Influence of laparoscopy and laparotomy on gasometry, leukocytes and cytokines in a rat abdominal sepsis model

Laparoscopic surgery is associated with reduced surgical trauma, and less acute phase response, as compared with open surgery. Cytokines are important regulators of the biological response to surgical and anesthetic stress. The aim of this study was to determine if CO2 pneumoperitoneum would change cytokine expression, gas parameters and leukocyte count in septic rats. Methods: Wistar rats were randomly assigned to five groups: control (anesthesia only), laparotomy, CO2 pneumoperitoneum, cecum ligation and puncture by laparotomy, and laparoscopic cecum ligation and puncture. After 30 min of the procedures, arterial blood samples were obtained to determine leukocytes subpopulations by hemocytometer. TNFα, IL-1β, IL-6 were determined in intraperitoneal fluid (by ELISA). Gas parameters were measured on arterial blood, intraperitoneal and subperitoneal exsudates. Results: Peritoneal TNFα, IL-1β and IL-6 concentrations were lower in pneumoperitoneum rats than in all other groups (p<0.05). TNFα, IL-1β and IL-6 expression was lower in the laparoscopic than in laparotomic sepsis (p<0.05). Rats from laparoscopic cecum ligation and puncture group developed significant hypercarbic acidosis in blood and subperitoneal fluid when compared to open procedure group. Total white blood cells and lymphocytes were significantly lower in laparoscopic cecum ligation and puncture rats than in the laparotomic (p<0.01). Nevertheless, the laparotomic cecum ligation rats had a significant increase in blood neutrophils and eosinophils when compared with controls (p<0.05). Conclusions: This study demonstrates that the CO2 pneumoperitoneum reduced the inflammatory response in an animal model of peritonitis with respect to intraperitoneal cytokines, white blood cell count and clinical correlates of sepsis. The pneumoperitoneum produced hypercarbic acidosis in septic animals

Dores e cores nas mal traçadas linhas dos devotos do Padre Cícero: as trocas linguísticas instauradas entre o discurso eclesial e o discurso epistolar dos romeiros

This study is concerned with analyzing the letters sent by the devotees tothe religious patriarch, Father Cicero, checking as is the relationship of linguistic exchanges between the pilgrims and the Father Cicero through the issuance of letters; and, between the Church and the pilgrims, through homilies uttered these devotees, focusing on the appeals contained therein, for, then, to define a parameter between the requirements contained in the letters and the religious discourse of the Church workers in the liturgical celebrations in view of social and religious demands of the market in question. Our purposes resided in understanding the causes that lead to the production of the letters by devotees, holding us in prayers of intercession to the Father Cicero. Finally, check and understand how is the process of inter - relationship between the writing of devotee and the clerical discourse, with regard to meeting this demand, noting especially the game force a religious field, based on postulates of Pierre Bourdieu (2008), to conceive the communicative act as linguistic exchanges, surpassing the sign and therefore decipherable speech character as well as the interactive strength of the wording and voice advocated by Paul Zumthor (2010) e Bakhtin (2006). Regarding the composition of the corpus, were determined, as the universe of research, letters of pilgrims, sent to Father Cicero, deposited in his own tomb, as well as in the Church of the Horto (Gethsemane) in Juazeiro do Norte-CE (Brazil); beyond religious sermons intended for pilgrims during the massin pilgrimage time

O trágico em lavoura arcaica

El escritor de São Paulo Raduan Nassar, lanza en 1975, su primera novela intitulado Lavoura arcaica. En su narrativa de estreno, el escritor nos trae la historia de un adolescente, André, que intenta destruir la plantación de su padre, Iohána. A través de sus sermones, el patriarca predicaba la moderación, la disciplina y la obediencia a las leyes impuestas por él, construyendo así, un mundo de ilusiones, donde el amor era una máscara para la hipocresía. En esta tensa relación, padre e hijo, representaciones místicas de Apolo y Dionisio, emprenden una contienda discursiva sobre la negación y la afirmación de la existencia. De ese modo, considerando la relación de lucha e integridad entre el impulso apolíneo y dionisiaco existentes en el romanticismo nassariano, la propuesta de este trabajo es presentar una lectura de lo trágico en Lavoura arcaica a partir de la perspectiva nietzscheana sobre el género trágico. Para eso, recorrimos al concepto desarrollado por Nietzsche en su obra, desde su primer libro O nascimento da tragédia (2007a), A visão dionisíaca do mundo (2005 a) y Ecce homo (2008 b).

Maturidade em gerenciamento de projetos no contexto da gestão estratégica no setor público: análise na Secretaria de Estado da Tributação do Rio Grande do Norte

This paperwork attempts to measure the project management maturity in the State Department of Taxation in Rio Grande do Norte. Project management has shown to be a critical component to any organization success, as the projects are directly related to a set of activities resulting into organizational innovations such as products, services and processes; and its improvement is directly aligned with the strategic management. Methodologically, this paperwork uses both a quantitative and qualitative approach that will be applied to the coordinators, sub-coordinators, and directors of the Regional Offices of the State Department of Taxation. In the theoretical reference it is about the public management and analyzes the strategic management in contemporary public administration. Presents the maturity in project management is by discussing the main models: CMM, Capability Maturity Model; PMMM, Project Management Maturity Model; OPM3, Organization Project Maturity Model and the Prado-MMGP, Modelo de Maturidade em Gerenciamento de Projetos. From this analysis, considering attributes as an aid in taking strategic positioning, access to the model, possibility of benchmarking and continuous improvement, the Prado-MMGP model was the most appropriate for this research process. It has been proved that the State Department of Taxation shows a very low project management maturity level. Regarding the acceptance of the maturity dimensions by the State Department, it is still in an early developmental stage, as one of the dimensions showed a poor performance while the rest showed a regular one. In contrast with similar organizations, the maturity results have shown to be below the national average. The maturity assessment enables in the institution the implementation of a plan for institutional growth with the creation of sector strategic and project management

Influence of laparoscopy and laparotomy on gasometry, leukocytes and cytokines in a rat abdominal sepsis model

Laparoscopic surgery is associated with reduced surgical trauma, and less acute phase response, as compared with open surgery. Cytokines are important regulators of the biological response to surgical and anesthetic stress. The aim of this study was to determine if CO2 pneumoperitoneum would change cytokine expression, gas parameters and leukocyte count in septic rats. Methods: Wistar rats were randomly assigned to five groups: control (anesthesia only), laparotomy, CO2 pneumoperitoneum, cecum ligation and puncture by laparotomy, and laparoscopic cecum ligation and puncture. After 30 min of the procedures, arterial blood samples were obtained to determine leukocytes subpopulations by hemocytometer. TNFα, IL-1β, IL-6 were determined in intraperitoneal fluid (by ELISA). Gas parameters were measured on arterial blood, intraperitoneal and subperitoneal exsudates. Results: Peritoneal TNFα, IL-1β and IL-6 concentrations were lower in pneumoperitoneum rats than in all other groups (p<0.05). TNFα, IL-1β and IL-6 expression was lower in the laparoscopic than in laparotomic sepsis (p<0.05). Rats from laparoscopic cecum ligation and puncture group developed significant hypercarbic acidosis in blood and subperitoneal fluid when compared to open procedure group. Total white blood cells and lymphocytes were significantly lower in laparoscopic cecum ligation and puncture rats than in the laparotomic (p<0.01). Nevertheless, the laparotomic cecum ligation rats had a significant increase in blood neutrophils and eosinophils when compared with controls (p<0.05). Conclusions: This study demonstrates that the CO2 pneumoperitoneum reduced the inflammatory response in an animal model of peritonitis with respect to intraperitoneal cytokines, white blood cell count and clinical correlates of sepsis. The pneumoperitoneum produced hypercarbic acidosis in septic animals