Enhanced Recovery after Elective Open Surgical Repair of Abdominal Aortic Aneurysm: A Complementary Overview through a Pooled Analysis of Proportions from Case Series Studies

Objectives: To evaluate the efficacy and safety of enhanced recovery after surgery (ERAS) programs in elective open surgical repair (OSR) of abdominal aortic aneurysm (AAA).Background: Open surgical repair of AAA is associated with high morbidity and mortality, prolonged hospital stay and high costs. ERAS programs contribute to the optimization of treatment by reducing hospital stay and improving clinical outcomes.Methods: A review of PubMed, EMBASE and LILACS databases was conducted. As only one randomized controlled trial was found, a pooled analysis of proportions from case series was conducted, considering it a complementary overview of the topic. Inclusion criteria were case series with more than five cases reported, adult patients who underwent an elective OSR of AAA and use of an ERAS program. ERAS was compared to conventional perioperative care. The pooled proportion and the confidence interval (CI) are shown for each outcome. The overlap of the CI suggests similar effect of the interventions studied.Results: Thirteen case series studies with ERAS involving 1,250 patients were compared to six case series with conventional care with a total of 1,429 patients. The pooled, respective proportions for ERAS and conventional care were: mortality, 1.51% [95% CI: 0.0091, 0.0226] and 3.0% [95% CI 0.0183, 0.0445]; and incidence of complications, 3.82% [95% CI 0.0259, 0.0528] and 4.0% [95% CI 0.03, 0.05].Conclusion: This review shows that ERAS and conventional care therapies have similar mortality and complication rates in OSR of AAA.

Description of a new species and complementary description of a known species of Iphiseiodes de Leon (Acari: Phytoseiidae)

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

Efficacy of several Salmonella vaccination programs against experimental challenge with Salmonella gallinarum in commercial brown layer and broiler breeder hens

The protective effect of various Salmonella vaccines regimens against an experimental Salmonella Gallinarum challenge (SGNalr strain at 12 wk of age) was evaluated in two experiments. In Experiment 1 commercial brown layers were vaccinated according to one of the following programs: (i) two doses of a SE bacterin (Layermune SE; group 1); (ii) a first dose of a live SG9R vaccine (Cevac SG9R) followed by a SE bacterin (Layermune SE; group 2); (iii) one dose of each of two different multivalent inactivated vaccines containing SE cells (Corymune 4 & Corymune 7; group 3) or (iv) not vaccinated (group 4). In Experiment 2, broiler breeders were given the same vaccination treatments except for the group vaccinated with the multivalent vaccines. Overall, in both experiments, all vaccination schemes were effective in reducing mortality after challenge with a SG field strain. Primary vaccination with an initial dose of a live SG9R vaccine followed some weeks later by a dose of an inactivated SE bacterin was the most effective (p<0.05) vaccination program against mortality induced by field SG experimental challenge in both experiments. In conclusion, Salmonella vaccination programs containing SE bacterins alone or in combination with a live SG9R vaccine are effective in preventing mortality induced by infection of field SG. Nevertheless, it is important to emphasize that any vaccination program against any Salmonella serotype will only be effective if it is part of a sound and comprehensive biosecurity program designed for Salmonella control in poultry farms.

Humoral and cellular immune response generated by different vaccine programs before and after Salmonella Enteritidis challenge in chickens

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

Diagnosis of Public Programs focused on Herbal Medicines in Brazil

The present study is aimed to diagnose the current public programs focused on herbal medicine in Brazil where the following results can be observed. The main purpose of implementation of these programs was the demand of the users of medicinal plants and herbal medicines. The initiative of the implementation of these programs was related to the managers (58%). The difficulties in this implementation were due to lack of funding (90%) of the programs. In 80% of the programs, the physicians did not adhere to herbal medicine services due to lack of knowledge in the subject. Training courses were proposed (70%) to increase the adhesion of prescribers to the system. Some municipalities use information obtained from patients to assess the therapeutic efficiency of medicinal plants and herbal medicines. of the programs underway, cultivation of medicinal plants was observed in 50%, and 67% of the programs adopted quality control. In most programs, this control is not performed in accordance with the legal requirements.

Energetic efficiency programs and power quality

This paper presents the results of the investigations that were done to identify and to quantify the power quality problems resultant from the actions done to improve the efficiency on electric energy consumption. The efficiencies of several electric devices were evaluated, among them: fluorescent bulb, electronic ballast, soft-starter, temperature controller for showers, dimmer and others. This evaluation allowed to establish a cause/effect analysis of the power quality.

A method for plotting the complementary root locus using the root-locus (positive gain) rules

The root-locus method is a well-known and commonly used tool in control system analysis and design. It is an important topic in introductory undergraduate engineering control disciplines. Although complementary root locus (plant with negative gain) is not as common as root locus (plant with positive gain) and in many introductory textbooks for control systems is not presented, it has been shown a valuable tool in control system design. This paper shows that complementary root locus can be plotted using only the well-known construction rules to plot root locus. It can offer for the students a better comprehension on this subject. These results present a procedure to avoid problems that appear in root-locus plots for plants with the same number of poles and zeros.

On Complementary Root Locus of Biproper Transfer Functions

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

Effect of three exercise programs on patients with chronic obstructive pulmonary disease

We compared the effect of three different exercise programs on patients with chronic obstructive pulmonary disease including strength training at 50_80% of one-repetition maximum (1-RM) (ST; N = 11), low-intensity general training (LGT; N = 13), or combined training groups (CT; N = 11). Body composition, muscle strength, treadmill endurance test (TEnd), 6-min walk test (6MWT), Saint George's Respiratory Questionnaire (SGRQ), and baseline dyspnea (BDI) were assessed prior to and after the training programs (12 weeks). The training modalities showed similar improvements (P > 0.05) in SGRQ-total (ST = 13 ± 14%; CT = 12 ± 14%; LGT = 11 ± 10%), BDI (ST = 1.8 ± 4; CT = 1.8 ± 3; LGT = 1 ± 2), 6MWT (ST = 43 ± 51 m; CT = 48 ± 50 m; LGT = 31 ± 75 m), and TEnd (ST = 11 ± 20 min; CT = 11 ± 11 min; LGT = 7 ± 5 min). In the ST and CT groups, an additional improvement in 1-RM values was shown (P < 0.05) compared to the LGT group (ST = 10 ± 6 to 57 ± 36 kg; CT = 6 ± 2 to 38 ± 16 kg; LGT = 1 ± 2 to 16 ± 12 kg). The addition of strength training to our current training program increased muscle strength; however, it produced no additional improvement in walking endurance, dyspnea or quality of life. A simple combined training program provides benefits without increasing the duration of the training sessions.

Hypoacousis prevalence in Kaiowá and Guarani indigenous children

OBJETIVOS: identificar a prevalência de hipoacusia em crianças indígenas Kaiowá e Guarani. MÉTODOS: estudo transversal, com uma amostra de 126 crianças indígenas de zero a 59 meses da Terra Indígena de Caarapó, em Mato Grosso do Sul, Brasil. As crianças foram submetidas ao exame das emissões otoacústicas evocadas transitórias, que serviu como triagem auditiva. O reteste foi realizado nas crianças que apresentaram resultado alterado na triagem auditiva. Os casos que, no reteste, permaneceram alterados foram encaminhados para o exame da imitanciometria. RESULTADOS: na triagem auditiva, foram identificadas 25 (23,6%) crianças com resultado alterado; dessas, 17 apresentaram resultado normal no reteste e 6 permaneceram com resultado alterado, sendo encaminhadas para imitanciometria. A prevalência de hipoacusia identificada ao final do estudo foi de 5,6%, sendo 3 (2,8%) do tipo condutiva e 3 (2,8%) do tipo neurossensorial. Estas últimas foram encaminhadas à avaliação otorrinolaringológica complementar para confirmação diagnóstica. As alterações auditivas identificadas neste estudo não apresentaram diferenças significantes quanto ao sexo e grupo etário. CONCLUSÕES: a prevalência de alteração auditiva encontrada nesta população alerta para a necessidade de implantação de programas de saúde auditiva e sua articulação com outras ações desenvolvidas na atenção à saúde infantil dos Kaiowá e Guarani.

Feeding programs to induce molting in Japanese quails (Coturnix japonica)

The experiment was carried out in the experimental poultry house of the Research and Development Unit of Brotas of Agência Paulista de Tecnologia dos Agronegócios do Centro-Oeste, SP, Brazil. The objective of the study was to evaluate forced-molting methods and their effects on body weight, egg production, feed intake, and mortality, as well as bird performance during the second laying cycle. A total number of 400 65-week-old Japanese quails was distributed in a completely randomized experimental design into five treatments, with four replicates of 20 birds each. The following treatments were applied: T1= not submitted to forced molting, T2= 01 day of fasting + 13 days receiving 15g feed/bird/day (1F+R), T3= 02 days of fasting + 12 days receiving 15g feed/bird/day (2F+R), T4= 03 days of fasting + 11 days receiving 15g feed/bird/day (3F+R), and T5= 3 days of fasting and fed ad libitum thereafter (3F+AL). Significant differences were detected among treatments. When submitted to 3 days of fasting followed by ad libitum feeding, birds presented complete body weight recovery. No egg production percentage differences were detected in birds submitted to forced molting.

Comparative study of 2 software programs for predicting profile changes in Class III patients having double-jaw orthognathic surgery

Introduction: Computer software can be used to predict orthognathic surgery outcomes. The aim of this study was to subjectively compare the soft-tissue surgical simulations of 2 software programs. Methods: Standard profile pictures were taken of 10 patients with a Class III malocclusion and a concave facial profile who were scheduled for double-jaw orthognathic surgery. The patients had horizontal maxillary deficiency or horizontal mandibular excess. Two software programs (Dentofacial Planner Plus [Dentofacial Software, Toronto, Ontario, Canada] and Dolphin Imaging [version 9.0, Dolphin Imaging Software, Canoga Park, Calif]) were used to predict the postsurgical profiles. The predictive images were compared with the actual final photographs. One hundred one orthodontists, oral-maxillofacial surgeons, and general dentists evaluated the images and were asked whether they would use either software program to plan treatment for, or to educate, their patients. Results: Statistical analyses showed differences between the groups when each point was judged. Dolphin Imaging software had better prediction of nasal tip, chin, and submandibular area. Dentofacial Planner Plus software was better in predicting nasolabial angle, and upper and lower lips. The total profile comparison showed no statistical difference between the softwares. Conclusions: The 2 types of software are similar for obtaining 2-dimensional predictive profile images of patients with Class III malocclusion treated with orthognathic surgery. (Am J Orthod Dentofacial Orthop 2010; 137: 452.e1-452.e5)

Using post-release monitoring data to optimize avian reintroduction programs: a 2-year case study from the Brazilian Atlantic Rainforest

Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)