternativos

Associação entre sintomas, veias varicosas e refluxo na veia safena magna ao eco-Doppler

PubMed Central

Seidel, Amélia Cristina; Campos, Mariana Baldini; Campos, Raquel Baldini; Harada, Dérica Sayuri; Rossi, Robson Marcelo; Cavalari, Pedro; Miranda, Fausto

2017-01-01

Resumo Contexto A doença venosa crônica requer avaliação clínica, quantificação dos efeitos hemodinâmicos e definição da distribuição anatômica para decisão diagnóstica e tratamento. Métodos Estudo prospectivo realizado em 2015 com amostra de 1.384 pacientes (2.669 membros) com idade entre 17 e 85 anos, sendo 1.227 do sexo feminino. Nas respostas do questionário aplicado, os sintomas pesquisados eram dor, cansaço, sensação de peso, queimação, câimbras e formigamento. Para a formação dos grupos, foi considerado o número de membros, distribuídos em relação ao gênero, ao índice de massa corporal e à idade. Após a definição grupos e a realização do eco-Doppler para estudo da veia safena magna (VSM), os pacientes foram distribuídos em três grupos (I: sintomas presentes e varizes ausentes, II: sintomas ausentes e varizes presentes e III: sintomas presentes e varizes presentes). A análise estatística utilizou o teste qui-quadrado ou exato de Fisher para verificar a homogeneidade entre os grupos. Em caso de associação com significância de 5%, foi calculada a razão de chances. Resultados Para ambos os gêneros, foi observada chance de insuficiência da VSM 11,2 vezes maior no grupo III. Por sua vez, os casos de obesidade mórbida ocorreram 9,1 vezes mais no mesmo grupo. Além disso, pacientes na faixa etária entre 30 e 50 anos desse grupo apresentaram chance de insuficiência da VSM 43,1 vezes maior. Conclusões A insuficiência da VSM foi significantemente mais frequente no grupo III, tanto globalmente como considerando apenas os casos de obesidade mórbida e a faixa etária mais elevada. PMID:29930616

ENDOSCOPIC SLEEVE GASTROPLASTY FOR OBESITY TREATMENT: TWO YEARS OF EXPERIENCE.

PubMed

Lopez-Nava, Gontrand; Galvão, M P; Bautista-Castaño, I; Fernandez-Corbelle, J P; Trell, M; Lopez, N

2017-01-01

Bariatric endoscopic techniques are minimally invasive and induce gastric volume reduction to treat obesity. Aim : To evaluate endoscopic sleeve gastroplasty (Apollo method) using a suturing method directed at the greater curvature, as well as the perioperative care, two year safety and weight loss. Prospective single-center study over 154 patients (108 females) using the endoscopic sleeve gastroplasty procedure under general anesthesia with overnight inpatient observation. Of the154 initial patients, 143 were available for 1-month of follow-up, 133 for 6-month, 64 for 12-month and 28 completed the 24 month assessment. Follow-up was carried out by a multidisciplinary team (nutritionist and psychologist). Outcomes evaluated were: change in BMI; change in body weight (TBWL); % of loss of initial body weight (%TBWL); % of excess body weight loss (%EWL) (segregated in > or <25% and adverse effects. Voluntary oral contrasted radiological examinations were scheduled to assess the gastroplasty at different times post-procedure. Mean age was 44.9 (23-69) years. At 24 months after the procedure baseline mean BMI change from 38.3 to 30.8 kg/m2. TBWL, %TBWL and %EWL were of 21.3 kg, 19.5% and 60.4% respectively. 85.7% of patients achieve the goal of >25% %EWL. There were no mayor adverse events intraprocedure or during the 24 months of follow-up . Endoscopic sleeve gastroplasty with regular monitoring by a multidisciplinary team can be considered an effective, safe and well tolerated procedure for obesity treatment, at least for two years of follow-up. As técnicas de endoscopia bariátrica são minimamente invasivas e induzem à redução do volume gástrico para tratar a obesidade. Avaliar a gastroplastia sleeve endoscópica (método Apollo) usando um método de sutura direcionado para a grande curvatura, bem como os cuidados perioperatórios, segurança em dois anos e perda de peso. Estudo prospectivo em um único centro com 154 pacientes (108 mulheres) usando o

Separating para and ortho water.

PubMed

Horke, Daniel A; Chang, Yuan-Pin; Długołęcki, Karol; Küpper, Jochen

2014-10-27

Water exists as two nuclear-spin isomers, para and ortho, determined by the overall spin of its two hydrogen nuclei. For isolated water molecules, the conversion between these isomers is forbidden and they act as different molecular species. Yet, these species are not readily separated, and no pure para sample has been produced. Accordingly, little is known about their specific physical and chemical properties, conversion mechanisms, or interactions. The production of isolated samples of both spin isomers is demonstrated in pure beams of para and ortho water in their respective absolute ground state. These single-quantum-state samples are ideal targets for unraveling spin-conversion mechanisms, for precision spectroscopy and fundamental symmetry-breaking studies, and for spin-enhanced applications, for example laboratory astrophysics and astrochemistry or hypersensitized NMR experiments. © 2014 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

[Not Available].

PubMed

Arellano Ortiz, Ana Lidia; Jiménez Vega, Florinda; Díaz Hernández, Cecilia; Salcedo Vargas, Muricio; De la Mora Covarrubias, Antonio; López Díaz, José Alberto; Vargas Requena, Claudia Lucía; Cassís Nosthas, María Lorena

2016-07-19

Introducción: las lesiones intraepiteliales escamosas (LIE) son un estado de transición hacia el cáncer cervicouterino (CaCu) y un déficit de micronutrientes puede acelerar este proceso. Por ello, determinar la existencia de este déficit y conocer qué factores se asocian permitiría una posible prevención en esta población de riesgo.Objetivo: determinar la presencia de alguna deficiencia de micronutrientes involucrados en el proceso anticancerígeno y asociar este déficit con hábitos y factores demográficos en pacientes con LIE de Ciudad Juárez, Chihuahua, México.Métodos:en un estudio transversal analítico fueron seleccionadas 102 pacientes con LIE. Se realizó una encuesta dietaría (recordatorio de 24 horas) para estimar la ingesta de micronutrientes. La deficiencia fue determinada con un consumo < 75% de la ingesta diaria recomendada o sugerida (IDR o IDS) en México. Algunos hábitos y factores demográficos fueron obtenidos mediante la entrevista con la paciente. Se realizó un modelo de regresión logística para asociar la presencia de deficiencia con factores que afectan a la ingesta o incrementan el requerimiento de micronutrientes.Resultados:el retinol, ácido fólico, zinc, vitaminas C y E, considerados como micronutrientes en el proceso anticancerígeno del CaCu, se encontraron por debajo del 75% de la IDR. Aquellas mujeres con sobrepeso, obesidad y amas de casa se asociaron significativamente con la deficiencia de micronutrientes.Conclusión: el sobrepeso, la obesidad y la ocupación han sido asociados para presentar deficiencias de micronutrientes en este estudio. Estas variables convergen en una posible inseguridad alimentaria, la cual podría asociarse al incremento de incidencia de CaCu en México.

[Not Available].

PubMed

Sendrós Madroño, José M

2016-06-03

La atención nutricional en el paciente oncohematológico debe formar parte del tratamiento global del paciente. Las alteraciones debidas a la localización de la neoplasia y los efectos secundarios del tratamiento oncoespecífico muchas veces dificultan o impiden la alimentación oral. Esto puede dar lugar a una desnutrición y es de gran importancia su detección, valoración e intervención temprana. El primer paso en la intervención nutricional es el consejo dietético. Este artículo muestra qué aspectos deben tenerse en cuenta para poder elaborar un consejo dietético y la importancia de que este sea individualizado. Se describen como ejemplo cuatro situaciones especiales, donde es necesario trasladar las recomendaciones nutricionales a un plan dietético. También se incide en el uso de los probióticos en pacientes inmunocomprometidos.

Trombocitopenia induzida por heparina em paciente com oclusão arterial aguda

PubMed Central

Pimenta, Rafael Elias Farres; Yoshida, Winston Bonetti; Rollo, Hamilton Almeida; Sobreira, Marcone Lima; Bertanha, Matheus; Mariúba, Jamil Victor de Oliveira; Jaldin, Rodrigo Gibin; de Camargo, Paula Angeleli Bueno

2016-01-01

Resumo A trombocitopenia induzida por heparina é uma complicação grave da terapêutica anticoagulante com heparina e está associada à formação de anticorpos antifator IV plaquetário. Costuma surgir a partir do quinto dia do tratamento, com queda de pelo menos 50% da contagem plaquetária. Em decorrência da ativação plaquetária concomitante, pode ocorrer quadro de trombose, venosa ou arterial, com repercussões clínicas graves. Apresentamos um caso de paciente portador de síndrome do anticorpo antifosfolípide, com quadro de oclusão arterial aguda, que foi tratado cirurgicamente e recebeu heparina não fracionada no intra e pós-operatório. No quinto dia de tratamento anticoagulante, apresentou queda maior de 50% da contagem de plaquetas em relação à contagem pré-heparina. A suspeita de trombocitopenia induzida por heparina e seus aspectos diagnósticos e terapêuticos serão abordados neste desafio terapêutico.

Doença cística adventicial da artéria poplítea: relato de caso

PubMed Central

de Oliveira, Julio Cesar Peclat; Barreto, Fernando Tebet Ramos; Souza, Diogo Di Battista de Abreu e; Fonseca, João Marcos Fonseca e; Chimelli, Bernardo de Castro Abi Ramia; Peclat, Ana Paula Rolim Maia; Marques, Marcos Arêas; Fiorelli, Stenio Karlos Alvim

2018-01-01

Resumo A doença cística adventicial da artéria poplítea é uma doença pouco frequente, que deve ser considerada no diagnóstico diferencial de pacientes jovens com claudicação intermitente e sem fatores de risco para doença arterial periférica aterosclerótica. Apresentamos um caso de claudicação intermitente de membros inferiores em paciente masculino de 51 anos no qual essa doença foi diagnosticada. Foi submetido a ressecção do segmento de artéria comprometido e interposição de safena autóloga ipsilateral. Discutimos alternativas diagnósticas e terapêuticas. PMID:29930682

Nursing Diagnoses of hospitalized patients with heart failure: a longitudinal study.

PubMed

Pereira, Juliana de Melo Vellozo; Flores, Paula Vanessa Peclat; Figueiredo, Lyvia da Silva; Arruda, Cristina Silva; Cassiano, Keila Mara; Vieira, Gláucia Cristina Andrade; Guerra, Thais de Rezende Bessa; Silva, Vanessa Alves da; Cavalcanti, Ana Carla Dantas

2016-01-01

Identifying Nursing Diagnoses of fatigue, activity intolerance and decreased cardiac output in hospitalized patients with heart failure and verifying the association between the defining characteristics and the Nursing Diagnoses. A longitudinal and prospective study that followed hospitalized patients with heart failure for three weeks. The data collected through interviews and physical examinations were sent to expert nurses for diagnostic inference. Descriptive and inferential statistical analyses were carried out. Of the 72 patients, 68.0% were male and presented the nursing diagnosis of decreased cardiac output (62.5%) in the first week, reducing to 52.8% and 38% in the second and third weeks, respectively. Fatigue only appeared in one patient. Activity intolerance was the diagnosis that had the greatest discrepancy among the experts. Decreased cardiac output was associated to the defining characteristics: dyspnea, edema, jugular venous distension and reduced ejection fraction during all three weeks of evaluation. Decreased cardiac output was more prevalent in hospitalized patients with heart failure, and the associated defining characteristics were determining factors for this nursing diagnosis. Identificar os diagnósticos de enfermagem fadiga, intolerância à atividade e débito cardíaco diminuído em pacientes com insuficiência cardíaca hospitalizados e verificar a associação entre as características definidoras e os diagnósticos de enfermagem. Estudo longitudinal e prospectivo que acompanhou pacientes com insuficiência cardíaca hospitalizados por três semanas. Os dados coletados por entrevista e exame físico foram encaminhados a enfermeiros peritos para inferência diagnóstica. Realizou-se análise estatística descritiva e inferencial. Dos 72 pacientes, 68,0% eram do sexo masculino e apresentaram o diagnóstico de enfermagem débito cardíaco diminuído (62,5%) na primeira semana, reduzindo para 52,8% e 38% na segunda e terceira semana

CYP96T1 of Narcissus sp. aff. pseudonarcissus Catalyzes Formation of the Para-Para' C-C Phenol Couple in the Amaryllidaceae Alkaloids

PubMed Central

Kilgore, Matthew B.; Augustin, Megan M.; May, Gregory D.; Crow, John A.; Kutchan, Toni M.

2016-01-01

The Amaryllidaceae alkaloids are a family of amino acid derived alkaloids with many biological activities; examples include haemanthamine, haemanthidine, galanthamine, lycorine, and maritidine. Central to the biosynthesis of the majority of these alkaloids is a C-C phenol-coupling reaction that can have para-para', para-ortho', or ortho-para' regiospecificity. Through comparative transcriptomics of Narcissus sp. aff. pseudonarcissus, Galanthus sp., and Galanthus elwesii we have identified a para-para' C-C phenol coupling cytochrome P450, CYP96T1, capable of forming the products (10bR,4aS)-noroxomaritidine and (10bS,4aR)-noroxomaritidine from 4′-O-methylnorbelladine. CYP96T1 was also shown to catalyzed formation of the para-ortho' phenol coupled product, N-demethylnarwedine, as less than 1% of the total product. CYP96T1 co-expresses with the previously characterized norbelladine 4′-O-methyltransferase. The discovery of CYP96T1 is of special interest because it catalyzes the first major branch in Amaryllidaceae alkaloid biosynthesis. CYP96T1 is also the first phenol-coupling enzyme characterized from a monocot. PMID:26941773

Cooling by Para-to-Ortho-Hydrogen Conversion

NASA Technical Reports Server (NTRS)

Sherman, A.; Nast, T.

1983-01-01

Catalyst speeds conversion, increasing capacity of solid hydrogen cooling system. In radial-flow catalytic converter, para-hydrogen is converted to equilibrium mixture of para-hydrogen and ortho-hydrogen as it passes through porous cylinder of catalyst. Addition of catalyst increases capacity of hydrogen sublimation cooling systems for radiation detectors.

ParaChoice Model.

DOE Office of Scientific and Technical Information (OSTI.GOV)

Heimer, Brandon Walter; Levinson, Rebecca Sobel; West, Todd H.

Analysis with the ParaChoice model addresses three barriers from the VTO Multi-Year Program Plan: availability of alternative fuels and electric charging station infrastructure, availability of AFVs and electric drive vehicles, and consumer reluctance to purchase new technologies. In this fiscal year, we first examined the relationship between the availability of alternative fuels and station infrastructure. Specifically, we studied how electric vehicle charging infrastructure affects the ability of EVs to compete with vehicles that rely on mature, conventional petroleum-based fuels. Second, we studied how the availability of less costly AFVs promotes their representation in the LDV fleet. Third, we used ParaChoicemore » trade space analyses to help inform which consumers are reluctant to purchase new technologies. Last, we began analysis of impacts of alternative energy technologies on Class 8 trucks to isolate those that may most efficaciously advance HDV efficiency and petroleum use reduction goals.« less

[Not Available].

PubMed

Vila Nova, Larissa Pessoa; Araújo Tavares de Sá, Cristiane Maria; Freire Clementino da Silva, Maria Cleide; Lustosa, Marinaldo Freire; Batista de Medeiros, Rafael Augusto; Calado Brito, Daniel; De Araújo Burgos, Maria Goretti Pessoa

2016-07-19

Introducción: en los últimos años la importancia de identificar la resistencia a la insulina (RI) en pacientes con enfermedades cardiovasculares isquémicas viene siendo debatida. Métodos alternativos, como los indicadores antropométricos y de composición corporal, han sido señalados como una buena opción y contribuyen para identificar anomalías metabólicas y prevenir complicaciones.Objetivo: asociar indicadores antropométricos y de composición corporal como predictores de la resistencia a la insulina (RI) en pacientes con enfermedad de las arterias coronarias.Métodos: estudio transversal realizado en el hospital de referencia cardiológica de Pernambuco, en el periodo de junio a septiembre de 2014, con pacientes adultos y ancianos hospitalizados, de ambos sexos. Se verificaron los siguientes parámetros: estilo de vida, la presencia del síndrome metabólico (SM) y otras comorbilidades. Se analizó la RI por el cálculo del HOMA-IR. Los pacientes se sometieron a la impedancia bioeléctrica (BIA) y a las verificaciones antropométricas.Resultados: la muestra fue constituida por 75 pacientes con edad media de 63,75 ± 12,43 años, con un 64% de ancianos. Se encontró el diagnóstico de SM en el 65,3% de los pacientes, el 81,3% de sedentarios y el 37,4% con exceso de peso. Se diagnosticó la RI en el 28% de los pacientes. Se observó correlación entre el HOMA-IR y el diámetro abdominal sagital (DAS) (r = 0,476; p = 0,016), el índice de masa corporal (r = 0,233; p = 0,040) y el porcentual de grasa corporal (r = 0,276; p = 0,016).Conclusión: el DAS fue el indicador antropométrico que presentó mejor correlación con la RI en pacientes con enfermedad de las arterias coronarias hospitalizados.

Study on cross-reactivity to the para group.

PubMed

Picardo, M; Cannistraci, C; Cristaudo, A; De Luca, C; Santucci, B

1990-01-01

In 80 patients, positive to at least one hapten of the para group (para-phenylenediamine, diaminodiphenylmethane, benzocaine, PPD mix), patch tests were carried out with freshly prepared solutions of para-phenylenediamine (PPD) and of 3 selected aromatic compounds related structurally to PPD (para-aminophenol, ortho-aminophenol, hydroquinone). The number of positive reactions correlated with the rate of decomposition of the substances as evaluated by high-pressure liquid chromatography. PPD, which was almost decomposed after 24 h, gave the highest number of positive reactions, followed by ortho-aminophenol and by para-aminophenol, while hydroquinone, which was oxidized to the extent of 35%, did not give any reactions. To evaluate if a different rate of oxidation can modify the patch test response, in the same patients and in 10 normal volunteers, tests were carried out with PPD solutions containing the oxidizing agent silver oxide (0.1%). By this procedure a significant increase in the number of positive responses was observed. The results suggest that the rate of decomposition and therefore the amount of quinone(s) generated, might be the key to eliciting patch test responses to oxidizable aromatic haptens.

Programa de conservacion para aves migratorias neotropicales

Treesearch

Deborah Finch; Marcia Wilson; Roberto Roca

1992-01-01

Mas de 250 especies de aves terrestres migran a Norte America durante la epoca reproductiva para aprovechar los sistemas templados. No obstante, las aves migratorias neotropicales pasan la mayor parte de su ciclo de vida en los habitat tropicales y subtropicales de paises latinoamericanos y caribefios donde viven en una asociacion cercana con las aves residentes. Para...

Polymorphism and Modulation of Para-Substituted l-Phenylalanine.

PubMed

Sögütoglu, Leyla-Cann; Lutz, Martin; Meekes, Hugo; de Gelder, René; Vlieg, Elias

2017-12-06

The crystal structure of para -methyl-l-phenylalanine at 230 K resembles that of the para-fluorinated analogue from the literature but is commensurately modulated with seven molecules in the asymmetric unit ( Z ' = 7). At 100 K, the superstructure loses its modulation, leading to a unit cell with Z ' = 1, with clear disorder in the phenyl ring orientations. The methyl-substituent in para -methyl-l-phenylalanine has, in contrast to fluorine, no polar interactions with protons of neighboring molecules, which might allow for the well-defined modulation of the crystal structure at 230 K.

Para hydrogen equilibration in the atmospheres of the outer planets

NASA Technical Reports Server (NTRS)

Conrath, Barney J.

1986-01-01

The thermodynamic behavior of the atmospheres of the Jovian planets is strongly dependent on the extent to which local thermal equilibration of the ortho and para states of molecular hydrogen is achieved. Voyager IRIS data from Jupiter imply substantial departures of the para hydrogen fraction from equilibrium in the upper troposphere at low latitudes, but with values approaching equilibrium at higher latitudes. Data from Saturn are less sensitive to the orth-para ratio, but suggest para hydrogen fractions near the equilibrium value. Above approximately the 200 K temperature level, para hydrogen conversion can enhance the efficiency of convection, resulting in a substantial increase in overturning times on all of the outer planets. Currently available data cannot definitively establish the ortho-para ratios in the atmospheres of Uranus and Neptune, but suggest values closer to local equilibrium than to the 3.1 normal ratio. Modeling of sub-millimeter wavelength measurements of these planets suggest thermal structures with frozen equilibrium lapse rates in their convective regions.

Relevancia de los grados de Simpson en la resección de meningiomas grado I

PubMed Central

Ajler, Pablo; Beltrame, Sofía; Massa, Daniela; Tramontano, Julian; Baccanelli, Matteo; Yampolsky, Claudio

2017-01-01

Resumen Objetivo: Comparar el porcentaje de recurrencias en pacientes con meningiomas grado I de la OMS sometidos a exéresis microquirúrgica. Introducción: En 1957 Simpson estandarizó 5 grados de resección quirúrgica para los meningiomas intracraneanos y el porcentaje de recurrencia relacionado con cada uno, estableciendo el paradigma de que la remoción agresiva de estos tumores junto con fragmentos durales y óseos era necesario para alcanzar la curación. Los avances principalmente en Resonancia Magnética, anatomía patológica y técnica microqurúrgica nos llevan a plantear la relevancia actual de dicha clasificación. Métodos: Se realizó una revisión retrospectiva de los pacientes operados de meningiomas grado I entre Febrero de 2006 y Diciembre de 2015. Se analizaron las imágenes pre y postoperatorias y la anatomía patológica. Las variables se relacionaron mediante un análisis estadístico multivariado estableciendo como estadísticamente significativo una P < 0.05. Resultados: No se objetivó una diferencia estadísticamente significativa entre el número de recidivas y el grado de resección tumoral según Simpson I, II, III o IV (P = 0,3117). Esto puede afirmarse para los grados Simpson I y II en donde el número de pacientes incluidos en la muestra (n) fue alto. Al analizar como factor de recurrencia la localización tumoral tampoco se encontró una diferencia significativa en cuanto al porcentaje de recidivas entre aquellos tumores localizados en la convexidad, base de cráneo y parasagitales (P = 0,2203). Conclusión: Para los meningiomas grado I la exéresis Simpson I no presenta diferencias significativas con la Simpson II en cuanto a la recurrencia tumoral, por lo que aumentar la morbilidad del procedimiento no tendría justificación. Un replanteo de la escala de resección debería idearse teniendo en cuenta la clasificación de la OMS. PMID:29142775

The Ratio of Ortho- to Para-H2 in Photodissociation Regions

NASA Technical Reports Server (NTRS)

Sternberg, Amiel; Neufeld, David A.

1999-01-01

We discuss the ratio of ortho- to para-H2 in photodissociation regions (PDRs). We draw attention to an apparent confusion in the literature between the ortho-to-para ratio of molecules in FUV-pumped vibrationally excited states and the total H2 ortho-to-para abundance ratio. These ratios are not the same because the process of FUV pumping of fluorescent H2 emission in PDRs occurs via optically thick absorption lines. Thus gas with an equilibrium ratio of ortho- to para-H2 equal to 3 will yield FUV-pumped vibrationally excited ortho-to-para ratios smaller than 3, because the ortho-H2 pumping rates are preferentially reduced by optical depth effects. Indeed, if the ortho and para pumping lines are on the "square root" part of the curve of growth, then the expected ratio of ortho and para vibrational line strengths is 3(sup 1/2) approximately 1.7, close to the typically observed value. Thus, contrary to what has sometimes been stated in the literature, most previous measurements of the ratio of ortho- to para-H2 in vibrationally excited states are entirely consistent with a total ortho-to-para ratio of 3, the equilibrium value for temperatures greater than 200 K. We present an analysis and several detailed models that illustrate the relationship between the total ratios of ortho- to para-H2 and the vibrationally excited ortho-to-para ratios in PDRs. Recent Infrared Space Observatory measurements of pure rotational and vibrational H2 emissions from the PDR in the star-forming region S140 provide strong observational support for our conclusions.

Towards a double field theory on para-Hermitian manifolds

DOE Office of Scientific and Technical Information (OSTI.GOV)

Vaisman, Izu

In a previous paper, we have shown that the geometry of double field theory has a natural interpretation on flat para-Kähler manifolds. In this paper, we show that the same geometric constructions can be made on any para-Hermitian manifold. The field is interpreted as a compatible (pseudo-)Riemannian metric. The tangent bundle of the manifold has a natural, metric-compatible bracket that extends the C-bracket of double field theory. In the para-Kähler case, this bracket is equal to the sum of the Courant brackets of the two Lagrangian foliations of the manifold. Then, we define a canonical connection and an action ofmore » the field that correspond to similar objects of double field theory. Another section is devoted to the Marsden-Weinstein reduction in double field theory on para-Hermitian manifolds. Finally, we give examples of fields on some well-known para-Hermitian manifolds.« less

Care management: agreement between nursing prescriptions and patients' care needs.

PubMed

Faeda, Marília Silveira; Perroca, Márcia Galan

2016-08-08

analyze agreement between nursing prescriptions recorded in medical files and patients' care needs; investigate the correlation between the nurses' professional background and agreement of prescriptions. descriptive study with quantitative and documentary approach conducted in the medical clinic, surgical, and specialized units of a university hospital in the interior of São Paulo, Brazil. The new validated version of a Patient Classification Instrument was used and 380 nursing prescriptions written at the times of hospital admission and discharge were assessed. 75% of the nursing prescriptions items were compatible with the patients' care needs. Only low correlation between nursing prescription agreement and professional background was found. the nursing prescriptions did not fully meet the care needs of patients. The care context and work process should be analyzed to enable more effective prescriptions, while strategies to assess the care needs of patients are recommended. analisar a concordância entre prescrições de enfermagem, registradas nos prontuários, e as necessidades de cuidados dos pacientes; investigar a correlação entre o perfil profissional dos enfermeiros e a concordância das prescrições. estudo descritivo com abordagem quantitativa e documental, realizado em unidades de clínica médica, cirúrgica e especializada de um hospital de ensino, no interior do Estado de São Paulo. Foi aplicada a nova versão validada do Instrumento de Classificação de Pacientes e, posteriormente, investigadas 380 prescrições de enfermagem no momento da admissão e alta hospitalar. foi identificado que 75% dos itens das prescrições de enfermagem estavam compatíveis com as necessidades cuidativas dos pacientes. Encontrou-se baixa correlação entre a concordância da prescrição de enfermagem e o perfil profissional. as prescrições de enfermagem não estão sendo realizadas, em sua totalidade, em consonância com as necessidades dos pacientes. Para

Para-nitrobenzyl esterases with enhanced activity in aqueous and nonaqueous media

DOEpatents

Arnold, F.H.; Moore, J.C.

1999-05-25

A method is disclosed for isolating and identifying modified para-nitrobenzyl esterases which exhibit improved stability and/or esterase hydrolysis activity toward selected substrates and under selected reaction conditions relative to the unmodified para-nitrobenzyl esterase. The method involves preparing a library of modified para-nitrobenzyl esterase nucleic acid segments (genes) which have nucleotide sequences that differ from the nucleic acid segment which encodes for unmodified para-nitrobenzyl esterase. The library of modified para-nitrobenzyl nucleic acid segments is expressed to provide a plurality of modified enzymes. The clones expressing modified enzymes are then screened to identify which enzymes have improved esterase activity by measuring the ability of the enzymes to hydrolyze the selected substrate under the selected reaction conditions. Specific modified para-nitrobenzyl esterases are disclosed which have improved stability and/or ester hydrolysis activity in aqueous or aqueous-organic media relative to the stability and/or ester hydrolysis activity of unmodified naturally occurring para-nitrobenzyl esterase. 43 figs.

Para-nitrobenzyl esterases with enhanced activity in aqueous and nonaqueous media

DOEpatents

Arnold, Frances H.; Moore, Jeffrey C.

1998-01-01

A method for isolating and identifying modified para-nitrobenzyl esterases which exhibit improved stability and/or esterase hydrolysis activity toward selected substrates and under selected reaction conditions relative to the unmodified para-nitrobenzyl esterase. The method involves preparing a library of modified para-nitrobenzyl esterase nucleic acid segments (genes) which have nucleotide sequences that differ from the nucleic acid segment which encodes for unmodified para-nitrobenzyl esterase. The library of modified para-nitrobenzyl nucleic acid segments is expressed to provide a plurality of modified enzymes. The clones expressing modified enzymes are then screened to identify which enzymes have improved esterase activity by measuring the ability of the enzymes to hydrolyze the selected substrate under the selected reaction conditions. Specific modified para-nitrobenzyl esterases are disclosed which have improved stability and/or ester hydrolysis activity in aqueous or aqueous-organic media relative to the stability and/or ester hydrolysis activity of unmodified naturally occurring para-nitrobenzyl esterase.

Para-nitrobenzyl esterases with enhanced activity in aqueous and nonaqueous media

DOEpatents

Arnold, Frances H.; Moore, Jeffrey C.

1999-01-01

A method for isolating and identifying modified para-nitrobenzyl esterases which exhibit improved stability and/or esterase hydrolysis activity toward selected substrates and under selected reaction conditions relative to the unmodified para-nitrobenzyl esterase. The method involves preparing a library of modified para-nitrobenzyl esterase nucleic acid segments (genes) which have nucleotide sequences that differ from the nucleic acid segment which encodes for unmodified para-nitrobenzyl esterase. The library of modified para-nitrobenzyl nucleic acid segments is expressed to provide a plurality of modified enzymes. The clones expressing modified enzymes are then screened to identify which enzymes have improved esterase activity by measuring the ability of the enzymes to hydrolyze the selected substrate under the selected reaction conditions. Specific modified para-nitrobenzyl esterases are disclosed which have improved stability and/or ester hydrolysis activity in aqueous or aqueous-organic media relative to the stability and/or ester hydrolysis activity of unmodified naturally occurring para-nitrobenzyl esterase.

Para-nitrobenzyl esterases with enhanced activity in aqueous and nonaqueous media

DOEpatents

Arnold, F.H.; Moore, J.C.

1998-04-21

A method is disclosed for isolating and identifying modified para-nitrobenzyl esterases. These enzymes exhibit improved stability and/or esterase hydrolysis activity toward selected substrates and under selected reaction conditions relative to the unmodified para-nitrobenzyl esterase. The method involves preparing a library of modified para-nitrobenzyl esterase nucleic acid segments (genes) which have nucleotide sequences that differ from the nucleic acid segment which encodes for unmodified para-nitrobenzyl esterase. The library of modified para-nitrobenzyl nucleic acid segments is expressed to provide a plurality of modified enzymes. The clones expressing modified enzymes are then screened to identify which enzymes have improved esterase activity by measuring the ability of the enzymes to hydrolyze the selected substrate under the selected reaction conditions. Specific modified para-nitrobenzyl esterases are disclosed which have improved stability and/or ester hydrolysis activity in aqueous or aqueous-organic media relative to the stability and/or ester hydrolysis activity of unmodified naturally occurring para-nitrobenzyl esterase. 43 figs.

Para-hydrogen perspectives in hyperpolarized NMR.

PubMed

Glöggler, Stefan; Colell, Johannes; Appelt, Stephan

2013-10-01

The first instance of para-hydrogen induced polarization (PHIP) in an NMR experiment was serendipitously observed in the 1980s while investigating a hydrogenation reaction (Seldler et al., 1983; Bowers and Weitekamp, 1986, 1987; Eisenschmid et al., 1987) [1-4]. Remarkably a theoretical investigation of the applicability of para-hydrogen as a hyperpolarization agent was being performed in the 1980's thereby quickly providing a theoretical basis for the PHIP-effect (Bowers and Weitekamp, 1986) [2]. The discovery of signal amplification by a non-hydrogenating interaction with para-hydrogen has recently extended the interest to exploit the PHIP effect, as it enables investigation of compounds without structural alteration while retaining the advantages of spectroscopy with hyperpolarized compounds [5]. In this article we will place more emphasis of the future applications of the method while only briefly discussing the efforts that have been made in the understanding of the phenomenon and the development of the method so far. Copyright © 2013 Elsevier Inc. All rights reserved.

Selective detection of hyperpolarized NMR signals derived from para-hydrogen using the Only Para-hydrogen SpectroscopY (OPSY) approach.

PubMed

Aguilar, Juan A; Adams, Ralph W; Duckett, Simon B; Green, Gary G R; Kandiah, Rathika

2011-01-01

A new family of NMR pulse sequences is reported for the recording of para-hydrogen enhanced NMR spectra. This Only Para-hydrogen SpectroscopY (OPSY) approach uses coherence selection to separate hyperpolarized signals from those of fully relaxed and thermally equilibrated protons. Sequence design, performance, practical aspects and applicability to other hyperpolarization techniques are discussed. Copyright © 2010 Elsevier Inc. All rights reserved.

Comparación de la efectividad de ranibizumab intravítreo para el tratamiento del edema macular diabético en ojos vitrectomizados y no vitrectomizados.

PubMed

Koyanagi, Yoshito; Yoshida, Shigeo; Kobayashi, Yoshiyuki; Kubo, Yuki; Yamaguchi, Muneo; Nakama, Takahito; Nakao, Shintaro; Ikeda, Yasuhiro; Ohshima, Yuji; Ishibashi, Tatsuro; Sonoda, Kohhei

2017-07-11

Objetivo: Comparar la efectividad de ranibizumab intravítreo (RIV) para el tratamiento del edema macular diabético (EMD) en ojos con y sin vitrectomía previa. Procedimientos: Evaluamos de manera prospectiva la mejor agudeza visual corregida (MAVC) y el grosor macular central (GMC) tras el tratamiento con RIV durante 6 meses. Resultados: No se observaron diferencias significativas en la MAVC o GMC inicial en ninguno de los dos grupos. En el grupo no vitrectomizado (n = 15), los cambios medios en la MAVC y GMC hasta el sexto mes de tratamiento con respecto al valor inicial resultaron significativos (p < 0,01). En el grupo vitrectomizado (n = 10), se observó una mejora más lenta, y la mejora media en la MAVC no resultó significativa (p = 0,5), aunque la media en la disminución del GMC sí que lo fue (p < 0,05). No se observaron diferencias significativas en los cambios medios en la MAVC y el GMC entre ambos grupos a los 6 meses del tratamiento. Conclusiones: La diferencia en la efectividad de RIV entre ambos grupos no resultó significativa. Ranibizumab intravítreo puede ser una opción de tratamiento incluso en pacientes vitrectomizados con EMD. © 2017 S. Karger AG, Basel.

[In Process Citation].

PubMed

Santos, Carla Adriana; Fonseca, Jorge; Carolino, Elisabete; Lopes, Teresa; Sousa Guerreiro, António

2016-03-25

Introducción y objetivos: el cobre (Cu) es un oligoelemento muy estudiado, pero poco se sabe de su evolución en los pacientes alimentados por gastrostomía endoscópica (GEP). Pretendemos evaluar la evolución del Cu sérico desde la gastrostomía hasta 12 semanas después de la intervención en estos pacientes alimentados con preparaciones domésticas.  Métodos: realizamos un estudio observacional prospectivo para evaluar el Cu sérico, la albúmina, la transferrina y el índice de masa corporal (IMC) en el momento de la GEP, tras 4 semanas y 12 semanas después de la intervención. Los datos incluyen edad, género, NRS 2002 y enfermedad subyacente: cánceres de cabeza y cuello (CCC) y disfagia neurológica (DN). Después de la intervención, estos pacientes fueron alimentados conpreparaciones domésticas. Resultados: 146 enfermos (89 hombres), entre 21-95 años: CCC-56, DN-90. Valores de Cu entre 42-160 μg/dl (normal: 70-140 μg/dl); normales 89% (n = 130); bajos 11% (n = 16), albúmina baja: 53% (n = 77), transferrina baja: 65% (n = 94), IMC bajo: 53% (n = 78). Después de 4 semanas: valores normales de Cu en 93% y bajos en 7%, albúmina baja en 34%, transferrina baja en 52%. Tras 12 semanas: valores normales de Cu en 95% y bajos en 5%, albúmina baja en 25%, transferrina baja en 32%. No encontramos diferencias significativas en el Cusérico cuando se compara edad, género, enfermedad subyacente, IMC, albúmina y transferrina. Conclusiones: la mayoría de los enfermos presentan Cu sérico normal en el momento de la gastrostomía. Para los enfermos con Cu sérico bajo antes del procedimiento, la alimentación con preparaciones domésticas parece suficiente para su normalización progresiva.

Cirugía de los trastornos del comportamiento: el estado del arte

PubMed Central

Yampolsky, Claudio; Bendersky, Damián

2014-01-01

Introducción: La cirugía de los trastornos del comportamiento (CTC) se está convirtiendo en un tratamiento más común desde el desarrollo de la neuromodulación. Métodos: Este artículo es una revisión no sistemática de la historia, indicaciones actuales, técnicas y blancos quirúrgicos de la CTC. Dividimos su historia en 3 eras: la primera comienza en los inicios de la psicocirugía y termina con el desarrollo de las tícnicas estereotácticas, cuando comienza la segunda era. Ésta se caracteriza por la realización de lesiones estereotácticas. Nos encontramos transitando la tercera era, que comienza cuando la estimulación cerebral profunda (ECP) comienza a ser usada en CTC. Resultados: A pesar de los errores graves cometidos en el pasado, hoy en día, la CTC está renaciendo. Los trastornos psiquiátricos que se más frecuentemente se tratan con cirugía son: depresión refractaria, trastorno obsesivo-compulsivo y síndrome de Tourette. Además, algunos pacientes con agresividad fueron tratados quirúrgicamente. Hay varios blancos estereotácticos descriptos para estos trastornos. La estimulación vagal puede ser usada también para depresión. Conclusión: Los resultados de la ECP en estos trastornos parecen alentadores. Sin embargo, se necesitan más estudios randomizados para establecer la efectividad de la CTC. Debe tenerse en cuenta que una apropiada selección de pacientes nos ayudará a realizar un procedimiento más seguro así como también a lograr mejores resultados quirúrgicos, conduciendo a la CTC a ser más aceptada por psiquiatras, pacientes y sus familias. Se necesita mayor investigación en varios temas como: fisiopatología de los trastornos del comportamiento, indicaciones de CTC y nuevos blancos quirúrgicos. PMID:25165612

Análise dos fatores de risco relacionados às amputações maiores e menores de membros inferiores em hospital terciário

PubMed Central

de Jesus-Silva, Seleno Glauber; de Oliveira, João Pedro; Brianezi, Matheus Henrique Colepicolo; Silva, Melissa Andreia de Moraes; Krupa, Arturo Eduardo; Cardoso, Rodolfo Souza

2017-01-01

Resumo Contexto As amputações dos membros inferiores, sejam definidas como maiores ou menores, são um grave problema de saúde, com altos índices de morbimortalidade e de relevante impacto social. Diferentes características clínicas dos pacientes parecem estar relacionadas aos diferentes tipos de amputação realizados. Objetivos Analisar os fatores de risco presentes em pacientes submetidos a amputações de membros inferiores em hospital terciário. Métodos Estudo retrospectivo, transversal, envolvendo 109 pacientes submetidos a amputação de membro inferior em um período de 31 meses, através da análise de gênero e idade, 15 dados clínicos e cinco parâmetros laboratoriais presentes no momento da admissão. Os dados foram submetidos a estatística descritiva e comparativa através do teste t de Student não pareado (para variáveis numéricas), e dos testes de Mann-Whitney e exato de Fisher (para variáveis categóricas). Resultados Das 109 amputações realizadas, 59 foram maiores e 50 menores. A maioria dos pacientes era do gênero masculino (65%), e a média de idade foi de 65 anos (mín. 39, máx. 93). Dentre os fatores de risco observados, idade avançada, acidente vascular encefálico, isquemia, sepse e níveis baixos de hemoglobina e hematócrito estavam estatisticamente mais relacionados às amputações maiores (p < 0,05). Diabetes melito, neuropatia e pulsos distais palpáveis foram fatores mais associados às amputações menores. Conclusões Os níveis das amputações de membros inferiores estão relacionados a diferentes fatores de risco. Os quadros isquêmicos mais graves e de maior morbidade estiveram associados a amputações maiores, enquanto a neuropatia e perfusão preservada, mais relacionados às amputações menores. PMID:29930618

Spontaneous pneumomediastinum: experience in 18 patients during the last 12 years.

PubMed

Dionísio, Patrícia; Martins, Luís; Moreira, Susana; Manique, Alda; Macedo, Rita; Caeiro, Fátima; Boal, Luísa; Bárbara, Cristina

2017-01-01

To characterize clinically all of the patients with spontaneous pneumomediastinum (SPM) admitted to an adult pulmonology ward in Lisbon, Portugal. This was a retrospective descriptive study of all adult patients (≥ 18 years of age) diagnosed with SPM between January of 2004 and September of 2015. At least one predisposing factor was identified in most (88.9%) of the 18 patients who presented with SPM during the study period. With regard to precipitating factors, bouts of cough were present in 50.0% of the patients. Other precipitating factors included a sudden increase in tobacco consumption, inhaled drug use, occupational inhalation of varnish fumes, intense exercise, and vomiting. The most common complaints were dyspnea (in 83.3%) and chest pain (in 77.8%). Other complaints included cough, neck pain, dysphagia, and odynophagia. Subcutaneous emphysema was found in most of the patients. The diagnosis of SPM was based on chest X-ray findings in 61.1% of the patients. Although SPM is a rare condition, it should be considered in the differential diagnosis of chest pain and dyspnea. It can develop without a triggering event or conclusive findings on a chest X-ray, which is usually sufficient for diagnosis. Caracterizar clinicamente todos os pacientes com pneumomediastino espontâneo (PME) admitidos em uma enfermaria de pneumologia para adultos em Lisboa, Portugal. Estudo descritivo retrospectivo no qual foram analisados todos os pacientes adultos (≥ 18 anos de idade) com diagnóstico de PME entre janeiro de 2004 e setembro de 2015. Pelo menos um fator predisponente foi identificado na maioria (isto é, em 88,9%) dos 18 pacientes que apresentaram PME durante o período de estudo. No tocante a fatores precipitantes, crises de tosse ocorreram em 50,0% dos pacientes. Outros fatores precipitantes foram um aumento repentino do consumo de tabaco, uso de drogas inalatórias, inalação ocupacional de vapores de vernizes, exercício intenso e vômitos. As queixas mais

Cavernomas de la región temporal mesial: Anatomía microquirúrgica y abordajes

PubMed Central

Campero, Alvaro

2015-01-01

Objetivo: Describir la anatomía microquirúrgica y los abordajes a la región temporal mesial (RTM), en relación a cavernomas de dicho sector. Materiales y Método: Cinco cabezas de cadáveres adultos, fijadas en formol e inyectadas con silicona coloreada, fueron estudiadas. Además, desde enero de 2007 a junio de 2014, 7 pacientes con cavernomas localizados en la RTM fueron operados por el autor. Resultados: Anatomia: La RTM fue dividida en 3 sectores: Anterior, medio y posterior. Pacientes: 7 enfermos con cavernomas de la RTM fueron operados por el autor. De acuerdo a la ubicacion en la RTM, 4 cavernomas se ubicaron en el sector anterior, 2 cavernomas se localizaron en el sector medio y 1 cavernoma se ubico en el sector posterior. Para el sector anterior de la RTM se utilizo un abordaje transsilviano-transinsular; para el sector medio de la RTM se utilizo un abordaje transtemporal (lobectomia temporal anterior); y para el sector posterior de la RTM se utilizo un abordaje supracerebeloso-transtentorial. Conclusión: Dividir la RTM en 3 sectores nos permite adecuar el abordaje en función a la localización de la lesión. Así, el sector anterior es bien abordable a través de la fisura silviana; el sector medio a través de una vía transtemporal; y el sector posterior por un abordaje supracerebeloso. PMID:26600986

SLEEVE GASTRECTOMY IN PATIENTS WITH MORBID OBESITY AND HIV.

PubMed

Pinto, José Máximo Costa; Lima, Marianna Gomes Cavalcanti Leite de; Almeida, Ana Luiza Melo Cavalcanti de; Sousa, Marcelo Gonçalves

It is estimated that there are nearly 40 million people with the human immunodeficiency virus (HIV) worldwide. Due to the advent of antiretroviral drugs, it has been observed increasing in obesity and metabolic rates among patients undergoing treatment. Thus, numerous surgical therapies for weight loss are proposed for continuous improvement in health of patients with HIV, being the vertical gastrectomy an option for intact intestinal transit. To evaluate the applicability of the vertical gastrectomy in patients with morbid obesity and HIV. Was conducted a systematic review of the literature, in the electronic databases Scopus, Pubmed, Cinahl, Scielo, Cochrane and Lilacs, from 1998 to 2015. MeSH headings used in data collection were "Gastrectomy" and "Morbid obesity" being combined with the descriptor "HIV". Were found 2148 articles in Scopus, 1234 in PubMed and 784 in Cinahl. The articles were analyzed by the Jadad Quality Scale, being reduced to 40 articles, subsequently reassessed using an elaborated form by the Critical Appraisal Skills Programme (CASP), reaching 12 articles in the end. It was found that vertical gastrectomy constitutes a safe and effective method, with low mortality and low rate of postoperative complications, being recommended as surgical technique in patients with obesity, HIV and comorbidities. Estima-se que haja quase 40 milhões de pessoas com o vírus da imunodeficiência adquirida (HIV) no mundo. Com o advento dos antirretrovirais, observou-se aumento da obesidade e de taxas metabólicas nos pacientes em tratamento. Assim, inúmeras terapias cirúrgicas para a perda de peso estão sendo estudadas para a melhoria contínua da saúde dos pacientes com HIV, sendo a gastrectomia vertical uma opção de trânsito íntegro. Avaliar a aplicabilidade da gastrectomia vertical em pacientes com obesidade mórbida e HIV. Foi realizada revisão sistemática de literatura, de artigos publicados nas bases eletrônicas de dados Scopus, Pubmed, Cinahl

Curvas de fusión de regiones genómicas específicas: una herramienta prometedora para el diagnóstico y tipificación de las especies causantes de la leishmaniasis cutánea en Colombia.

PubMed

Marin, Johana; Urrea, Daniel; Muskus, Carlos; Echeverry, María Clara; Mejía, Ana María; Triana, Omar

2017-12-01

Introducción. La leishmaniasis cutánea es una enfermedad causada por parásitos del género Leishmania que tiene gran incidencia en Colombia. El diagnóstico y la identificación de la especie infecciosa son factores críticos en el momento de escoger e iniciar el tratamiento. Actualmente, los métodos de diagnóstico y tipificación requieren procedimientos complejos, por lo que es necesario validar nuevos marcadores moleculares y métodos que simplifiquen el proceso.Objetivo. Desarrollar una herramienta basada en la reacción en cadena de la polimerasa (PCR) con curvas de fusión (High Resolution Melting; PCR-HRM) para el diagnóstico y tipificación de las tres especies de Leishmania de importancia epidemiológica en casos de leishmaniasis cutánea en Colombia.Materiales y métodos. Los genomas de Leishmania panamensis, L. braziliensis y L. guyanensis se compararon mediante métodos bioinformáticos. Las regiones específicas de especie identificadas se validaron mediante PCR. Para los marcadores seleccionados se diseñó una PCR-HRM y se estimaron algunos parámetros de validez y seguridad usando aislamientos de pacientes colombianos caracterizados previamente mediante PCR y análisis de polimorfismos en la longitud de los fragmentos de restricción (Restriction Fragment Length Polymorphism - RFLP; PCR-RFLP) del gen hsp70.Resultados. El análisis genómico comparativo mostró 24 regiones específicas de especie. Sin embargo, la validación mediante PCR solo identificó un marcador específico para cada especie de Leishmania. Los otros marcadores mostraron amplificación cruzada. El límite de detección para los tres marcadores seleccionados fue de un parásito, mientras que la sensibilidad, la especificidad, el valor predictivo positivo y el negativo fueron de 91,4, 100, 100 y 75 %, respectivamente.Conclusiones. Las tres regiones seleccionadas pueden emplearse como marcadores moleculares en el diagnóstico y tipificación de las especies causantes de la

ORTHO-PARA SELECTION RULES IN THE GAS-PHASE CHEMISTRY OF INTERSTELLAR AMMONIA

DOE Office of Scientific and Technical Information (OSTI.GOV)

Faure, A.; Hily-Blant, P.; Le Gal, R.

The ortho-para chemistry of ammonia in the cold interstellar medium is investigated using a gas-phase chemical network. Branching ratios for the primary reaction chain involved in the formation and destruction of ortho- and para-NH{sub 3} were derived using angular momentum rules based on the conservation of the nuclear spin. We show that the 'anomalous' ortho-to-para ratio of ammonia ({approx}0.7) observed in various interstellar regions is in fact consistent with nuclear spin selection rules in a para-enriched H{sub 2} gas. This ratio is found to be independent of temperature in the range 5-30 K. We also predict an ortho-to-para ratio ofmore » {approx}2.3 for NH{sub 2}. We conclude that a low ortho-to-para ratio of H{sub 2} naturally drives the ortho-to-para ratios of nitrogen hydrides below the statistical values.« less

Surgical site infection in patients submitted to heart transplantation.

PubMed

Rodrigues, Jussara Aparecida Souza do Nascimento; Ferretti-Rebustini, Renata Eloah de Lucena; Poveda, Vanessa de Brito

2016-08-29

to analyze the occurrence and predisposing factors for surgical site infection in patients submitted to heart transplantation, evaluating the relationship between cases of infections and the variables related to the patient and the surgical procedure. retrospective cohort study, with review of the medical records of patients older than 18 years submitted to heart transplantation. The correlation between variables was evaluated by using Fisher's exact test and Mann-Whitney-Wilcoxon test. the sample consisted of 86 patients, predominantly men, with severe systemic disease, submitted to extensive preoperative hospitalizations. Signs of surgical site infection were observed in 9.3% of transplanted patients, with five (62.5%) superficial incisional, two (25%) deep and one (12.5%) case of organ/space infection. There was no statistically significant association between the variables related to the patient and the surgery. there was no association between the studied variables and the cases of surgical site infection, possibly due to the small number of cases of infection observed in the sample investigated. analisar a ocorrência e os fatores predisponentes para infecção de sítio cirúrgico em pacientes submetidos a transplante cardíaco e verificar a relação entre os casos de infecção e as variáveis referentes ao paciente e ao procedimento cirúrgico. estudo de coorte retrospectivo, com exame dos prontuários médicos de pacientes maiores de 18 anos, submetidos a transplante cardíaco. A correlação entre variáveis foi realizada por meio dos testes exato de Fischer e de Mann-Whitney-Wilcoxon. a amostra foi constituída por 86 pacientes, predominantemente homens, com doença sistêmica grave, submetidos a internações pré-operatórias extensas. Apresentaram sinais de infecção do sítio cirúrgico 9,3% dos transplantados, sendo cinco (62,5%) incisionais superficiais, duas (25%) profundas e um (12,5%) caso de infecção de órgão/espaço. Não houve associa

Retrospective analysis of a case series of patients with traumatic injuries to the craniocervical junction.

PubMed

Esteves, Luiz Adriano; Joaquim, Andrei Fernandes; Tedeschi, Helder

2016-01-01

sexo masculino e a média de idade foi de 41,7 anos. Inicialmente 32% dos pacientes foram submetidos a tratamento cirúrgico, e 68% foram submetidos a tratamento conservador. Sete pacientes (29%) do grupo conservador foram submetidos posteriormente à cirurgia. No grupo cirúrgico, houve sete casos de fratura de odontóide tipo II, dois casos de fratura de elementos posteriores do áxis, um caso de luxação C1-C2, um caso de deslocamento occipito-cervical e um caso de fraturas de C1 e C2 e luxação facetária. Um paciente apresentava déficit neurológico, melhorando após o tratamento. Houve duas complicações pós-cirúrgicas, uma fístula liquórica e uma infecção de ferida operatória (reabordada). No grupo conservador, predominaram as fraturas do odontóide (oito) e dos elementos posteriores de C2 (cinco). Em dois casos, havia também fraturas em outros segmentos da coluna. Nenhum dos pacientes deste grupo apresentou deterioração neurológica. As lesões da junção craniocervical são raras, sendo mais frequentes as fraturas do odontóide e dos elementos posteriores do áxis. Nossos resultados recomendam o tratamento cirúrgico precoce para os pacientes com fraturas do odontóide tipo II e lesões ligamentares, e tratamento conservador para os demais pacientes.

Measurement of Family-centered care perception and parental stress in a neonatal unit.

PubMed

Balbino, Flávia Simphronio; Balieiro, Maria Magda Ferreira Gomes; Mandetta, Myriam Aparecida

2016-08-08

to evaluate the effects of the implementation of the Patient and Family-Centered Care Model on parents and healthcare perceptions and parental stress. a quasi-experimental study developed in a neonatal unit of a university hospital in the municipality of São Paulo, Brazil, with the implementation of this model of care. Data collection were performed by two sample groups, one using non-equivalent groups of parents, and another using equivalent groups of healthcare professionals. The instruments Perceptions of Family-Centered Care-Parent Brazilian Version, Perceptions of Family-Centered Care-Staff Brazilian Version and Parental Stress Scale: Neonatal Intensive Care Unit, were applied to 132 parents of newborns hospitalized and to 57 professionals. there was a statistically significant improvement in the perceptions of the parents in most items assessed (p ≤0,05) and for the staff in relation to the family welcome in the neonatal unit (p = 0.041) and to the comprehension of the family's experience with the infant´s hospitalization (p = 0,050). There was a reduction in the average scores of parental stress, with a greater decrease in the Alteration in Parental Role from 4,2 to 3,8 (p = 0,048). the interventions improved the perceptions of parents and healthcare team related to patient and family-centered care and contributed to reducing parental stress. avaliar os efeitos da implementação do Modelo do Cuidado Centrado no Paciente e Família na percepção de pais e profissionais de saúde e no estresse parental. Estudo quase experimental com grupos não equivalentes para avaliação dos efeitos da intervenção na percepção de pais; e com grupos equivalentes para a avaliação na percepção de profissionais de saúde, desenvolvido na unidade neonatal de um hospital universitário do município de São Paulo. Os instrumentos, Percepção do Cuidado Centrado na Família- Pais versão brasileira, Percepção do Cuidado Centrado na Família- Equipe vers

Key Nutritional Strategies to Optimize Performance in Para Athletes.

PubMed

Scaramella, Jacque; Kirihennedige, Nuwanee; Broad, Elizabeth

2018-05-01

Para athletes are a high-risk population for inadequate dietary intake leading to insufficiencies in nutrients important to athletic performance. This is partly due to minimal support and resources, especially in sport nutrition education, combined with limited prior nutrition knowledge and risks associated with different impairment types. Inadequate energy, carbohydrate, protein, iron, and vitamin D status are of particular concern in Para athletes. Assessment of these key nutrients, along with sport nutrition education, is needed to empower Para athletes with the knowledge to understand their individual nutrition needs and maximize athletic performance. Copyright © 2018 Elsevier Inc. All rights reserved.

Probing the Superfluid Response of para-Hydrogen with a Sulfur Dioxide Dopant.

PubMed

Zeng, Tao; Guillon, Grégoire; Cantin, Joshua T; Roy, Pierre-Nicholas

2013-07-18

We recently presented the first attempt at using an asymmetric top molecule (para-water) to probe the superfluidity of nanoclusters (of para-hydrogen) [ Zeng , T. ; Li , H. ; Roy , P.-N. J. Phys. Chem. Lett. 2013 , 4 , 18 - 22 ]. Unfortunately, para-water could not be used to probe the para-hydrogen superfluid response. We now report a theoretical simulation of sulfur dioxide rotating in para-hydrogen clusters and show that this asymmetric top can serve as a genuine probe of superfluidity. With this probe, we predict that as few as four para-hydrogen molecules are enough to form a superfluid cluster, the smallest superfluid system to date. We also propose the concept of "exchange superfluid fraction" as a more precise measurement. New superfluid scenarios brought about by an asymmetric top dopant and potential experimental measurements are discussed.

Does the Attention Deficit Hyperactivity Disorder interfere with bariatric surgery results?

PubMed

Marchesi, Doglas Gobbi; Ciriaco, Jovana Gobbi Marchesi; Miguel, Gustavo Peixoto Soares; Batista, Gustavo Adolfo Pavan; Cabral, Camila Pereira; Fraga, Larissa Carvalho

2017-01-01

to analyze possible negative effects of Attention Deficit Hyperactivity Disorder (ADHD) on the success of bariatric surgery. we evaluated forty patients undergoing bariatric surgery and with regular post-operative follow-up of at least one year. To all, we applied the questionnaire advocated in the fourth edition of the Diagnostic and Statistical Manual (DSM-IV) of the American Psychiatric Association for ADHD, as well as analyzed their postoperative data. fifteen (38%) patients presented a positive questionnaire for ADHD. Patients with ADHD presented higher BMI than patients without the disorder (45.8 vs. 40.9 kg/m2, p=0.017), and the difference remained in all postoperative stages. There was no statistically significant difference in surgery success (33.3% x 66.7%, p=0.505) or in BMI reduction (30.71% x 31.88%, p=0.671) one year after the procedure. ADHD patients have a higher BMI. However, the presence of ADHD does not influence the success of bariatric surgery and the reduction of BMI. analisar possíveis efeitos negativos do Transtorno do Déficit de Atenção e Hiperatividade (TDAH) no sucesso da cirurgia bariátrica. foram avaliados 40 pacientes submetidos à cirurgia bariátrica e com acompanhamento pós-operatório regular mínimo de um ano. Todos foram submetidos ao questionário preconizado na quarta edição do Diagnostic and Statistical Manual (DSM-IV) da Associação Americana de Psiquiatria para TDAH e analisados os dados pós operatórios. : quinze (38%) pacientes apresentaram questionário positivo para TDAH. Os pacientes com TDAH apresentaram IMC maior do que os pacientes sem o transtorno (45,8x40,9 Kg/m2; p=0,017), mantendo-se a diferença em todas as etapas do pós-operatório. Não foi encontrada diferença estatisticamente significativa no sucesso da cirurgia (33,3% x 66,7%; p=0,505), e na redução do IMC (30,71% x 31,88%; p=0,671) após um ano do procedimento. : pacientes com TDAH apresentam maior IMC, entretanto, a presença do TDAH n

[Not Available].

PubMed

Germán Díaz, Marta; Moreno Villares, José Manuel; Gomis Muñoz, Pilar

2016-07-19

Introducción: la nutrición parenteral domiciliaria se ha convertido en un punto clave en el tratamiento de pacientes con fracaso intestinal crónico. A pesar de los importantes avances que se han producido en las últimas décadas, tanto en los accesos vasculares, como en las soluciones empleadas, las infecciones asociadas a catéter venoso central siguen constituyendo una de las complicaciones más importantes. Dentro de las estrategias para la prevención o el tratamiento de estas infecciones se encuentra el empleo de sellados con antisépticos, como el etanol o la taurolidina, o de antibióticos.Objetivo: el objetivo de este artículo es revisar la evidencia disponible sobre el empleo de sellados con antisépticos o antibióticos en el manejo de pacientes pediátricos con nutrición parenteral domiciliaria.Material y métodos: el uso de sellados con etanol o taurolidina para prevenir el desarrollo de infecciones asociadas a catéter central estaría indicado en pacientes con nutrición parenteral domiciliaria que hayan tenido más de una infección en el año anterior o que se consideren pacientes de riesgo. Los sellados con antibióticos están indicados en el tratamiento de bacteriemias asociadas a catéter central producidas por S. coagulasa-negativo o gramnegativos, asociados a un tratamiento sistémico, siempre que sea posible, con el fin de salvar el catéter. Se debería llevar a cabo la retirada del mismo cuando existan signos de infección del punto de entrada o del trayecto subcutáneo, o cuando el germen responsable de la infección sea S. aureus o Cándida.Conclusión: a pesar de que la fuerza de la evidencia sobre la eficacia del sellado en la prevención o el tratamiento de infecciones asociadas al catéter es limitada, tanto en el niño como en el adulto, cada vez existen más datos a usar esta alternativa en pacientes con nutrición parenteral domiciliaria en los que la atención y salvaguarda de los catéteres es primordial.

Lampreys, the jawless vertebrates, contain only two ParaHox gene clusters.

PubMed

Zhang, Huixian; Ravi, Vydianathan; Tay, Boon-Hui; Tohari, Sumanty; Pillai, Nisha E; Prasad, Aravind; Lin, Qiang; Brenner, Sydney; Venkatesh, Byrappa

2017-08-22

ParaHox genes ( Gsx , Pdx , and Cdx ) are an ancient family of developmental genes closely related to the Hox genes. They play critical roles in the patterning of brain and gut. The basal chordate, amphioxus, contains a single ParaHox cluster comprising one member of each family, whereas nonteleost jawed vertebrates contain four ParaHox genomic loci with six or seven ParaHox genes. Teleosts, which have experienced an additional whole-genome duplication, contain six ParaHox genomic loci with six ParaHox genes. Jawless vertebrates, represented by lampreys and hagfish, are the most ancient group of vertebrates and are crucial for understanding the origin and evolution of vertebrate gene families. We have previously shown that lampreys contain six Hox gene loci. Here we report that lampreys contain only two ParaHox gene clusters (designated as α- and β-clusters) bearing five ParaHox genes ( Gsxα , Pdxα , Cdxα , Gsxβ , and Cdxβ ). The order and orientation of the three genes in the α-cluster are identical to that of the single cluster in amphioxus. However, the orientation of Gsxβ in the β-cluster is inverted. Interestingly, Gsxβ is expressed in the eye, unlike its homologs in jawed vertebrates, which are expressed mainly in the brain. The lamprey Pdxα is expressed in the pancreas similar to jawed vertebrate Pdx genes, indicating that the pancreatic expression of Pdx was acquired before the divergence of jawless and jawed vertebrate lineages. It is likely that the lamprey Pdxα plays a crucial role in pancreas specification and insulin production similar to the Pdx of jawed vertebrates.

Ortho- and para-hydrogen in dense clouds, protoplanets, and planetary atmospheres

NASA Technical Reports Server (NTRS)

Decampli, W. M.; Cameron, A. G. W.; Bodenheimer, P.; Black, D. C.

1978-01-01

If ortho- and para-hydrogen achieve a thermal ratio on dynamical time scales in a molecular hydrogen cloud, then the specific heat is high enough in the temperature range 35-70 K to possibly induce hydrodynamic collapse. The ortho-para ratio in many interstellar cloud fragments is expected to meet this condition. The same may have been true for the primitive solar nebula. Detailed hydrodynamic and hydrostatic calculations are presented that show the effects of the assumed ortho-para ratio on the evolution of Jupiter during its protoplanetary phase. Some possible consequences of a thermalized ortho-para ratio in the atmospheres of the giant planets are also discussed.

Cooling by conversion of para to ortho-hydrogen

NASA Technical Reports Server (NTRS)

Sherman, A. (Inventor)

1983-01-01

The cooling capacity of a solid hydrogen cooling system is significantly increased by exposing vapor created during evaporation of a solid hydrogen mass to a catalyst and thereby accelerating the endothermic para-to-ortho transition of the vapor to equilibrium hydrogen. Catalyst such as nickel, copper, iron or metal hydride gels of films in a low pressure drop catalytic reactor are suitable for accelerating the endothermic para-to-ortho conversion.

Patient Safety Incidents and Nursing Workload.

PubMed

Carlesi, Katya Cuadros; Padilha, Kátia Grillo; Toffoletto, Maria Cecília; Henriquez-Roldán, Carlos; Juan, Monica Andrea Canales

2017-04-06

to identify the relationship between the workload of the nursing team and the occurrence of patient safety incidents linked to nursing care in a public hospital in Chile. quantitative, analytical, cross-sectional research through review of medical records. The estimation of workload in Intensive Care Units (ICUs) was performed using the Therapeutic Interventions Scoring System (TISS-28) and for the other services, we used the nurse/patient and nursing assistant/patient ratios. Descriptive univariate and multivariate analysis were performed. For the multivariate analysis we used principal component analysis and Pearson correlation. 879 post-discharge clinical records and the workload of 85 nurses and 157 nursing assistants were analyzed. The overall incident rate was 71.1%. It was found a high positive correlation between variables workload (r = 0.9611 to r = 0.9919) and rate of falls (r = 0.8770). The medication error rates, mechanical containment incidents and self-removal of invasive devices were not correlated with the workload. the workload was high in all units except the intermediate care unit. Only the rate of falls was associated with the workload. identificar a relação entre a carga de trabalho da equipe de enfermagem e a ocorrência de incidentes de segurança dos pacientes ligados aos cuidados de enfermagem de um hospital público no Chile. pesquisa transversal analítica quantitativa através de revisão de prontuários médicos. A estimativa da carga de trabalho em Unidade de Terapia Intensiva (UTI) foi realizada utilizando o Índice de Intervenções Terapêuticas-TISS-28 e para os outros serviços, foram utilizados os cocientes enfermeira/paciente e auxiliar de enfermagem/ paciente. Foram feitas análises univariada descritiva e multivariada. Para a análise multivariada utilizou-se análise de componentes principais e correlação de Pearson. foram analisados 879 prontuáriosclínicos de pós-alta e a carga de trabalho de 85 enfermeiros e 157

Physical Stress Echocardiography: Prediction of Mortality and Cardiac Events in Patients with Exercise Test showing Ischemia.

PubMed

Araujo, Ana Carla Pereira de; Santos, Bruno F de Oliveira; Calasans, Flavia Ricci; Pinto, Ibraim M Francisco; Oliveira, Daniel Pio de; Melo, Luiza Dantas; Andrade, Stephanie Macedo; Tavares, Irlaneide da Silva; Sousa, Antonio Carlos Sobral; Oliveira, Joselina Luzia Menezes

2014-11-01

ísico na doença arterial coronária, mas a predição de mortalidade e de eventos cardíacos maiores, em pacientes com teste ergométrico positivo para isquemia miocárdica, é limitada. Objetivo: Avaliar a predição de mortalidade e de eventos cardíacos maiores pela ecocardiografia com estresse físico em pacientes com teste ergométrico positivo para isquemia miocárdica. Métodos: Trata-se de uma coorte retrospectiva em que foram estudados 866 pacientes consecutivos, com teste ergométrico positivo para isquemia miocárdica, submetidos à ecocardiografia com estresse físico. Os pacientes foram divididos em dois grupos: ecocardiografia com estresse físico negativa (G1) ou positiva (G2) para isquemia miocárdica. Os desfechos avaliados foram mortalidade por qualquer causa e eventos cardíacos maiores, definidos como óbito cardíaco e infarto agudo do miocárdio não fatal. Resultados: O G2 constituiu-se de 205 (23,7%) pacientes. Durante o seguimento médio de 85,6 ± 15,0 meses, ocorreram 26 óbitos, sendo seis por causa cardíaca, e 25 casos de infarto agudo do miocárdio não fatais. Os preditores independentes de mortalidade foram idade, diabetes melito e a ecocardiografia com estresse físico + (hazard ratio: 2,69; intervalo de confiança de 95%: 1,20 - 6,01; p = 0,016), com os seguintes eventos cardíacos maiores: idade, doença arterial coronária prévia, ecocardiografia com estresse físico + (hazard ratio: 2,75; intervalo de confiança de 95%: 1,15 - 6,53; p = 0,022) e ausência do incremento de 10% na fração de ejeção. A mortalidade por qualquer causa e os eventos cardíacos maiores foram significativamente superiores no G2 (p < 0, 001 e p = 0,001, respectivamente). Conclusão: A ecocardiografia com estresse físico oferece informações prognósticas adicionais em pacientes com teste ergométrico positivo para isquemia miocárdica.

Influence of Molecular Oxygen on Ortho-Para Conversion of Water Molecules

NASA Astrophysics Data System (ADS)

Valiev, R. R.; Minaev, B. F.

2017-07-01

The mechanism of influence of molecular oxygen on the probability of ortho-para conversion of water molecules and its relation to water magnetization are considered within the framework of the concept of paramagnetic spin catalysis. Matrix elements of the hyperfine ortho-para interaction via the Fermi contact mechanism are calculated, as well as the Maliken spin densities on water protons in H2O and O2 collisional complexes. The mechanism of penetration of the electron spin density into the water molecule due to partial spin transfer from paramagnetic oxygen is considered. The probability of ortho-para conversion of the water molecules is estimated by the quantum chemistry methods. The results obtained show that effective ortho-para conversion of the water molecules is possible during the existence of water-oxygen dimers. An external magnetic field affects the ortho-para conversion rate given that the wave functions of nuclear spin sublevels of the water protons are mixed in the complex with oxygen.

Simple motor tasks independently predict extubation failure in critically ill neurological patients.

PubMed

Kutchak, Fernanda Machado; Rieder, Marcelo de Mello; Victorino, Josué Almeida; Meneguzzi, Carla; Poersch, Karla; Forgiarini, Luiz Alberto; Bianchin, Marino Muxfeldt

2017-01-01

To evaluate the usefulness of simple motor tasks such as hand grasping and tongue protrusion as predictors of extubation failure in critically ill neurological patients. This was a prospective cohort study conducted in the neurological ICU of a tertiary care hospital in the city of Porto Alegre, Brazil. Adult patients who had been intubated for neurological reasons and were eligible for weaning were included in the study. The ability of patients to perform simple motor tasks such as hand grasping and tongue protrusion was evaluated as a predictor of extubation failure. Data regarding duration of mechanical ventilation, length of ICU stay, length of hospital stay, mortality, and incidence of ventilator-associated pneumonia were collected. A total of 132 intubated patients who had been receiving mechanical ventilation for at least 24 h and who passed a spontaneous breathing trial were included in the analysis. Logistic regression showed that patient inability to grasp the hand of the examiner (relative risk = 1.57; 95% CI: 1.01-2.44; p < 0.045) and protrude the tongue (relative risk = 6.84; 95% CI: 2.49-18.8; p < 0.001) were independent risk factors for extubation failure. Acute Physiology and Chronic Health Evaluation II scores (p = 0.02), Glasgow Coma Scale scores at extubation (p < 0.001), eye opening response (p = 0.001), MIP (p < 0.001), MEP (p = 0.006), and the rapid shallow breathing index (p = 0.03) were significantly different between the failed extubation and successful extubation groups. The inability to follow simple motor commands is predictive of extubation failure in critically ill neurological patients. Hand grasping and tongue protrusion on command might be quick and easy bedside tests to identify neurocritical care patients who are candidates for extubation. Avaliar a utilidade de tarefas motoras simples, tais como preensão de mão e protrusão da língua, para predizer extubação malsucedida em pacientes neurológicos críticos. Estudo

[Not Available].

PubMed

Ballesteros-Pomar, María; Villar-Taibo, Rocío; Calleja-Fernández, Alicia; Pintor-de-la-Maza, Begoña; Álvarez-Del-Campo, Cecilia; Vidal-Casariego, Alfonso; Cano-Rodríguez, Isidoro

2016-06-03

Los datos del estudio PREDYCES® nos revelaron que en España la desnutrición relacionada con la enfermedad (DRE) afecta a uno de cada cuatro pacientes hospitalizados. Esta cifra aumenta hasta el 36,8% en los pacientes hematológicos. Se calcula que un 20% de los pacientes oncológicos muere por complicaciones relacionadas con la DRE. Nuestro grupo se planteó en 2011 comenzar la implantación de un cribado nutricional en los servicios con mayor riesgo de DRE. La presente revisión trata de describir todo el proceso que hemos seguido para mejorar la situación nutricional en los pacientes ingresados en el Servicio de Hematología del Complejo Asistencial Universitario de León (CAULE), mayoritariamente con diagnóstico de neoplasias hematológicas. En un primer estudio piloto, detectamos una alta prevalencia de desnutrición, que tendió a aumentar durante la hospitalización. Además, solo el 8,3% los enfermos valorados recibieron algún tipo de soporte nutricional y no se estaban cubriendo sus necesidades ni calóricas ni proteicas, lo que se asociaba a un peor pronóstico. Por este motivo, nos decidimos a implantar de manera sistemática un cribado y una intervención nutricional adecuada, que comenzó en 2011 y que ha recibido el reconocimiento como Buena Práctica del Sistema Nacional de Salud.

The Ortho-to-para Ratio of Water Molecules Desorbed from Ice Made from Para-water Monomers at 11 K

NASA Astrophysics Data System (ADS)

Hama, Tetsuya; Kouchi, Akira; Watanabe, Naoki

2018-04-01

Water has two nuclear-spin isomers: ortho- and para-H2O. Some observations of interstellar space and cometary comae have reported the existence of gaseous H2O molecules with anomalous ortho-to-para ratios (OPRs) less than the statistical value of three. This has been often used to estimate the formation temperature of ice on dust, which is inferred to be below 50 K. The relation between the nuclear-spin dynamics of H2O in ice at low temperatures and the OPR of gaseous H2O desorbed from the ice has yet to be explored in a laboratory. Consequently, the true meaning of the observed OPRs remains debated. We measure the OPR of H2O photodesorbed from ice made from para-H2O monomers at 11 K, which was prepared by the sublimation of Ne from a para-H2O/Ne matrix. The photodesorbed H2O molecules from the ice have the statistical OPR value of three, demonstrating the immediate nuclear-spin-state mixing of H2O toward the statistical value of ice even at 11 K. The OPR of H2O thermally desorbed from the ice also shows the expected statistical value. Our results indicate that the OPR of H2O desorbed from interstellar ice should be the statistical value regardless of the formation process of the ice, which cannot be used to deduce the ice-formation temperature. This study highlights the importance of interstellar gas-phase processes in understanding anomalous abundance ratios of nuclear-spin isomers of molecules in space.

Detection of the MW Transition Between Ortho and Para States

NASA Astrophysics Data System (ADS)

Kanamori, Hideto; Dehghani, Zeinab Tafti; Mizoguchi, Asao; Endo, Yasuki

2017-06-01

Thorough the detailed analysis of the hyperfine resolved rotational transitions, we have been pointed out that there exists not a little interaction between ortho and para states in the molecular Hamiltonian of S_2Cl_2. Using the ortho-para mixed molecular wavefunctions derived from the Hamiltonian, we calculated the transition moment and frequency of the ortho-para forbidden transitions in the cm- and mm-wave region, and picked up some promising candidate transitions for the spectroscopic detection. In the experiment, the S_2Cl_2 vapor with Ar buffer gas in a supersonic jet condition was used with FTMW spectrometer at National Chiao Tung University. As a result, seven hyperfine resolved rotational transitions in the cm-wave region were detected as the ortho-para transition at the predicted frequency within the experimental error range. The observed intensity was 10^{-3} smaller than that of an allowed transition, which is also consistent with the prediction. This is the first time the electric dipole transition between ortho and para states has been detected in a free isolated molecule. A. Mizoguchi, S. Ota, H. Kanamori, Y. Sumiyoshi, and Y. Endo, J. Mol. Spectrosc, 250, 86 (2008) Z. T. Dehghani, S. Ota, A. Mizoguchi and H. Kanamori, J. Phys. Chem. A, 117(39), 10041, (2013)

Sugammadex ED90 dose to reverse the rocuronium neuromuscular blockade in obese patients.

PubMed

Silva, Mauro Prado DA; Matsui, Christiano; Kim, Daniel Dongiou; Vieira, Joaquim Edson; Malheiros, Carlos Alberto; Mathias, Ligia Andrade Silva Telles

2017-01-01

to determine the ED90 (minimum effective dose in 90% of patients) of sugammadex for the reversal of rocuronium-induced moderate neuromuscular blockade (NMB) in patients with grade III obesity undergoing bariatric surgery. we conducted a prospective study with the biased coin up-and-down sequential design. We chosen the following doses: 2.0mg/Kg, 2.2mg/Kg, 2.4mg/Kg, 2.6mg/Kg, 2.8mg/Kg. The complete reversal of rocuronium-induced NMB considered a T4/T1 ratio ≥0.9 as measured by TOF. After induction of general anesthesia and calibration of the peripheral nerve stimulator and accelerometer, we injected rocuronium 0.6mg/kg. We administered propofol and remifentanil by continuous infusion, and intermittent boluses of rocuronium throughout the procedure. we evaluated 31 patients, of whom 26 had displayed successful reversal of the NMB with sugammadex, and failure in five. The mean time to complete moderate NMB reversal was 213 seconds (172-300, median 25-75%). The ED90 of sugammadex calculated by regression was 2.39mg/kg, with a 95% confidence interval of 2.27-2.46 mg/kg. the ED90 of sugammadex in patients with grade III obesity or higher was 2.39mg/kg. determinar a ED90 (dose mínima eficaz em 90% dos pacientes) de sugamadex para a reversão de bloqueio neuromuscular (BNM) moderado induzido pelo rocurônio em pacientes com obesidade grau III submetidos à cirurgia bariátrica. estudo prospectivo com o método de projeção sequencial para cima e para baixo da moeda enviesada. As seguintes doses foram escolhidas: 2,0mg/kg-1, 2,2mg/kg-1, 2,4mg/kg-1, 2,6mg/kg-1, 2,8mg/kg-1. A reversão completa de BNM induzido por rocurônio considerou uma relação T4/T1 ≥0,9 na medida do TOF. Após a indução da anestesia geral e calibração do estimulador de nervo periférico e acelerômetro, rocurônio 0,6mg/kg-1 foi injetado. Infusão contínua de propofol e remifentanil, e bolus intermitente de rocurônio foram injetados durante todo o procedimento. trinta e um pacientes foram

A Comparative Usage-Based Approach to the Reduction of the Spanish and Portuguese Preposition "Para"

ERIC Educational Resources Information Center

Gradoville, Michael Stephen

2013-01-01

This study examines the frequency effect of two-word collocations involving "para" "to," "for" (e.g. "fui para," "para que") on the reduction of "para" to "pa" (in Spanish) and "pra" (in Portuguese). Collocation frequency effects demonstrate that language speakers…

Prototype of a computerized scale for the active search for potential organ donors.

PubMed

Ludwig, Érika Fernanda Dos Santos Bezerra; Pereira, Marta Cristiane Alves; Martinez, Yolanda Dora Évora; Mendes, Karina Dal Sasso; Rossaneis, Mariana Angela

2017-09-12

to develop a prototype of a computerized scale for the active search for potential organ and tissue donors. methodological study, with the analysis of 377 electronic medical records of patients who died due to encephalic death or cardiorespiratory arrest in the intensive care units of a tertiary hospital. Among the deaths due to cardiorespiratory arrest, the study aimed to identify factors indicating underreported encephalic death cases. The Acute Physiology and Chronic Health Evaluation II and Sepsis Related Organ Failure Assessment severity indexes were applied in the protocols. Based on this, a scale was built and sent to five experts for assessment of the scale content, and subsequently, it was computerized by using a prototyping model. 34 underreported encephalic death cases were identified in the medical records of patients with cardiorespiratory arrest. Statistically significant differences were found in the Wilcoxon test between the scores of hospital admissions in the intensive care unit and the opening of the encephalic death protocol for both severity indexes. the prototype was effective for identifying potential organ donors, as well as for the identification of the degree of organ dysfunction in patients with encephalic death. desenvolver protótipo de escala informatizada para busca ativa de potenciais doadores de órgãos e tecidos. pesquisa metodológica, com análise de 377 prontuários eletrônicos de pacientes que evoluíram a óbito, por morte encefálica, ou parada cardiorrespiratória, nas unidades de terapia intensiva de hospital terciário. Nos óbitos por parada cardiorrespiratória, buscou-se identificar fatores que indicassem subnotificação de morte encefálica. Nos protocolos, foram aplicados os índices de gravidade Acute Physiology and Chronic Health Evaluation II e Sepsis Related Organ Failure Assessment. A partir disso, construiu-se a escala que foi encaminhada a cinco especialistas, para avaliação de conteúdo, e, posteriormente

Preparation of ortho-para ratio controlled D2 gas for muon-catalyzed fusion.

PubMed

Imao, H; Ishida, K; Kawamura, N; Matsuzaki, T; Matsuda, Y; Toyoda, A; Strasser, P; Iwasaki, M; Nagamine, K

2008-05-01

A negative muon in hydrogen targets, e.g., D2 or D-T mixture, can catalyze nuclear fusions following a series of atomic processes involving muonic hydrogen molecular formation (muon-catalyzed fusion, muCF). The ortho-para state of D2 is a crucial parameter not only for enhancing the fusion rate but also to precisely investigate various muonic atom processes. We have developed a system for controlling and measuring the ortho-para ratio of D2 gas for muCF experiments. We successfully collected para-enriched D2 without using liquid-hydrogen coolant. Ortho-enriched D2 was also obtained by using a catalytic conversion method with a mixture of chromium oxide and alumina. The ortho-para ratio of D2 gas was measured with a compact Raman spectroscopy system. We produced large volume (5-30 l at STP), high-purity (less than ppm high-Z contaminant) D2 targets with a wide range of ortho-para ratios (ortho 20%-99%). By using the ortho-para controlled D2 in muCF experiments, we observed the dependence of muCF phenomena on the ortho-para ratio.

Rotational excitation of HCN by para- and ortho-H₂.

PubMed

Vera, Mario Hernández; Kalugina, Yulia; Denis-Alpizar, Otoniel; Stoecklin, Thierry; Lique, François

2014-06-14

Rotational excitation of the hydrogen cyanide (HCN) molecule by collisions with para-H2(j = 0, 2) and ortho-H2(j = 1) is investigated at low temperatures using a quantum time independent approach. Both molecules are treated as rigid rotors. The scattering calculations are based on a highly correlated ab initio 4-dimensional (4D) potential energy surface recently published. Rotationally inelastic cross sections among the 13 first rotational levels of HCN were obtained using a pure quantum close coupling approach for total energies up to 1200 cm(-1). The corresponding thermal rate coefficients were computed for temperatures ranging from 5 to 100 K. The HCN rate coefficients are strongly dependent on the rotational level of the H2 molecule. In particular, the rate coefficients for collisions with para-H2(j = 0) are significantly lower than those for collisions with ortho-H2(j = 1) and para-H2(j = 2). Propensity rules in favor of even Δj transitions were found for HCN in collisions with para-H2(j = 0) whereas propensity rules in favor of odd Δj transitions were found for HCN in collisions with H2(j ⩾ 1). The new rate coefficients were compared with previously published HCN-para-H2(j = 0) rate coefficients. Significant differences were found due the inclusion of the H2 rotational structure in the scattering calculations. These new rate coefficients will be crucial to improve the estimation of the HCN abundance in the interstellar medium.

Factors associated with the incidence of pressure ulcer during hospital stay.

PubMed

Matozinhos, Fernanda Penido; Velasquez-Melendez, Gustavo; Tiensoli, Sabrina Daros; Moreira, Alexandra Dias; Gomes, Flávia Sampaio Latini

2017-05-25

Estimating the incidence rate of pressure ulcers and verifying factors associated with this occurrence in a cohort of hospitalized patients. This is a cohort study in which the considered outcome was the time until pressure ulcer occurrence. Estimated effect of the variables on the cumulative incidence ratio of the outcome was performed using the Cox proportional hazards model. Variable selection occurred via the Logrank hypothesis test. The sample consisted of 442 adults, with 25 incidents of pressure ulcers. Patients with high scores on the Braden scale presented a higher risk of pressure ulcer incidence when compared to those classified into the low score category. These results reinforce the importance of using the Braden Scale to assist in identifying patients more likely to develop pressure ulcers. Estimar a taxa de incidência de úlcera por pressão e verificar fatores associados a essa ocorrência em uma coorte de pacientes hospitalizados. Trata-se de estudo de coorte no qual o desfecho foi a ocorrência da úlcera por pressão. A estimativa do efeito das variáveis para a proporção de incidência acumulada do desfecho foi realizada utilizando o modelo de riscos proporcionais de Cox. A seleção das variáveis ocorreu por meio do teste de hipóteses Logrank. A amostra foi composta de 442 adultos, com 25 casos incidentes de úlcera por pressão. Pacientes com altos escores na escala de Braden apresentaram maior risco de incidência de úlcera por pressão quando comparados com aqueles classificados na categoria de baixo escore. Os resultados reforçam a importância do uso da Escala de Braden para auxiliar na identificação dos pacientes com maior probabilidade de desenvolver úlcera por pressão.

Escleroterapia de safena associada a enxerto de pele no tratamento de úlceras venosas

PubMed Central

de Oliveira, Alexandre Faraco; de Oliveira, Horácio

2017-01-01

Resumo Contexto Úlceras são a resultante final de varizes associadas a refluxo de veias safenas. Objetivo Demonstrar a possibilidade de associar dois procedimentos, a escleroterapia com espuma de veias safenas e o enxerto de pele parcial, para o tratamento de pacientes com úlceras venosas relacionadas a refluxo de veias safenas. Métodos Foram tratados 20 membros em 20 pacientes, todos com ulcerações relacionadas a refluxo de veias safenas. Realizamos o enxerto de pele expandida, seguido da escleroterapia ecoguiada com espuma de polidocanol nas veias associadas às úlceras, através de punção ou dissecção da veia. Resultados Em todos os casos, houve melhora dos sintomas relacionados à úlcera e cicatrização da lesão. Em 11 casos, obtivemos a viabilidade do enxerto de pele por completo; em quatro casos, houve cicatrização de cerca de 50% da lesão; e nos cinco casos restantes, houve cicatrização de aproximadamente 75% da lesão. A primeira ultrassonografia de controle revelou esclerose completa dos vasos tratados em 19 dos 20 casos e esclerose parcial sem refluxo detectável em um caso. Na segunda ultrassonografia, realizada após 45 dias, observamos esclerose completa de 15 casos; em cinco casos, houve esclerose parcial, dos quais três sem refluxo detectável e dois com refluxo em segmentos isolados associados a varizes. A complicação mais frequente foi a pigmentação nos trajetos venosos, observada em 13 pacientes. Um caso apresentou trombose assintomática de veias musculares da perna. Conclusão Essa associação de procedimentos consiste em uma opção válida com potencial para promover um tratamento mais breve e de menor custo. PMID:29930660

Use of technologies in intravenous therapy: contributions to a safer practice.

PubMed

Moreira, Ana Paula Amorim; Escudeiro, Cristina Lavoyer; Christovam, Bárbara Pompeu; Silvino, Zenith Rosa; Carvalho, Márglory Fraga de; Silva, Roberto Carlos Lyra da

2017-01-01

To identify what are the difficulties of the nursing staff in the management of technologies during intravenous therapy (IVT) and discuss the difficulties identified under the perspective of patient's safety. Descriptive study of qualitative approach with data collected by semi-structured interview and analyzed by the Alceste software. The greatest difficulty of cognitive and technical emphasis was the lack of training; and regarding administrative emphasis, the greatest difficulty was the lack of material and human resources. Infusion pumps and their proper use were highlighted as the technological resource that most contributed to patient safety. The lack of training is presented as the greatest difficulty of nursing professionals and permeates safety issues of both patient and professional when using the hard technologies in IVT. Training is essential to the development of techniques, considered nursing tools. Identificar quais são as dificuldades da equipe de Enfermagem no manejo das tecnologias durante a terapia intravenosa (TIV) e discutir as dificuldades identificadas sob a perspectiva da segurança do paciente. abordagem qualitativa, do tipo descritivo com dados coletados por entrevista semiestruturada e analisados pelo programa Alceste. A maior dificuldade de ênfase cognitiva e técnica foi a falta de treinamento; e de ênfase administrativa, foi a falta de recursos materiais e humanos. As bombas de infusão e sua utilização adequada foram destacadas como o recurso tecnológico que mais contribuiu para a segurança do paciente. A falta de treinamento é apresentada como a maior dificuldade dos profissionais de Enfermagem e permeia as questões de segurança do paciente e do profissional ao utilizar as tecnologias duras na TIV. O treinamento é imprescindível para o desenvolvimento das técnicas, consideradas como ferramentas do fazer da Enfermagem.

Opioid analgesic administration in patients with suspected drug use.

PubMed

Kreling, Maria Clara Giorio Dutra; Mattos-Pimenta, Cibele Andrucioli de

2017-01-01

To identify the prevalence of patients suspected of drug use according to the nursing professionals' judgement, and compare the behavior of these professionals in opioid administration when there is or there is no suspicion that patient is a drug user. A cross-sectional study with 507 patients and 199 nursing professionals responsible for administering drugs to these patients. The Chi-Square test, Fisher's Exact and a significance level of 5% were used for the analyzes. The prevalence of suspected patients was 6.7%. The prevalence ratio of administration of opioid analgesics 'if necessary' is twice higher among patients suspected of drug use compared to patients not suspected of drug use (p = 0.037). The prevalence of patients suspected of drug use was similar to that of studies performed in emergency departments. Patients suspected of drug use receive more opioids than patients not suspected of drug use. Identificar a prevalência de pacientes com suspeita de uso de drogas conforme opinião de profissionais de enfermagem e comparar a conduta desses profissionais na administração de opioides quando há ou não suspeita de que o paciente seja usuário de drogas. Estudo transversal com 507 pacientes e 199 profissionais de enfermagem responsáveis pela administração de medicamentos a esses pacientes. Para as análises foram utilizados os testes de Qui-Quadrado, Exato de Fisher e um nível de significância de 5%. A prevalência de pacientes suspeitos foi 6,7%. A razão de prevalência de administração de analgésicos opioides "se necessário" é duas vezes maior entre os pacientes suspeitos em relação aos não suspeitos (p=0,037). A prevalência de suspeitos foi semelhante à de estudos realizados em departamentos de emergência. Os suspeitos de serem usuários de drogas recebem mais opioides do que os não suspeitos.

Strategies for coping with family members of patients with mental disorders.

PubMed

Pompeo, Daniele Alcalá; Carvalho, Arélica de; Olive, Aline Morgado; Souza, Maria da Graça Girade; Galera, Sueli Aparecida Frari

2016-09-09

to identify the coping strategies of family members of patients with mental disorders and relate them to family member sociodemographic variables and to the patient's clinical variables. this was a descriptive study conducted at a psychiatric hospital in the interior of the state of São Paulo, with 40 family members of hospitalized patients over the age of 18, and who followed the patient before and during hospitalization. We used tools to characterize the subjects and the Folkman and Lazarus Inventory of Coping Strategies. the coping strategies most often used by family members were social support and problem solving. Mothers and fathers used more functional strategies (self-control p=0.037, positive reappraisal p=0.037, and social support p=0,021). We found no significant differences between the strategies and other variables examined. despite the suffering resulting from the illness of a dear one, family members make more use of functional strategies, allowing them to cope with adversities in a more well-adjusted way. identificar as estratégias de enfrentamento de familiares de pacientes com transtornos mentais e relacioná-las com as variáveis sociodemográficas do familiar e clínicas do paciente. estudo descritivo, desenvolvido em hospital psiquiátrico do interior do estado de São Paulo, com 40 familiares de pacientes internados, maiores de 18 anos e que acompanhavam o paciente antes e durante a internação. Foram utilizados instrumentos para caracterização dos sujeitos e o Inventário de Estratégias de Enfrentamento de Folkman e Lazarus. as estratégias de enfrentamento mais utilizadas pelos familiares foram suporte social e resolução de problemas. Pais e mães utilizaram mais estratégias funcionais (autocontrole p=0,037; reavaliação positiva p=0,037; suporte social p=0,021). Não foram evidenciadas diferenças significativas entre as estratégias e as demais variáveis estudadas. apesar do sofrimento causado pelo impacto do adoecimento do seu

Educational intervention for collecting sputum for tuberculosis: a quasi-experimental study.

PubMed

Sicsú, Amélia Nunes; Salem, Julia Ignez; Fujimoto, Luciana Botinelly Mendonça; Gonzales, Roxana Isabel Cardozo; Cardoso, Maria do Socorro de Lucena; Palha, Pedro Fredemir

2016-06-07

intervenção educativa. comprovou-se que, após a intervenção educativa, obtiveram-se amostras de escarro com maior qualidade, com aspecto e volume satisfatórios para efetividade do exame baciloscópico. evaluar la calidad de la muestra de esputo antes y después de las orientaciones de Enfermería al paciente. de estudio con diseño de investigación casi experimental, del tipo grupo único, antes y después, no aleatorio. Participaron del estudio pacientes con sospecha de tuberculosis pulmonar, sintomáticos respiratorios por más de 3 semanas, mayores de 18 años, de los dos sexos y sin antecedente de tuberculosis en los últimos dos años. La intervención educativa consistió en orientaciones individualizadas sobre la recolección de la muestra de esputo, fundamentadas en las directrices del Ministerio de la Salud de Brasil y en la entrega de folder explicativo. participaron 138 pacientes con sospecha de tuberculosis pulmonar. Los resultados evidenciaron un importante aumento de las muestras con partículas purulentas, volumen mayor que 5mL y aumento en la tasa de pacientes diagnosticados con tuberculosis, después de la intervención educativa. se comprobó que, después de la intervención educativa, se obtuvieron muestras de esputo con mejor calidad, con aspecto y volumen satisfactorios para efectividad del examen de baciloscopía.

Patient safety: knowledge between multiprofessional residents.

PubMed

Oliveira, João Lucas Campos de; Silva, Simone Viana da; Santos, Pamela Regina Dos; Matsuda, Laura Misue; Tonini, Nelsi Salete; Nicola, Anair Lazzari

2017-01-01

To assess the knowledge of multiprofesional residents in health about the security of the patient theme. Cross-sectional study, quantitative, developed with graduate courses/residence specialties of health in a public university of Paraná, Brazil. Participants (n=78) answered a questionnaire containing nine objective questions related to patient safety. Data were analyzed using descriptive statistics, in proportion measures. The minimum 75% of correct answers was considered the cutoff for positive evaluation. The sample was predominantly composed of young people from medical programs. Almost half of the items evaluated (n=5) achieved the established positive pattern, especially those who dealt with the hand hygiene moments (98.8%) and goal of the Patient Safety National Program (92.3%). The identification of the patient was the worst rated item (37.7%). In the analysis by professional areas, only the Nursing reached the standard of hits established. Knowledge of the residents was threshold. Verificar o conhecimento de residentes multiprofissionais na área da saúde sobre o tema segurança do paciente. Estudo transversal, quantitativo, desenvolvido com pós-graduandos dos cursos/especialidades de residência da área da saúde de uma universidade pública do Paraná. Os participantes (n=78) responderam um questionário contendo nove questões objetivas relacionadas com a segurança do paciente. Os dados foram analisados por estatística descritiva, em medidas de proporção. O mínimo de 75% de acertos foi considerado ponto de corte para avaliação positiva. A amostra foi composta por profissionais predominantemente jovens, oriundos de programas médicos. Quase metade dos itens avaliados (n=5) alcançou o padrão de positividade estabelecido, com destaque para os que trataram dos momentos de higienização das mãos (98,8%) e o objetivo do Programa Nacional de Segurança do Paciente (92,3%). A identificação do paciente foi o pior item avaliado (37,7%). Na an

Hepcidin: an important iron metabolism regulator in chronic kidney disease.

PubMed

Antunes, Sandra Azevedo; Canziani, Maria Eugênia Fernandes

2016-01-01

Anemia is a common complication and its impact on morbimortality in patients with chronic kidney disease (CKD) is well known. The discovery of hepcidin and its functions has contributed to a better understanding of iron metabolism disorders in CKD anemia. Hepcidin is a peptide mainly produced by hepatocytes and, through a connection with ferroportin, it regulates iron absorption in the duodenum and its release of stock cells. High hepcidin concentrations described in patients with CKD, especially in more advanced stages are attributed to decreased renal excretion and increased production. The elevation of hepcidin has been associated with infection, inflammation, atherosclerosis, insulin resistance and oxidative stress. Some strategies were tested to reduce the effects of hepcidin in patients with CKD, however more studies are necessary to assess the impact of its modulation in the management of anemia in this population. Resumo Anemia é uma complicação frequente e seu impacto na morbimortalidade é bem conhecido em pacientes com doença renal crônica (DRC). A descoberta da hepcidina e de suas funções contribuíram para melhor compreensão dos distúrbios do metabolismo de ferro na anemia da DRC. Hepcidina é um peptídeo produzido principalmente pelos hepatócitos, e através de sua ligação com a ferroportina, regula a absorção de ferro no duodeno e sua liberação das células de estoque. Altas concentrações de hepcidina descritas em pacientes com DRC, principalmente em estádios mais avançados, são atribuídas à diminuição da excreção renal e ao aumento de sua produção. Elevação de hepcidina tem sido associada à ocorrência de infecção, inflamação, aterosclerose, resistência à insulina e estresse oxidativo. Algumas estratégias foram testadas para diminuir os efeitos da hepcidina em pacientes com DRC, entretanto, serão necessários mais estudos para avaliar o impacto de sua modulação no manejo da anemia nessa população.

Analyzing and Visualizing Cosmological Simulations with ParaView

NASA Astrophysics Data System (ADS)

Woodring, Jonathan; Heitmann, Katrin; Ahrens, James; Fasel, Patricia; Hsu, Chung-Hsing; Habib, Salman; Pope, Adrian

2011-07-01

The advent of large cosmological sky surveys—ushering in the era of precision cosmology—has been accompanied by ever larger cosmological simulations. The analysis of these simulations, which currently encompass tens of billions of particles and up to a trillion particles in the near future, is often as daunting as carrying out the simulations in the first place. Therefore, the development of very efficient analysis tools combining qualitative and quantitative capabilities is a matter of some urgency. In this paper, we introduce new analysis features implemented within ParaView, a fully parallel, open-source visualization toolkit, to analyze large N-body simulations. A major aspect of ParaView is that it can live and operate on the same machines and utilize the same parallel power as the simulation codes themselves. In addition, data movement is in a serious bottleneck now and will become even more of an issue in the future; an interactive visualization and analysis tool that can handle data in situ is fast becoming essential. The new features in ParaView include particle readers and a very efficient halo finder that identifies friends-of-friends halos and determines common halo properties, including spherical overdensity properties. In combination with many other functionalities already existing within ParaView, such as histogram routines or interfaces to programming languages like Python, this enhanced version enables fast, interactive, and convenient analyses of large cosmological simulations. In addition, development paths are available for future extensions.

Nursing workload for cancer patients under palliative care.

PubMed

Fuly, Patrícia Dos Santos Claro; Pires, Livia Márcia Vidal; Souza, Claudia Quinto Santos de; Oliveira, Beatriz Guitton Renaud Baptista de; Padilha, Katia Grillo

2016-01-01

To verify the nursing workload required by cancer patients undergoing palliative care and possible associations between the demographic and clinical characteristics of the patients and the nursing workload. This is a quantitative, cross-sectional, prospective study developed in the Connective Bone Tissue (TOC) clinics of Unit II of the Brazilian National Cancer Institute José Alencar Gomes da Silva with patients undergoing palliative care. Analysis of 197 measures of the Nursing Activities Score (NAS) revealed a mean score of 43.09% and an association between the performance status of patients undergoing palliative care and the mean NAS scores. The results of the study point to the need to resize the team of the unit. The NAS has proven to be a useful tool in oncologic clinical units for patients undergoing palliative care. Verificar a carga de trabalho de enfermagem requerida por pacientes com câncer sob cuidados paliativos e possíveis associações entre as características demográficas e clínicas dos pacientes e a carga de trabalho de enfermagem. Trata-se de um estudo de abordagem quantitativa, transversal, prospectivo, desenvolvido na clínica de Tecido Ósseo Conectivo (TOC) da Unidade II do Instituto Nacional de Câncer José Alencar Gomes da Silva, com pacientes em cuidados paliativos. A análise de 197 medidas do Nursing Activities Score (NAS) revelou um escore médio de 43,09% e uma associação entre a performance status de pacientes em cuidados paliativos com os valores médios do NAS. Os resultados do estudo apontam para a necessidade de redimensionamento da equipe da Unidade. O NAS mostrou-se um instrumento passível de utilização em unidades clínicas oncológicas, com pacientes em cuidados paliativos.

Knowledge of adolescents regarding sexually transmitted infections and pregnancy.

PubMed

Almeida, Rebeca Aranha Arrais Santos; Corrêa, Rita da Graça Carvalhal Frazão; Rolim, Isaura Letícia Tavares Palmeira; Hora, Jessica Marques da; Linard, Andrea Gomes; Coutinho, Nair Portela Silva; Oliveira, Priscila da Silva

2017-01-01

To investigate the knowledge of adolescents related to sexually transmitted infections (STIs), AIDS, and pregnancy, and understand the role of school in sex education. A qualitative descriptive study, developed through a semi-structured interview and a form for participant characterization, with 22 high school students from a public school aged 16 to 19 years. Data were submitted to content analysis. After analysis, four thematic categories were developed: sexuality and sex education; understanding of risk behaviors; knowledge of STI/AIDS; and knowledge of and practices for prevention. This study showed the need for preventive educational actions for adolescents, because the lack of information contributes to their vulnerability. The adolescents recognize the importance of sex education; therefore it is important to implement strategies to promote and protect health in the school environment to encourage and strengthen self-care in health. investigar o conhecimento de adolescentes relacionado às Infecções Sexualmente Transmissíveis (IST), AIDS e gravidez, além de conhecer a compreensão sobre o papel da escola na educação sexual. estudo qualitativo, descritivo, desenvolvido por meio de entrevista semiestruturada e formulário para caracterização dos participantes, com 22 adolescentes entre 16 e 19 anos de idade, estudantes do Ensino Médio em uma escola pública. Os dados foram submetidos à análise de conteúdo. da análise emergiram quatro categorias temáticas: Sexualidade e educação sexual; Compreensão de comportamentos de risco; Conhecimento de IST/AIDS; Conhecimento e práticas de prevenção. revelou-se a necessidade de ações educativas de prevenção para os adolescentes, pois a falta de informações contribui para a sua vulnerabilidade. Os adolescentes reconhecem a importância da educação sexual; consequentemente, é importante a implementação de estratégias de promoção e de proteção à saúde no ambiente escolar para contribuir e

Comparison of enterovirus detection in cerebrospinal fluid with Bacterial Meningitis Score in children.

PubMed

Pires, Frederico Ribeiro; Franco, Andréia Christine Bonotto Farias; Gilio, Alfredo Elias; Troster, Eduardo Juan

2017-01-01

ção ventricular ou neurocirurgia recente, imunossupressão, outra infecção bacteriana concomitante que necessitasse de antibioticoterapia parenteral e aqueles que receberam antibiótico 72 horas antes da punção lombar. Foram incluídos no estudo 503 pacientes. Destes, 64 foram excluídos e 94 não realizaram todos os exames para análise. Dos 345 pacientes restantes, 7 ficaram no Grupo de Meningite Bacteriana e 338 no Grupo de Meningite Asséptica. Não houve diferença estatística entre os grupos. Na análise do Escore de Meningite Bacteriana, dos 338 pacientes com possível meningite asséptica (culturas negativas), 121 deles tiveram um ou mais pontos para o Escore de Meningite Bacteriana, com valor de sensibilidade de 100%, especificidade de 64,2% e valor preditivo negativo de 100%. Dos 121 pacientes com Escore de Meningite Bacteriana positivo, 71% (86 pacientes) tiveram a pesquisa de enterovírus positiva no líquido cefalorraquidiano. A pesquisa de enterovírus no líquido cefalorraquidiano mostrou-se eficaz em diferenciar a meningite bacteriana da viral. Analisada junto com o Escore de Meningite Bacteriana, a especificidade foi maior em comparação ao Escore de Meningite Bacteriana isolado.

ANTIBIOTIC PROPHYLAXIS IN LAPAROSCOPIC CHOLECISTECTOMY: IS IT WORTH DOING?

PubMed

Passos, Márcio Alexandre Terra; Portari-Filho, Pedro Eder

2016-01-01

Elective laparoscopic cholecystectomy has very low risk for infectious complications, ranging the infection rate from 0.4% to 1.1%. Many surgeons still use routine antibiotic prophylaxis. Evaluate the real impact of antibiotic prophylaxis in elective laparoscopic cholecystectomies in low risk patients. Prospective, randomized and double-blind study. Were evaluated 100 patients that underwent elective laparoscopic cholecystectomy divided in two groups: group A (n=50), patients that received prophylaxis using intravenous Cephazolin (2 g) during anesthetic induction and group B (n=50), patients that didn't receive any antibiotic prophylaxis. The outcome evaluated were infeccious complications at surgical site. The patients were reviewed seven and 30 days after surgery. There was incidence of 2% in infection complications in group A and 2% in group B. There was no statistical significant difference of infectious complications (p=0,05) between the groups. The groups were homogeneous and comparable. The use of the antibiotic prophylaxis in laparoscopic cholecystectomy in low risk patients doesn't provide any significant benefit in the decrease of surgical wound infection. A colecistectomia laparoscópica eletiva apresenta risco muito baixo para complicações infecciosas, com média de infecção entre 0,4% a 1,1%. Muitos cirurgiões ainda utilizam de rotina profilaxia antibiótica. Avaliar a real necessidade de profilaxia antibiótica em colecistectomias laparoscópicas eletivas em pacientes de baixo risco para infecção do sítio cirúrgico. Estudo prospectivo, randomizado e duplo-cego, em pacientes submetidos à colecistectomia laparoscópica eletiva, envolvendo 100 pacientes em dois grupos: A (n=50), que receberam profilaxia com cefazolina 2 g intravenoso na indução anestésica; B (n=50), não foi utilizado antibiótico. O desfecho avaliado foi presença de complicações infecciosas de sítio cirúrgico. Os pacientes foram revisados em sete e 30 dias no p

Determination of inadvertent atrial capture during para-Hisian pacing.

PubMed

Obeyesekere, Manoj; Leong-Sit, Peter; Skanes, Allan; Krahn, Andrew; Yee, Raymond; Gula, Lorne J; Bennett, Matthew; Klein, George J

2011-08-01

Inadvertent capture of the atrium will lead to spurious results during para-Hisian pacing. We sought to establish whether the stimulation-to-atrial electrogram interval at the proximal coronary sinus (stim-PCS) or high right atrium (stim-HRA) could signal inadvertent atrial capture. Para-Hisian pacing with and without intentional atrial capture was performed in 31 patients. Stim-HRA and stim-PCS intervals were measured with atrial capture, His plus para-Hisian ventricular (H+V) capture, and para-Hisian ventricular (V) capture alone. The mean stim-HRA interval was significantly shorter with atrial capture (66 ± 18 ms) than with H+V (121 ± 27 ms, P < 0.001) or V capture alone (174 ± 38 ms, P < 0.001). The mean stim-PCS interval was significantly shorter with atrial capture (51 ± 16 ms) than with H+V (92 ± 22 ms, P<0.001) or V capture alone (146 ± 33 ms, P < 0.001). A stim-PCS < 60 ms (stim-HRA < 70 ms) was observed only with atrial capture. A stim-PCS >90 ms (stim-HRA >100 ms) was observed only in the absence of atrial capture. A stim-HRA of < 85 ms was highly specific and stim-PCS of < 85 ms highly sensitive at identifying atrial capture. Stim-HRA intervals of 75 to 97 ms and stim-PCS intervals of 65 to 88 ms were observed with either atrial, His, or para-Hisian ventricular capture without atrial capture. In this overlap zone, all patients demonstrated a stim-PCS or stim-HRA interval prolongation of at least 20 ms when the catheter was advanced to avoid deliberate atrial pacing. The QRS morphology was of limited value in distinguishing atrial capture due to concurrent ventricular or H+V capture, as observed in 20 of 31 (65%) patients. Stim-PCS and stim-HRA intervals can be used to monitor for inadvertent atrial capture during para-Hisian pacing. A stim-PCS < 60 ms (or stim-HRA < 70 ms) and stim-PCS > 90 ms (or stim-HRA > 100 ms) were observed only with and without atrial capture, respectively, but there was significant overlap between these values. Deliberate

Efecto del Programa de Entrenamiento “Manejo del Dolor” en la Documentación de Enfermería en el Expediente Electrónico

PubMed Central

Monsiváis, María Guadalupe Moreno; Guzmán, Ma. Guadalupe Interial; Flores, Paz Francisco Sauceda; Arreola, Leticia Vázquez

2012-01-01

Resumen En el presente trabajo se muestra la importancia de entrenar al personal de enfermería para mejorar la documentación en el expediente electrónico. Se eligió el manejo del dolor por ser un área prioritaria; una alta proporción de pacientes en período post operatorio cursa con dolor, por lo tanto, la documentación debe ser útil para la toma de decisiones clínicas. Se implementó un programa de entrenamiento denominado “Manejo del Dolor” dirigido al personal de enfermería. Se utilizó la tecnología de la información como herramienta para fortalecer el conocimiento con base en la revisión sistemática de la literatura; el personal de enfermería participante seleccionó la mejor evidencia; posteriormente se trabajó en la transferencia de este conocimiento a la práctica a través del diseño de un protocolo para el manejo del dolor. Se concluye que el conocimiento del manejo del dolor es fundamental para que enfermería documente con mayor precisión sus intervenciones. PMID:24199106

Costs of topical treatment of pressure ulcer patients.

PubMed

Andrade, Cynthia Carolina Duarte; Almeida, Cláudia Fernanda Dos Santos Calixto de; Pereira, Walkíria Euzébio; Alemão, Márcia Mascarenhas; Brandão, Cristina Mariano Ruas; Borges, Eline Lima

2016-04-01

To evaluate the costs of a topical treatment of pressure ulcer (PU) patients in a hospital unit for treatment of chronic patients in 2014. This is an activity-based costing study. This method encompasses the identification, measurement and pricing of physical and human resources consumed for dressings. Procedure costs varied between BRL 16.41 and BRL 260.18. For PUs of the same category, of near areas and with the same type of barrier/adjuvant, the cost varied between 3.5% and 614.6%. For most dressings, the cost increased proportionally to the increase of the area and to the development of PU category. The primary barrier accounted for a high percentage of costs among all items required to the application of dressings (human and material resources). Dressings applied in sacral PUs had longer application times. This study allowed us to understand the costs involved in the treatment of PUs, and it may support decision-makers and other cost-effectiveness studies. Realizar uma avaliação do custo do tratamento tópico de pacientes com úlceras por pressão (UP), em uma unidade hospitalar de atendimento a pacientes crônicos no ano de 2014. Trata-se de um estudo de custos baseado no Sistema de custeio Baseado em Atividades. Este método contempla a identificação, mensuração e precificação dos recursos físicos e humanos consumidos para a realização de curativos. Os custos dos procedimentos variaram de R$16,41 a R$260,18. Para UP de mesma categoria, de áreas aproximadas e mesmo tipo de cobertura/adjuvante, a variação entre os custos foi de 3,5% a 614,6%. Para a maioria dos curativos, o custo aumentou proporcionalmente ao aumento da área e à progressão da categoria das UP. A cobertura primária representou elevado percentual nos custos entre todos os itens necessários para realizar os curativos (recursos humanos e materiais). Os curativos realizados nas UP sacrais foram os que apresentaram maiores tempos para execução. Este estudo permitiu conhecer os

Norma para la Certificación de Aplicadores de Plaguicidas Revisada

EPA Pesticide Factsheets

La EPA emitió una propuesta para la revisión de la norma para la Certificación de Aplicadores de Plaguicidas. La norma ayudará a mantener nuestras comunidades seguras, salvaguardar el medio ambiente y reducir el riesgo a los que aplican los plaguicidas.

Conformational explosion: Understanding the complexity of short chain para-dialkylbenzene potential energy surfaces

NASA Astrophysics Data System (ADS)

Mishra, Piyush; Hewett, Daniel M.; Zwier, Timothy S.

2018-05-01

The single-conformation ultraviolet and infrared spectroscopy of three short-chain para-dialkylbenzenes (para-diethylbenzene, para-dipropylbenzene, and para-dibutylbenzene) is reported for the jet-cooled, isolated molecules. The present study builds off previous work on single-chain n-alkylbenzenes, where an anharmonic local mode Hamiltonian method was developed to account for stretch-bend Fermi resonance in the alkyl CH stretch region [D. P. Tabor et al., J. Chem. Phys. 144, 224310 (2016)]. The jet-cooled molecules are interrogated using laser-induced fluorescence (LIF) excitation, fluorescence dip infrared spectroscopy, and dispersed fluorescence. The LIF spectra in the S1 ← S0 origin region show a dramatic increase in the number of resolved transitions with increasing length of the alkyl chains, reflecting an explosion in the number of unique low-energy conformations formed when two independent alkyl chains are present. Since the barriers to isomerization of the alkyl chain are similar in size, this results in an "egg carton" shaped potential energy surface. A combination of electronic frequency shift and alkyl CH stretch infrared spectra is used to generate a consistent set of conformational assignments. Using these experimental techniques in conjunction with computational methods, subsets of origin transitions in the LIF excitation spectrum can be classified into different conformational families. Two conformations are resolved in para-diethylbenzene, seven in para-dipropylbenzene, and about nineteen in para-dibutylbenzene. These chains are largely independent of each other as there are no new single-chain conformations induced by the presence of a second chain. A cursory LIF excitation scan of para-dioctylbenzene shows a broad congested spectrum at frequencies consistent with interactions of alkyl chains with the phenyl π cloud.

Conformational explosion: Understanding the complexity of short chain para-dialkylbenzene potential energy surfaces.

PubMed

Mishra, Piyush; Hewett, Daniel M; Zwier, Timothy S

2018-05-14

The single-conformation ultraviolet and infrared spectroscopy of three short-chain para-dialkylbenzenes (para-diethylbenzene, para-dipropylbenzene, and para-dibutylbenzene) is reported for the jet-cooled, isolated molecules. The present study builds off previous work on single-chain n-alkylbenzenes, where an anharmonic local mode Hamiltonian method was developed to account for stretch-bend Fermi resonance in the alkyl CH stretch region [D. P. Tabor et al., J. Chem. Phys. 144, 224310 (2016)]. The jet-cooled molecules are interrogated using laser-induced fluorescence (LIF) excitation, fluorescence dip infrared spectroscopy, and dispersed fluorescence. The LIF spectra in the S 1 ← S 0 origin region show a dramatic increase in the number of resolved transitions with increasing length of the alkyl chains, reflecting an explosion in the number of unique low-energy conformations formed when two independent alkyl chains are present. Since the barriers to isomerization of the alkyl chain are similar in size, this results in an "egg carton" shaped potential energy surface. A combination of electronic frequency shift and alkyl CH stretch infrared spectra is used to generate a consistent set of conformational assignments. Using these experimental techniques in conjunction with computational methods, subsets of origin transitions in the LIF excitation spectrum can be classified into different conformational families. Two conformations are resolved in para-diethylbenzene, seven in para-dipropylbenzene, and about nineteen in para-dibutylbenzene. These chains are largely independent of each other as there are no new single-chain conformations induced by the presence of a second chain. A cursory LIF excitation scan of para-dioctylbenzene shows a broad congested spectrum at frequencies consistent with interactions of alkyl chains with the phenyl π cloud.

Kit para aplicar la metodología de Lean en el gobierno

EPA Pesticide Factsheets

Este Kit para comenzar a aplicar la metodología Lean (Gobierno optimizado) ofrece información para ayudar a las agencias de protección ambiental a planificar e implementar iniciativas Lean exitosas.

[Reconstrucción ósea de defectos craneales secundarios a traumatismo con implantes personalizados].

PubMed

Cienfuegos, Ricardo; Fernández, Gerardo; Cruz, Aída; Sierra, Eduardo

2018-01-01

Los defectos craneales secundarios a traumatismos son frecuentes. Por lo común se reparan de forma secundaria por sintomatología como el síndrome del paciente trepanado, por protección cerebral y por el aspecto cosmético. Históricamente se han utilizado diversos materiales para la reconstrucción. Se presentan cinco casos de pacientes reconstruidos con implantes personalizados de polieteretercetona (PEEK) o polimetilmetacrilato poroso (PMMA). Las localizaciones afectaron el frontal, el borde orbitario superior y el techo orbitario en cuatro casos, y la porción lateral del frontal, la zona temporoparietal y el borde del occipital en un caso. La reconstrucción en cuatro pacientes fue entre 6 y 12 meses después de la lesión, y en un caso después de 25 años. En dos casos se requirió expansión tisular antes de colocar el implante. Cuatro pacientes evolucionaron favorablemente, con mejoría de los síntomas neurológicos, forma y contorno adecuados, así como un proceso de cicatrización adecuada de los colgajos de piel cabelluda. Un paciente presentó infección por Staphylococcus aureus, atribuida a la presencia de un mucocele y una fístula de la vía aérea a la cavidad craneal, lo que hizo necesario retirar el implante. Los implantes personalizados son un recurso útil para defectos óseos craneales. Brindan resultados satisfactorios desde el punto de vista funcional y cosmético. Deben tomarse precauciones respecto al tratamiento de las lesiones que afecten el seno frontal, para evitar la comunicación entre la vía aérea y la cavidad craneal. Cranial defects due to trauma are frequent. They are usually repaired in a secondary fashion due to features such as syndrome of the trephined, for brain protection and for cosmetic purposes. Historically, various materials have been used for reconstruction. Five cases of patients reconstructed with customized polyetheretherketone (PEEK) o polymethyl methacrylate (PMMA) implants are presented. Defects involved

Sistemas Correctores de Campo Para EL Telescopio Cassegrain IAC80

NASA Astrophysics Data System (ADS)

Galan, M. J.; Cobos, F. J.

1987-05-01

El proyecto de instrumentación de mayor importancia que ha tenido el Instituto de Astrofisica de Canarias en los últimos afios ha sido el diseflo y construcción del te1escopio IAC8O. Este requería del esfuerzo con junto en mec´nica, óptica y electrónica, lo que facilitó la estructuración y el crecimiento de los respectivos grupos de trabajo, que posteriormente se integraron en departamentos En su origen (1977), el telescopio IAC80 fue concebido como un sistema clásico tipo Cassegrain, con una razón focal F/i 1.3 para el sistema Casse grain y una razón focal F/20 para el sistema Coudé. Posteriormente, aunque se mantuvo la filosofia de que el sistema básico fuera el F/11.3, se consideró conveniente el diseño de secundarios para razones focales F/16 y F/32, y se eliminó el de F/20. Sin embargo, dada la importancia relativa que un foco estrictamente fotográfico tiene en un telescopio moderno, diseñado básicamente para fotometría fotoeléctrica y con un campo util mínimamente de 40 minutos de arco, se decídió Ilevar a cabo el diseño de un secundario F/8 con un sistema corrector de campo, pero que estuviera formado únicamente por lentes con superficies esféricas para que asl su construcción fuera posible en España ó en México. La creciente utilización de detectores bidimensionales para fines de investigación astron6mica y la viabilidad de que en un futuro cercano éstos tengan un área sensible cada vez mayor, hicieron atractiva la idea de tener diseñado un sistema corrector de campo para el foco primario (F/3), con un campo útil mínimo de un grado, y también con la limitante de que sus componentes tuvieron sólamente supérficies esféricas. Ambos diseños de los sis-temas correctores de campo se llevaron a cabo, en gran medida, como parte de un proyecto de colaboración e intercambio en el área de diseño y evaluación de sistemas ópticos.

Quantum fluctuations increase the self-diffusive motion of para-hydrogen in narrow carbon nanotubes.

PubMed

Kowalczyk, Piotr; Gauden, Piotr A; Terzyk, Artur P; Furmaniak, Sylwester

2011-05-28

Quantum fluctuations significantly increase the self-diffusive motion of para-hydrogen adsorbed in narrow carbon nanotubes at 30 K comparing to its classical counterpart. Rigorous Feynman's path integral calculations reveal that self-diffusive motion of para-hydrogen in a narrow (6,6) carbon nanotube at 30 K and pore densities below ∼29 mmol cm(-3) is one order of magnitude faster than the classical counterpart. We find that the zero-point energy and tunneling significantly smoothed out the free energy landscape of para-hydrogen molecules adsorbed in a narrow (6,6) carbon nanotube. This promotes a delocalization of the confined para-hydrogen at 30 K (i.e., population of unclassical paths due to quantum effects). Contrary the self-diffusive motion of classical para-hydrogen molecules in a narrow (6,6) carbon nanotube at 30 K is very slow. This is because classical para-hydrogen molecules undergo highly correlated movement when their collision diameter approached the carbon nanotube size (i.e., anomalous diffusion in quasi-one dimensional pores). On the basis of current results we predict that narrow single-walled carbon nanotubes are promising nanoporous molecular sieves being able to separate para-hydrogen molecules from mixtures of classical particles at cryogenic temperatures. This journal is © the Owner Societies 2011

Preparation of ortho-para ratio controlled D{sub 2} gas for muon-catalyzed fusion

DOE Office of Scientific and Technical Information (OSTI.GOV)

Imao, H.; Ishida, K.; Matsuzaki, T.

2008-05-15

A negative muon in hydrogen targets, e.g., D{sub 2} or D-T mixture, can catalyze nuclear fusions following a series of atomic processes involving muonic hydrogen molecular formation (muon-catalyzed fusion, {mu}CF). The ortho-para state of D{sub 2} is a crucial parameter not only for enhancing the fusion rate but also to precisely investigate various muonic atom processes. We have developed a system for controlling and measuring the ortho-para ratio of D{sub 2} gas for {mu}CF experiments. We successfully collected para-enriched D{sub 2} without using liquid-hydrogen coolant. Ortho-enriched D{sub 2} was also obtained by using a catalytic conversion method with a mixturemore » of chromium oxide and alumina. The ortho-para ratio of D{sub 2} gas was measured with a compact Raman spectroscopy system. We produced large volume (5-30 l at STP), high-purity (less than ppm high-Z contaminant) D{sub 2} targets with a wide range of ortho-para ratios (ortho 20%-99%). By using the ortho-para controlled D{sub 2} in {mu}CF experiments, we observed the dependence of {mu}CF phenomena on the ortho-para ratio.« less

Relative Contributions of Agricultural Drift, Para-Occupational ...

EPA Pesticide Factsheets

Background: Increased pesticide concentrations in house dust in agricultural areas have been attributed to several exposure pathways, including agricultural drift, para-occupational, and residential use. Objective: To guide future exposure assessment efforts, we quantified relative contributions of these pathways using meta-regression models of published data on dust pesticide concentrations. Methods: From studies in North American agricultural areas published from 1995-2015, we abstracted dust pesticide concentrations reported as summary statistics (e.g., geometric means (GM)). We analyzed these data using mixed-effects meta-regression models that weighted each summary statistic by its inverse variance. Dependent variables were either the log-transformed GM (drift) or the log-transformed ratio of GMs from two groups (para-occupational, residential use). Results: For the drift pathway, predicted GMs decreased sharply and nonlinearly, with GMs 64% lower in homes 250 m versus 23 m from fields (inter-quartile range of published data) based on 52 statistics from 7 studies. For the para-occupational pathway, GMs were 2.3 times higher (95% confidence interval [CI]: 1.5-3.3; 15 statistics, 5 studies) in homes of farmers who applied pesticides more versus less recently or frequently. For the residential use pathway, GMs were 1.3 (95%CI: 1.1-1.4) and 1.5 (95%CI: 1.2-1.9) times higher in treated versus untreated homes, when the probability that a pesticide was used for

Sistemas Correctores de Campo Para EL Telescopio Ritchey-Chretien UNAM212

NASA Astrophysics Data System (ADS)

Cobos, F. J.; Galan, M. J.

1987-05-01

El telescopio UNAM2l2 fue inaugurado hace siete años y concebido para trabajar en las razones focales: f/7.5, F/13.5, F/27 y F/98. El diseño Ritchey-Chretién corresponde a la razón focal F/7.5 y el foco primario (F/2.286) no se consideró como utilizable para fotografía directa. En el Instituto de Astronomía de la UNAM, se diseñó y construyó un sistema corrector de campo para la razón focal F/7.5, que actualmente está en funcionamiento. Dentro de un programa de colaboración en diseflo y evaluación de sistemas ópticos, entre el Instituto de Astrofísica de Canarias y el Instituto de Astronomía de la UNAM, decidimos intentar el diseño de una correctora de campo para el foco primario del tȩlescopio UNAM212 bajo la consideración de que no son insalvables los problemas que implicaría su instalación y de que es muy posible que, en un futuro relativamente cercano, podamom tener un detector bidimenmional tipo Mepsicrón cuya área sensible haga tentadora la idea de construir la cámara directa para foco primario

Para Sport Athletic Identity from Competition to Retirement: A Brief Review and Future Research Directions.

PubMed

Guerrero, Michelle; Martin, Jeffrey

2018-05-01

The primary purpose of this article is to review the literature on para sport athletic identity and provide avenues for future research direction. First, the authors briefly describe the existing quantitative and qualitative research on para sport athletic identity and, thereby, illustrate the complexities para sport athletes experience regarding the way they describe their participation in competitive sport. Next, the authors describe how para sport athletes with acquired permanent disabilities and congenital disabilities face similar, yet unique, identity-related challenges. Finally, the authors argue that future researchers should consider examining para sport athletes' identity through narrative identity. Copyright © 2018 Elsevier Inc. All rights reserved.

Augmentation mastopexy after bariatric surgery: evaluation of patient satisfaction and surgical results.

PubMed

Junior, Wilson Cintra; Modolin, Miguel Luiz Antonio; Rocha, Rodrigo Itocazo; Gemperli, Rolf

2016-01-01

: forma da mama, volume da mama, simetria entre as mamas, posicionamento do complexo aréolo-papilar e qualidade e extensão das cicatrizes. dezenove pacientes (95%) referiram satisfação com o resultado cirúrgico obtido (p<0,001). A média das somatórias das notas atribuídas pelos três cirurgiões, referentes a cada paciente, variou entre 4,7 e 10, sendo a média geral de 7,28. Os resultados foram considerados bons ou ótimos para 65% da amostra e pobres para 8,4%. houve satisfação de 95% das pacientes com os resultados obtidos pela mastopexia de aumento. A análise fotográfica dos resultados obteve nota média de 7,28, caracterizado como bom resultado, apesar da fraca concordância entre os avaliadores.

Astronomia para/com crianças carentes em Limeira

NASA Astrophysics Data System (ADS)

Bretones, P. S.; Oliveira, V. C.

2003-08-01

Em 2001, o Instituto Superior de Ciências Aplicadas (ISCA Faculdades de Limeira) iniciou um projeto pelo qual o Observatório do Morro Azul empreendeu uma parceria com o Centro de Promoção Social Municipal (CEPROSOM), instituição mantida pela Prefeitura Municipal de Limeira para atender crianças e adolescentes carentes. O CEPROSOM contava com dois projetos: Projeto Centro de Convivência Infantil (CCI) e Programa Criança e Adolescente (PCA), que atendiam crianças e adolescentes em Centros Comunitários de diversas áreas da cidade. Esses projetos têm como prioridades estabelecer atividades prazerosas para as crianças no sentido de retirá-las das ruas. Assim sendo, as crianças passaram a ter mais um tipo de atividade - as visitas ao observatório. Este painel descreve as várias fases do projeto, que envolveu: reuniões de planejamento, curso de Astronomia para as orientadoras dos CCIs e PCAs, atividades relacionadas a visitas das crianças ao Observatório, proposta de construção de gnômons e relógios de Sol nos diversos Centros Comunitários de Limeira e divulgação do projeto na imprensa. O painel inclui discussões sobre a aprendizagem de crianças carentes, relatos que mostram a postura das orientadoras sobre a pertinência do ensino de Astronomia, relatos do monitor que fez o atendimento no Observatório e o que o número de crianças atendidas representou para as atividades da instituição desde o início de suas atividades e, em particular, em 2001. Os resultados são baseados na análise de relatos das orientadoras e do monitor do Observatório, registros de visitas e matérias da imprensa local. Conclui com uma avaliação do que tal projeto representou para as Instituições participantes. Para o Observatório, em particular, foi feita uma análise com relação às outras modalidades de atendimentos que envolvem alunos de escolas e público em geral. Também é abordada a questão do compromisso social do Observatório na educação do

Quality of life of patients using intermittent urinary catheterization.

PubMed

Fumincelli, Laís; Mazzo, Alessandra; Martins, José Carlos Amado; Henriques, Fernando Manuel Dias; Orlandin, Leonardo

2017-07-10

ária neurogênica, e usuários do cateterismo urinário intermitente. na amostra de pacientes brasileiros (n = 170) e portugueses (n = 52), respectivamente, a maioria era solteira (87-51,2%; 25-48,1%), com ensino fundamental (47-45,3%; 31-59,6%), aposentada (70-41,2%; 21-40,4%). A lesão medular foi a principal causa do uso do cateter urinário nos dois países. Os pacientes brasileiros apresentaram média de escores mais elevados de qualidade de vida no domínio psicológico (68,9) e menos elevados no domínio físico (58,9). Os pacientes portugueses apresentaram escores mais elevados no domínio psicológico (68,4) e menos no domínio ambiente (59,4). A realização do autocateterismo urinário intermitente foi significativa para os dois países. nos dois países, a qualidade de vida desses pacientes pode ser determinada pela melhora dos sintomas urinários, da independência, autoconfiança, relações sociais e acesso a atividades laborais. mensurar y comparar la calidad de vida de pacientes con vejiga neurogénica en uso de cateterismo vesical intermitente durante el proceso de rehabilitación en Brasil y en Portugal. estudio multicéntrico, Brasil y Portugal, cuantitativo, trasversal, observacional-analítico y correlacional. Fueron utilizados dos instrumentos de recolecta, un cuestionario de datos sociodemográficos y clínicos y el World Health Organization Quality Life-bref. Fueron inclusos pacientes mayores de 18 años, con vejiga urinaria neurogénica, y usuarios de cateterismo vesical intermitente. en la muestra de pacientes brasileños (n = 170) y portugueses (n = 52), respectivamente, la mayoría era soltera (87-51,2%; 25-48,1%), con educación fundamental (47-45,3%; 31-59,6%), jubilada (70-41,2%; 21-40,4%). La lesión medular fue la principal causa del uso del catéter urinario en los dos países. En promedio, los pacientes brasileños presentaron scores de calidad de vida superiores en el dominio psicológico (68,9) e inferiores en el dominio físico (58

Autoguía para el telescopio 2,15 mts de CASLEO

NASA Astrophysics Data System (ADS)

Aballay, J. A.; Casagrande, A. R.; Pereyra, P. F.; Marún, A. H.

Se está desarrollando un sistema de autoguía para el telescopio de 2,15 mts. El mismo se realizará aprovechando el Offset Guider. Al ocular móvil de éste se vinculará alguna cámara digital (ST4-ST7-CH250) para lograr la visión del objeto. El funcionamiento del equipo será el siguiente: primero, dadas las coordenadas del objeto a observar, se tomarán las coordenadas del telescopio para que, a través de una base de datos, se determine un campo de objetos que sirvan para la cámara de visión, luego, la PC obtendrá el offset entre la estrella de observación y la estrella seleccionada como guía, este valor será trasladado a los motores que posicionarán en forma automática el ocular. Una vez que la estrella es visualizada en la cámara (monitor de PC ) se correrá el programa que guiará el telescopio automáticamente.

Evidence-based measures to prevent central line-associated bloodstream infections: a systematic review.

PubMed

Perin, Daniele Cristina; Erdmann, Alacoque Lorenzini; Higashi, Giovana Dorneles Callegaro; Sasso, Grace Teresinha Marcon Dal

2016-09-01

to identify evidence-based care to prevent CLABSI among adult patients hospitalized in ICUs. systematic review conducted in the following databases: PubMed, Scopus, Cinahl, Web of Science, Lilacs, Bdenf and Cochrane Studies addressing care and maintenance of central venous catheters, published from January 2011 to July 2014 were searched. The 34 studies identified were organized in an instrument and assessed by using the classification provided by the Joanna Briggs Institute. the studies presented care bundles including elements such as hand hygiene and maximal barrier precautions; multidimensional programs and strategies such as impregnated catheters and bandages and the involvement of facilities in and commitment of staff to preventing infections. care bundles coupled with education and the commitment of both staff and institutions is a strategy that can contribute to decreased rates of central line-associated bloodstream infections among adult patients hospitalized in intensive care units. identificar evidências de cuidados para prevenção de infecção de corrente sanguínea relacionada a cateter venoso central em pacientes adultos em Unidades de Terapia Intensiva. revisão Sistemática realizada por meio de busca nas bases de dados Pubmed, Scopus, Cinahl, Web of Science, Lilacs, Bdenf e Cochrane. Foram buscadas pesquisas com cuidados com a cateterização e manutenção do cateter venoso central, publicados de janeiro de 2011 a julho de 2014. Os 34 estudos incluídos foram organizados em um instrumento e avaliados por meio da classificação do The Joanna Briggs Institute. os estudos apresentaram bundles de cuidados com elementos como a higiene das mãos e precauções máximas de barreira; programas multidimensionais e estratégias como cateteres e curativos impregnados e o envolvimento da instituição e engajamento da equipe nos esforços para prevenção de infecção. os cuidados no formato de bundles aliados com a educação e engajamento da equipe e

Financial impact of nursing professionals staff required in an Intensive Care Unit.

PubMed

Araújo, Thamiris Ricci de; Menegueti, Mayra Gonçalves; Auxiliadora-Martins, Maria; Castilho, Valéria; Chaves, Lucieli Dias Pedreschi; Laus, Ana Maria

2016-11-21

to calculate the cost of the average time of nursing care spent and required by patients in the Intensive Care Unit (ICU) and the financial expense for the right dimension of staff of nursing professionals. a descriptive, quantitative research, using the case study method, developed in adult ICU patients. We used the workload index - Nursing Activities Score; the average care time spent and required and the amount of professionals required were calculated using equations and from these data, and from the salary composition of professionals and contractual monthly time values, calculated the cost of direct labor of nursing. the monthly cost of the average quantity of available professionals was US$ 35,763.12, corresponding to 29.6 professionals, and the required staff for 24 hours of care is 42.2 nurses, with a monthly cost of US$ 50,995.44. the numerical gap of nursing professionals was 30% and the monthly financial expense for adaptation of the structure is US$ 15,232.32, which corresponds to an increase of 42.59% in the amounts currently paid by the institution. calcular o custo do tempo médio de assistência de enfermagem despendido e requerido pelos pacientes internados em Unidade de Terapia Intensiva (UTI) e o dispêndio financeiro para adequação do quadro de profissionais de enfermagem. pesquisa descritiva, quantitativa, na modalidade de estudo de caso, desenvolvida na UTI de pacientes adultos. Utilizou-se o índice de carga de trabalho - Nursing Activities Score; o tempo médio de assistência despendido, requerido e o quantitativo de profissionais requerido foram calculados por meio de equações e, a partir desses dados, e de valores da composição salarial dos profissionais e tempo mensal contratual, calculou-se o custo da mão de obra direta de enfermagem. o custo mensal do quantitativo médio de profissionais disponível foi de US$ 35.763,12, correspondendo a 29,6 profissionais, e o requerido para 24 horas de cuidado é de 42,2 profissionais de

Electron Spin Polarization Transfer to ortho-H2 by Interaction of para-H2 with Paramagnetic Species: A Key to a Novel para → ortho Conversion Mechanism.

PubMed

Terenzi, Camilla; Bouguet-Bonnet, Sabine; Canet, Daniel

2015-05-07

We report that at ambient temperature and with 100% enriched para-hydrogen (p-H2) dissolved in organic solvents, paramagnetic spin catalysis of para → ortho hydrogen conversion is accompanied at the onset by a negative ortho-hydrogen (o-H2) proton NMR signal. This novel finding indicates an electron spin polarization transfer, and we show here that this can only occur if the H2 molecule is dissociated upon its transient adsorption by the paramagnetic catalyst. Following desorption, o-H2 is created until the thermodynamic equilibrium is reached. A simple theory confirms that in the presence of a static magnetic field, the hyperfine coupling between unpaired electrons and nuclear spins is responsible for the observed polarization transfer. Owing to the negative electron gyromagnetic ratio, this explains the experimental results and ascertains an as yet unexplored mechanism for para → ortho conversion. Finally, we show that the recovery of o-H2 magnetization toward equilibrium can be simply modeled, leading to the para → ortho conversion rate.

Sudan azo dyes and Para Red degradation by prevalent bacteria of the human gastrointestinal tract☆

PubMed Central

Xu, Haiyan; Heinze, Thomas M.; Paine, Donald D.; Cerniglia, Carl E.; Chen, Huizhong

2018-01-01

Sudan azo dyes have genotoxic effects and ingestion of food products contaminated with Sudan I, II, III, IV, and Para Red could lead to exposure in the human gastrointestinal tract. In this study, we examined thirty-five prevalent species of human intestinal bacteria to evaluate their capacity to degrade Sudan dyes and Para Red. Among these tested bacterial strains, 23, 13, 33, 30, and 29 out of 35 species tested were able to reduce Sudan I, II, III, IV, and Para Red, respectively, to some extent. Bifidobacterium infantis, Clostridium indolis, Enterococcus faecalis, Lactobacillus rhamnosus, and Ruminococcus obeum were able to reduce completely all four tested Sudan dyes and Para Red. Escherichia coli and Peptostreptococcus magnus were the only two strains that were not able to reduce any of the tested Sudan dyes and Para Red to any significant extent. Metabolites of the reduction of the tested Sudan dyes and Para Red by E. faecalis were isolated and identified by HPLC and LC/ESI-MS analyses and compared with authentic standards. Thus it appears that the ability to reduce Sudan dyes and Para Red except Sudan II is common among bacteria in the human colon. PMID:19580882

A novel method to guide classification of para swimmers with limb deficiency.

PubMed

Hogarth, Luke; Payton, Carl; Van de Vliet, Peter; Connick, Mark; Burkett, Brendan

2018-05-30

The International Paralympic Committee has directed International Federations that govern Para sports to develop evidence-based classification systems. This study defined the impact of limb deficiency impairment on 100 m freestyle performance to guide an evidence-based classification system in Para Swimming, which will be implemented following the 2020 Tokyo Paralympic games. Impairment data and competitive race performances of 90 international swimmers with limb deficiency were collected. Ensemble partial least squares regression established the relationship between relative limb length measures and competitive 100 m freestyle performance. The model explained 80% of the variance in 100 m freestyle performance, and found hand length and forearm length to be the most important predictors of performance. Based on the results of this model, Para swimmers were clustered into four-, five-, six- and seven-class structures using nonparametric kernel density estimations. The validity of these classification structures, and effectiveness against the current classification system, were examined by establishing within-class variations in 100 m freestyle performance and differences between adjacent classes. The derived classification structures were found to be more effective than current classification based on these criteria. This study provides a novel method that can be used to improve the objectivity and transparency of decision-making in Para sport classification. Expert consensus from experienced coaches, Para swimmers, classifiers and sport science and medicine personnel will benefit the translation of these findings into a revised classification system that is accepted by the Para swimming community. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.

Prevalence of hypoalbuminemia and nutritional issues in hospitalized elders.

PubMed

Brock, Felipe; Bettinelli, Luiz Antonio; Dobner, Taise; Stobbe, Júlio César; Pomatti, Gabriela; Telles, Cristina Trevizan

2016-08-08

to estimate the prevalence of hypoalbuminemia in hospitalized elders, related to socio-demographic variables, nutritional status and length of stay. crosscutting study with 200 patients hospitalized in a large hospital in the South of Brazil during three months. Evaluations, lab tests and interviews through questionnaires were performed. the average albuminemia was 2,9 ± 0,5g/dL. Hypoalbuminemia was diagnosed in 173 subjects (87%) and was absent in 27 (13%) that have normal albuminemia (p=0,000). After six days of hospitalization, the prevalence of low levels grew significantly to 90% (p=0,002), average 2,7 ± 0,5g/dL. Using the Mini Nutritional Assessment, it was observed that 41 patients were malnourished and from those, 40 had hypoalbuminemia. the prevalence of hypoalbuminemia proved to be high, in approx. nine in ten elders, and the nutritional status and the length of stay proved to be related to the decrease of serum albumin levels. Thus, it is suggested that monitoring albumin levels should be done to evaluate the risk that the patient has to develop malnutrition and other complications during hospital stays. estimar a prevalência de hipoalbuminemia em idosos hospitalizados, em relação às variáveis sociodemográficas, estado nutricional e tempo de internação. estudo transversal, com 200 pacientes internados em hospital de grande porte do sul do Brasil, durante o período de três meses. Foram realizadas avaliações, análise de exames laboratoriais e entrevista através de questionário. a média de albuminemia foi 2,9 ± 0,5g/dL. O diagnóstico de hipoalbuminemia, foi encontrado em 173 sujeitos (87%), e não revelado em 27 (13%), que apresentaram albuminemia normal (p=0,000). Constatou-se que após seis dias de internação a prevalência de níveis baixos aumentou significativamente para 90% (p=0,002), com média de 2,7 ± 0,5g/dL. Utilizando-se a Mini Avaliação Nutricional, observou-se que 41 pacientes estavam desnutridos, e que destes, 40

Factors associated with subendocardial ischemia risk in patients on hemodialysis.

PubMed

Silva, Bruno Caldin da; Sanjuan, Adriano; Costa-Hong, Valéria; Reis, Luciene Dos; Graciolli, Fabiana; Consolim-Colombo, Fernanda; Bortolotto, Luiz Aparecido; Moyses, Rosa Maria Affonso; Elias, Rosilene Motta

2016-01-01

Bone metabolism disorder (BMD) and vascular dysfunction contribute to excess cardiovascular mortality observed in hemodialysis patients. Vascular dysfunction, a new marker of atherosclerosis, can play a role in this risk. Even though associated with higher mortality in the general population, such vascular evaluation in patients on hemodialysis has not been extensively studied. In this cross-sectional study, hemodialysis patients were submitted to flow-mediated dilation, subendocardial viability ratio (SEVR) and ejection duration index assessment, in order to estimate the impact of BMD markers on vascular dysfunction. A matched cohort of patients with (n = 16) and without (n = 11) severe secondary hyperparathyroidism (SHPT) was studied. Additionally, time spent under severe SHPT was also evaluated. Patients with severe SHPT had lower SEVR and higher ejection duration index, indicating higher cardiovascular risk. Lower SEVR was also associated to diastolic blood pressure (r = 0.435, p = 0.049), serum 25-Vitamin-D levels (r = 0.479, p = 0.028) and to more time spent under severe secondary hyperparathyroidism (SHPT), defined as time from PTH > 500pg/ml until parathyroidectomy surgery or end of the study (r = -0.642, p = 0.027). In stepwise multiple regression analysis between SEVR and independent variables, lower SEVR was independently associated to lower serum 25-Vitamin-D levels (p = 0.005), female sex (p = 0.012) and more time spent under severe SHPT (p = 0.001) in a model adjusted for age, serum cholesterol, and blood pressure (adjusted r² = 0.545, p = 0.001). Subendocardial perfusion was lower in patients with BMD, reflecting higher cardiovascular risk in this population. Whether early parathyroidectomy in the course of kidney disease could modify such results still deserves further investigation. Distúrbios do metabolismo ósseo (DMO) e alterações da função vascular contribuem para a elevada mortalidade de pacientes em hemodiálise. A disfunção vascular

Nursing interventions for rehabilitation in Parkinson's disease: cross mapping of terms.

PubMed

Tosin, Michelle Hyczy de Siqueira; Campos, Débora Moraes; Andrade, Leonardo Tadeu de; Oliveira, Beatriz Guitton Renaud Baptista de; Santana, Rosimere Ferreira

2016-08-08

to perform a cross-term mapping of nursing language in the patient record with the Nursing Interventions Classification system, in rehabilitation patients with Parkinson's disease. a documentary research study to perform cross mapping. A probabilistic, simple random sample composed of 67 records of patients with Parkinson's disease who participated in a rehabilitation program, between March of 2009 and April of 2013. The research was conducted in three stages, in which the nursing terms were mapped to natural language and crossed with the Nursing Interventions Classification. a total of 1,077 standard interventions that, after crossing with the taxonomy and refinement performed by the experts, resulted in 32 interventions equivalent to the Nursing Interventions Classification (NIC) system. The NICs, "Education: The process of the disease.", "Contract with the patient", and "Facilitation of Learning" were present in 100% of the records. For these interventions, 40 activities were described, representing 13 activities by intervention. the cross mapping allowed for the identification of corresponding terms with the nursing interventions used every day in rehabilitation nursing, and compared them to the Nursing Interventions Classification. realizar o mapeamento cruzado de termos da linguagem de Enfermagem, com o sistema de Classificação das Intervenções de Enfermagem, em prontuários de pacientes com doença de Parkinson em reabilitação. estudo de pesquisa documental, para realização de mapeamento cruzado. Amostra probabilística, do tipo aleatória simples, composta por 67 prontuários de pacientes com doença de Parkinson que participaram de programa de reabilitação, entre março de 2009 e abril de 2013. Pesquisa realizada em três etapas onde foram mapeados os termos de Enfermagem em linguagem livre e cruzados com o sistema de Classificação das Intervenções de Enfermagem. foram identificadas 1.077 intervenções normalizadas que, após o cruzamento

Interface between social support, quality of life and depression in users eligible for palliative care.

PubMed

Azevedo, Cissa; Pessalacia, Juliana Dias Reis; Mata, Luciana Regina Ferreira da; Zoboli, Elma Lourdes Campos Pavone; Pereira, Maria da Graça

2017-08-28

Analyzing the relationship between social support, quality of life and depression in patients eligible for palliative care at Primary Health Care of a municipality in the interior of Minas Gerais, Brazil. A correlational cross-sectional study carried out with patients treated in six primary health care units. Data were submitted to descriptive statistical analysis, tests for differences between averages and medians, and correlation tests. The significance level was 0.05. The sample consisted of 115 participants, and it was identified that the higher the social support, the better the global quality of life (p<0.001) and functional quality of life (p=0.035); the greater the presence of physical symptoms, the lower the level of social support (p=0.012) and the higher the level of depression (p<0.001); the higher the symptoms of depression, the worse the global quality of life (p<0.001), functional quality of life (p<0.001) and the lower the levels of social support (p<0.001). Levels of quality of life, social support and depression of patients eligible for palliative care are influenced by socioeconomic factors such as marital status, gender, age, income, education and presence of a caregiver. Analisar a relação entre apoio social, qualidade de vida e depressão em pacientes elegíveis para cuidados paliativos atendidos na Atenção Primária à Saúde de um município no interior de Minas Gerais, Brasil. Estudo transversal correlacional, realizado com pacientes atendidos em seis unidades da atenção primária à saúde. Os dados foram submetidos à análise estatística descritiva, testes de diferenças entre médias e medianas e testes de correlação. O nível de significância adotado foi 0,05. A amostra foi composta por 115 participantes, e identificou-se que quanto maior o apoio social, melhor é a qualidade de vida global (p<0,001) e funcional (p=0,035); quanto maior a presença de sintomas físicos, menor o nível de apoio social (p=0,012) e maior o n

Action mechanism of tyrosinase on meta- and para-hydroxylated monophenols.

PubMed

Fenoll, L G; Rodríguez-López, J N; Varón, R; García-Ruiz, P A; García-Cánovas, F; Tudela, J

2000-04-01

The relationship between the structure and activity of meta- and para-hydroxylated monophenols was studied during their tyrosinase-catalysed hydroxylation and the rate-limiting steps of the reaction mechanism were identified. The para-hydroxylated substrates permit us to study the effect of a substituent (R) in the carbon-1 position (C-1) of the benzene ring on the nucleophilic attack step, while the meta group permits a similar study of the effect on the electrophilic attack step. Substrates with a -OCH3 group on C-1, as p-hydroxyanisol (4HA) and m-hydroxyanisol (3HA), or with a -CH2OH group, as p-hydroxybenzylalcohol (4HBA) and m-hydroxybenzylalcohol (3HBA), were used because the effect of the substituent (R) size was assumed to be similar. However, the electron-donating effect of the -OCH3 group means that the carbon-4 position (C-4) is favoured for nucleophilic attack (para-hydroxylated substrates) or for electrophilic attack (meta-hydroxylated substrates). The electron-attracting effect of the -CH2OH group has the opposite effect, hindering nucleophilic (para) or electrophilic (meta) attack of C-4. The experimental data point to differences between the maximum steady-state rate (V(M)Max) of the different substrates, the value of this parameter depends on the nucleophilic and electrophilic attack. However, differences are greatest in the Michaelis constants (K(M)m), with the meta-hydroxylated substrates having very large values. The catalytic efficiency k(M)cat/K(M)m is much greater for thepara-hydroxylated substrates although it varies greatly between one substrate and the other. However, it varies much less in the meta-hydroxylated substrates since this parameter describes the power of the nucleophilic attack, which is weaker in the meta OH. The large increase in the K(M)m of the meta-hydroxylated substrates might suggest that the phenolic OH takes part in substrate binding. Since this is a weaker nucleophil than the para-hydroxylated substrates, the binding

[Not Available].

PubMed

Molina Garrido, María José

2016-06-03

Cada vez es mayor el número de ancianos con diagnóstico de cáncer que acuden a las consultas de Oncología Médica. El proceso del envejecimiento y la gran variabilidad existente en la población geriátrica implican que, para hacer un abordaje adecuado del paciente, se deba considerar la edad fisiológica del anciano, y no su edad biológica. Para ello, es preciso hacer una evaluación somera, específica e individualizada a cada uno de los ancianos con diagnóstico de cáncer que acudan a nuestra consulta. La valoración geriátrica integral (VGI) es la herramienta clave que permite evaluarlos de forma adecuada, e incluso orienta la toma de decisiones "personalizada" en los ancianos con diagnóstico de cáncer. Dado que la VGI consume mucho tiempo en la consulta diaria, se están desarrollando distintas herramientas de cribado que permitan acortar la atención al paciente, al seleccionar aquellos ancianos que deban someterse a una VGI y aquellos en los que esta no sea necesaria. Se han publicado distintos modelos de VGI en la Oncogeriatría y se han desarrollado distintas herramientas de cribado de fragilidad; los más conocidos son el cuestionario Vulnerable Elders Survey-13 (VES-13) y el cuestionario G-8. En este artículo se hace una revisión acerca de la evidencia científica existente en cuanto a la atención y valoración del anciano oncológico, así como los distintos parámetros de los que se disponen para la toma de decisiones definitiva. Dichos datos reflejan el papel de la Oncogeriatría como la vía para ofrecer una atención global óptima a este grupo poblacional.

Ro-vibrational Spectra of (para-H2 )N -CH4 in He Droplets.

PubMed

Hoshina, Hiromichi; Sliter, Russell; Ravi, Aakash; Kuma, Susumu; Momose, Takamasa; Vilesov, Andrey F

2016-11-18

In this work, we report on the infrared spectroscopic study of clusters of CH 4 molecules with up to N=80 para-hydrogen molecules assembled inside He droplets. Upon increase of the number of the added para-hydrogen molecules up to about N=12, both the rotational constant, B, and the origin frequency of the υ 3 band of CH 4 decrease gradually. In the range of 6 ≤N≤12, the spectra indicate some abrupt changes of B and υ 3 with both values being approximately constant at N≥12. The origin of this effect is discussed. Comparison of the spectra of methane molecules in para-hydrogen clusters to that in solid para-hydrogen is also presented. © 2016 Wiley-VCH Verlag GmbH & Co. KGaA, Weinheim.

Achados incidentais de aneurismas torácicos e abdominais

PubMed Central

Góes, Adenauer Marinho de Oliveira; Mascarenhas, Bárbara Íris; Rodrigues, Sofia Cunha; de Andrade, Mariseth Carvalho; Franco, Reinaldo Sergio Monteiro

2016-01-01

Resumo Contexto Os aneurismas de aorta abdominal (AAAs) são os mais comuns. A incidência anual de ruptura do AAA é de oito casos por 100.000 habitantes. A detecção incidental pode beneficiar o paciente, desde que o diâmetro seja monitorado e o paciente receba o tratamento adequado. Objetivos Estimar a prevalência do diagnóstico incidental de aneurisma de aorta torácica (AAT) e de AAA em tomografias computadorizadas (TCs); avaliar a prevalência de sexo e idade dos pacientes e determinar quais as artérias acometidas e as características morfológicas dos aneurismas; determinar quais as indicações de TC mais associadas ao diagnóstico incidental de aneurismas. Métodos Estudo descritivo, retrospectivo e randomizado. Critérios de inclusão: pacientes com 50 anos ou mais submetidos a TC de tórax, abdome ou pelve. Critérios de exclusão: acompanhamento ou suspeita diagnóstica de aneurismas. Foram utilizados protocolos com questões sobre dados demográficos e anatômicos. Resultados Foram analisados 1.202 laudos radiológicos. Detectados 27 aneurismas (prevalência de 2,2%). Pacientes: 60% do sexo masculino e 40% do sexo feminino (p < 0,05). Localização: 13 casos (48,2%) na aorta ascendente (AAT); 7 (25,9%) na aorta infrarrenal (AAA); 2 (7,4%) aorta na transição toracoabdominal (ATA); 2 (7,4%) na ilíaca comum; 1 (3,7%) na ilíaca interna; 1 (3,7%) na artéria esplênica; e 1 (3,7%) na artéria renal. Conclusões A maioria dos pacientes foi do sexo masculino (60%); houve maior frequência de AAT (diâmetro médio de 4,1 cm), seguido de AAA (diâmetro médio de 4,0 cm) e ATA (diâmetro médio de 3,9 cm). A principal indicação para a realização de TC associada ao diagnóstico incidental de aneurismas foi em função de sintomas respiratórios. PMID:29930574

Relationship between anxiety, depression and quality of life with the intensity of reflex sweating after thoracoscopic sympathectomy for treatment of primary hyperhidrosis.

PubMed

Dias, Luciara Irene DE Nadai; Miranda, Eliana Cristina Martins; Toro, Ivan Felizardo Contrera; Mussi, Ricardo Kalaf

2016-01-01

to compare the intensity of reflex sweating with the degree of anxiety and its interference in the quality of life of patients undergoing Thoracoscopic (VATS) sympathectomy in the pre- and postoperative period. we evaluated 54 patients with a mean age of 26 years (16-49 years) undergoing sympathectomy in the R3-R4 level. We applied two questionnaires at three different times: "Quality of life in patients with primary hyperhidrosis" and "Scale for anxiety and depression". of the patients studied, 93% showed significant improvement in quality of life 30 days after surgery, the effects remaining after six months. There were no postoperative complications. The patient's level of anxiety is highly correlated with the intensity of reflex sweating after 30 and 180 days. Thoracoscopic sympathectomy improves quality of life of patients with primary hyperhidrosis, even with the emergence of reflex sweating. Anxiety directly relates to the intensity of reflex sweating, without compromising the degree of patient satisfaction. avaliar a intensidade de sudorese reflexa com o grau de ansiedade e sua interferência na qualidade de vida de indivíduos submetidos à simpatectomia por videotoracoscopia nos períodos pré e pós-operatório. foram avaliados 54 pacientes com média de idade de 26 anos (16 a 49 anos), submetidos à simpatectomia em nível R3-R4. Dois questionários foram aplicados em três momentos diferentes: "Qualidade de vida em pacientes com hiperidrose primária e "Escala para ansiedade e depressão". dos pacientes estudados, 93% mostrou melhora significativa na qualidade de vida após 30 dias da cirurgia, com os efeitos remanescentes após seis meses. Não houve complicações pós-operatórias. A análise mostrou que o nível de ansiedade do paciente é altamente correlacionado com a intensidade da sudorese reflexa após 30 e 180 dias. a simpatectomia torácica por videotoracoscopia melhora a qualidade de vida de pacientes com hiperidrose primária, mesmo com o

Efficacy of bacterial cellulose membrane for the treatment of lower limbs chronic varicose ulcers: a randomized and controlled trial.

PubMed

Cavalcanti, Luciana Marins; Pinto, Flávia Cristina Morone; Oliveira, Glícia Maria DE; Lima, Salvador Vilar Correia; Aguiar, José Lamartine DE Andrade; Lins, Esdras Marques

2017-01-01

to evaluate the efficacy of Bacterial Cellulose (BC) membrane dressings in the treatment of lower limb venous ulcers. we carried out a prospective, randomized, controlled study of 25 patients with chronic venous ulcer disease in the lower limbs from the Angiology and Vascular Surgery Service of the Federal University of Pernambuco Hospital and from the Salgado Polyclinic of the County Health Department, Caruaru, Pernambuco. We randomly assigned patients to two groups: control group, receiving dressings with triglyceride oil (11 patients) and experimental group, treated with BC membrane (14 patients). We followed the patients for a period of 120 days. There was a reduction in the wound area in both groups. There were no infections or reactions to the product in any of the groups. Patients in the BC group showed decreased pain and earlier discontinuation of analgesic use. BC membrane can be used as a dressing for the treatment of varicose ulcers of the lower limbs. avaliar a eficácia de curativos com membrana de Celulose Bacteriana (CB) no tratamento de úlceras venosas de membros inferiores. estudo prospectivo, randomizado e controlado de 25 pacientes com úlceras decorrentes de doença venosa crônica nos membros inferiores provenientes do Serviço de Angiologia e Cirurgia Vascular do Hospital de Clínicas da Universidade Federal de Pernambuco e da Policlínica do Salgado da Secretaria Municipal de Saúde, Caruaru, Pernambuco. Os pacientes foram distribuídos aleatoriamente em dois grupos: grupo controle, que recebeu curativos com óleo de triglicerídeos (11 pacientes) e grupo experimental, tratado com membrana de CB (14 pacientes). Os pacientes foram acompanhados por um período de 120 dias. houve uma redução na área de ferida em ambos os grupos. Não houve infecção ou reações ao produto em nenhum dos grupos. Pacientes do grupo CB mostraram diminuição da dor e interrupção mais precoce do uso de analgésicos. a membrana de CB pode ser usada como

Identificación de Intervenciones para el Desarrollo Positivo de la Juventud

PubMed Central

Sardiñas, Lili M.; Padilla, Viviana; Aponte, Mari; Boscio, Ana Morales; Pedrogo, Coralee Pérez; Santiago, Betzaida; Morales, Ángela Pérez; Dávila, Paloma Torres; Cesáreo, Marizaida Sánchez

2017-01-01

Resumen En el mundo hay más personas en la etapa de la juventud que en cualquier otra etapa del desarrollo. La juventud en Puerto Rico enfrenta muchas situaciones que inciden en su desarrollo y preparación para la adultez. Por lo tanto, es imperante identificar intervenciones para el desarrollo positivo de la juventud que han demostrado ser basadas en la evidencia. Además, a partir de dicha identificación, desarrollar prácticas que ayuden a los jóvenes a desarrollarse para prevenir situaciones adversas, promover experiencias positivas y propiciar que los niños y jóvenes estén involucrados y comprometidos. Se identificaron 147 intervenciones a través de una revisión tradicional de la literatura científica estadounidense. Los resultados reflejan que las intervenciones atienden la reducción de factores de riesgo y el incremento de factores de protección. Sin embargo, ninguna intervención propicia que los niños y jóvenes estén involucrados y comprometidos con su desarrollo óptimo y con sus comunidades. No obstante, todas brindan herramientas que podrían ser de utilidad para fomentar dichas prácticas en el contexto de Puerto Rico. De las 147 intervenciones identificadas seis están diseñadas para la población puertorriqueña residente en la Isla. Con el propósito de hacer la información accesible a los profesionales y la comunidad se expandió la colección del Archivo de Programas y Prácticas Basadas en Evidencia para la Prevención. PMID:28919943

Test-retest reliability of Brazilian version of Memorial Symptom Assessment Scale for assessing symptoms in cancer patients.

PubMed

Menezes, Josiane Roberta de; Luvisaro, Bianca Maria Oliveira; Rodrigues, Claudia Fernandes; Muzi, Camila Drumond; Guimarães, Raphael Mendonça

2017-01-01

To assess the test-retest reliability of the Memorial Symptom Assessment Scale translated and culturally adapted into Brazilian Portuguese. The scale was applied in an interview format for 190 patients with various cancers type hospitalized in clinical and surgical sectors of the Instituto Nacional de Câncer José de Alencar Gomes da Silva and reapplied in 58 patients. Data from the test-retest were double typed into a Microsoft Excel spreadsheet and analyzed by the weighted Kappa. The reliability of the scale was satisfactory in test-retest. The weighted Kappa values obtained for each scale item had to be adequate, the largest item was 0.96 and the lowest was 0.69. The Kappa subscale was also evaluated and values were 0.84 for high frequency physic symptoms, 0.81 for low frequency physical symptoms, 0.81 for psychological symptoms, and 0.78 for Global Distress Index. High level of reliability estimated suggests that the process of measurement of Memorial Symptom Assessment Scale aspects was adequate. Avaliar a confiabilidade teste-reteste da versão traduzida e adaptada culturalmente para o português do Brasil do Memorial Symptom Assessment Scale. A escala foi aplicada em forma de entrevista em 190 pacientes com diversos tipos de câncer internados nos setores clínicos e cirúrgicos do Instituto Nacional de Câncer José de Alencar Gomes da Silva e reaplicada em 58 pacientes. Os dados dos testes-retestes foram inseridos num banco de dados por dupla digitação independente em Excel e analisados pelo Kappa ponderado. A confiabilidade da escala mostrou-se satisfatória nos testes-retestes. Os valores do Kappa ponderado obtidos para cada item da escala apresentaram-se adequados, sendo o maior item de 0,96 e o menor de 0,69. Também se avaliou o Kappa das subescalas, sendo de 0,84 para sintomas físicos de alta frequência, de 0,81 para sintomas físicos de baixa frequência, de 0,81 também para sintomas psicológicos, e de 0,78 para Índice Geral de Sofrimento

[Not Available].

PubMed

De Abajo Larriba, Ana Beatriz; Díaz Rodríguez, Ángel; González-Gallego, Javier; Méndez Rodríguez, Enrique; Álvarez Álvarez, María Jesús; Capón Álvarez, Jessica; Peleteiro Cobo, Beatriz; Mahmoud Atoui, Omar; De Abajo Olea, Serafín; Martínez de Mandojana Hernández, Juan

2016-07-19

Introducción: estimar la prevalencia del tabaquismo y analizar cómo se diagnostican y se trata a los fumadores diagnosticados de EPOC.Métodos: estudio epidemiológico, transversal, multicéntrico (30 centros salud de la provincia de León). Incluyó pacientes mayores de 35 años diagnosticados y tratados de EPOC. Variables analizadas: edad, sexo, hábitat, datos antropométricos, tabaquismo, número de paquetes/año, cooximetría, dependencia (escala analógico-visual), motivación (test de Fagerström), autoeficacia, estado anímico, intentos previos, terapia cognitivo-conductual, tratamiento farmacológico (TSN, bupropión, vareniclina) y recaídas. Los resultados se expresan con sus IC al 95,5%.Resultados: se incluyó a 833 pacientes, el 85,8% varones, edad media: 64,69 (53,66-75,61) años y 20,65 (4,47-36,8) años de evolución de la EPOC. El 86,67% (80,30-93,30) tenían antecedentes de tabaquismo (n = 722), de 35,26 (17,87-52,64) años de evolución, con consumo medio 28,36 (9,60-46,86) paquetes año, p < 0,001, siendo el 58% fumadores severos. El 57,4% (53,90-60,60) son exfumadores. El 29,3% (26,40-32,70) fumadores activos declarados vs. 35,11% (33,90-37,12) fumadores diagnosticados por cooximetría p < 0,05. Los 288 fumadores activos, presentaban baja motivación (49,80%), alta dependencia (49,5%), actitud negativa (52,60%), bajo estado de ánimo (32,05%), con 2,72 (1,74-3,67) intentos para dejar de fumar, p < 0,0001. La terapia conductivo-conductual (TCC) combinado con tratamiento farmacológico se realizó en el 55,8% (52,2-54,9), p < 0,05; La intervención más efectiva fue TCC combinada con vareniclina logrando una abstinencia del 29,86%. En total dejaron de fumar un 51,05% (49,49-52,70) de los pacientes con EPOC, p < 0,001.Conclusiones: la prevalencia de tabaquismo en la EPOC en nuestro medio continúa siendo inadmisiblemente elevada. Es necesaria una mayor implicación para disminuir su impacto en la salud de estos pacientes.

Electrical detection of ortho–para conversion in fullerene-encapsulated water

PubMed Central

Meier, Benno; Mamone, Salvatore; Concistrè, Maria; Alonso-Valdesueiro, Javier; Krachmalnicoff, Andrea; Whitby, Richard J.; Levitt, Malcolm H.

2015-01-01

Water exists in two spin isomers, ortho and para, that have different nuclear spin states. In bulk water, rapid proton exchange and hindered molecular rotation obscure the direct observation of two spin isomers. The supramolecular endofullerene H2O@C60 provides freely rotating, isolated water molecules even at cryogenic temperatures. Here we show that the bulk dielectric constant of this substance depends on the ortho/para ratio, and changes slowly in time after a sudden temperature jump, due to nuclear spin conversion. The attribution of the effect to ortho–para conversion is validated by comparison with nuclear magnetic resonance and quantum theory. The change in dielectric constant is consistent with an electric dipole moment of 0.51±0.05 Debye for an encapsulated water molecule, indicating the partial shielding of the water dipole by the encapsulating cage. The dependence of bulk dielectric constant on nuclear spin isomer composition appears to be a previously unreported physical phenomenon. PMID:26299447

The nursing department's view towards moroccan patients.

PubMed

Sánchez-Ojeda, María Angustias; Alemany Arrebola, Inmaculada; Gallardo Vigil, Miguel Ángel

2017-05-25

To determine the Melilla Hospital Nursing Department's attitude towards Moroccan patients. Descriptive ex post facto study. A questionnaire has been handed over to staff, on the Immigration Attitude Scale for Nursing. In general, nurses exhibit negative attitudes towards Moroccan patients, such as: the increase in crime is caused by the arrival of immigrants, those who commit offenses must be expelled from Spain, they take advantage of the Spanish health system and too many resources are devoted to immigration. The worst-rated immigrants are the Moroccans, considering that they do not pay much attention to their personal hygiene and do not adapt to their host countries. It is necessary to work with the nursing staff to change these attitudes. Future degree students must be trained in cultural skills and the care of immigrants will improve with a greater commitment towards cultural differences. Conocer la actitud de enfermería del Hospital de Melilla hacia los pacientes marroquíes. Estudio ex post facto descriptivo. Se ha pasado un cuestionario de Escala de Actitud ante la Inmigración para Enfermería. En general las enfermeras presentan actitudes negativas ante los pacientes marroquíes, como: el aumento de la delincuencia es provocado por la llegada de inmigrantes, los que delinquen deben ser expulsados de España, se aprovechan del sistema sanitario y se dedican demasiados recursos para la inmigración. Los inmigrantes peores valorados son los marroquíes, considerando que son pocos cuidadosos con su higiene personal y no se adaptan a los países de acogida. Es necesario trabajar con el personal de enfermería para que cambien estas actitudes. Las futuras promociones de Grado deben estar formadas en competencias culturales y mejorarán los cuidados a los inmigrantes como un mayor compromiso con la diferencia cultural.

Integrando la historia clínica ambiental en el consejo prenatal y cuidado de 2 casos de gastrosquisis

PubMed Central

García, J.A. Ortega; Martín, M.; Lamas, A. Brea; De Paco-Matallana, C.; Jiménez, J.I. Ruiz; Soldin, O.P.

2017-01-01

Introducción La gastroquisis es una malformación de etiología desconocida en la que se han implicado factores de riesgo (FR) genéticos y medioambientales. El objetivo de este trabajo es desarrollar la historia clínica medioambiental pediátrica (HCMAP) de la gastroquisis en 2 pacientes. Pacientes y métodos Revisión bibliográfica en Pubmed y en el Developmental and Reproductive Toxicology Database. Búsqueda selectiva de sustancias con capacidad teratogénica en el Hazardous Substances Data Bank. Palabras clave utilizadas fueron: «gastroschisis» y «gastroschisis and risk factor». Resultados En ambos casos están presentes los siguientes FR descritos en la literatura: corta cohabitación, embarazos no planificados de madres relativamente jóvenes, cambio de pareja reciente, ingesta de alcohol, déficits nutricionales importantes, tabaquismo activo/pasivo. Un caso estuvo expuesto a cocaína, humo de cannabis y se realizó una ortopantografía durante el embarazo. Conclusiones 1) Es necesario obtener la HCMAP en todo paciente con gastroquisis; 2) una cuidadosa HCMAP requiere una adecuada revisión de los FR relacionados e instrucción básica para caracterizar y cuantificar las exposiciones medioambientales, y 3) siguiendo estos pasos, complementaremos nuestras labores asistenciales y preventivas. PMID:20122885

PubMed

Wanden-Berghe Lozano, Carmina; Campos Martín, Cristina; Cuerda Compes, Cristina; Gómez Candela, Carmen; Burgos Peláez, Rosa; Moreno Villares, José Manuel; Pereira Cunill, José Luis; Pérez de la Cruz, Antonio; Virgili Casas, Nuria; Martinez Faedo, Ceferino; Álvarez Hernández, Julia; Garde Orbaiz, Carmen; Penacho Lázaro, Mª Ángeles; Sánchez Martos, Eva Ángeles; Sanz Paris, Alejandro; Gonzalo Marín, Montserrat; Zugasti Murillo, Ana; Matía Martín, Pilar; Martín Folgueras, Tomás; Carabaña Pérez, Fátima; Díaz Guardiola, Patricia; Tejera Pérez, Cristina; De Luis Román, Daniel; Luengo Pérez, Luis Miguel; Santacruz Carmona, Nieves; Apezetxea Celaya, Antxón; Ponce González, Miguel Ángel; Urgeles Planella, Juan Ramón; Laborda González, Lucía; Martinez Olmos, Miguel Ángel; Sánchez-Vilar Burdiel, Olga; Joaquín Ortiz, Clara; Martínez Costa, Cecilia; Suárez Llanos, José Pablo; Calleja Fernández, Alicia; Leyes García, Pere; Gil Martinez, Mª Carmen; Mauri Roca, Silvia; García Zafra, Maria Victoria; Carrera Santaliestra, María José; Nadya-Senpe, Grupo

2016-11-29

Objetivo: Comunicar los datos del registro de Nutrición Parenteral Domiciliaria (NPD) del grupo de trabajo NADYA-SENPE del años 2015.Material y métodos: Recopilación de los datos de NPD del registro "on-line" del grupo de Nutrición Artificial Domiciliaria y Ambulatoria (NADYA) desde el 1 de enero de 2015 al 31 de diciembre de 2015.Resultados: Se registraron 236 pacientes, con 243 episodios de NPD procedentes de 40 hospitales. Lo que representa una tasa de 5,08 pacientes/millón de habitantes/ año 2015. La patología más frecuente en los adultos fue "otros" (26,3%) seguido por "oncológico paliativo" (21,6%).  La complicación más frecuente fue la séptica relacionada con el catéter que presentó una tasa de 0,53 infecciones/1000 días de NPD. Finalizaron 64 episodios, la principal causa fue el fallecimiento (43,7%) y el 'paso a la vía oral' (32,8%).Conclusiones: constatamos el aumento de los centros y profesionales colaboradores, dando respuesta a la cantidad progresivamente mayor de pacientes con soporte nutricional parenteral en domicilio. Se mantienen estables las principales indicaciones para el establecimiento de NPD y las causas de finalización del tratamiento.

Fusión intersomática lumbar extraforaminal mínimamente invasiva

PubMed Central

Landriel, Federico; Hem, Santiago; Rasmussen, Jorge; Vecchi, Eduardo; Yampolsky, Claudio

2018-01-01

Resumen Objetivo: El objetivo del presente trabajo es mostrar la indicación, técnica quirúrgica, resultados y complicaciones de la vía de abordaje extraforaminal para fusión intersomática (ELIF) mínimamente invasiva. Introducción: El ELIF se caracteriza por la remoción del proceso articular superior (PAS) y el acceso a la raíz intracanalicular y disco a través del triángulo de seguridad de Kambin. Material y Métodos: Estudio retrospectivo de 40 pacientes operados consecutivamente entre el 2013 y 2015. Se incluyeron pacientes con lumbalgia o dolor radicular por enfermedad degenerativa discal, espondilolistesis grado 1 y 2, hernia discal recurrente y estenosis receso-foraminales. Se utilizó la escala visual analógica, el índice de Oswestry, la escala de Weiner y los criterios de MacNab modificados para evaluar el dolor, resultados clínico-funcionales y satisfacción del paciente al año de la cirugía. Las complicaciones fueron documentadas de acuerdo a su gravedad en 4 grados. Resultados: 25 mujeres/15 hombres con una edad promedio de 57 años. El 47.5% fueron tratados por espondilolistesis, el 25% por estenosis receso-foraminal. Se colocaron 54 cajas intersomáticas y 188 tornillos pediculares percutáneos. La duración quirúrgica promedio fue 245 (±25.4) minutos. El tiempo de internación promedio fue 3.5 (±0.49) días. Presentamos 9 complicaciones Grado 1 y una complicación Grado 2. La escala de ODI preoperatoria promedio fue de 51.9 ± 4.96, al año de 12.2 ± 3.19, evidenciando una mejoría significativa (P < 0.0001). La EVA promedio para lumbalgia mejoró de 8.81 ± 0.62 a 2.12 ± 0.89 (P < 0.0001). El 77.5% presentó fusión en los grados 1 y 2 de Bridwel al año del procedimiento quirúrgico. Conclusión: El ELIF es una alternativa de tratamiento quirúrgico segura y eficaz. Se pueden lograr resultados clínicos satisfactorios comparables con las técnicas tradicionales con la resección facetaria limitada al proceso articular superior

Photodissociation dynamics of the ortho- and para-xylyl radicals

NASA Astrophysics Data System (ADS)

Pachner, Kai; Steglich, Mathias; Hemberger, Patrick; Fischer, Ingo

2017-08-01

The photodissociation dynamics of the C8H9 isomers ortho- and para-xylyl are investigated in a free jet. The xylyl radicals are generated by flash pyrolysis from 2-(2-methylphenyl)- and 2-(4-methylphenyl) ethyl nitrite and are excited into the D3 state. REMPI- spectra show vibronic structure and the origin of the transition is identified at 32 291 cm-1 for the para- and at 32 132 cm-1 for the ortho-isomer. Photofragment H-atom action spectra show bands at the same energy and thus confirm H-atom loss from xylyl radicals. To gain further insight into the photodissociation dynamics, velocity map images of the hydrogen atom photofragments are recorded. Their angular distribution is isotropic and the translational energy release is in agreement with a dissociation to products in their electronic ground state. Photodissociation of para-xylyl leads to the formation of para-xylylene (C8H8), while the data for ortho-xylyl agree much better with the isomer benzocyclobutene as the dominant molecular fragment rather than ortho-xylylene. In computations we identified a new pathway for the reaction ortho-xylyl → benzocyclobutene + H with a barrier of 3.39 eV (27 340 cm-1), which becomes accessible at the employed excitation energy. It proceeds via a combination of scissoring and rotational motion of the -CH2 and -CH3 groups. However, the observed rate constants measured by delaying the excitation and ionization laser with respect to each other are significantly faster than computed ones, indicating intrinsic non-RRKM behaviour. A comparably high value of around 30% of the excess energy is released as translation of the H-atom photofragment.

Photodissociation dynamics of the ortho- and para-xylyl radicals.

PubMed

Pachner, Kai; Steglich, Mathias; Hemberger, Patrick; Fischer, Ingo

2017-08-28

The photodissociation dynamics of the C 8 H 9 isomers ortho- and para-xylyl are investigated in a free jet. The xylyl radicals are generated by flash pyrolysis from 2-(2-methylphenyl)- and 2-(4-methylphenyl) ethyl nitrite and are excited into the D 3 state. REMPI- spectra show vibronic structure and the origin of the transition is identified at 32 291 cm -1 for the para- and at 32 132 cm -1 for the ortho-isomer. Photofragment H-atom action spectra show bands at the same energy and thus confirm H-atom loss from xylyl radicals. To gain further insight into the photodissociation dynamics, velocity map images of the hydrogen atom photofragments are recorded. Their angular distribution is isotropic and the translational energy release is in agreement with a dissociation to products in their electronic ground state. Photodissociation of para-xylyl leads to the formation of para-xylylene (C 8 H 8 ), while the data for ortho-xylyl agree much better with the isomer benzocyclobutene as the dominant molecular fragment rather than ortho-xylylene. In computations we identified a new pathway for the reaction ortho-xylyl → benzocyclobutene + H with a barrier of 3.39 eV (27 340 cm -1 ), which becomes accessible at the employed excitation energy. It proceeds via a combination of scissoring and rotational motion of the -CH 2 and -CH 3 groups. However, the observed rate constants measured by delaying the excitation and ionization laser with respect to each other are significantly faster than computed ones, indicating intrinsic non-RRKM behaviour. A comparably high value of around 30% of the excess energy is released as translation of the H-atom photofragment.

Surgical correction of ectopic penis and scrotum associated with bilateral orchidopexy.

PubMed

Sobral, Daniel Santos Rocha; Silva, Helder Damásio da; Damázio, Eulálio

2017-01-01

Ectopic penis is usually associated with penoscrotal transposition, and it is rarely observed in isolation. We report a surgical approach for an extremely rare case. A 10-year-old male patient with bilateral cryptorchidism and ectopic penis and scrotum in perineal area, with no penoscrotal transposition, representing an association not yet described in literature. A previous orchiopexy failed due to ectopic scrotum. By means of an inverted Y incision, the penis was mobilized and a perineal skin flap in form of a testicular sac was prepared. Finally orchiopexy was performed. The surgery was essential to treat cryptorchidism and to improve the self-image of the patient. RESUMO O pênis ectópico geralmente ocorre associado à transposição peno-escrotal, sendo raro isoladamente. Relatamos uma abordagem cirúrgica para um caso extremamente raro. Tratava-se de paciente do sexo masculino, 10 anos, com criptorquidia bilateral e pênis e escroto ectópicos, na região perineal, sem transposição peno-escrotal, representando uma associação ainda não descrita na literatura. Orquidopexia prévia sem sucesso, devido à ectopia do escroto. Por meio de uma incisão em Y invertido, mobilizou-se o pênis e preparou-se um retalho da pele perineal em forma de bolsa testicular. Por fim, realizou-se a orquidopexia. A cirurgia foi fundamental para tratar a criptorquidia e promover ganho na autoimagem do paciente.

[In Process Citation].

PubMed

Almeida Dos Santos, Alyne Dayana; Sabino Pinho, Cláudia Porto; Santos do Nascimento, Alexsandra Camila; Oliveira Costa, Ana Carolina

2016-03-25

Introducción: la sarcopenia se define como un síndrome geriátrico, multifactorial, caracterizado por la pérdida progresiva de masa muscular esquelética, asociada a consecuencias graves, tales como comorbideces, mala calidad de vida y mortandad. Objetivo: identificar la prevalencia y los factores asociados a la sarcopenia en ancianos atendidos ambulatoriamente. Métodos: estudio transversal y observacional realizado con pacientes ancianos de ambos sexos atendidos en ambulatorio geriátrico, entre junio y diciembre de 2014, en un hospital universitario ubicado en el nordeste brasileño. Se determinó la sarcopenia a través de la masa muscular (circunferencia de la pantorrilla < 31 cm), fuerza muscular (evaluada por la fuerza de prensión palmar < 30 kg para hombres y < 20 kg para mujeres) y velocidad de marcha (< 0,8 metros/segundo). Entre las variables de asociación, se consideraron aspectos socioeconómicos y demográficos, variables clínicas, estilo de vida y antropometría. La tabulación y análisis de los datos se realizaron por medio del paquete estadístico SPSS versión 13.0. Resultados: la muestra se compuso de 50 pacientes, con promedio de edad de 73,9 (± 7,4) años, en la que se verificó una prevalencia de sarcopenia del 18%. La sarcopenia fue más prevalente en individuos con edad ≥ 80 años (p = 0,012), en los ancianos con bajo peso según el IMC (p < 0,001), con desnutrición de acuerdo con la CB (p = 0,004) y en los pacientes sin hipertensión arterial (p = 0,027), no encontrándose asociación con variables socioeconómicas, clínicas y del estilo de vida. Conclusiones: la prevalencia de la sarcopenia fue significativa y semejante a la descrita por otros autores, encontrándose asociación con la edad avanzada, desnutrición y ausencia de hipertensión.

Influência da termoablação com baixa e alta densidade de energia na junção safeno-femoral, utilizando laser endovenoso 1470 nm

PubMed Central

de Araujo, Walter Junior Boim; Erzinger, Fabiano Luiz; Caron, Filipe Carlos; Nejm, Carlos Seme; Timi, Jorge Rufino Ribas

2017-01-01

Resumo Contexto Faz-se importante o conhecimento técnico dos ajustes de potência e de densidade de energia linear endovenosa (linear endovenous energy density, LEED) adequados para atingir o objetivo final da termoablação endovenosa (endovenous laser ablation, EVLA). Objetivos Avaliar a influência de diferentes LEEDs em termos de patência e presença de refluxo, bem como determinar a evolução clínica. Métodos Foram incluídas 60 veias safenas magnas (VSM). Os pacientes foram randomizados em dois grupos: EVLA com baixa potência (7 W e LEED de 20-40 J/cm) e com alta potência (15 W e LEED de 80-100 J/cm). O acompanhamento com eco-Doppler e escore de severidade clínica venoso (VCSS) foi realizado nos intervalos de 3-5 dias, 30 dias, 180 dias e 1 ano após o procedimento. Resultados Dezoito pacientes (29 membros) tratados com 7W de potência e 13 pacientes (23 membros) com 15 W completaram o estudo. Não houve diferença significativa considerando idade, tempo de cirurgia e o uso de analgésicos, lateralidade, gênero e presença de comorbidades. O LEED médio foi de 33,54 J/cm no grupo de 7 W e de 88,66 J/cm no de 15 W. Ambos apresentaram melhora no VCSS, redução significativa dos diâmetros da JSF e ausência de diferença significativa quanto ao aumento do comprimento do coto da VSM e de refluxo após o tratamento. Conclusões A utilização de maior densidade de energia mostrou-se mais efetiva em relação à estabilização do comprimento do coto da VSM e do refluxo em 6 meses. Fazem-se necessários estudos com um período de acompanhamento maior para fundamentar essa hipótese. PMID:29930650

[Not Available].

PubMed

Higuera Pulgar, Isabel; Bretón Lesmes, Irene; Carrascal Fabián, María Luisa; Prieto García, Alicia; Menchén Viso, Luis; Nogales Rincón, Óscar; Iglesias Hernández, Natalia Covadonga; Issasa Rodríguez, Leire; García Peris, Pilar

2016-07-19

Introducción: la esofagitis eosinofílica (EEo) es una enfermedad inmunoalérgica crónica emergente en adultos. Surge como respuesta disfuncional frente a los antígenos de los alimentos y se caracteriza por síntomas recurrentes de disfunción esofágica e inflamación. El tratamiento farmacológico y dietético se basa en su patogénesis y debe ser individualizado. Uno de los posibles abordajes dietéticos se basa en la eliminación empírica de alimentos que con mayor frecuencia causan EEo.Objetivo: evaluar la ingesta dietética de los pacientes con EEo que siguen la dieta de exclusión de los seis grupos de alimentos (DESGA) y conocer sus posibles carencias nutricionales.Métodos: estudio transversal descriptivo en un grupo de pacientes con EEo que inició tratamiento con DESGA durante el periodo de marzo de 2013 hasta marzo de 2015. Se evaluó la ingesta mediante registro de 72 horas. Se compararon los resultados con las referencias para población adulta sana española (23). Para el análisis estadístico se usaron los test de Mann-Whitney, Krhuskall-Wallis y Chi-cuadrado. Significación p < 0,05.Resultados: se incluyeron en el estudio 14 pacientes. En algunos de ellos, la ingesta dietética siguiendo DESGA fue deficitaria en energía, proteínas y fibra. Tampoco consiguieron cubrir las ingestas de micronutrientes de calcio, zinc, magnesio, ácido fólico, niacina y vitaminas B2 y D, teniendo en cuenta edad y sexo, el 60% de la muestra.Conclusiones: el abordaje terapéutico mediante DESGA, teniendo en cuenta las características de la dieta, debe acompañarse de una evaluación periódica del estado nutricional, que incluya micronutrientes y una pauta de suplementación específica.

Utility of Ultraportable Echocardiography in the Preoperative Evaluation of Noncardiac Surgery.

PubMed

Costa, Jean Allan; Almeida, Maria Lucia Pereira; Estrada, Tereza Cristina Duque; Werneck, Guilherme Lobosco; Rocha, Alexandre Marins; Rosa, Maria Luiza Garcia; Ribeiro, Mario Luiz; Mesquita, Claudio Tinoco

2016-11-01

The ultraportable echocardiogram machine, with relevant portability and easiness in performing diagnoses, when in experienced hands, may contribute to the reliability of preoperative evaluation in noncardiac surgeries. To assess cardiac function parameters in patients aged older than 60 years, candidates of elective noncardiac surgeries, classified as ASA1 or ASA 2 according to surgical risk. A total of 211 patients referred for elective surgeries, without suspicion of previous heart diseases, were included in the study. Assessment of patients was conducted by conventional echocardiogram using the ultraportable V Scan (GE) device right after the pre-anesthetic clinical evaluation. We assessed the clinical impact of echocardiography results by using a questionnaire addressed to the anesthetist. Mean age of patients was 68.9 ± 7.0 years, 154 were women. The most frequent surgeries were: a) facectomy - cataract - 18; b) inguinal hernia surgery - 18; c) Cholecystectomy - 16. We found 58 normal tests (27.5%), 70 (33.2%) with mild valve reflux, and 83 (39.3%) with relevant abnormality, such as increase in heart chamber size, global and/or segmental contractile dysfunction, significant valve dysfunction or other unspecified. Test results caused delay of surgical procedure for a more detailed cardiac evaluation in 20 (9.5%) patients, and change in anesthetic management in 7 (3.3%). There was a considerable clinical impact with the use of the ultraportable echocardiography, since one out of every ten patients evaluated had their clinical management changed due to the detection of previously unsuspected, significant heart diseases, with the potential for severe complications. O ecocardiógrafo ultraportátil, com importante mobilidade e facilidade diagnóstica em mãos experientes pode contribuir para a segurança na avaliação pré-operatória em cirurgias não cardíacas. Avaliar os parâmetros de função cardíaca nos pacientes com mais de 60 anos de idade, candidatos

Tumores neonatales y malformaciones congénitas

PubMed Central

Tornero, O. Berbel; García, J.A. Ortega; Tortajada, J. Ferrís i; Castell, J. García; Colomer, J. Donat i; Soldin, O.P.; Soler, J.L. Fuster

2013-01-01

paciente con síndrome de Down y cardiopatía congénita; g) tumor renal en un caso con hidrocefalia triventricular, y h) tumor adrenal en un caso con hemihipertrofia. En la bibliografía específica, las publicaciones engloban tumores de diferentes épocas pediátricas y sin unanimidad de criterios para clasificar las malformaciones congénitas. Apenas existen datos en el período neonatal y la asociación entre ambas entidades se obtiene de registros de instituciones médicas. La prevalencia oscila entre el 15 y el 31,6 %. Las hipótesis etiopatogénicas que explican la asociación entre tumores neonatales y malformaciones congénitas están basadas en las exposiciones prenatales (preconcepcionales y transplacentarias) a factores de riesgo potencialmente mutagénicos y carcinogénicos. Conclusiones Probablemente, los tumores neonatales se asocian con mayor frecuencia a malformaciones congénitas que los tumores diagnosticados en épocas posteriores de la vida. Para conocer la prevalencia real de la asociación entre tumores neonatales y malformaciones congénitas, es necesario unificar los criterios de inclusión y definición de ambas entidades. La obtención de una minuciosa historia medioambiental en todos los tumores neonatales asociados a malformaciones congénitas, donde se detallen y registren todos los factores de riesgo constitucionales y ambientales, es fundamental para mejorar nuestros escasos conocimientos de los mecanismos prenatales subyacentes y avanzar en su prevención. PMID:18559198

Rotational excitation of HCN by para- and ortho-H{sub 2}

DOE Office of Scientific and Technical Information (OSTI.GOV)

Vera, Mario Hernández, E-mail: marhvera@gmail.com; InSTEC, Quinta de Los Molinos, Plaza, La Habana 10600; Kalugina, Yulia

Rotational excitation of the hydrogen cyanide (HCN) molecule by collisions with para-H{sub 2}( j = 0, 2) and ortho-H{sub 2}( j = 1) is investigated at low temperatures using a quantum time independent approach. Both molecules are treated as rigid rotors. The scattering calculations are based on a highly correlated ab initio 4-dimensional (4D) potential energy surface recently published. Rotationally inelastic cross sections among the 13 first rotational levels of HCN were obtained using a pure quantum close coupling approach for total energies up to 1200 cm{sup −1}. The corresponding thermal rate coefficients were computed for temperatures ranging from 5 to 100 K.more » The HCN rate coefficients are strongly dependent on the rotational level of the H{sub 2} molecule. In particular, the rate coefficients for collisions with para-H{sub 2}( j = 0) are significantly lower than those for collisions with ortho-H{sub 2}( j = 1) and para-H{sub 2}( j = 2). Propensity rules in favor of even Δj transitions were found for HCN in collisions with para-H{sub 2}( j = 0) whereas propensity rules in favor of odd Δj transitions were found for HCN in collisions with H{sub 2}( j ⩾ 1). The new rate coefficients were compared with previously published HCN-para-H{sub 2}( j = 0) rate coefficients. Significant differences were found due the inclusion of the H{sub 2} rotational structure in the scattering calculations. These new rate coefficients will be crucial to improve the estimation of the HCN abundance in the interstellar medium.« less

Quantitative structure-activity relationship analysis of the pharmacology of para-substituted methcathinone analogues.

PubMed

Bonano, J S; Banks, M L; Kolanos, R; Sakloth, F; Barnier, M L; Glennon, R A; Cozzi, N V; Partilla, J S; Baumann, M H; Negus, S S

2015-05-01

Methcathinone (MCAT) is a potent monoamine releaser and parent compound to emerging drugs of abuse including mephedrone (4-CH3 MCAT), the para-methyl analogue of MCAT. This study examined quantitative structure-activity relationships (QSAR) for MCAT and six para-substituted MCAT analogues on (a) in vitro potency to promote monoamine release via dopamine and serotonin transporters (DAT and SERT, respectively), and (b) in vivo modulation of intracranial self-stimulation (ICSS), a behavioural procedure used to evaluate abuse potential. Neurochemical and behavioural effects were correlated with steric (Es ), electronic (σp ) and lipophilic (πp ) parameters of the para substituents. For neurochemical studies, drug effects on monoamine release through DAT and SERT were evaluated in rat brain synaptosomes. For behavioural studies, drug effects were tested in male Sprague-Dawley rats implanted with electrodes targeting the medial forebrain bundle and trained to lever-press for electrical brain stimulation. MCAT and all six para-substituted analogues increased monoamine release via DAT and SERT and dose- and time-dependently modulated ICSS. In vitro selectivity for DAT versus SERT correlated with in vivo efficacy to produce abuse-related ICSS facilitation. In addition, the Es values of the para substituents correlated with both selectivity for DAT versus SERT and magnitude of ICSS facilitation. Selectivity for DAT versus SERT in vitro is a key determinant of abuse-related ICSS facilitation by these MCAT analogues, and steric aspects of the para substituent of the MCAT scaffold (indicated by Es ) are key determinants of this selectivity. © 2014 The British Pharmacological Society.

Quantitative structure–activity relationship analysis of the pharmacology of para-substituted methcathinone analogues

PubMed Central

Bonano, J S; Banks, M L; Kolanos, R; Sakloth, F; Barnier, M L; Glennon, R A; Cozzi, N V; Partilla, J S; Baumann, M H; Negus, S S

2015-01-01

Background and Purpose Methcathinone (MCAT) is a potent monoamine releaser and parent compound to emerging drugs of abuse including mephedrone (4-CH3 MCAT), the para-methyl analogue of MCAT. This study examined quantitative structure–activity relationships (QSAR) for MCAT and six para-substituted MCAT analogues on (a) in vitro potency to promote monoamine release via dopamine and serotonin transporters (DAT and SERT, respectively), and (b) in vivo modulation of intracranial self-stimulation (ICSS), a behavioural procedure used to evaluate abuse potential. Neurochemical and behavioural effects were correlated with steric (Es), electronic (σp) and lipophilic (πp) parameters of the para substituents. Experimental Approach For neurochemical studies, drug effects on monoamine release through DAT and SERT were evaluated in rat brain synaptosomes. For behavioural studies, drug effects were tested in male Sprague-Dawley rats implanted with electrodes targeting the medial forebrain bundle and trained to lever-press for electrical brain stimulation. Key Results MCAT and all six para-substituted analogues increased monoamine release via DAT and SERT and dose- and time-dependently modulated ICSS. In vitro selectivity for DAT versus SERT correlated with in vivo efficacy to produce abuse-related ICSS facilitation. In addition, the Es values of the para substituents correlated with both selectivity for DAT versus SERT and magnitude of ICSS facilitation. Conclusions and Implications Selectivity for DAT versus SERT in vitro is a key determinant of abuse-related ICSS facilitation by these MCAT analogues, and steric aspects of the para substituent of the MCAT scaffold (indicated by Es) are key determinants of this selectivity. PMID:25438806

Neuroimagen en la enfermedad de Alzheimer: nuevas perspectivas

PubMed Central

Becker, James T.

2012-01-01

Introducción y desarrollo En los próximos 50 años vamos a presenciar un incremento significativo de la población mayor de 65 años y por lo tanto va a aumentar, considerablemente, el número de individuos con riesgo de desarrollar demencias neurodegenerativas, especialmente la enfermedad de Alzheimer (EA). Las estrategias actuales de tratamiento farmacológico y no farmacológico se han centrado en las fases sintomáticas de esta enfermedad y, gradualmente, vamos teniendo una mayor comprensión de los posibles factores de riesgo del síndrome clínico. Conclusiones Los estudios de neuroimagen han sido muy útiles para mostrar los cambios estructurales del envejecimiento normal y patológico, así como también los factores de riesgo para la EA. Los tratamientos apropiados de los factores de riesgo y su posible combinación con tratamientos específicos para la EA podrían prolongar el período presintomático de la EA y, por tanto, mejorar la calidad de vida y disminuir la carga para el paciente, la familia y la sociedad. PMID:20517866

DIETARY MANAGEMENT FOR DYSLIPIDEMIA IN LIVER TRANSPLANT RECIPIENTS.

PubMed

Pinto, Andressa S; Chedid, Marcio F; Guerra, Léa T; Cabeleira, Daiane D; Kruel, Cleber D P

2016-01-01

os efeitos de uma intervenção dietética no perfil lipídico de pacientes transplantados hepáticos dislipidêmicos em acompanhamento ambulatorial. Foram incluídos todos os pacientes adultos transplantados hepáticos com dislipidemia e em acompanhamento ambulatorial em nossa instituição. Avaliação antropométrica, anamnese alimentar, composição corporal (bioimpedância) e cálculo do metabolismo basal (calorimetria indireta) foram realizados. Pacientes foram atendidos por uma nutricionista e uma dieta individualizada baseada no metabolismo basal e consistindo de 25% do valor energético em gorduras totais e menos de 200 mg/dia de colesterol foi prescrita. Colesterol total (CT), HDL-colesterol (HDL), LDL-colesterol (LDL), triglicerídeos (TG) e medidas antropométricas foram medidos antes do início da dieta, sendo repetidos seis meses após o início da intervenção dietética. Cinquenta e três pacientes concluíram o seguimento e tinham idade 59±10 anos e 29 eram homens (51,8%). CT pré-intervenção=238,9±30; pós-intervenção=165,1±35, p<0.001; LDL pré-intervenção=154±33; pós-intervenção=90±29, p<0.001 e TG pré-intervenção=168, IQR=151-200; pós-intervenção=137, IQR=94-177, p=<0.001 sofreram modificações significativas seis meses após a intervenção. Antes do estudo, nenhum dos pacientes apresentava níveis séricos normais para o CT, e apenas 12 pacientes (22,7%) tinham níveis séricos ótimo ou quase ótimos para o LDL. Seis meses após o início da intervenção, 45 pacientes (84,9%) alcançaram níveis séricos normais de CT e 50 (94,4%) níveis séricos ótimos ou quase ótimos de LDL. Os níveis séricos de HDL e as medidas antropométricas não sofreram modificações significativas. Aconselhamento dietético com prescrição de dieta individualizada baseada no cálculo do metabolismo basal mostrou-se efetivo no manejo da dislipidemia em pacientes transplantados hepáticos em seguimento ambulatorial. Assim, todos os

Spontaneous breathing test in the prediction of extubation failure in the pediatric population.

PubMed

Nascimento, Milena Siciliano; Rebello, Celso Moura; Vale, Luciana Assis Pires Andrade; Santos, Érica; Prado, Cristiane do

2017-01-01

To assess whether the spontaneous breathing test can predict the extubation failure in pediatric population. A prospective and observational study that evaluated data of inpatients at the Pediatric Intensive Care Unit between May 2011 and August 2013, receiving mechanical ventilation for at least 24 hours followed by extubation. The patients were classified in two groups: Test Group, with patients extubated after spontaneous breathing test, and Control Group, with patients extubated without spontaneous breathing test. A total of 95 children were enrolled in the study, 71 in the Test Group and 24 in the Control Group. A direct comparison was made between the two groups regarding sex, age, mechanical ventilation time, indication to start mechanical ventilation and respiratory parameters before extubation in the Control Group, and before the spontaneous breathing test in the Test Group. There was no difference between the parameters evaluated. According to the analysis of probability of extubation failure between the two groups, the likelihood of extubation failure in the Control Group was 1,412 higher than in the Test Group, nevertheless, this range did not reach significance (p=0.706). This model was considered well-adjusted according to the Hosmer-Lemeshow test (p=0.758). The spontaneous breathing test was not able to predict the extubation failure in pediatric population. Avaliar se o teste de respiração espontânea pode ser utilizado para predizer falha da extubação na população pediátrica. Estudo prospectivo, observacional, no qual foram avaliados todos os pacientes internados no Centro de Terapia Intensiva Pediátrica, no período de maio de 2011 a agosto de 2013, que utilizaram ventilação mecânica por mais de 24 horas e que foram extubados. Os pacientes foram classificados em dois grupos: Grupo Teste, que incluiu os pacientes extubados depois do teste de respiração espontânea; e Grupo Controle, pacientes foram sem teste de respiração espont

Summary of FY17 ParaChoice Accomplishments

DOE Office of Scientific and Technical Information (OSTI.GOV)

Levinson, Rebecca Sobel; West, Todd H.

As part of analysis support for FCTO, Sandia assesses the factors that influence the future of FCEVs and Hydrogen in the US vehicle fleet. Using ParaChoice, we model competition between FCEVs, conventional vehicles, and other alternative vehicle technologies in order to understand the drivers and sensitivities of adoption of FCEVs. ParaChoice leverages existing tools such as Autonomie (Moawad et al., 2016), AEO (U.S. Energy Information Administration, 2016), and the Macro System Model (Ruth et al., 2009) in order to synthesize a complete picture of the co-evolution of vehicle technology development, energy price evolution, and hydrogen production and pricing, with consumermore » demand for vehicles and fuel. We then assess impacts of FCEV market penetration and hydrogen use on green- house gas (GHG) emissions and petroleum consumption, providing context for the role of policy, technology development, infrastructure, and consumer behavior on the vehicle and fuel mix through parametric and sensitivity analyses.« less

[Conservative management of tracheal rupture in a child after blunt trauma].

PubMed

Kucuk, Gonul; Ates, Ufuk; Gollu, Gulnur; Yagmurlu, Aydin

2016-12-01

La rotura traqueal tras una contusión es rara, aunque potencialmente mortal. En general, se recomienda el tratamiento quirúrgico para la rotura traqueal, aunque también se ha informado recientemente el abordaje conservador en los pacientes con signos vitales y parámetros respiratorios estables. El objetivo de este estudio es informar sobre un caso de rotura traqueal tras una contusión en el cuello producto de un accidente de bicicleta que se trató de manera conservadora. Sociedad Argentina de Pediatría.

Primer registro para Peru del genero Nielsonia Young, 1977 (Hemiptera: Cicadellidae: Cicadellinae: Cicadellini)

USDA-ARS?s Scientific Manuscript database

En este articulo se reporta por primera vez para el Peru una especies del genero Nielsonia Young, 1977, de material procedente del Departamento de Tumbes. El genero ha sido reportada anteriormente de Ecuador, como unico registro para Sudamerica, y America Central. El unico especimen hembra encontra...

Differential regulation of ParaHox genes by retinoic acid in the invertebrate chordate amphioxus (Branchiostoma floridae).

PubMed

Osborne, Peter W; Benoit, Gérard; Laudet, Vincent; Schubert, Michael; Ferrier, David E K

2009-03-01

The ParaHox cluster is the evolutionary sister to the Hox cluster. Like the Hox cluster, the ParaHox cluster displays spatial and temporal regulation of the component genes along the anterior/posterior axis in a manner that correlates with the gene positions within the cluster (a feature called collinearity). The ParaHox cluster is however a simpler system to study because it is composed of only three genes. We provide a detailed analysis of the amphioxus ParaHox cluster and, for the first time in a single species, examine the regulation of the cluster in response to a single developmental signalling molecule, retinoic acid (RA). Embryos treated with either RA or RA antagonist display altered ParaHox gene expression: AmphiGsx expression shifts in the neural tube, and the endodermal boundary between AmphiXlox and AmphiCdx shifts its anterior/posterior position. We identified several putative retinoic acid response elements and in vitro assays suggest some may participate in RA regulation of the ParaHox genes. By comparison to vertebrate ParaHox gene regulation we explore the evolutionary implications. This work highlights how insights into the regulation and evolution of more complex vertebrate arrangements can be obtained through studies of a simpler, unduplicated amphioxus gene cluster.

ParA and ParB coordinate chromosome segregation with cell elongation and division during Streptomyces sporulation

PubMed Central

Donczew, Magdalena; Mackiewicz, Paweł; Wróbel, Agnieszka; Flärdh, Klas; Zakrzewska-Czerwińska, Jolanta

2016-01-01

In unicellular bacteria, the ParA and ParB proteins segregate chromosomes and coordinate this process with cell division and chromosome replication. During sporulation of mycelial Streptomyces, ParA and ParB uniformly distribute multiple chromosomes along the filamentous sporogenic hyphal compartment, which then differentiates into a chain of unigenomic spores. However, chromosome segregation must be coordinated with cell elongation and multiple divisions. Here, we addressed the question of whether ParA and ParB are involved in the synchronization of cell-cycle processes during sporulation in Streptomyces. To answer this question, we used time-lapse microscopy, which allows the monitoring of growth and division of single sporogenic hyphae. We showed that sporogenic hyphae stop extending at the time of ParA accumulation and Z-ring formation. We demonstrated that both ParA and ParB affect the rate of hyphal extension. Additionally, we showed that ParA promotes the formation of massive nucleoprotein complexes by ParB. We also showed that FtsZ ring assembly is affected by the ParB protein and/or unsegregated DNA. Our results indicate the existence of a checkpoint between the extension and septation of sporogenic hyphae that involves the ParA and ParB proteins. PMID:27248800

Guía para la evaluación del riesgo de los polinizadores

EPA Pesticide Factsheets

La Guía para la evaluación del riesgo de los polinizadores de la EPA es parte de una estrategia de la evaluación de los riesgos que presentan los pesticidas para las abejas a fin de mejorar la protección de los polinizadores.

Para-Nonylphenol Induces Apoptosis of U937 Human Monocyte Leukemia Cells in vitro.

PubMed

Santa, Kazuki; Ohsawa, Tomonori; Sakimoto, Takehiko

2016-01-01

Human autoimmune diseases are caused by a variety of factors, such as environmental chemicals, including para-nonylphenol. Macrophages play many critical roles in the regulation of immunity and the progression of autoimmune diseases. However, little information is available regarding the effects of para-nonylphenol on cellular signaling pathways and the death of these cells in vitro. Here, we show that very high concentrations of para-nonylphenol (50-100 μM) induce apoptosis in U937 human monocyte leukemia cells in a dose-dependent manner. Cell viability was judged using the trypan blue exclusion method. FACS analysis for DNA fragmentation was conducted, cellular signaling pathways were evaluated using western blot analysis, and caspase activity was measured by using substrates. U937 cells were differentiated by PMA. Treatment with > 50 μM para-nonylphenol induced apoptosis in U937 monocyte cells and MCF- 7 and MDA-MB231 human breast cancer cells. We found cytochrome c release from the mitochondria to the cytoplasm, DNA fragmentation, and decreased expression of anti-apoptotic protein Bcl-XL. Caspase 3 and 9 were induced, but caspase 1 and 3-inhibitor treatment suppressed apoptosis. Para-nonylphenol decreased the levels of activated AKT and increased the levels of activated JNK/SAPK at 15 min after treatment. Furthermore, with PMA treatment, U937 cells were differentiated into a macrophage-like phenotype and showed attenuated cell death against para-nonylphenol. As this assay system is simple and rapid, it may represent a useful artificial tool to clarify the signaling pathways of apoptotic cell death in human monocytes in vitro. Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.org.

Sobre la terapia génica para enfermedades de la retina.

PubMed

Fischer, M Dominik

2017-07-11

Las mutaciones en un gran número de genes provocan degeneración de la retina y ceguera sin que exista actualmente cura alguna. En las últimas décadas, la terapia génica para enfermedades de la retina ha evolucionado y se ha convertido en un nuevo y prometedor paradigma terapéutico para estas enfermedades poco comunes. Este artículo refleja las ideas y los conceptos que parten de la ciencia básica hacia la aplicabilidad de la terapia génica en el ámbito clínico. Se describen los avances y las reflexiones actuales sobre la eficacia de los ensayos clínicos en la actualidad y se discuten los posibles obstáculos y soluciones de cara al futuro de la terapia génica para enfermedades de la retina. © 2017 S. Karger AG, Basel.

Conformational Explosion: Understanding the Complexity of the Para-Dialkylbenzene Potential Energy Surfaces

NASA Astrophysics Data System (ADS)

Mishra, Piyush; Hewett, Daniel M.; Zwier, Timothy S.

2017-06-01

This talk focuses on the single-conformation spectroscopy of small-chain para-dialkylbenzenes. This work builds on previous studies from our group on long-chain n-alkylbenzenes that identified the first folded structure in octylbenzene. The dialkylbenzenes are representative of a class of molecules that are common components of coal and aviation fuel and are known to be present in vehicle exhaust. We bring the molecules para-diethylbenzene, para-dipropylbenzene and para-dibutylbenzene into the gas phase and cool the molecules in a supersonic expansion. The jet-cooled molecules are then interrogated using laser-induced fluorescence excitation, fluorescence dip IR spectroscopy (FDIRS) and dispersed fluorescence. The LIF spectra in the S_{0}-S_{1} origin region show dramatic increases in the number of resolved transitions with increasing length of alkyl chains, reflecting an explosion in the number of unique low-energy conformations formed when two independent alkyl chains are present. Since the barriers to isomerization of the alkyl chain are similar in size, this results in an 'egg carton' shape to the potential energy surface. We use a combination of electronic frequency shift and alkyl CH stretch infrared spectra to generate a consistent set of conformational assignments.

Nonrelativistic para-Lorentzian mechanics

NASA Astrophysics Data System (ADS)

Vargas, J. G.

1981-04-01

After reviewing the foundations of special relativity and the room left for rival theories, a set of nonrelativistic para-Lorentzian transformations is derived uniquely, based on (a) a weaker first principle, (b) the requirement that the transformations sought do not give rise to the clock “paradox” (in a refined version), and (c) the compliance of the transformations with the classical experiments of Michelson-Morley, Kennedy-Thorndike, and Ives-Stilwell. The corresponding dynamics is developed. Most of the experimental support of special relativity is reconsidered in the light of the new theory. It is concluded that the relativity of simultaneity has so far not been tested.

TELEMEDICINA: UN DESAFÍO PARA AMÉRICA LATINA

PubMed Central

Litewka, Sergio

2011-01-01

La telemedicina es una tendencia creciente en la prestación de los servicios médicos. Aunque la eficacia de esta práctica no ha estado bien establecida, es probable que los países en desarrollo compartirán este nuevo paradigma con los desarrollados. Los defensores de la telemedicina en América Latina sostienen que será una herramienta útil para reducir las disparidades y mejorar la accesibilidad de atención de salud. Aunque América Latina quizá se convierta en un lugar para la investigación e investigación de estos procedimientos, no está claro cómo la telemedicina podría contribuir a mejorar la accesibilidad para las poblaciones desfavorecidas, o coexistir con sistemas de atención de salud públicos crónicamente enfermos. Telemedicine is a growing trend in the provision of medical services. Although the effectiveness of this practice has not been well established, it is likely that developing countries will share this new paradigm with developed ones. Supporters of telemedicine in Latin America maintain that it will be a useful tool for reducing disparities and improving health care accessibility. Although Latin America might become a place for research and investigation of these procedures, it is not clear how telemedicine could contribute to improving accessibility for disadvantaged populations, or coexist with chronically ill-funded public healthcare systems. PMID:21625326

TELEMEDICINA: UN DESAFÍO PARA AMÉRICA LATINA.

PubMed

Litewka, Sergio

2005-01-01

La telemedicina es una tendencia creciente en la prestación de los servicios médicos. Aunque la eficacia de esta práctica no ha estado bien establecida, es probable que los países en desarrollo compartirán este nuevo paradigma con los desarrollados. Los defensores de la telemedicina en América Latina sostienen que será una herramienta útil para reducir las disparidades y mejorar la accesibilidad de atención de salud. Aunque América Latina quizá se convierta en un lugar para la investigación e investigación de estos procedimientos, no está claro cómo la telemedicina podría contribuir a mejorar la accesibilidad para las poblaciones desfavorecidas, o coexistir con sistemas de atención de salud públicos crónicamente enfermos.Telemedicine is a growing trend in the provision of medical services. Although the effectiveness of this practice has not been well established, it is likely that developing countries will share this new paradigm with developed ones. Supporters of telemedicine in Latin America maintain that it will be a useful tool for reducing disparities and improving health care accessibility. Although Latin America might become a place for research and investigation of these procedures, it is not clear how telemedicine could contribute to improving accessibility for disadvantaged populations, or coexist with chronically ill-funded public healthcare systems.

Communications: Development and characterization of a source of rotationally cold, enriched para-H3+.

PubMed

Tom, Brian A; Mills, Andrew A; Wiczer, Michael B; Crabtree, Kyle N; McCall, Benjamin J

2010-02-28

In an effort to develop a source of H(3)(+) that is almost entirely in a single quantum state (J=K=1), we have successfully generated a plasma that is enriched to approximately 83% in para-H(3)(+) at a rotational temperature of 80 K. This enrichment is a result of the nuclear spin selection rules at work in hydrogenic plasmas, which dictate that only para-H(3)(+) will form from para-H(2), and that para-H(3)(+) can be converted to ortho-H(3)(+) by subsequent reaction with H(2). This is the first experimental study in which the H(2) and H(3) (+) nuclear spin selection rules have been observed at cold temperatures. The ions were produced from a pulsed solenoid valve source, cooled by supersonic expansion, and interrogated via continuous-wave cavity ringdown spectroscopy.

Capnography as a tool to detect metabolic changes in patients cared for in the emergency setting.

PubMed

Cereceda-Sánchez, Francisco José; Molina-Mula, Jesús

2017-05-15

to evaluate the usefulness of capnography for the detection of metabolic changes in spontaneous breathing patients, in the emergency and intensive care settings. in-depth and structured bibliographical search in the databases EBSCOhost, Virtual Health Library, PubMed, Cochrane Library, among others, identifying studies that assessed the relationship between capnography values and the variables involved in blood acid-base balance. 19 studies were found, two were reviews and 17 were observational studies. In nine studies, capnography values were correlated with carbon dioxide (CO2), eight with bicarbonate (HCO3), three with lactate, and four with blood pH. most studies have found a good correlation between capnography values and blood biomarkers, suggesting the usefulness of this parameter to detect patients at risk of severe metabolic change, in a fast, economical and accurate way. avaliar a utilidade da capnografia para a detecção de alterações metabólicas em pacientes com respiração espontânea, no contexto das emergências e dos cuidados intensivos. pesquisa bibliográfica estruturada aprofundada, nas bases de dados EBSCOhost, Biblioteca Virtual em Saúde, PubMed, Cochrane Library, entre outras, identificando estudos que avaliavam a relação entre os valores da capnografia e as variáveis envolvidas no equilíbrio ácido-base sanguíneo. foram levantados 19 estudos, dois eram revisões e 17 eram estudos observacionais. Em nove estudos, os valores capnográficos foram correlacionados com o dióxido de carbono (CO2), em oito com o bicarbonato (HCO3), em três com o lactato, e em quatro com o pH sanguíneo. na maioria dos estudos foi observada uma correlação adequada entre os valores capnográficos e os biomarcadores sanguíneos, sugerindo a utilidade deste parâmetro para a identificação de pacientes com risco de sofrer uma alteração metabólica grave, de uma forma rápida, econômica e precisa. explorar la utilidad de la capnografía para la detecci

paraGSEA: a scalable approach for large-scale gene expression profiling

PubMed Central

Peng, Shaoliang; Yang, Shunyun

2017-01-01

Abstract More studies have been conducted using gene expression similarity to identify functional connections among genes, diseases and drugs. Gene Set Enrichment Analysis (GSEA) is a powerful analytical method for interpreting gene expression data. However, due to its enormous computational overhead in the estimation of significance level step and multiple hypothesis testing step, the computation scalability and efficiency are poor on large-scale datasets. We proposed paraGSEA for efficient large-scale transcriptome data analysis. By optimization, the overall time complexity of paraGSEA is reduced from O(mn) to O(m+n), where m is the length of the gene sets and n is the length of the gene expression profiles, which contributes more than 100-fold increase in performance compared with other popular GSEA implementations such as GSEA-P, SAM-GS and GSEA2. By further parallelization, a near-linear speed-up is gained on both workstations and clusters in an efficient manner with high scalability and performance on large-scale datasets. The analysis time of whole LINCS phase I dataset (GSE92742) was reduced to nearly half hour on a 1000 node cluster on Tianhe-2, or within 120 hours on a 96-core workstation. The source code of paraGSEA is licensed under the GPLv3 and available at http://github.com/ysycloud/paraGSEA. PMID:28973463

Production and characterization of para-hydrogen gas for matrix isolation infrared spectroscopy

NASA Astrophysics Data System (ADS)

Sundararajan, K.; Sankaran, K.; Ramanathan, N.; Gopi, R.

2016-08-01

Normal hydrogen (n-H2) has 3:1 ortho/para ratio and the production of enriched para-hydrogen (p-H2) from normal hydrogen is useful for many applications including matrix isolation experiments. In this paper, we describe the design, development and fabrication of the ortho-para converter that is capable of producing enriched p-H2. The p-H2 thus produced was probed using infrared and Raman techniques. Using infrared measurement, the thickness and the purity of the p-H2 matrix were determined. The purity of p-H2 was determined to be >99%. Matrix isolation infrared spectra of trimethylphosphate (TMP) and acetylene (C2H2) were studied in p-H2 and n-H2 matrices and the results were compared with the conventional inert matrices.

Photoisomerization of Trans Ortho-, Meta-, Para-Nitro Diarylbutadienes: A Case of Regioselectivity.

PubMed

Agnihotri, Harsha; Paramasivam, Mahalingavelar; Palakollu, Veerabhadraiah; Kanvah, Sriram

2015-11-01

A series of ortho-, meta- and para-substituted trans-nitro aryl (phenyl and pyridyl) butadienes have been synthesized and characterized. The effect of substitution and positional selectivity on their fluorescence and photoisomerization were systematically investigated. Among all dienes, meta- and para-nitro phenyl-substituted derivatives exhibit remarkable solvatochromic emission shifts due to intramolecular charge transfer. On the other hand, ortho derivatives undergo regioselective isomerization upon photoexcitation in contrast to inefficient isomerization of para and meta nitro-substituted dienes. Single crystal X-ray analysis revealed existence of intramolecular hydrogen bonding between the nitro group and the hydrogen of the proximal double bond. This restricts the rotation of the proximal double bond thereby allowing regioselective isomerization. The observations were also supported by NMR spectroscopic studies. © 2015 The American Society of Photobiology.

Catalytic homogeneous hydrogenation of compounds containing X --> O semipolar bonds (X = N, S, P) with para-hydrogen as a promising route for preparation of para-water.

PubMed

Ustynyuk, Yuri A; Gavrikov, Alexei V; Sergeyev, Nikolay M

2006-11-28

The quantum-chemical simulation (DFT, PBE, TZ2p basis set) of the mechanism of catalytic hydrogenation of compounds containing R(n)X --> O semipolar bonds (R(n)X = N(2), Me(2)S, C(5)H(5)N, Ph(3)P) on the Wilkinson catalyst (Ph(3)P)(3)RhCl with para-hydrogen showed that this process proceeds with retention of proton nuclear spin correlation, which enables a principal possibility to synthesize para-H(2)O, i.e. the nuclear spin isomer of water with antiparallel proton spins, using this route.

Hearing thresholds in patients with drug-resistant tuberculosis: baseline audiogram configurations and associations.

PubMed

Sogebi, Olusola Ayodele; Fadeyi, Muse Olatunbosun; Adefuye, Bolanle Olufunlola; Soyinka, Festus Olukayode

2017-01-01

parâmetros do audiograma basal para verificar se a tuberculose resistente (TB-R) tem efeitos na audição, descrever as configurações dos audiogramas e determinar se há parâmetros que possam ser associados a essas configurações. Estudo prospectivo com pacientes diagnosticados com TB-R em um centro de tratamento de tuberculose no estado de Ogun, Nigéria. Os pacientes incluídos no estudo foram submetidos à audiometria de tons puros em até duas semanas após o início do tratamento (audiometria basal). Características demográficas e clínicas foram coletadas dos prontuários médicos dos pacientes para análises comparativas. A amostra final envolveu 132 pacientes. A média de idade dos pacientes foi de 34,5 ± 12,6 anos (variação, 8-82 anos), e a razão homem:mulher foi de 2:1. A maioria dos pacientes (n = 103; 78,0%) residia nos estados vizinhos e tinha história de falha de tratamento antituberculose (n = 125; 94.7%); 18 (13.6%) apresentavam status retroviral positivo. Doze pacientes (9,1%) apresentaram audiogramas normais, e 104 (78,8%) apresentaram perda auditiva neurossensorial, sendo as configurações mais comuns do tipo ascendente, em 54 (40,9%), e descendente, em 26 (19,7%). As médias de tons puros em frequências baixas (0,25-1,0 kHz) e altas (2,0-8,0 kHz) foram de 33,0 dB e 40,0 dB, respectivamente. Quanto ao grau de perda auditiva no melhor ouvido, 36 pacientes (27,3%) apresentaram audição normal, e 67 (50,8%) apresentaram perda auditiva leve (26-40 dB), enquanto 29 (21,9%) mostraram perda auditiva moderada ou grave. Entre as variáveis estudadas (idade, gênero, status retroviral, desfecho de tratamento anterior e peso na admissão), somente o gênero masculino foi associado às configurações audiométricas. Nesta amostra de pacientes com TB-R, a maioria apresentou perda auditiva neurossensorial leve e subótima bilateralmente, com configurações audiométricas ascendentes/descendentes associadas ao gênero masculino.

The nuclear quadrupole coupling constants and the structure of the para-para ammonia dimer

NASA Astrophysics Data System (ADS)

Heineking, N.; Stahl, W.; Olthof, E. H. T.; Wormer, P. E. S.; van der Avoird, A.; Havenith, M.

1995-06-01

Expressions are derived for the nuclear quadrupole splittings in the E3 and E4 (para-para) states of (NH3)2 and it is shown that these can be matched with the standard expressions for rigid rotors with two identical quadrupolar nuclei. The matching is exact only when the off-diagonal Coriolis coupling is neglected. However, the selection rules for rotational transitions are just opposite to those for the rigid rotor. Hyperfine splittings are measured for the J=2←1 transitions in the E3 and E4 states with ‖K‖=1; the quadrupole coupling constants χaa=0.1509(83) MHz and χbb-χcc=2.8365(83) MHz are extracted from these measurements by the use of the above mentioned correspondence with the rigid rotor expressions. The corresponding results are also calculated, with and without the Coriolis coupling, from the six-dimensional vibration-rotation-tunneling (VRT) wave functions of (NH3)2, which were previously obtained by Olthof et al. [E.H.T. Olthof, A. van der Avoird, and P.E.S. Wormer, J. Chem. Phys. 101, 8430 (1994)]. From the comparison of χaa with the measured value it follows that the semiempirical potential and the resulting VRT states of Olthof et al. are very accurate along the interchange (ϑA,ϑB) coordinate. From χbb-χcc it follows that this potential is probably too soft in the dihedral angle γ¯=γA-γB, which causes the torsional amplitude to be larger than derived from the experiment.

Studies on distribution of para-methoxymethamphetamine (PMMA) designer drug in rats using gas chromatography-mass spectrometry.

PubMed

Rohanova, Miroslava; Balikova, Marie

2009-04-01

para-Methoxymethamphetamine (PMMA) is an abused psychedelic compound with reports of several intoxications and deaths after ingestion. However, its pharmacokinetics based on a controlled study is unknown and only partial information on its biotransformation is available. Our experimental study was designed for the time disposition profile of PMMA and its metabolites para-methoxyamphetamine (PMA), para-hydroxymethamphetamine (OH-MAM) and para-hydroxyamphetamine (OH-AM) in blood and biological tissues in rats after the bolus subcutaneous dose 40 mg/kg using a validated GC-MS method. The experimental results ascertained could be useful for subsequent evaluation of PMMA psychotropic or neurotoxic effects and the diagnostic concern of intoxication.

Risk management in providing specialized care for people living with AIDS.

PubMed

Leadebal, Oriana Deyze Correia Paiva; Medeiros, Leidyanny Barbosa de; Morais, Kalline Silva de; Nascimento, João Agnaldo do; Monroe, Aline Aparecida; Nogueira, Jordana de Almeida

2016-01-01

Analyzing the provision of actions related to managing clinical risk in managing specialized care for people living with AIDS. A cross-sectional study carried out in a reference outpatient clinic in Paraíba, with a sample of 150 adults with AIDS. Data were collected through primary and secondary sources using a structured questionnaire, analyzed using descriptive statistics, multiple correspondence analysis and logistic regression model to determine the association between "providing care" and "clinical risk." Actions with satisfactory provision express a biological care focus; the dimensions that most contributed to a satisfactory assessment of care provision were "clinical and laboratory evaluations" and "prevention and self-care incentivization"; 45.3% of participants were categorized into high clinical risk, 34% into average clinical risk, and 20.7% into low clinical risk; a positive association between providing care and clinical risk was found. The need to use risk classification technologies to direct the planning of local care provision became evident considering its requirements, and thus qualifying the care provided in these areas. Analisar a oferta de ações relacionadas ao manejo de risco clínico na gestão do cuidado especializado a pessoas vivendo com aids. Estudo transversal realizado em ambulatório de referência na Paraíba, com amostra de 150 adultos com aids. Os dados foram coletados por meio de fontes primárias e secundárias utilizando-se de formulário estruturado, e analisados através de estatística descritiva, análise de correspondência múltipla e modelo de regressão logística para averiguar a associação entre "oferta" e "risco clínico". As ações de oferta satisfatória expressam foco biologicista do cuidado; as dimensões que mais contribuíram para o julgamento satisfatório da oferta foram "avaliação clínica e laboratorial" e "prevenção e estímulo ao autocuidado"; 45,3% dos participantes foram categorizados em risco

Support for learning in the perspective of patient safety in primary health care.

PubMed

Paranaguá, Thatianny Tanferri de Brito; Bezerra, Ana Lúcia Queiroz; Tobias, Gabriela Camargo; Ciosak, Suely Itsuko

2016-08-18

to analyze the support for learning, in the perspective of patient safety, offered in the work environment, according to health professionals working in primary care. a transversal study, held with 86 health professionals working in primary care. A validated instrument was used, applied via the Internet. Descriptive statistical analysis was undertaken with a presentation of median, mean, standard deviation and coefficient of variation. points which are favorable to supporting learning were evidenced, such as mutual respect, autonomy for organizing the work and valorization of new ideas, which obtained means above 7.0. The variables which hinder the process of learning in the work environment, perceived by the professionals, were: resistance to changes, and excess of work impeding reflection on how to improve the work, with means above 6.0. the study found evidence of indicators related to the process of staff development in the area of health and indicates the influence of support for learning for the improvement of the work processes and of patient safety. It is necessary that a culture involving the systematic assessment of educational interventions in health should be established, the aim being to diagnose actions which are more incisive for changing health professionals' attitude and, therefore, clinical practice. analisar o suporte para a aprendizagem, na perspectiva da segurança do paciente, oferecido no ambiente de trabalho, segundo os profissionais de saúde atuantes na atenção primária. estudo transversal, conduzido com 86 profissionais de saúde atuantes na atenção primária. Utilizou-se instrumento validado, aplicado via web. Foi realizada análise estatística descritiva com apresentação de mediana, média, desvio padrão e coeficiente de variação. foram evidenciados pontos favoráveis de suporte à aprendizagem, como respeito mútuo, autonomia para organizar o trabalho e a valorização de novas ideias, que obtiveram médias acima de 7,0. As

Aspergilosis cervical con diseminación al sistema nervioso central. Presentación de un caso y revisión de bibliografía

PubMed Central

Vergara, Guillermo Enrique; Roura, Natalia; del Castillo, Marcelo; Mora, Andrea; Alcorta, Santiago Condomi; Mormandi, Rubén; Cervio, Andrés; Salvat, Jorge

2015-01-01

Introducción: la Aspergilosis Invasiva (AI) del Sistema Nervioso Central (SNC) es infrecuente y ocurre generalmente en pacientes inmunocomprometidos. Puede presentarse con cuadros de meningitis, aneurismas micóticos, infartos o abscesos. Es una infección con pronóstico reservado y puede afectar el SNC de forma primaria o secundaria a partir de un foco que se disemina por vía hematógena. Presentamos el caso de un paciente con AI con invasión primaria a nivel óseo y diseminación posterior al cerebro. Caso clínico: Paciente masculino de 25 años con diagnóstico de leucemia linfática aguda en tratamiento quimioterápico que presentó neumonitis por metotrexate por lo que inicia tratamiento con corticoides. Posteriormente agregó cervicalgia y con el diagnóstico de osteomielitis cervical se realiza punción bajo tomografía computada (TC) sin aislarse gérmenes. Se colocó Halo Vest e inició tratamiento antibiótico empírico. Posteriormente presentó afasia de expresión secundaria a lesión frontal izquierda. Se realizó evacuación de absceso cerebral aislando A. fumigatus. El tratamiento antibiótico específico posterior permitió una buena respuesta clínica y radiológica. Conclusión: La presencia de lesiones en el SNC de pacientes inmunocomprometidos debe incluir a las micosis como diagnóstico diferencial. La evacuación quirúrgica permite llegar rápidamente al diagnóstico mejorando la respuesta posterior al tratamiento antibiótico. Para evaluar la respuesta terapéutica y posibles recaídas se debe realizar un seguimiento periódico clínico radiológico. Palabras clave: Aspergilosis cerebral; Aspergilosis cervical; Aspergilosis invasiva; Voriconazol. PMID:26600985

Pain assessment and management in patients undergoing endovascular procedures in the catheterization laboratory.

PubMed

Hilário, Thamires de Souza; Santos, Simone Marques Dos; Kruger, Juliana; Goes, Martha Georgina; Casco, Márcia Flores; Rabelo-Silva, Eneida Rejane

2017-05-25

To describe how pain is assessed (characteristic, location, and intensity) and managed in clinical practice in patients undergoing endovascular procedures in the catheterization laboratory setting. Cross-sectional study with retrospective data collection. Overall, 345 patients were included; 116 (34%) experienced post-procedural pain; in 107 (92%), pain characteristics were not recorded; the location of pain was reported in 100% of patients, and its intensity in 111 (96%); management was largely pharmacologic; of the patients who received some type of management (n=71), 42 (59%) underwent reassessment of pain. The location and intensity of pain are well reported in clinical practice. Pharmacologic pain management is still prevalent. Additional efforts are needed to ensure recording of the characteristics of pain and its reassessment after interventions. Describir cómo se evalúa el dolor (características, localización e intensidad) y su manejo en la práctica clínica en pacientes sometidos a procedimientos endovasculares en el laboratorio de cateterización. Estudio transversal con recolección retrospectiva de datos. En total, se incluyeron 345 pacientes; 116 (34%) experimentaron dolor post-procedimiento; en 107 (92%), no se registraron las características del dolor; la localización del dolor se informó en el 100% de los pacientes, y su intensidad en 111 (96%); el manejo fue en gran medida farmacológico; de los pacientes que recibieron algún tipo de tratamiento (n=71), 42 (59%) fueron sometidos a reevaluación del dolor. La ubicación y la intensidad del dolor se informan bien en la práctica clínica. El manejo farmacológico del dolor sigue siendo frecuente. Se necesitan esfuerzos adicionales para asegurar el registro de las características del dolor y su reevaluación después de las intervenciones.

RVA: A Plugin for ParaView 3.14

DOE Office of Scientific and Technical Information (OSTI.GOV)

2015-09-04

RVA is a plugin developed for the 64-bit Windows version of the ParaView 3.14 visualization package. RVA is designed to provide support in the visualization and analysis of complex reservoirs being managed using multi-fluid EOR techniques. RVA, for Reservoir Visualization and Analysis, was developed at the University of Illinois at Urbana-Champaign, with contributions from the Illinois State Geological Survey, Department of Computer Science and National Center for Supercomputing Applications. RVA was designed to utilize and enhance the state-of-the-art visualization capabilities within ParaView, readily allowing joint visualization of geologic framework and reservoir fluid simulation model results. Particular emphasis was placed onmore » enabling visualization and analysis of simulation results highlighting multiple fluid phases, multiple properties for each fluid phase (including flow lines), multiple geologic models and multiple time steps. Additional advanced functionality was provided through the development of custom code to implement data mining capabilities. The built-in functionality of ParaView provides the capacity to process and visualize data sets ranging from small models on local desktop systems to extremely large models created and stored on remote supercomputers. The RVA plugin that we developed and the associated User Manual provide improved functionality through new software tools, and instruction in the use of ParaView-RVA, targeted to petroleum engineers and geologists in industry and research. The RVA web site (http://rva.cs.illinois.edu) provides an overview of functions, and the development web site (https://github.com/shaffer1/RVA) provides ready access to the source code, compiled binaries, user manual, and a suite of demonstration data sets. Key functionality has been included to support a range of reservoirs visualization and analysis needs, including: sophisticated connectivity analysis, cross sections through simulation results

Trombose venosa profunda e vírus chicungunha

PubMed Central

Marques, Marcos Arêas; Adami de Sá, Fernanda Penza; Lupi, Otília; Brasil, Patricia; von Ristow, Arno

2017-01-01

Resumo Algumas infecções virais sistêmicas podem estar relacionadas ao desenvolvimento de trombose venosa profunda e/ou embolia pulmonar. Essa associação já está bem descrita em pacientes com infeções pelo vírus da imunodeficiência humana (HIV), hepatite C ou influenza. Recentemente introduzido no continente americano, o vírus chicungunha, agente etiológico da febre de chicungunha, ainda não tem essa relação bem sedimentada, mas com o aumento progressivo de sua incidência e pelo fato dessa infecção causar, muitas vezes, uma restrição severa da locomoção por poliartralgia e uma possível lesão endotelial direta, casos de tromboembolismo venoso podem começar a ser descritos. Neste relato de caso, descrevemos um paciente que desenvolveu trombose de veia poplítea direita durante internação para tratamento de febre por infecção por vírus chicungunha e poliartralgia severa. PMID:29930626

Chlorination of 2-phenoxypropanoic acid with NCP in aqueous acetic acid: using a novel ortho-para relationship and the para/meta ratio of substituent effects for mechanism elucidation.

PubMed

Segurado, Manuel A P; Reis, João Carlos R; de Oliveira, Jaime D Gomes; Kabilan, Senthamaraikannan; Shanthi, Manohar

2007-07-06

Rate constants were measured for the oxidative chlorodehydrogenation of (R,S)-2-phenoxypropanoic acid and nine ortho-, ten para- and five meta-substituted derivatives using (R,S)-1-chloro-3-methyl-2,6-diphenylpiperidin-4-one (NCP) as chlorinating agent. The kinetics was run in 50% (v/v) aqueous acetic acid acidified with perchloric acid under pseudo-first-order conditions with respect to NCP at temperature intervals of 5 K between 298 and 318 K, except at the highest temperature for the meta derivatives. The dependence of rate constants on temperature was analyzed in terms of the isokinetic relationship (IKR). For the 20 reactions studied at five different temperatures, the isokinetic temperature was estimated to be 382 K, which suggests the preferential involvement of water molecules in the rate-determining step. The dependence of rate constants on meta and para substitution was analyzed using the tetralinear extension of the Hammett equation. The parameter lambda for the para/meta ratio of polar substituent effects was estimated to be 0.926, and its electrostatic modeling suggests the formation of an activated complex bearing an electric charge near the oxygen atom belonging to the phenoxy group. A new approach is introduced for examining the effect of ortho substituents on reaction rates. Using IKR-determined values of activation enthalpies for a set of nine pairs of substrates with a given substituent, a linear correlation is found between activation enthalpies of ortho and para derivatives. The correlation is interpreted in terms of the selectivity of the reactant toward para- or ortho-monosubstituted substrates, the slope of which being related to the ortho effect. This slope is thought to be approximated by the ratio of polar substituent effects from ortho and para positions in benzene derivatives. Using the electrostatic theory of through-space interactions and a dipole length of 0.153 nm, this ratio was calculated at various positions of a charged reaction

ACUTE TOXICITY OF PARA-NONYLPHENOL TO SALTWATER ANIMALS

EPA Science Inventory

?para-Nonylphenol (PNP), a mixture of alkylphenols used in producing nonionic surfactants, is distributed widely in surface waters and aquatic sediments, where it can affect saltwater species. This article describes a database for acute toxicity of PNP derived for calculating a n...

Conversion rate of para-hydrogen to ortho-hydrogen by oxygen: implications for PHIP gas storage and utilization.

PubMed

Wagner, Shawn

2014-06-01

To determine the storability of para-hydrogen before reestablishment of the room temperature thermal equilibrium mixture. Para-hydrogen was produced at near 100% purity and mixed with different oxygen quantities to determine the rate of conversion to the thermal equilibrium mixture of 75: 25% (ortho: para) by detecting the ortho-hydrogen (1)H nuclear magnetic resonance using a 9.4 T imager. The para-hydrogen to ortho-hydrogen velocity constant, k, near room temperature (292 K) was determined to be 8.27 ± 1.30 L/mol · min(-1). This value was calculated utilizing four different oxygen fractions. Para-hydrogen conversion to ortho-hydrogen by oxygen can be minimized for long term storage with judicious removal of oxygen contamination. Prior calculated velocity rates were confirmed demonstrating a dependence on only the oxygen concentration.

INTERVENCIÓN EDUCATIVA EFECTIVA EN VIH PARA MUJERES

PubMed Central

Miner, Sarah; Poupin, Lauren; Bernales, Margarita; Ferrer, Lilian; Cianelli, Rosina

2016-01-01

RESUMEN En Chile se estima que aproximadamente 38 mil personas viven con el Virus de Inmunodeficiencia Humana [VIH]. En el año 2001, 1.092 mujeres chilenas vivían con VIH, actualmente se cree que hay más de 7.600 mujeres con el virus. Frente a estas cifras surge la necesidad de crear estrategias de prevención dirigidas a mujeres chilenas. Objetivo analizar los estudios ya realizados en la prevención de VIH para determinar qué aspectos se deben incluir en programas exitosos de prevención de VIH en mujeres. Diseño y Método se realizó una revisión de la literatura utilizando la base de datos Proquest, CINAHL, Pubmed y Scielo. Los límites comprendieron: textos completos, de los últimos 10 años, de acceso gratuito y escrito en español o inglés. Se seleccionaron 15 artículos para la revisión. Resultados todos los artículos comprenden la evaluación del efecto de una intervención sobre conocimiento y conductas relacionadas con VIH/SIDA. Catorce muestran resultados significativos en cambios positivos de conducta o conocimientos relacionados con la prevención de VIH. Conclusiones los programas de prevención de VIH en mujeres pueden ser efectivos para lograr cambios de conducta y de conocimiento. Las intervenciones exitosas son aquellas basadas en teorías o modelos de prevención y en cambios de conductas, todas adaptadas a la cultura de la población estudiada. PMID:27667897

Measurement of the para-hydrogen concentration in the ISIS moderators using neutron transmission and thermal conductivity

NASA Astrophysics Data System (ADS)

Romanelli, Giovanni; Rudić, Svemir; Zanetti, Matteo; Andreani, Carla; Fernandez-Alonso, Felix; Gorini, Giuseppe; Krzystyniak, Maciej; Škoro, Goran

2018-04-01

We present an experimental study to determine the para-hydrogen concentration in the hydrogen moderators at the ISIS pulsed neutron and muon source. The experimental characterisation is based on neutron transmission experiments performed on the VESUVIO spectrometer, and thermal conductivity measurements using the TOSCA para-hydrogen rig. A reliable estimation of the level of para-hydrogen concentration in the hydrogen moderators is of crucial importance in the framework of a current project to completely refurbish the first target station at ISIS. Moreover, we report a new measurement of the total neutron cross section for normal hydrogen at 15 K on the broad energy range 3 meV -10 eV suggesting a revision of the most recent nuclear libraries for incident neutron energies lower than 10 meV. Finally, we characterise systematic errors affecting the para-hydrogen level estimation due to conversion from para to ortho hydrogen, as a function of the time a batch of gas spends in every component of our gas panel and apparatus.

Crystal growth and DFT insight on sodium para-nitrophenolate para-nitrophenol dihydrate single crystal for NLO applications

NASA Astrophysics Data System (ADS)

Selvakumar, S.; Boobalan, Maria Susai; Anthuvan Babu, S.; Ramalingam, S.; Leo Rajesh, A.

2016-12-01

Single crystals of sodium para-nitrophenolate para-nitrophenol dihydrate (SPPD) were grown by slow evaporation technique and its structure has been studied by FT-IR, FT-Raman and single crystal X-ray diffraction techniques. The optical and electrical properties were characterized by UV-Vis spectrum, and dielectric studies respectively. SPPD was thermally stable up to 128 °C as determined by TG-DTA curves. Using the Kurtz-Perry powder method, the second-harmonic generation efficiency was found to be five times to that of KDP. Third-order nonlinear response was studied using Z-scan technique with a He-Ne laser (632.8 nm) and NLO parameters such as intensity dependent refractive index, nonlinear absorption coefficient and third-order susceptibility were also estimated. The molecular geometry from X-ray experiment in the ground state has been compared using density functional theory (DFT) with appropriate basis set. The first-order hyperpolarizability also calculated using DFT approaches. Stability of the molecule arising from hyperconjugative interactions leading to its nonlinear optical activity and charge delocalization were analyzed using natural bond orbital technique. HOMO-LUMO energy gap value suggests the possibility of charge transfer within the molecule. Based on optimized ground state geometries, Natural bond orbital (NBO) analysis was performed to study donor-acceptor interactions.

Tratamiento quirúrgico de las lesiones intradurales extramedulares mediante hemilaminectomía

PubMed Central

Villalonga, Juan F.; Cervio, Andrés

2017-01-01

Resumen Objetivo: Evaluar la utilidad de la hemilaminectomía como abordaje quirúrgico en pacientes con tumores intradurales-extramedulares. Material y métodos: Estudio descriptivo retrospectivo que incluye a 53 pacientes en los que se utilizó la hemilaminectomía como abordaje a tumores intradurales-extramedulares durante el periodo junio de 2006 a diciembre de 2015. Se analizaron datos demográficos, signo-sintomatología preoperatoria, características imagenológicas, hallazgos intraoperatorios, estirpe histológico y complicaciones post-quirúrgicas. El periodo de seguimiento promedio fue de 48.9 meses (6-120 meses). Resultados: Cincuenta y tres pacientes con tumores intradurales-extramedulares fueron intervenidos mediante hemilaminectomía. La serie incluyó 5 tumores cervicales, 24 dorsales y 24 lumbares. El análisis histológico reveló 28 neurinomas, 11 meningiomas, 7 ependimomas y 7 “lesiones varias”. En el 96% de los casos se efectuó una exéresis total sin causar déficit neurológico agregado. No se evidenció recidiva en ninguno de los casos durante el periodo de seguimiento. Conclusión: La hemilaminectomía constituye una vía efectiva para la resección de tumores intradurales-extramedulares lateralizados a nivel cervicodorsal. Mientras que a nivel lumbar esta técnica puede ser también útil en lesiones de línea media. PMID:29142776

Calcisponges have a ParaHox gene and dynamic expression of dispersed NK homeobox genes.

PubMed

Fortunato, Sofia A V; Adamski, Marcin; Ramos, Olivia Mendivil; Leininger, Sven; Liu, Jing; Ferrier, David E K; Adamska, Maja

2014-10-30

Sponges are simple animals with few cell types, but their genomes paradoxically contain a wide variety of developmental transcription factors, including homeobox genes belonging to the Antennapedia (ANTP) class, which in bilaterians encompass Hox, ParaHox and NK genes. In the genome of the demosponge Amphimedon queenslandica, no Hox or ParaHox genes are present, but NK genes are linked in a tight cluster similar to the NK clusters of bilaterians. It has been proposed that Hox and ParaHox genes originated from NK cluster genes after divergence of sponges from the lineage leading to cnidarians and bilaterians. On the other hand, synteny analysis lends support to the notion that the absence of Hox and ParaHox genes in Amphimedon is a result of secondary loss (the ghost locus hypothesis). Here we analysed complete suites of ANTP-class homeoboxes in two calcareous sponges, Sycon ciliatum and Leucosolenia complicata. Our phylogenetic analyses demonstrate that these calcisponges possess orthologues of bilaterian NK genes (Hex, Hmx and Msx), a varying number of additional NK genes and one ParaHox gene, Cdx. Despite the generation of scaffolds spanning multiple genes, we find no evidence of clustering of Sycon NK genes. All Sycon ANTP-class genes are developmentally expressed, with patterns suggesting their involvement in cell type specification in embryos and adults, metamorphosis and body plan patterning. These results demonstrate that ParaHox genes predate the origin of sponges, thus confirming the ghost locus hypothesis, and highlight the need to analyse the genomes of multiple sponge lineages to obtain a complete picture of the ancestral composition of the first animal genome.

Rapid Catalyst Capture Enables Metal-Free para-Hydrogen-Based Hyperpolarized Contrast Agents.

PubMed

Barskiy, Danila A; Ke, Lucia A; Li, Xingyang; Stevenson, Vincent; Widarman, Nevin; Zhang, Hao; Truxal, Ashley; Pines, Alexander

2018-05-10

Hyperpolarization techniques based on the use of para-hydrogen provide orders of magnitude signal enhancement for magnetic resonance spectroscopy and imaging. The main drawback limiting widespread applicability of para-hydrogen-based techniques in biomedicine is the presence of organometallic compounds (the polarization transfer catalysts) in solution with hyperpolarized contrast agents. These catalysts are typically complexes of platinum-group metals, and their administration in vivo should be avoided. Herein, we show how extraction of a hyperpolarized compound from an organic phase to an aqueous phase combined with a rapid (less than 10 s) Ir-based catalyst capture by metal scavenging agents can produce pure para-hydrogen-based hyperpolarized contrast agents, as demonstrated by high-resolution nuclear magnetic resonance (NMR) spectroscopy and inductively coupled plasma atomic emission spectroscopy (ICP-AES). The presented methodology enables fast and efficient means of producing pure hyperpolarized aqueous solutions for biomedical and other uses.

THE ROLE OF METABOLIC SURGERY FOR PATIENTS WITH OBESITY GRADE I ANDCLINICALLY UNCONTROLLED TYPE 2 DIABETES.

PubMed

Campos, Josemberg; Ramos, Almino; Szego, Thomaz; Zilberstein, Bruno; Feitosa, Heládio; Cohen, Ricardo

2016-07-07

Metabolic Risk Score defined by the surgical societies. Roux-en-Y gastric bypass (RYGB), because of its well known safety and efficacy and longer follow-up studies, is the main surgical technique indicated for patients eligible for surgery through the Metabolic Risk Score. The vertical sleeve gastrectomy may be considered if there is an absolute contraindication for the RYGB. T2DM patients should be evaluated by the multiprofessional team that will assess surgical eligibility, preoperative work up, follow up and long term monitoring for micro and macrovascular complications. Mesmo considerando o avanço do tratamento clínico ocorrido nos últimos 20 anos, com novos e mais eficientes medicamentos, os dados ainda são desanimadores quanto ao controle da obesidade e da diabete melito tipo 2(DMT2),com grande parcela de doentes em tratamento clínico ficando fora da meta desejada de controle. Apresentar proposta de Escore de Risco Metabólico para melhor orientar a indicação cirúrgica do diabete em pacientes com índice de massa corpórea (IMC) mais baixo nos quais o uso de procedimento cirúrgico para obesidade ainda é controverso. Foi realizada pesquisa nas bases de dados PubMed, Medline, PubMed Central, Scielo e Lilacs entre 2003-2015 correlacionando os descritores:cirurgia metabólica, obesidade e diabete melito tipo 2. Adicionalmente, representantes das sociedades envolvidas emitiram opiniões em pontos nos quais não existia na literatura trabalhos com graus de evidência elevados. Foram encontrados 45 artigos relacionadosque foram analisados pelos critérios da medicina baseada em evidências.As opiniões agrupadas procuraram responder as seguintes questões: Porque cirurgia metabólica e não bariátrica?;Mecanismos envolvidos no controle glicêmico; IMC como critério isolado de indicação cirúrgica para o DMT2 não controlado; Resultados de estudos de cirurgia metabólica em IMC<35 kg/m2; Segurança da cirurgia metabólica em pacientes com IMC<35 kg/m2; Efeitos

THE ROLE OF METABOLIC SURGERY FOR PATIENTS WITH OBESITY GRADE I AND TYPE 2 DIABETES NOT CONTROLLED CLINICALLY.

PubMed

Campos, Josemberg; Ramos, Almino; Szego, Thomaz; Zilberstein, Bruno; Feitosa, Heládio; Cohen, Ricardo

Metabolic Risk Score defined by the surgical societies. Roux-en-Y gastric bypass (RYGB), because of its well known safety and efficacy and longer follow-up studies, is the main surgical technique indicated for patients eligible for surgery through the Metabolic Risk Score. The vertical sleeve gastrectomy may be considered if there is an absolute contraindication for the RYGB. T2DM patients should be evaluated by the multiprofessional team that will assess surgical eligibility, preoperative work up, follow up and long term monitoring for micro and macrovascular complications. Mesmo considerando o avanço do tratamento clínico ocorrido nos últimos 20 anos, com novos e mais eficientes medicamentos, os dados ainda são desanimadores quanto ao controle da obesidade e da diabete melito tipo 2 (DMT2),com grande parcela de doentes em tratamento clínico ficando fora da meta desejada de controle. Apresentar proposta de Escore de Risco Metabólico para melhor orientar a indicação cirúrgica do diabete em pacientes com índice de massa corpórea (IMC) mais baixo nos quais o uso de procedimento cirúrgico para obesidade ainda é controverso. Foi realizada pesquisa nas bases de dados Pubmed, Medline, Pubmed Central, Scielo e Lilacs entre 2003-2015 correlacionando os descritores:cirurgia metabólica, obesidade e diabete melito tipo 2. Adicionalmente, representantes das sociedades envolvidas emitiram opiniões em pontos nos quais não existia na literatura trabalhos com graus de evidência elevados. Foram encontrados 45 artigos relacionados que foram analisados pelos critérios da medicina baseada em evidências. As opiniões agrupadas procuraram responder as seguintes questões: Porque cirurgia metabólica e não bariátrica?; Mecanismos envolvidos no controle glicêmico; IMC como critério isolado de indicação cirúrgica para o DMT2 não controlado; Resultados de estudos de cirurgia metabólica em IMC<35 kg/m2; Segurança da cirurgia metabólica em pacientes com IMC<35 kg/m2

Focused Cardiac Ultrasound Using a Pocket-Size Device in the Emergency Room.

PubMed

Mancuso, Frederico José Neves; Siqueira, Vicente Nicoliello; Moisés, Valdir Ambrósio; Gois, Aécio Flavio Teixeira; Paola, Angelo Amato Vincenzo de; Carvalho, Antonio Carlos Camargo; Campos, Orlando

2014-10-28

Background: Cardiovascular urgencies are frequent reasons for seeking medical care. Prompt and accurate medical diagnosis is critical to reduce the morbidity and mortality of these conditions. Objective: To evaluate the use of a pocket-size echocardiography in addition to clinical history and physical exam in a tertiary medical emergency care. Methods: One hundred adult patients without known cardiac or lung diseases who sought emergency care with cardiac complaints were included. Patients with ischemic changes in the electrocardiography or fever were excluded. A focused echocardiography with GE Vscan equipment was performed after the initial evaluation in the emergency room. Cardiac chambers dimensions, left and right ventricular systolic function, intracardiac flows with color, pericardium, and aorta were evaluated. Results: The mean age was 61 ± 17 years old. The patient complaint was chest pain in 51 patients, dyspnea in 32 patients, arrhythmia to evaluate the left ventricular function in ten patients, hypotension/dizziness in five patients and edema in one patient. In 28 patients, the focused echocardiography allowed to confirm the initial diagnosis: 19 patients with heart failure, five with acute coronary syndrome, two with pulmonary embolism and two patients with cardiac tamponade. In 17 patients, the echocardiography changed the diagnosis: ten with suspicious of heart failure, two with pulmonary embolism suspicious, two with hypotension without cause, one suspicious of acute coronary syndrome, one of cardiac tamponade and one of aortic dissection. Conclusion: The focused echocardiography with pocket-size equipment in the emergency care may allow a prompt diagnosis and, consequently, an earlier initiation of the therapy.Fundamento: As urgências cardiovasculares são causas importantes de procura por atendimento médico, sendo fundamentais a rapidez e a precisão no diagnóstico para diminuir sua morbimortalidade. Objetivo: Avaliar o uso da ecocardiografia

Validation of an educative manual for patients with head and neck cancer submitted to radiation therapy.

PubMed

Cruz, Flávia Oliveira de Almeida Marques da; Ferreira, Elaine Barros; Vasques, Christiane Inocêncio; Mata, Luciana Regina Ferreira da; Reis, Paula Elaine Diniz Dos

2016-06-14

develop the content and face validation of an educative manual for patients with head and neck cancer submitted to radiation therapy. descriptive methodological research. The Theory of Psychometrics was used for the validation process, developed by 15 experts in the theme area of the educative manual and by two language and publicity professionals. A minimum agreement level of 80% was considered to guarantee the validity of the material. the items addressed in the assessment tool of the educative manual were divided in three blocks: objectives, structure and format, and relevance. Only one item, related to the sociocultural level of the target public, obtained an agreement rate <80%, and was reformulated based on the participants' suggestions. All other items were considered appropriate and/or complete appropriate in the three blocks proposed: objectives - 92.38%, structure and form - 89.74%, and relevance - 94.44%. the face and content validation of the educative manual proposed were attended to. This can contribute to the understanding of the therapeutic process the head and neck cancer patient is submitted to during the radiation therapy, besides supporting clinical practice through the nursing consultation. validar o conteúdo e a aparência de manual educativo direcionado aos pacientes com câncer de cabeça e pescoço, submetidos à radioterapia. pesquisa metodológica, de caráter descritivo. Utilizou-se a Teoria da Psicometria para o processo de validação, o qual foi realizado por 15 peritos na área temática do manual educativo e por dois profissionais de letras e publicidade. Foi considerado o índice de concordância de, no mínimo, 80% para se garantir a validação do material. os itens abordados no instrumento de avaliação do manual educativo foram divididos em três blocos: objetivos, estrutura e apresentação, e relevância. Apenas um item, relacionado ao nível sociocultural do público-alvo, obteve índice de concordância <80%, tendo sido

Vínculos observacionais para o processo-S em estrelas gigantes de Bário

NASA Astrophysics Data System (ADS)

Smiljanic, R. H. S.; Porto de Mello, G. F.; da Silva, L.

2003-08-01

Estrelas de bário são gigantes vermelhas de tipo GK que apresentam excessos atmosféricos dos elementos do processo-s. Tais excessos são esperados em estrelas na fase de pulsos térmicos do AGB (TP-AGB). As estrelas de bário são, no entanto, menos massivas e menos luminosas que as estrelas do AGB, assim, não poderiam ter se auto-enriquecido. Seu enriquecimento teria origem em uma estrela companheira, inicialmente mais massiva, que evolui pelo TP-AGB, se auto-enriquece com os elementos do processo-s e transfere material contaminado para a atmosfera da atual estrela de bário. A companheira evolui então para anã branca deixando de ser observada diretamente. As estrelas de bário são, portanto, úteis como testes observacionais para teorias de nucleossíntese pelo processo-s, convecção e perda de massa. Análises detalhadas de abundância com dados de alta qualidade para estes objetos são ainda escassas na literatura. Neste trabalho construímos modelos de atmosferas e, procedendo a uma análise diferencial, determinamos parâmetros atmosféricos e evolutivos de uma amostra de dez gigantes de bário e quatro normais. Determinamos seus padrões de abundância para Na, Mg, Al, Si, Ca, Sc, Ti, V, Cr, Mn, Fe, Co, Ni, Cu, Zn, Sr, Y, Zr, Ba, La, Ce, Nd, Sm, Eu e Gd, concluindo que algumas estrelas classificadas na literatura como gigantes de bário são na verdade gigantes normais. Comparamos dois padrões médios de abundância, para estrelas com grandes excessos e estrelas com excessos moderados, com modelos teóricos de enriquecimento pelo processo-s. Os dois grupos de estrelas são ajustados pelos mesmos parâmetros de exposição de nêutrons. Tal resultado sugere que a ocorrência do fenômeno de bário com diferentes intensidades não se deve a diferentes exposições de nêutrons. Discutimos ainda efeitos nucleossintéticos, ligados ao processo-s, sugeridos na literatura para os elementos Cu, Mn, V e Sc.

Ortho-para-H2 conversion by hydrogen exchange: comparison of theory and experiment.

PubMed

Lique, François; Honvault, Pascal; Faure, Alexandre

2012-10-21

We report fully-quantum time-independent calculations of cross sections and rate coefficients for the collisional (de)excitation of H(2) by H. Our calculations are based on the H(3) global potential energy surface of Mielke et al. [J. Chem. Phys. 116, 4142 (2002)]. The reactive hydrogen exchange channels are taken into account. We show that the ortho-para and para-ortho conversion of H(2) are significant processes at temperatures above ~300 K and for the last process we provide the first comparison with available experimental rate coefficients between 300 and 444 K. The good agreement between theory and experiment is a new illustration of our detailed understanding of the simplest chemical reaction. The importance of the ortho-para-H(2) conversion by hydrogen exchange in astrophysics is discussed.

The use of a metronome during cardiopulmonary resuscitation in the emergency room of a university hospital.

PubMed

Botelho, Renata Maria de Oliveira; Campanharo, Cássia Regina Vancini; Lopes, Maria Carolina Barbosa Teixeira; Okuno, Meiry Fernanda Pinto; Góis, Aécio Flávio Teixeira de; Batista, Ruth Ester Assayag

2016-11-21

to compare the rate of return of spontaneous circulation (ROSC) and death after cardiac arrest, with and without the use of a metronome during cardiopulmonary resuscitation (CPR). case-control study nested in a cohort study including 285 adults who experienced cardiac arrest and received CPR in an emergency service. Data were collected using In-hospital Utstein Style. The control group (n=60) was selected by matching patients considering their neurological condition before cardiac arrest, the immediate cause, initial arrest rhythm, whether epinephrine was used, and the duration of CPR. The case group (n=51) received conventional CPR guided by a metronome set at 110 beats/min. Chi-square and likelihood ratio were used to compare ROSC rates considering p≤0.05. ROSC occurred in 57.7% of the cases, though 92.8% of these patients died in the following 24 hours. No statistically significant difference was found between groups in regard to ROSC (p=0.2017) or the occurrence of death (p=0.8112). the outcomes of patients after cardiac arrest with and without the use of a metronome during CPR were similar and no differences were found between groups in regard to survival rates and ROSC. comparar a taxa de retorno da circulação espontânea e óbito após parada cardiorrespiratória, com e sem a utilização do metrônomo durante ressuscitação cardiopulmonar. estudo caso-controle aninhado a estudo de coorte, com 285 adultos atendidos em parada cardíaca em um serviço de emergência e submetidos à ressuscitação cardiopulmonar. Os dados foram coletados por meio do In-hospital Utstein Style. O grupo controle (n=60) foi selecionado pelo pareamento dos pacientes considerando-se o estado neurológico pré-parada cardiorrespiratória, causa imediata e ritmo inicial da parada, utilização de epinefrina e duração da ressuscitação. O grupo caso (n=51) foi submetido à ressuscitação cardiopulmonar convencional com a utilização do metrônomo a 110sons/min. Para comparar

Factors associated with mortality in patients undergoing coronary artery bypass grafting.

PubMed

Koerich, Cintia; Lanzoni, Gabriela Marcellino de Melo; Erdmann, Alacoque Lorenzini

2016-08-08

to investigate the factors associated with mortality in patients undergoing coronary artery bypass grafting in a cardiovascular referral hospital in Santa Catarina. quantitative, exploratory, descriptive and retrospective study. The medical records of 1447 patients, from 2005 to 2013, were analyzed for statistically related variables, these being: profile, hospitalization diagnosis, risk factors for coronary artery disease, complications recorded during the hospitalization, length of hospitalization and cause of death. the mortality rate was 5.3% during the study period. Death was more common in females and those of black skin color, with a mean age of 65 years. Acute myocardial infarction was the most common hospitalization diagnosis. The majority of the complications recorded during hospitalization were characterized by changes in the cardiovascular system, with longer hospitalization periods being directly related to death from septic shock. the data provide subsidies for nursing work with preventive measures and early detection of complications associated with coronary artery bypass grafting. This reinforces the importance of using the data as quality indicators, aiming to guarantee care guided by reliable information to guide managers in planning patient care and high complexity health services. conhecer os fatores associados à mortalidade de pacientes submetidos à cirurgia de revascularização do miocárdio em hospital referência cardiovascular em Santa Catarina. estudo quantitativo, exploratório, descritivo e retrospectivo. Foram analisados os prontuários de 1447 pacientes, entre 2005 e 2013, e as variáveis relacionadas estatisticamente, sendo estas: perfil, diagnóstico da internação, fatores de risco para doença arterial coronariana, intercorrências registradas na internação, tempo de internação e causa do óbito. a taxa de mortalidade foi de 5,3% no período do estudo. Os óbitos foram mais frequentes em negros, do sexo feminino e média de

Bacterial genus is a risk factor for major amputation in patients with diabetic foot.

PubMed

Cardoso, Natália Anício; Cisneiros, Lígia DE Loiola; Machado, Carla Jorge; Cenedezi, Juliana Merlin; Procópio, Ricardo Jayme; Navarro, Túlio Pinho

2017-01-01

to evaluate whether bacterial genus is a risk factor for major amputation in patients with diabetic foot and infected ulcer. we conducted a case-control, observational study of 189 patients with infected ulcers in diabetic feet admitted to the Vascular Surgery Service of the Risoleta Tolentino Neves Hospital, from January 2007 to December 2012. The bacteriological evaluation was performed in deep tissue cultures from the lesions and amputation was considered major when performed above the foot'smiddle tarsus. the patients'mean age was 61.9±12.7 years; 122 (64.6%) were men. The cultures were positive in 86.8%, being monomicrobial in 72% of the cases. In patients with major amputation, Acinetobacter spp. (24.4%), Morganella spp. (24.4%), Proteus spp. (23.1%) and Enterococcus spp. (19.2%) were the most frequent types of bacteria. The most commonly isolated species were Acinetobacter baumannii, Morganella morganii, Pseudomonas aeruginosa and Proteus mirabilis. As predictors of major amputation, we identified the isolation of the generaAcinetobacter spp. and Klebsiella spp., serum creatinine ≥1.3mg/dl and hemoglobin <11g/dl. the bacterial genera Acinetobacter spp. and Klebsiella spp. identified in infected ulcers of patients with diabetic foot were associated with a higher incidence of major amputation. avaliar se gênero bacteriano é fator de risco para amputação maior em pacientes com pé diabético e úlcera infectada. estudo observacional do tipo caso-controle de 189 pacientes com úlcera infectada em pé diabético admitidos pelo Serviço de Cirurgia Vascular do Hospital Risoleta Tolentino Neves, no período de janeiro de 2007 a dezembro de 2012. A avaliação bacteriológica foi realizada em cultura de tecido profundo das lesões e a amputação foi considerada como maior quando realizada acima do médio tarso do pé. a média de idade dos pacientes foi 61,9±12,7 anos e 122 (64,6%) eram homens. As culturas foram positivas em 86,8%, sendo monomicrobianas em

Quantum rotation of ortho and para-water encapsulated in a fullerene cage

PubMed Central

Beduz, Carlo; Carravetta, Marina; Chen, Judy Y.-C.; Concistrè, Maria; Denning, Mark; Frunzi, Michael; Horsewill, Anthony J.; Johannessen, Ole G.; Lawler, Ronald; Lei, Xuegong; Levitt, Malcolm H.; Li, Yongjun; Mamone, Salvatore; Murata, Yasujiro; Nagel, Urmas; Nishida, Tomoko; Ollivier, Jacques; Rols, Stéphane; Rõõm, Toomas; Sarkar, Riddhiman; Turro, Nicholas J.; Yang, Yifeng

2012-01-01

Inelastic neutron scattering, far-infrared spectroscopy, and cryogenic nuclear magnetic resonance are used to investigate the quantized rotation and ortho–para conversion of single water molecules trapped inside closed fullerene cages. The existence of metastable ortho-water molecules is demonstrated, and the interconversion of ortho-and para-water spin isomers is tracked in real time. Our investigation reveals that the ground state of encapsulated ortho water has a lifted degeneracy, associated with symmetry-breaking of the water environment. PMID:22837402

Contextual Factors that Foster or Inhibit Para-Teacher Professional Development: The Case of an Indian, Non-Governmental Organization

ERIC Educational Resources Information Center

Raval, Harini; McKenney, Susan; Pieters, Jules

2012-01-01

The appointment of para-professionals to overcome skill shortages and/or make efficient use of expensive resources is well established in both developing and developed countries. The present research concerns para-teachers in India. The literature on para-teachers is dominated by training for special needs settings, largely in developed societies.…

Intact cluster and chordate-like expression of ParaHox genes in a sea star

PubMed Central

2013-01-01

Background The ParaHox genes are thought to be major players in patterning the gut of several bilaterian taxa. Though this is a fundamental role that these transcription factors play, their activities are not limited to the endoderm and extend to both ectodermal and mesodermal tissues. Three genes compose the ParaHox group: Gsx, Xlox and Cdx. In some taxa (mostly chordates but to some degree also in protostomes) the three genes are arranged into a genomic cluster, in a similar fashion to what has been shown for the better-known Hox genes. Sea urchins possess the full complement of ParaHox genes but they are all dispersed throughout the genome, an arrangement that, perhaps, represented the primitive condition for all echinoderms. In order to understand the evolutionary history of this group of genes we cloned and characterized all ParaHox genes, studied their expression patterns and identified their genomic loci in a member of an earlier branching group of echinoderms, the asteroid Patiria miniata. Results We identified the three ParaHox orthologs in the genome of P. miniata. While one of them, PmGsx is provided as maternal message, with no zygotic activation afterwards, the other two, PmLox and PmCdx are expressed during embryogenesis, within restricted domains of both endoderm and ectoderm. Screening of a Patiria bacterial artificial chromosome (BAC) library led to the identification of a clone containing the three genes. The transcriptional directions of PmGsx and PmLox are opposed to that of the PmCdx gene within the cluster. Conclusions The identification of P. miniata ParaHox genes has revealed the fact that these genes are clustered in the genome, in contrast to what has been reported for echinoids. Since the presence of an intact cluster, or at least a partial cluster, has been reported in chordates and polychaetes respectively, it becomes clear that within echinoderms, sea urchins have modified the original bilaterian arrangement. Moreover, the sea star

Impact of Intensive Physiotherapy on Cognitive Function after Coronary Artery Bypass Graft Surgery.

PubMed

Cavalcante, Elder Dos Santos; Magario, Rosmeiri; Conforti, César Augusto; Cipriano Júnior, Gerson; Arena, Ross; Carvalho, Antonio Carlos C; Buffolo, Enio; Luna Filho, Bráulio

2014-11-01

Background: Coronary artery bypass graft (CABG) is a standard surgical option for patients with diffuse and significant arterial plaque. This procedure, however, is not free of postoperative complications, especially pulmonary and cognitive disorders. Objective: This study aimed at comparing the impact of two different physiotherapy treatment approaches on pulmonary and cognitive function of patients undergoing CABG. Methods: Neuropsychological and pulmonary function tests were applied, prior to and following CABG, to 39 patients randomized into two groups as follows: Group 1 (control) - 20 patients underwent one physiotherapy session daily; and Group 2 (intensive physiotherapy) - 19 patients underwent three physiotherapy sessions daily during the recovery phase at the hospital. Non-paired and paired Student t tests were used to compare continuous variables. Variables without normal distribution were compared between groups by using Mann-Whitney test, and, within the same group at different times, by using Wilcoxon test. The chi-square test assessed differences of categorical variables. Statistical tests with a p value ≤ 0.05 were considered significant. Results: Changes in pulmonary function were not significantly different between the groups. However, while Group 2 patients showed no decline in their neurocognitive function, Group 1 patients showed a decline in their cognitive functions (P ≤ 0.01). Conclusion: Those results highlight the importance of physiotherapy after CABG and support the implementation of multiple sessions per day, providing patients with better psychosocial conditions and less morbidity.Fundamento: A cirurgia de revascularização miocárdica (CRM) é a opção cirúrgica padrão para pacientes com placas arteriais difusas e significativas. Tal procedimento, no entanto, não é desprovido de complicações pós-operatórias, especialmente distúrbios pulmonares e cognitivos. Objetivo: Comparar o impacto de duas abordagens fisioterap

Evaluating bronchodilator response in pediatric patients with post-infectious bronchiolitis obliterans: use of different criteria for identifying airway reversibility.

PubMed

Mattiello, Rita; Vidal, Paula Cristina; Sarria, Edgar Enrique; Pitrez, Paulo Márcio; Stein, Renato Tetelbom; Mocelin, Helena Teresinha; Fischer, Gilberto Bueno; Jones, Marcus Herbert; Pinto, Leonardo Araújo

2016-01-01

BOPI, comparando critérios diferentes para a definição da resposta. Foram avaliados pacientes pediátricos com diagnóstico de BOPI tratados em um de dois ambulatórios de pneumologia pediátrica na cidade de Porto Alegre (RS). Parâmetros espirométricos foram medidos de acordo com recomendações internacionais. Foram incluídos 72 pacientes pediátricos com BOPI no estudo. As médias dos valores pré- e pós-broncodilatador foram claramente inferiores aos valores de referência para todos os parâmetros, especialmente FEF25-75%. Houve uma melhora pós-broncodilatador. Quando medidos como aumentos percentuais médios, VEF1 e FEF25-75% melhoraram em 11% e 20%, respectivamente. Entretanto, quando os valores absolutos foram calculados, as médias de VEF1 e FEF25-75% aumentaram somente em 0,1 l. Verificamos que a idade da agressão viral, história familiar de asma e alergia não tiveram efeitos significativos na resposta ao broncodilatador. Pacientes pediátricos com BOPI têm uma obstrução das vias aéreas periféricas que responde ao tratamento, mas não uma reversão completa com o broncodilatador. O conceito de BOPI como obstrução fixa e irreversível parece não se aplicar a essa população. Nossos dados sugerem que a obstrução de vias aéreas em pacientes com BOPI é variável, e esse achado pode ter importantes implicações clínicas.

[Not Available].

PubMed

Zubiaga, Lorea; Ruiz-Tovar, Jaime; Giner, Lorena; González, Juan; Aguilar, María Del Mar; García, Alejandro; Calpena, Rafael; Durán, Manuel

2016-07-19

Introducción y objetivo: el IMC puede resultar engañoso para ciertas complexiones corporales, por lo que se han propuesto otros parámetros como la adiposidad (calculada a través de fórmula CUN-BAE,) el índice de Framingham de riesgo cardiovascular (IF) y el índice aterogénico (IA) (rCT/HDL-c) como predictores de riesgo cardiovascular. Se propone comparar estos factores como marcadores de éxito terapéutico tras cirugía en pacientes obesos sometidos a gastrectomía vertical laparoscópica (GVL) como procedimiento de cirugía bariátrica.Material y métodos: realizamos un estudio observacional prospectivo de pacientes sometidos a GVL y con un periodo de seguimiento mínimo de 1 año. Analizamos la evolución de IMC, adiposidad, IF e IA.Resultados: analizamos 140 pacientes. El IMC preoperatorio fue de 49,1 kg/m2, con una adiposidad del 54,8%, un IF 7,54% y un IA de 4,2. A los 12 meses el IMC era de 28,4 kg/m2, con una adiposidad del 39,4%, un IF del 3,7% y un IA de 1,64. En función de estos resultados, a los 12 meses el IMC medio está en rango de sobrepeso, la adiposidad en niveles de obesidad (obesidad: > 25% en hombres y > 35% en mujeres), el IF en rango de riesgo cardiovascular bajo (< 5%) y el IA dentro del rango de normalidad (< 3). Correlacionando estos parámetros observamos que el IMC se correlaciona con la adiposidad tanto en valores preoperatorios (Pearson 0,486; p = 0,004), posoperatorios (Pearson 0,957; p < 0,001), como en la diferencia entre ambos (Pearson 0,606; p = 0,017), lo cual es lógico, porque el IMC se incluye en la fórmula CUN-BAE para el cálculo de la adiposidad. En los valores posoperatorios se objetiva una correlación de la adiposidad con el IF (Pearson 0,814, p = 0,036) y con el IA (Pearson 0,517; p = 0,049). En los valores preoperatorios no se objetivan dichas correlaciones. El IMC no se correlacionó con la adiposidad.Conclusión: la adiposidad se correlaciona con índices de riesgo cardiovascular, como el índice de

Anatomic pulmonary resection via video-assisted thoracic surgery: analysis of 117 cases at a referral center in Brazil.

PubMed

Soder, Stephan Adamour; Barth, Frederico; Perin, Fabiola Adelia; Felicetti, José Carlos; Camargo, José de Jesus Peixoto; Camargo, Spencer Marcantônio

2017-01-01

To describe our experience with video-assisted thoracic surgery (VATS) for anatomic pulmonary resection at a referral center for thoracic surgery in Brazil. All patients who underwent anatomic pulmonary resection by VATS between 2010 and 2015 were included. Clinical and pathological data, as well as postoperative complications, were analyzed. A total of 117 pulmonary resections by VATS were performed, of which 98 were lobectomies and 19 were anatomic segmentectomies. The mean age of the patients was 63.6 years (range, 15-86 years). Females predominated (n = 69; 59%). The mean time to chest tube removal was 2.47 days, and the mean length of ICU stay was 1.88 days. The mean length of hospital stay was 4.48 days. Bleeding ≥ 400 mL occurred in 15 patients. Conversion to thoracotomy was required in 4 patients. Our results are similar to those published in major international studies, indicating that VATS is an important strategy for pulmonary resection. They also show that VATS can be safely performed with adequate training. This technique should be used more often for the treatment of lung diseases in Brazil. Relatar a experiência com cirurgia torácica videoassistida (CTVA) para ressecções pulmonares anatômicas em um centro nacional de referência de cirurgia torácica no Brasil. Foram incluídos todos os pacientes tratados com ressecções pulmonares anatômicas por CTVA entre 2010 e 2015 e analisados dados clínicos e patológicos, assim como complicações pós-operatórias. Foram realizadas 117 ressecções pulmonares por CTVA, sendo 98 lobectomias e 19 segmentectomias anatômicas. A média de idade foi de 63,6 anos (variação, 15-86 anos), sendo a maioria mulheres (n = 69; 59%). A média de tempo de permanência com dreno foi de 2,47 dias e a de estada em UTI foi de 1,88 dias. A média de tempo de internação foi de 4,48 dias. Sangramento ≥ 400 ml ocorreu em 15 pacientes. Houve conversão para toracotomia em 4 pacientes. Nossos resultados vão ao

El Informe de Progreso en Justicia Ambiental de la EPA para el Año Fiscal 17 demuestra resultados tangibles para comunidades vulnerables

EPA Pesticide Factsheets

La EPA publicó su Informe de Progreso en Justicia Ambiental AF2017 destacando los continuos logros en crear ambientes más limpios, más seguros y más saludables para comunidades minoritarias, de bajos ingresos, tribales e indígenas.

Development of the TabacoQuest app for computerization of data collection on smoking in psychiatric nursing.

PubMed

Oliveira, Renata Marques de; Duarte, Alexandre Freitas; Alves, Domingos; Furegato, Antonia Regina Ferreira

2016-08-29

to develop a mobile app for research on the use of tobacco among psychiatric patients and the general population. applied research with the technological development of an app for data collection on an Android tablet. For its development, we considered three criteria: data security, benefits for participants and optimization of the time of researchers. We performed tests with twenty fictitious participants and a final test with six pilots. the app collects data, stores them in the database of the tablet and export then to an Excel spreadsheet. calculator, stopwatch, offline operation, branching logic, field validation and automatic tabulation. the app prevents human error, increases the quality of the data by validating them during the interview, allows the performing of automatic tabulation and makes the interviews less tiring. Its success may encourage the use of this and other computational resources by nurses as a research tool. desenvolver aplicativo mobile para pesquisa sobre o uso de tabaco entre pacientes psiquiátricos e a população geral. pesquisa aplicada com o desenvolvimento tecnológico de um aplicativo para coleta de dados em tablet Android. Para seu desenvolvimento, consideraram-se três critérios: segurança dos dados, benefícios para os participantes e otimização do tempo dos pesquisadores. Testes com 20 participantes fictícios e teste final com seis pilotos. o aplicativo coleta os dados, armazena-os no banco de dados do tablet e os exporta para planilha Excel. Recursos: calculadora; cronômetro; funcionamento off-line, lógica de ramificação, validação de campos e tabulação automática. o aplicativo previne erros humanos e aumenta a qualidade dos dados ao validá-los durante a entrevista, permite realizar tabulação automática e torna as entrevistas menos cansativas. Seu sucesso poderá incentivar o uso desse e outros recursos computacionais pelos enfermeiros, como ferramenta de pesquisa. desarrollar aplicativo móvil para hacer

Evidence for disequilibrium of ortho and para hydrogen on Jupiter from Voyager IRIS measurements

NASA Technical Reports Server (NTRS)

Conrath, B. J.; Gierasch, P. J.

1983-01-01

Preliminary results of an analysis of the ortho state/para state ratio (parallel/antiparallel) for molecular H2 in the Jovian atmosphere using Voyager IR spectrometer (IRIS) data are reported. The study was undertaken to expand the understanding of the thermodynamics of a predominantly H2 atmosphere, which takes about 100 million sec to reach equilibrium. IRIS data provided 4.3/cm resolution in the 300-700/cm spectral range dominated by H2 lines. Approximately 600 spectra were examined to detect any disequilibrium between the hydrogen species. The results indicate that the ortho-para ratio is not in an equilibrium state in the upper Jovian troposphere. A thorough mapping of the para-state molecules in the upper atmosphere could therefore aid in mapping the atmospheric flowfield.

Amazon Land Wars in the South of Para

NASA Technical Reports Server (NTRS)

Simmons, Cynthia S.; Walker, Robert T.; Arima, Eugenio Y.; Aldrich, Stephen P.; Caldas, Marcellus M.

2007-01-01

The South of Para, located in the heart of the Brazilian Amazon, has become notorious for violent land struggle. Although land conflict has a long history in Brazil, and today impacts many parts of the country, violence is most severe and persistent here. The purpose of this article is to examine why. Specifically, we consider how a particular Amazonian place, the so-called South of Para has come to be known as Brazil's most dangerous badland. We begin by considering the predominant literature, which attributes land conflict to the frontier expansion process with intensified struggle emerging in the face of rising property values and demand for private property associated with capitalist development. From this discussion, we distill a concept of the frontier, based on notions of property rights evolution and locational rents. We then empirically test the persistence of place-based violence in the region, and assess the frontier movement through an analysis of transportation costs. The findings from the analyses indicate that the prevalent theorization of frontier violence in Amazonia does little to explain its persistent and pervasive nature in the South of Para. To fill this gap in understanding, we develop an explanation based the geographic conception of place, and we use contentious politics theory heuristically to elucidate the ways in which general processes interact with place specific history to engender a landscape of violence. In so doing, we focus on environmental, cognitive, and relational mechanisms (and implicated structures), and attempt to deploy them in an explanatory framework that allows direct observation of the accumulating layers of the region's tragic history. We end by placing our discussion within a political ecological context, and consider the implications of the Amazon Land War for the environment.

"Espanol para ti": A Video Program That Works.

ERIC Educational Resources Information Center

Steele, Elena; Johnson, Holly

2000-01-01

Describes the development of "Espanol para ti," a video program for teaching Spanish at the elementary school level. The program was designed for use in Clark County, Nevada elementary schools and is taught by a certified Spanish teacher via video twice a week, utilizing comprehensible input through visuals, games, and songs that are conducive to…

Uma grade de perfis teóricos para estrelas massivas em transição

NASA Astrophysics Data System (ADS)

Nascimento, C. M. P.; Machado, M. A.

2003-08-01

Na XXVIII Reunião Anual da Sociedade Astronômica Brasileira (2002) apresentamos uma grade de perfis calculados de acordo com os pontos da trajetória evolutiva de metalicidade solar, Z = 0.02 e taxa de perda de massa () padrão, para estrelas com massa inicial de 25, 40, 60, 85 e 120 massas solares. Estes perfis foram calculados com o auxílio de um código numérico adequado para descrever os ventos de objetos massivos, supondo simetria esférica, estacionaridade e homogeneidade. No presente trabalho, apresentamos a complementação da grade com os perfis teóricos relativos às trajetórias de Z = 0.02 com taxa de perda de massa dobrada em relação a padrão (2´), e de metalicidade Z = 0.008. Para cada ponto das três trajetórias obtemos os perfis teóricos de Ha, Hb, Hg e Hd, e como esperado eles se apresentam em pura emissão, pura absorção ou em P-Cygni. Para valores de taxa de perda de massa muito baixos (~10-7) não há formação de linhas, o que é visto nos primeiros pontos em todas as trajetórias. Em geral, para um mesmo ponto a componente de emissão diminui e a absorção aumenta de Ha para Hd. É verificado que as trajetórias com Z = 0.02 e padrão possuem menos circuitos (loops) do que as com metalicidade Z = 0.02 e 2´ padrão, e seus perfis são, em geral, menos intensos. Em relação a trajetória de Z = 0.008, verifica-se menos circuitos e maior variação em luminosidade, e seus perfis mostram-se em, algumas trajetórias, mais intensos. Verificamos também que, pontos distintos em uma mesma trajetória, apresentam perfis diferentes para valores similares de luminosidade e temperatura efetiva. Sendo assim, uma grade de perfis teóricos parece ser útil para fornecer uma informação preliminar sobre o estágio evolutivo de uma estrela massiva.

Anomalous heat transfer in two polymorphs of para-bromobenzophenone

NASA Astrophysics Data System (ADS)

Romantsova, O. O.; Horbatenko, Yu. V.; Krivchikov, A. I.; Korolyuk, O. A.; Vdovichenko, G. A.; Zloba, D. I.; Pyshkin, O. S.

2017-03-01

The thermal conductivity of a polycrystalline sample of monoclinic polymorph of para-bromobenzophenone in the T = 3-320 K temperature range was measured using steady-state linear heat flow. The temperature dependences of thermal conductivity are presented as the sum of two independent contributions: a contribution that corresponds to the thermal conductivity of an orientationally ordered crystal structure, and a new additional thermally activated contribution that manifests itself above 130 K. A comparison is made with the data on the thermal conductivity of a single crystal triclinic polymorph of para-bromobenzophenone. It is established that the contribution corresponding to the thermal conductivity of the orientationally ordered crystal structure depends on the molecular crystal packing, and the characteristic activation energy of the thermal activation contribution, which is caused by the intramolecular vibrations of the C-Br bond, does not depend on the grain size or on the structure of the sample.

Um enfoque antropológico para o ensino de astronomia no nível médio

NASA Astrophysics Data System (ADS)

Costa, G. B.; Jafelice, L. C.

2003-08-01

Há uma enorme carência de materiais didático-pedagógicos em astronomia para professores do ensino médio, sobretudo materiais que explorem também aspectos humanísticos. A origem do Universo é um bom exemplo desta constatação central. Embora tal origem teve explicações culturais diversas, os professores não têm informações sobre isso e muito menos material que trabalhe diferentes visões de mundo e treinamento que os capacite a abordá-las devidamente. Conseqüentemente o ensino de astronomia costuma ser tecnicista e dissociado do aspecto humano que alimenta o grande interesse e curiosidade que esses temas despertam. Aqui apresentamos propostas visando contribuir para reverter esse quadro e trabalhamos distintas visões de Universo: espontâneas, autóctones e científicas. Desenvolvemos práticas, materiais instrucionais e textos para viabilizar a adoção de um enfoque antropológico para o ensino de astronomia no nível médio, no qual as culturas humanística e científica sejam integradas de uma maneira contextualizada e eficaz para aquele ensino. Estas propostas foram aplicadas em um curso de treinamento para professores da rede pública de diferentes disciplinas. A receptividade dos professores à abordagem proposta e os resultados alcançados foram muito estimulantes. Destes, destacamos: produção de roteiros de atividades; desenvolvimento de práticas didático-pedagógicas específicas (e.g., encenação de mitos; dança primordial guarani; "criação" de constelações e interpretações pluriculturais; etc.); e sugestões concretas para a efetiva realização de um ensino interdisciplinar contextualizado, onde questões cosmogônicas servem de mote para iniciar tal ensino. Discutimos estes resultados e como o enfoque adotado pode instrumentalizar os professores para leituras de mundo que incluem naturalmente aspectos culturais, sociais e históricos associados aos temas estudados. (PPGECNM/UFRN; PRONEX/FINEP; NUPA/USP; Temáticos/FAPESP)

Base de linhas moleculares para síntese espectral estelar

NASA Astrophysics Data System (ADS)

Milone, A.; Sanzovo, G.

2003-08-01

A análise das abundâncias quí micas fotosféricas em estrelas do tipo solar ou tardia, através do cálculo teórico de seus espectros, emprega a espectroscopia de alta resolução e necessita de uma base representativa de linhas atômicas e moleculares com suas respectivas constantes bem determinadas. Nesse trabalho, utilizamos como ponto de partida as extensas listas de linhas espectrais de sistemas eletrônicos de algumas moléculas diatômicas compiladas por Kurucz para a construção de uma base de linhas moleculares para a sí ntese espectral estelar. Revisamos as determinações dos fatores rotacionais de Honl-London das forças de oscilador das linhas moleculares, para cada banda vibracional de alguns sistemas eletrônicos, seguindo a regra usual de normalização. Usamos as forças de oscilador eletrônicas da literatura. Os fatores vibracionais de Franck-Condon de cada banda foram especialmente recalculados empregando-se novas constantes moleculares. Reproduzimos, com êxito, as absorções espectrais de determinadas bandas eletrônicas-vibracionais das espécies moleculares C12C12, C12N14 e Mg24H em espectros de estrelas de referência como o Sol e Arcturus.

Comparison of estrogen-derived ortho-quinone and para-quinol concerning induction of oxidative stress.

PubMed

Rivera-Portalatin, Nilka M; Vera-Serrano, José L; Prokai-Tatrai, Katalin; Prokai, Laszlo

2007-01-01

Ortho-quinones formed from catechol estrogens are considered prooxidants due to the production of superoxide radical anions through redox cycling via semiquinones. Para-quinols have been identified as novel metabolites of and as the major products of hydroxyl-radical scavenging by estrogens. Cycling of these compounds has also been discovered, because they are converted back to the parent estrogen via reductive aromatization in vitro and in vivo. We hypothesized that, unlike ortho-quinones, para-quinols do not induce oxidative stress due to this cycling. Like the estrogen itself, the 17beta-estradiol-derived para-quinol (10beta,17beta-dihydroxyestra-1,4-diene-3-one) did not induce oxidative stress, as the rate of hydrogen peroxide production during the incubations of the compounds in various tissue homogenates was not significantly different from that of the control experiments performed without the addition of a test compound. We also confirmed that the estrogen metabolite estra-1,5(10)-dien-3,4,17-trione (estrone 3,4-quinone) was a profound prooxidant due to redox cycling, especially in uterine tissue. Therefore, we concluded that para-quinols do not induce oxidative stress.

Comparison of estrogen-derived ortho-quinone and para-quinol concerning induction of oxidative stress

PubMed Central

Rivera-Portalatin, Nilka M.; Vera-Serrano, José L.; Prokai-Tatrai, Katalin; Prokai, Laszlo

2009-01-01

Ortho-quinones formed from catechol estrogens are considered prooxidants due to the production of superoxide radical anions through redox cycling via semiquinones. Para-quinols have been identified as novel metabolites of and as the major products of hydroxyl-radical scavenging by estrogens. Cycling of these compounds has also been discovered, because they are converted back to the parent estrogen via reductive aromatization in vitro and in vivo. We hypothesized that, unlike ortho-quinones, para-quinols do not induce oxidative stress due to this cycling. Like the estrogen itself, the 17β-estradiol-derived para-quinol (10β,17β-dihydroxyestra-1,4-diene-3-one) did not induce oxidative stress, as the rate of hydrogen peroxide production during the incubations of the compounds in various tissue homogenates was not significantly different from that of the control experiments performed without the addition of a test compound. We also confirmed that the estrogen metabolite estra-1,5(10)-dien-3,4,17-trione (estrone 3,4-quinone) was a profound prooxidant due to redox cycling, especially in uterine tissue. Therefore, we concluded that para-quinols do not induce oxidative stress. PMID:17582759

A new approach to the study of therapeutic work in the transference.

PubMed

Pessier, J; Stuart, J

2000-02-01

Vergangenheit der Fall war. Cet article propose une nouvelle méthode pour évaluer les effets du travail sur le transfert entre thérapeute et patient. Ce travail est souvent difficile pour le patient, et il peut y avoir un pattern caractéristique de délai entre une înterprétation de transfert et son effet thérapeutique. Pour expliquer ce délai, nous avons évalué les réponses des patients à des interprétatios au cours de séances entières. C'est les narrations des patients sur d'autres, ou Episodes Relationnels (ERs), qui ont constitué les unités de base de cette étude. Dans un échantillon de 3 séances consécutives venant de 3 cas psychodynamiques, nous avons identifié plusieurs moments où le traail sur le transfert semblait avoir un effet inhibitoire initial, mais favorisait le progrès en regardant la séance entière. Nous recommandons pour de futures études sur l'effet des interprétations de prendre des segments plus longs et cliniquement significatifs du récit du patient que ceux utilisés dans le passé. Este artículo propone un nuevo método para evaluar los efectos del trabajo de terapeuta y paciente en la transferencia. El trabajo en la transferencia es, con frecuencia, dificil para el paciente y puede mostrar un lapso característico entre una interpretación transferencial y sus efectos terapéuticos. Para explicar este lapso, hemos evaluado las respuestas del paciente a las interpretaciones a lo largo de sesiones enteras. Como unidad de estudio se usaron las narrativas de los pacientes acerca de otros, o sea, los episodios relacionales (REs). En una muestra de tres sesiones consecutivas tomadas de tres casos psicodinámicos, identificamos varioss casos en los que la trasferencia parecía tener un efecto inicial inhibitorio, aunque se vio que a lo largo de la sesión facilitaba el progreso. Recomendamos que, para examinar los efectos de las interpretaciones, los futuros estudios usen segmentos más largos y clínicamente más significativos

Traumatismo craneoencefálico leve

PubMed Central

Ortega Zufiría, José Manuel; Prieto, Noemí Lomillos; Cuba, Bernardino Choque; Degenhardt, Martin Tamarit; Núñez, Pedro Poveda; López Serrano, María Remedios; López Raigada, Azahara Belén

2018-01-01

Resumen Introducción y objetivo: El TCE leve representa un problema sanitario de enorme interés debido a que un número significativo de enfermos con trauma leve desarrollará complicaciones potencialmente mortales. El objetivo de este estudio ha sido describir una serie amplia de pacientes adultos, mayores de 14 años, que sufren TCE leve, atendidos en el Hospital Universitario de Getafe, entre los años 2010 y 2015 (n = 2480), estudiar el perfil epidemiológico y analizar el diagnóstico y el tratamiento efectuados, así como establecer los principales factores pronósticos que influyen en el resultado final. Método: Se ha realizado un estudio retrospectivo, de revisión de historias clínicas, analizando los resultados con estudio estadístico bivariable y multivariable. Resultados: El TCE leve es más frecuente en varones, y el mecanismo causante más común en nuestro medio es el accidente de tráfico. Se propone un modelo de clasificación de pacientes según grupos de riesgo, que los subdivide en riesgo bajo, intermedio o alto, que se correlaciona bien con la probabilidad de desarrollar complicación intracraneal, y, consecuentemente, con el resultado final. Se discute la indicación de la radiografía simple de cráneo y de la Tomografía Computarizada (TC), así como del ingreso hospitalario para observación neurológica. Conclusiones: En este estudio, la presencia de focalidad neurológica en la exploración clínica, la edad, las alteraciones de la coagulación y la existencia de fractura en la radiografía simple se relacionan con mayor posibilidad de desarrollar lesiones traumáticas intracraneales y con peor pronóstico final. La escala de Glasgow para el Coma es deficitaria en la determinación del resultado final del paciente que sufre TCE, porque no considera variables tales como la amnesia o la pérdida de conocimiento, muy frecuentes en el traumatismo craneoencefálico leve. PMID:29430327

Cardiac Magnetic Resonance-Verified Myocardial Fibrosis in Chagas Disease: Clinical Correlates and Risk Stratification.

PubMed

Uellendahl, Marly; Siqueira, Maria Eduarda Menezes de; Calado, Eveline Barros; Kalil-Filho, Roberto; Sobral, Dário; Ribeiro, Clébia; Oliveira, Wilson; Martins, Silvia; Narula, Jagat; Rochitte, Carlos Eduardo

2016-11-01

Rassi. As análises morfológica e funcional mostraram significativas diferenças entre os 2 grupos (p < 0,001). Houve ainda uma forte correlação entre a extensão da FM e o escore de Rassi (r = 0,76). A RMC é uma importante técnica para avaliar pacientes com DC, ressaltando as diferenças morfológicas e funcionais em todas as apresentações clínicas. A forte correlação entre o escore de Rassi e a extensão da FM detectada por RMC enfatiza seu papel na estratificação prognóstica de pacientes com DC.

Anatomic Distribution of Fluorodeoxyglucose-Avid Para-aortic Lymph Nodes in Patients With Cervical Cancer

DOE Office of Scientific and Technical Information (OSTI.GOV)

Takiar, Vinita; Fontanilla, Hiral P.; Eifel, Patricia J.

Purpose: Conformal treatment of para-aortic lymph nodes (PAN) in cervical cancer allows dose escalation and reduces normal tissue toxicity. Currently, data documenting the precise location of involved PAN are lacking. We define the spatial distribution of this high-risk nodal volume by analyzing fluorodeoxyglucose (FDG)-avid lymph nodes (LNs) on positron emission tomography/computed tomography (PET/CT) scans in patients with cervical cancer. Methods and Materials: We identified 72 PANs on pretreatment PET/CT of 30 patients with newly diagnosed stage IB-IVA cervical cancer treated with definitive chemoradiation. LNs were classified as left-lateral para-aortic (LPA), aortocaval (AC), or right paracaval (RPC). Distances from the LNmore » center to the closest vessel and adjacent vertebral body were calculated. Using deformable image registration, nodes were mapped to a template computed tomogram to provide a visual impression of nodal frequencies and anatomic distribution. Results: We identified 72 PET-positive para-aortic lymph nodes (37 LPA, 32 AC, 3 RPC). All RPC lymph nodes were in the inferior third of the para-aortic region. The mean distance from aorta for all lymph nodes was 8.3 mm (range, 3-17 mm), and from the inferior vena cava was 5.6 mm (range, 2-10 mm). Of the 72 lymph nodes, 60% were in the inferior third, 36% were in the middle third, and 4% were in the upper third of the para-aortic region. In all, 29 of 30 patients also had FDG-avid pelvic lymph nodes. Conclusions: A total of 96% of PET positive nodes were adjacent to the aorta; PET positive nodes to the right of the IVC were rare and were all located distally, within 3 cm of the aortic bifurcation. Our findings suggest that circumferential margins around the vessels do not accurately define the nodal region at risk. Instead, the anatomical extent of the nodal basin should be contoured on each axial image to provide optimal coverage of the para-aortic nodal compartment.« less

The ortho:para-H_2 ratio in C- and J-type shocks

NASA Astrophysics Data System (ADS)

Wilgenbus, D.; Cabrit, S.; Pineau des Forêts, G.; Flower, D. R.

2000-04-01

We have computed extensive grids of models of both C- and J-type planar shock waves, propagating in dark, cold molecular clouds, in order to study systematically the behaviour of the ortho:para-H_2 ratio. Careful attention was paid to both macroscopic (dynamical) and microscopic (chemical reactions and collisional population transfer in H_2) aspects. We relate the predictions of the models to observational determinations of the ortho:para-H_2 ratio using both pure rotational lines and rovibrational lines. As an illustration, we consider ISO and ground-based H_2 observations of HH 54. Neither planar C-type nor planar J-type shocks appear able to account fully for these observations. Given the additional constraints provided by the observed ortho:para H_2 ratios, a C-type bowshock, or a C-type precursor followed by a J-type shock, remain as plausible models. Tables~2a-f and 4a-f are only available in electronic form at the CDS via anonymous ftp to cdsarc.u-strasbg.fr (130.79.128.5) or via http://cdsweb.u-strasbg.fr/Abstract.html

Integrating Visualization Applications, such as ParaView, into HEP Software Frameworks for In-situ Event Displays

NASA Astrophysics Data System (ADS)

Lyon, A. L.; Kowalkowski, J. B.; Jones, C. D.

2017-10-01

ParaView is a high performance visualization application not widely used in High Energy Physics (HEP). It is a long standing open source project led by Kitware and involves several Department of Energy (DOE) and Department of Defense (DOD) laboratories. Futhermore, it has been adopted by many DOE supercomputing centers and other sites. ParaView is unique in speed and efficiency by using state-of-the-art techniques developed by the academic visualization community that are often not found in applications written by the HEP community. In-situ visualization of events, where event details are visualized during processing/analysis, is a common task for experiment software frameworks. Kitware supplies Catalyst, a library that enables scientific software to serve visualization objects to client ParaView viewers yielding a real-time event display. Connecting ParaView to the Fermilab art framework will be described and the capabilities it brings discussed.

Identification of an intact ParaHox cluster with temporal colinearity but altered spatial colinearity in the hemichordate Ptychodera flava

PubMed Central

2013-01-01

Background ParaHox and Hox genes are thought to have evolved from a common ancestral ProtoHox cluster or from tandem duplication prior to the divergence of cnidarians and bilaterians. Similar to Hox clusters, chordate ParaHox genes including Gsx, Xlox, and Cdx, are clustered and their expression exhibits temporal and spatial colinearity. In non-chordate animals, however, studies on the genomic organization of ParaHox genes are limited to only a few animal taxa. Hemichordates, such as the Enteropneust acorn worms, have been used to gain insights into the origins of chordate characters. In this study, we investigated the genomic organization and expression of ParaHox genes in the indirect developing hemichordate acorn worm Ptychodera flava. Results We found that P. flava contains an intact ParaHox cluster with a similar arrangement to that of chordates. The temporal expression order of the P. flava ParaHox genes is the same as that of the chordate ParaHox genes. During embryogenesis, the spatial expression pattern of PfCdx in the posterior endoderm represents a conserved feature similar to the expression of its orthologs in other animals. On the other hand, PfXlox and PfGsx show a novel expression pattern in the blastopore. Nevertheless, during metamorphosis, PfXlox and PfCdx are expressed in the endoderm in a spatially staggered pattern similar to the situation in chordates. Conclusions Our study shows that P. flava ParaHox genes, despite forming an intact cluster, exhibit temporal colinearity but lose spatial colinearity during embryogenesis. During metamorphosis, partial spatial colinearity is retained in the transforming larva. These results strongly suggest that intact ParaHox gene clustering was retained in the deuterostome ancestor and is correlated with temporal colinearity. PMID:23802544

Longitudinal nuclear spin relaxation of ortho- and para-hydrogen dissolved in organic solvents.

PubMed

Aroulanda, Christie; Starovoytova, Larisa; Canet, Daniel

2007-10-25

The longitudinal relaxation time of ortho-hydrogen (the spin isomer directly observable by NMR) has been measured in various organic solvents as a function of temperature. Experimental data are perfectly interpreted by postulating two mechanisms, namely intramolecular dipolar interaction and spin-rotation, with activation energies specific to these two mechanisms and to the solvent in which hydrogen is dissolved. This permits a clear separation of the two contributions at any temperature. Contrary to the self-diffusion coefficients at a given temperature, the rotational correlation times extracted from the dipolar relaxation contribution do not exhibit any definite trend with respect to solvent viscosity. Likewise, the spin-rotation correlation time obeys Hubbard's relation only in the case of hydrogen dissolved in acetone-d6, yielding in that case a spin-rotation constant in agreement with literature data. Concerning para-hydrogen, which is NMR-silent, the only feasible approach is to dissolve para-enriched hydrogen in these solvents and to follow the back-conversion of the para-isomer into the ortho-isomer. Experimentally, this conversion has been observed to be exponential, with a time constant assumed to be the relaxation time of the singlet state (the spin state of the para-isomer). A theory, based on intermolecular dipolar interactions, has been worked out for explaining the very large values of these relaxation times which appear to be solvent-dependent.

Cross-reactions among parabens, para-phenylenediamine, and benzocaine: a retrospective analysis of patch testing.

PubMed

Turchin, Irina; Moreau, Linda; Warshaw, Erin; Sasseville, Denis

2006-12-01

Parabens are alkyl ester derivatives of para-hydroxybenzoic acid and are the most commonly used preservatives in the cosmetic industry. Cross-reactions with para-amino compounds, namely, benzocaine and para-phenylenediamine (PPD), have been reported but are thought to be extremely rare. To evaluate the rate of cross-reactivity between parabens, PPD, and benzocaine in a population of patients patch-tested in a hospital-based contact dermatitis clinic. A retrospective analysis of 4,368 patients consecutively patch-tested between July 1989 and June 2005. Our study demonstrated that the rate of cross-reactions to parabens in PPD- and benzocaine-positive patients combined is 2%. This cross-reaction rate is significant in the tested population but still falls within the previously reported rates of sensitivity to parabens in the general population (0 to 3.5%).

Value of the Qrs-T Angle in Predicting the Induction of Ventricular Tachyarrhythmias in Patients with Chagas Disease.

PubMed

Zampa, Hugo Bizetto; Moreira, Dalmo Ar; Ferreira Filho, Carlos Alberto Brandão; Souza, Charles Rios; Menezes, Camila Caldas; Hirata, Henrique Seichii; Armaganijan, Luciana Vidal

2014-10-28

.95; CI 0.99-15.82; p = 0.052). The EF also emerged as a predictor of induction of VT / VF: for each point increase in EF, there was a 4% reduction in the rate of sustained ventricular arrhythmia on EPS. Conclusions: Changes in the QRS-T angle and decreases in EF were associated with an increased risk of induction of VT / VF on EPS.Fundamento: O ângulo QRS-T mostra correlação com prognóstico em pacientes com insuficiência cardíaca e doença coronariana, traduzido por um aumento na mortalidade proporcional ao aumento na diferença entre os eixos do complexo QRS e da onda T no plano frontal. Até hoje, nenhuma informação a este respeito foi obtida em pacientes com cardiopatia chagásica. Objetivo: Correlacionar o ângulo QRS-T com a indução de taquicardia ventricular / fibrilação ventricular (TV / FV) em chagásicos durante estudo eletrofisiológico (EEF). Métodos: Estudo caso-controle em centro terciário. Pacientes sem indução de TV / FV ao EEF foram utilizados como controles. O ângulo QRS-T foi categorizado como normal (0-105º), limítrofe (105-135º) e anormal (135-180º). As diferenças entre os grupos foram analisadas pelo teste t ou teste de Mann-Whitney para variáveis contínuas, e teste exato de Fisher ou qui-quadrado para variáveis categóricas. Valores de p < 0,05 foram considerados significativos. Resultados: De 116 pacientes submetidos ao EEF, 37,9% foram excluídos por estarem com dados incompletos / prontuários inativos ou pela impossibilidade de se calcular corretamente o ângulo QRS-T (presença de bloqueio de ramo esquerdo e fibrilação atrial). De 72 pacientes incluídos, 31 induziram TV / FV ao EEF. Destes, o ângulo QRS-T se encontrava normal em 41,9%, limítrofe em 12,9% e anormal em 45,2%. No grupo de pacientes sem indução de TV / FV, o ângulo QRS-T se encontrava normal em 63,4%, limítrofe em 14,6% e anormal em 17,1% (p = 0,04). Quando comparados aos pacientes com ângulo QRS-T normal, o risco de indução de TV / FV nos

Revision curricular a partir de un analisis comparativo de las discrepancias en los curriculos de una escuela de optometria en Puerto Rico con las competencias requeridas para las agencias de revalida y acreditacion 2004

NASA Astrophysics Data System (ADS)

Rivera Pacheco, Andres

El proposito de esta investigacion, un estudio cualitativo de caso, fue comparar y contrastar el curriculo vigente de la Escuela de Optometria de la UIAPR con las competencias y estandares requeridos por las agencias de acreditacion y de revalida. Con este proposito, decidimos realizar una revision y un analisis de documentos: el prontuario de cada uno de los cursos de los curriculos implantados en el 1993 y en el 2001; las competencias y estandares establecidos por las agencias de revalida y de acreditacion; y las estadisticas en las que se analiza el porcentaje de estudiantes que aprueban cada una de las partes de los examenes de revalida entre el 1998 al 2003. Se realizaron entrevistas dirigidas para dar apoyo y complementar la revision y el analisis de estos documentos. Los participantes de las entrevistas fueron tres estudiantes de la clase de optometria del 2004 (ultima clase del curriculo del 1993); tres estudiantes de la clase de optometria del 2005 (primera clase graduanda del curriculo vigente) y tres profesores y/o directores de los Departamentos de Ciencias Basicas, Ciencias Clinicas y Cuidado al Paciente. Esta investigacion se enmarco en el modelo de evaluacion curricular de discrepancia de Malcolm Provus y en el modelo de desarrollo basado en competencias. Uno de los hallazgos mas importantes del estudio es que los cambios que se implantaron al curriculo del 2001 no han logrado que los estudiantes mejoren su ejecucion en los examenes de revalida. Por otro lado, se encontro que el curriculo vigente atiende completamente los estandares de la practica de Optometria, pero no las competencias. Esta informacion fue validada mediante el uso de una tabla de cotejo para el analisis de los cursos y de la informacion obtenida de las entrevistas. El estudio determina y concluye que existen discrepancias entre los prontuarios de los cursos del curriculo y las competencias requeridas por la agencia de revalida. Segundo, que el Departamento de Ciencias Basicas es el

Aplicación del Teorema de Nekhorochev para tiempos de estabilidad en Mecánica Celeste

NASA Astrophysics Data System (ADS)

Miloni, O.; Núñez, J.; Brunini, A.

En Mecánica Celeste, uno de los problemas centrales consiste en la determinación de los tiempos de estabilidad. El teorema de Nekhorochev proporciona un método para dicho estudio, para un sistema determinado por un hamiltoniano descripto en las variables acción-ángulo. El trabajo consiste en la acotación tanto del potencial perturbador y de la matriz hessiana del hamiltoniano integrable para determinar luego el tiempo de estabilidad de dicho sistema, donde por estabilidad se entiende la separación en norma infinito en el espacio de las acciones.

Terapia fibrinolítica sistêmica no tromboembolismo pulmonar

PubMed Central

Ceresetto, José Manuel; Marques, Marcos Arêas

2017-01-01

Resumo O tromboembolismo pulmonar permanece como um grande desafio terapêutico para os médicos especialistas, pois, apesar de todo investimento e desenvolvimento em seu diagnóstico, profilaxia e tratamento, essa condição continua sendo a principal causa de morte evitável em ambiente hospitalar. Ainda restam muitas dúvidas em relação a qual perfil de paciente vai se beneficiar de fato da terapia fibrinolítica sistêmica, sem ficar exposto a um grande risco de sangramento. A estratificação de risco e a avaliação do prognóstico do evento, através de escores clínicos de insuficiência ventricular direita, marcadores de dilatação e disfunção do ventrículo direito e avaliação da massa trombótica, associados ou de forma isolada, são ferramentas que podem auxiliar na identificação do paciente que irá se beneficiar dessa terapia. Os únicos consensos em relação à terapia fibrinolítica no tratamento do tromboembolismo pulmonar são: não deve ser indicada de forma rotineira; nenhum dos escores ou marcadores, isoladamente, devem justificar seu uso; e os pacientes com instabilidade hemodinâmica são os mais beneficiados. Além disto, deve-se avaliar cada caso em relação ao risco de sangramento, especialmente no sistema nervoso central. PMID:29930636

Atlas de aves: Un metodo para documentar distribucion y seguir poblaciones

USGS Publications Warehouse

Robbins, C.S.; Dowell, B.A.; Dawson, D.K.; Alvarez-Lopez, Humberto; Kattan, Gustavo; Murcia, Carolina

1988-01-01

Los Atlas de Aves son proyectos nacionales o regionalies para trazar en mapas la distribucion en reproduccion de cada especie de ave. Ese procedimiento se esta usando en Europa, Australia, Nueva Zelanda, Norteamerica, y partes de Africa. El tama?o de los cuadrados varia de medio grado de latitud y Iongitud hasta 5 x 5 km. El trabajo de campo de cada proyecto exige aproxlmadamente cinco a?os, pero los aficionados pueden llevar a cabo la mayor parte del trabajo. Es posible almacenar los resultados en un computador personal. Hay muchos beneficios: (I) se presenta la distribucion corriente de las aves de la nacion, del estado, o de la Iocalidad; (2) se desarrolla nueva informacion especialmente sobre especies raras o en peligro; (3) se descubren areas que tienen una avlfauna sobresaliente o habitats raros y ayuda a su proteccion, (4) se documentan cambios de dlstribucion; (5) se pueden usar para documentar cambios de poblacion, especialmente en los tropicos donde otros metodos son mas dificiles de usar porque hay muchas especies y no hay muchos observadores calificados en la identificacion de sonidos de las aves; (6) son proyectos buenos de investigacion para estudiantes graduados; (7) los turistas y los jefes de excursiones de historia natural pueden contribuir con muchas informaciones

The "drinking-buddy" scale as a measure of para-social behavior.

PubMed

Powell, Larry; Richmond, Virginia P; Cantrell-Williams, Glenda

2012-06-01

Para-social behavior is a form of quasi-interpersonal behavior that results when audience members develop bonds with media personalities that can resemble interpersonal social interaction, but is not usually applied to political communication. This study tested whether the "Drinking-Buddy" Scale, a simple question frequently used in political communication, could be interpreted as a single-item measure of para-social behavior with respect to political candidates in terms of image judgments related to interpersonal attraction and perceived similarity to self. The participants were college students who had voted in the 2008 election. They rated the candidates, Obama or McCain, as drinking buddies and then rated the candidates' perceived similarity to themselves in attitude and background, and also the social and task attraction to the candidate. If the drinking-buddy rating serves as a proxy measure for para-social behavior, then it was expected that participants' ratings for all four kinds of similarity to and attraction toward a candidate would be higher for the candidate they chose as a drinking buddy. The directional hypotheses were supported for interpersonal attraction, but not for perceived similarity. These results indicate that the drinking-buddy scale predicts ratings of interpersonal attraction, while voters may view perceived similarity as an important but not essential factor in their candidate preference.

MAÑANA: U.S. EPA, National Econ Corporation demostrarán prácticas seguras de trabajo con plomo para contratistas, se anunciará compromiso para reducir la exposición al plomo en la región

EPA Pesticide Factsheets

EPA News Release: MAÑANA: U.S. EPA, National Econ Corporation demostrarán prácticas seguras de trabajo con plomo para contratistas, se anunciará compromiso para reducir la exposición al plomo en la región

Integrating Visualization Applications, such as ParaView, into HEP Software Frameworks for In-situ Event Displays

DOE Office of Scientific and Technical Information (OSTI.GOV)

Lyon, A. L.; Kowalkowski, J. B.; Jones, C. D.

ParaView is a high performance visualization application not widely used in High Energy Physics (HEP). It is a long standing open source project led by Kitware and involves several Department of Energy (DOE) and Department of Defense (DOD) laboratories. Futhermore, it has been adopted by many DOE supercomputing centers and other sites. ParaView is unique in speed and efficiency by using state-of-the-art techniques developed by the academic visualization community that are often not found in applications written by the HEP community. In-situ visualization of events, where event details are visualized during processing/analysis, is a common task for experiment software frameworks.more » Kitware supplies Catalyst, a library that enables scientific software to serve visualization objects to client ParaView viewers yielding a real-time event display. Connecting ParaView to the Fermilab art framework will be described and the capabilities it brings discussed.« less

Para rubber seed oil: new promising unconventional oil for cosmetics.

PubMed

Lourith, Nattaya; Kanlayavattanakul, Mayuree; Sucontphunt, Apirada; Ondee, Thunnicha

2014-01-01

Para rubber seed was macerated in petroleum ether and n-hexane, individually, for 30 min. The extraction was additionally performed by reflux and soxhlet for 6 h with the same solvent and proportion. Soxhlet extraction by petroleum ether afforded the greatest extractive yield (22.90 ± 0.92%). Although antioxidant activity by means of 1, 1-diphenyl-2-picrylhydrazyl (DPPH) assay was insignificantly differed in soxhleted (8.90 ± 1.15%) and refluxed (9.02 ± 0.71%) by n-hexane, soxhlet extraction by n-hexane was significantly (p < 0.05) potent scavenged 2,2'-azino-bis(3-ethylbenzothaiazoline)-6-sulfonic acid) or ABTS radical with trolox equivalent antioxidant capacity (TEAC) of 66.54 ± 6.88 mg/100 g oil. This extract was non cytotoxic towards normal human fibroblast cells. In addition, oleic acid and palmitic acid were determined at a greater content than in the seed of para rubber cultivated in Malaysia, although linoleic and stearic acid contents were not differed. This bright yellow extract was further evaluated on other physicochemical characters. The determined specific gravity, refractive index, iodine value, peroxide value and saponification value were in the range of commercialized vegetable oils used as cosmetic raw material. Therefore, Para rubber seed oil is highlighted as the promising ecological ingredient appraisal for cosmetics. Transforming of the seed that is by-product of the important industrial crop of Thailand into cosmetics is encouraged accordingly.

Conversion of para and ortho hydrogen in the Jovian planets

NASA Technical Reports Server (NTRS)

Massie, S. T.; Hunten, D. M.

1982-01-01

A mechanism is proposed which partially equilibrates the para and ortho rotational levels of molecular hydrogen in the atmospheres of Jupiter, Saturn, and Uranus. Catalytic reactions between the free-radical surface sites of aerosol particles and hydrogen modecules yield significant equilibration near 1 bar pressure, if the efficiency of conversion per collision is between 10 to the -8th and 10 to the -10th and the effective eddy mixing coefficient is 10,000 sq cm/sec. At lower pressures the ortho-para ratio retains the value at the top of the cloud layer, except for a very small effect from conversion in the thermosphere. The influence of conversion on the specific heat and adiabatic lapse rate is also investigated. The effect is found to be generally small, though is can rise to 10% inside the aerosol layer.

Para-hydrogen induced polarization of Si-29 NMR resonances as a potentially useful tool for analytical applications.

PubMed

Ellena, Silvano; Viale, Alessandra; Gobetto, Roberto; Aime, Silvio

2012-08-01

Para-hydrogen-induced polarization effects have been observed in the (29)Si NMR spectra of trimethylsilyl para-hydrogenated molecules. The high signal enhancements and the long T(1) values observed for the (29)Si hyperpolarized resonances point toward the possibility of using (29)Si for hyperpolarization applications. A method for the discrimination of multiple compounds and/or complex mixtures of hydroxylic compounds (such as steroids), consisting of the silylization of alcoholic functionalities with an unsaturated silylalkyl moiety and subsequent reaction with para-H(2), is proposed. Copyright © 2012 John Wiley & Sons, Ltd.

Splenic artery aneurysm.

PubMed

Tcbc-Rj, Rui Antônio Ferreira; Ferreira, Myriam Christina Lopes; Ferreira, Daniel Antônio Lopes; Ferreira, André Gustavo Lopes; Ramos, Flávia Oliveira

2016-01-01

Splenic artery aneurysms - the most common visceral artery aneurysms - are found most often in multiparous women and in patients with portal hypertension. Indications for treatment of splenic artery aneurysm or pseudoaneurysm include specific symptoms, female gender and childbearing age, presence of portal hypertension, planned liver transplantation, a pseudoaneurysm of any size, and an aneurysm with a diameter of more than 2.5cm. Historically, the treatment of splenic artery aneurysm has been surgical ligation of the splenic artery, ligation of the aneurysm, or aneurysmectomy with or without splenectomy, depending on the aneurysm location. There are other percutaneous interventional techniques. The authors present a case of a splenic artery aneurysm in a 51-year-old woman, detected incidentally. RESUMO Aneurismas da artéria esplênica - os aneurismas arteriais viscerais mais comuns - são encontrados mais frequentemente em mulheres multíparas e em pacientes com hipertensão portal. As indicações para o seu tratamento incluem sintomas específicos, sexo feminino e idade fértil, presença de hipertensão portal, paciente em fila de transplante hepático, um pseudoaneurisma de qualquer tamanho, e um aneurisma com um diâmetro superior a 2,5cm. Historicamente, o tratamento do aneurisma da artéria esplênica tem sido a ligadura cirúrgica da artéria esplênica, a ligadura do aneurisma ou a aneurismectomia, com ou sem esplenectomia, dependendo do local do aneurisma. Existem outras técnicas intervencionistas percutâneas. Os autores apresentam o caso de um aneurisma de artéria esplênica em uma mulher de 51 anos de idade, diagnosticado incidentalmente.

Vibration and Vibration-Torsion Levels of the S_{1} and Ground Cationic D_{0}^{+} States of Para-Fluorotoluene and Para-Xylene Below 1000 \\wn

NASA Astrophysics Data System (ADS)

Tuttle, William Duncan; Gardner, Adrian M.; Whalley, Laura E.; Wright, Timothy G.

2017-06-01

We have employed resonance-enhanced multiphoton ionisation (REMPI) spectroscopy and zero-kinetic-energy (ZEKE) spectroscopy to investigate the first excited electronic singlet (S_{1}) state and the cationic ground state (D_{0}^{+}) of para-fluorotoluene (pFT) and para-xylene (pXyl). Spectra have been recorded via a large number of selected intermediate levels, to support assignment of the vibration and vibration-torsion levels in these molecules and to investigate possible couplings. The study of levels in this region builds upon previous work on the lower energy regions of pFT and pXyl and here we are interested in how vibration-torsion (vibtor) levels might combine and interact with vibrational ones, and so we consider the possible couplings which occur. Comparisons between the spectra of the two molecules show a close correspondence, and the influence of the second methyl rotor in para-xylene on the onset of intramolecular vibrational redistribution (IVR) in the S_{1} state is a point of interest. This has bearing on future work which will need to consider the role of both more flexible side chains of substituted benzene molecules, and multiple side chains. A. M. Gardner, W. D. Tuttle, L. Whalley, A. Claydon, J. H. Carter and T. G. Wright, J. Chem. Phys., 145, 124307 (2016). A. M. Gardner, W. D. Tuttle, P. Groner and T. G. Wright, J. Chem. Phys., (2017, in press). W. D. Tuttle, A. M. Gardner, K. O'Regan, W. Malewicz and T. G. Wright, J. Chem. Phys., (2017, in press).

Melhoramentos no código Wilson-Devinney para binárias eclipsantes

NASA Astrophysics Data System (ADS)

Vieira, L. A.; Vaz, L. P. R.

2003-08-01

A análise de curvas de luz e velocidades radiais de sistemas binários eclipsantes pode ser feita por meio de vários modelos. Um desses é o Modelo Wilson-Devinney (WD). Ao longo dos anos, esse modelo sofreu várias alterações em seus códigos principais, com a finalidade de torná-lo mais consistente tanto fíisica como numericamente. O Modelo WD tem sido melhorado de várias maneiras em seus dois códigos: um para a predição das curvas de luz teórica e de velocidade radiais e outra para as soluções destas curvas. Teoricamente, na física do modelo, nós introduzimos a possibilidade de levar em conta os efeitos do movimento apsidal. Numericamente, nós introduzimos a possibilidade de usar o Método SIMPLEX no procedimento da solução, como uma alternativa para o já implementado Método de Mínimos Quadrados (Least Squares Method). Estas modificações, juntamente com outras já introduzidas pelo nosso grupo anteriormente, tornam o código mais eficiente na solução das curvas de luz e de velocidade radiais de binárias eclipsantes. Como o modelo tem sido usado para analisar sistemas com componentes pré-sequência principal (TY CrA, Casey et al. 1998, Vaz et al. 1998), SM 790, Stassun et al. 2003), este melhoramento beneficiará estes casos também. Apresentamos os resultados obtidos com a modificação do código WD por meio do uso de dados da estrela GL Carinae, comprovando, (1) que os parâmetros orbitais calculados por nós são coerentes com os obtidos anteriormente na literatura (Giménez & Clausen, 1986) e com os obtidos por Faria (1987), e (2) que a implementação do Método SIMPLEX torna o código mais lento mas completamente consistente internamente e evita os problemas gerados pelo uso do Método de Mínimos Quadrados, tais como imprecisão no cálculo das derivadas parciais e convergência para mínimos locais.

Determination of the ortho to para ratio of H2Cl+ and H2O+ from submillimeter observations.

PubMed

Gerin, Maryvonne; de Luca, Massimo; Lis, Dariusz C; Kramer, Carsten; Navarro, Santiago; Neufeld, David; Indriolo, Nick; Godard, Benjamin; Le Petit, Franck; Peng, Ruisheng; Phillips, Thomas G; Roueff, Evelyne

2013-10-03

The opening of the submillimeter sky with the Herschel Space Observatory has led to the detection of new interstellar molecular ions, H2O(+), H2Cl(+), and HCl(+), which are important intermediates in the synthesis of water vapor and hydrogen chloride. In this paper, we report new observations of H2O(+) and H2Cl(+) performed with both Herschel and ground-based telescopes, to determine the abundances of their ortho and para forms separately and derive the ortho-to-para ratio. At the achieved signal-to-noise ratio, the observations are consistent with an ortho-to-para ratios of 3 for both H2O(+) and H2Cl(+), in all velocity components detected along the lines-of-sight to the massive star-forming regions W31C and W49N. We discuss the mechanisms that contribute to establishing the observed ortho-to-para ratio and point to the need for a better understanding of chemical reactions, which are important for establishing the H2O(+) and H2Cl(+) ortho-to-para ratios.

Reversible interactions with para-hydrogen enhance NMR sensitivity by polarization transfer.

PubMed

Adams, Ralph W; Aguilar, Juan A; Atkinson, Kevin D; Cowley, Michael J; Elliott, Paul I P; Duckett, Simon B; Green, Gary G R; Khazal, Iman G; López-Serrano, Joaquín; Williamson, David C

2009-03-27

The sensitivity of both nuclear magnetic resonance spectroscopy and magnetic resonance imaging is very low because the detected signal strength depends on the small population difference between spin states even in high magnetic fields. Hyperpolarization methods can be used to increase this difference and thereby enhance signal strength. This has been achieved previously by incorporating the molecular spin singlet para-hydrogen into hydrogenation reaction products. We show here that a metal complex can facilitate the reversible interaction of para-hydrogen with a suitable organic substrate such that up to an 800-fold increase in proton, carbon, and nitrogen signal strengths are seen for the substrate without its hydrogenation. These polarized signals can be selectively detected when combined with methods that suppress background signals.

ParaExp Using Leapfrog as Integrator for High-Frequency Electromagnetic Simulations

NASA Astrophysics Data System (ADS)

Merkel, M.; Niyonzima, I.; Schöps, S.

2017-12-01

Recently, ParaExp was proposed for the time integration of linear hyperbolic problems. It splits the time interval of interest into subintervals and computes the solution on each subinterval in parallel. The overall solution is decomposed into a particular solution defined on each subinterval with zero initial conditions and a homogeneous solution propagated by the matrix exponential applied to the initial conditions. The efficiency of the method depends on fast approximations of this matrix exponential based on recent results from numerical linear algebra. This paper deals with the application of ParaExp in combination with Leapfrog to electromagnetic wave problems in time domain. Numerical tests are carried out for a simple toy problem and a realistic spiral inductor model discretized by the Finite Integration Technique.

75 FR 34943 - Defense Federal Acquisition Regulation Supplement; Para-Aramid Fibers and Yarns Manufactured in a...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-06-21

... needed for national defense purposes. Another respondent notes that DuPont is in the process of building.... Domestic Para-Aramid Sewing Thread May Be of Lower Quality One respondent fully supported the interim rule... specification to use para-aramid thread that was heavier and weaker than the commercial thread that was used in...

Where does the electron go? The nature of ortho/para and meta group directing in electrophilic aromatic substitution

DOE Office of Scientific and Technical Information (OSTI.GOV)

Liu, Shubin, E-mail: shubin@email.unc.edu

Electrophilic aromatic substitution as one of the most fundamental chemical processes is affected by atoms or groups already attached to the aromatic ring. The groups that promote substitution at the ortho/para or meta positions are, respectively, called ortho/para and meta directing groups, which are often characterized by their capability to donate electrons to or withdraw electrons from the ring. Though resonance and inductive effects have been employed in textbooks to explain this phenomenon, no satisfactory quantitative interpretation is available in the literature. Here, based on the theoretical framework we recently established in density functional reactivity theory (DFRT), where electrophilicity andmore » nucleophilicity are simultaneously quantified by the Hirshfeld charge, the nature of ortho/para and meta group directing is systematically investigated for a total of 85 systems. We find that regioselectivity of electrophilic attacks is determined by the Hirshfeld charge distribution on the aromatic ring. Ortho/para directing groups have most negative charges on the ortho/para positions, while meta directing groups often possess the largest negative charge on the meta position. Our results do not support that ortho/para directing groups are electron donors and meta directing groups are electron acceptors. Most neutral species we studied here are electron withdrawal in nature. Anionic systems are always electron donors. There are also electron donors serving as meta directing groups. We predicted ortho/para and meta group directing behaviors for a list of groups whose regioselectivity is previously unknown. In addition, strong linear correlations between the Hirshfeld charge and the highest occupied molecular orbital have been observed, providing the first link between the frontier molecular orbital theory and DFRT.« less

Applying a coping with stress questionnaire for cancer patients to patients with non-cancer chronic illnesses.

PubMed

Orive, Miren; Quintana, Jose M; Vrotsou, Kalliopi; Las Hayas, Carlota; Bilbao, Amaia; Barrio, Irantzu; Matellanes, Begoña; Padierna, Jesús A

2013-06-01

One of the few instruments to evaluate coping skills among patients with chronic illnesses is the Cuestionario de Afrontamiento al Estrés para Pacientes Oncológicos (CAEPO), created initially for cancer patients. We evaluate how well CAEPO applies to patients with non-cancer chronic illnesses. A total of 344 patients (115 with chronic hepatitis C, 120 with inflammatory bowel disease and 109 with recurrent vertigo) completed the CAEPO. Exploratory factor analysis and Cronbach's alpha provide only partial support for the seven factors suggested by the original CAEPO. A streamlined version with fewer dimensions and items may be a better solution for identifying coping strategies among these patients.

[Not Available].

PubMed

Vales Montero, Marta; Chavarría Cano, Beatriz; Martínez Ginés, María Luisa; Díaz Otero, Fernando; Velázquez Pérez, José Miguel; Cuerda Compes, María Cristina; Bretón Lesmes, Irene

2016-07-19

La deficiencia de vitamina A es infrecuente en los países desarrollados. La cirugía bariátrica constituye un factor de riesgo de deficiencia de esta vitamina. Se han descrito varios casos en pacientes sometidos a técnicas con un importante componente malabsortivo, como la derivación biliopancreática. En este artículo se describe un caso de deficiencia clínica de vitamina A con manifestaciones oculares y cutáneas tras bypass gástrico y se revisan las publicaciones sobre este tema y las recomendaciones para la prevención de esta importante complicación.

Para-hydrogenated glucose derivatives as potential 13C-hyperpolarized probes for magnetic resonance imaging.

PubMed

Reineri, Francesca; Santelia, Daniela; Viale, Alessandra; Cerutti, Erika; Poggi, Luisa; Tichy, Tomas; Premkumar, Samuel S D; Gobetto, Roberto; Aime, Silvio

2010-05-26

A set of molecules in which a glucose moiety is bound to a hydrogenable synthon has been synthesized and evaluated for hydrogenation reactions and for the corresponding para-hydrogen-induced polarization (PHIP) effects, in order to select suitable candidates for an in vivo magnetic resonance imaging (MRI) method for the assessment of glucose cellular uptake. It has been found that amidic derivatives do not yield any polarization enhancement, probably due to singlet-triplet state mixing along the reaction pathway. In contrast, ester derivatives are hydrogenated in high yield and afford enhanced (1)H and (13)C NMR spectra after para-hydrogenation. The obtained PHIP patterns are discussed and explained on the basis of the calculated spin level populations in the para-hydrogenated products. These molecules may find interesting applications in (13)C MRI as hyperpolarized probes for assessing the activity of glucose transporters in cells.

Nursing Activities Score and Acute Kidney Injury.

PubMed

Coelho, Filipe Utuari de Andrade; Watanabe, Mirian; Fonseca, Cassiane Dezoti da; Padilha, Katia Grillo; Vattimo, Maria de Fátima Fernandes

2017-01-01

to evaluate the nursing workload in intensive care patients with acute kidney injury (AKI). A quantitative study, conducted in an intensive care unit, from April to August of 2015. The Nursing Activities Score (NAS) and Kidney Disease Improving Global Outcomes (KDIGO) were used to measure nursing workload and to classify the stage of AKI, respectively. A total of 190 patients were included. Patients who developed AKI (44.2%) had higher NAS when compared to those without AKI (43.7% vs 40.7%), p <0.001. Patients with stage 1, 2 and 3 AKI showed higher NAS than those without AKI. A relationship was identified between stage 2 and 3 with those without AKI (p = 0.002 and p <0.001). The NAS was associated with the presence of AKI, the score increased with the progression of the stages, and it was associated with AKI, stage 2 and 3. avaliar a carga de trabalho de enfermagem em pacientes de terapia intensiva com lesão renal aguda (LRA). estudo quantitativo, em Unidade de Terapia Intensiva, no período de abril a agosto de 2015. O Nursing Activities Score (NAS) e o Kidney Disease Improving Global Outcomes (KDIGO) foram utilizados para medir a carga de trabalho de enfermagem e classificar o estágio da LRA, respectivamente. foram incluídos 190 pacientes. Os pacientes que desenvolveram LRA (44,2%) possuíam NAS superiores quando comparados aos sem LRA (43,7% vs 40,7%), p<0,001. Os pacientes com LRA nos estágios 1, 2 e 3 de LRA demonstraram NAS superiores aos sem LRA, houve relação entre os estágios 2 e 3 com os sem LRA, p=0,002 e p<0,001. o NAS apresentou associação com a existência de LRA, visto que seu valor aumenta com a progressão dos estágios, tendo associação com os estágios 2 e 3 de LRA.

[Not Available].

PubMed

Angulo, Daniela; Bustos, Edson; Sánchez, Andrés; Barja, Salesa

2016-07-19

Introducción: la rehabilitación de la alimentación por vía oral (RVO) es compleja en pacientes que han recibido nutrición enteral (NE) prolongada. Objetivo: describir este proceso en niños con enfermedades respiratorias crónicas y sonda nasoenteral (SNE) o gastrostomía (GT).Pacientes y métodos: estudio retrospectivo con revisión de registros clínicos de niños con NE mayor a dos meses, ingresados entre 2005 y 2014 al Hospital Josefina Martínez.Resultados: Se incluyeron 116 pacientes, con mediana de edad 10 meses (Rango: 3 a 101), 56% hombres. Diagnóstico: 34,5% Daño pulmonar crónico postinfeccioso (DPC), 29,3% Insuficiencia respiratoria por enfermedad neuromuscular, 19% Displasia broncopulmonar y 17,2% enfermedad de la vía aérea. Con traqueostomía: 82,8%. Eran usuarios de GT 89,7% y de SNG 10,3%, instaladas con mediana de edad 6 meses (0 a 74), por ingesta insuficiente (6,6%) o trastorno de deglución (92,4%). Del grupo total, 36,2% (42/116) tenía indicación de RVO, los cuales habían recibido NE durante 12,2 meses (2 a 41); de estos 50% (21/42) logró alimentarse exclusivamente por vía oral (91% SNG y 35,4% GT, Chi2 p = 0,023), 14% parcialmente y 36% no lo logró. El tiempo para lograr la vía oral exclusiva fue de 9,75 meses (0,5 a 47), sin diferencia por edad, sexo, vía de acceso, duración NE ni presencia de enfermedad neurológica.Conclusión: en pacientes con enfermedades respiratorias crónicas graves y NE prolongada, la RVO es un proceso lento pero posible: 64% lo logra de modo completo o parcial.

Alvarado score in the diagnostic of pain in the right lower quadrant.

PubMed

Lada, Paul Eduardo

2017-09-08

Acute appendicitis neither suspected nor diagnosed could develop a perforation or otherwise it would take to removing of a normal appendix. Utilization of a clinical score system for aided diagnosis of this pathology and can reduce a negative appendicitis. National Clinicas Hospital. Córdoba. Argentina. Prospective and protocolized study. 594 patients were studied between October 2002 and December 2013. 312 males and 282 females their age average was 26.2 years. Alvarado score was realized in all patients when they entered. According clinic and second valoration with the score surgical exploration was decided in 574 patients. The remaining 20 were excluded due to other pathology. The diagnosis in acute appendicitis was confirmed by surgical finding and histopathologic studies. In surgical finding we showed 594 patients (91,28 %) had acute appendicitis. There was no operative mortality. Respects morbidity there was 1,74 % of medical and 13,93 % of surgical complications. The anatomo-pathologic report showed a normal cecal appendix in 50. The incidence of negative appendicectomy was about 8.71 %. The utilization of score related to the surgical and anatomo-pathologic finding confirmed it was appreciable from 6 points to acute appendicitis diagnosis.   RESUMENAntecedentes: La apendicitis aguda no sospechada y diagnosticada puede evolucionar hacia la perforación, ó por el contrario conduce a la remoción de un apéndice normal. Objetivo: La utilización de un  sistema  de Score, desde un  punto de vista clínico, para el diagnóstico de esta patología y lograr disminuir las apendicetomías negativas.Lugar de Aplicación: Hospital Nacional de Clínicas. Córdoba. (Argentina)Diseño: Estudio prospectivo y protocolizado.Material y Métodos: Comprende a 594 pacientes estudiados entre octubre de 2002 y diciembre del 2013. De ellos, 312 eran del sexo masculino y 282 del femenino, con una edad promedio de 26,2 años de edad. A todos los pacientes se les realizo al

Are PTH levels related to oxidative stress and inflammation in chronic kidney disease patients on hemodialysis?

PubMed

Jaqueto, Marcel; Delfino, Vinicius Daher Alvares; Bortolasci, Chiara Cristina; Barbosa, Decio Sabbatini; Morimoto, Helena Kaminami; Frange, Raquel Ferreira Nassar; Ferreira, Larissa França Fontoura; Guimarães, Fernanda Burle Dos Santos

2016-01-01

Patients at end stage renal disease have higher levels of inflammation and oxidative stress than the general population. Many factors contribute to these issues, and the parathyroid hormone (PTH) is also implicated. The study was conducted in order to assess the relationship between PTH levels and inflammation and oxidative stress in hemodialysis patients. Cross-sectional study with patients of two hemodialysis facilities in Londrina, Brazil. Patients with other conditions known to generate oxidative stress and inflammation were excluded. Blood levels of PTH and biochemical parameters of inflammation (interleukins 1 and 6, tumor necrosis factor-alpha) and oxidative stress (total plasma antioxidant capacity, malonic dialdehyde, lipid hydroperoxidation, advanced oxidation protein products, quantification of nitric oxide metabolites, and 8-isoprostane) were measured before a dialysis session. Then, we made correlation analyses between PTH levels - either as the continuous variable or categorized into tertiles-, and inflammatory and oxidative stress biomarkers. PTH did not show any correlation with the tested inflammation and oxidative stress parameters, nor as continuous variable neither as categorical variable. In this descriptive study, the results suggest that the inflammation and oxidative stress of hemodialysis patients probably arise from mechanisms other than secondary hyperparathyroidism. Pacientes com doença renal em estágio terminal têm níveis de inflamação e estresse oxidativo maiores do que a população geral. Muitos fatores contribuem para isso, e o hormônio paratireoidiano (PTH) é um deles. Estudo foi realizado para avaliar a relação entre os níveis de PTH e níveis de inflamação e estresse oxidativo em pacientes em hemodiálise. estudo transversal com pacientes de duas unidades de hemodiálise de Londrina, Brasil. Pacientes com condições causadoras de inflamação e estresse oxidativo foram exclusos. Níveis plasmáticos de PTH e par

Impact of respiratory therapy in vital capacity and functionality of patients undergoing abdominal surgery.

PubMed

Fernandes, Shanlley Cristina da Silva; Santos, Rafaella Souza Dos; Giovanetti, Erica Albanez; Taniguchi, Corinne; Silva, Cilene Saghabi de Medeiros; Eid, Raquel Afonso Caserta; Timenetsky, Karina Tavares; Carnieli-Cazati, Denise

2016-01-01

ória, conforme o grupo randomizado. Foram incluídos 38 pacientes, sendo 20 randomizados para Grupo Pressão Positiva Intermitente e 18 para o Grupo Incentivador Inspiratório a Volume. A capacidade vital entre o D1 e Dalta do Grupo Pressão Positiva Intermitente não teve ganho significativo (média de 1.410mL±547,2 versus 1.809mL±692,3; p=0,979), assim como no Grupo Incentivador Inspiratório a Volume (1.408,3mL±419,1 versus 1.838,8mL±621,3; p=0,889). Houve melhora significativa da capacidade vital no D1 (p<0,001) e na Dalta (p<0,001) e da Medida de Independência Funcional (p<0,001) após a fisioterapia respiratória. A melhora da capacidade vital não apresentou relação com o ganho da força muscular. A fisioterapia respiratória, por meio de pressão positiva ou de incentivador inspiratório a volume, foi eficaz na melhora da capacidade vital em pacientes submetidos à cirurgia abdominal.

[Clinical value of para-recurrent laryngeal nerve lymphadenectomy for middle thoracic esophageal squamous cell carcinoma].

PubMed

Wang, Zhen; Liu, Shuoyan

2015-09-01

To analyze the pattern of lymphatic metastasis in middle thoracic esophageal squamous cell carcinoma (ESCC) with different T staging and to investigate the clinical value of para-recurrent laryngeal nerve lymphadenectomy. Clinicopathological data of 717 patients with middle thoracic ESCC undergoing Mckeown esophagectomy plus three-field lymph node dissection in Fujian Provincial Hospital from January 1999 to December 2007 were analyzed retrospectively. Lymph node metastatic rates of different T stages were calculated. Clinical value of each station lymphadenectomy, especially the para-recurrent laryngeal nerve lymphadenectomy, was evaluated by the efficacy index (EI, cross product of one station metastatic rate and 5-year survival of patient with positive lymph nodes of above station). Rates of lymph node metastasis were 29.0% (18/62), 61.1% (91/149) and 64.8% (328/506) in stage T1, T2 and T3 patients respectively. Despite T staging, metastatic rates of right para-recurrent laryngeal nerve lymph node (rRLN LN) were 21.0% (13/62), 28.9% (43/149) and 29.4% (149/506) in stage T1, T2 and T3 patients respectively, which was the most common among all lymph node stations. Metastatic rates of left para-recurrent laryngeal nerve lymph node (lRLN LN) were the second, with 8.1% (5/62), 17.4% (26/149) and 24.7% (125/506) in stage T1, T2, T3 patients respectively. Follow-up period lasted more than 5 years. The 5-year survival rates of positive rRLN LN were 53.8%, 39.5% and 32.2% in stage T1, T2 and T3 patients respectively, whose EI values were 11.3, 11.4 and 9.5 respectively. The 5-year survival rates of positive lRLN LN were 40.0%, 34.6% and 40.0% in stage T1, T2 and T3 patients respectively, whose EI values were 3.2, 6.0 and 9.9 respectively. Bilateral para-recurrent laryngeal nerve lymph nodes are the common sites of metastasis in middle thoracic esophageal squamous cell carcinoma. Right para-recurrent laryngeal nerve lymphadenectomy is of high clinical value despite the T

The School of Posture as a postural training method for Paraíba Telecommunications Operators.

PubMed

Cardia, M C; Soares Màsculo, F

2001-01-01

This work proposes to show the experience of posture training accomplished in the Paraíba State Telecommunication Company, using the knowledge of the Back School. The sample was composed of 12 operators, employees of the company, representing 31% of this population. The model applied in TELPA (Paraíba Telecommunication Company, Brazil) was based on the models of Sherbrooke, Canada, and of the School of Posture of Paraìba Federal University. Fifty-eight point four percent of participants showed a reduction of column pain, 25% improved the quality of the rest and the received training was considered enough for the learning of correct postures at work in 75% of the cases. The whole population approved of the training, and 83.3% of the cases considered that this training influenced their lives very positively.

Ortho-para spin isomers of the protons in the methylene group--possible implications for protein structure.

PubMed

Shinitzky, Meir; Elitzur, Avshalom C

2006-09-01

The two hydrogen atoms attached to the carbon in the methylene group are of two different spin configurations, similar to those in the case of water: ortho, where the two proton spins are parallel to each other, and para, where they are antiparallel. The ortho configuration has three degenerate states, while the para configuration is singular, leading to a statistical ratio of these isomers 3:1 ortho/para. Such spin isomers are present in glycine and most chiral amino acids where they may induce broadening of structural zones, a possibility which remains to be assessed. The implications of this neglected possibility could be far-reaching, in particular with respect to protein structure and the origins of biochirality.

Consistent assignment of the vibrations of symmetric and asymmetric para-disubstituted benzene molecules

NASA Astrophysics Data System (ADS)

Andrejeva, Anna; Gardner, Adrian M.; Tuttle, William D.; Wright, Timothy G.

2016-03-01

We give a description of the phenyl-ring-localized vibrational modes of the ground states of the para-disubstituted benzene molecules including both symmetric and asymmetric cases. In line with others, we quickly conclude that the use of Wilson mode labels is misleading and ambiguous; we conclude the same regarding the related ones of Varsányi. Instead we label the modes consistently based upon the Mulliken (Herzberg) method for the modes of para-difluorobenzene (pDFB). Since we wish the labelling scheme to cover both symmetrically- and asymmetrically-substituted molecules, we apply the Mulliken labelling under C2v symmetry. By studying the variation of the vibrational wavenumbers with mass of the substituent, we are able to identify the corresponding modes across a wide range of molecules and hence provide consistent assignments. Particularly interesting are pairs of vibrations that evolve from in- and out-of-phase motions in pDFB to more localized modes in asymmetric molecules. We consider the para isomers of the following: the symmetric dihalobenzenes, xylene, hydroquinone, the asymmetric dihalobenzenes, halotoluenes, halophenols and cresol.

Jupiter's para-H2 distribution from SOFIA/FORCAST and Voyager/IRIS 17-37 μm spectroscopy

NASA Astrophysics Data System (ADS)

Fletcher, Leigh N.; de Pater, I.; Reach, W. T.; Wong, M.; Orton, G. S.; Irwin, P. G. J.; Gehrz, R. D.

2017-04-01

Spatially resolved maps of Jupiter's far-infrared 17-37 μm hydrogen-helium collision-induced spectrum were acquired by the FORCAST instrument on the Stratospheric Observatory for Infrared Astronomy (SOFIA) in May 2014. Spectral scans in two grisms covered the broad S(0) and S(1) absorption lines, in addition to contextual imaging in eight broad-band filters (5-37 μm) with spatial resolutions of 2-4″. The spectra were inverted to map the zonal-mean temperature and para-H2 distribution (fp, the fraction of the para spin isomer with respect to the ortho spin isomer) in Jupiter's upper troposphere (the 100-700 mbar range). We compared these to a reanalysis of Voyager-1 and -2 IRIS spectra covering the same spectral range. Tropospheric temperature contrasts match those identified by Voyager in 1979, within the limits of temporal variability consistent with previous investigations. Para-H2 increases from equator to pole, with low-fp air at the equator representing sub-equilibrium conditions (i.e., less para-H2 than expected from thermal equilibration), and high-fp air and possible super-equilibrium at higher latitudes. In particular, we confirm the continued presence of a region of high-fp air at high northern latitudes discovered by Voyager/IRIS, and an asymmetry with generally higher fp in the north than in the south. Far-IR aerosol opacity is not required to fit the data, but cannot be completely ruled out. We note that existing collision-induced absorption databases lack opacity from (H2)2 dimers, leading to under-prediction of the absorption near the S(0) and S(1) peaks. There appears to be no spatial correlation between para-H2 and tropospheric ammonia, phosphine and cloud opacity derived from Voyager/IRIS at mid-infrared wavelengths (7-15 μm). We note, however, that para-H2 tracks the similar latitudinal distribution of aerosols within Jupiter's upper tropospheric and stratospheric hazes observed in reflected sunlight, suggesting that catalysis of hydrogen

CONHECIMENTO DA LEI GERAL DE SAÚDE – RESPEITO ÀS TRANSFUSÕES SANGUÍNEAS EM MÉDICOS E PACIENTES TESTEMUNHAS DE JEOVÁ DO HOSPITAL DR. DARÍO CONTRERAS DA REPÚBLICA DOMINICANA

PubMed Central

SANTANA, ELSA DÍAZ

2010-01-01

Este estudo avalia quanto o corpo médico do Hospital Dr. Darío Contreras de República Dominicana conhece, respeita, informa e aplica a Lei Geral de Saúde em relação aos direitos do paciente Testemunha de Jeová de negar-se a ser transfundido (respeito a sua autonomia); também se os Testemunhas de Jeová conhecem a Lei Geral de Saúde e até que ponto têm se beneficiado diante dessa proposição. O estudo revelou que nem médicos, nem Testemunhas de Jeová conhecem de fato essa lei. PMID:20689657

Utilice en forma segura los productos con cebo para roedores

EPA Pesticide Factsheets

Si se usan de manera inadecuada, los productos con veneno para ratas y ratones podrían hacerle daño a usted, a sus hijos o a sus mascotas. Siempre que use pesticidas lea la etiqueta del producto y siga todas las indicaciones.

A Xylenol Orange-Based Screening Assay for the Substrate Specificity of Flavin-Dependent para-Phenol Oxidases.

PubMed

Ewing, Tom A; van Noord, Aster; Paul, Caroline E; van Berkel, Willem J H

2018-01-14

Vanillyl alcohol oxidase (VAO) and eugenol oxidase (EUGO) are flavin-dependent enzymes that catalyse the oxidation of para -substituted phenols. This makes them potentially interesting biocatalysts for the conversion of lignin-derived aromatic monomers to value-added compounds. To facilitate their biocatalytic exploitation, it is important to develop methods by which variants of the enzymes can be rapidly screened for increased activity towards substrates of interest. Here, we present the development of a screening assay for the substrate specificity of para -phenol oxidases based on the detection of hydrogen peroxide using the ferric-xylenol orange complex method. The assay was used to screen the activity of VAO and EUGO towards a set of twenty-four potential substrates. This led to the identification of 4-cyclopentylphenol as a new substrate of VAO and EUGO and 4-cyclohexylphenol as a new substrate of VAO. Screening of a small library of VAO and EUGO active-site variants for alterations in their substrate specificity led to the identification of a VAO variant (T457Q) with increased activity towards vanillyl alcohol (4-hydroxy-3-methoxybenzyl alcohol) and a EUGO variant (V436I) with increased activity towards chavicol (4-allylphenol) and 4-cyclopentylphenol. This assay provides a quick and efficient method to screen the substrate specificity of para -phenol oxidases, facilitating the enzyme engineering of known para- phenol oxidases and the evaluation of the substrate specificity of novel para -phenol oxidases.

Rotational excitations in para-H2+para-H2 collisions: full- and reduced-dimensional quantum wave packet studies comparing different potential energy surfaces.

PubMed

Otto, Frank; Gatti, Fabien; Meyer, Hans-Dieter

2008-02-14

We study the process of rotational excitation in the collisions of para-H(2) with para-H(2) by propagating wave packets with the multiconfiguration time-dependent Hartree (MCTDH) algorithm. Transition probabilities are then calculated by the method of Tannor and Weeks based on time-correlation functions. Calculations were carried out up to a total angular momentum of J=70 to compute integral cross sections up to 1.2 eV in collision energy and thermal rate coefficients from 100 to 3000 K. The process is studied on the full-dimensional potential energy surface of Boothroyd-Martin-Keogh-Peterson (BMKP) as well as on the rigid rotor surface of Diep and Johnson. We test the validity of the rigid rotor approximation by also considering two rigid rotor restrictions of the BMKP potential energy surface (PES). Additionally, we investigate a variant of the BMKP PES suggested by Pogrebnya and Clary [Chem. Phys. Lett. 363, 523 (2002)] with reduced anisotropy. We compare our results with previous theoretical data for the cross sections and with experimental data for the rate coefficients at low temperatures.

El diseño final del espectrógrafo de banco (EBASIM) para CASLEO

NASA Astrophysics Data System (ADS)

Simmons, J.; Levato, H.

Utilizando el código de óptica ACCOS V se ha finalizado el diseño del espectrógrafo de banco para CASLEO. En una comunicación anterior habíamos indicado que utilizaríamos un colimador de 150 mm de diámetro con un radio de curvatura de 1540 mm. Para el espejo cámara, que tiene un diámetro de 200 mm, el radio de curvatura es de 1200 mm, ambos radios con una tolerancia no mayor a los 3 mm. En la presente, se informa sobre los detalles finales del cálculo del espectrógrafo que incluye el cómputo para 5 longitudes de onda diferentes y alrededor de 100 rayos. En todos los casos el 75 % de energía está dentro de un diámetro de 13 micrones. El diseño ha sido probado entre 3500 Å hasta 9000 Å con resultados satisfactorios.

Relación masa-radio para estrellas enanas blancas y la interpretación de recientes mediciones hechas por Hipparcos

NASA Astrophysics Data System (ADS)

Panei, J. A.; Althaus, L. G.; Benvenuto, O. G.

Recientes mediciones de la masa y el radio hechas por Hipparcos de las estrellas enanas blancas 40 Eri B y Procyon B (Shipman, H. & Provencal, J. - ApJ. 1998, 494, 759), sugieren un núcleo compuesto de hierro para dichas estrellas, en lugar de carbono y oxígeno como predice la teoría standard de evolución estelar. Para interpretar estas observaciones, presentamos aquí, relaciones masa-radio para configuraciones degeneradas a temperatura finita para distintas composiciones químicas centrales. Para tal fin hemos calculado secuencias evolutivas de enanas blancas utilizando el código de evolución estelar, desarrollado en el Observatorio de La Plata. Dicho código resuelve las ecuaciones de estructura y evolución estelar mediante la técnica de relajación de Henyey, y esta basado en una descripción física muy detallada y actualizada.

A Multivariate Model for Prediction of Obstructive Coronary Disease in Patients with Acute Chest Pain: Development and Validation.

PubMed

Correia, Luis Cláudio Lemos; Cerqueira, Maurício; Carvalhal, Manuela; Ferreira, Felipe; Garcia, Guilherme; Silva, André Barcelos da; Sá, Nicole de; Lopes, Fernanda; Barcelos, Ana Clara; Noya-Rabelo, Márcia

2017-04-01

Currently, there is no validated multivariate model to predict probability of obstructive coronary disease in patients with acute chest pain. To develop and validate a multivariate model to predict coronary artery disease (CAD) based on variables assessed at admission to the coronary care unit (CCU) due to acute chest pain. A total of 470 patients were studied, 370 utilized as the derivation sample and the subsequent 100 patients as the validation sample. As the reference standard, angiography was required to rule in CAD (stenosis ≥ 70%), while either angiography or a negative noninvasive test could be used to rule it out. As predictors, 13 baseline variables related to medical history, 14 characteristics of chest discomfort, and eight variables from physical examination or laboratory tests were tested. The prevalence of CAD was 48%. By logistic regression, six variables remained independent predictors of CAD: age, male gender, relief with nitrate, signs of heart failure, positive electrocardiogram, and troponin. The area under the curve (AUC) of this final model was 0.80 (95% confidence interval [95%CI] = 0.75 - 0.84) in the derivation sample and 0.86 (95%CI = 0.79 - 0.93) in the validation sample. Hosmer-Lemeshow's test indicated good calibration in both samples (p = 0.98 and p = 0.23, respectively). Compared with a basic model containing electrocardiogram and troponin, the full model provided an AUC increment of 0.07 in both derivation (p = 0.0002) and validation (p = 0.039) samples. Integrated discrimination improvement was 0.09 in both derivation (p < 0.001) and validation (p < 0.0015) samples. A multivariate model was derived and validated as an accurate tool for estimating the pretest probability of CAD in patients with acute chest pain. Atualmente, não existe um modelo multivariado validado para predizer a probabilidade de doença coronariana obstrutiva em pacientes com dor torácica aguda. Desenvolver e validar um modelo multivariado para predizer doen

Estimated costs of advanced lung cancer care in a public reference hospital.

PubMed

Knust, Renata Erthal; Portela, Margareth Crisóstomo; Pereira, Claudia Cristina de Aguiar; Fortes, Guilherme Bastos

2017-08-17

coorte de 277 pacientes matriculados no Instituto Nacional do Câncer em 2011. Os custos foram estimados sob a perspectiva do hospital como prestador de serviços de referência para o SUS. Insumos e procedimentos utilizados foram identificados e quantificados, por paciente, sendo a eles atribuídos valores monetários, consolidados por fases da assistência definidas. As análises tiveram caráter descritivo com custos em reais (R$). Em termos globais, a coorte representou um custo de R$2.473.559,91, sendo 71,5% relacionados à atenção ambulatorial e 28,5% as internações. Na atenção ambulatorial, predominaram os custos com radioterapia (34%) e quimioterapia (22%). Os resultados apontaram para custos menores na fase inicial de tratamento (7,2%) e custos muito elevados na fase de manutenção (61,6%). Por fim, identificaram-se diferenças estatisticamente significativas das médias dos custos por faixas etárias, níveis de escolaridade, desempenho físico e tipo histológico. Este estudo fornece um retrato atual, útil e relevante sobre os custos de pacientes com câncer de pulmão não pequenas células assistidos em um hospital público de referência e provê elementos sobre a magnitude do problema do câncer no âmbito da saúde pública. Os resultados ratificam a importância do tratamento radioterápico e das internações como principais componentes de custo do tratamento. Apesar de algumas perdas de seguimento avalia-se que, para cerca de 80% dos pacientes incluídos no estudo, as estimativas aqui apresentadas sejam satisfatoriamente fidedignas ao cuidado da doença, sob a perspectiva de um prestador de referência do SUS, fornecendo elementos para a gestão do serviço, bem como para estudos que redundem em formas mais racionais de alocação de recursos.

Evolution of Antp-class genes and differential expression of Hydra Hox/paraHox genes in anterior patterning

PubMed Central

Gauchat, Dominique; Mazet, Françoise; Berney, Cédric; Schummer, Michèl; Kreger, Sylvia; Pawlowski, Jan; Galliot, Brigitte

2000-01-01

The conservation of developmental functions exerted by Antp-class homeoproteins in protostomes and deuterostomes suggested that homologs with related functions are present in diploblastic animals. Our phylogenetic analyses showed that Antp-class homeodomains belong either to non-Hox or to Hox/paraHox families. Among the 13 non-Hox families, 9 have diploblastic homologs, Msx, Emx, Barx, Evx, Tlx, NK-2, and Prh/Hex, Not, and Dlx, reported here. Among the Hox/paraHox, poriferan sequences were not found, and the cnidarian sequences formed at least five distinct cnox families. Two are significantly related to the paraHox Gsx (cnox-2) and the mox (cnox-5) sequences, whereas three display some relatedness to the Hox paralog groups 1 (cnox-1), 9/10 (cnox-3) and the paraHox cdx (cnox-4). Intermediate Hox/paraHox genes (PG 3 to 8 and lox) did not have clear cnidarian counterparts. In Hydra, cnox-1, cnox-2, and cnox-3 were not found chromosomally linked within a 150-kb range and displayed specific expression patterns in the adult head. During regeneration, cnox-1 was expressed as an early gene whatever the polarity, whereas cnox-2 was up-regulated later during head but not foot regeneration. Finally, cnox-3 expression was reestablished in the adult head once it was fully formed. These results suggest that the Hydra genes related to anterior Hox/paraHox genes are involved at different stages of apical differentiation. However, the positional information defining the oral/aboral axis in Hydra cannot be correlated strictly to that characterizing the anterior–posterior axis in vertebrates or arthropods. PMID:10781050

An "adiabatic-hindered-rotor" treatment allows para-H(2) to be treated as if it were spherical.

PubMed

Li, Hui; Roy, Pierre-Nicholas; Le Roy, Robert J

2010-09-14

In para-H(2)-{molecule} interactions, the common assumption that para-H(2) may be treated as a spherical particle is often substantially in error. For example, quantum mechanical eigenvalues on a full four-dimensional (4D) potential energy surface for para H(2)-{linear molecule} species often differ substantially from those calculated from the corresponding two-dimensional (2D) surface obtained by performing a simple spherical average over the relative orientations of the H(2) moiety. However, use of an "adiabatic-hindered-rotor" approximation can yield an effective 2D surface whose spectroscopic properties are an order of magnitude closer to those yielded by a full 4D treatment.

Binding Isotope Effects for para-Aminobenzoic Acid with Dihydropteroate Synthase from Staphylococcus aureus and Plasmodium falciparum.

PubMed

Stratton, Christopher F; Namanja-Magliano, Hilda A; Cameron, Scott A; Schramm, Vern L

2015-10-16

Dihydropteroate synthase is a key enzyme in folate biosynthesis and is the target of the sulfonamide class of antimicrobials. Equilibrium binding isotope effects and density functional theory calculations indicate that the substrate binding sites for para-aminobenzoic acid on the dihydropteroate synthase enzymes from Staphylococcus aureus and Plasmodium falciparum present distinct chemical environments. Specifically, we show that para-aminobenzoic acid occupies a more sterically constrained vibrational environment when bound to dihydropteroate synthase from P. falciparum relative to that of S. aureus. Deletion of a nonhomologous, parasite-specific insert from the plasmodial dihydropteroate synthase abrogated the binding of para-aminobenzoic acid. The loop specific to P. falciparum is important for effective substrate binding and therefore plays a role in modulating the chemical environment at the substrate binding site.

Type 2 Diabetes Mellitus remission eighteen months after Roux-en-Y gastric bypass.

PubMed

Girundi, Marcelo Gomes

2016-01-01

410 pacientes (87,6%) após 18 meses da cirurgia, sendo essa diferença significativa com p-valor <0,001. A doença se manteve inalterada em 48 pacientes (10,3%), e dez pacientes (2,1%) permaneceram com o risco aumentado para DM2. a gastroplastia com derivação em Y-de-Roux foi efetiva na promoção e manutenção do controle glicêmico em longo prazo.

A bone tissue engineering strategy based on starch scaffolds and bone marrow cells cultured in a flow perfusion bioreactor

NASA Astrophysics Data System (ADS)

Gomes, Maria Manuela Estima

tecido osseo, uma vez que estas celulas podem ser facilmente recolhidas do proprio paciente a tratar por metodos nao-invasivos (bioppsia) e em quantidades suficientes. Alem disso, tratando-se de uma fonte de celulas autologas (obtidas do proprio paciente) permitem evitar os riscos de transmissao de doencas contagiosas e/ou de rejeicao pelo sistema imunologico. • Estudo da influencia das condicoes de cultura in vitro geradas por um bioreactor de perfusao (em comparacao com os metodos tradicionais de cultura em condicoes estaticas) no desenvolvimento dos materiais hibridos, compostos pelas celulas e scaffolds, assim como as interaccoes do ambiente proporcionado por este sistema de cultura com as diferentes estruturas/arquitecturas e porosidades dos scaffolds utilizados. Estes objectivos convergem para o objectivo geral desta tese que consistiu no desenvolvimento de uma terapia de engenharia do tecido osseo alternativa as existentes e com potencial para vir a ser posteriormente utilizada na pratica clinica. Este objectivo foi avaliado atraves do estudo da funcionalidade dos materiais hibridos obtidos em diferentes condicoes de cultura in vitro (e utilizando diferentes scaffolds), partindo do principio que o sistema de perfusao poderia eventualmente superar as limitacoes de difusao tipicas dos sistema de cultura estatica e simultaneamente proporcionar estimulos mecânicos as celulas, semelhantes aos encontrados em condicoes fisiologicas. (Abstract shortened by ProQuest.).

Risk factors for mortality in ventilator-associated tracheobronchitis: a case-control study.

PubMed

Pontes, Leonilda Giani; Menezes, Fernando Gatti de; Gonçalves, Priscila; Toniolo, Alexandra do Rosário; Silva, Claudia Vallone; Kawagoe, Julia Yaeko; Santos, Camila Marques Dos; Castagna, Helena Maria Fernandes; Martino, Marinês Dalla Valle; Corrêa, Luci

2017-01-01

To describe the microbiological characteristics and to assess the risk factors for mortality of ventilator-associated tracheobronchitis in a case-control study of intensive care patients. This case-control study was conducted over a 6-year period in a 40-bed medical-surgical intensive care unit in a tertiary care, private hospital in São Paulo, Brazil. Case patients were identified using the Nosocomial Infection Control Committee database. For the analysis of risk factors, matched control subjects were selected from the same institution at a 1:8.8 ratio, between January 2006 and December 2011. A total of 40 episodes of ventilator-associated tracheobronchitis were evaluated in 40 patients in the intensive care unit, and 354 intensive care patients who did not experience tracheobronchitis were included as the Control Group. During the 6-year study period, a total of 42 organisms were identified (polymicrobial infections were 5%) and 88.2% of all the microorganisms identified were Gram-negative. Using a logistic regression model, we found the following independent risk factors for mortality in ventilator-associated tracheobronchitis patients: Acute Physiology and Chronic Health Evaluation I score (odds ratio 1.18 per unit of score; 95%CI: 1.05-1.38; p=0.01), and duration of mechanical ventilation (odds ratio 1.09 per day of mechanical ventilation; 95%CI: 1.03-1.17; p=0.004). Our study provided insight into the risk factors for mortality and microbiological characteristics of ventilator-associated tracheobronchitis. Descrever as características microbiológicas e avaliar os fatores de risco para mortalidade na traqueobronquite associada à ventilação mecânica em um estudo caso-controle de pacientes de terapia intensiva. Estudo realizado ao longo de 6 anos em uma unidade de terapia intensiva médico-cirúrgica de 40 leitos, em um hospital privado e de nível terciário em São Paulo, Brasil. O Grupo Caso foi identificado usando o banco de dados da Comissão de

Cretaceous-Paleogene ostracods from the Paraíba Basin, northeastern Brazil

NASA Astrophysics Data System (ADS)

de Lima Barros, Cecília; Piovesan, Enelise Katia; Oliveira Agostinho, Sonia Maria

2018-04-01

This work presents a detailed taxonomic study on the marine ostracods from the Paraíba Basin, northeastern Brazil, in wells from the wells Itamaracá-1IT-03-PE and Poty-1PO-01-PE, which record the Maastrichtian-Danian boundary. Besides the taxonomic data, this paper contributes to the paleoenvironmental knowledge of Cretaceous-Paleogene ostracods from the Paraíba Basin. The analysis of 98 samples of the well Itamaracá-1IT-03-PE and 59 samples of the Poty-1PO-01-PE resulted in the record of 34 ostracode species, all representative of a marine environment with normal salinity. Seven new species are proposed: Cytherella centrocompressa sp. nov.; Cytherella paraibensis sp. nov.; Neonesidea potyensis sp. nov.; Bythoceratina spinosa sp. nov.; Eucytherura ventrotuberculata sp. nov.; Langiella fauthi sp. nov. and Protobuntonia punctatum sp. nov.

Usina de ciências: um espaço pedagógico para aprendizagens múltiplas

NASA Astrophysics Data System (ADS)

Martin, V. A. F.; Poppe, P. C. R.; Orrico, A. C. P.; Pereira, M. G.

2003-08-01

Entendemos que o Ensino de Astronomia é especialmente apropriado para motivar os alunos e aprofundar conteúdos em diversas áreas do conhecimento, pois envolve temas ligados à Física, Matemática, Química, Computação, Tratamento de Imagens e Instrumentação de Alta Precisão, além daqueles pertinentes as áreas de Geografia, História e Antropologia. Contudo, apesar do caráter interdisciplinar que esta ciência possui, a realidade atual é que a maioria dos professores em sala de aula não foram devidamente capacitados, durante o período de formação acadêmica, para ministrar conteúdos de Astronomia nos atuais Ensinos Fundamental e Médio. Neste trabalho, discutiremos de maneira ampla, num primeiro momento, a realidade do atual ensino de ciências praticado no Estado da Bahia, apontando por dependência administrativa, o crescimento e a redução do número de escolas, da taxa de analfabetismo por faixa etária, da escolarização, do atendimento, da aprovação, reprovação e abandono, de equipamentos e laboratórios e o grau de formação dos nossos atuais professores em pleno exercício de atividade docente. Num segundo momento, discutiremos o papel do Observatório Astronômico Antares/UEFS dentro desse contexto, ou seja, suas ações implementadas ao longo dos últimos anos e em particular, o recente projeto de extensão Ensino e Difusão de Astronomia, financiado pela Fundação Vitae, que procura traduzir no lúdico, no brincar de ciências, um espaço pedagógico para aprendizagens múltiplas. Neste, o papel do professor multiplicador associado ao laboratório de kits didáticos, de fácil construção e manipulação (alguns dos quais serão mostrados), perfazem os principais veículos para o desenvolvimento de conhecimentos, atitudes, habilidades e valores que preparam os nossos alunos para a carreira técnico-científica e para sua participação crítica e criativa na Sociedade.

The effects of progressive muscular relaxation as a nursing procedure used for those who suffer from stress due to multiple sclerosis.

PubMed

Novais, Paolla Gabrielle Nascimento; Batista, Karla de Melo; Grazziano, Eliane da Silva; Amorim, Maria Helena Costa

2016-09-01

íodo de oito semanas. O grupo experimental foi orientado a realizar diariamente o Relaxamento Muscular Progressivo. Após oito semanas de intervenção avaliou-se novamente os níveis de estresse. Para análise dos dados foi utilizado o pacote Estatístico para Ciências Sociais-versão 19.0. a aplicação do Teste t demonstrou uma diminuição significante dos escores da Escala de Stress Percebido no grupo experimental (p<0,001), evidenciando diminuição nos níveis de estresse após a prática do relaxamento. a intervenção Relaxamento Muscular Progressivo contribui para redução dos níveis de estresse em pessoas com Esclerose Múltipla, podendo ser incluída como prática na assistência de enfermagem prestada a esses pacientes. NCT 02673827. evaluar el efecto del Relajamiento Muscular Progresivo, como intervención de Enfermería en los niveles de estrés en personas con Esclerosis Múltiple. ensayo clínico aleatorio conducido en un ambulatorio de Neurología de un Hospital Universitario. La muestra estuvo constituida por 40 pacientes acompañados en ambulatorio (20 en el grupo control y 20 en el experimental). Se empleó la técnica de Relajamiento Muscular Progresivo. Las variables de control fueron recolectadas por la técnica de entrevista con registro en formulario y se aplicó la Escala de Estrés Percibido. Fueron realizados cinco encuentros quincenales en un período de ocho semanas. El grupo experimental fue orientado a realizar diariamente el Relajamiento Muscular Progresivo. Después de ocho semanas de intervención se evaluó nuevamente los niveles de estrés. Para analizar los datos fue utilizado el programa Estadístico para Ciencias Sociales versión 19.0. la aplicación de la Prueba t demostró una disminución significativa de los puntajes de la Escala de Estrés Percibido en el grupo experimental (p<0,001), evidenciando la disminución de los niveles de estrés después de la práctica del relajamiento. la intervención Relajamiento Muscular

ParaView visualization of Abaqus output on the mechanical deformation of complex microstructures

NASA Astrophysics Data System (ADS)

Liu, Qingbin; Li, Jiang; Liu, Jie

2017-02-01

Abaqus® is a popular software suite for finite element analysis. It delivers linear and nonlinear analyses of mechanical and fluid dynamics, includes multi-body system and multi-physics coupling. However, the visualization capability of Abaqus using its CAE module is limited. Models from microtomography have extremely complicated structures, and datasets of Abaqus output are huge, requiring a visualization tool more powerful than Abaqus/CAE. We convert Abaqus output into the XML-based VTK format by developing a Python script and then using ParaView to visualize the results. Such capabilities as volume rendering, tensor glyphs, superior animation and other filters allow ParaView to offer excellent visualizing manifestations. ParaView's parallel visualization makes it possible to visualize very big data. To support full parallel visualization, the Python script achieves data partitioning by reorganizing all nodes, elements and the corresponding results on those nodes and elements. The data partition scheme minimizes data redundancy and works efficiently. Given its good readability and extendibility, the script can be extended to the processing of more different problems in Abaqus. We share the script with Abaqus users on GitHub.

Time domain para hydrogen induced polarization.

PubMed

Ratajczyk, Tomasz; Gutmann, Torsten; Dillenberger, Sonja; Abdulhussaein, Safaa; Frydel, Jaroslaw; Breitzke, Hergen; Bommerich, Ute; Trantzschel, Thomas; Bernarding, Johannes; Magusin, Pieter C M M; Buntkowsky, Gerd

2012-01-01

Para hydrogen induced polarization (PHIP) is a powerful hyperpolarization technique, which increases the NMR sensitivity by several orders of magnitude. However the hyperpolarized signal is created as an anti-phase signal, which necessitates high magnetic field homogeneity and spectral resolution in the conventional PHIP schemes. This hampers the application of PHIP enhancement in many fields, as for example in food science, materials science or MRI, where low B(0)-fields or low B(0)-homogeneity do decrease spectral resolution, leading to potential extinction if in-phase and anti-phase hyperpolarization signals cannot be resolved. Herein, we demonstrate that the echo sequence (45°-τ-180°-τ) enables the acquisition of low resolution PHIP enhanced liquid state NMR signals of phenylpropiolic acid derivatives and phenylacetylene at a low cost low-resolution 0.54 T spectrometer. As low field TD-spectrometers are commonly used in industry or biomedicine for the relaxometry of oil-water mixtures, food, nano-particles, or other systems, we compare two variants of para-hydrogen induced polarization with data-evaluation in the time domain (TD-PHIP). In both TD-ALTADENA and the TD-PASADENA strong spin echoes could be detected under conditions when usually no anti-phase signals can be measured due to the lack of resolution. The results suggest that the time-domain detection of PHIP-enhanced signals opens up new application areas for low-field PHIP-hyperpolarization, such as non-invasive compound detection or new contrast agents and biomarkers in low-field Magnetic Resonance Imaging (MRI). Finally, solid-state NMR calculations are presented, which show that the solid echo (90y-τ-90x-τ) version of the TD-ALTADENA experiment is able to convert up to 10% of the PHIP signal into visible magnetization. Copyright © 2012 Elsevier Inc. All rights reserved.

Asymmetric Top Rotors in Superfluid Para-Hydrogen Nano-Clusters

NASA Astrophysics Data System (ADS)

Zeng, Tao; Li, Hui; Roy, Pierre-Nicholas

2012-06-01

We present the first simulation study of bosonic clusters doped with an asymmetric top molecule. A variation of the path-integral Monte Carlo method is developed to study a para-water (pH_2O) impurity in para-hydrogen (pH_2) clusters. The growth pattern of the doped clusters is similar in nature to that of the pure clusters. The pH_2O molecule appears to rotate freely in the cluster due to its large rotational constants and the lack of adiabatic following. The presence of pH_2O substantially quenches the superfluid response of pH_2 with respect to the space fixed frame. We also study the behaviour of a sulphur dioxide (32S16O_2) dopant in the pH_2 clusters. For such a heavy rotor, the adiabatic following of the pH_2 molecules is established and the superfluid renormalization of the rotational constants is observed. The rotational structure of the SO_2-p(H_2)_N clusters' ro-vibrational spectra is predicted. The connection between the superfluid response respect to the external boundary rotation and the dopant rotation is discussed.

Global variation of the para hydrogen fraction in Jupiter's atmosphere and implications for dynamics on the outer planets

NASA Technical Reports Server (NTRS)

Conrath, B. J.; Gierasch, P. J.

1984-01-01

A detailed analysis of the Voyager infrared spectrometer measurements on Jupiter's atmosphere is presented, and possible implications of para hydrogen disequilibrium for the energetics and dynamics of that atmosphere are examined. The method of data analysis is described, and results for the large scale latitude variation of the para hydrogen fraction are presented. The Jovian results show pronounced latitude variation, and are compared with other parameters including wind fields, thermal structure, and various indicators of atmospheric clouds. The problem of equilibration rate is reexamined, and it is concluded that on Jupiter the equilibration time is longer than the radiative time constant at the level of emission to space, but that this inequality reverses at greater depths. A model for the interaction of fluid motions with the ortho-para conversion process is presented, and a consistent mixing length theory for the reacting ortho-para mixture is developed. Several implications of the Jovian data for atmospheric energetics and stability on the outer planets are presented.

Theoretical study of the design of a catalyst for para to ortho hydrogen conversion

NASA Technical Reports Server (NTRS)

Coffman, Robert E.

1992-01-01

The theory of Petzinger and Scalapino (1973) was thoroughly reviewed, and all of the basic equations for paramagnetic para to ortho hydrogen catalysis re-derived. There are only a few minor phase errors and errors of omission in the description of the theory. Three models (described by Petzinger and Scalapino) for the rate of para to ortho H2 catalysis were worked out, and uniform agreement obtained to within a constant factor of 2 pi. The analytical methods developed in the course of this study were then extended to two new models, which more adequately describe the process of surface catalysis including transfer of hydrogen molecules onto and off of the surface. All five equations for the para to ortho catalytic rate of conversion are described. The two new equations describe the catalytic rate for these models: H2 on the surface is a 2-D gas with lifetime tau; and H2 on the surface is a 2-D liquid undergoing Brownian motion (diffusion) with surface lifetime tau.

Pressure-induced orientational glass phase in molecular para-hydrogen.

PubMed

Schelkacheva, T I; Tareyeva, E E; Chtchelkatchev, N M

2009-02-01

We propose a theoretical description of a possible orientational glass transition in solid molecular para-hydrogen and ortho-deuterium under pressure supposing that they are mixtures of J=0 and J=2 states of molecules. The theory uses the basic concepts and methods of standard spin-glass theory. We expect our orientational glass to correspond to the II' phase of the high-pressure hydrogen phase diagram.

Nursing Diagnosis Based on Signs and Symptoms of Patients With Heart Disease.

PubMed

da Costa, Cíntia; da Costa Linch, Graciele Fernanda; Nogueira de Souza, Emiliane

2016-10-01

The aim was to identify the main signs and symptoms of cardiac patients hospitalized in a unit of intensive cardiology care in order to infer the main nursing diagnoses (NDs). We performed a cross-sectional study; the sample consisted of 77 randomly selected records. Those records included only patients hospitalized for cardiovascular causes and with electronic chart available. Signs and symptoms identified at admission were psychic (40.3%), compressive dressing on arterial puncture site (33.8%), chest pain (29.9%), tachycardia (22.1%), and hemodynamic instability (20.8%). According to the data collected, we were able to infer that acute pain, excess of fluid volume, decreased cardiac output, spontaneous ventilation impaired, anxiety and impaired skin integrity are priority for the NDs in the studied population. OBJETIVO: identificar os principais sinais e sintomas de pacientes cardíacos internados em uma unidade de cuidados intensivos de cardiologia, visando inferir os diagnósticos de enfermagem prioritários. MÉTODO: Estudo transversal; a amostra foi composta por 77 registros selecionados aleatoriamente. Incluíram-se apenas pacientes internados por causa cardiovascular e com registro eletrônico disponível. Os sinais e sintomas identificados na admissão foram psíquicos (40,3%), curativo compressivo em sítio de punção arterial (33,8%), dor torácica (29,9%), taquicardia (22,1%) e instabilidade hemodinâmica (20,8%). CONCLUSÕES E IMPLICAÇÕES PARA A PRÁTICA: De acordo com os dados levantados foram inferidos Dor Aguda, Volume de Líquidos Excessivo, Débito Cardíaco Diminuído, Ventilação Espontânea Prejudicada, Ansiedade e Integridade da Pele Prejudicada como diagnósticos de enfermagem prioritários para a população estudada. © 2016 NANDA International, Inc.

Psychometric Testing of INTEGRARE, an Instrument for the Assesment of Pressure Ulcer Risk in Inpatients.

PubMed

Porcel-Gálvez, Ana María; Romero-Castillo, Rocío; Fernández-García, Elena; Barrientos-Trigo, Sergio

2017-08-21

The aim of this study is to evaluate the psychometric properties of INTEGRARE, an instrument based on Nursing Outcome Classification. A multicenter, cross-sectional, methodological design was used. The study included 3,835 patients. Internal consistency α = 0.86. Confirmatory factor analysis demonstrated the unidimensionality of the scale, indicating a good model fit (CMIN/DF = 4; GFI, CFI, NFI, IFI = 0.999; RMSEA = 0.028). INTEGRARE is a valid and reliable instrument with high sensitivity, specificity, and diagnostic accuracy in measuring pressure ulcer (PU) risk in inpatients. This instrument allows us to know the effectiveness of nursing interventions, providing evidence for the validation of the diagnosis Risk for pressure ulcer (00249) as well as on health outcomes, due to the fact that PUs are nursing-sensitive outcomes. Evaluar las propiedades psicométricas de INTEGRARE, un instrumento basado en la Clasificación de Resultados de Enfermería. MÉTODO: Se optó por un diseño transversal multicéntrico. El estudio incluyó a 3,835 pacientes. Consistencia interna α = 0.86. El análisis factorial confirmatorio demostró la unidimensionalidad de la escala, indicando un buen ajuste del modelo (CMIN/DF = 4; GFI, CFI, NFI, IFI = 0.999; RMSEA = 0.028). INTEGRARE es un instrumento válido y fiable con alta sensibilidad, especificidad y precisión diagnóstica en la medición de riesgo de úlcera por presión (UPP) en pacientes hospitalizados. IMPLICACIONES PARA LA PRÁCTICA ENFERMERA: Este instrumento nos permite conocer la efectividad de las intervenciones enfermeras, aportando evidencia para la validación del diagnóstico Riesgo de úlcera por presión (00249), así como sobre los resultados de salud, debido a que las UPP son resultados sensibles a la práctica enfermera. © 2017 NANDA International, Inc.

Theoretical Study of the Mechanism Behind the para-Selective Nitration of Toluene in Zeolite H-Beta

DOE Office of Scientific and Technical Information (OSTI.GOV)

Andersen, Amity; Govind, Niranjan; Subramanian, Lalitha

Periodic density functional theory calculations were performed to investigate the origin of the favorable para-selective nitration of toluene exhibited by zeolite H-beta with acetyl nitrate nitration agent. Energy calculations were performed for each of the 32 crystallographically unique Bronsted acid sites of a beta polymorph B zeolite unit cell with multiple Bronsted acid sites of comparable stability. However, one particular aluminum T-site with three favorable Bronsted site oxygens embedded in a straight 12-T channel wall provides multiple favorable proton transfer sites. Transition state searches around this aluminum site were performed to determine the barrier to reaction for both para andmore » ortho nitration of toluene. A three-step process was assumed for the nitration of toluene with two organic intermediates: the pi- and sigma-complexes. The rate limiting step is the proton transfer from the sigma-complex to a zeolite Bronsted site. The barrier for this step in ortho nitration is shown to be nearly 2.5 times that in para nitration. This discrepancy appears to be due to steric constraints imposed by the curvature of the large 12-T pore channels of beta and the toluene methyl group in the ortho approach that are not present in the para approach.« less

Supported transition metal catalysts for para- to ortho-hydrogen conversion

NASA Technical Reports Server (NTRS)

Brooks, Christopher J.; Wang, Wei; Eyman, Darrell P.

1994-01-01

The main goal of this study was to develop and improve on existing catalysts for the conversion of ortho- to para-hydrogen. Starting with a commercially available Air Products nickel silicate, which had a beta value of 20, we were trying to synthesize catalysts that would be an improvement to AP. This was accomplished by preparing silicates with various metals as well as different preparation methods. We also prepared supported ruthenium catalysts by various techniques using several metal precursors to improve present technology. What was also found was that the activation conditions prior to catalytic testing was highly important for both the silicates and the supported ruthenium catalysts. While not the initial focus of the research, we made some interesting observations into the adsorption of H2 on ruthenium. This helped us to get a better understanding of how ortho- to para-H2 conversion takes place, and what features in a catalyst are important to optimize activity. Reactor design was the final area in which some interesting conclusions were drawn. As discussed earlier, the reactor catalyst bed must be constructed using straight 1/8 feet OD stainless steel tubing. It was determined that the use of 1/4 feet OD tubing caused two problems. First, the radius from the center of the bed to the wall was too great for thermal equilibrium. Since the reaction of ortho- to para-H2 is exothermic, the catalyst bed center was warmer than the edges. Second, the catalyst bed was too shallow using a 1/4 feet tube. This caused reactant blow-by which was thought to decrease the measured activity when the flow rate was increased. The 1/8 feet tube corrected both of these concerns.

H2CS abundances and ortho-to-para ratios in interstellar clouds

NASA Technical Reports Server (NTRS)

Minh, Y. C.; Irvine, W. M.; Brewer, M. K.

1991-01-01

Several H2CS ortho and para transitions have been observed toward interstellar molecular clouds, including cold, dark clouds and star-forming regions. H2CS fractional abundances f(H2CS) about 1-2 10 to the -9th relative to molecular hydrogen toward TMC-1, Orion A, and NGC 7538, and about 5 10 to the -10th for L134N are derived. The H2CS ortho-to-para ratios in TMC-1 are about 1.8 toward the cyanopolyyne peak and the ammonia peak, which may indicate the thermalization of H2CS on 10 K grains. A ratio of about 3, the statistical value, for Orion (3N, 1E) and NGC 7538 is derived, while a value of about 2 for Orion (KL) is found.

Semantics-based distributed I/O with the ParaMEDIC framework.

DOE Office of Scientific and Technical Information (OSTI.GOV)

Balaji, P.; Feng, W.; Lin, H.

2008-01-01

Many large-scale applications simultaneously rely on multiple resources for efficient execution. For example, such applications may require both large compute and storage resources; however, very few supercomputing centers can provide large quantities of both. Thus, data generated at the compute site oftentimes has to be moved to a remote storage site for either storage or visualization and analysis. Clearly, this is not an efficient model, especially when the two sites are distributed over a wide-area network. Thus, we present a framework called 'ParaMEDIC: Parallel Metadata Environment for Distributed I/O and Computing' which uses application-specific semantic information to convert the generatedmore » data to orders-of-magnitude smaller metadata at the compute site, transfer the metadata to the storage site, and re-process the metadata at the storage site to regenerate the output. Specifically, ParaMEDIC trades a small amount of additional computation (in the form of data post-processing) for a potentially significant reduction in data that needs to be transferred in distributed environments.« less

In-Situ Visualization Experiments with ParaView Cinema in RAGE

DOE Office of Scientific and Technical Information (OSTI.GOV)

Kares, Robert John

2015-10-15

A previous paper described some numerical experiments performed using the ParaView/Catalyst in-situ visualization infrastructure deployed in the Los Alamos RAGE radiation-hydrodynamics code to produce images from a running large scale 3D ICF simulation. One challenge of the in-situ approach apparent in these experiments was the difficulty of choosing parameters likes isosurface values for the visualizations to be produced from the running simulation without the benefit of prior knowledge of the simulation results and the resultant cost of recomputing in-situ generated images when parameters are chosen suboptimally. A proposed method of addressing this difficulty is to simply render multiple images atmore » runtime with a range of possible parameter values to produce a large database of images and to provide the user with a tool for managing the resulting database of imagery. Recently, ParaView/Catalyst has been extended to include such a capability via the so-called Cinema framework. Here I describe some initial experiments with the first delivery of Cinema and make some recommendations for future extensions of Cinema’s capabilities.« less

SAMe-TT2R2 Score in the Outpatient Anticoagulation Clinic to Predict Time in Therapeutic Range and Adverse Events.

PubMed

Pivatto Junior, Fernando; Scheffel, Rafael Selbach; Ries, Lucas; Wolkind, Ricardo Roitman; Marobin, Roberta; Barkan, Sabrina Sigal; Amon, Luís Carlos; Biolo, Andréia

2017-04-01

ório de anticoagulação de um hospital terciário. Foi realizada uma avaliação retrospectiva de consultas ambulatoriais, visitas a emergência e internações hospitalares na instituição no período de janeiro-dezembro/2014. O TFT foi calculado aplicando-se o método de Rosendaal. Foram analisados 263 pacientes com TFT mediano de 62,5%. O grupo de baixo risco (0-1 ponto) obteve um TFT mediano maior em comparação com o grupo de alto risco (≥ 2 pontos): 69,2% vs. 56,3%, p = 0,002. Da mesma forma, o percentual de pacientes com TFT ≥ 60%, 65% ou 70% foi superior nos pacientes de baixo risco (p < 0,001, p = 0,001 e p = 0,003, respectivamente). Os pacientes de alto risco tiveram um percentual maior de eventos adversos (11,2% vs. 7,2%), embora não significativo (p = 0,369). O escore SAMe-TT2R2 foi uma ferramenta eficaz na predição do TFT em pacientes com FA em uso de AVKs para anticoagulação, porém não se associou à ocorrência de eventos adversos.

Hard metal lung disease: a case series.

PubMed

Mizutani, Rafael Futoshi; Terra-Filho, Mário; Lima, Evelise; Freitas, Carolina Salim Gonçalves; Chate, Rodrigo Caruso; Kairalla, Ronaldo Adib; Carvalho-Oliveira, Regiani; Santos, Ubiratan Paula

2016-01-01

�o Paulo, entre 2010 e 2013. Entre 320 pacientes atendidos no período do estudo, 5 (1,56%) foram diagnosticados com DPMD. Todos os pacientes eram do sexo masculino, com média de idade de 42,0 ± 13,6 anos e média de tempo de exposição a metal duro de 11,4 ± 8,0 anos. Os pacientes foram submetidos a avaliação clinica, história ocupacional, TCAR de tórax, prova de função pulmonar, broncoscopia com LBA e biópsia pulmonar. Todos apresentaram distúrbio ventilatório restritivo. O achado de imagem à TCAR de tórax mais frequente foi de opacidades em vidro fosco (em 80%). Em 4 pacientes, o LBA revelou presença de células gigantes multinucleadas. Em 3, foi diagnosticada pneumonia intersticial por células gigantes na biópsia pulmonar. Houve o diagnóstico de pneumonia intersticial descamativa associada à bronquiolite celular em 1 paciente e de pneumonite de hipersensibilidade em 1. Todos foram afastados da exposição e tratados com corticoide. Houve melhora em 2 pacientes e progressão da doença em 3. Apesar de ser uma entidade rara, a DPMD deve ser sempre considerada em trabalhadores com risco ocupacional elevado de exposição a metais duros. A história clínica e ocupacional associada a achados em TCAR de tórax e LBA sugestivos da doença podem ser suficientes para o diagnóstico.

Translation and adaptation of the Competencias Esenciales en Salud Pública para los recursos humanos en salud.

PubMed

Almeida, Maria de Lourdes de; Peres, Aida Maris; Ferreira, Maria Manuela Frederico; Mantovani, Maria de Fátima

2017-06-05

to perform the translation and cultural adaptation of the document named Marco Regional de Competencias Esenciales en Salud Pública para los Recursos Humanos en Salud de la Región de las Américas (Regional Framework of Core Competencies in Public Health for Health Human Resources in the Region of Americas) from Spanish to Brazilian Portuguese. a methodological study comprising the following phases: authorization for translation; initial translation; synthesis of translations and consensus; back-translation and formation of an expert committee. in the translation of domain names, there was no difference in 66.7% (N = 4); in the translation of domain description and competencies there were divergences in 100% of them (N = 6, N = 56). A consensus of more than 80% was obtained in the translation and improvement in the expert committee by the change of words and expressions for approximation of meanings to the Brazilian context. the translated and adapted document has the potential of application in research, and use in the practice of collective/public health care in Brazil. realizar a tradução e adaptação cultural do Marco Regional de Competencias Esenciales en Salud Pública para los Recursos Humanos en Salud de la Región de las Américas, do espanhol para a língua portuguesa do Brasil. pesquisa metodológica, que seguiu as fases: autorização para tradução; tradução inicial; síntese das traduções e consenso; retrotradução e composição de um comitê de especialistas. na tradução dos nomes dos domínios, não houve diferença em 66,7 % (N=4); na tradução da descrição dos domínios e das competências ocorreram divergências em 100 % destes (N=6, N=56), obteve-se consenso acima de 80% ainda na tradução, e aprimoramento no comitê de especialistas pela alteração de palavras e expressões para aproximar os significados ao contexto brasileiro. o documento traduzido e adaptado possui potencial de aplicação em pesquisas e utilização na pr

Desarrollo de fotonovelas para concienciar sobre trastornos de la conducta alimentaria en latinos en los Estados Unidos

PubMed Central

Reyes-Rodríguez, Mae Lynn; García, Marissa; Silva, Yormeri; Sala, Margarita; Quaranta, Michela; Bulik, Cynthia M.

2016-01-01

Resumen El objetivo de este estudio fue desarrollar fotonovelas, un tipo de novela gráfica popular en la población latina, para crear conciencia y educar sobre los trastornos de la conducta alimentaria (TCA). Cuatro caricaturas ilustradas y guiones adaptados para adultos y adolescentes de ambos sexos fueron presentados en discusiones focales y en una entrevista de profundidad. Diecisiete latinos adultos (14 mujeres; 3 hombres) y 10 adolescentes (9 féminas; 1 varón) participaron en el estudio. Los participantes encontraron las fotonovelas interesantes y que captaban más la atención que los folletos tradicionales. El uso del espanglish y la clarificación de las diferencias entre los TCA fueron sugeridos por las adolescentes femeninas. Los adultos varones sugirieron cambiar el título, que se enfocara en las consecuencias en la salud de los TCA para que llame la atención en los hombres a leer la historia. Basado en la aceptación encontrada en este estudio, la fotonovela pudiera ser una avenida prometedora para crear conciencia y educar a la comunidad latina sobre los TCA en los Estados Unidos. PMID:27313838

Violencia de Pareja en Mujeres Hispanas: Implicaciones para la Investigación y la Práctica

PubMed Central

Gonzalez-Guarda, Rosa Maria; Becerra, Maria Mercedes

2012-01-01

Las investigaciones sobre la violencia entre parejas sugieren que las mujeres hispanas están siendo afectadas desproporcionadamente por la ocurrencia y consecuencias de este problema de salud pública. El objetivo del presente artículo es dar a conocer el estado del arte en relación a la epidemiologia, consecuencias y factores de riesgo para VP entre mujeres Hispanas, discutiendo las implicaciones para la investigación y la práctica. Investigaciones han demostrado una fuerte asociación del status socioeconómico, abuso de droga y el alcohol, la salud mental, aculturación, inmigración, comportamientos sexuales riesgosos e historia de abuso con la violencia entre parejas. Sin embargo, más estudios se deben llevar a cabo para identificar otros factores de riesgos y de protección a poblaciones hispanas no clínicas. Mientras que el conocimiento sobre la etiología de la VP entre mujeres Hispanas se expanda, enfermeras y otros profesionales de la salud deben desarrollar, implementar y evaluar estrategias culturalmente adecuadas para la prevención primaria y secundaria de la violencia entre pareja. PMID:26166938

Uso de curativo a vácuo como terapia adjuvante na cicatrização de sítio cirúrgico infectado

PubMed Central

de Camargo, Paula Angeleli Bueno; Bertanha, Matheus; Moura, Regina; Jaldin, Rodrigo Gibin; Yoshida, Ricardo de Alvarenga; Pimenta, Rafael Elias Farres; Mariúba, Jamil Victor de Oliveira; Sobreira, Marcone Lima

2016-01-01

Resumo Infecções de sítios cirúrgicos com envolvimento de próteses sintéticas constituem grande desafio para tratamento. Apresentamos o caso de uma paciente com múltiplas comorbidades, histórico de enxerto aortobifemoral há 6 anos e reabordagem das anastomoses femorais por reestenoses há 5 anos. Apresentou dor inguinal esquerda e abaulamento súbitos com diagnóstico de pseudoaneurisma femoral roto e instabilidade hemodinâmica. Foi submetida a correção emergencial com interposição de prótese de dácron recoberta por prata e correção de grande hérnia incisional abdominal com tela sintética ao mesmo tempo. No pós-operatório, manteve-se por longo período sob terapia intensiva com dificuldade de extubação. Nesse ínterim, apresentou deiscência das suturas e fístula purulenta inguinal esquerda em contato com a prótese vascular. Optou-se pelo tratamento conservador, com desbridamento das feridas e aplicação de curativo a vácuo. A paciente evoluiu com melhora e cicatrização das feridas. Essa pode se constituir em ferramenta importante em casos similares.

Dipolar induced para-hydrogen-induced polarization.

PubMed

Buntkowsky, Gerd; Gutmann, Torsten; Petrova, Marina V; Ivanov, Konstantin L; Bommerich, Ute; Plaumann, Markus; Bernarding, Johannes

2014-01-01

Analytical expressions for the signal enhancement in solid-state PHIP NMR spectroscopy mediated by homonuclear dipolar interactions and single pulse or spin-echo excitation are developed and simulated numerically. It is shown that an efficient enhancement of the proton NMR signal in solid-state NMR studies of chemisorbed hydrogen on surfaces is possible. Employing typical reaction efficacy, enhancement-factors of ca. 30-40 can be expected both under ALTADENA and under PASADENA conditions. This result has important consequences for the practical application of the method, since it potentially allows the design of an in-situ flow setup, where the para-hydrogen is adsorbed and desorbed from catalyst surfaces inside the NMR magnet. Copyright © 2014 Elsevier Inc. All rights reserved.

Resultados de médio e longo prazo do tratamento endovenoso de varizes com laser de diodo em 1940 nm: análise crítica e considerações técnicas

PubMed Central

Viarengo, Luiz Marcelo Aiello; Viarengo, Gabriel; Martins, Aline Meira; Mancini, Marília Wechellian; Lopes, Luciana Almeida

2017-01-01

Resumo Contexto Desde a introdução do laser endovenoso para tratamento das varizes, há uma busca pelo comprimento de onda ideal, capaz de produzir o maior dano seletivo possível com maior segurança e menor incidência de efeitos adversos. Objetivos Avaliar os resultados de médio e longo prazo do laser de diodo de 1940 nm no tratamento de varizes, correlacionando os parâmetros utilizados com a durabilidade do desfecho anatômico. Métodos Revisão retrospectiva de pacientes diagnosticados com insuficiência venosa crônica em estágio clínico baseado em clínica, etiologia, anatomia e patofisiologia (CEAP) C2 a C6, submetidos ao tratamento termoablativo endovenoso de varizes tronculares, com laser com comprimento de onda em 1940 nm com fibra óptica de emissão radial, no período de abril de 2012 a julho de 2015. Uma revisão sistemática dos registros médicos eletrônicos foi realizada para obter dados demográficos e dados clínicos, incluindo dados de ultrassom dúplex, durante o período de seguimento pós-operatório. Resultados A média de idade dos pacientes foi de 53,3 anos; 37 eram mulheres (90,2%). O tempo médio de seguimento foi de 803 dias. O calibre médio das veias tratadas foi de 7,8 mm. A taxa de sucesso imediato foi de 100%, com densidade de energia endovenosa linear (linear endovenous energy density, LEED) média de 45,3 J/cm. A taxa de sucesso tardio foi de 95,1%, com duas recanalizações por volta de 12 meses pós-ablação. Não houve nenhuma recanalização nas veias tratadas com LEED superior a 30 J/cm. Conclusões O laser 1940 nm mostrou-se seguro e efetivo, em médio e longo prazo, para os parâmetros propostos, em segmentos venosos com até 10 mm de diâmetro. PMID:29930619

Validation of the self-assessment of communication skills and professionalism for nurses.

PubMed

Pereira, Thaís Josgrilberg; Puggina, Ana Claudia

2017-01-01

to translate, adapt cross-culturally and validate into Brazilian Portuguese the following instrument: "Self-assessment of communication skills and professionalism in residents" for the nursing professional, and to determine if personal characteristics and performance of the nurse interfere in the self-assessment about professionalism and interpersonal communication. quantitative study. the sample consisted of 110 nurses with mean age of 32 years old (± 7.3), most of them were women (n = 80; 72.7%). The internal consistency of the scale "Autoavaliação sobre profissionalismo e comunicação interpessoal entre enfermeiro e paciente" presented moderate and satisfactory reliability (α=0,712). Factorial analysis identified four factors: Interpersonal Skills, Exchange of Information, Honesty in the Relationship and Professionalism. the instrument is valid and reliable in Portuguese and for Brazilian culture. Interpersonal Skills changed with gender and marital status. Ability to exchange information was influenced by gender and working sector. Self-assessment of professionalism changed with marital status. traduzir, adaptar culturalmente e validar para o português o instrumento Self-assessment of communication skills and professionalism in residents para o profissional enfermeiro e avaliar se características pessoais e de atuação do enfermeiro interferem na autoavaliação sobre o profissionalismo e comunicação interpessoal. estudo metodológico quantitativo. A amostra foi de 110 enfermeiros com média de idade de 32 anos (±7,3) e a maioria mulheres (n=80; 72,7%). A consistência interna da escala "Autoavaliação sobre profissionalismo e comunicação interpessoal entre enfermeiro e paciente" apresentou confiabilidade moderada e satisfatória (α=0,712). A análise fatorial identificou quatro fatores: Habilidade Interpessoal, Troca de Informação, Sinceridade na Relação e Profissionalismo. o instrumento é válido e confiável na língua portuguesa e para a

Intensity-Modulated Radiation Therapy for the Treatment of Squamous Cell Anal Cancer With Para-aortic Nodal Involvement

DOE Office of Scientific and Technical Information (OSTI.GOV)

Hodges, Joseph C.; Das, Prajnan, E-mail: PrajDas@mdanderson.or; Eng, Cathy

2009-11-01

Purpose: To determine the rates of toxicity, locoregional control, distant control, and survival in anal cancer patients with para-aortic nodal involvement, treated with intensity-modulated radiotherapy (IMRT) and concurrent chemotherapy at a single institution. Methods and Materials: Between 2001 and 2007, 6 patients with squamous cell anal cancer and para-aortic nodal involvement were treated with IMRT and concurrent infusional 5-fluorouracil and cisplatin. The primary tumor was treated with a median dose of 57.5 Gy (range, 54-60 Gy), involved para-aortic, pelvic, and inguinal lymph nodes were treated with a median dose of 55 Gy (range, 50.5-55 Gy), and noninvolved nodal regions weremore » treated with a median dose of 45 Gy (range, 43.5-45 Gy). Results: After a median follow-up of 25 months, none of the patients had a recurrence at the primary tumor, pelvic/inguinal nodes, or para-aortic nodes, whereas 2 patients developed distant metastases to the liver. Four of the 6 patients are alive. The 3-year actuarial locoregional control, distant control, and overall survival rates were 100%, 56%, and 63%, respectively. Four of the 6 patients developed Grade 3 acute gastrointestinal toxicity during chemoradiation. Conclusions: Intensity-modulated radiotherapy and concurrent chemotherapy could potentially serve as definitive therapy in anal cancer patients with para-aortic nodal involvement. Adjuvant chemotherapy may be indicated in these patients, as demonstrated by the distant failure rates. These patients need to be followed carefully because of the potential for treatment-related toxicities.« less

Factors associated with the risk of fall in adults in the postoperative period: a cross-sectional study.

PubMed

Mata, Luciana Regina Ferreira da; Azevedo, Cissa; Policarpo, Aryanne Gabrielle; Moraes, Juliano Teixeira

2017-06-08

ún paciente presentó recuperación quirúrgica precaria. En relación a los resultados del análisis bivariado, se identificó que edad (p<0,001), HAS (p<0,001) y diabetes (p=0,017) estuvieron asociados positivamente con alto riesgo de caída y el cáncer (p=0,004) estuvo asociado positivamente con moderado riesgo de caída. La recuperación quirúrgica (p=0,008) estuvo asociada inversamente con alto riesgo de caída. los resultados de este estudio posibilitaran la identificación de cinco factores asociados al riesgo de caída en adultos de internación quirúrgica. Los hallazgos podrán auxiliar la planificación de acciones de enfermería dirigidas para prevenir el riesgo de caída en el posoperatorio. avaliar os fatores associados ao risco de queda em pacientes submetidos a procedimentos cirúrgicos. estudo quantitativo, transversal, realizado com 257 pacientes adultos em um hospital de Minas Gerais, Brasil. A coleta de dados se deu por meio de um questionário sociodemográfico e clínico, Morse Fall Scale e Quality of Recovery Score. Os dados foram submetidos a análise estatística descritiva e regressão logística multinominal. O nível de significância adotado foi de 0,05. 35,4% dos pacientes apresentaram elevado risco de quedas, 38,9% moderado risco e 25,7% baixo risco. A escala de recuperação cirúrgica indicou valor médio de 175,37 pontos e nenhum paciente apresentou recuperação cirúrgica precária. Em relação aos resultados da análise bivariada, identificou-se que idade (p<0,001), HAS (p<0,001) e diabetes (p=0,017) estiveram associados positivamente com o alto risco de queda e o câncer (p=0,004) esteve associado positivamente com o moderado risco de queda. Já a recuperação cirúrgica (p=0,008) esteve associada inversamente com o alto risco de queda. os resultados deste estudo possibilitaram a identificação de cinco fatores associados ao risco de queda em adultos de internação cirúrgica. Os achados poderão subsidiar o planejamento de a

Efficient Synthesis of Molecular Precursors for Para-Hydrogen-Induced Polarization of Ethyl Acetate-1-(13) C and Beyond.

PubMed

Shchepin, Roman V; Barskiy, Danila A; Coffey, Aaron M; Manzanera Esteve, Isaac V; Chekmenev, Eduard Y

2016-05-10

A scalable and versatile methodology for production of vinylated carboxylic compounds with (13) C isotopic label in C1 position is described. It allowed synthesis of vinyl acetate-1-(13) C, which is a precursor for preparation of (13) C hyperpolarized ethyl acetate-1-(13) C, which provides a convenient vehicle for potential in vivo delivery of hyperpolarized acetate to probe metabolism in living organisms. Kinetics of vinyl acetate molecular hydrogenation and polarization transfer from para-hydrogen to (13) C via magnetic field cycling were investigated. Nascent proton nuclear spin polarization (%PH ) of ca. 3.3 % and carbon-13 polarization (%P13C ) of ca. 1.8 % were achieved in ethyl acetate utilizing 50 % para-hydrogen corresponding to ca. 50 % polarization transfer efficiency. The use of nearly 100% para-hydrogen and the improvements of %PH of para-hydrogen-nascent protons may enable production of (13) C hyperpolarized contrast agents with %P13C of 20-50 % in seconds using this chemistry. © 2016 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

Charge Transfer Directed Radical Substitution Enables para-Selective C–H Functionalization

PubMed Central

Boursalian, Gregory B.; Ham, Won Seok; Mazzotti, Anthony R.; Ritter, Tobias

2016-01-01

Efficient C–H functionalization requires selectivity for specific C–H bonds. Progress has been made for directed aromatic substitution reactions to achieve ortho- and meta- selectivity, but a general strategy for para-selective C–H functionalization has remained elusive. Herein, we introduce a previously unappreciated concept which enables nearly complete para selectivity. We propose that radicals with high electron affinity elicit areneto-radical charge transfer in the transition state of radical addition, which is the factor primarily responsible for high positional selectivity. We demonstrate that the selectivity is predictable by a simple theoretical tool and show the utility of the concept through a direct synthesis of aryl piperazines. Our results contradict the notion, widely held by organic chemists, that radical aromatic substitution reactions are inherently unselective. The concept of charge transfer directed radical substitution could serve as the basis for the development of new, highly selective C–H functionalization reactions. PMID:27442288

Charge-transfer-directed radical substitution enables para-selective C-H functionalization

NASA Astrophysics Data System (ADS)

Boursalian, Gregory B.; Ham, Won Seok; Mazzotti, Anthony R.; Ritter, Tobias

2016-08-01

Efficient C-H functionalization requires selectivity for specific C-H bonds. Progress has been made for directed aromatic substitution reactions to achieve ortho and meta selectivity, but a general strategy for para-selective C-H functionalization has remained elusive. Herein we introduce a previously unappreciated concept that enables nearly complete para selectivity. We propose that radicals with high electron affinity elicit arene-to-radical charge transfer in the transition state of radical addition, which is the factor primarily responsible for high positional selectivity. We demonstrate with a simple theoretical tool that the selectivity is predictable and show the utility of the concept through a direct synthesis of aryl piperazines. Our results contradict the notion, widely held by organic chemists, that radical aromatic substitution reactions are inherently unselective. The concept of radical substitution directed by charge transfer could serve as the basis for the development of new, highly selective C-H functionalization reactions.

Implementação de um algoritmo para a limpeza de mapas da RCFM

NASA Astrophysics Data System (ADS)

Souza, C. L.; Wuensche, C. A.

2003-08-01

A Radiação Cósmica de Fundo em Microondas (RCFM), descoberta por Penzias e Wilson em 1965, é uma das ferramentas mais poderosas para o estudo da cosmologia. Com a descoberta de flutuações de temperatura na RCFM, da ordem de uma parte em 105, pelo COBE (1992), uma nova era teve início. Nos últimos onze anos, diversos instrumentos fizeram novas medidas de alta precisão, refinando os resultados apresentados pelo COBE, culminando com os resultados recentes do satélite WMAP. A análise de dados da RCFM, especialmente no caso de experimentos com pequena cobertura do céu, apresenta uma série de dificuldades devido a emissões de contaminantes externos, tais como a emissão da Galáxia e de fontes pontuais, e de ruídos intrínsecos tanto ao sistema de detecção quanto à estratégia de observação do céu. Uma das soluções típicas para a filtragem de dados brutos de um experimento para medir flutuações de temperatura é aplicar um gabarito (template) e um filtro passa alta ao produzir mapas simplificados (sem considerar matrizes de correlação ou covariância). No caso de experimentos que utilizam detectores HEMT, essa combinação de filtros remove, satisfatoriamente, ruídos do tipo 1/f gerados pela instabilidade no ganho do detector acoplado ao movimento do instrumento, definido pela estratégia de observação. Entretanto, o sinal resultante medido, tanto em simulações quanto em séries temporais reais, sugere que parte do sinal cosmológico pode estar sendo removido junto com o ruído dos detectores. Este trabalho descreve as etapas para a produção de um mapa típico (simulado) e os testes preliminares de um algoritmo para remover ruídos do tipo 1/f introduzidos pela estratégia de observação sem prejudicar a qualidade do sinal cosmológico presente no mapa.

Refinement of the experimental dynamic structure factor for liquid para-hydrogen and ortho-deuterium using semi-classical quantum simulation.

PubMed

Smith, Kyle K G; Poulsen, Jens Aage; Cunsolo, A; Rossky, Peter J

2014-01-21

The dynamic structure factor of liquid para-hydrogen and ortho-deuterium in corresponding thermodynamic states (T = 20.0 K, n = 21.24 nm(-3)) and (T = 23.0 K, n = 24.61 nm(-3)), respectively, has been computed by both the Feynman-Kleinert linearized path-integral (FK-LPI) and Ring-Polymer Molecular Dynamics (RPMD) methods and compared with Inelastic X Ray Scattering spectra. The combined use of computational and experimental methods enabled us to reduce experimental uncertainties in the determination of the true sample spectrum. Furthermore, the refined experimental spectrum of para-hydrogen and ortho-deuterium is consistently reproduced by both FK-LPI and RPMD results at momentum transfers lower than 12.8 nm(-1). At larger momentum transfers the FK-LPI results agree with experiment much better for ortho-deuterium than for para-hydrogen. More specifically we found that for k ∼ 20.0 nm(-1) para-hydrogen provides a test case for improved approximations to quantum dynamics.

Linfoma Nasal de Células T/Natural Killer Extranodal Refractario Mal Diagnosticado, Tratado de Manera Exitosa: Informe de Caso.

PubMed

Saavedra Ramírez, José Domingo

2017-01-01

El linfoma de células T/natural killer extranodal ("extranodal natural killer/T-cell lymphoma", ENKL) nasal es un linfoma no Hodgkin (LNH) agresivo y poco común para el cual no se ha establecido un tratamiento de referencia claro, especialmente en el escenario de la enfermedad recidivante/refractaria. Debido a su rareza, no se han llevado a cabo ensayos aleatorizados específicamente en ENKL nasal; sin embargo, los informes de caso y las series de caso pequeñas ofrecen un conocimiento importante sobre nuevos tratamientos potenciales. Presentamos el informe de caso de un paciente con ENKL nasal (previamente mal diagnosticado como una sinusitis crónica recidivante) en quien la enfermedad progresó durante la quimioterapia con múltiples agentes pero respondió al tratamiento de segunda línea con pralatrexato como agente único. Analizamos opciones de tratamiento para el ENKL nasal recidivante/refractario y sugerimos que el pralatrexato se evalúe más a fondo en este escenario clínico.

Linfoma Nasal de Células T/Natural Killer Extranodal Refractario Mal Diagnosticado, Tratado de Manera Exitosa: Informe de Caso

PubMed Central

Saavedra Ramírez, José Domingo

2017-01-01

El linfoma de células T/natural killer extranodal (“extranodal natural killer/T-cell lymphoma”, ENKL) nasal es un linfoma no Hodgkin (LNH) agresivo y poco común para el cual no se ha establecido un tratamiento de referencia claro, especialmente en el escenario de la enfermedad recidivante/refractaria. Debido a su rareza, no se han llevado a cabo ensayos aleatorizados específicamente en ENKL nasal; sin embargo, los informes de caso y las series de caso pequeñas ofrecen un conocimiento importante sobre nuevos tratamientos potenciales. Presentamos el informe de caso de un paciente con ENKL nasal (previamente mal diagnosticado como una sinusitis crónica recidivante) en quien la enfermedad progresó durante la quimioterapia con múltiples agentes pero respondió al tratamiento de segunda línea con pralatrexato como agente único. Analizamos opciones de tratamiento para el ENKL nasal recidivante/refractario y sugerimos que el pralatrexato se evalúe más a fondo en este escenario clínico. PMID:29430232

DIAGNOSTIC ACCURACY OF BARIUM ENEMA FINDINGS IN HIRSCHSPRUNG'S DISEASE.

PubMed

Peyvasteh, Mehran; Askarpour, Shahnam; Ostadian, Nasrollah; Moghimi, Mohammad-Reza; Javaherizadeh, Hazhir

2016-01-01

átrica. Enema baritado é usado para a avaliação dos pacientes com o diagnóstico . Avaliar a sensibilidade, especificidade, valor preditivo positivo e valor preditivo negativo de achados radiológicos para diagnóstico de Hirschsprung em pacientes submetidos ao enema opaco. Este estudo transversal foi realizado em Imam Khomeini Hospital por um ano a partir de abril de 2012. Sessenta pacientes foram incluídos. Os critérios de inclusão foram: recém-nascidos com insuficiência de passagem de mecônio, distensão abdominal, e constipação refratária sem resposta ao tratamento médico. Foram avaliadas no enema zona de transição, atraso na evacuação de bário após 24 h, índice retossigmoide (máximo do diâmetro do reto dividido pelo máximo do sigmóide; anormal se <1), e as irregularidades da mucosa (jejunização). Biópsia foi obtida em três localizações acima da linha dentada. VPP, VPN, especificidade e sensibilidade foram calculados para cada achado. A idade média dos casos com a doença de Hirschsprung e sem foi 17,90±18,29 meses e 17,8±18,34 meses, respectivamente (p=0,983). Confirmou-se em 30 (M=20, F=10) dos casos. Falha no mecônio foi encontrada em 21 (70%) casos. Sensibilidade, especificidade, VPP e VPN foram de 90%, 80%, 81,8% e 88,8%, respectivamente, para a zona de transição no enema. Sensibilidade, especificidade, VPP e VPN foram 76,7%, 83,3%, 78,1% e 82,1%, respectivamente para o índice de retossigmoide. Sensitividade, especificidade, VPP e VPN foram 46,7%, 100%, 100% e 65,2%, respectivamente, para contração irregular detectada no enema baritado. Sensibilidade, especificidade, VPP e VPN foram de 23,3%, 100%, 100% e 56,6%, respectivamente, para a irregularidade da mucosa. O achado mais sensível foi zona de transição. Os achados mais específicos foram contração irregular, irregularidade da mucosa, e seguido por aparecimento de mucosa em forma de paralelepípedos.

Development of Height and Body Mass Index After Pediatric Kidney Transplantation: Experience of the Nephrology Pediatric Service at HCFMRP- USP, 2005-2014.

PubMed

Hillesheim, Elaine; Ambrósio, Valéria Laguna Salomão; Facincani, Inalda

2016-01-01

adolescentes transplantados renais e identificar fatores associados com o estado nutricional final. Foram revisados os prontuários de 17 pacientes com seguimento regular até 24 meses após o (TxR). O estado nutricional foi avaliado por estatura para idade (E/I) e índice de massa corporal para idade (IMC/I). Foi considerado catch-up de crescimento o aumento no escore-z E/I ≥ 0,5 desvios-padrão. A análise de regressão linear múltipla foi utilizada para estimar a influência de variáveis clínicas e demográficas na variação dos indicadores antropométricos aos 24 meses após TxR. A média de idade foi 9,1 ± 4,1 anos. Após 24 meses de TxR, a média de escore-z E/I aumentou de -2,66 ± 1,66 para -1,93 ± 1,08 (p ≤ 0,05), 47,0% dos pacientes apresentaram catch-up de crescimento e a mesma proporção apresentou escore-z E/I < -2. A média do escore-z IMC/I aumentou de -0,48 ± 1,03 no TxR para 0,80 ± 0,94 no terceiro mês após TxR (p < 0,001) e manteve-se estável até 24 meses. A frequência de excesso de peso aumentou de 5,9% no TxR para 41,2% aos 24 meses. A idade (r = -0,66; p = 0,006) e o escore-z E/I no TxR (r = -0,72; p = 0,002) foram inversamente associados ao crescimento. Após 24 meses de TxR verificou-se crescimento insuficiente para recuperação do déficit estatural e ganho ponderal excessivo. O TxR promoveu maior crescimento nos pacientes mais jovens e com maior déficit estatural no TxR.

Clinical and epidemiological aspects of cornea transplant patients of a reference hospital.

PubMed

Cruz, Giovanna Karinny Pereira; Azevedo, Isabelle Campos de; Carvalho, Diana Paula de Souza Rego Pinto; Vitor, Allyne Fortes; Santos, Viviane Euzébia Pereira; Ferreira, Marcos Antonio

2017-06-08

clinically characterizing cornea transplant patients and their distribution according to indicated and post-operative conditions of cornea transplantation, as well as estimating the average waiting time. a cross-sectional, descriptive and analytical study performed for all cornea transplants performed at a reference service (n=258). Data were analyzed using Statistical Package for the Social Sciences, version 20.0. the main indicator for cornea transplant was keratoconus. The mean waiting time for the transplant was approximately 5 months and 3 weeks for elective transplants and 9 days for urgent cases. An association between the type of corneal disorder with gender, age, previous surgery, eye classification, glaucoma and anterior graft failure were found. keratoconus was the main indicator for cornea transplant. Factors such as age, previous corneal graft failure (retransplantation), glaucoma, cases of surgeries prior to cornea transplant (especially cataract surgery) may be related to the onset corneal endothelium disorders. caracterizar clínicamente los pacientes trasplantados y su distribución, con descripción de las condiciones indicadoras y posoperatorias de los trasplantes de córneas, así como estimar el tiempo promedio en la fila de espera. estudio epidemiológico, transversal, descriptivo y analítico, realizado con todos los trasplantes de córnea realizados en un servicio de referencia (n=258). Los datos fueron analizados con el software Statistical Package for the Social Sciences, versión 20.0. la principal condición indicadora para el trasplante de córnea fue el queratocono. El tiempo promedio en fila de espera para realización del trasplante fue de aproximadamente 5 meses y tres semanas, para trasplantes electivos y de 9 días para los casos de urgencia. Existió asociación entre el tipo de disturbio de la córnea con: sexo, intervalo etario, cirugía previa, clasificación del ojo, glaucoma y rechazo del injerto anterior. el queratocono fue

Anuncios de servicio público para proteger a los trabajadores de plaguicidas

EPA Pesticide Factsheets

Estos archivos de anuncios de servicio público se pueden descargar libremente para su uso en la formación, transmisiones de audio, etc.(These public service announcement files can be freely downloaded for use in training, audio broadcasts, etc.)

Nitroxide paramagnet-induced para-ortho conversion and nuclear spin relaxation of H2 in organic solvents.

PubMed

Sartori, Elena; Ruzzi, Marco; Lawler, Ronald G; Turro, Nicholas J

2008-09-24

The kinetics of para-ortho conversion and nuclear spin relaxation of H 2 in chloroform- d 1 were investigated in the presence of nitroxides as paramagnetic catalysts. The back conversion from para-hydrogen ( p-H 2) to ortho-hydrogen ( o-H 2) was followed by NMR by recording the increase in the intensity of the signal of o-H 2 at regular intervals of time. The nitroxides proved to be hundreds of times more effective at inducing relaxation among the spin levels of o-H 2 than they are in bringing about transitions between p-H 2 and the levels of o-H 2. The value of the encounter distance d between H 2 and the paramagnetic molecule, calculated from the experimental bimolecular conversion rate constant k 0, using the Wigner theory of para-ortho conversion, agrees perfectly with that calculated from the experimental relaxivity R 1 using the force free diffusion theory of spin-lattice relaxation.

Practical in-situ determination of ortho-para hydrogen ratios via fiber-optic based Raman spectroscopy

DOE PAGES

Sutherland, Liese -Marie; Knudson, James N.; Mocko, Michal; ...

2015-12-17

An experiment was designed and developed to prototype a fiber-optic-based laser system, which measures the ratio of ortho-hydrogen to para-hydrogen in an operating neutron moderator system at the Los Alamos Neutron Science Center (LANSCE) spallation neutron source. Preliminary measurements resulted in an ortho to para ratio of 3.06:1, which is within acceptable agreement with the previously published ratio. As a result, the successful demonstration of Raman Spectroscopy for this measurement is expected to lead to a practical method that can be applied for similar in-situ measurements at operating neutron spallation sources.

Practical in-situ determination of ortho-para hydrogen ratios via fiber-optic based Raman spectroscopy

DOE Office of Scientific and Technical Information (OSTI.GOV)

Sutherland, Liese -Marie; Knudson, James N.; Mocko, Michal

An experiment was designed and developed to prototype a fiber-optic-based laser system, which measures the ratio of ortho-hydrogen to para-hydrogen in an operating neutron moderator system at the Los Alamos Neutron Science Center (LANSCE) spallation neutron source. Preliminary measurements resulted in an ortho to para ratio of 3.06:1, which is within acceptable agreement with the previously published ratio. As a result, the successful demonstration of Raman Spectroscopy for this measurement is expected to lead to a practical method that can be applied for similar in-situ measurements at operating neutron spallation sources.

Role of pelvic and para-aortic lymphadenectomy in abandoned radical hysterectomy in cervical cancer.

PubMed

Barquet-Muñoz, Salim Abraham; Rendón-Pereira, Gabriel Jaime; Acuña-González, Denise; Peñate, Monica Vanessa Heymann; Herrera-Montalvo, Luis Alonso; Gallardo-Alvarado, Lenny Nadia; Cantú-de León, David Francisco; Pareja, René

2017-01-14

Cervical cancer (CC) occupies fourth place in cancer incidence and mortality worldwide in women, with 560,505 new cases and 284,923 deaths per year. Approximately, nine of every ten (87%) take place in developing countries. When a macroscopic nodal involvement is discovered during a radical hysterectomy (RH), there is controversy in the literature between resect macroscopic lymph node compromise or abandonment of the surgery and sending the patient for standard chemo-radiotherapy treatment. The objective of this study is to compare the prognosis of patients with CC whom RH was abandoned and bilateral pelvic lymphadenectomy and para-aortic lymphadenectomy was performed with that of patients who were only biopsied or with removal of a suspicious lymph node, treated with concomitant radiotherapy/chemotherapy in the standard manner. A descriptive and retrospective study was conducted in two institutions from Mexico and Colombia. Clinical records of patients with early-stage CC programmed for RH with an intraoperative finding of pelvic lymph, para-aortic nodes, or any extracervical involvement that contraindicates the continuation of surgery were obtained. Between January 2007 and December 2012, 42 clinical patients complied with study inclusion criteria and were selected for analysis. In patients with CC whom RH was abandoned due to lymph node affectation, there is no difference in overall survival or in disease-free period between systematic lymphadenectomy and tumor removal or lymph node biopsy, in pelvic lymph nodes as well as in para-aortic lymph nodes, when these patients receive adjuvant treatment with concomitant radiotherapy/chemotherapy. This is a hypothesis-generator study; thus, the recommendation is made to conduct randomized prospective studies to procure better knowledge on the impact of bilateral pelvic and para-aortic lymphadenectomy on this group of patients.

Um supressor de fundo térmico para a câmara infravermelha CamIV

NASA Astrophysics Data System (ADS)

Jablonski, F.; Laporte, R.

2003-08-01

O ângulo sólido subtendido pelos pixels na câmara infravermelha do NexGal (CamIV) que operamos no OPD/LNA contém contribuições provenientes do sistema de coleta de fluxo propriamente dito - sendo esta a parte que interessa para as medidas astronômicas - e contribuições da obstrução central, sistema de suporte do espelho secundário e região exterior à pupila de entrada do telescópio. Estas últimas contribuições são devi-das à emissão de corpo negro à temperatura ambiente e aumentam exponencialmente para comprimentos de onda maiores que 2 micra (banda K, no infravermelho próximo). Embora a resultante pode ser quantificada e subtraída dos sinais relevantes, sua variância se adiciona à variância do sinal, e pode ser facilmente a contribuição domi-nante para a incerteza final das medidas, tornando ineficiente o processo de extração de informação e degradando a sensibilidade da câmara. A maneira clássica de resolver esse problema em sistemas ópticos que operam no infravermelho, onde os efeitos da emissão térmica do ambiente são importantes, é restringir o ângulo sólido subtendido pelos pixels individuais exclusivamente aos raios provenientes do sistema óptico. Para tanto, projeta-se uma imagem real, bastante reduzida, da pupila de entrada do sistema óptico num anteparo que transmita para o sistema de imageamento só o que interessa, bloqueando as contribuições das bordas externas à pupila de entrada, obstrução central do telescópio e sistema de suporte. Como a projeção é realizada em ambiente criogênico, a contribuição térmica espúria é efetivamente eliminada. Nós optamos por um sistema do tipo Offner para implementar na prática esta função. Trata-se de um sistema baseado em espelhos esféricos, bastante compacto e ajustado por construção. A opção por espelhos do mesmo material que o sistema de suporte (Alumínio) minimiza a dilatação diferencial, crítica nesse tipo de aplicação. Apresentamos as solu

Brachial insertion of fully implantable venous catheters for chemotherapy: complications and quality of life assessment in 35 patients.

PubMed

Fonseca, Igor Yoshio Imagawa; Krutman, Mariana; Nishinari, Kenji; Yazbek, Guilherme; Teivelis, Marcelo Passos; Bomfim, Guilherme André Zottele; Cavalcante, Rafael Noronha; Wolosker, Nelson

2016-01-01

complicações pós-operatórias precoces, ocorridas em até 30 dias após o implante. A avaliação do grau de satisfação foi realizada com base na aplicação de um questionário específico já utilizado em estudos prévios. Em todos os casos, a punção ecoguiada da veia basílica foi possível, e o procedimento foi concluído com sucesso. As complicações precoces observadas incluíram um caso de tromboflebite de basílica e um de infecção de bolsa, ambos tratados clinicamente sem necessidade de retirada do dispositivo. Dos 35 pacientes interrogados, 33 (94,3%) recomendariam o dispositivo para outras pessoas. A implantação do port braquial é uma opção factível, com baixo risco intraoperatório e taxas semelhantes de complicações pós-operatórias imediatas quando comparada a dados já existentes da técnica convencional. Os pacientes estudados apresentaram-se satisfeitos com o dispositivo e recomendariam o procedimento para outras pessoas.

[Not Available].

PubMed

MIján de la Torre, Alberto

2016-06-03

El síndrome de caquexia cancerosa es responsable de la muerte de un número significativo de pacientes con cáncer. Se caracteriza por la presencia de una ingesta reducida, con inflamación sistémica y un metabolismo alterado. Los enfermos presentan característicamente una progresiva pérdida de peso y de masa muscular, junto a deterioro funcional. La pérdida muscular se debe a la combinación de reducción de la síntesis proteica con aumento de su degradación. Ello conduce tanto a un acortamiento como a una reducción en el área de la fibra muscular. Asimismo, existen datos que apoyan que selectivamente algunos de los tipos de fibra muscular se ven más afectados. Es necesario definir bien los valores de corte de sarcopenia para diagnosticar la pérdida muscular y existen diferentes métodos. El sistema de la ubiquitina-proteasoma parece desempeñar un papel predominante en la degradación de la proteína miofibrilar. La tendencia a perder masa muscular en los pacientes con caquexia cancerosa parece estar asociada a la activación de señales catabólicas por citoquinas proinflamatorias, así como por productos tumorales del tipo factor inductor de proteólisis. En referencia a los factores pronósticos, el riesgo de muerte está bien documentado en pacientes con sarcopenia y, especialmente, en aquellos con obesidad asociada a la sarcopenia. Asimismo, se ha establecido una relación directa entre la pérdida intensa de masa muscular y la supervivencia en pacientes con diferentes tipos de tumores del tipo de cáncer de páncreas, pulmón, tracto biliar o cáncer colorrectal. Respecto de la terapia en el síndrome de caquexia cancerosa, es factible que requiera tratamiento con varios grupos combinados que incluyan, junto al soporte nutricional, fármacos orexígenos, con efecto anabólico y antinflamatorio, asociados a intervenciones que estimulen el ejercicio físico.

Extracorporeal respiratory support in adult patients.

PubMed

Romano, Thiago Gomes; Mendes, Pedro Vitale; Park, Marcelo; Costa, Eduardo Leite Vieira

2017-01-01

In patients with severe respiratory failure, either hypoxemic or hypercapnic, life support with mechanical ventilation alone can be insufficient to meet their needs, especially if one tries to avoid ventilator settings that can cause injury to the lungs. In those patients, extracorporeal membrane oxygenation (ECMO), which is also very effective in removing carbon dioxide from the blood, can provide life support, allowing the application of protective lung ventilation. In this review article, we aim to explore some of the most relevant aspects of using ECMO for respiratory support. We discuss the history of respiratory support using ECMO in adults, as well as the clinical evidence; costs; indications; installation of the equipment; ventilator settings; daily care of the patient and the system; common troubleshooting; weaning; and discontinuation. RESUMO Em pacientes com insuficiência respiratória grave (hipoxêmica ou hipercápnica), o suporte somente com ventilação mecânica pode ser insuficiente para suas necessidades, especialmente quando se tenta evitar o uso de parâmetros ventilatórios que possam causar danos aos pulmões. Nesses pacientes, extracorporeal membrane oxygenation (ECMO, oxigenação extracorpórea por membrana), que também é muito eficaz na remoção de dióxido de carbono do sangue, pode manter a vida, permitindo o uso de ventilação pulmonar protetora. No presente artigo de revisão, objetivamos explorar alguns dos aspectos mais relevantes do suporte respiratório por ECMO. Discutimos a história do suporte respiratório por ECMO em adultos; evidências clínicas; custos; indicações; instalação do equipamento; parâmetros ventilatórios; cuidado diário do paciente e do sistema; solução de problemas comuns; desmame e descontinuação.

Educational interventions to improve inhaler techniques and their impact on asthma and COPD control: a pilot effectiveness-implementation trial.

PubMed

Maricoto, Tiago; Madanelo, Sofia; Rodrigues, Luís; Teixeira, Gilberto; Valente, Carla; Andrade, Lília; Saraiva, Alcina

2016-01-01

To assess the impact that educational interventions to improve inhaler techniques have on the clinical and functional control of asthma and COPD, we evaluated 44 participants before and after such an intervention. There was a significant decrease in the number of errors, and 20 patients (46%) significantly improved their technique regarding prior exhalation and breath hold. In the asthma group, there were significant improvements in the mean FEV1, FVC, and PEF (of 6.4%, 8.6%, and 8.3% respectively). Those improvements were accompanied by improvements in Control of Allergic Rhinitis and Asthma Test scores but not in Asthma Control Test scores. In the COPD group, there were no significant variations. In asthma patients, educational interventions appear to improve inhaler technique, clinical control, and functional control. RESUMO Para avaliar o impacto do ensino da técnica inalatória no controle clínico e funcional de pacientes com asma ou DPOC, incluíram-se 44 participantes antes e após essa intervenção. Houve uma diminuição significativa no número de erros cometidos, sendo que 20 pacientes (46%) melhoraram significativamente sua técnica na expiração prévia e apneia final. No grupo asma, houve significativa melhora nas médias de FEV1 (6,4%), CVF (8,6%) e PFE (8,3%), e essa melhora correlacionou-se com os resultados no Control of Allergic Rhinitis and Asthma Test, mas não com os do Asthma Control Test. No grupo DPOC, não houve variações significativas. O ensino da técnica inalatória parece melhorar seu desempenho e os controles clínico e funcional em pacientes com asma.

Refinement of the experimental dynamic structure factor for liquid para-hydrogen and ortho-deuterium using semi-classical quantum simulation

DOE Office of Scientific and Technical Information (OSTI.GOV)

Smith, Kyle K. G., E-mail: kylesmith@utexas.edu; Rossky, Peter J., E-mail: peter.rossky@austin.utexas.edu; Poulsen, Jens Aage, E-mail: jens72@chem.gu.se

The dynamic structure factor of liquid para-hydrogen and ortho-deuterium in corresponding thermodynamic states (T = 20.0 K, n = 21.24 nm{sup −3}) and (T = 23.0 K, n = 24.61 nm{sup −3}), respectively, has been computed by both the Feynman-Kleinert linearized path-integral (FK-LPI) and Ring-Polymer Molecular Dynamics (RPMD) methods and compared with Inelastic X Ray Scattering spectra. The combined use of computational and experimental methods enabled us to reduce experimental uncertainties in the determination of the true sample spectrum. Furthermore, the refined experimental spectrum of para-hydrogen and ortho-deuterium is consistently reproduced by both FK-LPI and RPMD results at momentum transfers lower than 12.8 nm{sup −1}.more » At larger momentum transfers the FK-LPI results agree with experiment much better for ortho-deuterium than for para-hydrogen. More specifically we found that for k ∼ 20.0 nm{sup −1} para-hydrogen provides a test case for improved approximations to quantum dynamics.« less

Diseño y Operación de un Secador Solar de Madera para Países Tropicales

Treesearch

Brian Bond; Omar Espinoza; Philip Araman

2011-01-01

La madera es usualmente secada a un contenido de humedad específico antes de ser transformada en productos finales. A pesar de que la madera puede ser secada al aire, la humedad ambiental en la mayoría de las ubicaciones previene a la madera alcanzar el contenido de humedad necesario para su estabilidad dimensional y adecuado procesamiento, especialmente para usos de...

From core belief challenge to posttraumatic growth in para sport athletes: moderated mediation by needs satisfaction and deliberate rumination.

PubMed

Hammer, Chris; Podlog, Leslie; Wadey, Ross; Galli, Nick; Forber-Pratt, Anjali J; Newton, Maria

2018-04-25

To examine how deliberate rumination and psychological need satisfaction interact to facilitate posttraumatic growth for para sport athletes with acquired disability. Utilizing a sample of 70 para sport athletes, the hypothesized mediating role of deliberate rumination was examined via a simple mediation model. The interaction between needs satisfaction and deliberate rumination and their effect on posttraumatic growth was examined utilizing a moderated mediation procedure. Disruption to one's core beliefs was significantly associated with posttraumatic growth. This relationship, was in part, explained by the deliberate rumination engaged in soon after the trauma. Needs satisfaction, while a significant predictor of posttraumatic growth, did not moderate the indirect effect. Although deliberate rumination at both timeframes and needs satisfaction were independently associated with posttraumatic growth, they did not interact in the hypothesized manner to influence posttraumatic growth. There remains a need to better understand how the experience of posttraumatic growth is achieved amongst individuals with acquired disability, and the role that para sport may play in this process. Implications for rehabilitation The disruption to one's core beliefs caused by acquiring a physical disability is not only a natural experience but also a necessary antecedent to posttraumatic growth. As such, rehabilitation practitioners ought to normalize these types of challenges when working with individuals with acquired disability. Practitioners may help to facilitate growth outcomes by encouraging individuals to deliberately ruminate about their acquired disability. That is, practitioners can help those with acquired disability to seek meaning and understanding about their disability or the precipitating event. For those who struggle to deliberately ruminate in the immediate disability aftermath, practitioners may encourage para sport participation to potentially prompt constructive

DETECTION OF OCCULT LYMPH NODE TUMOR CELLS IN NODE-NEGATIVE GASTRIC CANCER PATIENTS.

PubMed

Pereira, Marina Alessandra; Ramos, Marcus Fernando Kodama Pertille; Dias, Andre Roncon; Yagi, Osmar Kenji; Faraj, Sheila Friedrich; Zilberstein, Bruno; Cecconello, Ivan; Mello, Evandro Sobroza de; Ribeiro, Ulysses

2017-01-01

estudadas como fator prognóstico no câncer gástrico, sendo relacionadas à diminuição da sobrevida global e aumento do risco de recidiva da doença. Entretanto, sua identificação é limitada pela metodologia convencional, uma vez que podem não ser identificadas pela rotina histopatológica por meio da coloração de H&E. Investigar a presença de células tumorais ocultas através de imunoistoquimica utilizando as citoqueratinas (CK) AE1/AE3 em pacientes com câncer gástrico com linfonodos histologicamente classificados como negativos por H&E. Quarenta pacientes (T1-T4N0) submetidos à gastrectomia potencialmente curativa com linfadenectomia D2 foram avaliados. A presença de metástases, micrometástases e células tumorais isoladas foram correlacionadas com características clínicopatológicas e impacto no estadiamento. Os depósitos tumorais nos linfonodos foram classificados de acordo com o sistema TNM (7º TNM). Um total de 1439 linfonodos foi obtido (~36 por paciente). Células tumorais foram detectadas por imunoistoquimica em 24 linfonodos de 12 pacientes (30%). As células neoplásicas estavam presentes na forma isolada ou em cluster. Invasão tumoral (p=0,002), venosa (p=0,016), linfática (p=0,006) e perineural (p=0,04), assim como resposta linfocítica peritumoral (p=0,012) foram correlacionadas com linfonodos CK-positivos que originalmente eram negativos à H&E. Dois pacientes tiveram o estadiamento alterado, migrando do estádio IB para IIA. Quatro dos 28 CK-negativos (14,3%) e três dos 12 CK-positivos (25%) tiveram recorrência da doença (p=0,65). A imunoistoquimica é meio eficaz para a detecção de células tumorais ocultas em linfonodos, podendo ser recomendada para melhor determinar o estágio do tumor. Ela pode ser útil como técnica complementar à rotina de H&E, de modo a fornecer melhor estadiamento patológico.

ParaBTM: A Parallel Processing Framework for Biomedical Text Mining on Supercomputers.

PubMed

Xing, Yuting; Wu, Chengkun; Yang, Xi; Wang, Wei; Zhu, En; Yin, Jianping

2018-04-27

A prevailing way of extracting valuable information from biomedical literature is to apply text mining methods on unstructured texts. However, the massive amount of literature that needs to be analyzed poses a big data challenge to the processing efficiency of text mining. In this paper, we address this challenge by introducing parallel processing on a supercomputer. We developed paraBTM, a runnable framework that enables parallel text mining on the Tianhe-2 supercomputer. It employs a low-cost yet effective load balancing strategy to maximize the efficiency of parallel processing. We evaluated the performance of paraBTM on several datasets, utilizing three types of named entity recognition tasks as demonstration. Results show that, in most cases, the processing efficiency can be greatly improved with parallel processing, and the proposed load balancing strategy is simple and effective. In addition, our framework can be readily applied to other tasks of biomedical text mining besides NER.

A nanoparticle catalyst for heterogeneous phase para-hydrogen-induced polarization in water.

PubMed

Glöggler, Stefan; Grunfeld, Alexander M; Ertas, Yavuz N; McCormick, Jeffrey; Wagner, Shawn; Schleker, P Philipp M; Bouchard, Louis-S

2015-02-16

Para-hydrogen-induced polarization (PHIP) is a technique capable of producing spin polarization at a magnitude far greater than state-of-the-art magnets. A significant application of PHIP is to generate contrast agents for biomedical imaging. Clinically viable and effective contrast agents not only require high levels of polarization but heterogeneous catalysts that can be used in water to eliminate the toxicity impact. Herein, we demonstrate the use of Pt nanoparticles capped with glutathione to induce heterogeneous PHIP in water. The ligand-inhibited surface diffusion on the nanoparticles resulted in a (1) H polarization of P=0.25% for hydroxyethyl propionate, a known contrast agent for magnetic resonance angiography. Transferring the (1) H polarization to a (13) C nucleus using a para-hydrogen polarizer yielded a polarization of 0.013%. The nuclear-spin polarizations achieved in these experiments are the first reported to date involving heterogeneous reactions in water. © 2015 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

Efficient second harmonic generation by para-nitroaniline embedded in electro-spun polymeric nanofibres

NASA Astrophysics Data System (ADS)

Gonçalves, Hugo; Saavedra, Inês; Ferreira, Rute AS; Lopes, PE; de Matos Gomes, Etelvina; Belsley, Michael

2018-03-01

Intense well polarized second harmonic light was generated by poly(methyl methacrylate) nanofibres with embedded para-nitroaniline nanocrystals. Subwavelength diameter fibres were electro-spun using a 1:2 weight ratio of chromophore to polymer. Analysis of the generated second harmonic light indicates that the para-nitroaniline molecules, which nominally crystalize in the centrosymmetric space group, were organized into noncentrosymmetric structures leading to a second order susceptibility dominated by a single tensor element. Under the best deposition conditions, the nanofibrers display an effective nonlinear optical susceptibility approximately two orders of magnitude greater than that of potassium dihydrogen phosphate. Generalizing this approach to a broad range of organic molecules with strong individual molecular second order nonlinear responses, but which nominally form centrosymmetric organic crystals, could open a new pathway for the fabrication of efficient sub-micron sized second harmonic light generators.

Spectroscopic and structural studies of a new para-iodo-N-benzyl amide of salinomycin

NASA Astrophysics Data System (ADS)

Antoszczak, Michał; Janczak, Jan; Rutkowski, Jacek; Brzezinski, Bogumił; Huczyński, Adam

2017-11-01

A new para-iodo-N-benzyl amide of salinomycin was synthesized and characterized by NMR, FT-IR, DFT, single crystal X-ray diffraction and theoretical methods. The results obtained for the crystal, in solution and in gas phase provided evidence of pseudo-cyclic structure of this compound stabilized by intramolecular hydrogen bonds. It was shown that the compound studied forms stable 1:1 complexes with monovalent (Li+, Na+, K+, Rb+ and Cs+) and divalent (Mg2+, Ca2+, Sr2+ and Ba2+) cations demonstrating that the chemical modification of salinomycin carboxyl group considerably changes the ionophoretic properties of this antibiotic. For the first time, the ESI MS fragmentations of the complex of para-iodo-N-benzyl amide of salinomycin with Na+ are also discussed in details.

Modelizacion, control e implementacion de un procesador energetico paralelo para aplicacion en sistemas multisalida

NASA Astrophysics Data System (ADS)

Ferreres Sabater, Agustin

Cualquier sistema electronico que incluya un procesado o tratamiento de la senal, y ademas, algun tipo de actuador mecanico generalmente necesita, como minimo, dos tensiones diferentes de alimentacion. Excluyendo los sistemas de alimentacion distribuida, la solucion tecnica mas utilizada para proporcionar dos o mas tensiones consiste en las fuentes de alimentacion multisalida. En una fuente de alimentacion multisalida los diferentes circuitos que conforman cada salida comparten un mismo transformador de potencia optimizando coste, masa, y volumen. Las ventajas obtenidas con este procedimiento tienen en su contra el efecto que sobre cada salida individual provocan las demas en su conjunto debido, principalmente, a los efectos de los elementos parasitos de los componentes. Un cambio de carga en una de las salidas produce un transitorio que es visto por todas las demas como un efecto de impedancia cruzada, y al final del transitorio, la tension de cada salida es diferente respecto a la que tenian antes del transitorio. Este ultimo resultado se conoce como regulacion cruzada. La disminucion de los efectos de la regulacion cruzada ha sido objeto de estudio durante los ultimos anos. El objetivo ha sido el desarrollo de distintas estrategias que permiten, desde disminuir los efectos de la regulacion cruzada hasta los niveles deseables, a eliminarla completamente. El resultado final suele suponer una penalizacion sobre el diseno del sistema directamente proporcional al grado de regulacion a conseguir en las distintas salidas. Entre las soluciones propuestas para eliminar la regulacion cruzada las tecnicas de post-regulacion se han consolidado como la opcion mas aceptada ya que, pueden aplicarse a cualquier convertidor y no suponen ninguna complejidad adicional a la hora de plantear el diseno. En esta Tesis Doctoral se abordara el estudio de la tecnica conocida como postregulacion mediante transformador controlado, que si bien se ha empleado en convertidores resonantes, su

Effects of para-substituents of styrene derivatives on their chemical reactivity on platinum nanoparticle surfaces

NASA Astrophysics Data System (ADS)

Hu, Peiguang; Chen, Limei; Deming, Christopher P.; Lu, Jia-En; Bonny, Lewis W.; Chen, Shaowei

2016-06-01

Stable platinum nanoparticles were successfully prepared by the self-assembly of para-substituted styrene derivatives onto the platinum surfaces as a result of platinum-catalyzed dehydrogenation and transformation of the vinyl groups to the acetylene ones, forming platinum-vinylidene/-acetylide interfacial bonds. Transmission electron microscopic measurements showed that the nanoparticles were well dispersed without apparent aggregation, suggesting sufficient protection of the nanoparticles by the organic capping ligands, and the average core diameter was estimated to be 2.0 +/- 0.3 nm, 1.3 +/- 0.2 nm, and 1.1 +/- 0.2 nm for the nanoparticles capped with 4-tert-butylstyrene, 4-methoxystyrene, and 4-(trifluoromethyl)styrene, respectively, as a result of the decreasing rate of dehydrogenation with the increasing Taft (polar) constant of the para-substituents. Importantly, the resulting nanoparticles exhibited unique photoluminescence, where an increase of the Hammett constant of the para-substituents corresponded to a blue-shift of the photoluminescence emission, suggesting an enlargement of the HOMO-LUMO band gap of the nanoparticle-bound acetylene moieties. Furthermore, the resulting nanoparticles exhibited apparent electrocatalytic activity towards oxygen reduction in acidic media, with the best performance among the series of samples observed with the 4-tert-butylstyrene-capped nanoparticles due to an optimal combination of the nanoparticle core size and ligand effects on the bonding interactions between platinum and oxygen species.Stable platinum nanoparticles were successfully prepared by the self-assembly of para-substituted styrene derivatives onto the platinum surfaces as a result of platinum-catalyzed dehydrogenation and transformation of the vinyl groups to the acetylene ones, forming platinum-vinylidene/-acetylide interfacial bonds. Transmission electron microscopic measurements showed that the nanoparticles were well dispersed without apparent

WormBase ParaSite - a comprehensive resource for helminth genomics.

PubMed

Howe, Kevin L; Bolt, Bruce J; Shafie, Myriam; Kersey, Paul; Berriman, Matthew

2017-07-01

The number of publicly available parasitic worm genome sequences has increased dramatically in the past three years, and research interest in helminth functional genomics is now quickly gathering pace in response to the foundation that has been laid by these collective efforts. A systematic approach to the organisation, curation, analysis and presentation of these data is clearly vital for maximising the utility of these data to researchers. We have developed a portal called WormBase ParaSite (http://parasite.wormbase.org) for interrogating helminth genomes on a large scale. Data from over 100 nematode and platyhelminth species are integrated, adding value by way of systematic and consistent functional annotation (e.g. protein domains and Gene Ontology terms), gene expression analysis (e.g. alignment of life-stage specific transcriptome data sets), and comparative analysis (e.g. orthologues and paralogues). We provide several ways of exploring the data, including genome browsers, genome and gene summary pages, text search, sequence search, a query wizard, bulk downloads, and programmatic interfaces. In this review, we provide an overview of the back-end infrastructure and analysis behind WormBase ParaSite, and the displays and tools available to users for interrogating helminth genomic data. Copyright © 2016 The Authors. Published by Elsevier B.V. All rights reserved.

The economic burden of lung cancer and mesothelioma due to occupational and para-occupational asbestos exposure

PubMed Central

Tompa, Emile; Kalcevich, Christina; McLeod, Chris; Lebeau, Martin; Song, Chaojie; McLeod, Kim; Kim, Joanne; Demers, Paul A

2017-01-01

Objectives To estimate the economic burden of lung cancer and mesothelioma due to occupational and para-occupational asbestos exposure in Canada. Methods We estimate the lifetime cost of newly diagnosed lung cancer and mesothelioma cases associated with occupational and para-occupational asbestos exposure for calendar year 2011 based on the societal perspective. The key cost components considered are healthcare costs, productivity and output costs, and quality of life costs. Results There were 427 cases of newly diagnosed mesothelioma cases and 1904 lung cancer cases attributable to asbestos exposure in 2011 for a total of 2331 cases. Our estimate of the economic burden is $C831 million in direct and indirect costs for newly identified cases of mesothelioma and lung cancer and $C1.5 billion in quality of life costs based on a value of $C100 000 per quality-adjusted life year. This amounts to $C356 429 and $C652 369 per case, respectively. Conclusions The economic burden of lung cancer and mesothelioma associated with occupational and para-occupational asbestos exposure is substantial. The estimate identified is for 2331 newly diagnosed, occupational and para-occupational exposure cases in 2011, so it is only a portion of the burden of existing cases in that year. Our findings provide important information for policy decision makers for priority setting, in particular the merits of banning the mining of asbestos and use of products containing asbestos in countries where they are still allowed and also the merits of asbestos removal in older buildings with asbestos insulation. PMID:28756416

[80 years of soial service in medicine].

PubMed

Hace 80 años, la Escuela de Medicina de la Universidad Nacional, en voz de su director, Gustavo Baz Prada, hizo una propuesta que pronto se convirtió en realidad y finalmente en norma, la que desde entonces se conoce como SS. Esta iniciativa se vio como una manera para que los estudiantes de medicina del último año retribuyeran a la sociedad una parte de lo que esta invirtió en su educación, consolidaran su formación mediante la exposición a las realidades de todos los días en los medios más necesitados, se pusieran a prueba sobre sus verdaderas capacidades para atender pacientes y participaran en la solución de un problema de atención sanitaria que en ese entonces era mucho más apremiante que ahora. Unos años después, los recién egresados de otras licenciaturas (pasantes) también fueron incorporados a esta estrategia y, al fin, se reconoció formalmente como una responsabilidad de las instituciones educativas. Las aportaciones del SS a la salud de las personas y a la formación de los médicos han sido incuestionables, y la experiencia humana que ha representado para quienes lo han vivido ha dejado marcas indelebles.

La EPA propone normas más rigurosas para las personas que aplican los plaguicidas de más alto riesgo

EPA Pesticide Factsheets

La EPA emitió una propuesta para la revisión de la norma para la Certificación de Aplicadores de Plaguicidas. La norma ayudará a mantener nuestras comunidades seguras, salvaguardar el medio ambiente y reducir el riesgo a los que aplican los plaguicidas.

Electron impact ionization dynamics of para-benzoquinone

NASA Astrophysics Data System (ADS)

Jones, D. B.; Ali, E.; Ning, C. G.; Colgan, J.; Ingólfsson, O.; Madison, D. H.; Brunger, M. J.

2016-10-01

Triple differential cross sections (TDCSs) for the electron impact ionization of the unresolved combination of the 4 highest occupied molecular orbitals (4b3g, 5b2u, 1b1g, and 2b3u) of para-benzoquinone are reported. These were obtained in an asymmetric coplanar geometry with the scattered electron being observed at the angles -7.5°, -10.0°, -12.5° and -15.0°. The experimental cross sections are compared to theoretical calculations performed at the molecular 3-body distorted wave level, with a marginal level of agreement between them being found. The character of the ionized orbitals, through calculated momentum profiles, provides some qualitative interpretation for the measured angular distributions of the TDCS.

PSYCHOLOGICAL PROFILE OF PATIENTS ELIGIBLE FOR BARIATRIC SURGERY.

PubMed

Ribeiro, Graziela Aparecida Nogueira de Almeida; Giampietro, Helenice Brizolla; Belarmino, Lídia Barbieri; Salgado-Júnior, Wilson

édio foi 51 kg/m²+7, sendo a maioria (81%) do gênero feminino. A pontuação média no BDI foi 14,8+8 e as mulheres tiveram pontuação significativamente maior que os homens. No BAI a pontuação média foi 11+ 8 e no ECAP 14+ 8, ambos sem diferença entre os grupos. A caracterização psicossocial dos pacientes avaliados aponta para a presença significativa de indicadores de depressão, com baixos níveis de ansiedade e de compulsão alimentar.

Molecular hydrogen in the vicinity of NGC 7538 IRS 1 and IRS 2 - Temperature and ortho-to-para ratio

NASA Technical Reports Server (NTRS)

Hoban, Susan; Reuter, Dennis C.; Mumma, Michael J.; Storrs, Alex D.

1991-01-01

Near-infrared spectroscopic observations of the active star-forming region near NGC 7538 IRS 1 and IRS 2 were made. The relative intensities of the v = 1-0 Q(1), Q(3), and Q(5) lines of molecular hydrogen are used to calculate a rotational excitation temperature. Comparison of the measured intensity of the Q(2) transition relative to the intensity of Q(1) and Q(3) permitted the retrieval of the ratio of ortho-to-para hydrogen. It is found that an ortho-to-para ratio of between 1.6 and 2.35 is needed to explain the Q-branch line intensity ratios, depending on the excitation model used. This range in ortho-to-para ratios implies a range of molecular hydrogen formation temperature of approximately 105 K to 140 K.

Descripción de la zona de alta difusión en un modelo bidimensional para hojas de corriente

NASA Astrophysics Data System (ADS)

Montero, M. F.; Paola, C. A.; Platzeck, A. M.

Los modelos bidimensionales para describir hojas de corriente de alta simetría no suministran una descripción detallada de las regiones donde la difusión es considerablemente importante. Tal es el caso de los modelos desarrollados en la década del '60 por Sweet, Parker, Petschek y Sonnerup. En esta comunicación presentamos una solución de las ecuaciones MHD en el entorno del origen, construyendo series bidimensionales para todas las magnitudes físicas involucradas. Valiéndonos de la alta simetría y de las características del problema, logramos reducir el número de coeficientes a calcular. Utilizamos un programa autoconsistente para extender el cálculo a regiones vecinas con difusión moderada o despreciable.

ParaCEST agents encapsulated in Reverse nano-Assembled Capsules (RACs): How slow molecular tumbling can quench CEST

NASA Astrophysics Data System (ADS)

Farashishiko, Annah; Slack, Jacqueline R.; Botta, Mauro; Woods, Mark

2018-04-01

Although paraCEST is a method with immense scope for generating image contrast in MRI, it suffers from the series the serious drawback of high detection limits. For a typical discrete paraCEST agent the detection limit is roughly an order of magnitude higher than that of a clinically used relaxation agent. One solution to this problem may be the incorporation of a large payload of paraCEST agents into a single macromolecular agent. Here we report a new synthetic method for accomplishing this goal: incorporating a large payload of the paraCEST agent DyDOTAM3+ into a Reverse Assembled nano-Capsule. An aggregate can be generated between this chelate and polyacrylic acid after the addition of ethylene diamine. Subsequent addition of polyallylamine hydrochloride followed by silica nanoparticles generated a robust encapsulating shell and afforded capsule with a mean hydrodynamic diameter of 650 ± 250 nm. Unfortunately this encapsulation did not have the effect of amplifying the CEST effect per agent, but quenched the CEST altogether. A significant proportion of the quenching effect of encapsulation could be attributed to the effect of slowing molecular tumbling, which is inevitable when the chelate is incorporated into a nano-scale material. This increases the transverse relaxation rate of chelate protons and a theoretical examination using Solomon Bloembergen Morgan theory and the Bloch equations shows that the increase in the transverse relaxation rate constant for the amide protons, in even modestly sized nano-materials, is sufficient to significantly quench CEST.

A Web-based nomogram predicting para-aortic nodal metastasis in incompletely staged patients with endometrial cancer: a Korean Multicenter Study.

PubMed

Kang, Sokbom; Lee, Jong-Min; Lee, Jae-Kwan; Kim, Jae-Weon; Cho, Chi-Heum; Kim, Seok-Mo; Park, Sang-Yoon; Park, Chan-Yong; Kim, Ki-Tae

2014-03-01

The purpose of this study is to develop a Web-based nomogram for predicting the individualized risk of para-aortic nodal metastasis in incompletely staged patients with endometrial cancer. From 8 institutions, the medical records of 397 patients who underwent pelvic and para-aortic lymphadenectomy as a surgical staging procedure were retrospectively reviewed. A multivariate logistic regression model was created and internally validated by rigorous bootstrap resampling methods. Finally, the model was transformed into a user-friendly Web-based nomogram (http://http://www.kgog.org/nomogram/empa001.html). The rate of para-aortic nodal metastasis was 14.4% (57/397 patients). Using a stepwise variable selection, 4 variables including deep myometrial invasion, non-endometrioid subtype, lymphovascular space invasion, and log-transformed CA-125 levels were finally adopted. After 1000 repetitions of bootstrapping, all of these 4 variables retained a significant association with para-aortic nodal metastasis in the multivariate analysis-deep myometrial invasion (P = 0.001), non-endometrioid histologic subtype (P = 0.034), lymphovascular space invasion (P = 0.003), and log-transformed serum CA-125 levels (P = 0.004). The model showed good discrimination (C statistics = 0.87; 95% confidence interval, 0.82-0.92) and accurate calibration (Hosmer-Lemeshow P = 0.74). This nomogram showed good performance in predicting para-aortic metastasis in patients with endometrial cancer. The tool may be useful in determining the extent of lymphadenectomy after incomplete surgery.

Control of Photoluminescence of Carbon Nanodots via Surface Functionalization using Para-substituted Anilines

NASA Astrophysics Data System (ADS)

Kwon, Woosung; Do, Sungan; Kim, Ji-Hee; Seok Jeong, Mun; Rhee, Shi-Woo

2015-07-01

Carbon nanodots (C-dots) are a kind of fluorescent carbon nanomaterials, composed of polyaromatic carbon domains surrounded by amorphous carbon frames, and have attracted a great deal of attention because of their interesting properties. There are still, however, challenges ahead such as blue-biased photoluminescence, spectral broadness, undefined energy gaps and etc. In this report, we chemically modify the surface of C-dots with a series of para-substituted anilines to control their photoluminescence. Our surface functionalization endows our C-dots with new energy levels, exhibiting long-wavelength (up to 650 nm) photoluminescence of very narrow spectral widths. The roles of para-substituted anilines and their substituents in developing such energy levels are thoroughly studied by using transient absorption spectroscopy. We finally demonstrate light-emitting devices exploiting our C-dots as a phosphor, converting UV light to a variety of colors with internal quantum yields of ca. 20%.

New ortho-para conversion mechanism in dense solid hydrogen.

PubMed

Strzhemechny, M A; Hemley, R J

2000-12-25

Analysis of recent measurements of striking changes in the rate of ortho-para conversion of solid H(2) up to 58 GPa shows that the conversion mechanism must differ from that at ambient pressure. A new conversion mechanism is identified in which the emerging excitations are coupled to the converting molecules via electric quadrupole-quadrupole rather than nuclear spin-spin interactions. The latter only initiates conversion while the coupling enhancement associated with the new mechanism is ensured by high compression and a gap closing, with the conversion energy diminishing strongly with increasing pressure.

Estudio participativo para el desarrolllo de un instrumento de observación de violencia escolar

PubMed Central

Medina Santiago, Nilda G.; Rivera, Tania Cruz; Rodríguez, Maryanes Trenche; Báez Ávila, Loggina S.

2018-01-01

La violencia en las escuelas es reconocida como un problema de salud pública a nivel mundial que impacta negativamente el proceso de enseñanza-aprendizaje. Sin embargo, en Puerto Rico las estadísticas oficiales y los medios de comunicación generalmente se enfocan en hechos aislados de violencia extrema donde se utilizan armas o se destruye propiedad y no recogen formas de violencia más comunes que suelen ocurrir a diario en las escuelas. En este estudio se utilizó el Instrumento de Observación de Violencia Escolar (INOVE), preparado con el insumo de las comunidades escolares participantes del Proyecto VIAS (Violence and Asthma Health Disparity Network) de la Universidad del Este (UNE), para recopilar información acerca de las características de la violencia en dos escuelas puertorriqueñas. Entre los hallazgos del estudio se destacan diferencias por sexo en cuanto a categorías de violencia observadas y la observación de agresividad en juegos e interacciones entre estudiantes. Los datos recopilados han servido de base para la toma de decisiones en cuanto a la prevención de la violencia en las escuelas participantes y tienen implicaciones para el desarrollo de estrategias y programas de prevención. PMID:29643972

Madres para la Salud: design of a theory-based intervention for postpartum Latinas.

PubMed

Keller, Colleen; Records, Kathie; Ainsworth, Barbara; Belyea, Michael; Permana, Paska; Coonrod, Dean; Vega-López, Sonia; Nagle-Williams, Allison

2011-05-01

Weight gain in young women suggests that childbearing may be an important contributor to the development of obesity in women. Depressive symptoms can interfere with resumption of normal activity levels following childbirth or with the initiation of or adherence to physical activity programs essential for losing pregnancy weight. Depression symptoms may function directly to promote weight gain through a physiologic mechanism. Obesity and its related insulin resistance may contribute to depressed mood physiologically. Although physical activity has well-established beneficial effects on weight management and depression, women tend to under participate in physical activity during childbearing years. Further, the mechanisms underpinning the interplay of overweight, obesity, physical activity, depression, and inflammatory processes are not clearly explained. This report describes the theoretical rationale, design considerations, and cultural relevance for "Madres para la Salud" [Mothers for Health]. Madres para la Salud is a 12 month prospective, randomized controlled trial exploring the effectiveness of a culturally specific intervention using "bouts" of physical activity to effect changes in body fat, systemic and fat tissue inflammation, and postpartum depression symptoms in sedentary postpartum Latinas. The significance and innovation of Madres para la Salud includes use of a theory-driven approach to intervention, specification and cultural relevance of a social support intervention, use of a Promotora model to incorporate cultural approaches, use of objective measures of physical activity in post partum Latinas women, and the examination of biomarkers indicative of cardiovascular risk related to physical activity behaviors in postpartum Latinas. Copyright © 2011 Elsevier Inc. All rights reserved.

Madres para la Salud: Design of a Theory-based Intervention for Postpartum Latinas

PubMed Central

Keller, Colleen; Records, Kathie; Ainsworth, Barbara; Belyea, Michael; Permana, Paska; Coonrod, Dean; Vega-López, Sonia; Nagle-Williams, Allison

2011-01-01

Background Weight gain in young women suggests that childbearing may be an important contributor to the development of obesity in women. Depressive symptoms can interfere with resumption of normal activity levels following childbirth or with the initiation of or adherence to physical activity programs essential for losing pregnancy weight. Depression symptoms may function directly to promote weight gain through a physiologic mechanism. Obesity and its related insulin resistance may contribute to depressed mood physiologically. Although physical activity has well-established beneficial effects on weight management and depression, women tend to under participate in physical activity during childbearing years. Further, the mechanisms underpinning the interplay of overweight, obesity, physical activity, depression, and inflammatory processes are not clearly explained. Objectives This report describes the theoretical rationale, design considerations, and cultural relevance for “Madres para la Salud” [Mothers for Health]. Design and Methods Madres para la Salud is a 12 month prospective, randomized controlled trial exploring the effectiveness of a culturally specific intervention using “bouts” of physical activity to effect changes in body fat, systemic and fat tissue inflammation, and postpartum depression symptoms in sedentary postpartum Latinas. Summary The significance and innovation of Madres para la Salud includes use of a theory-driven approach to intervention, specification and cultural relevance of a social support intervention, use of a Promotora model to incorporate cultural approaches, use of objective measures of physical activity in post partum Latinas women, and the examination of biomarkers indicative of cardiovascular risk related to physical activity behaviors in postpartum Latinas. PMID:21238614

Challenges in preparing, preserving and detecting para-water in bulk: overcoming proton exchange and other hurdles.

PubMed

Mammoli, Daniele; Salvi, Nicola; Milani, Jonas; Buratto, Roberto; Bornet, Aurélien; Sehgal, Akansha Ashvani; Canet, Estel; Pelupessy, Philippe; Carnevale, Diego; Jannin, Sami; Bodenhausen, Geoffrey

2015-10-28

Para-water is an analogue of para-hydrogen, where the two proton spins are in a quantum state that is antisymmetric under permutation, also known as singlet state. The populations of the nuclear spin states in para-water are believed to have long lifetimes just like other Long-Lived States (LLSs). This hypothesis can be verified by measuring the relaxation of an excess or a deficiency of para-water, also known as a "Triplet-Singlet Imbalance" (TSI), i.e., a difference between the average population of the three triplet states T (that are symmetric under permutation) and the population of the singlet state S. In analogy with our recent findings on ethanol and fumarate, we propose to adapt the procedure for Dissolution Dynamic Nuclear Polarization (D-DNP) to prepare such a TSI in frozen water at very low temperatures in the vicinity of 1.2 K. After rapid heating and dissolution using an aprotic solvent, the TSI should be largely preserved. To assess this hypothesis, we studied the lifetime of water as a molecular entity when diluted in various solvents. In neat liquid H2O, proton exchange rates have been characterized by spin-echo experiments on oxygen-17 in natural abundance, with and without proton decoupling. One-dimensional exchange spectroscopy (EXSY) has been used to study proton exchange rates in H2O, HDO and D2O mixtures diluted in various aprotic solvents. In the case of 50 mM H2O in dioxane-d8, the proton exchange lifetime is about 20 s. After dissolving, one can observe this TSI by monitoring intensities in oxygen-17 spectra of H2O (if necessary using isotopically enriched samples) where the AX2 system comprising a "spy" oxygen A and two protons X2 gives rise to binomial multiplets only if the TSI vanishes. Alternatively, fast chemical addition to a suitable substrate (such as an activated aldehyde or ketone) can provide AX2 systems where a carbon-13 acts as a spy nucleus. Proton signals that relax to equilibrium with two distinct time constants can be

Manual de reforestación para América Tropical

Treesearch

Blanca I. Ruiz

2002-01-01

Aún cuando las comunidades tengan necesidad apremiante de sembrar árboles y tengan conciencia de ésta, la tarea que enfrentan no es sencilla ni barata (capítulo 5). Sin embargo, los beneficios que proveen los árboles son incontables (capítulo 2). De hecho, sin éstos nuestra civilización no podría existir tal cual la conocemos. Este manual fue escrito para ayudar a...

Application of Three-Dimensional Models for the Teaching of Time Zones. (Breton Title: Aplicação de Modelos Tridimensionais Para o Ensino de Fusos Horários.) Aplicación de Modelos Tridimensionales Para la Enseñanza de Husos Horarios

NASA Astrophysics Data System (ADS)

Azevedo Sobreira, Paulo Henrique

2012-07-01

There are several interesting astronomical topics that must be addressed in the High School and Elementary/Middle School in the disciplines of Geography and of Sciences. Among them, the topic of time zones which is one of the most important to understand the correlation of the Earth's rotation and its implications on daily activities of citizens in local scale, regional and global scales which involve problems of time differences. For the teaching of time zones in the lessons of Geography, for example, there are bi-dimensional representations of thematic maps of world time zones, textbooks and atlas. It happens that teachers face some difficulties to permit its students to view three-dimensionally this astronomical phenomenon from the textbooks available in schools. The aim of this paper is to present two proposals with low-cost materials, which allow the preparation of three-dimensional models for the teaching of time zones. Há vários temas astronômicos interessantes que devem ser trabalhados nos Ensinos Médio e Fundamental, nas disciplinas de Geografia e de Ciências. Entre eles, o tema dos fusos horários que é um dos mais importantes para se correlacionar a rotação da Terra e suas implicações nas atividades cotidianas dos cidadãos em escala local, regional e global, que envolvem problemas de diferenças horárias. Para o ensino dos fusos horários nas aulas de Geografia, por exemplo, há representações bidimensionais de mapas temáticos de fusos horários mundiais, nos livros didáticos e nos atlas. Ocorre que os professores enfrentam algumas dificuldades para possibilitar aos seus alunos a visão tridimensional deste fenômeno astronômico, a partir dos materiais didáticos disponíveis nas escolas. O objetivo deste trabalho é apresentar duas propostas para a confecção de materiais de baixo custo, que possibilitem a elaboração de modelos tridimensionais para o ensino dos fusos horários. Hay algunos temas astronómicos interesantes que se

Drosophila as a model for intractable epilepsy: gilgamesh suppresses seizures in para(bss1) heterozygote flies.

PubMed

Howlett, Iris C; Rusan, Zeid M; Parker, Louise; Tanouye, Mark A

2013-08-07

Intractable epilepsies, that is, seizure disorders that do not respond to currently available therapies, are difficult, often tragic, neurological disorders. Na(+) channelopathies have been implicated in some intractable epilepsies, including Dravet syndrome (Dravet 1978), but little progress has been forthcoming in therapeutics. Here we examine a Drosophila model for intractable epilepsy, the Na(+) channel gain-of-function mutant para(bss1) that resembles Dravet syndrome in some aspects (parker et al. 2011a). In particular, we identify second-site mutations that interact with para(bss1), seizure enhancers, and seizure suppressors. We describe one seizure-enhancer mutation named charlatan (chn). The chn gene normally encodes an Neuron-Restrictive Silencer Factor/RE1-Silencing Transcription factor transcriptional repressor of neuronal-specific genes. We identify a second-site seizure-suppressor mutation, gilgamesh (gish), that reduces the severity of several seizure-like phenotypes of para(bss1)/+ heterozygotes. The gish gene normally encodes the Drosophila ortholog of casein kinase CK1g3, a member of the CK1 family of serine-threonine kinases. We suggest that CK1g3 is an unexpected but promising new target for seizure therapeutics.

A novel dynamic field-matching technique for treatment of patients with para-aortic node-positive cervical cancer: Clinical experience

PubMed Central

Baden, Craig; Whitley, Alexander; López-Araujo, Javier; Popple, Richard; Duan, Jun; Kim, Robert

2016-01-01

Aim To report outcomes for patients with para-aortic lymph node positive cervical cancer treated with a dynamic field-matching technique. Background PET staging of cervical cancer has increased identification of patients with para-aortic lymph node metastasis. IMRT enables dose escalation in this area, but matching IMRT fields with traditional whole pelvis fields presents a challenge. Materials and methods From 2003 to 2012, 20 patients with cervical cancer and para-aortic lymph node metastasis were treated utilizing the dynamic field-matching technique. As opposed to single-isocenter half-beam junction techniques, this technique employs wedge-shaped dose junctions for the abutment of fields. We reviewed the records of all patients who completed treatment with the technique and abstracted treatment, toxicity, and disease-related outcome data for analysis. Results Median prescribed dose to the whole pelvis field was 45 Gy and para-aortic IMRT field 50.4 Gy. All but 3 patients underwent HDR (13 pts) or LDR (4 pts) brachytherapy. All patients developed lower GI toxicity; 10 grade 1, 9 grade 2, and 1 grade 4 (enterovaginal fistula). Median DFS was 12.4 months with 1 and 2-year DFS 60.0% and 38.1%. One-year OS was 83.7% and 2-year OS, 64.4%. A total of 10 patients developed recurrence; none occurred at the matched junction. Conclusions The dynamic field-matching technique provides a means for joining conventional whole pelvis fields and para-aortic IMRT fields that substantially reduces dose deviations at the junction due to field mismatch. Treatment with the dynamic matching technique is simple, effective, and tolerated with no apparent increase in toxicity. PMID:26900356

The PAediatric Risk Assessment (PARA) Mobile App to Reduce Postdischarge Child Mortality: Design, Usability, and Feasibility for Health Care Workers in Uganda.

PubMed

English, Lauren Lacey; Dunsmuir, Dustin; Kumbakumba, Elias; Ansermino, John Mark; Larson, Charles P; Lester, Richard; Barigye, Celestine; Ndamira, Andrew; Kabakyenga, Jerome; Wiens, Matthew O

2016-02-15

Postdischarge death in children is increasingly being recognized as a major contributor to overall child mortality. The PAediatric Risk Assessment (PARA) app is an mHealth tool developed to aid health care workers in resource-limited settings such as Sub-Saharan Africa to identify pediatric patients at high risk of both in-hospital and postdischarge mortality. The intended users of the PARA app are health care workers (ie, nurses, doctors, and clinical officers) with varying levels of education and technological exposure, making testing of this clinical tool critical to successful implementation. Our aim was to summarize the usability evaluation of the PARA app among target users, which consists of assessing the ease of use, functionality, and navigation of the interfaces and then iteratively improving the design of this clinical tool. Health care workers (N=30) were recruited to participate at Mbarara Regional Referral Hospital and Holy Innocents Children's Hospital in Mbarara, Southwestern Uganda. This usability study was conducted in two phases to allow for iterative improvement and testing of the interfaces. The PARA app was evaluated using quantitative and qualitative measures, which were compared between Phases 1 and 2 of the study. Participants were given two patient scenarios that listed hypothetical information (ie, demographic, social, and clinical data) to be entered into the app and to determine the patient's risk of in-hospital and postdischarge mortality. Time-to-completion and user errors were recorded for each participant while using the app. A modified computer system usability questionnaire was utilized at the end of each session to elicit user satisfaction with the PARA app and obtain suggestions for future improvements. The average time to complete the PARA app decreased by 30% from Phase 1 to Phase 2, following user feedback and modifications. Participants spent the longest amount of time on the oxygen saturation interface, but modifications

Torsional, Vibrational and Vibration-Torsional Levels in the S_{1} and Ground Cationic D_{0}^{+} States of Para-Xylene

NASA Astrophysics Data System (ADS)

Gardner, Adrian M.; Tuttle, William Duncan; Groner, Peter; Wright, Timothy G.

2017-06-01

Insight gained from examining the "pure" torsional, vibrational and vibration-torsional (vibtor) levels of the single rotor molecules: toluene (methylbenzene) and para-fluorotoluene (pFT), is applied to the double rotor para-xylene (p-dimethylbenzene) molecule . Resonance-enhanced multiphoton ionization (REMPI) spectroscopy and zero-kinetic-energy (ZEKE) spectroscopy are employed in order to investigate the S_{1} and ground cationic states of para-xylene. Observed transitions are assigned in the full molecular symmetry group (G_{72}) for the first time. J. R. Gascooke, E. A. Virgo, and W. D. Lawrance, J. Chem. Phys., 143, 044313 (2015). A. M. Gardner, W. D. Tuttle, L. Whalley, A. Claydon, J. H. Carter and T. G. Wright, J. Chem. Phys., 145, 124307 (2016). A. M. Gardner, W. D. Tuttle, P. Groner and T. G. Wright, J. Chem. Phys., (2017, in press).

Partner notification for sexually transmitted infections and perception of notified partners.

PubMed

Cavalcante, Elani Graça Ferreira; Miranda, Mahara Coelho Crisostomo; Carvalho, Ana Zaiz Flores Hormain Teixeira de; Lima, Ivana Cristina Vieira de; Galvão, Marli Teresinha Gimeniz

2016-01-01

Learn the perceptions of patients with sexually transmitted infections and sexual partners who are notified of the infection. A descriptive and qualitative study, based on the collective subject discourse technique, was conducted in four healthcare centers of reference in Fortaleza, Ceará, from March to July 2014. The sample comprised 21 subjects (11 index patients and 10 notified partners). The index patients reported complicity, concern about the partner's health and revelation of diagnosis aiming to preserve the relationship. The partners showed antagonistic perceptions: tranquility-betrayal, fear of death, of incurability and the diagnosis, especially of HIV. The reasons for coming to a healthcare center were: fear of being sick, attenuation of guilt of infection transmission, need for diagnosis, early start of treatment. Fear of losing trust, insecurities when dealing with a sexual infection and being responsible or co-responsible for the transmission were the predominant feelings. Various types of partner notification were reported (verbal, telephone, notification card), according to individual convenience. This study suggests the use of alternative methods of notification and an integrated system of notification. Conhecer as percepções dos pacientes com infecções sexualmente transmissíveis e parceiros sexuais sobre a notificação da infecção. Estudo descritivo e qualitativo, baseado na técnica do discurso do sujeito coletivo, realizado em quatro Unidades de Saúde de referência em Fortaleza/CE, de março a julho de 2014. Amostra composta por 21 sujeitos (11 pacientes-índice e 10 parceiros notificados). Pacientes-índice relataram cumplicidade, preocupação com a saúde do parceiro e revelação do diagnóstico como forma de preservação do relacionamento. Para os parceiros, as percepções foram antagônicas: tranquilidade-traição, medo da morte, da incurabilidade e do diagnóstico, especialmente do HIV. Os motivos para o comparecimento foram

STOP-Bang questionnaire: translation to Portuguese and cross-cultural adaptation for use in Brazil.

PubMed

Fonseca, Lorena Barbosa de Moraes; Silveira, Erika Aparecida; Lima, Nathalia Meireles; Rabahi, Marcelo Fouad

2016-01-01

falada no Brasil, de forma a possibilitar sua aplicação como instrumento de triagem para o diagnóstico da apneia obstrutiva do sono. Embasado nos princípios de boas práticas para a tradução e adaptação transcultural desses instrumentos, o protocolo incluiu os seguintes passos: obtenção de autorização da autora principal do questionário original; tradução, realizada por dois tradutores; reconciliação; tradução retrógrada realizada por dois professores de inglês procedentes de países de língua inglesa e fluentes na língua portuguesa; revisão da tradução retrógrada; harmonização; revisão e aprovação do questionário pela autora original; desdobramento cognitivo com 14 pacientes que responderam ao questionário; análise dos resultados; e revisão e preparação da versão final do instrumento pelo comitê revisor. A versão final do questionário STOP-Bang traduzida para a língua portuguesa falada no Brasil apresentou uma média de clareza > 9 (em uma escala de 1-10) em todas as questões. O coeficiente alfa de Cronbach foi de 0,62, demonstrando a consistência interna do instrumento. As médias e desvios-padrão da idade, do índice de massa corpórea e da circunferência de pescoço dos pacientes foram de, respectivamente, 46,8 ± 11,2 anos, 43,7 ± 8,5 kg/m² e 41,3 ± 3,6 cm. O questionário STOP-Bang mostrou-se compreensível, claro e aplicável. Houve consistência na equivalência do questionário original com o traduzido e adaptado para uso no Brasil, podendo esse se tornar um instrumento de triagem amplamente utilizado para pacientes com suspeita de apneia obstrutiva do sono.

Effects of acoustic feedback training in elite-standard Para-Rowing.

PubMed

Schaffert, Nina; Mattes, Klaus

2015-01-01

Assessment and feedback devices have been regularly used in technique training in high-performance sports. Biomechanical analysis is mainly visually based and so can exclude athletes with visual impairments. The aim of this study was to examine the effects of auditory feedback on mean boat speed during on-water training of visually impaired athletes. The German National Para-Rowing team (six athletes, mean ± s, age 34.8 ± 10.6 years, body mass 76.5 ± 13.5 kg, stature 179.3 ± 8.6 cm) participated in the study. Kinematics included boat acceleration and distance travelled, collected with Sofirow at two intensities of training. The boat acceleration-time traces were converted online into acoustic feedback and presented via speakers during rowing (sections with and without alternately). Repeated-measures within-participant factorial ANOVA showed greater boat speed with acoustic feedback than baseline (0.08 ± 0.01 m·s(-1)). The time structure of rowing cycles was improved (extended time of positive acceleration). Questioning of athletes showed acoustic feedback to be a supportive training aid as it provided important functional information about the boat motion independent of vision. It gave access for visually impaired athletes to biomechanical analysis via auditory information. The concept for adaptive athletes has been successfully integrated into the preparation for the Para-Rowing World Championships and Paralympics.

Biodegradation of Para Amino Acetanilide by Halomonas sp. TBZ3.

PubMed

Hajizadeh, Nader; Sefidi Heris, Youssof; Zununi Vahed, Sepideh; Vallipour, Javad; Hejazi, Mohammad Amin; Golabi, Sayyed Mahdi; Asadpour-Zeynali, Karim; Hejazi, Mohammad Saeid

2015-09-01

Aromatic compounds are known as a group of highly persistent environmental pollutants. Halomonas sp. TBZ3 was isolated from the highly salty Urmia Lake of Iran. In this study, characterization of a new Halomonas isolate called Halomonas sp. TBZ3 and its employment for biodegradation of para-amino acetanilide (PAA), as an aromatic environmental pollutant, is described. This study aimed to characterize the TBZ3 isolate and to elucidate its ability as a biodegradative agent that decomposes PAA. Primarily, DNA-DNA hybridization between TBZ3, Halomonas denitrificans DSM18045T and Halomonas saccharevitans LMG 23976T was carried out. Para-amino acetanilide biodegradation was assessed using spectrophotometry and confirmed by gas chromatography-mass spectroscopy (GC-MS). Parameters effective on biodegradation of PAA were optimized by the Response Surface Methodology (RSM). The DNA-DNA hybridization experiments between isolate TBZ3, H. denitrificans and H. saccharevitans revealed relatedness levels of 57% and 65%, respectively. According to GC-MS results, TBZ3 degrades PAA to benzene, hexyl butanoate, 3-methyl-1-heptanol and hexyl hexanoate. Temperature 32.92°C, pH 6.76, and salinity 14% are the optimum conditions for biodegradation with a confidence level of 95% (at level α = 0.05). According to our results, Halomonas sp. TBZ3 could be considered as a biological agent for bioremediation of PAA and possibly other similar aromatic compounds.

A Diagnostic Assessment for the Teaching of Astronomy. (Spanish Title: Una Evaluación Diagnóstica Para la Enseñanza de la Astronomia.) Uma Avaliação Diagnóstica Para o Ensino da Astronomia

NASA Astrophysics Data System (ADS)

Pacifico Ribeiro de Assis Silveira, Felipa; Soares Gomes de Sousa, Célia Maria; Moreira, Antonio

2011-07-01

This article aims to present the results of a diagnostic evaluation, used as a tool for collecting data on prior knowledge of scientific concepts needed to understand the topic "Earth and Universe", from a group comprised of 47 students of 6th grade. The educational method of diagnosing the student's prior knowledge before teaching them is founded on the Meaningful Learning theory, proposed by David Ausubel. The diagnostic evaluation consisted of 25 questions; the answers were analyzed and categorized, making possible their interpretation, which allows us to understand the meanings assigned by the student to these concepts. It follows from the diagnostic evaluation, that the majority of students surveyed had difficulties in exposing scientific concepts on the topic "Earth and Universe" when starting the 6th grade. However, we identified relevant ideas and representations that contributed to the re-signification of scientific concepts proposed for the teaching of the subject in this grade. The results of diagnostic evaluation served as reference to the organization of the syllabus, making possible the learning process by matching the sequence of teaching to the students" characteristics and context of the classroom. It is expected that other researchers in this topic can also use the instrument presented in this paper. Este artículo tiene como objetivo presentar los resultados de una evaluación diagnóstica, utilizada como una herramienta para recoger datos sobre el conocimiento previo de los conceptos científicos necesarios para comprender el tema "Tierra y Universo", de un grupo compuesto por 47 alumnos de 6º grado de la escuela primaria. La acción pedagógica del diagnóstico de los conocimientos previos del estudiante antes de enseñarles está justificada por la teoría del Aprendizaje Significativo, propuesta por David Ausubel. La evaluación de diagnóstico consistió en 25 preguntas, las respuestas fueron analizadas y clasificadas objetivando-se su

Residual dentin thickness in mandibular premolars prepared with gates glidden and ParaPost drills.

PubMed

Pilo, R; Tamse, A

2000-06-01

The main factor that determines the prognosis of restored pulpless teeth is preservation of sound dentin. This study evaluated the residual dentinal thickness (RDT) of mandibular premolars after preparation of post space with Gates Glidden and ParaPost drills. Twelve extracted single canal mandibular premolars were embedded in clear polyester resin to the cementoenamel junction (CEJ) in a muffle device. Three horizontal sections were made 1, 3, and 5 mm apical to the CEJ. Mesiodistal (MD) and faciolingual (FL) axes were carefully marked and the RDT was measured for each slice. Each tooth slice was reassembled in the muffle device with orientation pins, then secured with stabilizing pins. This procedure was repeated after enlarging the root canal to K-40 file and preparing the coronal root canal space with Gates Glidden drills and ParaPost drills Nos. 3, 4, and 5. Residual dentinal thickness in a MD direction was 3.77 +/- 0.51 mm in the unprepared upper slice and 2.23 +/- 0.31 mm in the No. 5 ParaPost drill prepared lower slice, for a difference of 41%. The corresponding values for the FL direction were 4.35 +/- 0.51 mm and 4.08 +/- 0.46 mm, respectively (6%). The average dentinal thickness 5 mm below the CEJ in the mesial and distal directions after post space preparation approached the accepted minimal 1 mm. A conservative approach to post space preparation was advocated.

Pulsed Magnetic Resonance to Signal-Enhance Metabolites within Seconds by utilizing para-Hydrogen.

PubMed

Korchak, Sergey; Yang, Shengjun; Mamone, Salvatore; Glöggler, Stefan

2018-05-01

Diseases such as Alzheimer's and cancer have been linked to metabolic dysfunctions, and further understanding of metabolic pathways raises hope to develop cures for such diseases. To broaden the knowledge of metabolisms in vitro and in vivo, methods are desirable for direct probing of metabolic function. Here, we are introducing a pulsed nuclear magnetic resonance (NMR) approach to generate hyperpolarized metabolites within seconds, which act as metabolism probes. Hyperpolarization represents a magnetic resonance technique to enhance signals by over 10 000-fold. We accomplished an efficient metabolite hyperpolarization by developing an isotopic labeling strategy for generating precursors containing a favorable nuclear spin system to add para -hydrogen and convert its two-spin longitudinal order into enhanced metabolite signals. The transfer is performed by an invented NMR experiment and 20 000-fold signal enhancements are achieved. Our technique provides a fast way of generating hyperpolarized metabolites by using para -hydrogen directly in a high magnetic field without the need for field cycling.

Hyperfine excitation of C2H in collisions with ortho- and para-H2

NASA Astrophysics Data System (ADS)

Dagdigian, Paul J.

2018-06-01

Accurate estimation of the abundance of the ethynyl (C2H) radical requires accurate radiative and collisional rate coefficients. Hyperfine-resolved rate coefficients for (de-)excitation of C2H in collisions with ortho- and para-H2 are presented in this work. These rate coefficients were computed in time-independent close-coupling quantum scattering calculations that employed a potential energy surface recently computed at the coupled-clusters level of theory that describes the interaction of C2H with H2. Rate coefficients for temperatures from 10 to 300 K were computed for all transitions among the first 40 hyperfine energy levels of C2H in collisions with ortho- and para-H2. These rate coefficients were employed in simple radiative transfer calculations to simulate the excitation of C2H in typical molecular clouds.

Una propuesta para el desarrollo de un arreglo de síntesis de apertura

NASA Astrophysics Data System (ADS)

Arnal, E. M.

Los estudios llevados a cabo en la transición del hidrógeno neutro a λ~21-cm han contribuído a incrementar nuestro conocimiento acerca de las propiedades globales del medio interestelar, sea este galáctico o extragaláctico. Avances en este campo han sido provocados, a menudo, por la puesta en servicio de radiotelescopios que poseen una mayor resolución angular. Aquí se presenta una propuesta para desarrollar un nuevo instrumento, un interferómetro, que permitirá abrir nuevas líneas de investigación. Este instrumento combinará la técnica de síntesis de apertura con la de espectroscopía de correlación digital, para alcanzar una resolución angular de 1' y un campo de visión de ~1o.7.

Estrategia de Aprendizaje Basado en Problemas (ABP) para explorar las concepciones alternativas relacionadas al tema estados de agregacion de la materia en estudiantes de nivel elemental =

NASA Astrophysics Data System (ADS)

Rosado Olivieri, Wilda Y.

Gran parte de la investigacion acerca de la ensenanza de las ciencias se dedica a estudiar la forma o manera en que los estudiantes visualizan los conceptos cientificos. Para Driver (1983) esas ideas o concepciones se conocen como concepciones alternativas; las cuales pueden ocasionar dificultad para comprender los conceptos de las diferentes areas del conocimiento. El proposito de este estudio fue: (a) indagar como las distintas etapas del ABP permiten explorar las concepciones alternativas que poseen los estudiantes de nivel elemental acerca de los estados de agregacion de la materia y, (b) explorar en que medida el ABP permite identificar e incorporar las concepciones alternativas que poseen los estudiantes de nivel elemental con relacion al concepto de estados de agregacion de la materia para facilitar su aprendizaje. Con el fin de explorar las concepciones alternativas en el tema de los estados agregados de la materia se implanto la estrategia de Aprendizaje Basado en Problemas (ABP) con estudiantes de quinto grado de nivel elemental. Se utilizo la metodologia mixta con varias estrategias de recopilacion de datos, como una pre y pos prueba para elucidar el conocimiento previo y al mismo tiempo las concepciones alternativas sobre el tema bajo estudio y luego verificar el aprendizaje en los estudiantes. Asimismo, el uso de mapas conceptuales para determinar la profundidad del tema estudiado y el entrelazamiento de los conceptos Una tercera estrategia fue el grupo focal para tomar en cuenta la impresion de los estudiantes acerca del proyecto ABP. El aspecto colaborativo y cooperativo fue un factor fundamental, ya que el aprendizaje ocurrio en ese contexto educativo. Para los hallazgos de esta investigacion fue tan importante el conocimiento previo como los procesos que se generaban para que la adquisicion del mismo fuera de forma significativa y funcional (Escribano & Del Valle, 2010). La estrategia de ABP constituyo en este estudio una forma para indagar las

Trapping para-Quinone Methide Intermediates with Ferrocene: Synthesis and Preliminary Biological Evaluation of New Phenol-Ferrocene Conjugates.

PubMed

González-Pelayo, Silvia; López, Enol; Borge, Javier; de-Los-Santos-Álvarez, Noemí; López, Luis A

2018-06-01

The reaction of para -hydroxybenzyl alcohols with ferrocene in the presence of a catalytic amount of InCl₃ provided ferrocenyl phenol derivatives, an interesting class of organometallic compounds with potential applications in medicinal chemistry. This transformation exhibited a reasonable substrate scope delivering the desired products in synthetically useful yields. Evidence of involvement of a para -quinone methide intermediate in this coupling process was also provided. Preliminary biological evaluation demonstrated that some of the ferrocene derivatives available by this methodology exhibit significant cytotoxicity against several cancer cell lines with IC 50 values within the range of 1.07⁻4.89 μM.

Electron-impact electronic-state excitation of para-benzoquinone

NASA Astrophysics Data System (ADS)

Jones, D. B.; da Costa, R. F.; Kossoski, F.; Varella, M. T. do N.; Bettega, M. H. F.; Ferreira da Silva, F.; Limão-Vieira, P.; García, G.; Lima, M. A. P.; White, R. D.; Brunger, M. J.

2018-03-01

Angle resolved electron energy loss spectra (EELS) for para-benzoquinone (C6H4O2) have been recorded for incident electron energies of 20, 30, and 40 eV. Measured differential cross sections (DCSs) for electronic band features, composed of a combination of energetically unresolved electronic states, are subsequently derived from those EELS. Where possible, the obtained DCSs are compared with those calculated using the Schwinger multichannel method with pseudopotentials. These calculations were performed using a minimum orbital basis single configuration interaction framework at the static exchange plus polarisation level. Here, quite reasonable agreement between the experimental cross sections and the theoretical cross sections for the summation of unresolved states was observed.

Infrared Space Observatory Observations of Molecular Hydrogen in HH 54: Measurement of a Nonequilibrium Ratio of Ortho- to Para-H2

NASA Technical Reports Server (NTRS)

Neufeld, David A.; Melnick, Gary J.; Harwit, Martin

1998-01-01

We have detected the S(1), S(2), S(3), S(4), and S(5) pure rotational lines of molecular hydrogen toward the outflow source HH 54 using the Short Wavelength Spectrometer on board the Infrared Space Observatory. The observed H2 line ratios indicate the presence of warm molecular gas with an H2 density of at least 10(sup 5) /cc and a temperature approximately 650 K in which the ratio of ortho- to para-H2 is only 1.2 -+ 0.4, significantly smaller than the equilibrium ratio of 3 expected in gas at that temperature. These observations imply that the measured ratio of ortho- to para-H2 is the legacy of an earlier stage in the thermal history of the gas when the gas had reached equilibrium at a temperature approximately 90 K. Based upon the expected timescale for equilibration, we argue that the nonequilibrium ratio of ortho- to para-H2 observed in HH 54 serves as a chronometer that places a conservative upper limit of approximately 5000 yr on the period for which the emitting gas has been warm. The S(2)/,S(l) and S(3)/S(1) H2 line ratios measured toward HH 54 are consistent with recent theoretical models of Timmermann for the conversion of para- to ortho-H2 behind slow, C-type shocks, but only if the preshock ratio of ortho- to para-H2 was approximately < 0.2.

Nursing workload and occurrence of adverse events in intensive care: a systematic review.

PubMed

Oliveira, Andrea Carvalho de; Garcia, Paulo Carlos; Nogueira, Lilia de Souza

2016-01-01

To identifyevidences of the influence of nursing workload on the occurrence of adverse events (AE) in adult patients admitted to the intensive care unit (ICU). A systematic literature review was conducted in the databases MEDLINE, CINAHL, LILACS, SciELO, BDENF, and Cochrane from studies in English, Portuguese, or Spanish, published by 2015. The analyzed AE were infection, pressure ulcer (PU), patient falls, and medication errors. Of 594 potential studies, eight comprised the final sample of the review. TheNursing Activities Score (NAS; 37.5%) and the Therapeutic Intervention Scoring System(TISS; 37.5%) were the instruments most frequently used for assessing nursing workload. Six studies (75.0%) identified the influence of work overload in events of infection, PU, and medicationerrors. An investigation found that the NAS was a protective factor for PU. The nursing workload required by patients in the ICU influenced the occurrence of AE, and nurses must monitor this variable daily to ensure proper sizing of staff and safety of care. Identificar evidências sobre a influência da carga de trabalho de enfermagem na ocorrência de eventos adversos (EA) em pacientes adultos internados em Unidade de Terapia Intensiva (UTI). Revisão sistemática da literatura realizada nas bases de dados MEDLINE, CINAHL, LILACS, SciELO, BDENF e Cochrane deestudosem inglês, português ou espanhol, publicados até 2015. Os EA analisados foram infecção, úlcera por pressão (UPP), quedas e erros associados a medicamentos. Das 594 pesquisas potenciais identificadas, oito compuseram a amostra final da revisão. O NursingActivities Score -NAS (37,5%) e o TherapeuticInterventionScoring System -TISS (37,5%) foram os instrumentos mais utilizados para avaliação da carga de trabalho de enfermagem. Seis pesquisas (75,0%) identificaram influência da sobrecarga de trabalho na ocorrência de infecção, UPP e uso de medicamentos. Uma investigação identificou que o NAS foi fator de prote

[Not Available].

PubMed

Baena González, Marta; Molina Recio, Guillermo

2016-06-30

Introducción: la disfagia es un síntoma que se refiere a la dificultad para mover el bolo alimentario desde la boca al estómago. A pesar de su relevancia y de la gravedad de sus posibles complicaciones, es poco conocida y estudiada. La prevalencia de la disfagia orofaríngea en enfermosde alzhéimer es de un 84% y puede originar complicaciones de gran trascendencia clínica como consecuencia de las alteraciones en la eficacia de la deglución, y en la seguridad de la misma.Objetivo: conocer el estado actual del conocimiento en relación al abordaje de la disfagia en enfermos de alzhéimer, localizando aquellos factores que permitan un diagnóstico precoz que facilite la prevención de complicaciones y la elección de la pauta de actuación más adecuada.Metodología: revisión sistemática. Estudios publicados entre 2005 y 2014 en inglés y castellano. Bases de datos: PubMed, Cochrane, Scopus, Elsevier, Scielo y Dialnet. Términos MeSH empleados: disfagia, dysphagia, alzheimer, modified y texture food.Resultados: el diagnóstico en los pacientes de alzhéimer se realiza mediante métodos clínicos y exploraciones complementarias como la videofluoroscopia, considerada como el estándar para el estudio de la disfagia orofaríngea, ya que permite identificar entre 1/3 y 1/4 de los pacientes que presentan aspiraciones silentes no diagnosticables clínicamente. Existen estrategias terapéuticas que incluyen cambios en el volumen y viscosidad del bolo, cambios posturales, maniobras deglutorias, procedimientos de rehabilitación y técnicas de incremento sensorial que han demostrado su eficacia, pero se trata de una labor compleja que exige un abordaje multidisciplinar para un correctodiagnóstico y tratamiento.Conclusiones: existe una escasa evidencia científica en el abordaje de la disfagia y un gran desconocimiento en cuanto a la alimentación de los enfermos de alzhéimer. Esta patología necesita una intervención multidisciplinar en la cual las medidas

Gel pillow designed specifically for obstructive sleep apnea treatment with continuous positive airway pressure.

PubMed

Salvaggio, Adriana; Lo Bue, Anna; Isidoro, Serena Iacono; Romano, Salvatore; Marrone, Oreste; Insalaco, Giuseppe

2016-01-01

To determine whether the use of a gel pillow with side cutouts designed to accommodate a continuous positive airway pressure (CPAP) mask and reduce head temperature improves the efficacy of and adherence to auto-CPAP therapy. Twenty-three consecutive CPAP-naïve patients with obstructive sleep apnea were enrolled in the study. Patients were given an auto-CPAP machine with an appropriate CPAP mask and were instructed to use CPAP for 15 nights. They were instructed to sleep with their own pillow (the control pillow) from nights 1 to 5 and with either a foam pillow or a gel pillow, both of which had side cutouts, for 5 consecutive nights each, in random order. After night 15, auto-CPAP machine data were downloaded and patients rated their satisfaction with each pillow on a visual analog scale. Twenty-two patients completed the protocol. The pressures administered, residual apnea-hypopnea index, air leaks, and mean duration of CPAP use did not differ among the periods during which each pillow was used. Patients were significantly more satisfied with the gel pillow than with the control pillow and the foam pillow (p = 0.022 and p = 0.004, respectively), their level of satisfaction with the gel pillow correlating significantly with excessive daytime sleepiness (r2 = 0.19; p = 0.0443). Among obstructive sleep apnea patients treated with nasal CPAP, the use of a gel pillow with side cutouts appears to have no impact on treatment effectiveness. Nevertheless, such patients seem to prefer a gel pillow over other types of pillows. Determinar se o uso de um travesseiro de gel com recortes laterais para acomodar a máscara de continuous positive airway pressure (CPAP, pressão positiva contínua nas vias aéreas) e diminuir a temperatura em torno da cabeça melhora a eficácia do tratamento com auto-CPAP e a adesão dos pacientes ao tratamento. Foram incluídos no estudo 23 pacientes consecutivos com apneia obstrutiva do sono que nunca haviam recebido tratamento com CPAP. Os

Elevated Heart Rate is Associated with Cardiac Denervation in Patients with Heart Failure: A 123-Iodine-MIBG Myocardial Scintigraphy Study.

PubMed

Villacorta, Aline Sterque; Villacorta, Humberto; Souza, Jenne Serrão de; Teixeira, José Antônio Caldas; Muradas, Maria Clara S S S; Alves, Christiane Rodrigues; Precht, Bernardo Campanário; Porto, Pilar; Ubaldo, Letícia; Mesquita, Cláudio Tinoco; Nóbrega, Antônio Cláudio Lucas da

2016-11-01

atividade clínica, neuro-hormonal e simpática cardíaca em pacientes com IC crônica e FC elevada. Pacientes com IC crônica em ritmo sinusal e FC≥70 apesar de tratamento adequado foram incluídos em um estudo duplo-cego, randomizado, que comparou ivabradina com piridostigmina. Este artigo refere-se a dados basais dos primeiros 16 pacientes. A FC basal (antes da randomização para um dos medicamentos) foi avaliada, e os pacientes classificados em dois grupos, com FC abaixo ou acima dos valores médios. A atividade simpática cardíaca foi avaliada por cintilografia com metaiodobenzilguanidina marcada com iodo 123. A FC média foi 83,5±11,5 bpm (intervalo 72 a 104), e sete pacientes (43.7%) tinham FC acima da média. Esses pacientes apresentaram menor distância percorrida no teste de caminhada de 6 minutos (292,3±93 vs 465,2±97,1 m, p=0,0029), valores mais altos de N-terminal do pró-BNP (mediana 708,4 vs 76,1, p=0,035) e menor relação coração/mediastino tardia, indicando desnervação cardíaca (1,48±0,12 vs 1,74±0,09, p<0,001). A FC de repouso elevada em pacientes com IC em tratamento médico adequado associou-se com desnervação cardíaca, pior capacidade funcional e ativação neuro-hormonal.

Laparoscopic versus open repair of para-umbilical hernia. Is it a good alternative?

PubMed

Malik, Arshad Mehmood

2015-08-01

To compare the experience of laparoscopic repair of para-umbilical hernia with conventional open repair in terms of operative time, pre- and post-operative complications, total hospital stay, post-operative pain, morbidity, mortality and cosmesis. The prospective, randomized study was conducted at Liaquat University of Medical and Health Sciences, Jamshoro, Pakistan, and two private hospitals from June 2011 to June 2013, and comprised patients who were admitted with para-umbilical hernias of different sizes during the study period. The patients were divided into two groups. Group A underwent laparoscopic surgery, while Group B had conventional mesh repair. Variables studied included duration of surgery, operative and post-operative complications, morbidity and mortality. SPSS 20 was used for statistical analysis. Of the 337 patients in the study, 200(59.34%) were at the Liaquat University Hospital, while remaining 137(40.65%) patients were operated in two private hospitals. The overall mean age of the study sample was 42.18±9.789 years (range: 23-73). There were 68(20.18%) males and 269(79.82%) females. There were 166(49.26%) patients in Group A and 171(50.74%) Group B. The operative time was comparatively longer in Group A (p<0.001) especially in the first 30 operations. The laparoscopic approach was associated with a comparatively low incidence of operative and post-operative complications, reduced duration of hospital stay and cosmetically better results (p<0.05). There was no mortality in this series. Laparoscopic para-umbilical hernia repair, though a new technique, gave promising results compared to open conventional technique. However, there is a long way to go before coming to a consensus.

ParaCEST Agents Encapsulated in Reverse Nano-Assembled Capsules (RACs): How Slow Molecular Tumbling Can Quench CEST Contrast.

PubMed

Farashishiko, Annah; Slack, Jacqueline R; Botta, Mauro; Woods, Mark

2018-01-01

Although paraCEST is a method with immense scope for generating image contrast in MRI, it suffers from the serious drawback of high detection limits. For a typical discrete paraCEST agent the detection limit is roughly an order of magnitude higher than that of a clinically used relaxation agent. One solution to this problem may be the incorporation of a large payload of paraCEST agents into a single macromolecular agent. Here we report a new synthetic method for accomplishing this goal: incorporating a large payload of the paraCEST agent DyDOTAM 3+ into a Reverse Assembled nano-Capsule. An aggregate can be generated between this chelate and polyacrylic acid (PAA) after the addition of ethylene diamine. Subsequent addition of polyallylamine hydrochloride (PAH) followed by silica nanoparticles generated a robust encapsulating shell and afforded capsule with a mean hydrodynamic diameter of 650 ± 250 nm. Unfortunately this encapsulation did not have the effect of amplifying the CEST effect per agent, but quenched the CEST altogether. The quenching effect of encapsulation could be attributed to the effect of slowing molecular tumbling, which is inevitable when the chelate is incorporated into a nano-scale material. This increases the transverse relaxation rate of chelate protons and a theoretical examination using Solomon Bloembergen Morgan theory and the Bloch equations shows that the increase in the transverse relaxation rate constant for the amide protons, in even modestly sized nano-materials, is sufficient to significantly quench CEST.

ParaCEST Agents Encapsulated in Reverse Nano-Assembled Capsules (RACs): How Slow Molecular Tumbling Can Quench CEST Contrast

PubMed Central

Farashishiko, Annah; Slack, Jacqueline R.; Botta, Mauro; Woods, Mark

2018-01-01

Although paraCEST is a method with immense scope for generating image contrast in MRI, it suffers from the serious drawback of high detection limits. For a typical discrete paraCEST agent the detection limit is roughly an order of magnitude higher than that of a clinically used relaxation agent. One solution to this problem may be the incorporation of a large payload of paraCEST agents into a single macromolecular agent. Here we report a new synthetic method for accomplishing this goal: incorporating a large payload of the paraCEST agent DyDOTAM3+ into a Reverse Assembled nano-Capsule. An aggregate can be generated between this chelate and polyacrylic acid (PAA) after the addition of ethylene diamine. Subsequent addition of polyallylamine hydrochloride (PAH) followed by silica nanoparticles generated a robust encapsulating shell and afforded capsule with a mean hydrodynamic diameter of 650 ± 250 nm. Unfortunately this encapsulation did not have the effect of amplifying the CEST effect per agent, but quenched the CEST altogether. The quenching effect of encapsulation could be attributed to the effect of slowing molecular tumbling, which is inevitable when the chelate is incorporated into a nano-scale material. This increases the transverse relaxation rate of chelate protons and a theoretical examination using Solomon Bloembergen Morgan theory and the Bloch equations shows that the increase in the transverse relaxation rate constant for the amide protons, in even modestly sized nano-materials, is sufficient to significantly quench CEST. PMID:29682499

The economic burden of lung cancer and mesothelioma due to occupational and para-occupational asbestos exposure.

PubMed

Tompa, Emile; Kalcevich, Christina; McLeod, Chris; Lebeau, Martin; Song, Chaojie; McLeod, Kim; Kim, Joanne; Demers, Paul A

2017-11-01

To estimate the economic burden of lung cancer and mesothelioma due to occupational and para-occupational asbestos exposure in Canada. We estimate the lifetime cost of newly diagnosed lung cancer and mesothelioma cases associated with occupational and para-occupational asbestos exposure for calendar year 2011 based on the societal perspective. The key cost components considered are healthcare costs, productivity and output costs, and quality of life costs. There were 427 cases of newly diagnosed mesothelioma cases and 1904 lung cancer cases attributable to asbestos exposure in 2011 for a total of 2331 cases. Our estimate of the economic burden is $C831 million in direct and indirect costs for newly identified cases of mesothelioma and lung cancer and $C1.5 billion in quality of life costs based on a value of $C100 000 per quality-adjusted life year. This amounts to $C356 429 and $C652 369 per case, respectively. The economic burden of lung cancer and mesothelioma associated with occupational and para-occupational asbestos exposure is substantial. The estimate identified is for 2331 newly diagnosed, occupational and para-occupational exposure cases in 2011, so it is only a portion of the burden of existing cases in that year. Our findings provide important information for policy decision makers for priority setting, in particular the merits of banning the mining of asbestos and use of products containing asbestos in countries where they are still allowed and also the merits of asbestos removal in older buildings with asbestos insulation. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Effects of para-substituents of styrene derivatives on their chemical reactivity on platinum nanoparticle surfaces.

PubMed

Hu, Peiguang; Chen, Limei; Deming, Christopher P; Lu, Jia-En; Bonny, Lewis W; Chen, Shaowei

2016-06-09

Stable platinum nanoparticles were successfully prepared by the self-assembly of para-substituted styrene derivatives onto the platinum surfaces as a result of platinum-catalyzed dehydrogenation and transformation of the vinyl groups to the acetylene ones, forming platinum-vinylidene/-acetylide interfacial bonds. Transmission electron microscopic measurements showed that the nanoparticles were well dispersed without apparent aggregation, suggesting sufficient protection of the nanoparticles by the organic capping ligands, and the average core diameter was estimated to be 2.0 ± 0.3 nm, 1.3 ± 0.2 nm, and 1.1 ± 0.2 nm for the nanoparticles capped with 4-tert-butylstyrene, 4-methoxystyrene, and 4-(trifluoromethyl)styrene, respectively, as a result of the decreasing rate of dehydrogenation with the increasing Taft (polar) constant of the para-substituents. Importantly, the resulting nanoparticles exhibited unique photoluminescence, where an increase of the Hammett constant of the para-substituents corresponded to a blue-shift of the photoluminescence emission, suggesting an enlargement of the HOMO-LUMO band gap of the nanoparticle-bound acetylene moieties. Furthermore, the resulting nanoparticles exhibited apparent electrocatalytic activity towards oxygen reduction in acidic media, with the best performance among the series of samples observed with the 4-tert-butylstyrene-capped nanoparticles due to an optimal combination of the nanoparticle core size and ligand effects on the bonding interactions between platinum and oxygen species.

Construção de um catálogo de aglomerados abertos para estudo da dinâmica da estrutura espiral da Galáxia

NASA Astrophysics Data System (ADS)

Carlos, I. M.; Lépine, J. R. D.

2003-08-01

Os aglomerados abertos são objetos de grande valor para o estudo da dinâmica da Galáxia devido esses objetos terem uma faixa de idade relativamente ampla. O trabalho visa estudar a dinâmica da estrutura espiral da Galáxia principalmente através do uso desses aglomerados, uma vez que o estudo da cinemática desses objetos é fundamental para esse objetivo. Nosso grupo trabalha no sentido de construir uma base de dados de aglomerados abertos contendo coordenadas, distância, idade, movimentos próprios e velocidades radiais e já disponibiliza uma nova versão do catálogo de aglomerados abertos o qual é uma compilação de edições anteriores, principalmente Lynga (1987), Mermilliod (1995) e ESO-B (Lauberts 1982). Nossa amostra possui cerca de 1630 aglomerados, mas nem todos os parâmetros acima citados foram determinados em sua totalidade. Para determinarmos esses parâmetros, derivamos as cores intrínsecas das estrelas membro de cada aglomerado a partir de seus tipos espectrais (busca feita no SIMBAD) obtendo assim o excesso de cor individual. A distribuição dos excessos de cor foi então utilizada para derivarmos o avermelhamento médio para cada aglomerado. De maneira similar, os tipos espectrais foram usados para estimar as magnitudes absolutas, e com as magnitudes absolutas e aparentes determinamos a respectiva distribuição do módulo de distância e finalmente a distância. Para determinar as idades foram confeccionados os diagramas cor-magnitude das estrelas de cada aglomerado onde foram superpostas a Seqüência Principal de Idade Zero (ZAMS). Superpomos a ZAMS de Schmidt-Kaler e isócronas de composição solar. Essas isócronas foram usadas para determinação das idades dos aglomerados. Uma vez que não temos ainda resultados finais, apresentamos então alguns diagramas cor-magnitude os quais foram usados para determinação, principalmente, da distância e idade dos aglomerados.

The PAediatric Risk Assessment (PARA) Mobile App to Reduce Postdischarge Child Mortality: Design, Usability, and Feasibility for Health Care Workers in Uganda

PubMed Central

English, Lauren Lacey; Dunsmuir, Dustin; Kumbakumba, Elias; Ansermino, John Mark; Larson, Charles P; Lester, Richard; Barigye, Celestine; Ndamira, Andrew; Kabakyenga, Jerome

2016-01-01

Background Postdischarge death in children is increasingly being recognized as a major contributor to overall child mortality. The PAediatric Risk Assessment (PARA) app is an mHealth tool developed to aid health care workers in resource-limited settings such as Sub-Saharan Africa to identify pediatric patients at high risk of both in-hospital and postdischarge mortality. The intended users of the PARA app are health care workers (ie, nurses, doctors, and clinical officers) with varying levels of education and technological exposure, making testing of this clinical tool critical to successful implementation. Objective Our aim was to summarize the usability evaluation of the PARA app among target users, which consists of assessing the ease of use, functionality, and navigation of the interfaces and then iteratively improving the design of this clinical tool. Methods Health care workers (N=30) were recruited to participate at Mbarara Regional Referral Hospital and Holy Innocents Children’s Hospital in Mbarara, Southwestern Uganda. This usability study was conducted in two phases to allow for iterative improvement and testing of the interfaces. The PARA app was evaluated using quantitative and qualitative measures, which were compared between Phases 1 and 2 of the study. Participants were given two patient scenarios that listed hypothetical information (ie, demographic, social, and clinical data) to be entered into the app and to determine the patient’s risk of in-hospital and postdischarge mortality. Time-to-completion and user errors were recorded for each participant while using the app. A modified computer system usability questionnaire was utilized at the end of each session to elicit user satisfaction with the PARA app and obtain suggestions for future improvements. Results The average time to complete the PARA app decreased by 30% from Phase 1 to Phase 2, following user feedback and modifications. Participants spent the longest amount of time on the oxygen

Factor Structure of the "Escala de Autoeficacia para la Depresion en Adolescentes" (EADA)

ERIC Educational Resources Information Center

Diaz-Santos, Mirella; Cumba-Aviles, Eduardo; Bernal, Guillermo; Rivera-Medina, Carmen

2011-01-01

The current concept and measures of self-efficacy for depression in adolescents do not consider developmental and cultural aspects essential to understand and assess this construct in Latino youth. We examined the factor structure of the "Escala de Autoeficacia para la Depresion en Adolescentes" (EADA), a Spanish instrument designed to…

Correlation between classification in risk categories and clinical aspects and outcomes.

PubMed

Oliveira, Gabriella Novelli; Vancini-Campanharo, Cássia Regina; Lopes, Maria Carolina Barbosa Teixeira; Barbosa, Dulce Aparecida; Okuno, Meiry Fernanda Pinto; Batista, Ruth Ester Assayag

2016-12-08

to correlate classification in risk categories with the clinical profiles, outcomes and origins of patients. analytical cross-sectional study conducted with 697 medical forms of adult patients. The variables included: age, sex, origin, signs and symptoms, exams, personal antecedents, classification in risk categories, medical specialties, and outcome. The Chi-square and likelihood ratio tests were used to associate classifications in risk categories with origin, signs and symptoms, exams, personal antecedents, medical specialty, and outcome. most patients were women with an average age of 44.5 years. Pain and dyspnea were the symptoms most frequently reported while hypertension and diabetes mellitus were the most common comorbidities. Classifications in the green and yellow categories were the most frequent and hospital discharge the most common outcome. Patients classified in the red category presented the highest percentage of ambulance origin due to surgical reasons. Those classified in the orange and red categories also presented the highest percentage of hospitalization and death. correlation between clinical aspects and outcomes indicate there is a relationship between the complexity of components in the categories with greater severity, evidenced by the highest percentage of hospitalization and death. correlacionar as categorias de classificação de risco com perfil clínico, desfechos e procedência. estudo transversal analítico realizado com 697 fichas de atendimento de pacientes adultos. Variáveis estudadas: idade, sexo, procedência, sinais e sintomas, exames, antecedentes pessoais, categorias da classificação de risco, especialidade médica de atendimento e desfecho. Para associar as categorias de classificação de risco com procedência, sinais e sintomas, exames, antecedentes pessoais, especialidade médica e desfecho, utilizaram-se o teste qui-quadrado e a razão de verossimilhança. pacientes do sexo feminino foram a maioria e com média de

Quotidian of accompanying family members in an environment of care: the emergence of hospital tribes.

PubMed

Passos, Silvia da Silva Santos; Pereira, Álvaro; Nitschke, Rosane Gonçalves

2016-01-01

Compreender o relacionamento no quotidiano dos familiares acompanhantes nos cenários de cuidado que se aproximam da metáfora da tribo no ambiente hospitalar. Estudo qualitativo com dados coletados a partir de entrevistas semiestruturadas e observação com 16 familiares acompanhantes de pessoas hospitalizadas com dependência para o autocuidado. Os dados foram submetidos à análise temática e analisados através da metáfora da tribo proposta pela sociologia compreensiva. Os familiares formam um agrupamento social em torno do cuidado onde encontramos as características das tribos: a ambiência emocional; a solidariedade baseada nos vínculos de simpatia e ajuda mútua; a nebulosa afetual no processo interacional; a lógica da fusão nas relações tácteis e a comunhão/religiosidade no processo de ligação numa identidade coletiva. Os familiares na presença do trágico criam agrupamentos sociais que se assemelham a tribos cujo totem é o cuidado. Understand the quotidian relationships of accompanying family members in an environment of care, which are close to the metaphor of a tribe in hospital environment. METHODQualitative study with data gathered from semi-structured interviews and observations with 16 family members accompanying hospitalized individuals with dependence on self-care. Data were submitted to thematic analysis, and analyzed through the metaphor of "tribe" proposed by comprehensive sociology. Family members build up social clusters around caring, where we find traits typical of tribes: emotional ambience; solidarity based on links of sympathy and mutual assistance; an affectual nebula in the process of interaction; a logic of fusion in tactile relations; and communion/religiosity in the process of connecting in a collective identity. In the presence of tragedy, families build social clusters similar to tribes having care as a totem.

Photooxidation of Trimethyl Phosphite in Nitrogen, Oxygen, and para-Hydrogen Matrixes at Low Temperatures.

PubMed

Ramanathan, N; Sundararajan, K; Gopi, R; Sankaran, K

2017-03-16

Trimethyl phosphite (TMPhite) was photooxidized to trimethyl phosphate (TMP) in N 2 , O 2 , and para-H 2 matrixes at low temperatures to correlate the conformational landscape of these two molecules. The photooxidation produced the trans (TGG)-rich conformer with respect to the ground state gauche (GGG) conformer of TMP in N 2 and O 2 matrixes, which has diverged from the conformational composition of freshly deposited pure TMP in the low-temperature matrixes. The enrichment of the trans conformer in preference to the gauche conformer of TMP during photooxidation is due to the TMPhite precursor, which exists exclusively in the trans conformer. Interestingly, whereas the photooxidized TMP molecule suffers site effects possibly due to the local asymmetry in N 2 and O 2 matrixes, in the para-H 2 matrix owing to the quantum crystal nature the site effects were observed to be self-repaired.

Survival benefits of pelvic lymphadenectomy versus pelvic and para-aortic lymphadenectomy in patients with endometrial cancer

PubMed Central

Guo, Weina; Cai, Jing; Li, Min; Wang, Hongbo; Shen, Yi

2018-01-01

Abstract Background: Despite that pelvic and para-aortic lymphadenectomy (PPaLND) is recommended as part of accurate surgical staging by International Federation of Gynecology and Obstetrics (FIGO) in endometrial cancer, the impact of para-aortic lymphadenectomy on survival remains controversial. The aim of this work is to evaluate the survival benefits or risks in endometrial cancer patients who underwent surgical staging with or without para-aortic lymphadenectomy using meta-analysis. Methods: Literature search was undertaken using PubMed, Embase, and Cochrane Library databases for relevant articles published between January 1, 1990, and January 1, 2017, without language restriction. The primary outcome was overall survival (OS); progression-free survival (PFS)/recurrence-free survival (RFS)/disease-free survival (DFS)/disease-related survival (DRS) was also analyzed. Subgroup analysis and sensitivity analysis were conducted to investigate the source of heterogeneity. Quality assessments were performed by Newcastle–Ottawa Quality Assessment Scale (NOS). Publication bias was evaluated by using Begg and Egger tests. The hazard ratio (HR) was pooled with random-effects or fixed-effects model as appropriate. Results: Eight studies with a total of 2793 patients were included. OS was significantly longer in PPaLND group than in pelvic lymphadenectomy (PLND) group for patients with endometrial cancer [HR 0.68; 95% confidence interval (CI) 0.55–0.84, P < .001, I2 = 12.2%]. Subgroup analysis by recurrence risk explored the same association in patients at intermediate- or high-risk (HR 0.52; 95% CI 0.39–0.69, P < .001, I2 = 41.4%), but not for low-risk patients (HR 0.48; 95% CI 0.21–1.08, P = .077, I2 = 0). PPaLND with systematic resection of all para-aortic nodes up to renal vein also improved PFS/RFS/DFS/DRS, compared with PLND (HR 0.52, 95% CI 0.37–0.72, P < .001, I2 = 0). No publication bias was observed among included studies

Increasing the Analytical Sensitivity by Oligonucleotides Modified with Para- and Ortho-Twisted Intercalating Nucleic Acids – TINA

PubMed Central

Schneider, Uffe V.; Géci, Imrich; Jøhnk, Nina; Mikkelsen, Nikolaj D.; Pedersen, Erik B.; Lisby, Gorm

2011-01-01

The sensitivity and specificity of clinical diagnostic assays using DNA hybridization techniques are limited by the dissociation of double-stranded DNA (dsDNA) antiparallel duplex helices. This situation can be improved by addition of DNA stabilizing molecules such as nucleic acid intercalators. Here, we report the synthesis of a novel ortho-Twisted Intercalating Nucleic Acid (TINA) amidite utilizing the phosphoramidite approach, and examine the stabilizing effect of ortho- and para-TINA molecules in antiparallel DNA duplex formation. In a thermal stability assay, ortho- and para-TINA molecules increased the melting point (Tm) of Watson-Crick based antiparallel DNA duplexes. The increase in Tm was greatest when the intercalators were placed at the 5′ and 3′ termini (preferable) or, if placed internally, for each half or whole helix turn. Terminally positioned TINA molecules improved analytical sensitivity in a DNA hybridization capture assay targeting the Escherichia coli rrs gene. The corresponding sequence from the Pseudomonas aeruginosa rrs gene was used as cross-reactivity control. At 150 mM ionic strength, analytical sensitivity was improved 27-fold by addition of ortho-TINA molecules and 7-fold by addition of para-TINA molecules (versus the unmodified DNA oligonucleotide), with a 4-fold increase retained at 1 M ionic strength. Both intercalators sustained the discrimination of mismatches in the dsDNA (indicated by ΔTm), unless placed directly adjacent to the mismatch – in which case they partly concealed ΔTm (most pronounced for para-TINA molecules). We anticipate that the presented rules for placement of TINA molecules will be broadly applicable in hybridization capture assays and target amplification systems. PMID:21673988

Perspectivas para mejorar la salud sexual de las minorías sexuales y de identidad de género en Guatemala

PubMed Central

Alonzo, Jorge; Mann, Lilli; Simán, Florence; Sun, Christina J.; Andrade, Mario; Villatoro, Guillermo; Rhodes, Scott D.

2016-01-01

Resumen Las minorías sexuales y de identidad de género en Guatemala son afectadas de manera desproporcionada por el VIH y otras infecciones transmitidas sexualmente (ITS). Sin embargo, poco se sabe de los factores que contribuyen al riesgo de infección en estas minorías. Investigadores de Estados Unidos y Guatemala quisimos informarnos sobre las necesidades de salud sexual e identificar características de programas de prevención de VIH/ITS para estas minorías. Llevamos a cabo 8 grupos focales con hombres gay, bisexuales y personas transgénero y entrevistas en profundidad con líderes comunitarios. Utilizamos el Método Comparativo Constante para analizar las transcripciones. Identificamos 24 factores que influyen en la salud sexual y 16 características de programas para reducir el riesgo de VIH/ITS en estas poblaciones. La identificación de factores de conductas sexuales de riesgo y de características de programas potencialmente efectivos ofrece gran potencial para desarrollar intervenciones que contribuyan a reducir el riesgo de infección por VIH/ITS en estas minorías en Guatemala. PMID:27494000

Biodegradation of Para Amino Acetanilide by Halomonas sp. TBZ3

PubMed Central

Hajizadeh, Nader; Sefidi Heris, Youssof; Zununi Vahed, Sepideh; Vallipour, Javad; Hejazi, Mohammad Amin; Golabi, Sayyed Mahdi; Asadpour-Zeynali, Karim; Hejazi, Mohammad Saeid

2015-01-01

Background: Aromatic compounds are known as a group of highly persistent environmental pollutants. Halomonas sp. TBZ3 was isolated from the highly salty Urmia Lake of Iran. In this study, characterization of a new Halomonas isolate called Halomonas sp. TBZ3 and its employment for biodegradation of para-amino acetanilide (PAA), as an aromatic environmental pollutant, is described. Objectives: This study aimed to characterize the TBZ3 isolate and to elucidate its ability as a biodegradative agent that decomposes PAA. Materials and Methods: Primarily, DNA-DNA hybridization between TBZ3, Halomonas denitrificans DSM18045T and Halomonas saccharevitans LMG 23976T was carried out. Para-amino acetanilide biodegradation was assessed using spectrophotometry and confirmed by gas chromatography-mass spectroscopy (GC-MS). Parameters effective on biodegradation of PAA were optimized by the Response Surface Methodology (RSM). Results: The DNA-DNA hybridization experiments between isolate TBZ3, H. denitrificans and H. saccharevitans revealed relatedness levels of 57% and 65%, respectively. According to GC-MS results, TBZ3 degrades PAA to benzene, hexyl butanoate, 3-methyl-1-heptanol and hexyl hexanoate. Temperature 32.92°C, pH 6.76, and salinity 14% are the optimum conditions for biodegradation with a confidence level of 95% (at level α = 0.05). Conclusions: According to our results, Halomonas sp. TBZ3 could be considered as a biological agent for bioremediation of PAA and possibly other similar aromatic compounds. PMID:26495103

Breaking the Barrier to Slow Water Exchange Rates for Optimal Magnetic Resonance Detection of paraCEST Agents.

PubMed

Fernando, W Shirangi; Martins, André F; Zhao, Piyu; Wu, Yunkou; Kiefer, Garry E; Platas-Iglesias, Carlos; Sherry, A Dean

2016-03-21

EuDOTA-tetraamide complexes as paraCEST agents offer an attractive platform for designing biological sensors and responsive agents. The early versions of these agents showed low sensitivity at temperature and power levels suitable for in vivo applications partly due to non-optimal water exchange rates. Here we report two new EuDOTA derivatives having glutamyl-phosphonate side arms that display the slowest water exchange rates of any other paraCEST agent reported so far. The advantages of such systems are demonstrated experimentally both in vitro and in vivo and DFT calculations were performed to help understand the physical-chemical reasons for this interesting behavior.

Crystal dimension of ZSM-5 influences on para selective disproportionation of ethylbenzene.

PubMed

Hariharan, Srinivasan; Palanichamy, Muthaiahpillai

2014-03-01

Crystal size and crystal dimensions are vital role in shape selective feature. Para selective disproportionation of EthylBenzene (Dip-EB) was investigated over ZSM-5 synthesized in acidic medium. The catalysts were prepared by hydrothermal process with various Si/Al ratios (50, 75 and 100) using fluoride ion precursor. This fluoride ion precursor dissolves the ZSM-5 nutrients below it neutral pH between 4 and 6. The synthesized material was subjected into various physico chemical characterizations such as XRD, SEM, TGA and BET analyses. The XRD patterns showed high crystalline nature and their resulting SEM images were also indicate thin prismatic crystals of large dimension compared with alkaline medium synthesized one. The BET results earned good textural property. Catalytic activity of vapor phase Dip-EB was carried out between 523 and 673 K. As their result, diethylbenzene (DEB) isomers were obtained, but para selective Diethylbenzene (p-DEB) was observed higher than others. The high selectivity towards p-DEB was due to large crystal dimension of ZSM-5 catalysts synthesized in fluoride medium. Hence it is good commercial application for petrochemical feed stock production.

PubMed

Morales Guerrero, Josefina Consuelo; Rosas Romero, Reina; García Zepeda, Rodrigo Antonio; Oropeza Hernández, Rodolfo; Ruiz Jiménez, Silvia; Ríos Chávez, Alejandra R; Cervantes Covarrubias, Leticia

2016-09-20

Introducción: el índice glucémico (IG) y la carga glucémica (CG) de productos lácteos fermentados (PLF) con lactobacilos puede ser una recomendación útil para pacientes diabéticos y para la población en general.Objetivo: el objetivo del estudio fue medir el IG y la CG de PLF con lactobacilos en sujetos sedentarios y deportistas, y evaluar si existe diferencia entre ellos.Métodos: el estudio se realizó en México (DF) de acuerdo con la ISO26642:210 (Organización Internacional de Normalización). Los participantes fueron: 10 sedentarios y 10 deportistas. Los PLF analizados fueron: Soful, Yakult, Gastroprotect, BeneGastro, Bonacult, Lala Bio 4 y leche descremada con sacarosa (LDS) y la cantidad de alimento que ingirieron dependió de ajustar a 25 g los HC en la porción.Resultados: el IG de la mayoría de los PLF fue bajo para ambos grupos de sujetos; en los deportistas los PLF Yakult y Bonacult presentaron los mayores IG y solo el Yakult puede considerarse como de IG medio para este grupo; estos dos PLF presentaron la menor relación de proteína/HC. La LDS, lácteo con los HC no fermentados, presentó un IG alto para ambos grupos. La CG de los PLF se encontró entre 4 a 7,6 y solo Gastroprotect presentó estadísticamente la menor CG, lo que pudo deberse a su bajo IG, aun cuando su tamaño de ración no fue la menor, entre los PLF.Conclusión: en general los valores de IG y CG de los PLF fueron bajos para ambos grupos. Por tanto, su consumo puede recomendarse en forma moderada. El IG y CG entre productos lácteos con azúcares fermentados y con azúcares no fermentados fueron diferentes.

Infrared Space Observatory Observations of Molecular Hydrogen in HH 54: Measurement of a Nonequilibrium Ratio of Ortho- to Para-H2

NASA Technical Reports Server (NTRS)

Neufeld, David A.; Melnick, Gary J.; Harwit, Martin

1998-01-01

We have detected the S(1), S(2), S(3), S(4), and S(5) pure rotational lines of molecular hydrogen toward the outflow source HH 54 using the Short Wavelength Spectrometer on board the Infrared Space Observatory. The observed H2 line ratios indicate the presence of warm molecular gas with an H2 density of at least 10(exp 5) cm(exp -3) and a temperature approximately 650 K in which the ratio of ortho- to para-H2 is only 1.2 +/- 0.4, significantly smaller than the equilibrium ratio of 3 expected in gas at that temperature. These observations imply that the measured ratio of ortho- to para-H2 is the legacy of an earlier stage in the thermal history of the gas when the gas had reached equilibrium at a temperature approximately less than 90 K. Based upon the expected timescale for equilibration, we argue that the nonequilibrium ratio of ortho- to para-H2 observed in HH 54 serves as a chronometer that places a conservative upper limit of approximately 5000 yr on the period for which the emitting gas has been warm. The S(2)/S(1) and S(3)/S(1) H2 line ratios measured toward HH 54 are consistent with recent theoretical models of Timmermann for the conversion of para- to ortho-H2 behind slow, C-type shocks, but only if the preshock ratio of ortho- to para-H2 was approximately less than 0.2.

Use of cuff tear arthroplasty head prosthesis for rotator cuff arthropathy treatment in elderly patients with comorbidities.

PubMed

Carvalho, Cassiano Diniz; Andreoli, Carlos Vicente; Pochini, Alberto de Castro; Ejnisman, Benno

2016-01-01

To evaluate the clinical and functional behavior of patients undergoing cuff tear arthroplasty at different stages of the disease. Cuff tear arthroplasty hemiarthroplasties were performed in 34 patients with rotator cuff arthropathy and associated comorbidities, classified according to Seebauer. The mean age was 76.3 years, and the sample comprised 23 females (67.6%) and 11 males (32.4%). The mean follow-up period was 21.7 months, and evaluations were performed using the Visual Analog Scale for pain and the Constant scale. There were no statistically significant differences in the mean reduction in the Visual Analog Scale or in the Constant scale increase between the female and male groups. The variation between the pre- and postoperative Visual Analog Scale and Constant scale evaluations was significant. There was also no statistically significant difference between the Seebauer classification groups regarding the mean Visual Analog Scale reduction, or the mean Constant scale increase. Cuff tear arthroplasty shoulder hemiarthroplasty is a good option for rotator cuff arthropathy in patients with comorbidities. Avaliar o comportamento clínico e funcional dos pacientes submetidos à artroplastia do tipo cuff tear arthroplasty para o tratamento da artropatia do manguito rotador em diferentes estágios da afecção. Foram realizadas 34 hemiartroplastias do tipo cuff tear arthroplasty em 34 pacientes com artropatia do manguito rotador e comorbidades associadas, classificadas de acordo com Seebauer. A média de idade foi de 76,3 anos, sendo 23 pacientes do sexo feminino (67,6%) e 11 do sexo masculino (32,4%). O seguimento médio foi de 21,7 meses e a avaliação foi realizada por meio da Escala Visual Analógica da dor e pela escala de Constant. Não houve diferença estatisticamente significante entre os grupos feminino e masculino, tanto nas médias de redução na Escala Visual Analógica quanto nas de aumento na escala de Constant. A variação entre as avalia

Modelo de accesibilidad de conceptos matematicos aplicados en el curso de Astronomia Descriptiva para estudiantes con impedimentos visuales en la UPR

NASA Astrophysics Data System (ADS)

Isidro Villamizar, Gloria Maria

Este estudio utiliza metodologia de investigacion cualitativa, con el proposito de describir, analizar y evaluar los procesos de diseno y desarrollo de un modelo de accesibilidad que consiste en estrategias de ensenanza de las matematicas para estudiantes con impedimentos visuales matriculados en el curso de Astronomia Descriptiva en la UPR. Se utilizaron las siguientes estrategias para recopilar la informacion, 1) reflexiones de la investigadora en el proceso de diseno y desarrollo de las lecciones adaptadas, que se registraron en un diario reflexivo. 2) entrevista semiestructurada luego de haber trabajado las lecciones de aprendizaje adaptadas con los participantes. 3) observaciones y notas de la investigadora del trabajo de los participantes. Para obtener la informacion de los participantes se obtuvo los permisos institucionales necesarios; se seleccionaron los participantes y se validaron los instrumentos; se realizo el desarrollo de las lecciones adaptadas con los participantes; y finalmente, se analizo la informacion obtenida. El diseno de las lecciones de aprendizaje adaptadas se hizo siguiendo las recomendaciones curriculares de los temas de matematicas aplicados en el curso de Astronomia Descriptiva realizado por la investigadora durante su semestre de internado. El testimonio de las voces de los participantes se obtuvo del proceso de desarrollo de las lecciones de aprendizaje adaptadas de temas seleccionados de conceptos matematicos requeridos en el curso de Astronomia Descriptiva y de la entrevista semiestructurada con los participantes, luego de haber trabajado las lecciones de aprendizaje. Para el desarrollo de las lecciones de aprendizaje, se utilizaron materiales tactiles adaptados, materiales tactiles disenados y materiales disponibles comercialmente. Los textos de las lecciones se imprimieron en tinta y en Braille. Se exhorta a disenar y desarrollar estrategias de ensenanza accesibles, considerando como recursos para evaluar su efectividad a

Transcultural adaptation of the Johns Hopkins Fall Risk Assessment Tool.

PubMed

Martinez, Maria Carmen; Iwamoto, Viviane Ernesto; Latorre, Maria do Rosário Dias de Oliveira; Noronha, Adriana Moreira; Oliveira, Ana Paula de Sousa; Cardoso, Carlos Eduardo Alves; Marques, Ifigenia Augusta Braga; Vendramim, Patrícia; Lopes, Paula Cristina; Sant'Ana, Thais Helena Saes de

2016-08-29

to perform the transcultural adaptation and content validity analysis of the Johns Hopkins Fall Risk Assessment Tool to assess both fall risk and fall-related injury risk for hospitalized elderly in Brazil. the transcultural adaptation consisted of translating the scale to Portuguese (Brazil), back-translating it into its language of origin, establishing a consensus version, and having an expert committee verify its transcultural equivalence. Content assessment was conducted by a committee of judges, ending with the calculation of the items and scales' content validity index. Nurses tested the tool. the scale's translated version went through two evaluation rounds by the judges, based on which, the items with unsatisfactory performance were changed. The content validity index for the items was ≥80.0% and the global index 97.1%. The experimental application showed the scale is user-friendly. the scale presents valid content for the assessment of fall risk and risk of fall-related injuries and is easy to use, with the potential to contribute to the proper identification of risks and the establishment of care actions. realizar a adaptação transcultural para uso no Brasil e a avaliação da validade de conteúdo da Johns Hopkins Fall Risk Assessment Tool para avaliação de risco de quedas e de danos por quedas em pacientes adultos hospitalizados. adaptação transcultural consistiu na tradução da escala para a língua portuguesa (Brasil), retrotradução para a língua de origem, versão de consenso e análise da equivalência transcultural por um comitê de especialistas. A avaliação do conteúdo foi realizada por meio de um comitê de juízes, finalizando com o cálculo do índice de validade de conteúdo dos itens e da escala. Foi realizada a aplicação experimental do instrumento por enfermeiros. a versão traduzida da escala passou por duas rodadas de avaliação pelos juízes, a partir das quais os itens com desempenho insatisfatório foram modificados

Los Protectores del Planeta: actividades para niños y recursos educativos sobre reciclaje

EPA Pesticide Factsheets

Información sobre el Club Protectores del Planeta que enseña cómo reducir la basura desde el punto de origen, cómo reciclar y conservar los recursos naturales. La información incluye recursos educativos para el salón de clases.

Positive Pacing Strategies Are Utilized by Elite Male and Female Para-cyclists in Short Time Trials in the Velodrome.

PubMed

Wright, Rachel L

2015-01-01

In para-cycling, competitors are classed based on functional impairment resulting in cyclists with neurological and locomotor impairments competing against each other. In Paralympic competition, classes are combined by using a factoring adjustment to race times to produce the overall medallists. Pacing in short-duration track cycling events is proposed to utilize an "all-out" strategy in able-bodied competition. However, pacing in para-cycling may vary depending on the level of impairment. Analysis of the pacing strategies employed by different classification groups may offer scope for optimal performance; therefore, this study investigated the pacing strategy adopted during the 1-km time trial (TT) and 500-m TT in elite C1 to C3 para-cyclists and able-bodied cyclists. Total times and intermediate split times (125-m intervals; measured to 0.001 s) were obtained from the C1-C3 men's 1-km TT (n = 28) and women's 500-m TT (n = 9) from the 2012 Paralympic Games and the men's 1-km TT (n = 19) and women's 500-m TT (n = 12) from the 2013 UCI World Track Championships from publically available video. Split times were expressed as actual time, factored time (for the para-cyclists) and as a percentage of total time. A two-way analysis of variance was used to investigate differences in split times between the different classifications and the able-bodied cyclists in the men's 1-km TT and between the para-cyclists and able-bodied cyclists in the women's 500-m TT. The importance of position at the first split was investigated with Kendall's Tau-b correlation. The first 125-m split time was the slowest for all cyclists, representing the acceleration phase from a standing start. C2 cyclists were slowest at this 125-m split, probably due to a combination of remaining seated in this acceleration phase and a high proportion of cyclists in this group being trans-femoral amputees. Not all cyclists used aero-bars, preferring to use drop, flat or bullhorn handlebars. Split times

Positive Pacing Strategies Are Utilized by Elite Male and Female Para-cyclists in Short Time Trials in the Velodrome

PubMed Central

Wright, Rachel L.

2016-01-01

In para-cycling, competitors are classed based on functional impairment resulting in cyclists with neurological and locomotor impairments competing against each other. In Paralympic competition, classes are combined by using a factoring adjustment to race times to produce the overall medallists. Pacing in short-duration track cycling events is proposed to utilize an “all-out” strategy in able-bodied competition. However, pacing in para-cycling may vary depending on the level of impairment. Analysis of the pacing strategies employed by different classification groups may offer scope for optimal performance; therefore, this study investigated the pacing strategy adopted during the 1-km time trial (TT) and 500-m TT in elite C1 to C3 para-cyclists and able-bodied cyclists. Total times and intermediate split times (125-m intervals; measured to 0.001 s) were obtained from the C1-C3 men's 1-km TT (n = 28) and women's 500-m TT (n = 9) from the 2012 Paralympic Games and the men's 1-km TT (n = 19) and women's 500-m TT (n = 12) from the 2013 UCI World Track Championships from publically available video. Split times were expressed as actual time, factored time (for the para-cyclists) and as a percentage of total time. A two-way analysis of variance was used to investigate differences in split times between the different classifications and the able-bodied cyclists in the men's 1-km TT and between the para-cyclists and able-bodied cyclists in the women's 500-m TT. The importance of position at the first split was investigated with Kendall's Tau-b correlation. The first 125-m split time was the slowest for all cyclists, representing the acceleration phase from a standing start. C2 cyclists were slowest at this 125-m split, probably due to a combination of remaining seated in this acceleration phase and a high proportion of cyclists in this group being trans-femoral amputees. Not all cyclists used aero-bars, preferring to use drop, flat or bullhorn handlebars. Split times

The influence of para-seismic vibrations, induced by blasting works, on structures: a Case Study

NASA Astrophysics Data System (ADS)

Andrusikiewicz, Wacław

2018-04-01

Underground mining operations are often associated with the necessity to use explosives. Several hundreds of kilograms of explosives, subdivided into small charges suitable for a specific mining job, are used each time in a blasting operation. In many cases, mining engineers carry out remote central blasting works, which means that all the charges placed at faces are initiated from one control point (usually, a control room in the mine) at the same time. Such coordinated explosions generate para-seismic movements whose consequences can be felt on land surface, with subsequent effects identified in buildings and structures. This paper discusses briefly selected standards applicable to the harmful para-seismic impacts. The author presents the results of the research conducted with the intention to identify harmful effects of the basting works carried out in the "Kłodawa" Salt Mine.

Ortho-para transition rate in mu-molecular hydrogen and the proton's induced pseudoscalar coupling gp.

PubMed

Clark, J H D; Armstrong, D S; Gorringe, T P; Hasinoff, M D; King, P M; Stocki, T J; Tripathi, S; Wright, D H; Zolnierczuk, P A

2006-02-24

We report a measurement of the ortho-para transition rate in the p mu p molecule. The experiment was conducted at TRIUMF via the measurement of the time dependence of the 5.2 MeV neutrons from muon capture in liquid hydrogen. The measurement yielded an ortho-para rate Lambda op = (11.1 +/- 1.7 +/-(0.9)(0.6)) x 10(4) s(-1), which is substantially larger than the earlier result of Bardin et al. The result has striking implications for the proton's induced pseudoscalar coupling g(p), changing the value of g(p) obtained from the most precise ordinary muon capture measurement from 10.6 +/- 2.7 to 0.8 +/- 2.8, and from the sole radiative muon capture measurement from 12.2 +/- 1.1 to 10.6 +/- 1.2, bringing the latter result closer to theoretical predictions.

Sludge reduction by uncoupling metabolism: SBR tests with para-nitrophenol and a commercial uncoupler.

PubMed

Zuriaga-Agustí, E; Mendoza-Roca, J A; Bes-Piá, A; Alonso-Molina, J L; Amorós-Muñoz, I

2016-11-01

Nowadays cost reduction is a very important issue in wastewater treatment plants. One way, is to minimize the sludge production. Microorganisms break down the organic matter into inorganic compounds through catabolism. Uncoupling metabolism is a method which promote catabolism reactions instead of anabolism ones, where adenosine triphosphate synthesis is inhibited. In this work, the influence of the addition of para-nitrophenol and a commercial reagent to a sequencing batch reactor (SBR) on sludge production and process performance has been analyzed. Three laboratory SBRs were operated in parallel to compare the effect of the addition of both reagents with a control reactor. SBRs were fed with synthetic wastewater and were operated with the same conditions. Results showed that sludge production was slightly reduced for the tested para-nitrophenol concentrations (20 and 25 mg/L) and for a LODOred dose of 1 mL/day. Biological process performance was not influenced and high COD removals were achieved. Copyright © 2016 Elsevier Ltd. All rights reserved.

Solid and liquid heat capacities of n-alkyl para-aminobenzoates near the melting point.

PubMed

Neau, S H; Flynn, G L

1990-11-01

The expression that relates the ideal mole fraction solubility of a crystalline compound to physicochemical properties of the compound includes a term involving the difference in the heat capacities of the solid and liquid forms of the solute, delta Cp. There are two alternate conventions which are employed to eliminate this term. The first assumes that the term involving delta Cp, or delta Cp itself, is zero. The alternate assumption assigns the value of the entropy of fusion to the differential heat capacity. The relative validity of these two assumptions was evaluated using the straight-chain alkyl para-aminobenzoates as test compounds. The heat capacities of the solid and liquid forms of each of the para-aminobenzoates, near the respective melting point, were determined by differential scanning calorimetry. The data lead one to conclude that the assumption that the differential heat capacity is not usually negligible and is better approximated by the entropy of fusion.

Staphylococcal superantigen-specific IgE antibodies: degree of sensitization and association with severity of asthma.

PubMed

Elabras, José; Mello, Fernanda Carvalho de Queiroz; Lupi, Omar; Bica, Blanca Elena Rios Gomes; Papi, José Angelo de Souza; França, Alfeu Tavares

2016-01-01

To determine the presence of staphylococcal superantigen-specific IgE antibodies and degree of IgE-mediated sensitization, as well as whether or not those are associated with the severity of asthma in adult patients. This was a cross-sectional study involving outpatients with asthma under treatment at a tertiary care university hospital in the city of Rio de Janeiro, Brazil. Consecutive patients were divided into two groups according to the severity of asthma based on the Global Initiative for Asthma criteria: mild asthma (MA), comprising patients with mild intermittent or persistent asthma; and moderate or severe asthma (MSA). We determined the serum levels of staphylococcal toxin-specific IgE antibodies, comparing the results and performing a statistical analysis. The study included 142 patients: 72 in the MA group (median age = 46 years; 59 females) and 70 in the MSA group (median age = 56 years; 60 females). In the sample as a whole, 62 patients (43.7%) presented positive results for staphylococcal toxin-specific IgE antibodies: staphylococcal enterotoxin A (SEA), in 29 (20.4%); SEB, in 35 (24.6%); SEC, in 33 (23.2%); and toxic shock syndrome toxin (TSST), in 45 (31.7%). The mean serum levels of IgE antibodies to SEA, SEB, SEC, and TSST were 0.96 U/L, 1.09 U/L, 1.21 U/L, and 1.18 U/L, respectively. There were no statistically significant differences between the two groups in terms of the qualitative or quantitative results. Serum IgE antibodies to SEA, SEB, SEC, and TSST were detected in 43.7% of the patients in our sample. However, neither the qualitative nor quantitative results showed a statistically significant association with the clinical severity of asthma. Determinar a presença de anticorpos IgE específicos para superantígenos estafilocócicos e o grau de sensibilização mediada por esses, assim como se esses estão associados à gravidade da asma em pacientes adultos. Estudo transversal incluindo asmáticos adultos em acompanhamento ambulatorial em

Remodelar Correctamente: Guía de Prácticas Acreditadas Seguras Para Trabajar Con Plomo

EPA Pesticide Factsheets

Información general sobre los requisitos legales de las prácticas relacionadas al manejo seguro del plomo para dueños de hogares, inquilinos, proveedores de cuido infantil, y padres durante las actividades de remodelación

Desarrollo de la Escala sobre el Estigma Relacionado con el VIH/SIDA para Profesionales de la Salud mediante el uso de métodos mixtos123

PubMed Central

Varas-Díaz, Nelson; Neilands, Torsten B.; Guilamo-Ramos, Vincent; Cintrón Bou, Francheska N.

2009-01-01

El estigma relacionado con el VIH/SIDA continúa siendo un obstáculo para la prevención primaria y secundaria del VIH. Las consecuencias para las personas que viven con la enfermedad han sido muy documentadas y continúan siendo una gran preocupación para las personas que proveen servicios de salud y para aquellas que investigan el tema. Estas consecuencias son preocupantes cuando el estigma emana de profesionales de la salud porque se puede limitar el acceso a los servicios. Uno de los principales obstáculos para la investigación del estigma relacionado con el VIH en Puerto Rico es la falta de instrumentos cuantitativos para evaluar las manifestaciones del estigma entre profesionales de la salud. El objetivo principal de este estudio fue desarrollar y probar las propiedades psicométricas de una escala sobre el estigma relacionado con el VIH/SIDA culturalmente apropiada para personas que proveen servicios de salud puertorriqueñas y desarrollar una versión corta de la escala que pudiera usarse en escenarios clínicos con tiempo limitado. El instrumento desarrollado estuvo basado en evidencia cualitativa recopilada entre profesionales y estudiantes de profesiones de la salud puertorriqueños/as (n=80) y administrado a una muestra de 421 profesionales de la salud en adiestramiento. La escala contenía 12 dimensiones del estigma relacionado con el VIH/SIDA. El análisis cuantitativo corroboró 11 de ellas, teniendo como resultado un instrumento con validez y confiabilidad satisfactoria. Estas dimensiones, a su vez, fueron subcomponentes de un factor de estigma general superior. PMID:20333258

Infrared spectra of seeded hydrogen clusters: (para-H2)N-N2O and (ortho-H2)N-N2O, N = 2-13.

PubMed

Tang, Jian; McKellar, A R W

2005-09-15

High-resolution infrared spectra of clusters containing para-H2 and/or ortho-H2 and a single nitrous oxide molecule are studied in the 2225-cm(-1) region of the upsilon1 fundamental band of N2O. The clusters are formed in pulsed supersonic jet expansions from a cooled nozzle and probed using a tunable infrared diode laser spectrometer. The simple symmetric rotor-type spectra generally show no resolved K structure, with prominent Q-branch features for ortho-H2 but not para-H2 clusters. The observed vibrational shifts and rotational constants are reported. There is no obvious indication of superfluid effects for para-H2 clusters up to N=13. Sharp transitions due to even larger clusters are observed, but no definite assignments are possible. Mixed (para-H2)N-(ortho-H2)M-N2O cluster line positions can be well predicted by linear interpolation between the corresponding transitions of the pure clusters.

[Not Available].

PubMed

Joaquín Ortiz, Clara

2016-06-03

En la actualidad existe una alta variabilidad en la práctica clínica en nutrición que podría afectar al estado nutricional de los pacientes oncológicos. La implementación de guías de práctica clínica de adecuada calidad puede ayudarnos a disminuir esta variabilidad y minimizar los efectos deletéreos de la malnutrición en los pacientes oncológicos. Las guías suelen estar basadas en la evidencia, formulando las recomendaciones a partir de la mejor información disponible. No obstante, es importante tener en cuenta la calidad metodológica en la elaboración de las guías y valorar si existen conflictos de interés. Los principales problemas de las guías actuales suelen ser que existe limitada evidencia de alta calidad, y que las recomendaciones basadas exclusivamente en la evidencia pueden no ser útiles en la práctica clínica diaria, ya que no tienen en cuenta la aplicabilidad que es fundamental para su implementación. Por otro lado, las guías clínicas hasta la actualidad han sido inconsistentes en la forma de evaluar la calidad de la evidencia y el grado de recomendación. Como resultado, los usuarios se enfrentan al desafío de comprender los mensajes que los diferentes sistemas de grados de evidencia tratan de comunicar. En esta revisión se realiza un resumen de las recomendaciones de las principales guías clínicas sobre valoración y/o soporte nutricional en pacientes oncohematológicos desarrolladas en los últimos 10 años, incluyendo algunas guías de calidad de sociedades científicas que no son accesibles a través de las bases de datos comúnmente usadas como PubMed.

A Miocene wave-dominated estuarine system in the Paraíba Basin, northeastern Brazil

NASA Astrophysics Data System (ADS)

Gandini, Rosana; Rossetti, Dilce de Fátima; Netto, Renata Guimarães; Góes, Ana Maria

2017-11-01

A number of publications have documented the effect of the Miocene transgression on several coasts of the world. However, this event is incompletely documented along the Brazilian margin, despite the existence of an impressive record of Miocene deposits exposed mostly as several coastal cliffs along more than 5000 km of distance. The transgressive nature of Miocene deposits, so far recognized only in a few localities of northeastern Brazil, needs to be amplified in order to better characterize the impact of the Miocene transgression in eastern South America. In this work, we provide facies analysis of early/middle Miocene strata exposed in the Paraíba Basin, northeastern Brazil, aiming reconstruct the depositional paleoenvironments and analyze their evolution within the context of relative sea-level fluctuations data. The results revealed deposits characterized by several features that were related to the action of tidal currents, such as alternating thicker/thinner forest packages, abundant reactivation surfaces, mud drapes and oppositely-dipping (herringbone) cross sets. These sedimentary structures were associated with an ichnological assemblage indicative of marine-influenced and brackish water, best represented by Ophiomorpha, Planolites-Palaeophycus-Thalassinoides and Thallassinoides-Planolites-Palaeophycus ichnofabrics. Sedimentation occurred in environments consisting of estuarine channel, estuarine central basin, tidal inlet/tidal channel, tidal delta/washover, tidal flat/shoal and foreshore, which were related to an estuarine setting, at least in part of a wave-dominated type. Analysis of facies stratal patterns led to suggest that the estuarine deposits of the Paraíba Basin reflect a rise in relative sea level probably during the transgressive and/or highstand stage of a depositional sequence formed directly overlying Cretaceous rocks. This rise can be correlated with the worldwide early/mid Miocene marine transgression. However, while the eustatic sea

Viviendo Con Incendios: Una guia para los duenos de casas en Nuevo Mexico [Living with Fire: A Guide for the Homeowner-New Mexico

Treesearch

U.S. Department of the Interior Bureau of Land Management

2008-01-01

La posibilidad de perdidas humanas y de propiedad en Nuevo Mexico debido a un incendio forestal ha ido incrementando. Para responder a este peligro, entidades locales, estatales, federales, particulares y sin fines de lucro se han unido para crear Como Reducir la Amenaza de Incendios Forestales, un programa dirigido a los propietarios de casas. Este no es un programa...

Quantum effects of translational motions in solid para-hydrogen and ortho-deuterium: anharmonic extension of the Einstein model.

PubMed

Kühn, O; Manz, J; Schild, A

2010-04-07

An anharmonic extension of the Einstein model is developed in order to describe the effect of translational zero point motion on structural and thermodynamic properties of para-H(2) and ortho-D(2) crystals in the zero temperature limit. Accordingly, the molecules carry out large amplitude translational motions in their matrix cage, which are formed by the frozen environment of all other molecules. These translations lead from the molecular equilibrium positions via the harmonic to the anharmonic domain of the potential energy surface. The resulting translational distributions are roughly isotropic, and they have approximately Gaussian shapes, with rather broad full widths at half-maximum, FWHM(para-H(2)/ortho-D(2)) = 1.36/1.02 Å. The translational zero point energies induce expansions of the crystals, in nearly quantitative agreement with experimental results. Furthermore, they make significant contributions to the sublimation energies and zero pressure bulk moduli. These quantum effects decrease with heavier molecular masses. The corresponding isotope effects for ortho-D(2) compared to para-H(2) are confirmed by application of the model to Ar crystals. The results imply consequences for laser induced reaction dynamics of dopants with their host crystals.

para-Aminosalicylic acid is a prodrug targeting dihydrofolate reductase in Mycobacterium tuberculosis.

PubMed

Zheng, Jun; Rubin, Eric J; Bifani, Pablo; Mathys, Vanessa; Lim, Vivian; Au, Melvin; Jang, Jichan; Nam, Jiyoun; Dick, Thomas; Walker, John R; Pethe, Kevin; Camacho, Luis R

2013-08-09

para-Aminosalicylic acid (PAS) is one of the antimycobacterial drugs currently used for multidrug-resistant tuberculosis. Although it has been in clinical use for over 60 years, its mechanism(s) of action remains elusive. Here we report that PAS is a prodrug targeting dihydrofolate reductase (DHFR) through an unusual and novel mechanism of action. We provide evidences that PAS is incorporated into the folate pathway by dihydropteroate synthase (DHPS) and dihydrofolate synthase (DHFS) to generate a hydroxyl dihydrofolate antimetabolite, which in turn inhibits DHFR enzymatic activity. Interestingly, PAS is recognized by DHPS as efficiently as its natural substrate para-amino benzoic acid. Chemical inhibition of DHPS or mutation in DHFS prevents the formation of the antimetabolite, thereby conferring resistance to PAS. In addition, we identified a bifunctional enzyme (riboflavin biosynthesis protein (RibD)), a putative functional analog of DHFR in a knock-out strain. This finding is further supported by the identification of PAS-resistant clinical isolates encoding a RibD overexpression mutation displaying cross-resistance to genuine DHFR inhibitors. Our findings reveal that a metabolite of PAS inhibits DHFR in the folate pathway. RibD was shown to act as a functional analog of DHFR, and as for DHFS, both were shown to be associated in PAS resistance in laboratory strains and clinical isolates.

Mix-infection of S. Typhi and ParaTyphi A in Typhoid Fever and Chronic Typhoid Carriers: A Nested PCR Based Study in North India

PubMed Central

Pratap, Chandra Bhan; Kumar, Gopal; Patel, Saurabh Kumar; Shukla, Vijay K; Kumar, Kailash; Singh, Tej Bali

2014-01-01

Introduction: Enteric fever is a systemic disease caused by Salmonella organism such as serotypes Typhi and ParaTyphi A, B, C. Salmonella ParaTyphi A contributes more than 50% of all the enteric fever cases and it has recently been projected as an emerging pathogen. Materials and Methods: The present study was aimed to detect Salmonella Typhi and ParaTyphi A in urine, blood and stool specimens collected from cases of enteric fever (110), chronic typhoid carriers (46) and healthy controls (75) to explore the possibility of mixed infection by nested PCR. A new nested PCR primer was designed targeting putative fimbrial protein (stkG) gene which is one of the fimbrial gene families to Salmonella ParaTyphi A and for S. Typhi already reported primers targeting flagellin (fliC) gene. Results: Large volume of urine specimens (15 ml) was found to be the best for detection of Salmonella serotypes. The urine sample was found to have mixed-infection by both the serotypes in 40.9% of the cases but lower in blood (27.3%) and stool (13.6%). Conclusion: The present study concludes that occurrence of mixed infection may be quite frequent in typhoid and chronic typhoid carriers’ individuals, although the reported recent rise in ParaTyphi A incidence may not be real. PMID:25584217

Comment on "A centroid molecular dynamics study of liquid para hydrogen and ortho deuterium" [J. Chem. Phys. 121, 6412 (2004)].

PubMed

Miller, Thomas F; Manolopoulos, David E; Madden, Paul A; Konieczny, Martin; Oberhofer, Harald

2005-02-01

We show that the two phase points considered in the recent simulations of liquid para hydrogen by Hone and Voth lie in the liquid-vapor coexistence region of a purely classical molecular dynamics simulation. By contrast, their phase point for ortho deuterium was in the one-phase liquid region for both classical and quantum simulations. These observations are used to account for their report that quantum mechanical effects enhance the diffusion in liquid para hydrogen and decrease it in ortho deuterium.(c) 2005 American Institute of Physics.

Effects of indacaterol versus tiotropium on exercise tolerance in patients with moderate COPD: a pilot randomized crossover study.

PubMed

Berton, Danilo Cortozi; Santos, Álvaro Huber Dos; Bohn, Ivo; Lima, Rodrigo Quevedo de; Breda, Vanderléia; Teixeira, Paulo José Zimermann

2016-01-01

longa duração administrado uma vez por dia (indacaterol 150 µg) a um anticolinérgico de longa duração administrado uma vez por dia (tiotrópio 5 µg) quanto a seus efeitos na resistência ao exercício (limite de tolerância, Tlim) em pacientes com DPOC moderada. Os desfechos secundários foram seus efeitos na hiperinsuflação pulmonar, na dispneia causada pelo exercício e na dispneia na vida diária. Estudo piloto randomizado cruzado e simples cego com 20 pacientes (média de idade: 60,9 ± 10,0 anos; média do VEF1: 69 ± 7% do previsto). Parâmetros espirométricos, pontuação no Transition Dyspnea Index, Tlim e dispneia aos esforços foram comparados após três semanas de cada tratamento (com uma semana de intervalo entre os tratamentos). Dezenove pacientes completaram o estudo - um foi excluído por causa de exacerbação da DPOC. A melhora no Tlim tendeu a ser maior com tiotrópio do que com indacaterol (96 ± 163 s vs. 8 ± 82 s; p = 0,06). Em comparação com os valores basais, o Tlim melhorou significativamente com tiotrópio (aumentando de 396 ± 319 s para 493 ± 347 s; p = 0,010), mas não com indacaterol (aumentando de 393 ± 246 para 401 ± 254 s; p = 0,678). Não houve diferença entre os tratamentos quanto à melhora na pontuação na escala de dispneia de Borg e na insuflação pulmonar no "isotempo" e no pico do exercício. Também não houve diferenças significativas entre os tratamentos quanto à pontuação no Transition Dyspnea Index (1,5 ± 2,1 vs. 0,9 ± 2,3; p = 0,39). Em pacientes com DPOC moderada, o tiotrópio tende a melhorar o Tlim em comparação com o indacaterol. Não houve diferenças significativas entre os tratamentos quanto a seus efeitos na insuflação pulmonar, na dispneia durante o exercício e na dispneia na vida diária. São necessários mais estudos, com um número maior de pacientes, para confirmar nossos achados e explorar explicações mecanicistas. (ClinicalTrials.gov identifier: NCT01693003 [http://www.clinicaltrials.gov/]).

Can para-aryl-dithiols cross-link two plasmonic noble nanoparticles as monolayer dithiolate spacers

USDA-ARS?s Scientific Manuscript database

Para-aryl-dithiols (PADTs, HS-(C6H4)n-SH, n = 1, 2, and 3) have been used extensively in molecular electronics, surface-enhanced Raman spectroscopy (SERS), and quantum electron tunneling between two gold or silver nanoparticles (AuNPs and AgNPs). One popular belief is that these dithiols cross-link ...

Lean thinking in health and nursing: an integrative literature review.

PubMed

Magalhães, Aline Lima Pestana; Erdmann, Alacoque Lorenzini; Silva, Elza Lima da; Santos, José Luís Guedes Dos

2016-08-08

organizacionais, promovendo vantagens em termos de qualidade, segurança e eficiência dos cuidados de saúde e enfermagem com foco no paciente. evidenciar el conocimiento científico desarrollado sobre el pensamiento Lean en el área de la salud (destacando el impacto y las contribuciones en el cuidado de la salud) y en la enfermería. revisión integradora de la literatura a partir de las bases de datos PubMed, CINAHL, Scopus, Web of Science, Emerald, LILACS y en la biblioteca electrónica SciELO, de 2006 a 2014, con sintaxis de palabras clave para cada base; fueron seleccionados 47 artículos para análisis. las categorías fueron elaboradas a partir de la tríade de calidad propuesta por Donabedian: estructura, proceso y resultado. El pensamiento Lean está en ascensión en las investigaciones sobre salud, principalmente en el ámbito internacional, con destaque para los Estados Unidos y Reino Unido, mejorando la estructura, el proceso y el resultado a partir de acciones asistenciales y administrativas. Sin embargo, es una temática incipiente en la enfermería. por medio de ese estudio se observó que la utilización del pensamiento Lean, en el contexto de la salud, tiene un efecto transformador en los aspectos asistenciales y organizacionales, promoviendo ventajas en términos de calidad, seguridad y eficiencia de los cuidados de salud y enfermería con enfoque en el paciente.

Pressure ulcer dressings in critical patients: a cost analysis.

PubMed

Silva, Dinara Raquel Araújo; Bezerra, Sandra Marina Gonçalves; Costa, Jéssica Pereira; Luz, Maria Helena Barros Araújo; Lopes, Vanessa Caminha Aguiar; Nogueira, Lidya Tolstenko

2017-06-12

To assess the direct cost of dressings in pressure ulcer treatment. This was a descriptive observational study conducted at an intensive care unit in the Northeast region of Brazil, between November and December 2015. Data were gathered using the Pressure Ulcer Scale for Healing and a form to characterize and assess costs. Values in Brazilian reais (BRL) were converted into U.S. dollars at the exchange rate of USD 0.26/BRL. Univariate and bivariate analyses were conducted. The sample consisted of 15 patients with at least stage 2 ulcers. There was a significant reduction in costs with dressing materials between the initial and final assessments (p=0.002), with a mean of USD 11.9 (±7.4). The most common topical treatments used were essential fatty acids and papain. Cost reduction was proportional to the stage of pressure ulcer. The role of nurses in creating evidence-based care plans is crucial to improve care management. Avaliar o custo direto com curativos no tratamento de lesões por pressão. Estudo observacional descritivo, realizado em Unidade de Terapia Intensiva do nordeste do Brasil, de novembro a dezembro de 2015. Foi aplicada a Pressure Ulcer Scale for Healing e formulário para caracterização e avaliação de custos. Os valores da moeda brasileira (R$) foram convertidos para a moeda norte-americana (US$) à taxa de US$0,26/R$. Foram realizadas análises univariadas e bivariadas. Compuseram a amostra 15 pacientes com lesões, no mínimo, estágio 2. Houve redução significativa dos custos com materiais de curativos entre as avaliações inicial e final (p=0,002), com média de US$11,9 (±7,4). As terapias tópicas mais frequentes foram ácidos graxos essenciais e papaína. Verificou-se redução de custos proporcional aos estágios das lesões. Enfatiza-se o papel do enfermeiro na elaboração de planos de cuidados baseados em evidências para melhor gerenciamento do cuidado. Evaluar el costo directo de curativos para el tratamiento de lesiones por

[Acute-stage para- and tetraplegia].

PubMed

Hachen, H J

1993-03-20

A quarter of a century ago, in October 1964, the first spinal cord injury center in Switzerland was opened at Geneva University Hospital. At that time all para- and tetraplegics were classified as "high-risk" patients. Early mortality, covering the initial four weeks following trauma, was still around 15%. The available resources for diagnostic assessment were limited to clinical examination and neuroradiological assessment (subsequently improved by the introduction of tomography and gas myelography). A great many patients suffered a deteriorated neurological level due to inadequate, multiple transfers between hospitals. Most patients who are paralyzed following a road-traffic accident show severe polytrauma. Their chances of survival and functional recovery have greatly improved in recent years due to efficient emergency transport by helicopter, admission to an intensive care unit (respiratory therapy, prophylactic anticoagulation, gastrointestinal cytoprotection, prevention of pressure sores, etc.) and a comprehensive medico-surgical team approach (orthopedic surgeons, neurosurgeons, ICU specialists, internists, etc.). Evaluation of the spine and spinal cord by NMR and CT scan allows precise assessment of the extent of CNS damage and provides additional guide-lines regarding efficient surgical reposition and spinal fusion. Ongoing experimental research in neurophysiology and neurobiochemistry of the brain and spinal cord is presently yielding some interesting results which hold out new hopes for functional recovery in some specific types of incomplete spinal cord trauma.

Concordance study between the ParaDNA® Intelligence Test, a rapid DNA profiling assay, and a conventional STR typing kit (AmpFlSTR® SGM Plus®).

PubMed

Ball, G; Dawnay, N; Stafford-Allen, B; Panasiuk, M; Rendell, P; Blackman, S; Duxbury, N; Wells, S

2015-05-01

The ParaDNA® Intelligence Test enables STR profiling directly from human biological samples and evidence items collected from crime scene in 75min. Designed for non-expert use this system allows DNA information to be available to investigators before it would typically be available from a laboratory. The ParaDNA Intelligence Test system amplifies D3S1358, D8S119, D16S539, D18S1358 and TH01 STR loci and the gender typing locus amelogenin and detects the alleles present with HyBeacon® probes. Individual DNA samples from 381 UK Caucasian individuals were analysed using AmpFlSTR® SGM Plus® and the ParaDNA Intelligence Test with the derived STR profiles compared. Here we describe the high level of concordance demonstrated between the two systems and discuss this with reference to allele frequencies and the discriminatory power offered by the ParaDNA Intelligence Test. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

Alcohol and drug use disorders, HIV status and drug resistance in a sample of Russian TB patients

PubMed Central

Fleming, M. F.; Krupitsky, E.; Tsoy, M.; Zvartau, E.; Brazhenko, N.; Jakubowiak, W.; E. McCaul, M.

2006-01-01

��emploi d’une combinaison du cliché thoracique, de la bacilloscopie et des cultures d’expectoration. Chez 62% des patients, les critères DSM-IV pour utilisation courante d’alcool ou pour dépendance étaient présents. L’utilisation de drogues est inhabituelle: deux patients seulement ont signalé une utilisation récente de l’héroïne par voie intraveineuse. Il n’y avait qu’un seul cas d’infection VIH. Le score total moyen de la batterie d’évaluation des risques a été de 3,4. Il y avait de la dépression chez 60% de 1’échantillon, dont 17% étaient en dépression sévère. L’utilisation ou la dépendance à l’égard de l’alcool étaient associées avec une multiplication par huit de la résistance aux médicaments (OR 8,58 ; IC95% 2,09-35,32). Les patients atteints de rechute de TB ou de TB chronique sont plus susceptibles de répondre aux critérés d’abus ou de dépendance de l’alcool (OR 2,56; IC95% 1,0-6,54). CONCLUSION: Les maladies liées à l’utilisation d’alcool sont fréquentes chez les patients traités pour TB active et sont associées à une morbidité significative. Des enquêtes complémentaires sont nécessaires pour examiner les relations entre les maladies liées à l’utilisation d’alcool et la résistance à l’égard des médicaments antituberculeux. MARCO DE REFERENCIA: El consumo de alcohol, la tuberculosis (TB) farmacorresistente y los comportamientos de riesgo para la infección por el virus de la inmunodeficiencia humana (VIH) constituyen una preocupación creciente en los pacientes con TB en la Fedéración de Rusia. MÉTODOS: Se llevó a cabo un estudio de prevalencia del consumo de alcohol y del comportamiento de riesgo para la infección por el VIH en una muestra de 200 adultos, hombres y mujeres, ingresados por TB en dos hospitales de San Petersburgo e Ivanovo en la Federación de Rusia. RESULTADOS: El 72% de los individuos fueron de sexo masculino. La media de la edad fue 41 años. El diagn

Probes for Narcotic Receptor Mediated Phenomena. 37.1 Synthesis and Opioid Binding Affinity of the Final Pair of Oxide-Bridged Phenylmorphans, the ortho- and para-b Isomers and Their N-Phenethyl Analogues, and the Synthesis of the N-Phenethyl Analogues of the ortho- and para-d Isomers

PubMed Central

Kurimura, Muneaki; Liu, Hehua; Sulima, Agnieszka; Hashimoto, Akihiro; Przybyl, Anna K.; Ohshima, Etsuo; Kodato, Shinichi; Deschamps, Jeffrey R.; Dersch, Christina M.; Rothman, Richard B.; Lee, Yong Sok; Jacobson, Arthur E.; Rice, Kenner C.

2008-01-01

In the isomeric series of 12 racemic topologically rigid N-methyl analogues of oxide-bridged phenylmorphans, all but two of the racemates, the ortho- and para-b-oxide-bridged phenylmorphansa 20 and 12, have remained to be synthesized. The b-isomers were very difficult to synthesize because of the highly strained 5,6-trans-fused ring junction that had to be formed. Our successful strategy required functionalization of the position para (or ortho) to a fluorine atom on the aromatic ring using an electron-withdrawing nitro group to activate that fluorine. The racemic N-phenethyl analogues 24 and 16 were moderately potent κ-receptor antagonists in the [35S]GTPγS assay. We synthesized the N-phenethyl-substituted oxide-bridged phenylmorphans in the ortho- and para-d oxide-bridged phenylmorphana series (51 and 52) which had not been previously evaluated using contemporary receptor binding assays to see whether they also have higher affinity for opioid receptors than their N-methyl relatives 46 and 47. PMID:19053757

First report of the protozoan parasite Perkinsus marinus in South America, infecting mangrove oysters Crassostrea rhizophorae from the Paraíba River (NE, Brazil).

PubMed

da Silva, Patricia Mirella; Vianna, Rogério Tubino; Guertler, Cristhiane; Ferreira, Liana Pinho; Santana, Lucas Nunes; Fernández-Boo, Sergio; Ramilo, Andrea; Cao, Asunción; Villalba, Antonio

2013-05-01

The present work aimed to study the infection by Perkinsus sp. in the mangrove oysters Crassostrea rhizophorae from the estuary of the Paraíba River (Paraíba State, Brazil). Perkinsosis was detected by incubation of oyster gill pieces in Ray's fluid thioglycollate medium. The monthly prevalence values were all above 70%, thus infection was not likely to be a transient event. Perkinsus sp. parasites isolated from eight oysters were propagated in vitro. PCR-RFLP analysis of in vitro cultured cells as well as the sequences of the rDNA ITS region allowed the identification of the in vitro propagated parasites as Perkinsus marinus. Phylogenetic analyses using rDNA ITS region sequences strongly supported the Perkinsus sp. from Paraíba in a monophyletic group with P. marinus. Thus, the results confirmed the species affiliation of Paraíba Perkinsus sp. as P. marinus. This is the first report of P. marinus in Brazil and South America and the first report of P. marinus naturally infecting C. rhizophorae. Copyright © 2013 Elsevier Inc. All rights reserved.

A Conceptual Model for Supporting Para-Teacher Learning in an Indian Non-Governmental Organization (NGO)

ERIC Educational Resources Information Center

Raval, Harini; McKenney, Susan; Pieters, Jules

2010-01-01

Non-governmental organizations (NGOs) are being recognized globally for their influential role in realizing the UN Millennium Development Goal of education for all in developing countries. NGOs mostly employ untrained para-educators for grassroots activities. The professional development of these teachers is critical for NGO effectiveness, yet…

Nuevos sistemas de frecuencia intermedia para el IAR

NASA Astrophysics Data System (ADS)

Olalde, J. C.; Perilli, D.; Larrarte, J. J.

Se presenta el diagrama en bloques de los nuevos sistemas de Frecuencia Intermedia para los dos radiómetros instalados en el IAR. Entre las características más importantes del sistema podemos mencionar la posibilidad de conectar cualquiera de las dos antenas a los ``backend" disponibles: analizador espectral de alta resolución (META II) de 0,05 Hz, autocorrelador de 1008 canales y contínuo. Se incorporan al sistema nuevos sintetizadores de frecuencia implementados con PLL y la moderna técnica de síntesis digital directa. Por último, el conjunto del sistema es susceptible de ser configurado por las computadoras de adquisición de datos, supervisadas por otra, que entrega el estado de funcionamiento actual y evita la selección de configuraciones incorrectas por parte del usuario.

La función de la EPA para la protección contra la radiación

EPA Pesticide Factsheets

Conforme al mandato congresional, la Agencia de Protección Ambiental de EE.UU. el la entidad responsable de establecer normas para proteger la salud humana y el medioambiente de materiales radioactivos.

Protocolo Nacional para la Evaluacion de Disturbios en Suelos Forestales; Volumen II: Metodos complementarios, estadística y recoleccion de datos

Treesearch

Deborah S. Page-Dumroese; Ann M. Abbott; Thomas M. Rice

2013-01-01

Este documento-El Volumen II: Métodos complementarios, estadística y recolección de datos- define las bases, los métodos estadísticos y de almacenamiento de datos de un Protocolo Nacional para la Evaluación de Disturbios en Suelos Forestales. Esta guía técnica proporciona las bases de un método consistente, con definiciones comunes, para generar datos de alta calidad,...

Cross-cultural adaptation of the Innsbruck Health Dimensions Questionnaire for Neurosurgical Patients (IHD-NS).

PubMed

Santos, Camila Batista dos; Carvalho, Simone Carneiro Ahualli de; Silva, Maria Fernanda Gouveia da; Fuentes, Daniel; Santana, Pedro Augusto; Furlan, André Beer; Aguiar, Paulo Henrique Pires de

2008-09-01

The goal of this study was to accomplish the cross-cultural adaptation of a quality of life instrument, specific for neurosurgical patients, called Innsbruck Health Dimensions Questionnaire for Neurosurgical Patients (IHD-NS). Thirty patients participated in this study, male and female, all having been submitted to brain tumor surgery more than twelve months before, and whose ages ranged from 26 to 66. After the process of translation/back translation and the elaboration of the Brazilian version of the instrument, the patients were assessed and reassessed within a one-month period. Statistical analyses evinced the preservation of the internal consistency, high agreement levels and highly significant intra-class correlation, allowing for the belief in the quality and reliability of the Portuguese version, named Questionário de Dimensões de Saúde para Pacientes Neurocirúrgicos de Innsbruck--DSI (NC).

EXPERIENCIAS RELACIONADAS A UNA INTERVENCIÓN PARA REDUCIR EL ESTIGMA RELACIONADO AL VIH/SIDA ENTRE ESTUDIANTES DE MEDICINA EN PUERTO RICO

PubMed Central

Cintrón-Bou, Francheska; Varas-Díaz, Nelson; Marzán-Rodríguez, Melissa; Neilands, Torsten B.

2016-01-01

Existe estigma relacionado al VIH. A las personas con VIH/SIDA-PCVS se les viola sus derechos y obstaculiza su bienestar mental/físico. Profesionales de la salud-PS son fuente de apoyo primordial, sin embargo estos/as le estigmatizan. Es útil adiestrar a PS en relación al estigma social. Implantamos la intervención para reducir el estigma relacionado al VIH/SIDA con 507 estudiantes de medicina. Resultó ser una intervención efectiva, hubo reducción en los niveles de estigma a partir de nuestra intervención y diferencias significativas con el grupo control (p≤.05). Generar espacios de adiestramiento para atender el estigma relacionado al VIH/SIDA es pertinente para la psicología comunitaria porque colaboramos en la reducción de actitudes estigmatizantes que afectan adversamente la prevención de nuevas infecciones, la adherencia al tratamiento antirretroviral y la calidad de vida. PMID:27829690

Comparative genomics of ParaHox clusters of teleost fishes: gene cluster breakup and the retention of gene sets following whole genome duplications

PubMed Central

Siegel, Nicol; Hoegg, Simone; Salzburger, Walter; Braasch, Ingo; Meyer, Axel

2007-01-01

Background The evolutionary lineage leading to the teleost fish underwent a whole genome duplication termed FSGD or 3R in addition to two prior genome duplications that took place earlier during vertebrate evolution (termed 1R and 2R). Resulting from the FSGD, additional copies of genes are present in fish, compared to tetrapods whose lineage did not experience the 3R genome duplication. Interestingly, we find that ParaHox genes do not differ in number in extant teleost fishes despite their additional genome duplication from the genomic situation in mammals, but they are distributed over twice as many paralogous regions in fish genomes. Results We determined the DNA sequence of the entire ParaHox C1 paralogon in the East African cichlid fish Astatotilapia burtoni, and compared it to orthologous regions in other vertebrate genomes as well as to the paralogous vertebrate ParaHox D paralogons. Evolutionary relationships among genes from these four chromosomal regions were studied with several phylogenetic algorithms. We provide evidence that the genes of the ParaHox C paralogous cluster are duplicated in teleosts, just as it had been shown previously for the D paralogon genes. Overall, however, synteny and cluster integrity seems to be less conserved in ParaHox gene clusters than in Hox gene clusters. Comparative analyses of non-coding sequences uncovered conserved, possibly co-regulatory elements, which are likely to contain promoter motives of the genes belonging to the ParaHox paralogons. Conclusion There seems to be strong stabilizing selection for gene order as well as gene orientation in the ParaHox C paralogon, since with a few exceptions, only the lengths of the introns and intergenic regions differ between the distantly related species examined. The high degree of evolutionary conservation of this gene cluster's architecture in particular – but possibly clusters of genes more generally – might be linked to the presence of promoter, enhancer or inhibitor

Increased ultrasensitive C-reactive protein is not associated with obesity in hospitalized heart failure patients.

PubMed

Schommer, Vânia Ames; Stein, Airton Tetelbom; Marcadenti, Aline; Wittke, Estefania Inez; Galvão, André Luís Câmara; Rosito, Guido Bernardo Aranha

2016-01-01

íveis séricos de PCR-us, em mg/L. Em 123 pacientes, a média da idade foi 61,9±12,3 anos, e 60,2% eram do sexo masculino. A mediana de PCR-us foi de 8,87mg/L (3,34 a 20,01). Detectou-se tendência à correlação inversa entre circunferência do pescoço e PCR-us (r=-0,167; p=0,069). Na análise por regressão linear múltipla, após ajustes para idade, gravidade da doença (classificação NYHA III e IV, fração de ejeção baixa, disfunção ventricular esquerda durante a diástole) e quadros infecciosos, houve associação inversa entre PCR-us e circunferência do pescoço (ß=-0,196; p=0,03) e dobra cutânea subescapular (ß=-0,005; p=0,01) na amostra total, que não se manteve após estratificação para sexo. O aumento dos níveis de PCR-us em pacientes hospitalizados por insuficiência cardíaca não se associou à obesidade.

PRE- AND POSTOPERATIVE IN BARIATRIC SURGERY: SOME BIOCHEMICAL CHANGES.

PubMed

Tedesco, Amanda Kaseker; Biazotto, Rafaela; Gebara, Telma Souza E Silva; Cambi, Maria Paula Carlini; Baretta, Giorgio Alfredo Pedroso

B12, ácido fólico, valores de homocisteína, ferro e cálcio séricos, no referido período. Compuseram a amostra 29 pacientes de ambos os sexos. Houve redução de peso após o procedimento cirúrgico com média de 108,53 kg para 78,69 kg. A variável LDL-c apresentou diferença significativa com diminuição de aproximadamente 30,3 mg/dl após a gastroplastia. Com relação à média de níveis séricos de vitamina B12 ela passou de 341,9 pg/ml para 667,2 pg/ml. Os valores de triglicérides encontravam-se na faixa de 129,6 mg/dl-173,3 mg/dl, e 81,9 mg/dl-105,3 mg/dl no pré e pós-cirúrgico, respectivamente. Foi evidenciada redução da atividade inflamatória verificada mediante queda dos níveis de PCR. A variável homocisteína foi avaliada de maneira pareada e não apresentou mudança significativa no antes e depois, havendo, contudo, forte correlação com o LDL-colesterol. Pacientes candidatos à cirurgia bariátrica frequentemente apresentam deficiências nutricionais anteriores ao procedimento com riscos aumentados no período pós-cirúrgico quando não aderem ao acompanhamento nutricional adequado.

Para-phenylenediamine allergy: current perspectives on diagnosis and management

PubMed Central

Mukkanna, Krishna Sumanth; Stone, Natalie M; Ingram, John R

2017-01-01

Para-phenylenediamine (PPD) is the commonest and most well-known component of hair dyes. Oxidative hair dyes and dark henna temporary tattoos contain PPD. Individuals may be sensitized to PPD by temporary henna tattooing in addition to dyeing their hair. PPD allergy can cause severe reactions and may result in complications. In recent years, frequency of positive patch test reactions to PPD has been increasing. Cross-sensitization to other contact allergens may occur, in particular to other hair dye components. Hairdressers are at a high risk for PPD allergy and require counseling regarding techniques to minimize exposure and protective measures while handling hair dye. We focus this review on the current perspectives of diagnosis and management of PPD allergy. PMID:28176912

Deposition, clearance, and shortening of Kevlar para-aramid fibrils in acute, subchronic, and chronic inhalation studies in rats.

PubMed

Kelly, D P; Merriman, E A; Kennedy, G L; Lee, K P

1993-10-01

The deposition and clearance of lung-deposited Kevlar para-aramid fibrils (subfibers) have been investigated as part of a subchronic and chronic inhalation toxicity testing program. Fibrils recovered from lung tissue in para-aramid-exposed Sprague-Dawley rats were microscopically counted and measured after exposures to airborne fibrils which were about 12 microns median length (ML) and < 0.3 micron median diameter. In each of three studies lung-recovered fibrils were progressively shorter with increasing residence time in the lungs. Twenty-eight days after a single 6-hr exposure at 400 respirable fibrils per cubic centimeter (f/cm3) the ML of recovered fibrils decreased to about 5 microns. Twenty-four months after a 3-week exposure to 25 or 400 f/cm3, fibrils reached about 2 microns ML. After 2 years of continuous exposure at 2.5, 25, or 100 f/cm3 or 1 year exposure plus 1 year recovery at 400 f/cm3, fibril ML approached 4 microns. In the 2-year study, the lung-fiber accumulation rate/exposure concentration was similar for the three highest concentrations and was about 3 x greater than that seen at 2.5 f/cm3, indicating that concentrations of about 25 f/cm3 or more may overwhelm clearance mechanisms. Time required for fibrils to be reduced to < 5 microns in the lung was markedly less at lower exposure concentration and shorter exposure time. The primary shortening mechanism is proposed to be long fibril cutting by enzymatic attack at fibril defects. However, length-selective fibril deposition and clearance may contribute to shortening in the first few days after exposure. The enzymatic cutting hypothesis is supported by measured increases in numbers of short fibers following cessation of exposures, continued shortening of the fibril length distribution up to 2 years following exposure, and in vitro fibril shortening after 3 months in a proteolytic enzyme preparation. The conclusion is that para-aramid fibrils are less durable in the lungs of rats than expected from

Pharmaceutical interventions in medications prescribed for administration via enteral tubes in a teaching hospital.

PubMed

Ferreira, Carolina Justus Buhrer; Plodek, Caroline Koga; Soares, Franciny Kossemba; Andrade, Rayza Assis de; Teleginski, Fernanda; Rocha, Maria Dagmar da

2016-01-01

administração para 294 medicamentos via sondas enterais; fluxograma decisório; procedimentos operacionais-padrão de diluição e unitarização de formas farmacêuticas orais e de administração de medicamentos via sondas enterais. Na Fase 2 investigou-se, retrospectivamente, erros em 872 medicamentos prescritos via sondas enterais, em 293 prescrições de pacientes internados de março a junho. Seguiu-se capacitação das equipes sobre diretrizes estabelecidas. Na Fase 3 investigou-se, prospectivamente, erros e intervenções farmacêuticas em 945 medicamentos prescritos via sondas enterais, em 292 prescrições de pacientes internados de agosto a setembro. Dados coletados, em formulário estruturado, foram compilados no programa Microsoft Office Excel(r) e calculadas as frequências. foram observados 786 erros, 63,9% (502) na Fase 2 e 36,1% (284) na Fase 3. Na Fase 3 verificou-se redução na frequência de prescrição de medicamentos, via sondas enterais, contraindicados e sem informações disponíveis. diretrizes e intervenções farmacêuticas foram determinantes na prevenção dos erros de medicamentos via sondas enterais. analizar el impacto de directrices sobre errores en medicamentos prescritos para administración vía sondas enterales. estudio cuantitativo, en tres fases, realizado en una clínica médica-neurología y en unidad de terapia intensiva de un hospital general universitario. En la Fase 1 se elaboró: protocolo de dilución, reenvasado - transformación y administración para 294 medicamentos vía sondas enterales; diagrama de flujo de decisión; procedimientos operacionales estándar de dilución y reenvasado - transformación de formas farmacéuticas orales y de administración de medicamentos vía sondas enterales. En la Fase 2 se investigó, retrospectivamente, errores en 872 medicamentos prescritos vía sondas enterales, en 293 prescripciones de pacientes internados de marzo a junio. La continuación, capacitación de los equipos sobre

Comparação entre cirurgia aberta e endovascular no tratamento do aneurisma da artéria poplítea: uma revisão

PubMed Central

Gonçalves, Ana Fernanda Fagundes; Pelek, Carlos Augusto; Nogueira, Lorena Slusarz; de Carvalho, Renan Francisco; Stumpf, Matheo Augusto Morandi; Gomes, Ricardo Zanetti; Kluthcovsky, Ana Claudia Garabeli Cavalli

2018-01-01

Resumo Os aneurismas de artéria poplítea correspondem a 70% dos aneurismas periféricos e o tratamento é cirúrgico, com controvérsias sobre os resultados da via endovascular. Este estudo objetivou realizar uma revisão da literatura sobre a comparação entre cirurgia aberta e endovascular no tratamento dos aneurismas da artéria poplítea. A pesquisa foi realizada utilizando os termos apropriados nos portais de periódicos LILACS e MEDLINE, com a seleção de 15 artigos. Um total de 5.166 procedimentos cirúrgicos foram comparados, sendo 3.930 cirurgias abertas e 1.236 cirurgias endovasculares. A cirurgia aberta com bypass venoso continua sendo o padrão-ouro. A cirurgia endovascular apresenta menor tempo de internação e é uma opção viável em pacientes eletivos, com baixa expectativa de vida, alto risco cirúrgico, comorbidades e mais idosos, desde que tenham anatomia favorável para o procedimento. Contudo, são necessários estudos de longo prazo para estabelecer os reais benefícios e indicações das duas técnicas, como o ensaio clínico randomizado controlado.

Fístula arteriovenosa após termoablação com laser endovenoso 1470 nm: relato de caso

PubMed Central

de Araujo, Walter Junior Boim; Guimarães, Adriano Carvalho; Moreira, Ricardo Herkenhoff

2016-01-01

Resumo O tratamento tradicional da insuficiência da veia safena magna (VSM) inclui a ligadura alta na junção safeno-femoral combinada com a fleboextração. No entanto, a morbidade associada à insatisfação do paciente com esse tratamento tem conduzido ao desenvolvimento de técnicas alternativas, e a termoablação com laser endovenoso (EVLT) tornou-se uma alternativa minimamente invasiva à cirurgia. A formação de fístula arteriovenosa (FAV) durante o EVLT é extremamente rara. Neste estudo, relatamos um caso de identificação ecográfica de FAV entre um segmento da veia safena acessória lateral e a artéria femoral superficial. Optou-se inicialmente pela realização de duas tentativas de compressão com transdutor linear, sem sucesso, e alternativamente o procedimento cirúrgico foi realizado sem intercorrência e com resolução da FAV. Esse relato de caso evidencia a importância do seguimento de vigilância ecográfica após o EVLT tanto para o controle da efetividade do método como para o diagnóstico e tratamento precoce de suas complicações. PMID:29930599

Summary of Documentation for DYNA3D-ParaDyn's Software Quality Assurance Regression Test Problems

DOE Office of Scientific and Technical Information (OSTI.GOV)

Zywicz, Edward

The Software Quality Assurance (SQA) regression test suite for DYNA3D (Zywicz and Lin, 2015) and ParaDyn (DeGroot, et al., 2015) currently contains approximately 600 problems divided into 21 suites, and is a required component of ParaDyn’s SQA plan (Ferencz and Oliver, 2013). The regression suite allows developers to ensure that software modifications do not unintentionally alter the code response. The entire regression suite is run prior to permanently incorporating any software modification or addition. When code modifications alter test problem results, the specific cause must be determined and fully understood before the software changes and revised test answers can bemore » incorporated. The regression suite is executed on LLNL platforms using a Python script and an associated data file. The user specifies the DYNA3D or ParaDyn executable, number of processors to use, test problems to run, and other options to the script. The data file details how each problem and its answer extraction scripts are executed. For each problem in the regression suite there exists an input deck, an eight-processor partition file, an answer file, and various extraction scripts. These scripts assemble a temporary answer file in a specific format from the simulation results. The temporary and stored answer files are compared to a specific level of numerical precision, and when differences are detected the test problem is flagged as failed. Presently, numerical results are stored and compared to 16 digits. At this accuracy level different processor types, compilers, number of partitions, etc. impact the results to various degrees. Thus, for consistency purposes the regression suite is run with ParaDyn using 8 processors on machines with a specific processor type (currently the Intel Xeon E5530 processor). For non-parallel regression problems, i.e., the two XFEM problems, DYNA3D is used instead. When environments or platforms change, executables using the current source code and

Assessing the risk of pelvic and para-aortic nodal involvement in apparent early-stage ovarian cancer: A predictors- and nomogram-based analyses.

PubMed

Bogani, Giorgio; Tagliabue, Elena; Ditto, Antonino; Signorelli, Mauro; Martinelli, Fabio; Casarin, Jvan; Chiappa, Valentina; Dondi, Giulia; Leone Roberti Maggiore, Umberto; Scaffa, Cono; Borghi, Chiara; Montanelli, Luca; Lorusso, Domenica; Raspagliesi, Francesco

2017-10-01

To estimate the prevalence of lymph node involvement in early-stage epithelial ovarian cancer in order to assess the prognostic value of lymph node dissection. Data of consecutive patients undergoing staging for early-stage epithelial ovarian cancer were retrospectively evaluated. Logistic regression and a nomogram-based analysis were used to assess the risk of lymph node involvement. Overall, 290 patients were included. All patients had lymph node dissection including pelvic and para-aortic lymphadenectomy. Forty-two (14.5%) patients were upstaged due to lymph node metastatic disease. Pelvic and para-aortic nodal metastases were observed in 22 (7.6%) and 42 (14.5%) patients. Lymph node involvement was observed in 18/95 (18.9%), 1/37 (2.7%), 4/29 (13.8%), 11/63 (17.4%), 3/41 (7.3%) and 5/24 (20.8%) patients with high-grade serous, low-grade-serous, endometrioid G1, endometrioid G2&3, clear cell and undifferentiated, histology, respectively (p=0.12, Chi-square test). We observed that high-grade serous histology was associated with an increased risk of pelvic node involvement; while, histology rather than low-grade serous and bilateral tumors were independently associated with para-aortic lymph node involvement (p<0.05). Nomograms displaying the risk of nodal involvement in the pelvic and para-aortic areas were built. High-grade serous histology and bilateral tumors are the main characteristics suggesting lymph node positivity. Our data suggested that high-grade serous and bilateral early-stage epithelial ovarian cancer are at high risk of having disease harboring in the lymphatic tissues of both pelvic and para-aortic area. After receiving external validation, our data will help to identify patients deserving comprehensive retroperitoneal staging. Copyright © 2017 Elsevier Inc. All rights reserved.

X-ray photoelectron spectroscopy study of para-substituted benzoic acids chemisorbed to aluminum oxide thin films

DOE Office of Scientific and Technical Information (OSTI.GOV)

Kreil, Justin; Ellingsworth, Edward; Szulczewski, Greg

A series of para-substituted, halogenated (F, Cl, Br, and I) benzoic acid monolayers were prepared on the native oxide of aluminum surfaces by solution self-assembly and spin-coating techniques. The monolayers were characterized by x-ray photoelectron spectroscopy (XPS) and water contact angles. Several general trends are apparent. First, the polarity of the solvent is critical to monolayer formation. Protic polar solvents produced low coverage monolayers; in contrast, nonpolar solvents produced higher coverage monolayers. Second, solution deposition yields a higher surface coverage than spin coating. Third, the thickness of the monolayers determined from XPS suggests the plane of the aromatic ring ismore » perpendicular to the surface with the carboxylate functional group most likely binding in a bidentate chelating geometry. Fourth, the saturation coverage (∼2.7 × 10{sup 14} molecules cm{sup −2}) is independent of the para-substituent.« less

Care production for tuberculosis cases:analysis according to the elements of the Chronic Care Model.

PubMed

Silva, Daiane Medeiros da; Farias, Hérika Brito Gomes de; Villa, Tereza Cristina Scatena; Sá, Lenilde Duarte de; Brunello, Maria Eugênia Firmino; Nogueira, Jordana de Almeida

2016-04-01

To analyze the care provided to tuberculosis cases in primary health care services according to the elements of the Chronic Care Model. Cross-sectional study conducted in a capital city of the northeastern region of Brazil involving 83 Family Health Strategy professionals.A structured tool adapted to tuberculosis-related care in Brazil was applied.Analysis was based on the development of indicators with capacity to produce care varying between limited and optimum. The organization of care for tuberculosis and supported self-care presented reasonable capacity.In the coordination with the community, the presence of the community agent presented optimum capacity.Partnership with organizations of the community and involvement of experts presented limited capacity.The qualification of professionals, the system for scheduling and monitoring tuberculosis in the community, and the clinical information system presented basic capacity. The capacity of the primary health care services to produce tuberculosis-related care according to the elements of the Chronic Care Model is still limited.Overcoming the fragmentation of care and prioritizing a systemic operation between actions and services of the health care network remains as a major challenge. Analisar,segundo os elementos doChronicCareModel,a produção do cuidado aos casos de tuberculose nos serviços de Atenção Primária à Saúde. Estudo transversal, realizado em capital do nordeste brasileiro, envolvendo 83 profissionais da Estratégia Saúde da Família. Aplicou-se um instrumento estruturado, adaptado para atenção à tuberculose no Brasil. A análise pautou-se na construção de indicadores, cujacapacidade para produção de cuidados variou entre limitada a ótima. A organização da atenção à tuberculose e o autocuidado apoiado apresentaram capacidade razoável. Na articulação com a comunidade, a presençadoagente comunitário de saúde apresentou capacidade ótima. A parceria com organizações da

Lower extremity reconstruction: epidemiology, management and outcomes of patients of the Federal District North Wing Regional Hospital.

PubMed

Macedo, Jefferson Lessa Soares; Rosa, Simone Corrêa; Botelho, Daniel Lobo; Santos, Clendes Pereira Dos; Queiroz, Murilo Neves DE; Gomes, Tabatha Gonçalves Andrade Castelo Branco

2017-01-01

contatos telefônicos. foram estudados 40 pacientes com média de idade de 25,6 anos, predominantemente homens (62,5%). As feridas do terço distal do membro inferior foram mais frequentes (37,5%). 55% apresentavam exposições óssea ou tendinosa e 35%, fraturas expostas do membro inferior. O tratamento foi enxerto de pele (57,5%), retalho fascio-cutâneo local (15%), retalho muscular (12,5%), retalho fascio-cutâneo de perna cruzada, retalho sural reverso (12,5%) e retalho microcirúrgico (2,5%). A avaliação em curto prazo evidenciou que 35 pacientes tiveram resultado excelente ou bom (87,5%), quatro tiveram resultado regular (10%), e um teve resultado insatisfatório (2,5%). Em longo prazo, dos 18 pacientes que responderam ao questionário, dez deambularam, mesmo que com apoio, no primeiro trimestre após a cirurgia (55,6%). nosso estudo mostrou que o perfil dos pacientes com trauma de membros inferiores que necessitaram de reconstrução cirúrgica foi representado por homens jovens, envolvidos em acidentes motociclísticos, durante situação de lazer, sendo o terço distal da perna a região mais acometida. A enxertia foi a técnica mais utilizada para reconstrução e a avaliação funcional pós-operatória demonstrou que, apesar de lesões complexas, a maioria dos pacientes evoluiu com processo de cicatrização favorável e sucesso na evolução funcional.

Comparison of Two Central Venous Pressure Control Strategies to Prevent Atrial Fibrillation After Coronary Artery Bypass Grafting.

PubMed

Costa, Mario Augusto Cray da; Lirani, Wesley; Wippich, Ana Caroline; Lopes, Luana; Tolentino, Eduardo de Souza; Zampar, Beatriz; Schafranski, Marcelo Derbli

2017-04-01

pacientes foram randomizados em dois grupos, G15 e G20, mantidos com PVC máxima de 15 cmH2O e 20 cmH2O, respectivamente. Foram incluídos 70 pacientes em cada grupo. A incidência da arritmia em G15 foi de 8,57% e, no G20, de 22,86%, com redução de risco absoluto de 14,28% e número necessário para tratar (NNT) de 7 (p = 0,03). Mortalidade (G15 = 5,71%; G20 = 11,42%; p = 0,07), tempo de internamento (G15 = 7,14 dias; G20 = 8,21 dias; p = 0,36), número de enxertos (medianas: G15 = 3, G2 = 2; p = 0,22) e uso de circulação extracorpórea (G15 = 67,10%; G20 = 55,70%; p = 0,22) mostraram-se estatisticamente semelhantes. A idade (p = 0,04) e o tempo de internamento (p = 0,001) foram significativamente maiores nos pacientes que desenvolveram FA nos dois grupos. Manter a PVC com valores mais baixos nas primeiras 72h após a cirurgia de RM reduz o risco relativo de FA e pode ser uma ferramenta útil na prevenção da FA após RM.

Mass spectrometry of analytical derivatives. 2. "Ortho" and "Para" effects in electron ionization mass spectra of derivatives of hydroxy, mercapto and amino benzoic acids.

PubMed

Todua, Nino G; Mikaia, Anzor I

2016-01-01

Derivatives requiring either anhydrous or aqueous reaction conditions were prepared for robust and reliable gas chromatography/mass spectrometry (GC/MS) characterization of hydroxyl, mercapto, and amino benzoic acids Methylation and trialkylsilytation are employed for blocking the acidic function. Alkyl, trimethylsilyl, acetyl, perfluoroacyl and alkoxycarbonyl derivatization groups are introduced to hydroxyl, mercapto and amino functions. The electron ionization induced fragmentation characteristics of corresponding derivatives are explained by comparing the MS 1 spectra of unlabeled compounds to their 2 H and 13 C labeled analogs, and analysis of collision-induced dissociation data from MS 2 spectra. Competing fragmentation alternatives are identified and specific decomposition processes are detailed that characterize (a) ortho isomers due to interaction or vicinal functional substituents and (b) para isomers prone to forming para quinoid type structures. Skeletal and hydrogen rearrangements typical for methyl benzoates and the blocking groups are considered when discussing diagnostically important ions. Characteristic ions produced as a result of rearrangements in ortho isomers are classified, and skeletal rearrangements required to produce para quinoid type ions specific for para isomers are noted. Key ions for structure elucidation and differentiation of isomers for derivatives of substituted benzoic acids by GC/MS are suggested.

Adapting a Common Photographic Camera to Take Pictures of the Sky. (Spanish Title: Adaptando Una Camara Fotografica Comun Para Obtener Fotografias del Cielo.) Adaptando Uma Câmera Fotográfica Manual Simples Para Fotografar o Céu

NASA Astrophysics Data System (ADS)

Danhoni Neves, Marcos Cesar; Pereira, Ricardo Francisco

2007-12-01

In this paper will be introduced a method of astrophotography using a non-reflex photographic camera (a low-cost method). It will be revised some photographic processes commonly used nowadays for comparison with the aims of this paper. En este trabajo será introducido un método de astrofotografia que utiliza una cámara fotográfica non-reflex (un método de bajo costo). Serán revisados algunos procesos fotográficos comúnmente utilizados actualmente para comparación con los objetivos de este trabajo. O presente artigo procura introduzir um método de astrofotografia utilizando uma câmera fotográfica não reflex, de baixo custo. É feita uma revisão do processo fotográfico comumente empregado para fins de comparação com os objetivos pretendidos no presente trabalho.

H6+ in irradiated solid para-hydrogen and its decay dynamics: reinvestigation of quartet electron paramagnetic resonance lines assigned to H2-.

PubMed

Kumada, Takayuki; Tachikawa, Hiroto; Takayanagi, Toshiyuki

2005-03-07

The quartet electron paramagnetic resonance (EPR) lines observed in gamma- and X-ray irradiated solid para-H2, which have previously been assigned to H2-, are reinvestigated. We have reassigned the quartet lines to H6 rather than H2- mainly due to comparison of experimentally obtained EPR parameters to theoretical results. Based on the new assignment, trapping site, rotation, ortho-para conversion, quantum diffusion and isotope effect of H+ have been reinterpreted by the precise reanalysis as follows. The H6+ ion is composed of the collinearly aligned H2+ core at the center and two H2 rotors at both ends, occupies a single substitutional site, and has a precession motion around a crystalline axis with the angle of approximately 57 degrees. The ortho-para conversion of H2+ core of H6+ is completed within the time-scale of hours, whereas ortho-H2 molecules near H6+ convert much faster. H6+ diffuses quantum mechanically by the repetition of H6+ + H2 --> H2 + H6+ reaction. The diffusion terminates by the reaction, H6(+) + HD --> H5D(+) + H2, with a HD impurity contained in the para-H2 sample at natural abundance. Finally, we will propose a possible reason why H6+ is produced instead of H3+ in the irradiated solid H2.

On the mode-coupling treatment of collective density fluctuations for quantum liquids: para-hydrogen and normal liquid helium.

PubMed

Kletenik-Edelman, Orly; Reichman, David R; Rabani, Eran

2011-01-28

A novel quantum mode coupling theory combined with a kinetic approach is developed for the description of collective density fluctuations in quantum liquids characterized by Boltzmann statistics. Three mode-coupling approximations are presented and applied to study the dynamic response of para-hydrogen near the triple point and normal liquid helium above the λ-transition. The theory is compared with experimental results and to the exact imaginary time data generated by path integral Monte Carlo simulations. While for liquid para-hydrogen the combination of kinetic and quantum mode-coupling theory provides semi-quantitative results for both short and long time dynamics, it fails for normal liquid helium. A discussion of this failure based on the ideal gas limit is presented.

Trends in electron-ion dissociative recombination of benzene analogs with functional group substitutions: Negative Hammett σpara values

NASA Astrophysics Data System (ADS)

Osborne, David; Lawson, Patrick Andrew; Adams, Nigel; Dotan, Itzhak

2014-06-01

An in-depth study of the effects of functional group substitution on benzene's electron-ion dissociative recombination (e-IDR) rate constant has been conducted. The e-IDR rate constants for benzene, biphenyl, toluene, ethylbenzene, anisole, phenol, and aniline have been measured using a Flowing Afterglow equipped with an electrostatic Langmuir probe (FALP). These measurements have been made over a series of temperatures from 300 to 550 K. A relationship between the Hammett σpara values for each compound and rate constant has indicated a trend in the e-IDR rate constants and possibly in their temperature dependence data. The Hammett σpara value is a method to describe the effect a functional group substituted to a benzene ring has upon the reaction rate constant.

Effectiveness and safety of a 6-month treatment with paricalcitol in patients on hemodialysis with secondary hyperparathyroidism.

PubMed

Olaizola, Inés; Caorsi, Hena; Fajardo, Laura; Ferreiro, Alejandro; Campistrus, Nieves; Dolinsky, Deyanira; Petraglia, Alicia; Ambrosoni, Pablo

2016-01-01

The mineral bone disorder, particularly secondary hyperparathyroidism, in chronic kidney disease (CKD) has a systemic impact affecting not only bone metabolism. Therefore its correction is important to prevent cardiovascular, inflammatory and immune diseases. To assess the effectiveness and safety of intravenous paricalcitol administered over a 6 month period for the treatment of secondary hyperparathyroidism (SHPT) in patients undergoing conventional hemodialysis, with close follow-up of treatment response. A phase 4 clinical trial was performed comparing clinical and laboratory data before and after 6 months of treatment. SHPT patients undergoing hemodialysis who were naïve to vitamin D metabolites or had failed to current therapy were included. Clinical and laboratory characteristics were analyzed. Efficacy analyses were based on intact parathyroid hormone (iPTH) levels and were performed using data from patients who completed 6 months of treatment. Nineteen of the 26 patients enrolled completed 6 months of treatment. All patients exhibited reduced baseline iPTH levels (mean reduction, 371.8 pg/mL; 95% CI, 273.3-470.2 pg/mL]; 17 patients (89.5%) had reductions exceeding 30%. Twelve patients (63%) achieved therapeutic success (defined as iPTH serum levels 150-300 pg/mL), with a median time of 2 months from the beginning of treatment. All reported episodes of hypercalcemia (n = 2) and hyperphosphatemia (n = 34) were asymptomatic. No major therapy-related serious AEs were reported. Paricalcitol was safely administered and was associated with significant decreases in iPTH levels over the study period. A doença metabólica óssea, em particular o hiperparatireoidismo secundário, na doença renal crônica (DRC) tem um impacto sistêmico que afeta nem só o metabolismo ósseo. Por tanto, sua correção é importante para prevenir as doenças do sistema imunitário, inflamatório e cardiovascular. Avaliar a eficácia e a segurança do paricalcitol intravenoso

ASSESSMENT OF BODY FAT IN OBESE PATIENTS PREOPERATIVELY FOR BARIATRIC SURGERY.

PubMed

Fernandez, Mônica; Toimil, Rosana Farah; Rasslan, Zied; Ilias, Elias Jirjoss; Gradinar, Ana Lúcia Torloni; Malheiros, Carlos Alberto

, observacional com 88 pacientes. Na análise antropométrica foram avaliados os dados de peso, altura, IMC e circunferência da cintura. Para bioimpedância elétrica utilizou-se a técnica recomendada pelo fabricante do aparelho e fórmula específica para obeso grave na determinação da gordura corporal. Para melhor análise dos resultados as pacientes foram divididas em dois subgrupos de acordo com a média de circunferência da cintura e IMC. O grupo apresentou média de idade 39,7 anos (±7,2), média de peso 125,6 kg (±16,2), média de IMC 48,7 kg/m2 (±6,4) e média de circunferência da cintura 137,6 cm (±12,4). Foram encontradas relações negativas e significativas entre os valores de IMC, circunferência da cintura e a resistência obtida através da bioimpedância elétrica. Ao analisar os dois subgrupos de valores médios de IMC e circunferência da cintura, observou-se relação significativa, ou seja, quanto maior o grau de obesidade menor é a resistência obtida através da bioimpedância elétrica. O aumento dos indicadores antropométricos (IMC e circunferência da cintura) determinaram redução nas variáveis resistência e reatância obtidas pela bioimpedância elétrica em mulheres candidatas à cirurgia bariátrica.