Desempenho dos ajustes do Trauma and Injury Severity Score (TRISS): revisão integrativa

RESUMO Objetivo identificar estudos que realizaram ajustes na equação do Trauma and InjurySeverity Score (TRISS) e compararam a capacidade discriminatória da equação modificada com a original. Método Revisão integrativa de pesquisas publicadas entre 1990 e 2014 nas bases de dados LILACS, MEDLINE, PubMed e SciELO utilizando-se a palavra TRISS. Resultados foram incluídos 32 estudos na revisão. Dos 67 ajustes de equações do TRISS identificados, 35 (52,2%) resultaram em melhora na acurácia do índice para predizer a probabilidade de sobrevida de vítimas de trauma. Ajustes dos coeficientes do TRISS à população de estudo foram frequentes, mas nem sempre melhoraram a capacidade preditiva dos modelos analisados. A substituição de variáveis fisiológicas do Revised Trauma Score (RTS) e modificações do Injury Severity Score (ISS) na equação original tiveram desempenho variado. A mudança na forma de inclusão da idade na equação, assim como a inserção do gênero, comorbidades e mecanismo do trauma apresentaram tendência de melhora do desempenho do TRISS. Conclusão Diferentes propostas de ajustes no TRISS foram identificadas nesta revisão e indicaram, principalmente, fragilidades do RTS no modelo original e necessidade de alteração da forma de inclusão da idade na equação para melhora da capacidade preditiva do índice.

The use of the Nursing Activities Score in clinical settings: an integrative review

ABSTRACT Objective analyze how studies have approached the results obtained from the application of the Nursing Activities Score (NAS) based on Donabedian’s model of healthcare organization and delivery. Method CINAHL and PubMed databases were searched for papers published between 2003 and March 2015. Results 36 articles that met the inclusion criteria were reviewed and double-coded by three independent coders and analyzed based on the three elements of Donabedian’s health care quality framework: structure, process and outcome. The most frequently addressed, but not always tested, variables were those that fell into the structure category. Conclusion variables that fell into the process category were used less frequently. Beside NAS, the most frequently used variables in the outcome category were mortality and length of stay. However, no study used a quality framework for healthcare or NAS to evaluate costs, and it is recommended that further research should explore this approach.

Low malathion concentrations influence metabolism in Chironomus sancticaroli (Diptera, Chironomidae) in acute and chronic toxicity tests

Low malathion concentrations influence metabolism in Chironomus sancticaroli (Diptera, Chironomidae) in acute and chronic toxicity tests. Organophosphate compounds are used in agro-systems, and in programs to control pathogen vectors. Because they are continuously applied, organophosphates often reach water sources and may have an impact on aquatic life. The effects of acute and chronic exposure to the organophosphate insecticide malathion on the midge Chironomus sancticaroli are evaluated. To that end, three biochemical biomarkers, acetylcholinesterase (AChE), alpha (EST-α) and beta (EST-β) esterase were used. Acute bioassays with five concentrations of malathion, and chronic bioassays with two concentrations of malathion were carried out. In the acute exposure test, AChE, EST-α and EST-β activities declined by 66, 40 and 37%, respectively, at 0.251 µg L-1 and more than 80% at 1.37, 1.96 and 2.51 µg L-1. In chronic exposure tests, AChE and EST-α activities declined by 28 and 15% at 0.251 µg L-1. Results of the present study show that low concentrations of malathion can influence larval metabolism, indicating high toxicity for Chironomus sancticaroli and environmental risk associated with the use of organophosphates.

Increase of grain and green matter of corn by liming

Despite the fact that aluminum toxicity to crops is eliminated near soil water pH of 5.5, lime recommendation in many regions aims to increase soil pH up to 6.0 or even higher. For highly buffered soils, high rates of limestone are required to raise the pH from 5.5 to 6.0, resulting in additional, sometimes unnecessary, costs. The objective of this study was to evaluate the effect of soil pH on corn yield in a very acid Hapludox. The experiment was carried out in Lages, Southern Brazil, from 1992 to 1996. The soil had water pH of 4.7, Al3+ of 33 mmol c kg-1, O.M. of 45 g kg-1 and lime requirement to pH 6.0 of 9.0 t ha-1. Dolomitic limestone at rates of 0, 4.5, 9.0, 13.5 and 18.0 t ha-1 (equivalent to pure CaCO3) was incorporated into the soil down to 17 cm depth, in 1992. Liming increased linearly the values of soil pH (from 4.7 to 6.6) and Ca and Mg, eliminated Al3+ with rates of 9.0 t ha-1 or higher, decreased slightly Al-CuCl2, Fe and Cu, and did not affect Zn and Mn. Maximum average corn yield for grain (7.9 t ha-1) and for green matter for silage (GM) (59 t ha-1) was obtained, respectively, at soil pH of 6.0 (12 t ha-1 of limestone) and of 6.1 (14 t ha-1 of limestone); maximum economic efficiency for grain was obtained at pH 5.6 (7.5 t ha-1 of limestone). Maximum yield increments due to liming were 17% for grain and 20% for GM.

Protective effect of divalent cations against aluminum toxicity in soybean

A large proportion of soybean fields in Brazil are currently cultivated in the Cerrado region, where the area planted with this crop is growing considerably every year. Soybean cultivation in acid soils is also increasing worldwide. Since the levels of toxic aluminum (Al) in these acid soils is usually high it is important to understand how cations can reduce Al rhizotoxicity in soybean. In the present study we evaluated the ameliorative effect of nine divalent cations (Ca, Mg, Mn, Sr, Sn, Cu, Zn, Co and Ba) in solution culture on Al rhizotoxicity in soybean. The growth benefit of Ca and Mg to plants in an acid Inceptisol was also evaluated. In this experiment soil exchangeable Ca:Mg ratios were adjusted to reach 10 and 60 % base saturation, controlled by different amounts of CaCl2 or MgCl2 (at proportions from 100:0 up to 0:100), without altering the soil pH level. The low (10 %) and adequate (60 %) base saturation were used to examine how plant roots respond to Al at distinct (Ca + Mg)/Al ratios, as if they were growing in soils with distinct acidity levels. Negative and positive control treatments consisted of absence (under native soil or undisturbed conditions) or presence of lime (CaCO3) to reach 10 and 60 % base saturation, respectively. It was observed that in the absence of Aluminum, Cu, Zn, Co and Sn were toxic even at a low concentration (25 µmol L-1), while the effect of Mn, Ba, Sr and Mg was positive or absent on soybean root elongation when used in concentrations up to 100 µmol L-1. At a level of 10 µmol L-1 Al, root growth was only reverted to the level of control plants by the Mg treatment. Higher Tin doses led to a small alleviation of Al rhizotoxicity, while the other cations reduced root growth or had no effect. This is an indication that the Mg effect is ion-specific and not associated to an electrostatic protection mechanism only, since all ions were divalent and used at low concentrations. An increased exchangeable Ca:Mg ratio (at constant soil pH) in the acid soil almost doubled the soybean shoot and root dry matter even though treatments did not modify soil pH and exchangeable Al3+. This indicates a more efficient alleviation of Al toxicity by Mg2+ than by Ca2+. The reason for the positive response to Mg2+ was not the supply of a deficient nutrient because CaCO3 increased soybean growth by increasing soil pH without inducing Mg2+ deficiency. Both in hydroponics and acid soil, the reduction in Al toxicity was accompanied by a lower Al accumulation in plant tissue, suggesting a competitive cation absorption and/or exclusion of Al from plant tissue stimulated by an Mg-induced physiological mechanism.

Timing, location and crop species influence the magnitude of amelioration of aluminum toxicity by magnesium

The protective effect of cations, especially Ca and Mg, against aluminum (Al) rhizotoxicity has been extensively investigated in the last decades. The mechanisms by which the process occurs are however only beginning to be elucidated. Six experiments were carried out here to characterize the protective effect of Mg application in relation to timing, location and crop specificity: Experiment 1 - Protective effect of Mg compared to Ca; Experiment 2 - Protective effect of Mg on distinct root classes of 15 soybean genotypes; Experiment 3 - Effect of timing of Mg supply on the response of soybean cvs. to Al; Experiment 4 - Investigating whether the Mg protective effect is apoplastic or simplastic using a split-root system; Experiment 5 - Protective effect of Mg supplied in solution or foliar spraying, and Experiment 6 - Protective effect of Mg on Al rhizotoxicity in other crops. It was found that the addition of 50 mmol L-1 Mg to solutions containing toxic Al increased Al tolerance in 15 soybean cultivars. This caused soybean cultivars known as Al-sensitive to behave as if they were tolerant. The protective action of Mg seems to require constant Mg supply in the external medium. Supplying Mg up to 6 h after root exposition to Al was sufficient to maintain normal soybean root growth, but root growth was not recovered by Mg addition 12 h after Al treatments. Mg application to half of the root system not exposed to Al was not sufficient to prevent Al toxicity on the other half exposed to Al without Mg in rooting medium, indicating the existence of an external protection mechanism of Mg. Foliar spraying with Mg also failed to decrease Al toxicity, indicating a possible apoplastic role of Mg. The protective effect of Mg appeared to be soybean-specific since Mg supply did not substantially improve root elongation in sorghum, wheat, corn, cotton, rice, or snap bean when grown in the presence of toxic Al concentrations.

Arsenic toxicity in Acacia mangium willd. and mimosa Caesalpiniaefolia benth. seedlings

Acacia mangium and Mimosa caesalpiniaefolia are fast-growing woody fabaceous species that might be suitable for phytoremediation of arsenic (As)-contaminated sites. To date, few studies on their tolerance to As toxicity have been published. Therefore, this study assessed As toxicity symptoms in A. mangium and M. caesalpiniaefolia seedlings under As stress in a greenhouse. Seedlings of Acacia mangium and M. caesalpiniaefolia were grown for 120 d in an Oxisol-sand mixture with 0, 50, 100, 200, and 400 mg kg-1 As, in four replications in four randomized blocks. The plants were assessed for visible toxicity symptoms, dry matter production, shoot/root ratio, root anatomy and As uptake. Analyses of variance and regression showed that the growth of A. mangium and M. caesalpiniaefolia was severely hindered by As, with a reduction in dry matter production of more than 80 % at the highest As rate. The root/shoot ratio increased with increasing As rates. At a rate of 400 mg kg-1 As, whitish chlorosis appeared on Mimosa caesalpiniaefolia seedlings. The root anatomy of both species was altered, resulting in cell collapse, death of root buds and accumulation of phenolic compounds. Arsenic concentration was several times greater in roots than in shoots, with more than 150 and 350 mg kg-1 in M. caesalpiniaefolia and A. mangium roots, respectively. These species could be suitable for phytostabilization of As-contaminated sites, but growth-stimulating measures should be used.

EFFECTS OF SILICON ON ALLEVIATING ARSENIC TOXICITY IN MAIZE PLANTS

Arsenic is a metalloid highly toxic to plants and animals, causing reduced plant growth and various health problems for humans and animals. Silicon, however, has excelled in alleviating stress caused by toxic elements in plants. The aim of this study was to investigate the effects of Si in alleviating As stress in maize plants grown in a nutrient solution and evaluate the potential of the spectral emission parameters and the red fluorescence (Fr) and far-red fluorescence (FFr) ratio obtained in analysis of chlorophyll fluorescence in determination of this interaction. An experiment was carried out in a nutrient solution containing a toxic rate of As (68 μmol L-1) and six increasing rates of Si (0, 0.25, 0.5, 1.0, 1.5, and 2.0 mmol L-1). Dry matter production and concentrations of As, Si, and photosynthetic pigments were then evaluated. Chlorophyll fluorescence was also measured throughout plant growth. Si has positive effects in alleviating As stress in maize plants, evidenced by the increase in photosynthetic pigments. Silicon application resulted in higher As levels in plant tissue; therefore, using Si for soil phytoremediation may be a promising choice. Chlorophyll fluorescence analysis proved to be a sensitive tool, and it can be successfully used in the study of the ameliorating effects of Si in plant protection, with the Fr/FFr ratio as the variable recommended for identification of temporal changes in plants.

New wheat genotypes tolerant to aluminum toxicity obtained by mutation induction

Seed from the sensitive wheat (Triticum aestivumL.) cultivar Anahuac was treated to gamma-ray irradiation and eleven Al3+ tolerant mutants selected. The objective was to compare these mutants to the original Anahuac and to the tolerant wheat cultivars IAC-24 and IAC-60 from 1994 to 1996 in acid (Capão Bonito) and limed (Monte Alegre do Sul) soil field trials, in the State of São Paulo, Brazil. Grain yield and agronomic characteristics were analyzed. All the mutant lines yielded higher than the sensitive Anahuac cultivar in the acid soils of Capão Bonito. Under limed soil conditions, 10 mutants had a similar yield to the original sensitive cultivar and one a lower yield. The majority of the mutants were similar in yield to the tolerant cultivars IAC-24 and IAC-60 under both conditions. Some of the mutants showed altered agronomic characteristics, but these alterations did not generally influence the grain yield. The results indicated that tolerant lines with good characteristics may be obtained from a susceptible cultivar by mutation induction, thus allowing cropping under conditions where Al3 + is a limiting factor.

Toxicity of pymetrozine and thiamethoxam to Aphelinus gossypii and Delphastus pusillus

The objective of this work was to study the toxicity of pymetrozine and thiamethoxam to the cotton aphid parasitoid Aphelinus gossypii Timberlake and to the whitefly predator Delphastus pusillus (LeConte). Cotton leaves containing mummies of the parasitoid A. gossypii were collected and treated with seven concentrations of both insecticides. Parasitoid emergence was not affected by pymetrozine and ranged from 59.9% to 75.0%, but decreased with the increase of thiamethoxam concentrations ranging from 30.2% to 69.6%. Cotton leaves infested by whitefly and treated with recommended rates of both insecticides were collected three hours, three days and six days after spraying and colonized with larvae and adults of D. pusillus. Predators released on thiamethoxam-treated leaves experienced mortality from 70% to 100%, while those released on pymetrozine-treated leaves showed mortality from 0% to 20%. Topical toxicity from both insecticides was studied on larvae, pupae and adults of D. pusillus. The survival of predator after six days of exposure to 400, 600 and 800 mg/L of pymetrozine a.i. was higher than 69.6%, and to 25, 100 and 200 mg/L of thiamethoxam a.i. was lower than 8.7%. The toxicity data for A. gossypii and D. pusillus characterize the pymetrozine as harmless for both species, and thiamethoxam of low to moderate toxicity for A. gossypii treated mummies, and high toxicity for D. pusillus.

Body condition score to predict the postpartum fertility of crossbred beef cows

The relationship between changes in body condition score (BCS) during the postpartum and fertility in beef cows suckling calves under extensive conditions were investigated. Cows were subjected to four BCS evaluations over the postpartum period, starting around one month after calving. In the second evaluation cows were treated with medroxy-progesterone acetate impregnated pessaries and received an injection of estradiol benzoate. At the third evaluation, pessaries were removed and calves were separated from the cows for 96 hours, during which time estrous was observed twice a day, and animals artificially inseminated 12 hours after detection. When calves returned to their dams, bulls were introduced until a 60-day mating period was reached. The distribution of BCS differed among calving groups and evaluations. Results indicated that only cows comprising a BCS 3 (1 to 5 scale) around the first month postpartum can be used in an artificial insemination program with possibilities of becoming pregnant. There was no statistical difference between the calving groups in pregnancy rate. The evolution of the BCS of the cows during postpartum can be used to adjust the start of the breeding season to coincide with the time of the year where herd pregnancy rates will be highest.

Toxicity of neem oil to Bemisia tabaci biotype B nymphs reared on dry bean

The objective of this work was to determine the most susceptible nymphal stage of Bemisia tabaci biotype B to neem (Azadirachta indica A. Juss.) oil applied to dry bean (Phaseolus vulgaris L.) in a screenhouse. A solution of commercial oil (Dalneem) extracted from neem seeds was sprayed directly on each nymphal instar at 0, 0.1, 0.25, 0.5, 1 and 2% concentrations for lethal concentration (LC) determination, and at 0, 0.5 and 1% concentrations for lethal time (LT) determination. The number of living and dead nymphs was recorded five days after spraying for LC determination, and daily during six days for LT determination. The LC50 estimated for fourth instar nymphs occurred at 0.56% concentration. For all instars, LC50 and LC95 were estimated at 0.32 and 2.78% concentrations, respectively. The estimated values of LT50 at 1% concentration were 2.46, 4.45, 3.02 and 6.98 days for the first to fourth instars, respectively. The LT50 occurred at five days for 0.5% and at four days for 1% concentration in all instars. A mortality rate of over 80% was observed on the 6th day for the first to third instars at 1% concentration. The first three nymphal stages were more susceptible to neem oil when compared to the fourth nymphal stage.

Toxicity of organic farming‑compatible products to the coffee leaf miner

The objective of this work was to evaluate the toxicity of organic farming‑compatible products to the coffee leaf miner Leucoptera coffeella. Lime sulphur, enriched Bordeaux mixture (Viça Café Plus), and the "supermagro" biofertilizer were first tested in laboratory. The most promising product was tested afterwards under field conditions. In laboratory, different concentrations of each product were applied on L. coffeella eggs and on infested coffee‑mined leaves. Only lime sulphur had ovicidal effects at an acceptable concentration (1.6%) for field applications, but no significant effect on larvae mortality was found. Enriched Bordeaux mixture and the "supermagro" biofertilizer had no effect on L. coffeella eggs and larvae. In the field trial, biweekly or monthly sprayings of lime sulphur at different concentrations caused population decrease after 30 days; however, this effect was not significant after 60 or 90 days.

Chemical, physico-chemical and sensory characterization of mixed açai (Euterpe oleracea) and cocoa´s honey (Theobroma cacao) jellies

Four formulations of mixed açaí (Euterpe oleracea) (A) and cocoa´s honey (Theobroma cacao) (CH) jellies were prepared according to the following proportions: T1 (40% A:60% CH), T2 (50% A:50% CH), T3 (60% A: 40% CH) and T4 (100% A - control). All formulations were prepared using a rate 60:40 (w/w) of sucrose and pulp, plus 0.5% pectin and the products reached to average of 65% soluble solids content. The jellies were analyzed by chemical and physicochemical (titratable acidity, pH, soluble solid content, dry matter, total protein, lipids, vitamin C and calories) and sensory characteristics; also were evaluated levels of P, K, Ca, Mg, Fe, Zn, Cu and Mn. It was used a hedonic scale of 7 points to evaluate the attributes: overall impression, spreadability, brightness, flavor, texture and color, and also was verified the purchase intention score. The titratable acidity and pH ranged from 0.46 to 0.64% and 3.35 to 3.64, respectively, that are within the range found at most fruit jellies. The soluble solids content ranged between 65.2 and 65.5 ºBrix. The sensory acceptance results showed that all treatments (T1, T2, T3 and T4) presented means of sensory attributes above 4, demonstrating good acceptance of the product, but the treatment T1 presented the higher scores for the evaluated attributes. Cocoa´s honey added a positive influence on the attributes of color, texture and spreadability.

Magnetic resonance imaging and BMB score in the evaluation of bone involvement in Gaucher’s disease patients

AbstractObjective:To evaluate by magnetic resonance imaging changes in bone marrow of patients undergoing treatment for type I Gaucher’s disease.Materials and Methods:Descriptive, cross-sectional study of Gaucher’s disease patients submitted to 3 T magnetic resonance imaging of femurs and lumbar spine. The images were blindly reviewed and the findings were classified according to the semiquantitative bone marrow burden (BMB) scoring system.Results:All of the seven evaluated patients (three men and four women) presented signs of bone marrow infiltration. Osteonecrosis of the femoral head was found in three patients, Erlenmeyer flask deformity in five, and no patient had vertebral body collapse. The mean BMB score was 11, ranging from 9 to 14.Conclusion:Magnetic resonance imaging is currently the method of choice for assessing bone involvement in Gaucher’s disease in adults due to its high sensitivity to detect both focal and diffuse bone marrow changes, and the BMB score is a simplified method for semiquantitative analysis, without depending on advanced sequences or sophisticated hardware, allowing for the classification of the disease extent and assisting in the treatment monitoring.