Emergence agitation in pediatric anesthesia: current features

Objective: Postoperative agitation in children is a well-documented clinical phenomenon with incidence ranging from 10% to 67%. There is no definitive explanation for this agitation. Possible causes include rapid awakening in unfamiliar settings, pain (wounds, sore throat, bladder distension, etc.), stress during induction, hypoxemia, airway obstruction, noisy environment, anesthesia duration, child's personality, premedication and type of anesthesia. The purpose of this paper is to discuss the possible causes of postoperative agitation in children, providing a foundation for better methods of identifying and preventing this problem.Sources: MEDLINE and PubMed were searched using the following words: emergence, agitation, incidence, etiology, diagnosis, treatment, children, pediatric, anesthesia.Summary of the findings: This study includes a review of potential agitation trigger factors and a proposal for a standardized diagnostic score system, in addition to measures to improve prevention and treatment.Conclusion: No single factor can identified as the cause of postoperative agitation, which should therefore be considered a syndrome made up of biological, pharmacological, psychological and social components, and which anesthesiologists and pediatric intensive care specialists should be prepared to identify, prevent and intervene appropriately as necessary.

International Recommendations for Training Future Toxicologic Pathologists Participating in Regulatory-Type, Nonclinical Toxicity Studies

The International Federation of Societies of Toxicologic Pathologists (IFSTP) proposes a common global framework for training future toxicologic pathologists who will support regulatory-type nonclinical toxicology studies. Trainees optimally should undertake a scientific curriculum of at least 5 years at an accredited institution leading to a clinical degree (veterinary medicine or medicine). Trainees should then obtain 4 or more years of intensive pathology practice during a residency and/or on-the-job "apprenticeship," at least 2 years of which must be focused on regulatory-type toxicologic pathology topics. Possession of a recognized pathology qualification (i.e., certification) is highly recommended. A non-clinical pathway (e.g., a graduate degree in medical biology or pathology) may be possible if medically trained pathologists are scarce, but this option is not optimal. Regular, lifelong continuing education (peer review of nonclinical studies, professional meetings, reading, short courses) will be necessary to maintain and enhance one's understanding of current toxicologic pathology knowledge, skills, and tools. This framework should provide a rigorous yet flexible way to reliably train future toxicologic pathologists to generate, interpret, integrate, and communicate data in regulatory-type, nonclinical toxicology studies. (J Toxicol Pathol 2010; 23: 171-181)

Relationship Between the Prevalence of the Dentigerous Cyst and the Odontogenic Keratocyst Tumor and the Current Etiologic Hypothesis

Cysts are considered as nonneoplastic benign lesions that, when present for a long period of time, can cause some discomfort, especially related to the treatment form. Among the types of cysts of the maxilla, the dentigerous cyst (DC) presents substances between the dental follicle and the crown of the tooth with high potential for resorption, and the odontogenic keratocyst tumor (OKT) characterizes for its noticed rapid growth pattern and the possibility to develop carcinomas in the lesion wall. The DC is the most common type among the developing odontogenic cystic lesions, while the OKT represents 10% of these lesions. The prevalence of the OKT found in the current study was superior to the DC, opposing data of the evaluated literature, as well as the predominance in relation to the age group. Dentigerous cyst cases were found mostly in younger individuals, whereas the OKT was observed mainly in individuals between the third and fourth decades of life. This fact reflects the fragility of these features while establishing the presumptive diagnosis and insinuates the strong relation with a probable genetic predisposition. In relation to sex and race, the findings in this article were similar to those found in the literature, highlighting the possibility of a hormonal involvement. However, the anatomopathologic examination remains essential to define the main diagnosis of the lesions observed by means of imaging examinations, providing for safer diagnoses to plan the treatment.

Influence of Implant Connection Type on the Biomechanical Environment of Immediately Placed Implants - CT-Based Nonlinear, Three-Dimensional Finite Element Analysis

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

Investigation of the Effects of a1-Adrenoceptor Antagonism and L-Type Calcium Channel Blockade on Ejaculation and Vas Deferens and Seminal Vesicle Contractility In Vitro

Introduction. Premature ejaculation is one of the most common male sexual dysfunctions. Current pharmacological treatments involve reduction in penile sensitivity by local anesthetics or increase of ejaculatory threshold by selective serotonin reuptake inhibitors. a1-Adrenoceptors (a1-ARs) and L-type calcium channels are expressed in the smooth muscles of the male reproductive tract, and their activations play an important role in the physiological events involved in the seminal emission phase of ejaculation.Aim. To evaluate if the inhibition of the contractility of the vas deferens and seminal vesicle by alpha(1)-AR antagonism or the L-type calcium channel blockade can delay ejaculation.Methods. The effects of the alpha(1)-AR antagonist tamsulosin and of the L-type calcium channel blockers, nifedipine and (S)-(+)-niguldipine, on contractions induced by norepinephrine in the rat vas deferens and seminal vesicles in vitro and on the ejaculation latency of male rats in behavioral mating tests were evaluated.Main Outcome Measure. Tension development of vas deferens and seminal vesicles in response to norepinephrine in vitro and behavioral mating parameters were quantified.Results. Tension development of vas deferens and seminal vesicle to alpha(1)-AR activation was significantly inhibited by tamsulosin, nifedipine, and (S)-(+)-niguldipine. Tamsulosin displayed insurmountable antagonism of contractions induced by norepinephrine in the rat vas deferens and seminal vesicle. Ejaculation latency of male rats was not modified by tamsulosin, nifedipine, or (S)-(+)-niguldipine; however, both the number and weight of the seminal plugs recovered from female rats mated with male rats treated with tamsulosin were significantly reduced.Conclusion. Seminal emission impairment by inhibition of vas deferens or seminal vesicle contractility by L-type calcium channel blockade or alpha(1)-AR antagonism is not able to delay the ejaculation. de Almeida Kiguti LR and Pupo AS. Investigation of the effects of alpha(1)-adrenoceptor antagonism and L-type calcium channel blockade on ejaculation and vas deferens and seminal vesicle contractility in vitro. J Sex Med 2012; 9: 159-168.

Interface Formation and Electrical Transport in SnO2:Eu3+/GaAs Heterojunction Deposited by Sol-Gel Dip-Coating and Resistive Evaporation

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

On the V-type asteroids outside the Vesta family - II. Is (21238) 1995 WV7 a fragment of the long-lost basaltic crust of (15) Eunomia?

Context. The V-type asteroids are associated with basaltic composition. Apart from ( 1459) Magnya, an asteroid that is clearly dynamically and mineralogically unconnected to the Vesta family, all currently known V-type asteroids are either members of the Vesta family, or are hypothesized to be former members of the dynamical family that migrated to their current orbital positions. The recent identification of ( 21238) 1995 WV7 as a V-type asteroid introduces the possibility that a second basaltic asteroid not connected with the Vesta family exists. This asteroid is on the opposite side of the 3: 1 mean motion resonance with respect to Vesta, and it would be very unlikely that a member of the Vesta family of its size (D > 5km) migrating via either the Yarkovsky effect or repeated close encounters with Vesta survived the passage through such a resonance.Aims. In this work we investigate the possibility that ( 21238) 1995 WV7 originated as a fragment of the parent body of the Eunomia family and then migrated via the interplay of the Yarkovsky effect and some powerful nonlinear secular resonances, such as the (s - s(6)) - ( g(5) - g(6)). If (15) Eunomia is, as claimed, a differentiated object whose originally pyroxene-enriched crust layer was lost in a collision that either created the Eunomia family or preceded its formation, can (21238) be a fragment of its long-lost basaltic crust that migrated to the current position?Methods. We mapped the phase space around (21238) and determined which of the nonlinear secular resonances that we identified are stronger and more capable of having caused the current difference in proper i between (21238) and members of the Eunomia family. We simulated the Yarkovsky effect by using the SWIFT-RMVSY integrator.Results. Our results suggest that it is possible to migrate from the Eunomia dynamical family to the current orbital location of ( 21238) via the interplay of the Yarkovsky effect and the (s - s6) - (g5 - g6) nonlinear secular resonance, on time-scales of at least 2.6 Gyr.Conclusions. (15) Eunomia might be the third currently known parent body for V-type asteroids.

Multi-functional properties of CaCu3Ti4O12 thin films

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

Interface entre história da matemática e ensino: uma atividade desenvolvida com base num documento do século XVI

Este artigo propõe a construção de uma interface entre história e ensino de matemática a partir de um diálogo entre historiadores e educadores da matemática. Para tanto, consideramos aspectos epistemológicos e metodológicos ligados à história da matemática, pautada em tendências historiográficas atuais, juntamente com a metodologia baseada no movimento lógico-histórico. A interface contemplou o movimento do pensamento na formação dos conceitos e o contexto no qual tais conceitos foram desenvolvidos, de modo a conduzir à reflexão sobre o processo histórico da construção do conhecimento para a elaboração de atividade didática. Esta atividade teve por base um documento do século XVI dedicado à construção e uso de instrumentos matemáticos, e sua elaboração levou em consideração uma intencionalidade e um plano de ação que viabilizaram o seu desenvolvimento. A organização do ensino articulou as conexões internas e externas trazidas pela análise do documento e a forma do pensamento do desenvolvimento do conceito.

Education for type 2 diabetes mellitus self-care: from compliance to empowerment

Em revisão crítica da literatura sobre a educação para o autocuidado e autocontrole no diabetes, procura-se apontar a inadequação das abordagens tradicionais da aderência ao tratamento e da transmissão de informações frente à complexidade do autocuidado em condições de cronicidade. Explora-se a influência das Ciências Sociais sobre o campo de estudo das doenças crônico-degenerativas, em geral, e do diabetes, em particular. Nesta perspectiva, pode-se reconhecer uma incorporação dos campos disciplinares da Antropologia e Sociologia em pesquisas mais orientadas para o indivíduo, em sua condição de portador, e a experiência que desenvolve nesse processo. Há certa inflexão, mais recente, no campo de pesquisas em educação em saúde no diabetes, com a introdução de estratégias que buscam valorizar a experiência e a autonomia dos pacientes como sujeitos de seu cuidado. Neste artigo, discute-se a estratégia do empoderamento na educação para o autocuidado e autocontrole no diabetes, como uma modalidade de prática de natureza mais dialógica e de maior respeito à autonomia moral e cognitiva do portador.

Surface effects on vortex dynamics in thin type-II superconducting stripes with random pinning

We analyze the dynamics of a driven vortex lattice moving in a thin Superconducting stripe. The two dimensional stripe is assumed to be finite in the longitudinal direction, where we take into account the Surface effects, and infinite in the transversal direction. The numerical simulations are performed using the Langevin dynamics, including the vortex-vortex interaction, interaction of vortices with the surface current, vortex images, transport current and randomly distributed pinning centers. We show results for the differential resistivity and the vortex trajectories as a function of the external force. (C) 2004 Elsevier B.V. All rights reserved.

Thickness dependence of leakage current in BaBi2Ta2O9 thin films

BaBi2Ta2O9 thin films having a layered structure were fabricated by metalorganic solution deposition technique. The films exhibited good structural, dielectric, and insulating properties. The room temperature resistivity was found to be in the range of 10(12)-10(14) Omega cm up to 4 V corresponding to a field of 200 kV/cm across the capacitor for films annealed in the temperature range of 500-700 degrees C. The current-voltage (I-V) characteristics as a function of thickness for films annealed at 700 degrees C for 1 h, indicated bulk limited conduction and the log(I) vs V-1/2 characteristics suggested a space-charge-limited conduction mechanism. The capacitance-voltage measurements on films in a metal-insulator-semiconductor configuration indicated good Si/BaBi2Ta2O9 interface characteristics and a SiO2 thickness of similar to 5 nm was measured and calculated. (C) 1999 American Institute of Physics. [S0003-6951(99)00830-X].

THEORY OF NON-STEADY-STATE ELECTRICAL CHARACTERISTICS OF METAL-INSULATOR-METAL STRUCTURES WITH SCHOTTKY BARRIERS AND UNIFORMLY DISTRIBUTED INTERFACE IMPURITY STATES

The metal-insulator (or amorphous semiconductor) blocking contact is still not well understood. In the present paper, we discuss the non steady state characteristics of Metal-lnsulator-Metal Structure with non-intimate blocking contacts (i.e. Metal-Oxide-Insulator-Metal Structure). We consider a uniform distribution (in energy) of impurity states in addition to impurity states at a single energy level within the depletion region. We discuss thermal as well as isothermal characteristics and present expressions for the temperature of maximum current (T-m) and a method to calculate the density of uniformly distributed impurity states. The variation of mobility with electrical field has also been considered. Finally we plot the theoretical curves under different conditions. The present results are closing into available experimental results.

Performance evaluation of a novel hybrid multipulse rectifier for utility interface of power electronic converters

This paper presents an improved analysis of a novel Programmable Power-factor-corrected-Based Hybrid Multipulse Power Rectifier (PFC-HMPR) for utility interface of power electronic converters. The proposed hybrid multipulse rectifier is composed of an ordinary three-phase six-pulse diode-bridge rectifier (Graetz bridge) with a parallel connection of single-phase switched converters in each three-phase rectifier leg. In this paper, the authors present a complete discussion about the controlled rectifiers' power contribution and also a complete analysis concerning the total harmonic distortion of current that can be achieved when the proposed converter operates as a conventional 12-pulse rectifier. The mathematical analysis presented in this paper corroborate, with detailed equations, the experimental results of two 6-kW prototypes implemented in a laboratory.

International recommendations for training future toxicologic pathologists participating in regulatory-type, nonclinical toxicity studies

The International Federation of Societies of Toxicologic Pathologists (IFSTP) proposes a common global framework for training future toxicologic pathologists who will support regulatory-type - nonclinical toxicology studies. Trainees optimally should undertake a scientific curriculum of at least 5 years at an accredited institution leading to a clinical degree (veterinary medicine or medicine). Trainees should then obtain 4 or more years of intensive pathology practice during a residency and/or on-the-job "apprenticeship," at least 2 years of which must be focused on regulatory-type toxicologic pathology topics. Possession of a recognized pathology qualification (i.e., certification) is highly recommended. A nonclinical pathway (e.g., a graduate degree in medical biology or pathology) may be possible if medically trained pathologists are scarce, but this option is not optimal. Regular, lifelong continuing education (peer review of nonclinical studies, professional meetings, reading, short courses) will be necessary to maintain and enhance one's understanding of current toxicologic pathology knowledge, skills, and tools. This framework should provide a rigorous yet flexible way to reliably train future toxicologic pathologists to generate, interpret, integrate, and communicate data in regulatory-type, nonclinical toxicology studies. (C) 2010 Reprinted by Permission of SAGE Publications Inc. Published by Elsevier GmbH. All rights reserved.