Current practices in the management of patients with ureteral calculi in the emergency room of a university hospital

OBJECTIVE: Urinary lithiasis is a common disease. The aim of the present study is to assess the knowledge regarding the diagnosis, treatment and recommendations given to patients with ureteral colic by professionals of an academic hospital. MATERIALS AND METHODS: Sixty-five physicians were interviewed about previous experience with guidelines regarding ureteral colic and how they manage patients with ureteral colic in regards to diagnosis, treatment and the information provided to the patients. RESULTS: Thirty-six percent of the interviewed physicians were surgeons, and 64% were clinicians. Forty-one percent of the physicians reported experience with ureterolithiasis guidelines. Seventy-two percent indicated that they use noncontrast CT scans for the diagnosis of lithiasis. All of the respondents prescribe hydration, primarily for the improvement of stone elimination (39.3%). The average number of drugs used was 3.5. The combination of nonsteroidal anti-inflammatory drugs and opioids was reported by 54% of the physicians (i. e., 59% of surgeons and 25.6% of clinicians used this combination of drugs) (p = 0.014). Only 21.3% prescribe alpha blockers. CONCLUSION: Reported experience with guidelines had little impact on several habitual practices. For example, only 21.3% of the respondents indicated that they prescribed alpha blockers; however, alpha blockers may increase stone elimination by up to 54%. Furthermore, although a meta-analysis demonstrated that hydration had no effect on the transit time of the stone or on the pain, the majority of the physicians reported that they prescribed more than 500 ml of fluid. Dipyrone, hyoscine, nonsteroidal anti-inflammatory drugs, and opioids were identified as the most frequently prescribed drug combination. The information regarding the time for the passage of urinary stones was inconsistent. The development of continuing education programs regarding ureteral colic in the emergency room is necessary.

Bearded capuchin monkeys` and a human`s efficiency at cracking palm nuts with stone tools: field experiments

Wild bearded capuchins, Cebus libidinosus, in Fazenda Boa Vista, Brazil crack tough palm nuts using hammer stones. We analysed the contribution of intrinsic factors (body weight, behaviour), size of the nuts and the anvil surface (flat or pit) to the efficiency of cracking. We provided capuchins with local palm nuts and a single hammer stone at an anvil. From video we scored the capuchins` position and actions with the nut prior to each strike, and outcomes of each strike. The most efficient capuchin opened 15 nuts per 100 strikes (6.6 strikes per nut). The least efficient capuchin that succeeded in opening a nut opened 1.32 nuts per 100 strikes (more than 75 strikes per nut). Body weight and diameter of the nut best predicted whether a capuchin would crack a nut on a given strike. All the capuchins consistently placed nuts into pits. To provide an independent analysis of the effect of placing the nut into a pit, we filmed an adult human cracking nuts on the same anvil using the same stone. The human displaced the nut on proportionally fewer strikes when he placed it into a pit rather than on a flat surface. Thus the capuchins placed the nut in a more effective location on the anvil to crack it. Nut cracking as practised by bearded capuchins is a striking example of a plastic behaviour where costs and benefits vary enormously across individuals, and where efficiency requires years to attain. (C) 2009 The Association for the Study of Animal Behaviour. Published by Elsevier Ltd. All rights reserved.

Stone tool use by adult wild bearded capuchin monkeys (Cebus libidinosus). Frequency, efficiency and tool selectivity

Chimpanzees have been the traditional referential models for investigating human evolution and stone tool use by hominins. We enlarge this comparative scenario by describing normative use of hammer stones and anvils in two wild groups of bearded capuchin monkeys (Cebus libidinosus) over one year. We found that most of the individuals habitually use stones and anvils to crack nuts and other encased food items. Further, we found that in adults (1) males use stone tools more frequently than females, (2) males crack high resistance nuts more frequently than females, (3) efficiency at opening a food by percussive tool use varies according to the resistance of the encased food, (4) heavier individuals are more efficient at cracking high resistant nuts than smaller individuals, and (5) to crack open encased foods, both sexes select hammer stones on the basis of material and weight. These findings confirm and extend previous experimental evidence concerning tool selectivity in wild capuchin monkeys (Visalberghi et al., 2009b; Fragaszy et al., 2010b). Male capuchins use tools more frequently than females and body mass is the best predictor of efficiency, but the sexes do not differ in terms of efficiency. We argue that the contrasting pattern of sex differences in capuchins compared with chimpanzees, in which females use tools more frequently and more skillfully than males, may have arisen from the degree of sexual dimorphism in body size of the two species, which is larger in capuchins than in chimpanzees. Our findings show the importance of taking sex and body mass into account as separate variables to assess their role in tool use. (C) 2011 Elsevier Ltd. All rights reserved.

Selection of Effective Stone Tools by Wild Bearded Capuchin Monkeys

Appreciation of objects` affordances and planning is a hallmark of human technology. Archeological evidence suggests that Pliocene hominins selected raw material for tool making [1, 2]. Stone pounding has been considered a precursor to tool making [3, 4], and tool use by living primates provides insight into the origins of material selection by human ancestors. No study has experimentally investigated selectivity of stone tools in wild animals, although chimpanzees appear to select stones according to properties of different nut species [5, 6]. We recently discovered that wild capuchins with terrestrial habits [7] use hammers to crack open nuts on anvils [8-10]. As for chimpanzees, examination of anvil sites suggests stone selectivity [11], but indirect evidence cannot prove it. Here, we demonstrate that capuchins, which last shared a common ancestor with humans 35 million years ago, faced with stones differing in functional features (friability and weight) choose, transport, and use the effective stone to crack nuts. Moreover, when weight cannot be judged by visual attributes, capuchins act to gain information to guide their selection. Thus, planning actions and intentional selection of tools is within the ken of monkeys and similar to the tool activities of hominins and apes.

Stone tool use in wild bearded capuchin monkeys, Cebus libidinosus. Is it a strategy to overcome food scarcity?

To determine whether tool use varied in relation to food availability in bearded capuchin monkeys, we recorded anvil and stone hammer use in two sympatric wild groups, one of which was provisioned daily, and assessed climatic variables and availability of fruits, invertebrates and palm nuts. Capuchins used tools to crack open encased fruits, mostly palm nuts, throughout the year. Significant differences between wet and dry seasons were found in rainfall, abundance of invertebrates and palm nuts, but not in fruit abundance. Catule nuts were more abundant in the dry season. We tested the predictions of the necessity hypothesis (according to which tool use is maintained by sustenance needs during resource scarcity) and of the opportunity hypothesis (according to which tool use is maintained by repeated exposure to appropriate ecological conditions, such as preferred food resources necessitating the use of tools). Our findings support only the opportunity hypothesis. The rate of tool use was not affected by provisioning, and the monthly rate of tool use was not correlated with the availability of fruits and invertebrates. Conversely, all capuchins cracked food items other than palm nuts (e.g. cashew nuts) when available, and adult males cracked nuts more in the dry season when catule nuts (the most common and exploited nut) are especially abundant. Hence, in our field site capuchins use tools opportunistically. (C) 2012 The Association for the Study of Animal Behaviour. Published by Elsevier Ltd. All rights reserved.

ADOLESCENCE AND DRUG USE THROUGH THE LENS OF PSYCHOANALYSIS: SUFFERING AND ECSTASY IN THE PASSAGE

ADOLESCENCE AND DRUG USE THROUGH THE LENS OF PSYCHOANALYSIS: SUFFERING AND ECSTASY IN THE PASSAGE The purpose of this study is to reflect upon the psychological factors of adolescent drug addiction according to a psychoanalytic perspective. First we consider adolescence as a social-historical category and then we discuss the psychoanalytic understanding of the adolescent transition. This theoretical path builds the approach that considers drug use as a phenomenon that serves as a passage ritual to contemporary adolescence. This phenomenon is modulated by the drive organization, which determines how the individual will take ownership of the use of psychoactive substances. We conclude that the substance use may function as a buffer-object, activated to deal with the structural fragility of the contemporary affective bonds.

The Bologna Stone: history's first persistent luminescent material

In 1603, the Italian shoemaker Vincenzo Cascariolo found that a stone (baryte) from the outskirts of Bologna emitted light in the dark without any external excitation source. However, the calcination of the baryte was needed prior to this observation. The stone later named as the Bologna Stone was among the first luminescent materials and the first documented material to show persistent luminescence. The mechanism behind the persistent emission in this material has remained a mystery ever since. In this work, the Bologna Stone (BaS) was prepared from the natural baryte (Bologna, Italy) used by Cascariolo. Its properties, e. g. impurities (dopants) and their valences, luminescence, persistent luminescence and trap structure, were compared to those of the pure BaS materials doped with different (transition) metals (Cu, Ag, Pb) known to yield strong luminescence. The work was carried out by using different methods (XANES, TL, VUV-UV-vis luminescence, TGA-DTA, XPD). A plausible mechanism for the persistent luminescence from the Bologna Stone with Cu+ as the emitting species was constructed based on the results obtained. The puzzle of the Bologna Stone can thus be considered as resolved after some 400 years of studies.

He II lambda 4686 IN eta CARINAE: COLLAPSE OF THE WIND-WIND COLLISION REGION DURING PERIASTRON PASSAGE

The periodic spectroscopic events in eta Carinae are now well established and occur near the periastron passage of two massive stars in a very eccentric orbit. Several mechanisms have been proposed to explain the variations of different spectral features, such as an eclipse by the wind-wind collision (WWC) boundary, a shell ejection from the primary star or accretion of its wind onto the secondary. All of them have problems explaining all the observed phenomena. To better understand the nature of the cyclic events, we performed a dense monitoring of eta Carinae with five Southern telescopes during the 2009 low-excitation event, resulting in a set of data of unprecedented quality and sampling. The intrinsic luminosity of the He II lambda 4686 emission line (L similar to 310 L-circle dot) just before periastron reveals the presence of a very luminous transient source of extreme UV radiation emitted in the WWC region. Clumps in the primary's wind probably explain the flare-like behavior of both the X-ray and He II lambda 4686 light curves. After a short-lived minimum, He II lambda 4686 emission rises again to a new maximum, when X-rays are still absent or very weak. We interpret this as a collapse of the WWC onto the "surface" of the secondary star, switching off the hard X-ray source and diminishing the WWC shock cone. The recovery from this state is controlled by the momentum balance between the secondary's wind and the clumps in the primary's wind.

Influence of the initial condition in equilibrium last-passage percolation models

In this paper we consider an equilibrium last-passage percolation model on an environment given by a compound two-dimensional Poisson process. We prove an L-2-formula relating the initial measure with the last-passage percolation time. This formula turns out to be a useful tool to analyze the fluctuations of the last-passage times along non-characteristic directions.

The fish fauna in the fish passage at the Ourinhos Dam, Paranapanema River

The composition and abundance of the fish assemblage were evaluated in the fish ladder of Ourinhos Dam, the newest dam (closed in 2005) in the cascade of dams constructed on the Paranapanema River. Samplings were carried out three times on a diel cycle, in three sampling periods, two in the warm season and one in the cold season of 2008 - 2009. The ladder was closed and emptied and the entire fish assemblage was sampled and identified. Most individuals were released alive downstream of the dam. The assemblage found in the ladder was compared with the fish fauna sampled in the reservoir and in downstream sites, in the same period. Twenty seven species and a total of 4682 individuals were caught in the ladder. Pimelodus maculatus was the only migratory species, which was caught in low number in the ladder (0.04% of the total captured), where small sedentary species predominated. The most abundant species were the non-migratory Apareiodon affinis, Bryconamericus stramineus, Astyanax fasciatus and Parodon nasus. Individuals observed in the ladder's window were moving up-and down the passage. The fish ladder is a microhabitat inhabited by an abundant association of benthic organisms that is probably used as a food resource for the fish assemblage in the ladder. The similarity between the fish fauna in the ladder and that of the Ourinhos Reservoir was low (26%). The species richness of migrants in the stretch between the uspstream reservoir (Chavantes) and the downstream one (Salto Grande), before the Ourinhos dam closure (23 species) was reduced to 16 and 12 species in Salto Grande and Ourinhos reservoirs, respectively, after the dam closure, and to a single species in the ladder.