36 resultados para Trauma severity indices

em Repositório Institucional UNESP - Universidade Estadual Paulista "Julio de Mesquita Filho"


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This study aimed at observing aspects of epidemiology in order to investigate the use of alcohol in patients older than 18 with severe and moderate traumatic brain injury, which were attended in the Clinics Hospital of the University of Uberlandia. Positive alcoholemy was found in 39.3% of the patients. of the 33 positive exams alcoholemy was found higher than 60 mg/dL in 28 (84.6%). There was not significant relation between alcoholemy levels and trauma severity. The major prevalence occurred on Saturdays nights. The most frequent types of external causes were transportation accidents (64.74) followed by accidental falls (17.27%) and physical aggression (16.55%). 93.9% of the patients with positive alcoholemy were men aged 20-29. 24.2% of the ones with positive alcoholemy died yet no significant difference was found in the study of the ones with negative alcoholemy (n=51) (p=0.93); RR= 0.9; IC95%=0.40-2.08.

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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.

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The quantification of the degree of activity of inflammatory bowel disease is assuming growing importance nowadays. The activity index of the disease can be attained by clinical and laboratorial indicators. For ulcerative colitis the mostly used clinical parameters are daily bowel movements and presence of bloody diarrhea whereas albumin, hemoglobin, ESR and positive acute phase protein measurements are the laboratory parameters. For Crohn's disease activity besides the daily bowel movements the presence of abdominal pain and discomfort sensation are also frequently used whereas the C-reactive protein is the most used laboratory test which is able to detect the disease reactivation even before the appearance of any clinical sign. The combinations of clinical signs with the laboratory tests earned the sympathy of the specialists and the set of ensembled indicators has been recognized by the author's name. In this sense, the classification of the ulcerative colitis activity originally proposed by Truelove and Witts deserves presently a wide acceptance whereas such agreement is still lacking for Crohn's disease activity. In the mean time, the Bristol index is clinically the most feasible, once the Crohn's disease activity index and the Van Hees index are considered too complex. However the latter indexes are still useful mainly for comparisons among multicentric data. It seems that the currently existing clinical signs used for Crohn's disease activity would be quantitatively improved by adding some easily made laboratory tests such as C-reactive protein.

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Objective: To determine the prevalence and severity of caries in 3-12-year-old children in three districts of the city of Araraquara, Design: An epidemiological survey was carried out by trained and calibrated examiners in 1995 and 1996, using the WHO diagnostic criteria. Setting: Two districts, Araraquara and Vila Xavier had been fluoridated since 1963 and one, Gavião Peixoto, since 1994. Subjects: The study included 1,191 children from Araraquara, 653 from Vila Xavier and 652 from Gavião Peixoto. Outcome measures: Prevalence of caries, dmft, dmfs, DMFT and DMFS indices. Results: Results showed moderate caries experience in all three districts. Differences between districts in relation to fluoridation history were particularly obvious in primary teeth. In 3-4-year-old children, one third of those in Araraquara and Vila Xavier had some caries experience compared to 58% in Gavião Peixoto. In permanent teeth, 20% or less of the mean DMFT was made up of untreated decay in Araraquara and Vila Xavier whereas in Gaviao Peixoto it made up between 50 and 57% of values in 7-12-year-old children. Conclusions: The prevalence and severity of caries was lower in dentitions of children from the districts fluoridated since 1963. Improvements are likely in the future in Gaviao Peixoto as the benefit of fluoridation continues but additional means of promoting oral health are needed in all three districts.

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Even though community-acquired methicillin resistant Staphylococcus aureus (CA-MRSA) was described a decade ago, reports from Brazil are scarce and cases occurred in large urban centers. We report MRSA sepsis in a 16-year-old male from a small town and who had no history of exposure to healthcare or recent travel. After trauma during a soccer match, he presented swelling in the right thigh, which evolved in a month to cellulitis complicated by local abscess, orchitis and pneumonia. The patient presented severe sepsis, with fever and respiratory failure. Laboratory findings included blood leukocyte counts above 40,000/mm3 and thrombocytopenia. He was submitted to mechanical ventilation and therapy with vancomycin and imipenem. He had a slow but favorable response to therapy and was discharged after six weeks of hospitalization. MRSA grew from blood cultures and respiratory aspirates obtained before antimicrobial therapy. The isolate belonged to sequence type 5, spa type t311, harbored SCCmec type IV and genes for Panton-Valentine leukocidin and Enterotoxin A. The pulsed-field gel electrophoresis pattern was distinct from North American classic CA-MRSA clones. However, the sequence type and the spa type revealed that the clone belong to the same clonal complex isolated in Argentina. This is the first CA-MRSA infection reported in that region, with significant epidemiologic and clinical implications. © 2013 Elsevier Inc.

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The aim of this study was to assess the validity and reliability of the Fonseca Anamnestic Index (IAF), used to assess the severity of temporomandibular disorders, applied to Brazilian women. We used a probabilistic sampling design. The participants were 700 women over 18 years of age, living in the city of Araraquara (SP). The IAF questionnaire was applied by telephone interviews. We conducted Confirmatory Factor Analysis (CFA) using Chi-Square Over Degrees of Freedom (χ2/df), Comparative Fit Index (CFI), Tucker-Lewis Index (TLI), and Root Mean Square Error of Approximation (RMSEA) as goodness of fit indices. We calculated the convergent validity, the average variance extracted (AVE) and the composite reliability (CR). Internal consistency was assessed by Cronbach's alpha coefficient (α).The factorial weights of questions 8 and 10 were below the adequate values. Thus, we refined the original model and these questions were excluded. The resulting factorial model showed appropriate goodness of fit to the sample (χ2/df = 3.319, CFI = 0.978, TLI = 0.967, RMSEA = 0.058). The convergent validity (AVE = 0.513, CR = 0.878) and internal consistency (α = 0.745) were adequate. The reduced IAF version showed adequate validity and reliability in a sample of Brazilian women.

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Aims: To evaluate the severity of temporomandibular disorders (TMD) of women in the municipality of Araraquara (Brazil) as well as the contribution of the perception of oral health, mandibular functional limitation, and sociodemographic variables on the severity of TMD. Methods: The participants were interviewed by telephone. Information regarding age, marital status, economic level, education, and use and type of dental prostheses was surveyed. To evaluate TMD severity, mandibular functional limitation and perception of oral health, Fonseca's Anamnesic Index (IAF), the Mandibular Function Impairment Questionnaire (MFIQ), and the General Oral Health Assessment Index (GOHAI) were used. To evaluate the contribution of these variables on TMD severity, a structural equation model (SEM) was fitted to the data and assessed by usual goodness-of-fit indices. Results: A total of 701 women with a mean age of 44.36 years (SD = 16.31) participated. According to the IAF, 59.6% (95% confidence interval = 56.00%-63.2%) of the women were classified as having TMD, of which 63.9% presented light, 26.8% moderate, and 9.3% severe TMD. Mandibular functional limitation was low in 91.0% of the women, moderate in 7.1%, and severe in 1.9%. Goodness-of-fit for the structural model was adequate. The predictors explained 43% of the variation in the TMD severity, with significant contributions of the variables dental prostheses (beta = -.008; P = .006), perception of oral health (beta = -.43; P < .001), and mandibular functional limitation (beta = .014; P = 014). Conclusion: The severity of TMD among Brazilian women was greater in non-users of dental prostheses and was also associated with greater mandibular functional limitation and poor perception of oral health.

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Soil erosion data in El Salvador Republic are scarce and there is no rainfall erosivity map for this region. Considering that rainfall erosivity is an important guide for planning soil erosion control practices, a spatial assessment of indices for characterizing the erosive force of rainfall in El Salvador Republic was carried out. Using pluviometric records from 25 weather stations, we applied two methods: erosivity index equation and the Fournier index. In all study area, the rainiest period is from May to November. Annual values of erosivity index ranged from 7,196 to 17,856 MJ mm ha(-1) h(-1) year(-1) and the Fournier index ranged from 52.9 to 110.0 mm. The erosivity map showed that the study area can be broadly divided into three major erosion risk zones, and the Fournier index map was divided into four zones. Both methods revealed that the erosive force is severe in all study area and presented significant spatial correlation with each other. The erosive force in the country is concentrated mainly from May to November.

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Dentre os materiais de construção utilizados nas instalações rurais, merecem destaque as coberturas, pois são grandes responsáveis pelo conforto térmico, influenciando no balanço térmico no interior das instalações. Este trabalho objetivou avaliar a influência das coberturas sobre a entalpia (H), Carga Térmica Radiante (CTR) e no Índice de Temperatura de Globo Negro e Umidade (ITGU), em abrigos individuais para bezerros leiteiros. O delineamento foi o inteiramente casualizado com três tratamentos: Z - telha de zinco; CA - telha de cimento amianto, e CAB - telha de cimento amianto pintada de branco na face superior. As médias foram comparadas pelo teste de Scott Knott, a 1% de probabilidade. Os resultados mostraram que não houve diferença estatística entre os tratamentos (P<0,01) e o ambiente externo, para a H. Para a CTR, houve diferença estatística entre todos os tratamentos, em que CAB demonstrou menor CTR, 489,28 W m-², seguido do tratamento CA, 506,72 W m-², e Z com maior valor de CTR, 523,55 W m-². Para o ITGU, observaram-se menores valores para CAB (76,8) e CA (77,4), diferindo-se, significativamente do Z, que obteve maior valor (81,6). As telhas com pintura branca em sua face superior promoveram menor CTR e menor ITGU, favorecendo o ambiente térmico da instalação.

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

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Realizou-se a contagem dos ovos não eclodidos, dos filhotes vivos e mortos de Podocnemis expansa oriundos de 327 ninhos naturais, localizados nas praias da Área de Proteção Ambiental (APA) - Meandros do Rio Araguaia, onde se determinou a porcentagem de eclosão dos ovos (94,63%); não eclosão (5,37%); sobrevivência (94,24%) e mortalidade dos filhotes (5,76%), e a média de filhotes mortos durante os 15 dias no berçário (0,97%). A média do total de filhotes por ninho foi determinada pela soma do número de filhotes vivos e mortos divididos pelo total de ninhos, enquanto que a média do total de ovos por ninho foi determinada pela soma do número de filhotes vivos, mortos e ovos não eclodidos divididos pelo total de ninhos. Com isso, obtiveram-se os valores médios do número de filhotes vivos (88,98 ± 23,94); mortos (0,37 ± 0,93); ovos não eclodidos (5,07 ± 9,57), e total de ovos (94,42 ± 21,30). A eficiência reprodutiva da população selvagem de P. expansa pode ser afetada por muitos fatores ambientais, como temperatura, umidade e precipitação. Além disso, fatores influenciados pelo homem, como a presença de produtos químicos na água e a possibilidade de doenças infecciosas, também têm impacto significativo. Os dados dos índices reprodutivos obtidos neste estudo são indispensáveis para futuras investigações de anomalias de incubação.

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The polyculture among vegetables is an activity that to have good results, needs a proper planning. Although it often requires more labor, has several advantages over monoculture, among them is that polycultures are generally are more productive, provide with productivity of various plant constituents and a more balanced human diet, contribute to economic return, economic and yield stability, social benefits and farmer's direct participation in decision-making. The objective of this study was to evaluate agroeconomic indices of polycultures derived from the combination of two cultivars of lettuce with two cultivars of rocket in two cultures strip-intercropped with carrot cultivar 'Brasilia' through uni-multivariate approaches in semi-arid Brazil. The experimental design used was of randomized complete blocks with five replications and the treatments arranged in a factorial scheme of 2 x 2. The treatments consisted of the combination of two lettuce cultivars (Baba de Verao and Taina) with two rocket cultivars (Cultivada and Folha Larga) in two cultures associated with carrot cv. Brasilia. hi each block were grown plots with two lettuce cultivars and two rocket cultivars, and carrot in sole crop. In each system was determined the lettuce leaf yield, rocket green mass yield and carrot commercial yield. Agrieconomic indices such as operational cost, gross and net income, monetary advantage, rate of return, profit margin, land equivalent ratio and yield efficiency for DEA were used to measure the efficiency of intercropping systems. In the bicropping of lettuce and rocket associated with carrot cv. 'Brasilia', suggests the use of lettuce cultivar 'Taina' combined with rocket cultivars 'Cultivada' or 'Folha Larga'. It was observed significant effect of lettuce cultivars in the evaluation of polycultures of lettuce, carrot and rocket, with strong expression for the lettuce cultivar 'Taina'. Both uni- and multivariate approaches were effective in the discrimination of the best polycultures. (C) 2011 Elsevier Ltd. All rights reserved.

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Prata Ana is the most planted banana cultivar in northern Minas Gerais, Brazil. It is however susceptible to several pathogens. This study was carried out to evaluate the disease severity of banana leaf spot in the Prata Ana cv. in the first and second cycle under six different planting systems. The randomized block experimental design was used with six treatments and four replications. lit an evaluation of the severity of banana leaf spot, no disease symptoms were found on Thap Maeo and Caipira. The evolution curve of the disease indicated seasonal effects in the first and second cycles. The severity, of banana leaf spot was highest soon after the regional rainy period from November to March. A comparison of the means of the evaluations indicated a reduction in disease severity from the first to the second cycle.

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One of the important issues about using renewable energy is the integration of dispersed generation in the distribution networks. Previous experience has shown that the integration of dispersed generation can improve voltage profile in the network, decrease loss, etc. but can create safety and technical problems as well. This work report the application of the instantaneous space phasors and the instantaneous complex power in observing performances of the distribution networks with dispersed generators in steady state. New IEEE apparent power definition, the so-called Buchholz-Goodhue effective apparent power, as well as new proposed power quality (oscillation) index in the three-phase distribution systems with unbalanced loads and dispersed generators, are applied. Results obtained from several case studies using IEEE 34 nodes test network are presented and discussed. (C) 2006 Elsevier B.V. All rights reserved.