978 resultados para H.264
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O objetivo deste trabalho foi avaliar o efeito da suplementação com sais proteinados sobre o desempenho de novilhos em pastagem nativa diferida, no Rio Grande do Sul, Brasil. Os suplementos de sal proteinado avaliados foram: com uréia, com amiréia, com amiréia mais levedura e sal mineral. O experimento teve duração de 118 dias e foram utilizadas 8 parcelas com área de 7,5 ha, cada uma com 8 novilhos, de peso médio 264 kg, com idade de 18 meses, em delineamento completamente casualizado. A pastagem apresentou valores médios de 6,8% de proteína bruta, 73,3% de fibra em detergente neutro, e 42,5% de digestibilidade in vitro da matéria orgânica, sem que fossem detectadas diferenças significativas entre tratamentos. O ganho médio diário (0,287 kg) dos animais suplementados com o sal proteinado com amiréia e levedura, foi superior ao apresentado pelos animais que consumiram sal mineralizado (0,019 kg) mas não houve diferenças entre uréia (0,159 kg) e amiréia (0,124 kg). O consumo diário dos suplementos proteinados (0,400 kg) foi superior ao consumo do suplemento mineral (0,038 kg). A adição de levedura ativa, ao sal proteinado formulado com amiréia, melhora o desempenho de novilhos em pastagem nativa diferida.
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When hypothermic patients appear to be dead, the decision to resuscitate may be difficult due to lack of reliable criteria of death. To discover useful prognostic indicators, we reviewed the hospital charts of nine hypothermic victims of snow avalanches (group A: median value of rectal temperature, 29.6 degrees C; range, less than 12 degrees C to 34 degrees C) and of 15 patients with hypothermia following acute drug intoxication and/or cold exposure (group B: 28.8 degrees C; range, 25.5 degrees C to 32 degrees C. In group A, plasma potassium level on admission was extremely high (14.5 mmol/L; range, 6.8 to 24.5 mmol/L) compared with that obtained in group B (3.5 mmol/L; range, 2.7 to 5.3 mmol/L). All patients in group A were in cardiorespiratory arrest. None could be successfully resuscitated despite effective rewarming by cardiopulmonary bypass or peritoneal lavage. In contrast, all of the patients in group B recovered from hypothermia, including two in cardiorespiratory arrest. Thus, extreme hyperkalemia during acute hypothermia appears to be a reliable marker of death. It might be used to select those patients in whom heroic resuscitation efforts can be useful.
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Comprend : Jésus-Christ devant les conseils de guerre
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O objetivo deste trabalho foi estimar a adaptabilidade e estabilidade de genótipos de trigo irrigado, nas condições do Cerrado do Brasil Central. O rendimento de grãos de cinco cultivares e nove linhagens de trigo irrigado foram aferidos no ensaio de valor de cultivo e uso. Os ensaios foram conduzidos nos anos de 2005 e 2006, em seis locais em Minas Gerais, três em Goiás e um no Distrito Federal. Os dados de rendimento de grãos foram submetidos à análise de variância individual e à análise de variância conjunta, para a estimativa dos parâmetros de adaptabilidade e estabilidade. Verificaram-se diferenças significativas, entre os genótipos, em 14 dos 16 ambientes avaliados. Nenhum dos genótipos avaliados apresentou o comportamento ideal preconizado pelo método de Cruz e colaboradores. Destacaram-se a cultivar BRS 264 e a linhagem CPAC 02167, pela superioridade em todas as condições do Cerrado do Brasil Central (adaptabilidade geral). Entre os demais genótipos avaliados, destacaram-se as cultivares BRS 207 e EMBRAPA 22, responsivas à melhoria das condições ambientais, e as cultivares BRS 254 e EMBRAPA 42, pela adaptabilidade específica a ambientes desfavoráveis ao cultivo de trigo irrigado.
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Chaque jour, le médecin utilise dans sa pratique des scores cliniques. Ces scores sont souvent des aides à la décision médicale. Les étapes de validation des scores cliniques sont par contre souvent méconnues du médecin. Cette revue rappelle les bases théoriques de la validation d'un score clinique et propose des exercices pratiques. [Abstract] Physicians are using clinical scores on a regular basis. These scores are generally helpful in making medical decisions. However, the process of validation of clinical scores is often unknown to the physicians. This paper reviews the theory of validation of clinical scores and proposes practical exercises.
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This paper addresses primary care physicians, cardiologists, internists, angiologists and doctors desirous of improving vascular risk prediction in primary care. Many cardiovascular risk factors act aggressively on the arterial wall and result in atherosclerosis and atherothrombosis. Cardiovascular prognosis derived from ultrasound imaging is, however, excellent in subjects without formation of intimal thickening or atheromas. Since ultrasound visualises the arterial wall directly, the information derived from the arterial wall may add independent incremental information to the knowledge of risk derived from global risk assessment. This paper provides an overview on plaque imaging for vascular risk prediction in two parts: Part 1: Carotid IMT is frequently used as a surrogate marker for outcome in intervention studies addressing rather large cohorts of subjects. Carotid IMT as a risk prediction tool for the prevention of acute myocardial infarction and stroke has been extensively studied in many patients since 1987, and has yielded incremental hazard ratios for these cardiovascular events independently of established cardiovascular risk factors. However, carotid IMT measurements are not used uniformly and therefore still lack widely accepted standardisation. Hence, at an individual, practicebased level, carotid IMT is not recommended as a risk assessment tool. The total plaque area of the carotid arteries (TPA) is a measure of the global plaque burden within both carotid arteries. It was recently shown in a large Norwegian cohort involving over 6000 subjects that TPA is a very good predictor for future myocardial infarction in women with an area under the curve (AUC) using a receiver operating curves (ROC) value of 0.73 (in men: 0.63). Further, the AUC for risk prediction is high both for vascular death in a vascular prevention clinic group (AUC 0.77) and fatal or nonfatal myocardial infarction in a true primary care group (AUC 0.79). Since TPA has acceptable reproducibility, allows calculation of posttest risk and is easily obtained at low cost, this risk assessment tool may come in for more widespread use in the future and also serve as a tool for atherosclerosis tracking and guidance for intensity of preventive therapy. However, more studies with TPA are needed. Part 2: Carotid and femoral plaque formation as detected by ultrasound offers a global view of the extent of atherosclerosis. Several prospective cohort studies have shown that cardiovascular risk prediction is greater for plaques than for carotid IMT. The number of arterial beds affected by significant atheromas may simply be added numerically to derive additional information on the risk of vascular events. A new atherosclerosis burden score (ABS) simply calculates the sum of carotid and femoral plaques encountered during ultrasound scanning. ABS correlates well and independently with the presence of coronary atherosclerosis and stenosis as measured by invasive coronary angiogram. However, the prognostic power of ABS as an independent marker of risk still needs to be elucidated in prospective studies. In summary, the large number of ways to measure atherosclerosis and related changes in human arteries by ultrasound indicates that this technology is not yet sufficiently perfected and needs more standardisation and workup on clearly defined outcome studies before it can be recommended as a practice-based additional risk modifier.
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The discussion about setting up a program for lung cancer screening was launched with the publication of the results of the National Lung Screening Trial, which suggested reduced mortality in high-risk subjects undergoing CT screening. However, important questions about the benefit-harm balance and the details of a screening program and its cost-effectiveness remain unanswered. A panel of specialists in chest radiology, respiratory medicine, epidemiology, and thoracic surgery representing all Swiss university hospitals prepared this joint statement following several meetings. The panel argues that premature and uncontrolled introduction of a lung cancer screening program may cause substantial harm that may remain undetected without rigorous quality control. This position paper focuses on the requirements of running such a program with the objective of harmonizing efforts across the involved specialties and institutions and defining quality standards. The underlying statement includes information on current evidence for a reduction in mortality with lung cancer screening and the potential epidemiologic implications of such a program in Switzerland. Furthermore, requirements for lung cancer screening centers are defined, and recommendations for both the CT technique and the algorithm for lung nodule assessment are provided. In addition, related issues such as patient management, registry, and funding are addressed. Based on the current state of the knowledge, the panel concludes that lung cancer screening in Switzerland should be undertaken exclusively within a national observational study in order to provide answers to several critical questions before considering broad population-based screening for lung cancer.
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Alcoholic liver disease is mediated via activation of TLR4 signaling; MyD88-dependent and -independent signals are important contributors to injury in mouse models. Adiponectin, an anti-inflammatory adipokine, suppresses TLR4/MyD88-dependent responses via induction of heme oxygenase-1 (HO-1). Here we investigated the interactions between chronic ethanol, adiponectin, and HO-1 in regulation of TLR4/MyD88-independent signaling in macrophages and an in vivo mouse model. After chronic ethanol feeding, LPS-stimulated expression of IFN-β and CXCL10 mRNA was increased in primary cultures of Kupffer cells compared with pair-fed control mice. Treatment of Kupffer cells with globular adiponectin (gAcrp) normalized this response. LPS-stimulated IFN-β/CXCL10 mRNA and CXCL10 protein was also reduced in RAW 264.7 macrophages treated with gAcrp or full-length adiponectin. gAcrp and full-length adiponectin acted via adiponectin receptors 1 and 2, respectively. gAcrp decreased TLR4 expression in both Kupffer cells and RAW 264.7 macrophages. Small interfering RNA knockdown of HO-1 or inhibition of HO-1 activity with zinc protoporphyrin blocked these effects of gAcrp. C57BL/6 mice were exposed to chronic ethanol feeding, with or without treatment with cobalt protoporphyrin, to induce HO-1. After chronic ethanol feeding, mice were sensitized to in vivo challenge with LPS, expressing increased IFN-β/CXCL10 mRNA and CXCL10 protein in liver compared with control mice. Pretreatment with cobalt protoporphyrin 24 h before LPS challenge normalized this effect of ethanol. Adiponectin and induction of HO-1 potently suppressed TLR4-dependent/MyD88-independent cytokine expression in primary Kupffer cells from rats and in mouse liver after chronic ethanol exposure. These data suggest that induction of HO-1 may be a useful therapeutic strategy in alcoholic liver disease.
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BACKGROUND: There is currently no consensus in the literature on which embolic agent induces the greatest degree of liver hypertrophy after portal vein embolization (PVE). Only experimental results in a pig model have demonstrated an advantage of n-butyl-cyanoacrylate (NBCA) over 3 other embolic materials (hydrophilic gel, small and large polyvinyl alcohol particles) for PVE. Therefore, the aim of this human study was to retrospectively compare the results of PVE using NBCA with those using spherical microparticles plus coils. METHODS: A total of 34 patients underwent PVE using either NBCA (n = 20), or spherical microparticles plus coils (n = 14). PVE was decided according to preoperative volumetry on the basis of contrast-enhanced CT. Groups were compared for age, sex, volume of the left lobe before PVE and future remnant liver ratio (FRL) (volume of the left lobe/total liver volume - tumor volume). The primary end point was the increase in left lobe volume 1 month after PVE. Secondary end points were procedure complications and biological tolerance. RESULTS: Both groups were similar in terms of age, sex ratio, left lobe volume, and FRL before PVE. NBCA induced a greater increase in volume after PVE than did microparticles plus coils (respectively, +74 ± 69 % and +23 ± 14 %, p < 0.05). The amount of contrast medium used for the procedure was significantly larger when microparticles and coils rather than NBCA were used (respectively, 264 ± 43 ml and 162 ± 34 ml, p < 0.01). The rate of PVE complications as well as the biological tolerance was similar in both groups. CONCLUSION: NBCA seems more effective than spherical microparticles plus coils to induce left-lobe hypertrophy.
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From the point of view of local development cultural tourism events represent an opportunity since they are distributed homogeneously by the Catalan territory and are experiencing a vertiginous growth as a way to differentiate the existing supply. In our study a sample of 264 telephone surveys made to organizers of events in Catalonia has been compiled, with the purpose of characterizing the existing supply, thematic typologies, management models, commercialization inputs and economic impact. The results allow us to characterize events from the point of view of their tourist potential. Finally some recommendations are set out to develop future tourism policies based on events according to product differentiation, seasonality, competitiveness and creativity.
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During the last three decades, the number of tourism events has been growing in Catalan coastal resorts because of the recover of Catalan cultural traditions, festivals and folklore, and also because of tourism growth. Catalan tourism resorts use events as catalysers for new supply and as a mean to differentiate and singularize themselves from their competitors. The tourism potential of cultural events is undeniable but there are some problems that prevent a more effective impact as economic and regional development agents. This paper reflects some discussions and conclusions obtained from the analysis of 264 valid responses of a survey made to different Catalan event organizers in 2008 and 2009. We describe and characterize cultural event supply in coastal resorts in order to study the events tourism importance, their capacity to generate and spread economic development, and their managerial model. The analysis is made in a geographical basis, comparing the results of the territorial organization of events of the city of Barcelona, coastal and inland municipalities. Finally some considerations about event regional tourism policy and tourism development are discussed.
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Descripció del projecte. S’han de destacar les innovacions i aportacions a l’avanç del coneixement que incorpora el projecte. Es poden incorporar memòries, plànols, fotografies, esbossos, etc. També l’adreça web si s’ha penjat més informació sobre el projecte a la web.www.arq-infad.arqa.com/fad2005www.arqa.com/informacion.cfm/n.5910.cfmDESCRIPCIÓ DE L’EDIFICI: El Centre Cultural, donat el seu caràcter de contenidor flexible de funcions diverses haurà d'assumir unes visions mes funcionals. La seva pròpia imatge reclamarà d'una part una identitat pròpia allunyada del seus veïns, i d'altra unes connexions, tant visuals com físiques amb les arquitectures adjacents. Serà en aquest cas que la representativitat de l'edifici serà provocada pel seu propi llenguatge formal i la voluntat de manifestar-se com un vertader contenidor funcional.