964 resultados para frequent episodes


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"Rob, Vikki, Shireen, Muzz and Delia have been randomly selected to work together to develop a presentation entitled 'The barriers to learning'. It's not an easy ride. The following 10 episodes show the journey, from their first meeting through to their impressions of the presentation and working together". Produced by the LearnHigher CETL Three areas covered by the site as follows Listening and Interpersonal Skills - the University of Leeds Oral Presentations - Brunel University Group Work - Bradford University

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Introducción: La endocarditis infecciosa es una infección microbiana del endocardio poco estudiada en nuestro país, la cual se asocia con múltiples complicaciones clínicas, y que presenta una mortalidad importante, que no ha disminuido a lo largo del tiempo sin importar los cambios epidemiológicos, de tratamiento y el aumento de la cirugía valvular que se presentan en la actualidad. Metodología: Se realizó la búsqueda de los pacientes adultos con diagnóstico de endocarditis infecciosa entre los años 2002 a 2012 en la Fundación Cardioinfantil para la revisión de los registros médicos y la descripción de las características clínicas, microbiológicas y ecocardiográficas. Resultados: se detectaron 144 pacientes hallando un predominio de la lesión de válvula nativa y el compromiso de válvula aórtica, encontrando como germen más común el S. aureus, sin embargo una tasa de 32.6% de hemocultivos negativos. La mortalidad intrahospitalaria fue de 22.2%. Discusión: los datos hallados en general son semejantes a los descritos en la literatura mundial con excepción de algunas variables discordantes en cuanto a la válvula aórtica mayormente comprometida y factores asociados a la endocarditis tricuspidea. Conclusión: la epidemiología de la endocarditis infecciosa de nuestra serie es muy semejante a la de la literatura actual de los países industrializados, aunque con algunas excepciones, requiriéndose la implementación y profundización del estudio de esta patología a nivel nacional.

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Introducción y objetivos: La endocarditis infecciosa (EI) es una enfermedad grave producida por diversos gérmenes que afectan las válvulas cardiacas y el tejido endomiocárdico. El objetivo fue describir las características epidemiológicas, clínicas, ecocardiográficas y microbiológicas de la endocarditis infecciosa por Staphylococcus aureus (S. aureus) meticilino sensible y resistente de la Fundación Cardioinfantil – Instituto de Cardiología (FCI-IC) en el periodo de tiempo 2010- 2015. Métodos: Cohorte retrospectiva de casos de EI por S. aureus en la FCIIC para el período 2010-2015. Se realizó descripción de las variables generales de la población a estudio utilizando medidas de tendencia central y dispersión. Análisis de desenlaces teniendo cuenta la concentración inhibitoria mínima de vancomicina. Resultados: En el estudio se presentaron 27 casos de EI, con una mayor proporción de pacientes de sexo masculino, con hipertensión, diabetes y hemodiálisis. La fiebre fue la manifestación más frecuente seguida de fenómenos vasculares. La válvula más comprometida fue la mitral, principalmente nativa. Discusión: La presentación clínica de los pacientes con EI por S. aureus es aguda por lo que la fiebre es la principal manifestación clínica presentada, lo anterior favorece un rápido diagnóstico clínico. De las cepas de S. aureus causante de EI no se encontró gérmenes con sensibilidad intermedia ni resistente a la vancomicina según criterios establecidos por CLSI. Se encontró mayor proporción de pacientes con un valor de CMI para vancomicina mayor a 0,5μg/ml lo cual es importante dado que podemos estar enfrentándonos a cepas hetero VISA (hVISA).

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Seed set of rice (Oryza sativa L.) is highly sensitive to short episodes of high temperature at anthesis events that are likely to be more frequent in future climates. Breeding for tolerance is therefore an essential component of adaptation to climate variability and change. Experiments were conducted in 2003 and 2004 at optimum (30 degrees C daytime) and high (35 and 38 degrees C) air temperature using parents of some prominent mapping populations (i) to determine whether there were differences in the daily flowering pattern and hence a potential heat avoidance mechanism, and (ii) to identify rice genotypes having true heat tolerance during anthesis, that is, high seed set in spikelets exposed to high temperature. Rice cultivar CG14 (O. glaberrima) reached peak anthesis earlier in the morning (1.5 h after dawn) under both control (30 degrees C) and high (38 degrees C) temperature conditions than O. sativa genotypes (>= 3 h after dawn). Exposure to high temperature (centered on the time of peak anthesis) for 6 h reduced spikelet fertility more than exposure for 2 h, and fertility was lower at 38 degrees C than at 35 degrees C. Genotypic ranking for spikelet fertility at 35 and 38 degrees C was highly correlated in both 2003 and 2004. Fertility was also highly correlated across years, suggesting a consistent and reproducible response of spikelet fertility to temperature. The check cultivar N22 was the most heat tolerant genotype (64-86% fertility at 38 degrees C) and cultivars Azucena and Moroberekan the most susceptible (<8%).

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Varicella-zoster virus (VZV) is a member of the Herpesviridae family, primary infection with which causes varicella, more commonly known as chicken pox. Characteristic of members of the alphaherpesvirus subfamily, VZV is neurotropic and establishes latency in sensory neurons. Reactivation of VZV causes herpes zoster, also known as shingles. The most frequent complication following zoster is chronic and often debilitating pain called postherpetic neuralgia (PHN), which can last for months after the disappearance of a rash. During episodes of acute zoster, VZV viremia occurs in some, but not all, patients; however, the effect of the viral load on the disease outcome is not known. Here we describe the development of a highly specific, sensitive, and reproducible real-time PCR assay to investigate the factors that may contribute to the presence and levels of baseline viremia in patients with zoster and to determine the relationship between viremia and the development and persistence of PHN. VZV DNA was detected in the peripheral blood mononuclear cells (PBMCs) of 78% of patients with acute zoster and in 9% of healthy asymptomatic blood donors. The presence of VZV in the PBMCs of patients with acute zoster was independently associated with age and being on antivirals but not with gender, immune status, extent of rash, the age of the rash at the time of blood sampling, having a history of prodromal pain, or the extent of acute pain. Prodromal pain was significantly associated with higher baseline viral loads. Viral load levels were not associated with the development or persistence of PHN at 6, 12, or 26 weeks.

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The importance of dispersal for the maintenance of biodiversity, while long-recognized, has remained unresolved. We used molecular markers to measure effective dispersal in a natural population of the vertebrate-dispersed Neotropical tree, Simarouba amara (Simaroubaceae) by comparing the distances between maternal parents and their offspring and comparing gene movement via seed and pollen in the 50 ha plot of the Barro Colorado Island forest, Central Panama. In all cases (parent-pair, mother-offspring, father-offspring, sib-sib) distances between related pairs were significantly greater than distances to nearest possible neighbours within each category. Long-distance seedling establishment was frequent: 74% of assigned seedlings established > 100 m from the maternal parent [mean = 392 +/- 234.6 m (SD), range = 9.3-1000.5 m] and pollen-mediated gene flow was comparable to that of seed [mean = 345.0 +/- 157.7 m (SD), range 57.6-739.7 m]. For S. amara we found approximately a 10-fold difference between distances estimated by inverse modelling and mean seedling recruitment distances (39 m vs. 392 m). Our findings have important implications for future studies in forest demography and regeneration, with most seedlings establishing at distances far exceeding those demonstrated by negative density-dependent effects.

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A detailed geochemical analysis was performed on the upper part of the Maiolica Formation in the Breggia (southern Switzerland) and Capriolo sections (northern Italy). The analysed sediments consist of well-bedded, partly siliceous, pelagic carbonate, which lodges numerous thin, dark and organic-rich layers. Stable-isotope, phosphorus, organic-carbon and a suite of redox-sensitive trace-element contents (RSTE: Mo, U, Co, V and As) were measured. The RSTE pattern and Corg:Ptot ratios indicate that most organic-rich layers were deposited under dysaerobic rather than anaerobic conditions and that latter conditions were likely restricted to short intervals in the latest Hauterivian, the early Barremian and the pre-Selli early Aptian. Correlations are both possible with organic-rich intervals in central Italy (the Gorgo a Cerbara section) and the Boreal Lower Saxony Basin, as well as with the facies and drowning pattern in the Helvetic segment of the northern Tethyan carbonate platform. Our data and correlations suggest that the latest Hauterivian witnessed the progressive installation of dysaerobic conditions in the Tethys, which went along with the onset in sediment condensation, phosphogenesis and platform drowning on the northern Tethyan margin, and which culminated in the Faraoni anoxic episode. This episode is followed by further episodes of dysaerobic conditions in the Tethys and the Lower Saxony Basin, which became more frequent and progressively stronger in the late early Barremian. Platform drowning persisted and did not halt before the latest early Barremian. The late Barremian witnessed diminishing frequencies and intensities in dysaerobic conditions, which went along with the progressive installation of the Urgonian carbonate platform. Near the Barremian-Aptian boundary, the increasing density in dysaerobic episodes in the Tethyan and Lower Saxony Basins is paralleled by a change towards heterozoan carbonate production on the northern Tethyan shelf. The following return to more oxygenated conditions is correlated with the second phase of Urgonian platform growth and the period immediately preceding and corresponding to the Selli anoxic episode is characterised by renewed platform drowning and the change to heterozoan carbonate production. Changes towards more humid climate conditions were the likely cause for the repetitive installation of dys- to anaerobic conditions in the Tethyan and Boreal basins and the accompanying changes in the evolution of the carbonate platform towards heterozoan carbonate-producing ecosystems and platform drowning.

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A study was carried out to determine whether spirochaetes are frequently associated with digital dermatitis in United Kingdom (UK) dairy cattle. Histopathological examination of lesions using a silver stain showed a large number of unidentified spirochaete-like organisms present in digital dermatitis hoof skin tissue in all examined biopsies. Immunocytochemical staining demonstrated that spirochaetes in skin lesions were identified by polyclonal antisera to Borrelia burgdorferi, Treponema denticola and Treponema vincentii (again all biopsies were positively stained), whereas monoclonal antibodies to B. burgdorferi and any Treponema pallidum did not stain any organisms in all biopsies. A PCR of 16S rRNA, previously shown to be specific for a new treponeme, was employed and produced positive results from 82.4% of digital dermatitis tissues. It is concluded that this spirochaete (or related spirochaetes), which is similar to human oral treponemes, is frequently associated with, and may be responsible for, pathological changes in digital dermatitis. (C) 1998 Elsevier Science B.V.

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The two-way relationship between Rossby Wave-Breaking (RWB) and intensification of extra tropical cyclones is analysed over the Euro-Atlantic sector. In particular, the timing, intensity and location of cyclone development are related to RWB occurrences. For this purpose, two potential-temperature based indices are used to detect and classify anticyclonic and cyclonic RWB episodes from ERA-40 Re-Analysis data. Results show that explosive cyclogenesis over the North Atlantic (NA) is fostered by enhanced occurrence of RWB on days prior to the cyclone’s maximum intensification. Under such conditions, the eddy-driven jet stream is accelerated over the NA, thus enhancing conditions for cyclogenesis. For explosive cyclogenesis over the eastern NA, enhanced cyclonic RWB over eastern Greenland and anticyclonic RWB over the sub-tropical NA are observed. Typically only one of these is present in any given case, with the RWB over eastern Greenland being more frequent than its southern counterpart. This leads to an intensification of the jet over the eastern NA and enhanced probability of windstorms reaching Western Europe. Explosive cyclones evolving under simultaneous RWB on both sides of the jet feature a higher mean intensity and deepening rates than cyclones preceded by a single RWB event. Explosive developments over the western NA are typically linked to a single area of enhanced cyclonic RWB over western Greenland. Here, the eddy-driven jet is accelerated over the western NA. Enhanced occurrence of cyclonic RWB over southern Greenland and anticyclonic RWB over Europe is also observed after explosive cyclogenesis, potentially leading to the onset of Scandinavian Blocking. However, only very intense developments have a considerable influence on the large-scale atmospheric flow. Non-explosive cyclones depict no sign of enhanced RWB over the whole NA area. We conclude that the links between RWB and cyclogenesis over the Euro-Atlantic sector are sensitive to the cyclone’s maximum intensity, deepening rate and location.

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The occurrence of strong and persistent mid-latitude anticyclonic ridges over the Eastern North Atlantic is a major contributor to the occurrence of severe winter droughts over Western Iberia. We analyze the development of strong and persistent ridge episodes within 40–50°N; 40°W–5°E, which are defined as 300 hPa geopotential height anomalies above 50 gpm that persist for at least 10 consecutive days. Results suggest that the generation and maintenance of these episodes, with positive stratospheric geopotential anomalies over the North American continent and the adjacent North Pacific, are associated with an intensified polar jet. Such positive anomalies tend to detach from the main stratospheric anomaly and propagate eastwards and downwards as Rossby tropospheric waves. Furthermore, the Eastern North Atlantic ridge is generated and repeatedly reinforced until the stratospheric anomaly dissipates. Results also show evidence for waves breaking anticyclonically during the episodes, which is dynamically coherent with their persistency and quasi-stationarity.

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The frequency of extreme rainfall events in Southern Brazil is impacted by Ell Nino - Southern Oscillation (ENSO) episodes, especially in austral spring. There are two areas in which this impact is more significant: one is on the coast, where extreme events are more frequent during El Nino (EN) and the other one extends inland, where extreme events increase during EN and decrease during La Nina (LN). Atmospheric circulation patterns associated with severe rainfall in those areas are similar (opposite) to anomalous patterns characteristic of EN (LN) episodes, indicating why increase (decrease) of extreme events in EN (LN) episodes is favoured. The most recurrent precipitation patterns during extreme rainfall events in each of these areas are disclosed by Principal Component Analysis (PCA) and evidence the separation between extreme events in these areas: a severe precipitation event generally does not occur simultaneously in the coast and inland, although they may Occur inland and in the coastal region in sequence. Although EN predominantly enhances extreme rainfall, there are EN years in which fewer severe events occur than the average of neutral years, and also the enhancement of extreme rainfall is not uniform for different EN episodes, because the interdecadal non-ENSO variability also modulates significantly the frequency of extreme events in Southern Brazil. The inland region, which is more affected, shows increase (decrease) of extreme rainfall in association with the negative (positive) phase of the Atlantic Multidecadal Variability, with the negative (positive) phase of the Pacific Multidecadal Variability and with the positive (negative) phase of the Pacific Interdecadal Variability. Copyright (C) 2008 Royal Meteorological Society

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Objectives. A large-scale survey of doses to patients undergoing the most frequent radiological examinations was carried out in health services in Sao Paulo (347 radiological examinations per 1 000 inhabitants), the most populous Brazilian state. Methods. A postal dosimetric kit with thermoluminescence dosimeters was used to evaluate the entrance surface dose (ESD) to patients. A stratified sampling technique applied to the national health database furnished important data on the distribution of equipment and the annual number of examinations. Chest, head (skull and sinus), and spine (cervical, thoracic, and lumbar) examinations were included in the trial. A total of 83 rooms and 868 patients were included, and 1 415 values of ESD were measured. Results. The data show large coefficients of variation in tube charge, giving rise to large variations in ESD values. Also, a series of high ESD values associated with unnecessary localizing fluoroscopy were detected. Diagnostic reference levels were determined, based on the 75th percentile (third quartile) of the ESD distributions. For adult patients, the diagnostic reference levels achieved are very similar to those obtained in international surveys. However, the situation is different for pediatric patients: the ESD values found in this survey are twice as large as the international recommendations for chest radiographs of children. Conclusions. Despite the reduced number of ESD values and rooms for the pediatric patient group, it is recommended that practices in chest examinations be revised and that specific national reference doses and image quality be established after a broader survey is carried out.