8 resultados para INITIAL PRECIPITATING INJURY
em Repositório Institucional UNESP - Universidade Estadual Paulista "Julio de Mesquita Filho"
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Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)
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Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)
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Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)
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Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)
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INTRODUÇÃO: Os acidentes causados por ouriços-do-mar são as ocorrências por animais marinhos mais comuns no país. O ouriço-do-mar preto (Echinometra lucunter) é a espécie que mais causa ferimentos em banhistas. MÉTODOS: Este trabalho registrou e estudou 314 agravos com ênfase nas manifestações clínicas iniciais observadas e suas implicações na terapêutica recomendada. RESULTADOS: Todos os acidentes foram causados pelo ouriço-do-mar preto e aconteceram em banhistas. As lesões e a dor foram associadas ao trauma causado pela penetração das espículas (não ocorreu inflamação ou dor imediata sem pressão sobre os pontos comprometidos). As complicações deste tipo de acidente, incluindo infecções e granulomas de corpo estranho, estão associadas com a permanência das espículas nos ferimentos. CONCLUSÕES: Foi confirmado o fato do acidente causado por esta espécie ser o mais comum no Brasil e apresentar caráter traumático, sendo a principal recomendação a retirada precoce dos espinhos para prevenção de complicações tardias como as infecções e formação de granulomas de corpo estranho.
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A case study of convective development in the Southwest Amazon region during the Wet Season Atmospheric Mesoscale Campaign (WETAMC) and Tropical Rainfall Measuring Mission (TRMM)/Large-Scale Biosphere-Atmosphere (LBA) Experiment in Amazonia is presented. The convective development during 7 February 1999 is shown to occur during a period of very weak large-scale forcing in the presence of topography and deforestation. The available data include dual Doppler radar analysis, radiosonde launches, and surface and boundary layer observations. The observational analysis is complemented with a series of model simulations using the RAMS with 2-km resolution over a 300 km 300 km area forced by a morning radiosonde profile. A comparison of the observed and simulated thermodynamic transformation of the boundary layer and of the formation of convective lines, and of their kinematic and microphysical properties is presented. It is shown that only a few very deep and intense convective cells are necessary to explain the overall precipitating line formation and that discrete propagation and coupling with upper atmosphere circulations may explain the appearance of several lines. The numerical simulation indicates that topography may be the cause of initial convective development, although later on the convective line is parallel to the midlevel shear. There are indications that small-scale deforestation may have an effect on increasing rainfall in the wet season when the large-scale forcing is very weak.
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Objectives: The purpose of this study was to determine if intra-abdominal pressure (IAP) could predict acute renal injury (AKI) in the postoperative period of abdominal surgeries, and which would be its cutoff value. Patients and methods: A prospective observational study was conducted in the period from January 2010 to March 2011 in the Intensive Care Units (ICUs) of the University Hospital of Botucatu Medical School, UNESP. Consecutive patients undergoing abdominal surgery were included in the study. Initial evaluation, at admission in ICU, was performed in order to obtain demographic, clinical surgical and therapeutic data. Evaluation of IAP was obtained by the intravesical method, four times per day, and renal function was evaluated during the patient's stay in the ICU until discharge, death or occurrence of AKI. Results: A total of 60 patients were evaluated, 16 patients developed intra-abdominal hypertension (IAH), 45 developed an abnormal IAP (>7 mmHg) and 26 developed AKI. The first IAP at the time of admission to the ICU was able to predict the occurrence of AKI (area under the receiver-operating characteristic curve was 0.669; p=0.029) with the best cutoff point (by Youden index method) >= 7.68 mmHg, sensitivity of 87%, specificity of 46% at this point. The serial assessment of this parameter did not added prognostic value to initial evaluation. Conclusion: IAH was frequent in patients undergoing abdominal surgeries during ICU stay, and it predicted the occurrence of AKI. Serial assessments of IAP did not provided better discriminatory power than initial evaluation.
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Pós-graduação em Fisiopatologia em Clínica Médica - FMB