32 resultados para 403
Resumo:
Extracorporeal treatments (ECTRs), such as hemodialysis and hemoperfusion, are used in poisoning despite a lack of controlled human trials demonstrating efficacy. To provide uniform recommendations, the EXTRIP group was formed as an international collaboration among recognized experts from nephrology, clinical toxicology, critical care, or pharmacology and supported by over 30 professional societies. For every poison, the clinical benefit of ECTR is weighed against associated complications, alternative therapies, and costs. Rigorous methodology, using the AGREE instrument, was developed and ratified. Methods rely on evidence appraisal and, in the absence of robust studies, on a thorough and transparent process of consensus statements. Twenty-four poisons were chosen according to their frequency, available evidence, and relevance. A systematic literature search was performed in order to retrieve all original publications regardless of language. Data were extracted on a standardized instrument. Quality of the evidence was assessed by GRADE as: High = A, Moderate = B, Low = C, Very Low = D. For every poison, dialyzability was assessed and clinical effect of ECTR summarized. All pertinent documents were submitted to the workgroup with a list of statements for vote (general statement, indications, timing, ECTR choice). A modified Delphi method with two voting rounds was used, between which deliberation was required. Each statement was voted on a Likert scale (1-9) to establish the strength of recommendation. This approach will permit the production of the first important practice guidelines on this topic.
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Chronic mucocutaneous candidiasis (CMC) is characterized by susceptibility to Candida infection of skin, nails, and mucous membranes. Autoimmune endocrinopathies are common in CMC patients, but there are no reports of the involvement of systemic autoimmune disorders. We present here the first case of this kind of association in a patient with an autosomal dominant variant of CMC. The individual had had this disorder since childhood and systemic lupus erythematosus with secondary antiphospholipid syndrome, as well as renal, articular and hepatic manifestations without thymoma.
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Witzkeite, ideally Na4K4Ca(NO3)(2)(SO4)(4)center dot 2H(2)O, is a new mineral found in the oxidation zone of the guano mining field at Punta de Lobos, Tarapaca region, Chile. It occurs as colorless, tabular crystals up to 140 mu m in length, associated with dittmanite and nitratine. Witzkeite is colorless and transparent, with a white streak and a vitreous luster. It is brittle, with Molts hardness 2 and distinct cleavage on {001}. Measured density is 2.40(2) g/cm(3), calculated density is 2.403 g/cm(3). Witzkeite is biaxial (-) with refractive indexes alpha = 1.470(5), beta = 1.495(5), gamma = 1.510(5), measured 2V = 50-70 degrees. The empirical composition is (electron microprobe, mean of five analyses, H2O, CO2, and N2O5 by gas chromatography; wt%): Na2O 12.83, K2O 22.64, CaO 7.57, FeO 0.44, SO3 39.96, N2O5 12.7, H2O 4.5, total 100.64; CO2 was not detected. The chemical formula, calculated based on 24 O, is: Na3.40K3.95Ca1.11Fe0.05(NO3)(1.93)(SO4)(4.10)(H4.10O1.81). Witzkeite is monoclinic, space group C2/c, with unit-cell parameters: a = 24.902(2), b = 5.3323(4), c = 17.246(1) angstrom, beta = 94.281(7)degrees, V = 2283.6(3) angstrom(3) (Z = 4). The crystal structure was solved using single-crystal X-ray diffraction data and refined to R-1(F) = 0.043. Witzkeite belongs to a new structure type and is noteworthy for the very rare simultaneous presence of sulfate and nitrate groups. The eight strongest X-ray powder-diffraction lines [d in angstrom (I in %) (h k l)] are: 12.38 (100) (2 0 0), 4.13 (19) (6 0 0), 3.10 (24) (8 0 0), 2.99 (7) ((8) over bar 02), 2.85 (6) (8 02), 2.69 (9) ((7) over bar 1 3), 2.48 (12) (10 0 0), and 2.07 (54) (12 0 0). The IR spectrum of witzkeite was collected in the range 390-4000 cm(-1). The spectrum shows the typical bands of SO42- ions (1192, 1154, 1116, 1101, 1084, 993, 634, and 617 cm(-1)) and of NO3- ions (1385, 1354, 830, 716, and 2775 cm(-1)). Moreover, a complex pattern of bands related to H2O is visible (bands at 3565, 3419, 3260, 2405, 2110, 1638, and 499 cm(-1)). The IR spectrum is discussed in detail.
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In order to assess the epidemiological potential of the Culicidae species in remaining areas of the Brazilian Atlantic Forest, specimens of this family were collected in wild and anthropic environments. A total of 9,403 adult mosquitoes was collected from May, 2009 to June, 2010. The most prevalent among species collected in the wild environment were Anopheles (Kerteszia) cruzii, the Melanoconion section of Culex (Melanoconion), and Aedes serratus, while the most common in the anthropic site were Coquillettidia chrysonotum/albifera, Culex (Culex) Coronator group, and An. (Ker.) cruzii. Mosquito richness was similar between environments, although the abundance of individuals from different species varied. When comparing diversity patterns between environments, anthropic sites exhibited higher richness and evenness, suggesting that environmental stress increased the number of favorable niches for culicids, promoting diversity. Increased abundance of opportunistic species in the anthropic environment enhances contact with culicids that transmit vector-borne diseases.
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Background An adult male Brachyteles arachanoides, kept in captivity since 1990, was found dead without apparent clinical evidence. Methods Necropsy report, histopathology, immunohistochemistry, and ultrastructural examination were conducted. Results Pulmonary syncytial cells were positive for respiratory syncytial virus (RSV), and ultrastructural examination revealed viral particles inside macrophages compatible with the Paramyxoviridae family. Conclusions Muriquis are susceptible to RSV pneumonia followed by respiratory distress syndrome and death.
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Studies have shown that there are inverse relationships between nut consumption and the reduction of cardiovascular risk. This study tested the hypothesis that daily consumption of Brazilian nuts would have a positive effect upon selenium (Se) status, erythrocyte glutathione peroxidase activity, lipid profile, and atherogenic risk in severely obese women. Thirty-seven severely obese women each consumed 1 Brazilian nut a day (290 mu g of Se a day) for 8 weeks. Blood Se concentrations, total erythrocyte glutathione peroxidase activity, lipid profile, and Castelli I and H indexes were evaluated before and after the nuts consumption. All the patients were Se deficient at baseline; this deficiency was remedied by the consumption of the Brazilian nut (P < .0001). The intake of Brazilian nuts promoted a significant increase in high-density lipoprotein cholesterol concentrations (P < .00001), which then resulted in a significant improvement of the Castelli I (P < .0002) and II (P < .0004) indexes. This study shows that obese people who implement daily consumption of Brazilian nuts can improve both Se status and lipid profile, especially high-density lipoprotein cholesterol levels, thereby reducing cardiovascular risks. (C) 2012 Published by Elsevier Inc.
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PURPOSE To report on our clinical experience with and the success rate and safety of percutaneous transcatheter embolization with N-butyl cyanoacrylate (NBCA) as the lone primary embolic agent used for arterial embolization of hemorrhagic liver lesions. MATERIALS AND METHODS This retrospective study enrolled all patients who presented to the emergency room with hemorrhagic liver lesions during a two-year period and were treated by percutaneous transcatheter embolization with NBCA. RESULTS Eight consecutive patients were evaluated, and 13 lesions were embolized exclusively with NBCA: eight pseudoaneurysms and five active bleeds. All patients were treated successfully using percutaneous transcatheter embolization with NBCA without re-bleedings or major complications. CONCLUSION Percutaneous transcatheter embolization with NBCA is a safe and effective method for treating hemorrhagic lesions.
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This paper discusses the effects of the internationalization of the Colombian armed conflict, understood as the participation of foreign actors in programs regarding the resolution of the conflict. Through an analysis of the involvement of multilateral and state actors, the authors argue that this process involved the dilemma between unilateralism and multilateralism. The empirical analysis is centered on the intervention of conflict mediation mechanisms from the Organization of American States (OAS), specifically the Mission to Support the Peace Process (MAPP/OAS), whose scope is aimed at demobilizing paramilitary groups in Colombia.
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Avaliar os fatores de risco cardiovascular, com ênfase na hipertensão, e estratificá-los de acordo com o Escore de Risco de Framingham (ERF). Estudo com 154 profissionais que atuavam em aten-dimento pré-hospitalar na cidade de São Paulo e rodovia Br-116. Foi considerado significante o valor de p<0,05. A prevalência de hipertensão foi de 33%, sendo que 20,1% eram tabagistas, 47% ingeriam bebidas alcoólicas, 64% eram sedentários, 66% apresentaram obesidade/sobrepeso e 70% cintura abdominal alterada, glicemia>110mg/dL- 11%, colesterol total>200mg/dL- 36%, LDL-c>130mg/dL- 33%, HDL-c<60mg/dL- 89%, triglicérides>150mg/dL- 30% e proteína C reativa>0,5mg/dL- 16%. O ERF foi médio em 10,3% e alto em 1,3%. Na análise de regressão logística verificou-se que a hipertensão associou-se com as variáveis: HDL-c (odds ratio: 0,257) e ERF (odds ratio: 23,159). Houve forte associação entre ERF e hipertensão. Os dados chamam a atenção, por se tratar principalmente de profissionais da área da saúde relativamente jovens.
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A systematic approach to model nonlinear systems using norm-bounded linear differential inclusions (NLDIs) is proposed in this paper. The resulting NLDI model is suitable for the application of linear control design techniques and, therefore, it is possible to fulfill certain specifications for the underlying nonlinear system, within an operating region of interest in the state-space, using a linear controller designed for this NLDI model. Hence, a procedure to design a dynamic output feedback controller for the NLDI model is also proposed in this paper. One of the main contributions of the proposed modeling and control approach is the use of the mean-value theorem to represent the nonlinear system by a linear parameter-varying model, which is then mapped into a polytopic linear differential inclusion (PLDI) within the region of interest. To avoid the combinatorial problem that is inherent of polytopic models for medium- and large-sized systems, the PLDI is transformed into an NLDI, and the whole process is carried out ensuring that all trajectories of the underlying nonlinear system are also trajectories of the resulting NLDI within the operating region of interest. Furthermore, it is also possible to choose a particular structure for the NLDI parameters to reduce the conservatism in the representation of the nonlinear system by the NLDI model, and this feature is also one important contribution of this paper. Once the NLDI representation of the nonlinear system is obtained, the paper proposes the application of a linear control design method to this representation. The design is based on quadratic Lyapunov functions and formulated as search problem over a set of bilinear matrix inequalities (BMIs), which is solved using a two-step separation procedure that maps the BMIs into a set of corresponding linear matrix inequalities. Two numerical examples are given to demonstrate the effectiveness of the proposed approach.
Resumo:
A deficiência de nutrientes durante os períodos críticos do desenvolvimento tem sido associada com maior risco para desenvolver obesidade e diabetes Mellitus na vida adulta. Um dos mecanismos propostos refere-se à regulação do comportamento alimentar e às alterações do metabolismo energético do músculo esquelético. Recentemente, tem sido proposta a existência de uma comunicação entre o hipotálamo e o músculo esquelético a partir de sinais autonômicos que podem explicar as repercussões da desnutrição perinatal. Assim, esta revisão tem como objetivo discutir as repercussões da desnutrição perinatal sobre o comportamento alimentar e o metabolismo energético muscular e a comunicação existente entre o hipotálamo e o músculo via sinais adrenérgicos. Foram utilizadas as bases de dados MedLine/PubMed, Lilacs e Bireme, com publicações entre 2000 e 2011. Os termos de indexação utilizados foram: feeding behavior, energy metabolism, protein malnutrition, developmental plasticity, skeletal muscle e autonomic nervous system. Concluiu-se que a desnutrição perinatal pode atuar no controle hipotalâmico do comportamento alimentar e no metabolismo energético muscular, e a comunicação hipotálamo-músculo pode favorecer o desenvolvimento de obesidade e comorbidades durante o desenvolvimento.
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OBJETIVOS: compreender as representações sociais de membros do Poder Judiciário acerca da prevenção da violência sexual intrafamiliar contra crianças e adolescentes. MÉTODOS: pesquisa de abordagem qualitativa que teve como campo de estudo as 1ª e 2ª Varas dos Crimes contra a Criança e o Adolescente, no Tribunal de Justiça de Pernambuco, com participação de 17 sujeitos (juiz, assessor, técnicos e analistas judiciários). Observação participante, entrevistas semiestruturadas e grupo focal compreenderam as técnicas para coleta de dados, que foram analisados por meio da interpretação dos sentidos. RESULTADOS: a categoria "cultura penal" emergiu dos discursos, bem como suas subcategorias: "prevenção do crime" e "prevenção do dano". CONCLUSÕES: as representações dos sujeitos revelam uma dicotomia, caracterizando o conflito entre a tradição do Poder Judiciário e o direito novo, que abrange os princípios da proteção integral e da prioridade absoluta às crianças e dos adolescentes. O conceito de prevenção da violência sexual intrafamiliar contra crianças e adolescentes deve ser ampliado para além da mera prevenção do crime. A abordagem do problema por meio da prevenção requer que se incorpore ao Poder Judiciário uma cultura penal que abarque os princípios da proteção integral e da prioridade absoluta.
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The hydrodynamics, morphology and sedimentology of the Taperaçu estuary were investigated. This is one of several estuaries located within the largest mangrove fringe in the world, bordering the Amazon region, subject to a macrotidal regime and regionally atypical negligible fresh water supply. The results reveal widespread sand banks that occupy the central portion of the estuarine cross-section. Well-sorted very fine sandy sediments of marine origin prevail. Shorter flood phases, with substantially higher current velocities, were observed in the upper sector of Taperaçu, as expected for a shallow, friction-dominated estuary. However, ebb domination can be expected for estuaries with large associated mangrove areas and substantial estuarine infilling, both of which situations occur on the Taperaçu. The tidal asymmetry favoring flood currents could be the result of the absence of an effective fluvial discharge. Furthermore, it was observed that the Taperaçu is connected by tidal creeks to the neighboring Caeté estuary, allowing a stronger flux during the flood and intensifying the higher flood currents. As a whole, the results have shown a complex interaction of morphological aspects (friction, fluvial drainage, connections with neighbor estuaries, infilling and large storage area) in determining hydrodynamic patterns, thus improving the understanding of Amazon estuaries.
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The in vitro organogenesis of woody species plays an essential role in the improvement of forest products by providing saplings with high commercial value. Furthermore, mineral nutrition plays an important role in the induction of organogenic responses. The objective of this study was to evaluate the effects of boron and calcium in the organogenesis of nodal segments from seedlings of Eucalyptus grandis growing under in vitro conditions. The concentration of boron and calcium in MS medium was modified to induce organogenic responses in 45-day-old nodal segments used as explants. After 60 days, the fresh weight, dry weight, ratio of fresh and dry weight, relative water content and relative matter content accumulated by the explants were evaluated. The concentrations of boron and calcium in the culture medium influenced the in vitro organogenic control of Eucalyptus grandis. Reduced combinations of boron and calcium induced callus formation and dry matter accumulation in the explants. A boron concentration of 100% (1.10 mg L-1) combined with 100% (119.950 mg L-1) and 200% (239.900 mg L-1) of calcium, and 200% (2.20 mg L-1) of boron combined with 100% (119.950 mg L-1) of calcium allowed the induction of well-developed buds, which can be used for the regeneration of micro-plants.