Usage analysis of the Nursing Activities Score in two Spanish ICUS

The aim of this study was to analyze the discourse of health managers on aspects related to delay in tuberculosis diagnosis. This was a qualitative research study, conducted with 16 Family Health Unit managers. The empirical data were obtained through semi-structured interviews. The analysis was based on the theoretical framework of the French school of discourse analysis. According to the managers’ statements, the delay in tuberculosis diagnosis is related to patient and health service aspects. As for patient aspects, managers report fear, prejudice and lack of information as factors that may promote a delayed diagnosis. Regarding health service aspects, structural problems and lack of professional skills were reported. The discourse of managers should be considered to qualify tuberculosis control actions and to prevent delays in diagnosis.

Thrombose veineuse cérébrale après ponction lombaire et stéroïdes intraveineux chez deux patients souffrant d'une sclérose en plaques [Cerebral venous thrombosis after lumbar puncture and intravenous steroids in two patients with multiple sclerosis]

Two patients affected with a multiple sclerosis developed cerebral venous thrombosis after lumbar puncture and treatment with intravenous methylprednisolone. In one case, the course was favorable. The second patient died in spite of intracerebral thrombolysis. The autopsy confirmed the diagnosis of cerebral venous thrombosis and multiple sclerosis. We discuss the relationship between lumbar puncture, steroid treatment and cerebral venous thrombosis.

The flower-visiting social wasps (Hymenoptera, Vespidae, Polistinae) in two areas of Rio Grande do Sul State, southern Brazil

The flower-visiting social wasps (Hymenoptera, Vespidae, Polistinae) in two areas of Rio Grande do Sul State, southern Brazil. The structure of flower-visiting social wasps' assemblages in the CPCN Pró-Mata of São Francisco de Paula and in the Green Belt of Santa Cruz do Sul, Rio Grande do Sul, are characterized. A total of 879 polistine wasps were collected, of which 475 (11 spp.) in the CPCN and 404 (21 spp.) in the Green Belt, from September 1997 to April 2001 and from September 2001 to April 2004, respectively. Foraging social wasps were observed on flowers of 36 species of angiosperms (20 families) in the Green Belt, and on flowers of 54 species of angiosperms (21 families) in the CPCN. Asteraceae was the most visited plant family on both studied localities. A list of pant species visited by the polistines is provided.

Local distribution of blackfly (Diptera, Simuliidae) larvae in two adjacent streams: the role of water current velocity in the diversity of blackfly larvae

This study aimed to evaluate the influence of water velocity speed on the local distribution and taxocenosis structure of blackfly larvae. The larvae were collected from two adjacent streams located in the municipality of Angra dos Reis (RJ): Caputera River and one of its tributaries. Riffle litter patches were sampled randomly using a 30 x 30 cm quadrat. Four blackfly species were found: Simulium incrustatum s. l. Lutz, 1910; Simulium (Inaequalium) sp. ; Simulium pertinax s. l. Kollar, 1832 and Simulium subpallidum s. l. Lutz, 1909. Among these species, Simulium pertinax s. l. was clearly associated with higher water current speeds, while Simulium subpallidum s. l. showed association with lower water velocities, and Simulium (Inaequalium) sp. had a relatively constant distribution along the water current gradient.

Species of thrips (Insecta, Thysanoptera) in two strawberry production systems in Rio Grande do Sul State, Brazil

Species of thrips (Insecta, Thysanoptera) in two strawberry production systems in Rio Grande do Sul, Brazil. Thrips are tiny insects responsible for the reduction of strawberry fruit quality. The work aimed to record and quantify the thysanopterofauna present in two strawberry production systems, low tunnel and semi-hydroponic. Leaves, flowers and fruits were collected weekly, from July 2005 to December 2006 in Caxias do Sul and Bom Princípio municipalities, RS. A total of 664 individuals were collected, representing two families, four genus and 10 species: Frankliniella occidentalis (Pergande, 1895), F. schultzei (Trybom, 1910), F. rodeos Moulton, 1933, F. simplex (Priesner, 1924), F. williamsi (Hood, 1915), F. gemina (Bagnall, 1919), Frankliniella sp., Thrips tabaci (Lindeman, 1888), Thrips tabaci (Lindeman, 1888), Caliothrips fasciatus (Pergande 1895) from Thripidae and Heterothrips sp. from Heterothripidae. Frankliniella occidentalis represented 89.7% of the samples with 95.8% of the species collected in flowers, 3.9% in fruits and 0.8% in leaves. The results show that flowers are the most important food resource for these insects on strawberry plants. Frankliniella rodeos, F. simplex, F. williamsi, C. fasciatus, and Heterothrips sp. are new records on strawberry for Brazil.

Arthropods associated with pig carrion in two vegetation profiles of Cerrado in the State of Minas Gerais, Brazil

Forensic Entomology research has been concentrated in only a few localities of the "Cerrado" vegetation, the Brazilian Savannah. The present study had, as its objective, an examination of the diversity of arthropod fauna associated with the carcasses of Sus scrofa (Linnaeus) in this biome. The study was conducted during the dry and humid periods in two Cerrado vegetation profiles of the State of Minas Gerais. The decaying process was slower and greater quantities of arthropods were collected during the dry period. Insects represented 99% of 161,116 arthropods collected. The majority of these were Diptera (80.2%) and Coleoptera (8.8%). The entomofauna belong to 85 families and at least 212 species. Diptera were represented by 31 families and at least 132 species. Sarcophagidae (Diptera) and Scarabaeidae (Coleoptera) were the richest groups. Oxysarcodexia (Sarcophagidae) presented the largest number of attracted species, however none of these species bred in the carcasses. The Coleoptera collected belong to at least 50 species of 21 families. Among these species, Dermestes maculatus and Necrobia rufipes were observed breeding in the carcasses. This study showed species with potential importance for estimating the postmortem interval (PMI), indicative of seasonal and environmental type located.

Stocks assesment, biomass and fish production in two mediterranean basins (NE Spain)

In order to evaluate the success of the reintroduction of the Eurasian otter (Lutra lutra) in the Empordh wetlands (Parc Natural dels Aiguamolls de I'Empordhà), and the Muga and Fluvih basins, density of fish, biomass and production in the Muga and Fluvia Rivers have been estimated, since fishes represent the principal prey in the otter diet. 12 study sites were selected in order to survey the main flows in both basins. Electrofishing surveys were conducted by blocking off the station with barrier nets, which was performed upon 3 successive catches. The density estimated presents a range of 1,136-1 25 ind .ha' in the Muga basin, 4,49-163 ind.ha' in the Fluvih basin and 3,76-52,2 ind.ha' in the Empordh wetlands. Estimated biomass ranges are 0,616-277,6 g.m2, 8,79-351,2 g.m2, and 5,7-108 g.m-2 respectively. These density anfi biomass ranges are similar to other results obtained from rivers inhabited by the Eurasian otter in NE Spain

Differences in Frontal Activation in Adult Patients with Schizophrenia and in Psychotic Adolescents with Schizophrenic Symptoms in Two Fmri Tasks

Background: Language processing abnormalities and inhibition difficulties are hallmark features of schizophrenia. The objective of this study is to asses the blood oxygenation level-dependent (BOLD) response at two different stages of the illness and compare the frontal activity between adolescents and adults with schizophrenia. Methods: 10 adults with schizophrenia (mean age 31,5 years) and 6 psychotic adolescents with schizophrenic symptoms (mean age 16,2 years) underwent functional magnetic resonance imaging while performing two frontal tasks. Regional activation is compared in the bilateral frontal areas during a covert verbal fluency task (letter version) and a Stroop task (inhibition task). Results: Preliminary results show poorer task performance and less frontal cortex activation during both tasks in the adult group of patients with schizophrenia. In the adolescent patients group, fMRI analysis show significant and larger activity in the left frontal operculum (Broca's area) in the verbal fluency task and greater activity in the medium cingulate during the inhibition phase of the Stroop task. Conclusions: These preliminary findings suggest a decrease of frontal activity in the course of the illness. We assume that schizophrenia contributes to frontal brain activity reduction.

Head-to-head comparison of length of stay, patients' outcome and satisfaction in Switzerland before and after SwissDRG-Implementation in 2012 in 2012: an observational study in two tertiary university centers.

On 1 January 2012 Swiss Diagnosis Related Groups (DRG), a new uniform payment system for in-patients was introduced in Switzerland with the intention to replace a "cost-based" with a "case-based" reimbursement system to increase efficiency. With the introduction of the new payment system we aim to answer questions raised regarding length of stay as well as patients' outcome and satisfaction. This is a prospective, two-centre observational cohort study with data from University Hospital Basel and the Cantonal Hospital Aarau, Switzerland, from January to June 2011 and 2012, respectively. Consecutive in-patients with the main diagnosis of either community-acquired pneumonia, exacerbation of COPD, acute heart failure or hip fracture were included. A questionnaire survey was sent out after discharge investigating changes before and after SwissDRG implementation. Our primary endpoint was LOS. Of 1,983 eligible patients 841 returned the questionnaire and were included into the analysis (429 in 2011, 412 in 2012). The median age was 76.7 years (50.8% male). Patients in the two years were well balanced in regard to main diagnoses and co-morbidities. Mean LOS in the overall patient population was 10.0 days and comparable between the 2011 cohort and the 2012 cohort (9.7 vs 10.3; p = 0.43). Overall satisfaction with care changed only slightly after introduction of SwissDRG and remained high (89.0% vs 87.8%; p = 0.429). Investigating the influence of the implementation of SwissDRG in 2012 regarding LOS patients' outcome and satisfaction, we found no significant changes. However, we observed some noteworthy trends, which should be monitored closely.

Maize response to nitrogen fertilization timing in two tillage systems in a soil with high organic matter content

No-tillage systems, associated to black oat as preceding cover crop, have been increasingly adopted. This has motivated anticipated maize nitrogen fertilization, transferring it from the side-dress system at the stage when plants have five to six expanded leaves to when the preceding cover crop is eliminated or to maize sowing. This study was conducted to evaluate the effects of soil tillage system and timing of N fertilization on maize grain yield and agronomic efficiency of N applied to a soil with high organic matter content. A three-year field experiment was conducted in Lages, state of Santa Catarina, from 1999 onwards. Treatments were set up in a split plot arrangement. Two soil tillage systems were tested in the main plots: conventional tillage (CT) and no-tillage (NT). Six N management systems were assessed in the split-plots: S1 - control, without N application; S2 - all N (100 kg ha-1) applied at oat desiccation; S3 - all N applied at maize sowing; S4 - all N side-dressed when maize had five expanded leaves (V5 growth stage); S5 - 1/3 of N rate applied at maize sowing and 2/3 at V5; S6 - 2/3 of nitrogen rate applied at maize sowing and 1/3 at V5. Maize response to the time and form of splitting N was not affected by the soil tillage system. Grain yield ranged from 6.0 to 11.8 t ha-1. The anticipation of N application (S2 and S3) decreased grain yield in two of three years. In the rainiest early spring season (2000/2001) of the experiment, S4 promoted an yield advantage of 2.2 t ha-1 over S2 and S3. Application of total N rate before or at sowing decreased the number of kernels produced per ear in 2000/2001 and 2001/2002 and the number of ears produced per area in 2001/2002, resulting in reduced grain yield. The agronomic efficiency of applied N (kg grain increase/kg of N applied) ranged from 13.9 to 38.8 and was always higher in the S4 than in the S2 and S3 N systems. Short-term N immobilization did not reduce grain yield when no N was applied before or at maize sowing in a soil with high organic matter content, regardless of the soil tillage system.

Disposition of oral valganciclovir during continuous renal replacement therapy in two lung transplant recipients

Background: Oral valganciclovir (VGC) is hydrolysed into active ganciclovir (GCV) which is eliminated in the kidney by filtration and secretion. VGC dosage has to be adapted in renal failure with continuous renal replacement therapy (CRRT), a condition sometimes encountered early after solid organ transplantation. This investigation aimed to determine whether VGC 450 mg every 48 hours provides appropriate GCV exposure for cytomegalovirus (CMV) prophylaxis during CRRT. Methods: GCV pharmacokinetics were extensively studied during CRRT in two lung transplant recipients with acute renal failure receiving VGC 450 mg every 48 hours trough a nasogastric tube. In vitro experiments using blank whole blood spiked with GCV further investigated exchanges between plasma and erythrocytes. Results: GCV disposition was characterised by an area under the curve (AUC) of 98.0 and 55.4 mg h/L, resulting in trough concentrations of 0.7 and 0.2 mg/L, an apparent total body clearance of 3.3 and 5.8 L/h, a terminal half-life of 16.9 and 14.1 h, and an apparent volume of distribution of 60.3 and 104.9 L. The observed sieving coefficient (filtrate/plasma) was 1.05 and 0.96, and the hemofiltration clearance 3.3 and 3.1 L/h, respectively. High sieving values could be explained by an efflux of GCV from erythrocytes. In vitro experiments confirmed that erythrocytes are loaded with significant GCV amount and release it quickly into plasma, thus contributing to the apparent efficacy of hemofiltration. Conclusion: These results indicate that a VGC dosage of 450 mg every 48 hours was adequate for CMV prophylaxis during CRRT, providing GCV levels similar to those reported using 900 mg qd in transplant recipients with normal renal function.

46, XY gonadal dysgenesis: new SRY point mutation in two siblings with paternal germ line mosaicism.

Stoppa-Vaucher S, Ayabe T, Paquette J, Patey N, Francoeur D, Vuissoz J-M, Deladoëy J, Samuels ME, Ogata T, Deal CL. 46, XY gonadal dysgenesis: new SRY point mutation in two siblings with paternal germ line mosaicism. Familial recurrence risks are poorly understood in cases of de novo mutations. In the event of parental germ line mosaicism, recurrence risks can be higher than generally appreciated, with implications for genetic counseling and clinical practice. In the course of treating a female with pubertal delay and hypergonadotropic hypogonadism, we identified a new missense mutation in the SRY gene, leading to somatic feminization of this karyotypically normal XY individual. We tested a younger sister despite a normal onset of puberty, who also possessed an XY karyotype and the same SRY mutation. Imaging studies in the sister revealed an ovarian tumor, which was removed. DNA from the father's blood possessed the wild type SRY sequence, and paternity testing was consistent with the given family structure. A brother was 46, XY with a wild type SRY sequence strongly suggesting paternal Y-chromosome germline mosaicism for the mutation. In disorders of sexual development (DSDs), early diagnosis is critical for optimal psychological development of the affected patients. In this case, preventive karyotypic screening allowed early diagnosis of a gonadal tumor in the sibling prior to the age of normal puberty. Our results suggest that cytological or molecular diagnosis should be applied for siblings of an affected DSD individual.

Phloem mobility of Boron in two eucalypt clones

Boron deficiency causes large productivity losses in eucalypt stands in extensive areas of the Brazilian Cerrado region, thus understanding B mobility is a key step in selecting genetic materials that will better withstand B limitation. Thus, in this study B mobility was evaluated in two eucalypt clones (68 and 129), under B sufficiency or B deficiency, after foliar application of the 10B isotope tracer to a single mature leaf. Samples of young tissue, mature leaves and roots were collected 0, 1, 5, 12 and 17 days after 10B application. The 10B:11B isotope ratio was determined by HR-ICP-MS. Samples of leaves and xylem sap were collected for the determination of soluble sugars and polyalcohols by ion chromatography. Boron was translocated within eucalypt. Translocation of foliar-applied 10B to the young tissues, mature leaves and roots was higher in clone 129 than in 68. Seventeen days after 10B application to a single mature leaf, between 14 and 18 % of B in the young tissue was originated from foliar B application. In plants with adequate B supply the element was not translocated out of the labeled leaf.