Factors influencing apple and pear physical properties and bruise susceptibility.

Fruit turgidity and firmness have shown to influence impact bruise susceptibility in apples and pears. Analysis of the impact response showed that stresses in the tissues are higher in turgid fruits, so they are more susceptible to bruising. A physical parameter, deformation at skin puncture, was able to detect fruit turgidity changes and showed to be related to bruise susceptibility.

Storabelity of melon for different ripeness stages at harvest. Selection of instrumental procedures for quality assessment.

The consumption of melon (Cucumis melo L.) has been, until several years ago, regional, seasonal and without commercial interest. Recent commercial changes and world wide transportation have changed this situation. Melons from 3 different ripeness stages at harvest and 7 cold storage periods have been analysed by destructive and non destructive tests. Chemical, physical, mechanical (non destructive impact, compression, skin puncture and Magness- Taylor) and sensory tests were carried out in order to select the best test to assess quality and to determine the optimal ripeness stage at harvest. Analysis of variance and Principal Component Analysis were performed to study the data. The mechanical properties based on non-destructive Impact and Compression can be used to monitor cold storage evolution. They can also be used at harvest to segregate the highest ripeness stage (41 days after anthesis DAA) in relation to less ripe stages (34 and 28 DAA).Only 34 and 41 DAA reach a sensory evaluation above 50 in a scale from 0-100.

Dispositivo de fijación, cierre y acoplamiento para catéter de perfusión intravenosa

(SPA) Introducción: los medios de fijación a la piel de un catéter venoso periférico, de un catéter venoso central o de un catéter arterial central presentan los siguientes graves inconvenientes: ser la sede de infecciones a nivel del lugar de la punción, provocar una saturación de la zona anatómica, la cual resulta muy difícil de soportar e incómodo para el paciente portador, y suponer un riesgo para el personal de enfermería cuando se usan hilos de sutura para fijar el soporte del catéter. Objetivo: por lo anteriormente expuesto, se ha detecta- do la necesidad de diseñar un dispositivo que reduzca la complejidad y aparatosidad de los sistemas conocidos y empleados en la actualidad, favoreciendo la asepsia y la movilidad del paciente. Método: el desarrollo presentado en este artículo se refie- re a un sistema mecánico de fijación, cierre y acoplamiento para catéter de perfusión intravenosa. El sistema dispone de una pieza circular de pequeño espesor con al menos dos orificios para su fijación subcutánea, centralmente de uno o más conductos para acoplar lúmenes, y de una parte cilín- drica hueca que sobresale a uno de los lados, exteriormente roscada e interiormente lisa con un tetón de posición. Para uso domiciliario se dispone de un tapón de estanqueidad con uno o más tubos de pequeño diámetro que se acoplan en los orificios para lúmenes, una ranura de posición, un tirador y un tapón roscado ciego para el cierre hermético con la parte roscada. Para uso hospitalario se dispone de un tapón intermedio con una o más entradas para lúmenes, así como de un tapón roscado hueco que permite su acopla- miento hermético con la parte roscada. Resultados: el desarrollo descrito en este artículo va a ser utilizado en dos ambientes: ambiente domiciliario y ambiente hospitalario. Además, reduce el riesgo de infec- ción y saturación de la zona anatómica de los pacientes en los que se realiza la punción cutánea en la que se fijan catéteres venosos periféricos, catéteres venosos centrales o catéteres arteriales centrales. (ENG) Introduction: skin fixing devices in peripheral, central or arterial catheters have several important drawbacks: site infection, stacking of material in the anatomical area which is very annoying for the patient and medical staff risk when fixating stitches are used. Objective: to develop a fixing device that simplifies presently used systems, favoring asepsis and motility. Methods: the device herein described is composed by a mechanical fixation, a closing system and coupling for intravenous catheters. The system has a thin circular pie- ce with at least two holes for subcutaneous fixation, one or several conducts for lumina and a hollow cylindrical part in one side, screwed exteriorly and flat inside, with an oriented protuberance. A watertight plug with one or several thin tubes that adapt to the lumina, a positional slot, a handle and a solid screwed tap for perfect closure are available for at home use. An intermediate plug with one or several lumina and a screwed hollow plug are pro- vided for in hospital use. Results: the above described device is intended to be used in two settings: in hospital and at home. It is su- pposed to reduce the risk of infection and stacking of the anatomical site where cutaneo us puncture with fixation of peripheral, central or arterial catheters is performed.

Polymerization of a single protein of the pathogen Yersinia enterocolitica into needles punctures eukaryotic cells

A number of pathogenic, Gram-negative bacteria are able to secrete specific proteins across three membranes: the inner and outer bacterial membrane and the eukaryotic plasma membrane. In the pathogen Yersinia enterocolitica, the primary structure of the secreted proteins as well as of the components of the secretion machinery, both plasmid-encoded, is known. However, the mechanism of protein translocation is largely unknown. Here we show that Y. enterocolitica polymerizes a 6-kDa protein of the secretion machinery into needles that are able to puncture the eukaryotic plasma membrane. These needles form a conduit for the transport of specific proteins from the bacterial to the eukaryotic cytoplasm, where they exert their cytotoxic activity. In negatively stained electron micrographs, the isolated needles were 60–80 nm long and 6–7 nm wide and contained a hollow center of about 2 nm. Our data indicate that it is the polymerization of the 6-kDa protein into these needles that provides the force to perforate the eukaryotic plasma membrane.

Comparação entre a técnica femoral com dispositivo de hemostasia e a técnica radial em pacientes submetidos à estratégia invasiva precoce

A via de acesso arterial é um importante sítio de complicações após a realização de procedimentos coronários invasivos. Dentre as estratégias para a redução de complicações vasculares, encontra-se estabelecida a eficácia da técnica radial. Os dispositivos de oclusão vascular propiciam maior conforto ao paciente, reduzindo o tempo de hemostasia e repouso no leito. Entretanto, a inconsistência de dados comprovando sua segurança limita sua adoção rotineira como estratégia para redução de complicações vasculares, requerendo evidências de estudos randomizados com metodologia adequada. O objetivo deste estudo foi comparar a incidência de complicações no sítio de punção arterial entre a técnica radial e a técnica femoral com utilização de Angio-Seal em pacientes com síndrome coronariana aguda sem supradesnível do segmento ST submetidos à estratégia invasiva precoce. Trata-se de um ensaio clínico unicêntrico, de não inferioridade, no qual duzentos e quarenta pacientes foram randomizados para a técnica radial ou técnica femoral com utilização de Angio-Seal. O objetivo primário foi a ocorrência de complicações no sítio de punção arterial até 30 dias após o procedimento, incluindo sangramento grave, hematoma >= 5 cm, hematoma retroperitoneal, síndrome compartimental, pseudoaneurisma, fístula arteriovenosa, infecção, isquemia de membro, oclusão arterial, lesão de nervo adjacente ou necessidade de reparo vascular cirúrgico. Em relação às características demográficas e clínicas, houve diferença apenas quanto ao gênero, com presença maior de pacientes do sexo feminino no grupo radial (33,3% versus 20,0%, p=0,020). Não se observaram diferenças entre os grupos quanto ao diagnóstico de admissão, alterações isquêmicas presentes no eletrocardiograma, elevação de marcadores de necrose miocárdica ou escores de risco, bem como quanto à farmacoterapia antitrombótica adjunta e características da intervenção coronária percutânea. A hemostasia foi obtida na totalidade dos procedimentos do grupo radial com a utilização da pulseira compressora seletiva TR Band e em 95% dos procedimentos realizados pela técnica femoral com o Angio-Seal (p=0,029). Exceto pela maior incidência de oclusão arterial no grupo radial comparado ao femoral, não houve diferenças entre os demais desfechos analisados. Segundo o teste de não inferioridade para complicações na via de acesso arterial aos 30 dias, verificou-se que a utilização do Angio-Seal não produziu resultados inferiores ao acesso radial, considerando-se a margem de 15% (12,5% versus 13,3%, diferença -0,83%, IC 95% -9,31 - 7,65, p para não inferioridade <0,001). Os resultados principais deste estudo demonstram que, em uma população de pacientes com diagnóstico de síndrome coronariana aguda sem supradesnível do segmento ST, submetida à estratificação de risco invasiva, a utilização do dispositivo de oclusão vascular Angio-Seal confere ao procedimento efetivado pelo acesso femoral inferioridade na incidência de complicações no sítio de punção arterial aos 30 dias quando comparado ao acesso radial.

Propriedades de soluções filmogênicas e de filmes de gelatina ou colágeno com extrato de boldo-do-Chile

Filmes à base de biopolímeros podem ser utilizados para produção de embalagens ativas, que além de proteger os alimentos, podem interagir com o produto. No caso de embalagens ativas com atividade antioxidante, tem-se privilegiado o uso de agentes antioxidantes naturais, considerando-se que o uso de antioxidantes sintéticos tem sido questionado, sobretudo em relação à sua inocuidade. Existem muitos extratos de plantas já conhecidos por sua atividade antioxidante, que têm sido utilizados com frequência em estudos de filmes à base de biopolímeros, não somente por serem ricos em polifenóis, mas principalmente por sua boa interação com a matriz polimérica. O extrato de boldo-do-Chile (Peumus boldus) possui atividade antioxidante comprovada, entretanto, não existem relatos sobre sua adição em filmes. Dessa forma, o objetivo geral desta tese foi o desenvolvimento de filmes à base de colágeno ou gelatina adicionados de extrato de boldo-do-Chile, com propriedades físicas e funcionais para seu emprego como embalagens bioativas. Foram realizadas as caracterizações (fenólicos totais, ABTS, DPPH, cor, °Brix e pH) do extrato aquoso de boldo-do-Chile, preparado em quatro diferentes temperaturas. Além disso, foram avaliadas as propriedades reológicas e térmicas da solução de gelatina, e também foram elaborados filmes com as soluções de gelatina e colágeno a partir de soluções filmogênicas com diferentes concentrações de macromoléculas e extrato de boldo. Esses filmes foram caracterizados para conhecimento de suas propriedades mecânicas (tração e perfuração), propriedades óticas (cor e opacidade), espessura, umidade e solubilidade em água. Uma concentração de macromoléculas foi escolhida para a realização de análises complementares, a saber: análises térmicas (DSC), cristalinidade por difração de raio X (DRX), permeabilidade ao vapor de água (PVA), microscopia eletrônica de varredura (MEV), brilho, espectroscopia de infravermelho com transformada de Fourier (FTIR), ângulo de contato, propriedades de barreira UV/Visível e atividade antioxidante. A adição do extrato de boldo-do-Chile nos filmes de gelatina e colágeno produziu filmes com atividade antioxidante, sem prejuízo às demais propriedades estudadas. Observou-se que o extrato aquoso de boldo-do-Chile apresentou propriedades antioxidantes, mas que foram dependentes da temperatura de extração. O extrato de boldo-do-Chile foi capaz de modificar as propriedades térmicas das soluções filmogênicas de gelatina, não sendo observado efeito nas análises reológicas. Por outro lado, o extrato aquoso de boldo-do-Chile não influenciou as propriedades mecânicas, solubilidade, umidade, cristalinidade e a permeabilidade ao vapor de água dos filmes de gelatina ou colágeno. Algumas propriedades térmicas sofreram efeito dos extratos, mas as análises de FTIR não mostraram a formação de novas interações. As propriedades óticas e de barreira UV/Visível foram influenciadas pelo extrato de boldo-do-Chile, sendo que os filmes se apresentaram mais amarelados com o aumento da concentração do extrato de boldo-do-Chile. As micrografias mostraram filmes de gelatina bastante homogêneos e filmes de colágeno com superfícies mais rugosas. Os resultados de brilho e ângulo de contato corroboraram com estas respostas. Em conclusão, os filmes de ambas macromoléculas apresentaram atividade antioxidante, podendo dessa forma, serem considerados como filmes ativos.

E-polynomials of the SL(2, C)-character varieties of surface groups

We compute the E-polynomials of the moduli spaces of representations of the fundamental group of a once-punctured surface of any genus into SL(2, C), for any possible holonomy around the puncture. We follow the geometric technique introduced in [12], based on stratifying the space of representations, and on the analysis of the behavior of the E-polynomial under fibrations.

Une étude cadavérique pour réduire les risques des approches chirurgicales et percutanées de l’artère fémorale

En chirurgie vasculaire, l’accès à l’artère fémorale, qu’il soit par une incision chirurgicale ou par une approche percutanée, est très fréquemment utilisé pour une multitude d’interventions vasculaires ou endovasculaires; pour des pontages divers, le traitement d’occlusions artérielles, la réparation d’anévrismes et la pose d’endoprothèses. L’objectif général de ce projet de recherche est de faciliter et réduire les risques des approches de l’artère fémorale par une meilleure compréhension anatomique du triangle fémoral. La méthodologie a été réalisée grâce à l’utilisation de cadavres spécialement embaumés par la méthode développée par Walter Thiel. Les résultats présentés dans ce mémoire ont permis de proposer des solutions en réponse à des problèmes cliniques en chirurgie vasculaire. Dans un premier temps, l’étude de la vascularisation cutanée du triangle fémoral a mené à proposer de nouvelles incisions chirurgicales afin de limiter la dévascularisation cutanée des plaies et ainsi réduire les problèmes de cicatrisation observés. Ensuite, nous avons validé l’identification radiographique et échographique de l’artère fémorale à son croisement avec le ligament inguinal afin de faciliter l’identification d’un site de ponction artérielle adéquat. Enfin, nous avons développé une méthode échographique simple qui facilite l’approche percutanée de l’artère fémorale, même chez les patients obèses. Les retombées de ce projet de recherche sont multiples pour les cliniciens, l’étude fournit une meilleure compréhension anatomique tridimensionnelle du triangle fémoral et les techniques proposées dans ce mémoire pourront apporter une amélioration de la pratique chirurgicale et faciliter le travail des médecins. Toutefois, ces propositions devront maintenant être validées en clinique.

EVALUATION OF COLOUR AND TEXTURE OF A PORTUGUESE TRADITIONAL SWEET: “EGG CHESTNUT”

This work aimed to evaluate the colour and texture of a Portuguese traditional sweet “egg chestnuts” along a storage period of 12 days under refrigeration. For this, the colour coordinates were measured through a colorimeter and the textural parameters were evaluated by compression and puncture tests using a textutrometer. The results showed that the colour coordinates do not vary along time, corresponding to very low values of total colour difference. Hardness, chewiness and springiness decreased in the first 3 days but after that the values were maintained approximately constant. In contrast, resilience and cohesiveness did not change along time. While crust firmness increased along storage, both the flesh firmness and stickiness did not change. The adhesiveness measured through the penetration test decreased considerably from the first to the last day. Hence, it was concluded that colour is better preserved than texture along a 12 day storage period under refrigeration.

Evaluation of a Quality Improvement Intervention for Anesthetic Management of Acute Ischemic Stroke Patients Undergoing Endovascular Therapy

Thesis (Master's)--University of Washington, 2016-06

First clinical experience with a new non-indwelling voice prosthesis (Provox (R) NID (TM)) for voice rehabilitation after total laryngectomy

Conclusion. The new Provox(R) NID (TM) non- indwelling voice prosthesis investigated in this study provides a good option for laryngectomized patients using non- indwelling voice prostheses and can potentially improve safety and increase patients' satisfaction with their voice and speech. Objective. To investigate the feasibility of and patient satisfaction with the Provox NID non- indwelling voice prosthesis. Material and methods. Pre- and post- study questionnaires were used to evaluate the patients' former voice prosthesis and the Provox NID voice prosthesis. In addition, measurements of pull- out force, maximum phonation time and loudness were made for both voice prostheses. In vitro measurements of airflow characteristics were also made. Following a 6- week trial, all patients provided feedback on the new voice prosthesis and the results were used to further improve the Provox NID. This final version of the new voice prosthesis was subsequently trialled and evaluated by 10 patients 6 months later. Results. Overall results showed that patient satisfaction with the Provox NID non- indwelling voice prosthesis was favourable. The pull- out force for the new prosthesis was significantly higher than that for the formerly used prosthesis and its aerodynamic characteristics were better.

A simulação como método de ensino de habilidades no curso de medicina: relato de uma experiência com punção lombar

The teaching of the lumbar puncture (LP) technique with simulator is not well systematized in the curricula of medical schools. Studies show that training in the simulator provides learning technical skills, acquisition and retention of knowledge, improve self-confidence of the learner and enables the transfer to clinical practice. We intend this study to introduce simulated training in LP in medical course at the Universidade Federal do Rio Grande do Norte evaluating the experience taking into account quantitative aspects (performance on standardized tests) and qualitative (perception of the students regarding the method and the teaching process learning). The study was conducted in two phases. In the first phase practical training in PL was introduced in the 3rd year of medical school. Seventy-seven students were trained in small groups, guided by a checklist developed in the model Objective Structured Assessment of Technical Skill (OSATS), at this moment they knew they were not under performance evaluation. They were also asked whether they had prior chances to make an LP in patients. At the end of the first phase the students evaluated training in the following areas: teaching technique, simulator realism, time available per group, number of participants per group and relevance to medical practice. In the second phase, two years later, 18 students trained in first stage performed a new LP on the mannequin simulator, and its performance was evaluated through the same checklist of training in order to verify the technical retention. In addition, they answered a multiple choice test about practical aspects of the LP technique. Each participant received individual feedback on their performance at the end of their participation in the study. In the first phase of the study we found that only 4% of students had performed a lumbar puncture in patients until the 3rd year. The training of LP technique with simulator mannequin was considered relevant and the teaching methods was thoroughly evaluated. In the second phase, all participants were successful in implementing the lumbar puncture on the mannequin simulator, compliance with the most steps in a reasonable time, suggesting that would be able to perform the procedure in a patient.

Obtenção de triacetato de celulose a partir do bagaço de cana-deaçúcar para revestimento de micropartículas de goma gelana e avaliação do seu perfil de liberação in vitro e da mucoadesão ex vivo

Oral route of administration is considered to be the most comfortable, safe and greater adaptation for patients. But, oral route presents some disadvantages such as drugs bioavailability and side effects on the stomach. Some technologies are studied to soften and/or resolve these problems, such as coating with polymeric films, which are able to protect the pharmaceutical form of the acid stomachic environment and to act in the drug release, and mucoadhesive systems, which allow the pharmaceutical form remains a greater time interval in the intestine, increasing the effectiveness of the drug. Cellulose triacetate (CTA) films were produced from cellulose extracted from sugar cane bagasse. The films were prepared with different morphologies (with and without water, acting as non-solvent) and concentrations (3, 6.5 and 10%) of CTA and characterized using scanning electron microscopy (SEM), water vapor permeability (WVP), puncture resistance (PR), enzymatic digestion (DE), and mucoadhesive force evaluation (MF). Microscopy showed the formation of symmetric and asymmetric morphologies. WVP data showed that more concentrated films have higher values for WVP; moreover, asymmetric films had higher values than symmetric films. PR measurements showed that symmetric membranes are more resistant than asymmetric ones. More concentrated films were also more puncture resistant, except for symmetric membranes with CTA concentrations of 6.5 and 10% that did not show significant differences. All of the films presented large mucoadhesive capacities independent of their morphology and CTA concentration. From the results of WVP and RP, a symmetric filme with 6.5% CTA showed better ability and mechanical resistance, therefore, was selected to serve as coating of gellan gum (GG) particles incorporating ketoprofen (KET), which was confirmed by SEM. The selected film presented low values in measurements of the swelling index (SI) and in a dissolution test (DT). TGA analysis showed that the CTA coating does not influence the thermal stability of the particles and there is no incompatibility evidence between CTA, GG and KET. Coated particles released 100% of the ketoprofen in 24 h, while uncoated particles released the same amount in 4 h. The results of this study highlight the potential of CTA in the development of new controlled oral delivery systems.

Influence of laparoscopy and laparotomy on gasometry, leukocytes and cytokines in a rat abdominal sepsis model

Laparoscopic surgery is associated with reduced surgical trauma, and less acute phase response, as compared with open surgery. Cytokines are important regulators of the biological response to surgical and anesthetic stress. The aim of this study was to determine if CO2 pneumoperitoneum would change cytokine expression, gas parameters and leukocyte count in septic rats. Methods: Wistar rats were randomly assigned to five groups: control (anesthesia only), laparotomy, CO2 pneumoperitoneum, cecum ligation and puncture by laparotomy, and laparoscopic cecum ligation and puncture. After 30 min of the procedures, arterial blood samples were obtained to determine leukocytes subpopulations by hemocytometer. TNFα, IL-1β, IL-6 were determined in intraperitoneal fluid (by ELISA). Gas parameters were measured on arterial blood, intraperitoneal and subperitoneal exsudates. Results: Peritoneal TNFα, IL-1β and IL-6 concentrations were lower in pneumoperitoneum rats than in all other groups (p<0.05). TNFα, IL-1β and IL-6 expression was lower in the laparoscopic than in laparotomic sepsis (p<0.05). Rats from laparoscopic cecum ligation and puncture group developed significant hypercarbic acidosis in blood and subperitoneal fluid when compared to open procedure group. Total white blood cells and lymphocytes were significantly lower in laparoscopic cecum ligation and puncture rats than in the laparotomic (p<0.01). Nevertheless, the laparotomic cecum ligation rats had a significant increase in blood neutrophils and eosinophils when compared with controls (p<0.05). Conclusions: This study demonstrates that the CO2 pneumoperitoneum reduced the inflammatory response in an animal model of peritonitis with respect to intraperitoneal cytokines, white blood cell count and clinical correlates of sepsis. The pneumoperitoneum produced hypercarbic acidosis in septic animals