The glasgow prognostic score. An useful tool to predict survival in patients with advanced esophageal squamous cell carcinoma

To evaluate the usefulness of the Glasgow Prognostic Score (GPS) in patients with esophageal carcinoma (EC). A total of 50 patients with EC were analyzed for GPS, nutritional and clinicopathologic parameters. Patients with CRP ≤ 1.0mg/L and albumin ≥ 3.5mg/L were considered as GPS=0. Patients with only CRP increased or albumin decreased were classified as GPS=1 and patients with CRP > 1.0mg/L and albumin < 3.5mg/L were considered as GPS=2. GPS of 0, 1 and 2 were observed in seven, 23 and 20 patients, respectively. A significant inverse relationship was observed between GPS scores and the survival rate. The survival rate was greatest in patients with GPS= 0 and significantly higher than those from patients with GPS=1 and GPS=2. Minimum 12-month survival was observed in 71% patients with GPS=0 and in 30% patients with GPS=1. None of the patients with GPS=2 survived for 12 months. A significant relationship between CRP or albumin individually and the survival rate was observed. No significant relationship among nutritional, clinic pathological parameters and survival was found. Glasgow Prognostic Score is an useful tool to predict survival in patients with esophageal carcinoma.

A resposta metabólica ao trauma cranioencefálico é autolimitada? Análise das proteínas de fase aguda e glicemia

Nos últimos anos tem havido referências à limitação da resposta metabólica nas duas primeiras semanas após trauma cranioencefálico (TCE). Foi feita proposta de estudo a partir de experimento clínico em pacientes com trauma encefálico grave, que foram avaliados por volta de 7 dias após a lesão (M1). A segunda avaliação ocorreu 4 dias após (M2), e a terceira 3 a 4 dias após (M3). em um período de 2 anos, foram selecionados 28 pacientes do sexo masculino, com trauma encefálico grave, escala de gravidade de Glasgow entre 4 e 6. Dentre os 28 pacientes, 6 completaram o estudo proposto. Os pacientes foram acompanhados clinicamente durante toda a fase do experimento. em cada um dos momentos de análise, foram feitas análises da excreção nitrogenada e proteínas de fase aguda. da mesma forma foram feitas determinações da glicemia plasmática, N-amínico e triglicerídeos. Os resultados do estudo demonstraram não haver modificações no balanço nitrogenado, normalização da proteína-C-reativa e redução relativa da glicemia ao final do experimento. Os autores tecem considerações sobre os possíveis mecanismos envolvidos na modulação da resposta metabólica e concluem que o hipermetabolismo, a basear-se na análise da glicemia e das proteínas de fase aguda, não persiste além do 13° dia do período de recuperação pós-trauma. São feitas sugestões de estudos futuros que possam elucidar os mecanismos envolvidos na normalização do hipercatabolismo e hipermetabolismo observados nas duas primeiras semanas após TCE.

Simulation of free surface flows in a distributed memory environment

A parallel technique, for a distributed memory machine, based on domain decomposition for solving the Navier-Stokes equations in cartesian and cylindrical coordinates in two dimensions with free surfaces is described. It is based on the code by Tome and McKee (J. Comp. Phys. 110 (1994) 171-186) and Tome (Ph.D. Thesis, University of Strathclyde, Glasgow, 1993) which in turn is based on the SMAC method by Amsden and Harlow (Report LA-4370, Los Alamos Scientific Laboratory, 1971), which solves the Navier-Stokes equations in three steps: the momentum and Poisson equations and particle movement, These equations are discretized by explicit and 5-point finite differences. The parallelization is performed by splitting the computation domain into vertical panels and assigning each of these panels to a processor. All the computation can then be performed using nearest neighbour communication. Test runs comparing the performance of the parallel with the serial code, and a discussion of the load balancing question are presented. PVM is used for communication between processes. (C) 1999 Elsevier B.V. B.V. All rights reserved.

Multiplicity of Boardman strata and deformations of map germs

We define algebraically for each map germ f: Kn, 0→ Kp, 0 and for each Boardman symbol i = (il, . . ., ik) a number ci(f) which is script A sign-invariant. If f is finitely determined, this number is the generalization of the Milnor number of f when p = 1, the number of cusps of f when n = p = 2, or the number of cross caps when n = 2, p = 3. We study some properties of this number and prove that, in some particular cases, this number can be interpreted geometrically as the number of Σi points that appear in a generic deformation of f. In the last part, we compute this number in the case that the map germ is a projection and give some applications to catastrophe map germs.

Sobre a analgesia pós-operatória da morfina, cetamina ou da associação em cadelas submetidas à ovariossalpingohisterectomia eletiva

This study aimed to evaluate the post operative analgesic effects of morphine or ketamine alone or their combination in 24 healthy bitches, weighing 11.01±8.69kg and aging 27±17 months, submitted to elective ovariohysterectomy. The animals were distributed to one of the three treatments after the anaesthetic induction: morphine (GM, n=8, 0.5mg kg-1 IM), ketamine (GK, n=8, 2.5mg kg-1 IM) or ketamine combined to morphine (GKM) using the same doses previously described. Sedation score and pain assessment were performed blindly two hours before surgery and at 1, 2, 4, 8, 12, and 24 hours after extubation, using the Dobbins scale (sedation) and visual analogue scale (pain) and Glasgow modified pain scale (GMPS). Rescue analgesia was performed with 1.0mg kg-1 of morphine and if not sufficient, followed by 0.2mg kg-1 of meloxicam, both IM, when the GMPS reached above 33% of the total score. Non parametric data were analyzed using Friedmańs test followed by Dunńs test for differences in time. Kruskal-Walliś test followed by Dunńs test were used to investigate differences in the number of analgesic rescues and among groups at each time. Parametric data were evaluated by ANOVA followed by Tukey's test (P<0.05). Except for GMPS, where the values of GM were greater than for GKM at 1h post-extubation, there were no other differences among groups. The number of rescue analgesia was greater in GM (11 in total; twice in 3 animals,) when compared to GKM (3; twice in 1 animal) and GK (2; twice in 1 animal). Analgesia provided by pre-incisional ketamine was more effective when compared to morphine. According to that, ketamine alone may be used as a preemptive analgesic in bitches undergoing ovariohysterectomy; however, rescue analgesia may be necessary.

Comparison of intrarectal ozone, ozone administered in acupoints and meloxicam for postoperative analgesia in bitches undergoing ovariohysterectomy

Since all analgesics currently available for use in dogs have been associated with some adverse effects, the search for an effective analgesic that does not cause harm is important. This study investigated the postoperative analgesic effects of ozone administered either intrarectally or into acupoints in bitches undergoing ovariohysterectomy (OH). Twenty-four healthy adult bitches were randomly assigned to one of the three treatments 10min after sedation, as follows: 0.2mg/kg of intramuscular (IM) meloxicam (M); rectal insufflation of 10mL of 30μg/mL ozone (OI), or acupoint injection of 0.5mL ozone (30μg/mL; OA). Following sedation with acetylpromazine, anaesthesia was induced with propofol and fentanyl and maintained with isoflurane/O2. Pain was assessed using the modified Glasgow pain scale (MGPS) and the visual analogue scale (VAS) on the day before surgery, before anaesthesia, and at 1, 2, 4, 6, 8, 12 and 24h after surgery. Rescue analgesia was performed using 0.5mg/kg of morphine IM if MGPS was >3.33 points.No statistically significant differences in pain scales were found among the three analgesic protocols or the time points in each group ( P>. 0.05). Two dogs treated with OA required rescue analgesia. Meloxicam, rectal insufflation of ozone and ozone injected into acupoints provided satisfactory analgesia for 24. h in bitches undergoing elective OH. Ozone had no measurable adverse effects and is an alternative option to promote pain relief. © 2013 Elsevier Ltd.

Perioperative evaluation of tumescent anaesthesia technique in bitches submitted to unilateral mastectomy

Background: Tumescent anaesthesia (TA) is a widely used technique in oncologic surgeries necessitating large resection margins. This technique produces transoperative and postoperative analgesia, reduces surgical bleeding, and facilitates tissue divulsion. This prospective, randomised, blind study evaluated the use of TA in bitches submitted to mastectomy and compared the effect of TA with an intravenous fentanyl bolus. A 2.5-mcg/kg intravenous fentanyl bolus (n = 10) was compared with TA using 0.275% lidocaine (n = 10) in bitches submitted to unilateral mastectomy. Sedation was performed by intramuscular (IM) injection of 0.05 mg/kg of acepromazine combined with 2 mg/kg of meperidine. Anaesthesia was induced with 5 mg/kg of intravenous propofol and maintained with isoflurane/O2. Heart and respiratory rates; systolic, mean, and diastolic arterial blood pressures; central venous pressure; SpO2; ETCO2; inspired and expired isoflurane concentrations; and temperature were measured transoperatively. Visual analogue scales for sedation and pain and the Glasgow composite and Melbourne pain scales were used for postoperative assessment. The surgeon investigated the quality of the surgical approach, considering bleeding and resection ability, and the incidence of postoperative wound complications.Results: The heart rate was lower and the end-tidal isoflurane concentration was higher in dogs treated with fentanyl than in dogs treated with TA. A fentanyl bolus was administered to 8 of 10 dogs treated with fentanyl and to none treated with TA. Intraoperative bleeding and the mammary gland excision time were lower in dogs treated with TA. The maximal mean and individual plasma lidocaine concentrations were 1426 ± 502 ng/ml and 2443 ng/ml at 90 minutes after infiltration, respectively. The Glasgow Composite Pain Scale scores were higher in dogs treated with fentanyl than in dogs treated with TA until 2 hours after extubation.Conclusions: Compared with intravenous fentanyl, TA in bitches: may be easily performed in non-inflamed, ulcerated, adhered mammary tumours; has an isoflurane-sparing effect; improves transoperative and immediate postoperative analgesia; is apparently safe for use in clinical conditions as evidenced by the fact that it did not produce any adverse signs or lidocaine plasma concentrations compatible with toxicity; does not modify the recovery time; and facilitates the surgical procedure without interfering with wound healing. © 2013 Credie et al.; licensee BioMed Central Ltd.

Levantamento sobre as concepções e práticas de educação ambiental nos cursos de educação de jovens e adultos do centro expandindo da cidade de São Paulo

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Arte e ética em The Bell de Iris Murdoch

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)