Outcome of stroke patients admitted to intensive care: Experience from an Australian teaching hospital

The objective of this study was to determine the mortality rate and the functional outcomes of stroke patients admitted to the intensive care unit (ICU) and to identify predictors of poor outcome in this population. The records of all patients admitted to the ICU with the diagnosis of stroke between January 1994 and December 1999 were reviewed. Patients with subarachnoid haemorrhage were excluded. Data were collected on clinical and biological variables, risk factors for stroke and the presence of comorbidities. Mortality (ICU, in-hospital and three-month) and functional outcome were used as end-points. In the six-year-period, 61 patients were admitted to the ICU with either haemorrhagic or ischaemic stroke. Medical records were available for only 58 patients. There were 23 ischaemic and 35 haemorrhagic strokes. The ICU, in-hospital and three-month mortality rates were 36%, 47% and 52% respectively. There were no significant differences in the prevalence of premorbid risk factors between survivors and non-survivors. The mean Barthel score was significantly different between the independent and dependent survivors (94 +/- 6 vs 45 +/- 26, P < 0.001). A substantial number of patients with good functional outcomes had lower Rankin scores (92% vs 11%, P < 0.001). Only 46% of those who were alive at three months were functionally independent. Intensive care admission was associated with a high mortality rate and a high likelihood of dependent lifestyle after hospital discharge. Haemorrhagic stroke, fixed dilated pupil(s) and GCS < 10 during assessment were associated with increased mortality and poor functional outcome.

Testing landscape metrics as indicators of habitat loss and fragmentation in continuous eucalypt forests (Queensland, Australia)

Landscape metrics are widely applied in landscape ecology to quantify landscape structure. However, many are poorly tested and require rigorous validation if they are to serve as reliable indicators of habitat loss and fragmentation, such as Montreal Process Indicator 1.1e. We apply a landscape ecology theory, supported by exploratory and confirmatory statistical techniques, to empirically test landscape metrics for reporting Montreal Process Indicator 1.1e in continuous dry eucalypt forests of sub-tropical Queensland, Australia. Target biota examined included: the Yellow-bellied Glider (Petaurus australis); the diversity of nectar and sap feeding glider species including P. australis, the Sugar Glider P. breviceps, the Squirrel Glider P. norfolcensis, and the Feathertail Glider Acrobates pygmaeus; six diurnal forest birds species; total diurnal bird species diversity; and the density of nectar-feeding diurnal bird species. Two scales of influence were considered: the stand-scale (2 ha), and a series of radial landscape extents (500 m - 2 km; 78 - 1250 ha) surrounding each fauna transect. For all biota, stand-scale structural and compositional attributes were found to be more influential than landscape metrics. For the Yellow-bellied Glider, the proportion of trace habitats with a residual element of old spotted-gum/ironbark eucalypt trees was a significant landscape metric at the 2 km landscape extent. This is a measure of habitat loss rather than habitat fragmentation. For the diversity of nectar and sap feeding glider species, the proportion of trace habitats with a high coefficient of variation in patch size at the 750 m extent was a significant landscape metric. None of the landscape metrics tested was important for diurnal forest birds. We conclude that no single landscape metric adequately captures the response of the region's forest biota per se. This poses a major challenge to regional reporting of Montreal Process Indicator 1.1e, fragmentation of forest types.

Photosynthetic light and temperature responses of Eucalyptus cloeziana and Eucalyptus argophloia

Acclimation of gas exchange to temperature and light was determined in 18-month-old plants of humid coastal (Gympie) and dry inland ( Hungry Hills) provenances of Eucalyptus cloeziana F. Muell., and in those of a dry inland provenance of Eucalyptus argophloia Blakely. Plants were acclimated at day/night temperatures of 18/13, 23/18, 28/23 and 33/ 28 degreesC in controlled-temperature glasshouses for 4 months. Light and temperature response curves were measured at the beginning and end of the acclimation period. There were no significant differences in the shape and quantum-yield parameters among provenances at 23, 28 and 33 degreesC day temperatures. Quantum yield [mumol CO2 mumol(- 1) photosynthetic photon flux density (PPFD)] ranged from 0.04 to 0.06 and the light response shape parameter ranged from 0.53 to 0.78. Similarly, no consistent trends in the rate of dark respiration for plants of each provenance were identified at the four growth temperatures. Average values of dark respiration for the plants of the three provenances ranged from 0.61 to 1.86 mumol m(-2) s(-1). The optimum temperatures for net photosynthesis increased from 23 to 32 degreesC for the humid- and from 25 to 33 degreesC for the dry-provenance E. cloeziana and from 21 to 33 degreesC for E. argophloia as daytime temperature of the growth environment increased from 18 to 33 degreesC. These results have implications in predicting survival and productivity of E. cloeziana and E. argophloia in areas outside their natural distribution.

Phylogeny of the lice (Insecta, Phthiraptera) inferred from small subunit rRNA

There has been much argument about the phylogenetic relationships of the four suborders of lice (Insecta: Phthiraptera). Lyal's study of the morphology of lice indicated that chewing/biting lice (Mallophaga) are paraphyletic with respect to sucking lice (Anoplura). To test this hypothesis we inferred the phylogeny of 33 species of lice from small subunit (SSU) rRNA sequences (18S rRNA). Liposcelis sp. from the Liposcelididae (Psocoptera) was used for outgroup reference. Phylogenetic relationships among the four suborders of lice inferred from these sequences were the same as those inferred from morphology. The Amblycera is apparently the sister-group to all other lice whereas the Rhynchophthirina is apparently sister to the Anoplura; these two suborders are sister to the Ischnocera, i.e. (Amblycera (Ischnocera (Anoplura, Rhynchophthirina))). Thus, the Mallophaga (Amblycera, Ischnocera, Rhynchophthirina) is apparently paraphyletic with respect to the Anoplura. Our analyses also provide evidence that: (i) each of the three suborders of lice that are well represented in our study (the Amblycera, Ischnocera, and Anoplura) are monophyletic; (ii) the Boopiidae is monophyletic; (iii) the genera Heterodoxus and Latumcephalum (Boopiidae) are more closely related to one another than either is to the genus Boopia (also Boopiidae); (iv) the Ricinidae and Laemobothridae may be sister-taxa; (v) the Philopteridae may be paraphyletic with respect to the Trichodectidae; (vi) the genera Pediculus and Pthirus are more closely related to each other than either is to the genus Pedicinus ; and (vii) in contrast to published data for mitochondrial genes, the rates of nucleotide substitution in the SSU rRNA of lice are not higher than those of other insects, nor do substitution rates in the suborders differ substantially from one another.

Efeito da adição de óleo essencial de pimenta rosa (Schinus terebinthifolius Raddi) microencapsulado em queijo minas frescal

A pimenta rosa é o fruto da aroeira (Schinus terebinthifolius Raddi), uma planta nativa do Brasil. A extração e caracterização do seu óleo essencial viabiliza a sua utilização industrial. Este trabalho teve como objetivo avaliar o efeito da adição de óleo essencial de pimenta rosa em queijo Minas Frescal . Foram identificados 95,36% dos constituintes do óleo essencial, sendo o δ-careno-3 o componente majoritário. O óleo essencial de pimenta rosa apresentou características antioxidante (2,53 ± 0,28 μmols de trolox por mL de óleo) e antimicrobiana para o desenvolvimento de Staphylococcus aureus. Foi observado, no teste de difusão em ágar, a formação do halo de inibição de 1,35 ± 0,32 cm, e na análise de concentração inibitória mínima, o valor de 3,13%. O óleo essencial é sensível à degradação no meio em que se encontra, portanto necessita de processos tecnológicos para assegurar sua ação. Para proteger o óleo essencial foi realizada a microencapsulação por meio da secagem por spray dryer. O óleo foi microencapsulado utilizando três formulações com diferentes concentrações de goma arábica, maltodextrina e amido modificado como papel de parede. As microcápsulas obtidas foram analisadas quanto às suas características físico-químicas e morfológicas e foi selecionada uma formulação para posterior adição ao queijo Minas Frescal. A formulação com 5% de amido modificado, 10% de maltodextrina e 5% de goma arábica foi selecionada. Para definição da concentração de óleo essencial que foi utilzada no queijo, foi realizado teste sensorial de ordenação-preferência, visto que a concentração inibitória mínima (3,13%) era muito alta para ser utilizada nos queijos. A formulação com 0,01% de óleo essencial foi a preferida e utilizada para fabricação dos queijos. Foram elaborados e caracterizados os queijos controle (CO) e o queijo com adição das microcápsulas de óleo essencial de pimenta rosa (OEPR). Em relação às características físico-químicas, os queijos CO e OEPR só apresentaram diferença significativa em relação à umidade (P= 0,0021; α=0,05). O queijo OEPR teve boa aceitação sensorial com média de aceitação global de 7,6 ± 0,97, não apresentando diferença significativa, ao nível de 95% de confiança, do queijo controle (7,6 ± 1,18). Para avaliar a capacidade do óleo essencial de pimenta rosa microencapsulado em inibir o desenvolvimento de S. aureus, foram inoculadas nos queijos CO e OEPR concentrações iniciais de 106 UFG.g. Os queijos foram armazenados em BOD à temperatura de 4 ± 1 °C até realização das análises, que ocorreram nos tempos: 0, 3, 6, 9, 12, 15 e 30 dias. Houve redução de 1,53 ciclos Log no queijo adicionado de óleo essencial de pimenta rosa. De acordo com os resultados obtidos, conclui-se que o óleo essencial de pimenta rosa é uma alternativa viável de utilização em queijo Minas Frescal , devido ao seu potencial antioxidante, antimicrobiano e à sua aceitação sensorial.

Avaliação da influência dos parâmetros de ensaio no índice de fluidez de termoplásticos

O presente trabalho teve como objectivos avaliar a influência de diversas grandezas e parâmetros de ensaio no índice de fluidez de termoplásticos e calcular a incerteza associada às determinações. Numa primeira fase, procedeu-se à identificação dos principais parâmetros que influenciam a determinação do índice de fluidez, tendo sido seleccionados a temperatura do plastómetro, o peso de carga, o diâmetro da fieira, o comprimento da medição, o tipo de corte e o número de provetes. Para avaliar a influência destes parâmetros na medição do índice de fluidez, optou-se pela realização de um planeamento de experiências, o qual foi dividido em três etapas. Para o tratamento dos resultados obtidos utilizou-se como ferramenta a análise de variância. Após a completa análise dos desenhos factoriais, verificou-se que os efeitos dos factores temperatura do plastómetro, peso de carga e diâmetro da fieira apresentam um importante significado estatístico na medição do índice de fluidez. Na segunda fase, procedeu-se ao cálculo da incerteza associada às medições. Para tal seleccionou-se um dos métodos mais usuais, referido no Guia para a Expressão da Incerteza da Medição, conhecido como método GUM, e pela utilização da abordagem “passo a passo”. Inicialmente, foi necessária a construção de um modelo matemático para a medição do índice de fluidez que relacionasse os diferentes parâmetros utilizados. Foi estudado o comportamento de cada um dos parâmetros através da utilização de duas funções, recorrendo-se novamente à análise de variância. Através da lei de propagação das incertezas foi possível determinar a incerteza padrão combinada,e após estimativa do número de graus de liberdade, foi possível determinar o valor do coeficiente de expansão. Finalmente determinou-se a incerteza expandida da medição, relativa à determinação do índice de fluidez em volume.

A efectividade da intervenção da fisioterapia nas disfunções crânio- cervico-mandibulares

Introdução: As teorias etiológicas recíprocas que relacionam as disfunções da articulação temporo mandibular (ATM) com as disfunções da coluna cervical, os seus critérios de diagnóstico e formas de tratamento, não reúnem consenso, constituindo, actualmente, uma temática de debate e investigação. Objectivo: Descrever a avaliação e intervenção em fisioterapia, e os seus resultados numa utente com disfunção do complexo crânio-cervico-mandibular. Métodos: Foi realizado um estudo observacional descritivo, do tipo estudo de caso, reportando-se a uma enfermeira, de 28 anos, com quadro sintomatológico compatível com disfunção crânio-cervico-mandibular, com antecedentes de condilectomia e artroplastia da ATM, aos 14 anos. Inicialmente a utente apresentava dor irradiada na região cervical (7/10) e limitação dos movimentos articulares da coluna cervical. Referia, também, dor na região do ptérion direito (6/10), limitação dos movimentos da mandíbula, desvio lateral na abertura da boca e dificuldades funcionais na mastigação. A avaliação inicial e final (após tratamento), foi efectuada recorrendo-se à utilização do Goniometro CROM e da Therabite Range of Motion Scale, para medição das amplitudes articulares da cervical e ATM, respectivamente; Estetoscópio, para avaliação dos sons articulares da ATM; Escala Visual Analógica para graduação da dor. A intervenção decorreu ao longo de 10 sessões, bissemanais. No tratamento, foram aplicadas técnicas sobre os trigers points da musculatura cervical e músculos da mastigação; Mobilização passiva da cervical e ATM; Manipulação dos segmentos vertebrais cervicais e torácicos; Streching e técnicas de energia muscular; Técnicas funcionais para a ATM; Técnicas miofasciais para a coluna cervical e ATM; Exercícios de controlo motor da coluna cervical. Resultados: No final do tratamento, as amplitudes dos movimentos cervicais estavam completas e sem dor (0/10), mantendo, sensibilidade dolorosa à palpação das espinhosas de C5-C6 (1/10). Relativamente à ATM, verifica-se a abolição da dor (0/10) e a ausência do desvio lateral da mandíbula na abertura da boca, bem como, o aumento das amplitudes de movimento na abertura da boca (33 para 36 mm), e no desvio lateral esquerdo (2 para 2,8 mm). Conclusão: os resultados sugerem que a intervenção, com recurso a técnicas de terapia manual, no caso em estudo, parecem surtir efeitos positivos no quadro sintomatológico e funcional da utente.

Economic burden of expected epidemiological changes in diseases related to tobacco, Mexico

OBJECTIVE: To determine health care costs and economic burden of epidemiological changes in diseases related to tobacco consumption. METHODS: A time-series analysis in Mexico (1994-2005) was carried out on seven health interventions: chronic obstructive pulmonary diseases, lung cancer with and without surgical intervention, asthma in smokers and non-smokers, full treatment course with nicotine gum, and full treatment course with nicotine patch. According with Box-Jenkins methodology, probabilistic models were developed to forecast the expected changes in the epidemiologic profile and the expected changes in health care services required for selected interventions. Health care costs were estimated following the instrumentation methods and validated with consensus technique. RESULTS: A comparison of the economic impact in 2006 vs. 2008 showed 20-90% increase in expected cases depending on the disease (p<0.05), and 25-93% increase in financial requirements (p<0.01). The study data suggest that changes in the demand for health services for patients with respiratory diseases related to tobacco consumption will continue showing an increasing trend. CONCLUSIONS: In economic terms, the growing number of cases expected during the study period indicates a process of internal competition and adds an element of intrinsic competition in the management of preventive and curative interventions. The study results support the assumption that if preventive programs remain unchanged, the increasing demands for curative health care may cause great financial and management challenges to the health care system of middle-income countries like Mexico.

Oral health, hygiene practices and oral cancer

OBJECTIVE: To assess the association between oral health and hygiene practices and oral cancer. METHODS: Hospital-based case-control study in the metropolitan area of São Paulo, southeastern Brazil, from 1998 to 2002. A total 309 patients with squamous cell carcinoma of the mouth and the pharynx and 468 controls matched by sex and age were included in the study. Cases were recruited in seven reference hospitals and controls were selected in five out of the seven participating hospitals. Detailed information on smoking, alcohol consumption, schooling, oral health status and hygiene practices were obtained through interviews. Odds ratios (OR) and 95% confidence intervals (95% CI), adjusted by sex, age, schooling, smoking, alcohol consumption as well as the variables oral health status and hygiene practices were estimated using unconditional logistic regression analyses. RESULTS: The use of complete dental prosthesis was not associated with oral cancer but regular gum bleeding showed a strong association (OR 3.1; 95% CI 1.2-7.9). Those who never attended a dental visit were more likely to have oral cancer (OR 2.5; 95% CI 1.3-4.8). Daily mouthwash use showed a stronger association to pharynx (OR 4.7; 95% CI 1.8-12.5) than mouth cancer (OR 3.2; 95% CI 1.6-6.3). CONCLUSIONS: Gum bleeding, no dental care, and daily mouthwash use were factors associated with oral cancer regardless of tobacco and alcohol consumption.

Transferência de calor em fluidos Não-Newtonianos

Foi realizado um estudo sobre o efeito do tipo de fluidos na transferência de calor. Pretende-se determinar a influência da concentração da solução de Goma de Xantano, do número de Reynolds, do número de Weissenberg, da temperatura e do tempo de escoamento no coeficiente de transferência de calor, jH. O estudo da transferência de calor foi feito num permutador de tubos duplos concêntricos. Já o estudo da reologia foi realizado num reómetro. Na caracterização reológica das soluções de XG, a viscosidade aumenta com a concentração das soluções, diminui para taxas de deformação crescentes e com o aumento da temperatura para ambas as soluções. Os dados mostram um aumento da intensidade da pseudoplasticidade com a concentração do polímero, sendo os valores representados pelo modelo de Sisco. A degradação da solução de 0,20% de goma de xantano a 25 ºC, com o escoamento, é muito acelerada. Os resultados dos ensaios apresentam uma diminuição da viscosidade de 9,4% a 22,9%, para tempos de escoamento de 12 a 47 horas, respectivamente. Num escoamento turbulento em conduta de secção circular constante os resultados mostram uma redução de arrasto total de 18 para 33%. Para a solução de 0,10 % de XG, verifica-se um aumento do calor transferido de 115% e de 130%, quando a temperatura aumenta de 25 ºC para 36 ºC, respectivamente. A água apresenta valores de calor transferido superiores, cerca de 170%, aos da solução de 0,1 %XG. O factor de correlação empírico de Colbourn (jH), utilizado neste trabalho apresenta valores de acordo com a relação de Cho and Hartnett (1985): jH<2/f. Quando o caudal do fluido quente aumenta verifica-se uma diminuição do factor jH. Em relação ao tempo de escoamento verifica-se uma diminuição de cerca de 70% do coeficiente de transferência de calor ao fim de 47 horas. Finalmente verificamos uma diminuição do factor de transferência de calor com o aumento da temperatura do fluido quente, para ambas as concentrações de goma de xantano. Para as soluções de 0,10 e 0,20% de XG essa diminuição variou entre 38 e 15% e entre 34 e 3%, respectivamente.

Preservation of catechin antioxidant properties loaded in carbohydrate nanoparticles

Epigallocatechin gallate (EGCG), an antioxidant with several pharmacological and biological activities, was encapsulated in carbohydrate particles to preserve its antioxidant properties and improve its bioavailability. Gum arabic–maltodextrin particles loaded with EGCG (EGCG/P) were successfully produced by homogenization and spray-drying, with an EGCG loading efficiency of 96 ± 3%. Spray-dried particles are spherical or corrugated and polydisperse with diameters less than 20 m. The particles in aqueous suspension revealed two main populations, with mean average diameters of 40 nm and 400 nm. Attenuated total reflection-infrared spectroscopy (ATR-IR) confirmed that EGCG was incorporated in the carbohydrate matrix by intermolecular interactions, maintaining its chemical integrity. Atomic force microscopy imaging proved the particle spherical shape and size. The present study demonstrates that the carbohydrate matrix is able to preserve EGCG antioxidant properties, as proof of concept to be used as polymeric drug carrier.

Friction losses of Newtonian and non-Newtonian fluids flowing in laminar regime in a helical coil

This study aimed to carry out experimental work to determine, for Newtonian and non-Newtonian fluids, the friction factor (fc) with simultaneous heat transfer, at constant wall temperature as boundary condition, in fully developed laminar flow inside a vertical helical coil. The Newtonian fluids studied were aqueous solutions of glycerol, 25%, 36%, 43%, 59% and 78% (w/w). The non-Newtonian fluids were aqueous solutions of carboxymethylcellulose (CMC), a polymer, with concentrations of 0.2%, 0.3%, 0.4% and 0.6% (w/w) and aqueous solutions of xanthan gum (XG), another polymer, with concentrations of 0.1% and 0.2% (w/w). According to the rheological study done, the polymer solutions had shear-thinning behavior and different values of viscoelasticity. The helical coil used has an internal diameter, curvature ratio, length and pitch, respectively: 0.00483 m, 0.0263, 5.0 m and 11.34 mm. It was concluded that the friction factors, with simultaneous heat transfer, for Newtonian fluids can be calculated using expressions from literature for isothermal flows. The friction factors for CMC and XG solutions are similar to those for Newtonian fluids when the Dean number, based in a generalized Reynolds number, is less than 80. For Dean numbers higher than 80, the friction factors of the CMC solutions are lower those of the XG solutions and of the Newtonian fluids. In this range the friction factors decrease with the increase of the viscometric component of the solution and increase for increasing elastic component. The change of behavior at Dean number 80, for Newtonian and non-Newtonian fluids, is in accordance with the study of Ali [4]. There is a change of behavior at Dean number 80, for Newtonian and non-Newtonian fluids, which is in according to previous studies. The data also showed that the use of the bulk temperature or of the film temperature to calculate the physical properties of the fluid has a residual effect in the friction factor values.

Heat transfer coefficients from Newtonian and non-Newtonian fluids flowing in laminar regime in a helical coil

This study aimed to carry out experimental work to obtain, for Newtonian and non-Newtonian fluids, heat transfer coefficients, at constant wall temperature as boundary condition, in fully developed laminar flow inside a helical coil. The Newtonian fluids studied were aqueous solutions of glycerol, 25%, 36%, 43%, 59% and 78% (w/w) and the non-Newtonian fluids aqueous solutions of carboxymethylcellulose (CMC), a polymer, with concentrations 0.1%, 0.2%, 0.3%, 0.4% and 0.6% (w/w) and aqueous solutions of xanthan gum (XG), another polymer, with concentrations 0.1% and 0.2% (w/w). According to the rheological study performed, the polymer solutions had shear thinning behavior and different values of elasticity. The helical coil used has internal diameter, curvature ratio, length and pitch, respectively: 0.004575 m, 0.0263, 5.0 m and 11.34 mm. The Nusselt numbers for the CMC solutions are, on average, slightly higher than those for Newtonian fluids, for identical Prandtl and generalized Dean numbers. As outcome, the viscous component of the shear thinning polymer tends to potentiate the mixing effect of the Dean cells. The Nusselt numbers of the XG solutions are significant lower than those of the Newtonian solutions, for identical Prandtl and generalized Dean numbers. Therefore, the elastic component of the polymer tends to diminish the mixing effect of the Dean cells. A global correlation, for Nusselt number as a function of Péclet, generalized Dean and Weissenberg numbers for all Newtonian and non-Newtonian solutions studied, is presented.

Evaluation of the influence of testing parameters on the melt flow index of thermoplastics

The main goals of the present work are the evaluation of the influence of several variables and test parameters on the melt flow index (MFI) of thermoplastics, and the determination of the uncertainty associated with the measurements. To evaluate the influence of test parameters on the measurement of MFI the design of experiments (DOE) approach has been used. The uncertainty has been calculated using a "bottom-up" approach given in the "Guide to the Expression of the Uncertainty of Measurement" (GUM). Since an analytical expression relating the output response (MFI) with input parameters does not exist, it has been necessary to build mathematical models by adjusting the experimental observations of the response variable in accordance with each input parameter. Subsequently, the determination of the uncertainty associated with the measurement of MFI has been performed by applying the law of propagation of uncertainty to the values of uncertainty of the input parameters. Finally, the activation energy (Ea) of the melt flow at around 200 degrees C and the respective uncertainty have also been determined.

Dengue type 2 outbreak in the south of the State of Bahia, Brazil: laboratorial and epidemiological studies

During March 1994 cases of a exanthematic acute disease were reported in the municipalities of Itagemirim, Eunápolis and Belmonte, state of Bahia. Dengue fever was confirmed by serology (MAC-ELISA) and by dengue virus type 2 isolation, genotype Jamaica. Signs and symptoms of classic dengue fever were observed with a high percentual of rash (73.8%) and pruritus (50.5%). Major haemorrhagic manifestations were unfrequent and only bleeding gum was reported. Dengue virus activity spreaded rapidly to important tourism counties like Porto Seguro, Ilhéus, Santa Cruz de Cabrália, Prado, Alcobaça and others, representing a risk for the spreading of dengue virus into the country and abroad.