Autopsy: quality assurance in the ICU

Objective: To examine the correlation between the clinical diagnosis and autopsy findings in adult patients who died in an intensive care unit (ICU). To determine the rate of agreement of the basic and terminal causes of death and the types of errors in order to improve quality control of future care,Design, Retrospective study.Setting: Adult ICU in a university hospital.Patients: 30 adult patients who died in the ICU. with the exclusion of medicolegal cases.Methods and main results: Anatomo-clinical meetings were held to analyze the pre- and postmortem correlations in 30 consecutive autopsies at the ICU of the University Hospital, School of Medicine of Botucatu/ UNESP, from January 1994 to January 1997. The rate of correct clinical diagnoses of the basic cause was 66.7 %; in 23.3 % of cases, if the correct diagnosis was made, management would have been different, as would have been the evolution of the patient's course (Class I error): in 10 % of the cases the error would not have led to a change in management (Class II error). The rate of correct clinical diagnoses of terminal cause was 80 %.Conclusions: the rate of recognition of the basic cause was 66.7 %, which is consistent with the literature, but the Class I error rate was higher than that reported in the literature.

Female monopolization and paternity assurance in South American crickets (Orthoptera, Grylloidea): mating plugs, extra claspers and forced copulation

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Testes de vigor para avaliação de sementes de pepino

Dentro de um programa de controle de qualidade, a avaliação do vigor de sementes é fundamental e necessária para o sucesso da produção. O trabalho teve por objetivo comparar diferentes métodos para avaliação do potencial fisiológico de sementes de pepino. Para tanto, cinco lotes de sementes do híbrido Safira foram submetidos aos seguintes testes: germinação, primeira contagem de germinação, condutividade elétrica (4x50 sementes; 25ºC; 50 e 75mL; 12, 18 e 24h), germinação a baixa temperatura (4x50 sementes; 18ºC; contagens aos quatro e oito dias após a semeadura); envelhecimento acelerado tradicional (41ºC; 48, 72 e 96h) e com solução saturada de NaCl (41ºC; 72 e 96h). Pelos resultados obtidos, pode-se concluir que os testes de condutividade elétrica (50 e 75mL; 12, 18 e 24h) e de envelhecimento acelerado com o uso de solução salina (41ºC, por 72h), possibilitam a melhor identificação de lotes com diferentes níveis de qualidade fisiológica.

Precocidade na emissão da raiz primária para avaliação do vigor de sementes de milheto

In a program of seed quality assurance, the evaluation of seed vigor is fundamental and necessary to the global production process outcome. The objective of this study was to evaluate the efficiency of the precocity of primary root emission test, for the substrates paper roll, on paper and between papers, on vigor of pearl millet seeds. Ten seed lots evaluated in four replication of 100 pearl millet seeds cultivar ADR 500 were sown in three different humidified substrates: between papers, paper roll and on paper. These were incubated at a temperature of 20-30 degrees C. Fifteen hours after the germination test was established, the emission of seed primary roots started to be observed every 2 hours up to 25 hours and then after 48 hours. For the comparison among lots, seeds were also evaluated by moisture content, weight of 1000 seeds, germination and vigor (first count, electrical conductivity, accelerated aging and seedling emergence). The statistical design was completely randomized, and the means comparisons were accomplished by the Tukey test at 0.05 level of probability. It was concluded that the precocity of primary root emission test on paper is promising for vigor evaluation of pearl millet seeds.

Testes de vigor utilizados na avaliação da qualidade fisiológica de lotes de sementes de milho-doce (sh2)

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Eventos adversos: análise de um instrumento de notificação utilizado no gerenciamento de enfermagem

A direção de enfermagem de um hospital universitário terciário da região Centro-Sul do Estado de São Paulo, visando a segurança do paciente e o estabelecimento de meio de comunicação entre equipe e direção, implementou em janeiro de 2004 o Boletim de Notificação de Eventos Adversos. O objetivo deste estudo foi analisar a utilização deste instrumento de comunicação e identificar: frequência, tipo, natureza e período dos incidentes/eventos adversos. Realizou-se análise descritiva dos dados de 826 boletins elaborados no período de janeiro/2004 a junho/2006. Verificou-se adesão à utilização do instrumento. Predominaram notificações de ocorrências assistenciais, embora notificações administrativas tenham apresentado número crescente de registros. Eventos adversos mais frequentes relacionaram-se à medicação, quedas, cateteres, sondas/drenos e integridade da pele. A praticidade do instrumento viabilizou sua utilização também por auxiliares e técnicos de enfermagem. A análise sistematizada e acompanhamento dos eventos adversos associados aos recursos de comunicação mostraram-se fundamentais para a segurança do paciente.

Support Tool to the Validation Process of Functional Requirements

The activity of validating identified requirements for an information system helps to improve the quality of a requirements specification document and, consequently, the success of a project. Although various different support tools to requirements engineering exist in the market, there is still a lack of automated support for validation activity. In this context, the purpose of this paper is to make up for that deficiency, with the use of an automated tool, to provide the resources for the execution of an adequate validation activity. The contribution of this study is to enable an agile and effective follow-up of the scope established for the requirements, so as to lead the development to a solution which would satisfy the real necessities of the users, as well as to supply project managers with relevant information about the maturity of the analysts involved in requirements specification.

Lactic Acid Bacteria Antimicrobial Compounds: Characteristics and Applications

Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)

Comparação entre métodos para a avaliação do vigor de lotes de sementes de triticale

Dentro de um programa de controle de qualidade, a avaliação do vigor de sementes é fundamental e necessária para o sucesso da produção. Este trabalho teve como objetivo avaliar a eficiência de diferentes testes de vigor na avaliação da qualidade fisiológica de sementes de triticale (X. triticosecale Wittmack), buscando a diferenciação de lotes. Cinco lotes da cultivar 'IPR 111' foram submetidos ao teste de germinação, primeira contagem, teste de frio, condutividade elétrica (50 sementes 50mL-1 de água; 25°C 24h-1), lixiviação de potássio (50 sementes 75mL-1 de água; 25°C 3h-1), envelhecimento acelerado (43°C 48h-1) e teor de água. O teste de condutividade elétrica e lixiviação de potássio são eficientes na diferenciação do vigor de lotes de sementes de triticale.

Protocols for hyperlactatemia induction in the lactate minimum test adapted to swimming rats

The lactate minimum test (LACmin) has been considered an important indicator of endurance exercise capacity and a single session protocol can predict the maximal steady state lactate (MLSS). The objective of this study was to determine the best swimming protocol to induce hyperlactatemia in order to assure the LACmin in rats (Rattus norvegicus), standardized to four different protocols (P) of lactate elevation. The protocols were PI: 6 min of intermittent jumping exercise in water (load of 50% of the body weight - bw); P2: two 13% bw load swimming bouts until exhaustion (thin); P3: one thin 13% bw load swimming bout; and P4: two 13% bw load swimming bouts (1st 30 s, 2nd to thin), separated by a 30 s interval. The incremental phase of LACmin beginning with initial loads of 4% bw, increased in 0.5% at each 5 min. Peak lactate concentration was collected after 5, 7 and 9 min (mmol L-1) and differed among the protocols P 1 (15.2 +/- 0.4, 14.9 +/- 0.7, 14.8 +/- 0.6) and P2 (14.0 +/- 0.4, 14.9 +/- 0.4, 15.5 +/- 0.5) compared to P3 (5.1 +/- 0.1, 5.6 +/- 0.3, 5.6 +/- 0.3) and P4 (4.7 +/- 0.2, 6.8 +/- 0.2, 7.1 +/- 0.2). The LACmin determination success rates were 58%, 55%, 80% and 91% in P1, P2, P3 and P4 protocols, respectively. The MLSS did not differ from LACmin in any protocol. The LACmin obtained from P4 protocol showed better assurance for the MLSS identification in most of the tested rats. (c) 2007 Elsevier B.V. All rights reserved.

Um programa de saúde mental: A experiência do Projeto UNI de Botucatu

The aim of this paper was to assess the Projeto UNI (Kellogg Foundation) in one of the Mental Health Centers (ARE) of Botucatu, SP, Brazil. We analysed 20% of the charts and the number of patients seen by psychiatrists and other mental health professionals before and after. Our results showed that: 1) the service users were mainly of neurotic patients (anxious, dysthymiacs, ICD-9 V code), followed by psychotics (schizophrenics, affectives) and organics (epileptics, mental deficients, demented patients); 2) there were more treatment options after the Projeto UNI implementation and over 2,495 group consultations were made in one year (as opposed to 90 in the year prior the project); 3) medical and nurse students are evaluating the program favourably; 4) there is a clear necessity of reassessing and changing some prescription practices: 43% of the patients were taking drug associations, there was an excessive use of benzodiazepines (54%) and low use of mood stabilizers (5%). There is also a need for more availability of depot neuroleptics, other antidepressants and better quality psychotropic drugs, and 5) there is a necessity of improving quality and quantity of charts information.

Envelhecimento acelerado em sementes de Eucalyptus grandis Hill ex Maiden classificadas por tamanho

Two experiments of seed ageing of Eucalyptus grandis Hill ex Maiden were carried out at laboratory conditions. In the first experiment, two seed lots were classified in two square mesh screens (< 0.84 to ≥ 0.71 mm and < 0.71 mm to ≥ 0.59 mm), submitted to 42 °C and 100% relative humidity, for 0, 8, 12, 24, and 32 hours of stress treatments. Seed germination tests were done with just aged seeds. The results showed that the stress period was not sufficient for ageing the seeds. In the second experiment, the best quality seed lot was separated in the same two sizes. The seeds were submitted under the same stress conditions of the first experiment but for 0, 48, 72, and 96 hours. The germination test was done right after the seeds were taken from the stress conditions, and with stored seeds at dry chamber (2 weeks and 26 months). It was concluded that both seed sizes reached 30% of moisture content under 72 hours of ageing conditions and showed significant germination losses when compared with seeds without ageing (control), as the moist seeds as the stored ones at dry chamber, for both 2 weeks and 26 months.

Nova proposta de critério de retenção para dimensionamento de filtros têxteis

The designs of filters made by granular material or textile are mainly based on empirical or semi empirical retention criteria according to Terzaghi proposal, which compares particle diameter of the soil base with the filter porous spaces. Silveira in 1965, proposed one rational design retention criteria based on the probability of a particle from the soil base, carried by one dimensional flow, be restrained by the porous of the filter while trying to pass through its thickness. This new innovating theory, besides of being very simple, it is not frequently used for granular filters since the necessary parameters for the design has to be determine for each natural material. However, for textile this problem no longer exists because it has quality control during manufacturing and the necessary characteristics properties of the product are specify in the product catalog. This work presents one adaptation of the Silveira theory for textile filters and the step-by-step procedure for the determination of the characteristics properties of the textile products necessary for the design. This new procedure permits the determination of the confiability level of retention that one specific particle diameter form the soil base has for one specified textile. One complete example is presented to demonstrate the simplicity of the method proposed and how the textile characteristics are obtained.

Intervenções benéficas no pré-natal para prevenção da mortalidade materna

Maternal mortality rate (MM) is a health quality indicator that is directly influenced by the economic, cultural and technological level of a country. Official data of MM in Brazil, although underestimated, point to the lack of quality in pregnancy, childbirth and puerperium care services. This characteristic is common in developing countries, where poorer pregnant women as well as those facing greater difficulty to quality care access are found. Prenatal care cannot prevent major childbirth complications, which are important causes of MM; however, some interventions during the prenatal period can favor maternal prognosis and prevent MM. In this setting, this study brings a scientifically based update concerning effective interventions for maternal mortality prevention during the prenatal period. The most important strategies consist of a tripod with specific interventions related to maternal health promotion, risk prevention and assurance of nutritional support during gestation, in addition to criteria to investigate gestational risk and inclusion of the pregnant woman in the basic component of the prenatal care model. It ends with the definition of priorities in the prevention of MM related to eclampsia/preeclampsia and reinforces the importance of normalization of reference systems for obstetric emergency cases.