981 resultados para Intussusception, Recurrence Rate, Pathologic Lead Point, OperativeReduction, Barium Enema Reduction
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Simultaneous measurement of the effects of low soy protein concentration, pH and high pressure treatment at room temperature on solubility, emulsifying properties and rheological properties (loss modulus, G '') of soy protein isolate (SPI) were evaluated. Central composite rotatable designs (2(3)) were employed over two pH ranges (2.66-4.34 and 5.16-6.84) with SPI concentration (0.32-3.68%) and pressure (198-702 MPa) as the other independent variables. The surface responses were obtained for protein solubility, emulsifying activity index (EAI) and G ''. The samples with the highest effect on protein solubility, EAI and G '' values were evaluated, as well, by electrophoresis and free sulphydryl determination. The pH was the main factor that affected protein solubility, with solubility at a maximum at pH < 3 or pH > 6. Increasing SPI concentration and decreasing/increasing the pH away from the isoelectric point both caused a reduction in EAI. Loss modulus (G '') was found to increase with SPI concentration in both pH ranges. (c) 2006 Elsevier Ltd. All rights reserved.
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This dissertation proposes a bivariate markov switching dynamic conditional correlation model for estimating the optimal hedge ratio between spot and futures contracts. It considers the cointegration between series and allows to capture the leverage efect in return equation. The model is applied using daily data of future and spot prices of Bovespa Index and R$/US$ exchange rate. The results in terms of variance reduction and utility show that the bivariate markov switching model outperforms the strategies based ordinary least squares and error correction models.
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P>A case of a type I rectal atresia (also known as membranous rectal atresia) in a newborn donkey is reported. Clinical examination, survey radiographs and barium enema radiographs suggested rectal atresia. An exploratory laparotomy was performed; however, surgical correction of the defect was not possible due to the narrow pelvic cavity. Euthanasia was performed. At necropsy, it was possible to observe a fibrous cord connecting the small colon to a residual rectal ampulla, which opened to a normal anus. The radiographic and anatomical characteristics enabled the classification of the defect as type I rectal atresia, which is a rare congenital anomaly that is difficult to correct through surgery. This report contributes to the study of rectal atresia in newborn equids, alerts for the occurrence in donkeys and is, to our knowledge, the first to be reported in this species in Brazil.
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OBJETIVO: Verificar, retrospectivamente, a prevalência do refluxo cecoileal diagnosticado pelo enema opaco, caracterizar sua distribuição etária e sexual e classificá-lo conforme o grau de intensidade. MATERIAIS E MÉTODOS: Foram revistos 715 enemas opacos, incluindo 268 homens e 447 mulheres com idade média de 54 anos. RESULTADOS: Dos 715 casos examinados, 46,5% apresentaram refluxo cecoileal, sendo 45% do tipo leve, 37,5% do tipo moderado e 17,5% do tipo severo. Refluxo cecoileal esteve presente em 48,3% das mulheres e em 43,6% dos homens. A distribuição percentual do refluxo cecoileal por faixa etária mostrou 46,1% nos indivíduos com menos de 21 anos, 42,1% nos indivíduos entre 21-40 anos, 49,8% nos indivíduos entre 41-60 anos e 44,7% nos indivíduos com mais de 60 anos. CONCLUSÃO: Refluxo cecoileal foi achado relativamente freqüente em nosso material, correspondendo os graus moderado e severo a 25% do material examinado. Aparentemente, não há associação entre seu surgimento e sexo ou idade. A etiopatogenia e conseqüências do refluxo cecoileal são ainda pouco conhecidas. Alguns estudos sugerem que o comprometimento de componentes da junção ileocecal, como os ligamentos, pode favorecer seu aparecimento. Entre as conseqüências prováveis, incluem-se a contaminação e alteração motora ileais, resultantes do material refluído do ceco.
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Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)
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RACIONAL: Fato de observação não rara, é o encontro de refluxo cecoileal durante realização de enema opaco. As causas e conseqüências deste achado têm sido pouco estudadas. OBJETIVOS: Sabendo que a junção ileocecal exerce função de barreira e proteção contra a invasão do delgado pela flora colônica, realizou-se o presente estudo com a finalidade de investigar se existe contaminação ileal em indivíduos com refluxo cecoileal ao enema opaco. MÉTODOS: Investigaram-se 36 indivíduos, 30 mulheres e 6 homens, idade média de 54 anos, 25 com e 11 com ausência refluxo cecoileal. Todos submetidos a pesquisa de contaminação bacteriana do delgado por intermédio de teste respiratório com lactulose-H2 e a determinação do tempo de trânsito orocecal por meio de biossusceptometria de corrente alternada. A caracterização da contaminação do delgado foi baseada no encurtamento do tempo de trânsito orocecal medido pelo teste da lactulose-H2. RESULTADOS: A comparação dos valores basais do H2, do tempo de trânsito orocecal-H2 e tempo de trânsito orocecal-biossusceptometria de corrente alternada não diferiram estatisticamente entre os grupos com e sem refluxo cecoileal. Quando comparados os tempo de trânsito orocecal-H2 e tempo de trânsito orocecal-biossusceptometria, foi observado aumento de tendência de redução do primeiro em relação ao último nos grupos com refluxo cecoileal e correlação significante entre os dois métodos apenas no grupo-controle, inexistindo nos com refluxo cecoileal. CONCLUSÃO: Encurtamento do tempo de trânsito orocecal-H2 e sua perda de correlação com o tempo de trânsito orocecal-biossusceptometria observado em indivíduos com refluxo cecoileal, sugerem comportamento diferenciado deste grupo em relação ao grupo-controle. Possível explicação para as diferenças registradas entre os grupos, seria a presença de flora anômala nos indivíduos com refluxo cecoileal.
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Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)
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This paper provides a contribution to the contingency analysis of electric power systems under steady state conditions. An alternative methodology is presented for static contingency analyses that only use continuation methods and thus provides an accurate determination of the loading margin. Rather than starting from the base case operating point, the proposed continuation power flow obtains the post-contingency loading margins starting from the maximum loading and using a bus voltage magnitude as a parameter. The branch selected for the contingency evaluation is parameterised using a scaling factor, which allows its gradual removal and assures the continuation power flow convergence for the cases where the method would diverge for the complete transmission line or transformer removal. The applicability and effectiveness of the proposed methodology have been investigated on IEEE test systems (14, 57 and 118 buses) and compared with the continuation power flow, which obtains the post-contingency loading margin starting from the base case solution. In general, for most of the analysed contingencies, few iterations are necessary to determine the post-contingency maximum loading point. Thus, a significant reduction in the global number of iterations is achieved. Therefore, the proposed methodology can be used as an alternative technique to verify and even to obtain the list of critical contingencies supplied by the electric power systems security analysis function. © 2013 Elsevier Ltd. All rights reserved.
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Pós-graduação em Medicina Veterinária - FCAV
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Corynebacterium pseudotuberculosis é uma bactéria Gram-positiva, intracelular facultativa, nãoesporulante, não-capsulada e sem mobilidade, contudo possui fímbria, e pode assumir formas cocóides e filamentosas (pleomórfica), além disto, apresenta crescimento ótimo à 37°C. Este patógeno apresenta dois biovares: ovis que geralmente acomete pequenos ruminantes, e causa a doença linfadenite caseosa, e biovar equi, mais comum em equinos, bovinos, camelídeos, e bubalinos causando a Linfangite ulcerativa. A infecção por esta bactéria pode levar a condenação das carcaças e redução de lã (em ovinos e caprinos), leite e carne destes animais, e consequentemente a perdas econômicas para a indústria agropecuária mundial. Atualmente, ainda não existe uma vacina eficaz para estas doenças. A fim de obter um maior entendimento biológico entre as espécies o presente trabalho tem como objetivo principal analisar, por meio da genômica comparativa a linhagem C. pseudotuberculosis 226 biotipo ovis isolada de um caprino na Califórnia com outras linhagens do biovarar ovis e equi. Na análise de sintenia entre as linhagens foi possível identificar que a linhagem 226 apresenta alta conservação da ordem gênica entre as linhagens do biótipo ovis. Através de análises filogenômicas foi possível identificar que as linhagens I19 e 267 apresentaram maior e menor proximidade filogenética com a linhagem 226. A linhagem 1/06-A foi a que apresentou maior proximidade filogenômica entre as linhagens do biovar equi, quando comparadas a linhagem 226. Foram preditas 8 ilhas de patogenicidade, estando presente na ilha 1 os genes relacionados a virulência de C. pseudotuberculosis mais bem descritos na literatura. Não houveram regiões novas relacionadas a genes de virulência entre nenhuma das linhagens. Foram identificados 248 genes ortólogos entre as linhagens I19, 267 e 226 e 282 genes ortólogos entre as linhagens 258,1/06-A e 226. Com base nesse estudo é possível inferir que as linhagens do biovar ovis possuem um repertório gênico pouco variado e que as linhagens do biovar equi apresentam uma quantidade menor de genes compartilhados com a linhagem 226, corroborando com a diversidade gênica entre os biovares.
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BACKGROUND: Neonates in a neonatal intensive care unit are exposed to a high number of painful procedures. Since repeated and sustained pain can have consequences for the neurological and behaviour-oriented development of the newborn, the greatest attention needs to be paid to systematic pain management in neonatology. Non-pharmacological treatment methods are being increasingly discussed with regard to pain prevention and relief either alone or in combination with pharmacological treatment. AIMS: To identify effective non-pharmacological interventions with regard to procedural pain in neonates. METHODS: A literature search was conducted via the MedLine, CINAHL, Cochrane Library databases and complemented by a handsearch. The literature search covered the period from 1984 to 2004. Data were extracted according to pre-defined criteria by two independent reviewers and methodological quality was assessed. RESULTS: 13 randomised controlled studies and two meta-analyses were taken into consideration with regard to the question of current nursing practice of non-pharmacological pain management methods. The selected interventions were "non-nutritive sucking", "music", "swaddling", "positioning", "olfactory and multisensorial stimulation", "kangaroo care" and "maternal touch". There is evidence that the methods of "non-nutritive sucking", "swaddling" and "facilitated tucking" do have a pain-alleviating effect on neonates. CONCLUSIONS: Some of the non-pharmacological interventions have an evident favourable effect on pulse rate, respiration and oxygen saturation, on the reduction of motor activity, and on the excitation states after invasive measures. However, unambiguous evidence of this still remains to be presented. Further research should emphasise the use of validated pain assessment instruments for the evaluation of the pain-alleviating effect of non-pharmacological interventions.
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Spinal cord injury (SCI) leads to severe bone loss in the paralysed limbs and to a resulting increased fracture risk thereof. Since long bone fractures can lead to comorbidities and a reduction in quality of life, it is important to improve bone strength in people with chronic SCI. In this prospective longitudinal cohort study, we investigated whether functional electrical stimulation (FES) induced high-volume cycle training can partially reverse the loss of bone substance in the legs after chronic complete SCI. Eleven participants with motor-sensory complete SCI (mean age 41.9+/-7.5 years; 11.0+/-7.1 years post injury) were recruited. After an initial phase of 14+/-7 weeks of FES muscle conditioning, participants performed on average 3.7+/-0.6 FES-cycling sessions per week, of 58+/-5 min each, over 12 months at each individual's highest power output. Bone and muscle parameters were investigated in the legs by means of peripheral quantitative computed tomography before the muscle conditioning (t1), and after six (t2) and 12 months (t3) of high-volume FES-cycle training. After 12 months of FES-cycling, trabecular and total bone mineral density (BMD) as well as total cross-sectional area in the distal femoral epiphysis increased significantly by 14.4+/-21.1%, 7.0+/-10.8% and 1.2+/-1.5%, respectively. Bone parameters in the femoral shaft showed small but significant decreases, with a reduction of 0.4+/-0.4% in cortical BMD, 1.8+/-3.0% in bone mineral content, and 1.5+/-2.1% in cortical thickness. These decreases mainly occurred between t1 and t2. No significant changes were found in any of the measured bone parameters in the tibia. Muscle CSA at the thigh increased significantly by 35.5+/-18.3%, while fat CSA at the shank decreased by 16.7+/-12.3%. Our results indicate that high-volume FES-cycle training leads to site-specific skeletal changes in the paralysed limbs, with an increase in bone parameters at the actively loaded distal femur but not the passively loaded tibia. Thus, we conclude that high-volume FES-induced cycle training has clinical relevance as it can partially reverse bone loss and thus may reduce fracture risk at this fracture prone site.
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Refixation of a trochanteric osteotomy carries a high complication rate. To enhance stability and facilitate anatomic reduction of the trochanteric fragment, we have introduced a stepped osteotomy. Between April 2006 and June 2007, we performed surgical hip dislocations using the modified trochanteric osteotomy combined with a relatively aggressive rehabilitation program. Full weightbearing was allowed at a mean of 42 days (range, 33-54 days). The minimum followup was 8 months (median, 13 months; range, 8-24 months). Postoperative radiographs were assessed prospectively for consolidation or the appearance of malreduction/nonunion/malunion of the osteotomy and heterotopic ossification. In 110 of 113 hips, the trochanteric osteotomy healed in the anatomic position. Two patients had a trochanteric delayed union with loss of anatomic position, and one additional patient underwent revision surgery for a pseudarthrosis and cranial migration of the trochanteric fragment. All three complications related to healing occurred in the first 60 patients when the step height was 3 to 4 mm. After increasing the step heights to 6 mm, we observed no healing complications. Despite more aggressive postoperative mobilization, the incidence of malunion or nonunion related to the new stepped osteotomy is low and approaches zero for steps of 6 mm. It is now our technique of choice.
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Previous studies have highlighted the severity of detrimental effects for life on earth after an assumed regionally limited nuclear war. These effects are caused by climatic, chemical and radiative changes persisting for up to one decade. However, so far only a very limited number of climate model simulations have been performed, giving rise to the question how realistic previous computations have been. This study uses the coupled chemistry climate model (CCM) SOCOL, which belongs to a different family of CCMs than previously used, to investigate the consequences of such a hypothetical nuclear conflict. In accordance with previous studies, the present work assumes a scenario of a nuclear conflict between India and Pakistan, each applying 50 warheads with an individual blasting power of 15 kt ("Hiroshima size") against the major population centers, resulting in the emission of tiny soot particles, which are generated in the firestorms expected in the aftermath of the detonations. Substantial uncertainties related to the calculation of likely soot emissions, particularly concerning assumptions of target fuel loading and targeting of weapons, have been addressed by simulating several scenarios, with soot emissions ranging from 1 to 12 Tg. Their high absorptivity with respect to solar radiation leads to a rapid self-lofting of the soot particles into the strato- and mesosphere within a few days after emission, where they remain for several years. Consequently, the model suggests earth's surface temperatures to drop by several degrees Celsius due to the shielding of solar irradiance by the soot, indicating a major global cooling. In addition, there is a substantial reduction of precipitation lasting 5 to 10 yr after the conflict, depending on the magnitude of the initial soot release. Extreme cold spells associated with an increase in sea ice formation are found during Northern Hemisphere winter, which expose the continental land masses of North America and Eurasia to a cooling of several degrees. In the stratosphere, the strong heating leads to an acceleration of catalytic ozone loss and, consequently, to enhancements of UV radiation at the ground. In contrast to surface temperature and precipitation changes, which show a linear dependence to the soot burden, there is a saturation effect with respect to stratospheric ozone chemistry. Soot emissions of 5 Tg lead to an ozone column reduction of almost 50% in northern high latitudes, while emitting 12 Tg only increases ozone loss by a further 10%. In summary, this study, though using a different chemistry climate model, corroborates the previous investigations with respect to the atmospheric impacts. In addition to these persistent effects, the present study draws attention to episodically cold phases, which would likely add to the severity of human harm worldwide. The best insurance against such a catastrophic development would be the delegitimization of nuclear weapons.