863 resultados para Obstrucción tracto urinario inferior


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After the outbreak of war in 1914 and the subsequent blockade implemented by British navy, the German economy faced serious food shortages leading to famine-like conditions, especially towards the end of the war. As a response to these shortages, the German authorities introduced and implemented socialist policies such as price ceilings and food rations. This study focuses on the inefficient use of high-quality foodstuffs by members of lower social strata by discussing consumer decisions during the First World War from a microeconomic perspective. The German rationing system provided small, but valuable – measured by black market prices – quantities of superior foodstuffs. Especially meat could have been traded on flourishing black markets for greater quantities of inferior staple foods such as bread and potatoes. In this paper I argue that a more efficient use of rations by the poor could have improved their nutritional situation.

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Objectives: A detailed investigation of the gross and microscopic anatomy of ligamentum flavum. Methods: Material included 14 lumbar vertebral columns obtained from the Anatomy Department, King Faisal University, Dammam during the period between January 2005 and January 2006. Height, width, and thickness of ligamenta flava were measured. A microscopic study was also performed. Computed tomography scan was carried out on the lumbar vertebrae of 30 patients for measuring the ligamentum flavum. Results: The anatomical results showed that the right and left ligamenta flava join in the midline forming an acute angle with a ventral opening. The ligamentum flavum is rectangular and has 4 borders and 2 surfaces. It is attached inferiorly to the superior edge and the postero-superior surface of the lamina below. It is attached superiorly to the inferior edge and the antero-inferior surface of the lamina above. Its height ranges from 14-22 mm. The width of its lower part ranges from 11-23 mm, and the thickness ranges from 3.5-6 mm. The histological results revealed that it is comprised chiefly of elastic fibres and some collagen fibres. Conclusion: The information reported in this study is of clinical value in the practice of lumbar epidural anesthesia or analgesia. Epidural puncture will be best performed through the lower and medial portion of the ligamentum flavum slightly lateral to the midline.

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Previous investigators have not described some of the new anatomic variations or provided quantitative and analytical data of the arterial anatomy of the lips in as much depth as in this study. Dissections of 14 different facial sides of cadavers were done. Through investigating the arterial supply of the upper and lower lips, measurements were performed and statistically analyzed. The main arterial supply of the upper lip was from the superior labial artery (SLA, mean external diameter, 1.8 mm [SD, 0.74 mm]); in addition, the subalar and septal branches contributed to its vascularization. The origin of the SLA was above the labial commissure in 78.6%. The subalar branch was not found but replaced by the alar artery that arose from the infraorbital artery in 1 specimen. The main arterial supply of the lower lip was derived from 3 branches of the facial artery, the inferior labial artery (mean external diameters, 1.4 mm [SD, 0.31 mm]) and the horizontal and vertical labiomental arteries. The inferior labial artery originated mostly below the labial commissure in 42.9% and formed a common trunk with the SLA in 28.6%. The horizontal labiomental artery was present in all, but vertical labiomental artery was absent in 21.4% of specimens. Overall, observed anatomic variations were classified into types I to VIII. Significant relations between the demographic variables and measured parameters were reported including the correlation coefficient among evaluated parameters. In conclusion, this study provides various information that aids in creating new flaps and supports the vascular base for clinical procedures in reconstructive surgery of the lip.

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A precise knowledge of the sources of the arterial and neural supply of the sternohyoid (SH), sternothyroid (STM), and superior belly of omohyoid (OM) is of value to surgeons using the infrahyoid muscles in reconstruction procedures of the head and neck. This study was designed to define the anatomical bases of the variable sources of the arterial and neural supply of these muscles. Fourteen cadavers were unilaterally dissected in the neck region, and the arterial pedicles of these muscles were followed and accurate measurements were taken. For the SH, two arterial pedicles (superior and inferior) originated from the superior thyroid artery ST and supplied the muscle in 57.1% of cases. The inferior pedicle was absent in 42.9% of cases. As regards the STM, one arterial pedicle from the ST supplied its upper end by multiple branches in 57.1% of cases. In 14.3% of cases, branches from the inferior thyroid artery (IT) supplied the STM in addition to its supply from the ST. As regards the OM, two arterial pedicles originated from the ST and supplied its upper and lower ends in 57.1% of cases. The main artery from the ST to the superior belly of OM entered at its superior portion. The ansa cervicalis (AC) innervated the infrahyoid muscles. SH usually had a double nerve supply. In 57.1% of cases, its superior part was innervated by the nerve to the superior belly of OM. Its inferior part received branches from the AC. In 35.7% of cases, its superior part received direct branches from the AC. As regards the STM, in (71.4%) of cases, a common trunk arose from the loop and supplied the inferior part of both the SH and STM. The nerve supply to the superior belly of OM originated from the AC below the loop in 64.3% of cases. These data will be useful for preserving the neuro-vascular supply of the infrahyoid muscles during flap preparation.

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Objective:

The aim of this study was to identify sources of anatomical misrepresentation due to the location of camera mounting, tumour motion velocity and image processing artefacts in order to optimise the 4DCT scan protocol and improve geometrical-temporal accuracy.

Methods:

A phantom with an imaging insert was driven with a sinusoidal superior-inferior motion of varying amplitude and period for 4DCT scanning. The length of a high density cube within the insert was measured using treatment planning software to determine the accuracy of its spatial representation. Scan parameters were varied including the tube rotation period and the cine time between reconstructed images. A CT image quality phantom was used to measure various image quality signatures under the scan parameters tested.

Results:

No significant difference in spatial accuracy was found for 4DCT scans carried out using the wall mounted or couch mounted camera for sinusoidal target motion. Greater spatial accuracy was found for 4DCT scans carried out using a tube rotation speed of 0.5s rather than 1.0s. The reduction in image quality when using a faster rotation speed was not enough to require an increase in patient dose.

Conclusions:

4DCT accuracy may be increased by optimising scan parameters, including choosing faster tube rotation speeds. Peak misidentification in the recorded breathing trace leads to spatial artefacts and this risk can be reduced by using a couch mounted infrared camera.

Advances in knowledge:

This study explicitly shows that 4DCT scan accuracy is improved by scanning with a faster CT tube rotation speed.

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Actinobacteria perform essential functions within soils, and are dependent on available water to do so. We determined the water-activity (aw) limits for cell division of Streptomyces albidoflavus, Streptomyces rectiviolaceus, Micromonospora grisea and Micromonospora (JCM 3050) over a range of temperatures, using culture media supplemented with a biologically permissive solute (glycerol). Each species grew optimally at 0.998 aw (control; no added glycerol) and growth rates were near-optimal in the range 0.971–0.974 (1 M glycerol) at permissive temperatures. Each was capable of cell division at 0.916–0.924 aw (2 M glycerol), but only S. albidoflavus grew at 0.895 or 0.897 aw (3 M glycerol, at 30 and 37°C respectively). For S. albidoflavus, however, no growth occurred on media at ≤ 0.870 (4 M glycerol) during the 40-day assessment period, regardless of temperature, and a theoretical limit of 0.877 aw was derived by extrapolation of growth curves. This level of solute tolerance is high for non-halophilic bacteria, but is consistent with reported limits for the growth and metabolic activities of soil microbes. The limit, within the range 0.895–0.870 aw, is very much inferior to those for obligately halophilic bacteria and extremely halophilic or xerophilic fungi, and is inconsistent with earlier reports of cell division at 0.500 aw. These findings are discussed in relation to planetary protection policy for space exploration and the microbiology of arid soils.

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Archaea and Bacteria constitute a majority of life systems on Earth but have long been considered inferior to Eukarya in terms of solute tolerance. Whereas the most halophilic prokaryotes are known for an ability to multiply at saturated NaCl (water activity (aw) 0.755) some xerophilic fungi can germinate, usually at high-sugar concentrations, at values as low as 0.650–0.605 aw. Here, we present evidence that halophilic prokayotes can grow down to water activities of <0.755 for Halanaerobium lacusrosei (0.748), Halobacterium strain 004.1 (0.728), Halobacterium sp. NRC-1 and Halococcus morrhuae (0.717), Haloquadratum walsbyi (0.709), Halococcus salifodinae (0.693), Halobacterium noricense (0.687), Natrinema pallidum (0.681) and haloarchaeal strains GN-2 and GN-5 (0.635 aw). Furthermore, extrapolation of growth curves (prone to giving conservative estimates) indicated theoretical minima down to 0.611 aw for extreme, obligately halophilic Archaea and Bacteria. These were compared with minima for the most solute-tolerant Bacteria in high-sugar (or other non-saline) media (Mycobacterium spp., Tetragenococcus halophilus, Saccharibacter floricola, Staphylococcus aureus and so on) and eukaryotic microbes in saline (Wallemia spp., Basipetospora halophila, Dunaliella spp. and so on) and high-sugar substrates (for example, Xeromyces bisporus, Zygosaccharomyces rouxii, Aspergillus and Eurotium spp.). We also manipulated the balance of chaotropic and kosmotropic stressors for the extreme, xerophilic fungi Aspergillus penicilloides and X. bisporus and, via this approach, their established water-activity limits for mycelial growth (~0.65) were reduced to 0.640. Furthermore, extrapolations indicated theoretical limits of 0.632 and 0.636 aw for A. penicilloides and X. bisporus, respectively. Collectively, these findings suggest that there is a common water-activity limit that is determined by physicochemical constraints for the three domains of life.

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Mycobacteria are associated with a number of well-characterized diseases, yet we know little about their stress-biology in natural ecosystems. This study focuses on the isolation and characterization of strains from Yellowstone-(YNP) and Glacier-National-Parks (GNP; USA), the majority of those identified were Mycobacterium parascrofulaceum, Mycobacterium avium (YNP) or Mycobacterium gordonae (GNP). Generally, their temperature windows for growth were >60°C; selected isolates grew at super-saturated concentrations of hydrophobic stressors and at levels of osmotic stress and chaotropic activity (up to 13.4 kJkg-1) similar to, or exceeding, those for the xerophilic fungus Aspergillus wentii and solvent-tolerant bacterium Pseudomonas putida. For example, mycobacteria grew down to 0.800 water-activity indicating that they are, with the sole exception of halophiles, more xerotolerant than other bacteria (or any Archaea). Furthermore, the fatty-acid composition of Mycobacterium cells grown over a range of salt concentrations changed less than that of other bacteria, indicating a high level of resilience, regardless of the stress load. Cells of M. parascrofulaceum, M. smegmatis and M. avium resisted the acute, potentially lethal challenges from extremes of pH (<1; >13), and saturated MgCl2-solutions (5 M; 212 kJ kg-1 chaotropicity). Collectively, these findings challenge the paradigm that bacteria have solute tolerances inferior to those of eukaryotes.

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β -type Ti-alloy is a promising biomedical implant material as it has a low Young’s modulus but is also known to have inferior surface hardness. Various surface treatments can be applied to enhance the surface hardness. Physical vapour deposition (PVD) and chemical vapour deposition (CVD) are two examples of this but these techniques have limitations such as poor interfacial adhesion and high distortion. Laser surface treatment is a relatively new surface modification method to enhance the surface hardness but its application is still not accepted by the industry. The major problem of this process involves surface melting which results in higher surface roughness after the laser surface treatment. This paper will report the results achieved by a 100 W CW fiber laser for laser surface treatment without the surface being melted. Laser processing parameters were carefully selected so that the surface could be treated without surface melting and thus the surface finish of the component could be maintained. The surface and microstructural characteristics of the treated samples were examined using X-ray diffractometry (XRD), optical microscopy (OM), 3-D surface profile & contact angle measurements and nano-indentation test.

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OBJECTIVE: Over several decades, there has been an increase in the number of elderly patients requiring hemodialysis. These older patients typically have an increased incidence of comorbidities including diabetes, hypertension, and peripheral vascular disease. We undertook a systematic review of the current literature to assess outcomes of arteriovenous fistula (AVF) formation in the elderly and to compare the results of radiocephalic AVFs vs brachiocephalic AVFs in older patients.

METHODS: A literature search was performed using MEDLINE, Embase, PubMed, and the Cochrane Library. All retrieved articles published before December 31, 2014 (and in English) primarily describing the creation of hemodialysis vascular access for elderly patients were considered for inclusion. We report pooled AVF patency rates and a comparison of radiocephalic vs brachiocephalic AVF patency rates using odds ratios (ORs).

RESULTS: Of 199 relevant articles reviewed, 15 were deemed eligible for the review. The pooled 12-month primary and secondary AVF patency rates were 53.6% (95% confidence interval [CI], 47.3-59.9) and 71.6% (95% CI, 59.2-82.7), respectively. Comparison of radiocephalic vs brachiocephalic AVF patency rates demonstrated that radiocephalic AVFs have inferior primary (OR, 0.72; 95% CI, 0.55-0.93; P = .01) and secondary (OR, 0.76; 95% CI, 0.58-1.00; P = .05) patency rates.

CONCLUSIONS: This meta-analysis confirms that adequate 12-month primary and secondary AVF patency rates can be achieved in elderly patients. Brachiocephalic AVFs have both superior primary and secondary patency rates at 12 months compared with radiocephalic AVFs. These important data can inform clinicians' and patients' decision-making about suitability of attempting AVF formation in older persons.

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Milk in its natural form has a high food value, since it is comprised of a wide variety of nutrients which are essential for proper growth and maintenance of the human body. In recent decades, there has been an upsurge in milk consumption worldwide, especially in developing countries, and it is now forming a significant part of the diet for a high proportion of the global population. As a result of the increased demand, in addition to the growth in competition in the dairy market and the increasing complexity of the supply chain, some unscrupulous producers are indulging in milk fraud. This malpractice has become a common problem in the developing countries, which lack strict vigilance by food safety authorities. Milk is often subjected to fraud (by means of adulteration) for financial gain, but it can also be adulterated due to ill-informed attempts to improve hygiene conditions. Water is the most common adulterant used, which decreases the nutritional value of milk. If the water is contaminated, for example, with chemicals or pathogens, this poses a serious health risk for consumers. To the diluted milk, inferior cheaper materials may be added such as reconstituted milk powder, urea, and cane sugar, even more hazardous chemicals including melamine, formalin, caustic soda, and detergents. These additions have the potential to cause serious health-related problems. This review aims to investigate the impacts of milk fraud on nutrition and food safety, and it points out the potential adverse human health effects associated with the consumption of adulterated milk.

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The relatively high elastic modulus coupled with the presence of toxic vanadium (V) in Ti6Al4 V alloy has long been a concern in orthopaedic applications. To solve the problem, a variety of non-toxic and low modulus beta-titanium (beta-Ti) alloys have been developed. Among the beta-Ti alloy family, the quaternary Ti-Nb-Zr-Ta (TNZT) alloys have received the highest attention as a promising replacement for Ti6Al4 V due to their lower elastic modulus and outstanding long term stability against corrosion in biological environments. However, the inferior wear resistance of TNZT is still a problem that must be resolved before commercialising in the orthopaedic market. In this work, a newly-developed laser surface treatment technique was employed to improve the surface properties of Ti-35.3Nb-7.3Zr-5.7Ta alloy. The surface structure and composition of the laser-treated TNZT surface were examined by grazing incidence x-ray diffraction (GI-XRD) and x-ray photoelectron spectroscopy (XPS). The wear and corrosion resistance were evaluated by pin-on-plate sliding test and anodic polarisation test in Hanks’ solution. The experimental results were compared with the untreated (or base) TNZT material. The research findings showed that the laser surface treatment technique reported in this work can effectively improve the wear and corrosion resistance of TNZT.

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PURPOSE:

To determine the test-retest variability in perimetric, optic disc, and macular thickness parameters in a cohort of treated patients with established glaucoma.

PATIENTS AND METHODS:

In this cohort study, the authors analyzed the imaging studies and visual field tests at the baseline and 6-month visits of 162 eyes of 162 participant in the Glaucoma Imaging Longitudinal Study (GILS). They assessed the difference, expressed as the standard error of measurement, of Humphrey field analyzer II (HFA) Swedish Interactive Threshold Algorithm fast, Heidelberg retinal tomograph (HRT) II, and retinal thickness analyzer (RTA) parameters between the two visits and assumed that this difference was due to measurement variability, not pathologic change. A statistically significant change was defined as twice the standard error of measurement.

RESULTS:

In this cohort of treated glaucoma patients, it was found that statistically significant changes were 3.2 dB for mean deviation (MD), 2.2 for pattern standard deviation (PSD), 0.12 for cup shape measure, 0.26 mm for rim area, and 32.8 microm and 31.8 microm for superior and inferior macular thickness, respectively. On the basis of these values, it was estimated that the number of potential progression events detectable in this cohort by the parameters of MD, PSD, cup shape measure, rim area, superior macular thickness, and inferior macular thickness was 7.5, 6.0, 2.3, 5.7, 3.1, and 3.4, respectively.

CONCLUSIONS:

The variability of the measurements of MD, PSD, and rim area, relative to the range of possible values, is less than the variability of cup shape measure or macular thickness measurements. Therefore, the former measurements may be more useful global measurements for assessing progressive glaucoma damage.

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Beta-type Ti-alloy is a promising biomedical implant material as it has a low Young’s modulus and is also known to have inferior surface hardness. Various surface treatments can be applied to enhance the surface hardness. Physical vapor deposition and chemical vapor deposition are two examples of this but these techniques have limitations such as poor interfacial adhesion and high distortion. Laser surface treatment is a relatively new surface modification method to enhance the surface hardness but its application is still not accepted by the industry. The major problem of this process involves surface melting which results in higher surface roughness after the laser surface treatment. This paper will report the results achieved by a 100 W continuous wave (CW) fiber laser for laser surface treatment without the surface being melted. Laser processing parameters were carefully selected so that the surface could be treated without surface melting and thus the surface finish of the component could be maintained. The surface and microstructural characteristics of the treated samples were examined using x-ray diffractometry, optical microscopy, three-dimensional surface profile and contact angle measurements, and nanoindentation test.

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A pegada hídrica de uma cultura representa o volume de água necessário para produzir, relacionando as necessidades hídricas da cultura com a produção. As suas componentes, pegadas hídricas azul, verde e cinzenta, referem-se respectivamente aos volumes de água superficial e subterrânea, precipitação e de água necessária para assimilar a poluição utilizados pela cultura. A determinação das pegadas hídricas azul e verde é normalmente conseguida através da estimativa da evapotranspiração cultural, aplicando coeficientes culturais a uma evapotranspiração de referência, calculada a partir de dados meteorológicos. No presente estudo foram utilizadas medições da evapotranspiração para estimar a pegada hídrica de um olival super-intensivo na região de Évora. As necessidades hídricas foram medidas utilizando um método de fluxo de seiva para determinar a transpiração e o método micrometeorológico das flutuações instantâneas para medir directamente a evapotranspiração. Esta técnica foi utilizada durante um período de tempo limitado, enquanto as medições do fluxo de seiva, que foram efectuadas para períodos alargados, permitiram a extensão dos registos. A evapotranspiração medida directamente apresentou valores de cerca de 3 mm d-1 e o quociente entre evapotranspiração real e evapotranspiração de referência é próximo de 0,6 para o mesmo período. Comparou-se a estimativa da pegada hídrica obtida com o procedimento habitual com a resultante de medições in-situ e utilizando técnicas de deteção remota. A pegada hídrica do olival sob estudo foi inferior às simulações encontradas na literatura, o que pode ser explicado por diferenças na densidade de plantação, produção e gestão da rega. O olival em estudo obteve uma produção elevada, com um azeite que preencheu as características essenciais à classificação de azeite extra virgem, o mais valorizado, o que contraria o efeito do elevado consumo de água, resultando numa pegada hídrica inferior à de olivais não regados ou com menor densidade de plantação.