941 resultados para Bank of Upper Canada
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Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)
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BackgroundThis is an update of a Cochrane Review first published in The Cochrane Library 2008, Issue 3.Upper abdominal surgical procedures are associated with a high risk of postoperative pulmonary complications. The risk and severity of postoperative pulmonary complications can be reduced by the judicious use of therapeutic manoeuvres that increase lung volume. Our objective was to assess the effect of incentive spirometry compared to no therapy or physiotherapy, including coughing and deep breathing, on all-cause postoperative pulmonary complications andmortality in adult patients admitted to hospital for upper abdominal surgery.ObjectivesOur primary objective was to assess the effect of incentive spirometry (IS), compared to no such therapy or other therapy, on postoperative pulmonary complications and mortality in adults undergoing upper abdominal surgery.Our secondary objectives were to evaluate the effects of IS, compared to no therapy or other therapy, on other postoperative complications, adverse events, and spirometric parameters.Search methodsWe searched the Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library 2013, Issue 8), MEDLINE, EMBASE, and LILACS (from inception to August 2013). There were no language restrictions. The date of the most recent search was 12 August 2013. The original search was performed in June 2006.Selection criteriaWe included randomized controlled trials (RCTs) of IS in adult patients admitted for any type of upper abdominal surgery, including patients undergoing laparoscopic procedures.Data collection and analysisTwo authors independently assessed trial quality and extracted data.Main resultsWe included 12 studies with a total of 1834 participants in this updated review. The methodological quality of the included studies was difficult to assess as it was poorly reported, so the predominant classification of bias was 'unclear'; the studies did not report on compliance with the prescribed therapy. We were able to include data from only 1160 patients in the meta-analysis. Four trials (152 patients) compared the effects of IS with no respiratory treatment. We found no statistically significant difference between the participants receiving IS and those who had no respiratory treatment for clinical complications (relative risk (RR) 0.59, 95% confidence interval (CI) 0.30 to 1.18). Two trials (194 patients) IS compared incentive spirometry with deep breathing exercises (DBE). We found no statistically significant differences between the participants receiving IS and those receiving DBE in the meta-analysis for respiratory failure (RR 0.67, 95% CI 0.04 to 10.50). Two trials (946 patients) compared IS with other chest physiotherapy. We found no statistically significant differences between the participants receiving IS compared to those receiving physiotherapy in the risk of developing a pulmonary condition or the type of complication. There was no evidence that IS is effective in the prevention of pulmonary complications.Authors' conclusionsThere is low quality evidence regarding the lack of effectiveness of incentive spirometry for prevention of postoperative pulmonary complications in patients after upper abdominal surgery. This review underlines the urgent need to conduct well-designed trials in this field. There is a case for large RCTs with high methodological rigour in order to define any benefit from the use of incentive spirometry regarding mortality.
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The purpose of this paper was to evaluate the agreement among different methods used to estimate angular deviation of the body to determine the risk for development of upper limb musculoskeletal disorders in dentistry undergraduates. Materials and Methods: Students (n = 79) enrolled in the final year undergraduate course of the Araraquara School of Dentistry-Sγo Paulo State University-UNESP were evaluated. Photographs were taken of students performing clinical procedures. The work postures adopted by each student were evaluated by means of rapid upper limb assessment (RULA). The basis used to obtain the individual's final risk score is the measurement of the angular deviations in the neutral positions of the regions evaluated. Two methods were used to estimate the angular deviation of the body: Visual exam and Image Tool software. A RULA final risk score was attributed to each procedure the student performed (n = 333). Study of the agreement between the methods about risk of musculoskeletal disorders was conducted by means of Kappa (κ) statistics. The level of significance adopted was 5%. Results: Fair agreement (κ = 0.32) between the evaluated methods was verified. Conclusion: The risk for development of upper limb musculoskeletal disorders by dentistry undergraduates evaluated by using RULA was not in agreement with the results obtained by use of visual exam and Image Tool.
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The purpose of this paper was to evaluate the agreement among different methods used to estimate angular deviation of the body to determine the risk for development of upper limb musculoskeletal disorders in dentistry undergraduates. Materials and Methods: Students (n = 79) enrolled in the final year undergraduate course of the Araraquara School of Dentistry-Sγo Paulo State University-UNESP were evaluated. Photographs were taken of students performing clinical procedures. The work postures adopted by each student were evaluated by means of rapid upper limb assessment (RULA). The basis used to obtain the individual's final risk score is the measurement of the angular deviations in the neutral positions of the regions evaluated. Two methods were used to estimate the angular deviation of the body: Visual exam and Image Tool software. A RULA final risk score was attributed to each procedure the student performed (n = 333). Study of the agreement between the methods about risk of musculoskeletal disorders was conducted by means of Kappa (κ) statistics. The level of significance adopted was 5%. Results: Fair agreement (κ = 0.32) between the evaluated methods was verified. Conclusion: The risk for development of upper limb musculoskeletal disorders by dentistry undergraduates evaluated by using RULA was not in agreement with the results obtained by use of visual exam and Image Tool.
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Expanding populations of resident Canada geese that remain in suburban and urban areas year-round often result in increased conflicts with humans. Non-lethal and humane means are needed for managing the size of Canada goose flocks residing near or on airports, golf courses, industrial parks, government sites, and city parks. A side effect of nicarbazin, a veterinary drug used to control coccidiosis in chickens, is decreased egg production and hatching. Exploiting this side effect, studies of nicarbazin for reducing the hatchability of eggs from Canada geese were conducted. An initial study in Coturnix quail verified reduction in hatchability in a species other than chickens. Because plasma nicarbazin was not routinely measured, a study in chickens was conducted to determine the relationship between plasma and egg nicarbazin. A comparative study in chickens, mallards, and Canada geese showed that nicarbazin absorption was lowest in geese. Studies in both penned and wild Canada geese showed that reduction in hatchability was possible but neither study used bait suitable for general field application. Bait development led to the OvoControl-G® (Innolytics LLC) bait, which resulted in reduction in hatchability of 51% at treated sites compared to control sites in the field. Previous studies showed that nicarbazin is practically non-toxic and is environmentally friendly; timing and management of baiting will minimize non-target hazards. OvoControl-G® 2500 ppm nicarbazin bait is recommended for incorporation into a comprehensive management plan as a reproductive inhibitor for use in controlling resident Canada goose flock sizes.
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Palynostratigraphic and sedimentary fades analyses were made on sedimentary deposits from the left bank of the Solimoes River, southwest of Manaus. State of Amazonas, Brazil. These provided the age-elating and subdivision of a post-Cietaceous stratigraphic succession in the Amazonas Basin. The Novo Remanso Formation is subdivided into upper and lower units, and delineated by discontinuous surfaces at its top and bottom. The formation consists primarily of sandstones and minor mudstones and conglomerates, reflecting fluvial channel, point bar and floodplain facies of a fluvial meandering paleosystem. Fairly well-preserved palynoflora was recovered from four palynologically productive samples collected in a local irregular concentration of gray clay deposits, rich in organic material and fossilized wood, at the top of the Nova Remanso Formation upper unit. The palynoflora is dominated by terrestrial spores and pollen grains, an d is characterized by abundant angiosperm pollen grains (Tricolpites, Grimsdalea, Perisyncolporites, Tricolporites and Malvacearumpollis). Trilete spores are almost as abundant as the angiosperm pollen, and are represented mainly by the genera Deltoidospora. Verrutriletes, and Hamulatisporis. Gymnosperm pollen is scarce. The presence of the index species Grimsdalea magnaclavata Germeraad et al. (1968) indicates that these deposits belong to the Middle Miocene homonymous palynozone (Lorente, 1986; Hoorn, 1993; Jaramillo et al., 2011). Sedimentological characteristics (poorly sorted, angular to sub-angular, fine to very-coarse quartz sands facies) are typical of the NOW Remanso Formation upper part. These are associated with a paleoflow to the NE-E and SE-E, and with a a entirely lowland-derived palinofloristic content with no Andean ferns and gymnosperms representatives. All together, this suggests a cratonic origin for this Middle Miocene fluvial paleosystem, which was probably born in the Purus Arch eastern flank and areas surrounding the crystalline. The palynological analysis results presented herein are the first direct and unequivocal evidence of the occurrence of Middle Miocene deposits in the central part of the Amazonas Basin. They also provide new perspectives for intra- and interbasin correlations, as well as paleogeographic and paleoenvironmental interpretations for the later deposition stages in the northern Brazilian sedimentary basins. (C) 2011 Elsevier Ltd. All rights reserved.
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Introduction: Cell adhesion molecules (CAM) are required for maintaining a normal epithelial phenotype, and abnormalities in CAM expression have been related to cancer progression, including bladder urothelial carcinomas. There is only one study that correlates E-cadherin and alpha-, beta- and gamma-catenin expression with prognosis of upper tract urothelial carcinomas. Our aim is to study the pattern of immune expression of these CAMs in urothelial carcinomas from the renal pelvis and ureter in patients who have been treated surgically. Our goal is to correlate these expression levels and characteristics with well-known prognostic parameters for disease-free survival. Materials and Methods: We evaluated specimens from 20 patients with urothelial carcinomas of the renal pelvis and ureter who were treated with nephroureterectomy or ureterectomy between June 1997 and January 2007. CAM expression was evaluated by immunohistochemistry in a tissue microarray and correlated with histopathological characteristics and patient outcomes after a mean follow-up of 55 months. Results: We observed a relationship between E-cadherin expression and disease recurrence. Disease recurrence occurred in 87.5% of patients with strong E-cadherin expression. Only 50.0% of patients with moderate expression and 0% of patients with weak or no expression of E-cadherin had disease recurrence (p = 0.014). There was also a difference in disease-free survival. Patients with strong E-cadherin expression had a mean disease-free survival rate of 49.1 months, compared to 83.9 months for patients with moderate expression (p = 0.011). Additionally, an absence of a-catenin expression was associated with tumors that were larger than 3 cm (p = 0.003). Conclusions: We demonstrated for the first time that immune expression of E-cadherin is related to tumor recurrence and disease-free survival rates, and the absence of a-catenin expression is related to tumor size in upper tract urothelial carcinomas.
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Final Gondwana amalgamation was marked by the closure of the Neoproterozoic Clymene ocean between the Amazonia craton and central Gondwana. The events which occurred in the last stage of this closure were recorded in the upper Alto Paraguai Group in the foreland of the Paraguay orogen. Outcrop-based fades analysis of the siliciclastic rocks of upper Alto Paraguai Group, composed of the Sepotuba and Diamantino Formations, was carried out in the Diamantino region, within the eastern part of the Barra dos Bugres basin, Mato Grosso state, central-western Brazil. The Sepotuba Formation is composed of sandy shales with planar to wave lamination interbedded with fine-grained sandstone with climbing ripple cross-lamination, planar lamination, swaley cross-stratification and tangential to sigmoidal cross-bedding with mud drapes, related to marine offshore deposits. The lower Diamantino Formation is composed of a monotonous, laterally continuous for hundreds of metres, interbedded siltstone and fine-grained sandstone succession with regular parallel lamination, climbing ripple cross-lamination and ripple-bedding interpreted as distal turbidites. The upper part of this formation consists of fine to medium-grained sandstones with sigmoidal cross-bedding, planar lamination, climbing ripple cross-lamination, symmetrical to asymmetrical and linguoid ripple marks arranged in lobate sand bodies. These fades are interbedded with thick siltstone in coarsening upward large-scale cycles related to a delta system. The Sepotuba Formation characterises the last transgressive deposits of the Paraguay basin representing the final stage of a marine incursion of the Clymene ocean. The progression of orogenesis in the hinterland resulted in the confinement of the Sepotuba sea as a foredeep sub-basin against the edge of the Amazon craton. Turbidites were generated during the deepening of the basin. The successive filling of the basin was associated with progradation of deltaic lobes from the southeast, in a wide lake or a restricted sea that formed after 541 +/- 7 Ma. Southeastern to east dominant Neoproterozoic source regions were confirmed by zircon grains that yielded ages around 600 to 540 Ma, that are interpreted to be from granites in the Paraguay orogen. This overall regressive succession recorded in the Alto Paraguai Group represents the filling up of a foredeep basin after the final amalgamation of westem Gondwana in the earliest Phanerozoic. (C) 2011 International Association for Gondwana Research. Published by Elsevier B.V. All rights reserved.
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The best available test for the diagnosis of upper extremity deep venous thrombosis (UEDVT) is contrast venography. The aim of this systematic review was to assess whether the diagnostic accuracy of other tests for clinically suspected UEDVT is high enough to justify their use in clinical practise and to evaluate if any test can replace venography.
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Objective In the pediatric population traumatic injuries of the upper extremity are common. After therapy a decision has to be made if the mobility of the joint lies within a normal range. The purpose of this study was to give an introduction to normative data. We investigate if there is a significant difference in the range of motion (ROM) between male and female probands and furthermore, if an effect of the age can be detected. Methods We performed an institutional review board-approved study of healthy girls and boys aged between 2 and 16 years without any medical history of an upper extremity fracture. We investigated the active ROM of the elbow, wrist, metacarpophalangeal, and interphalangeal joints. Furthermore, age, handedness, weight, and height were recorded. A total of 171 adolescents with a mean age of 10.6 years were included and separated into four cohorts by age: 2 to 5, 6 to 10, 11 to 13, and 14 to 16 years. Results We found significant differences between the genders in the age group from 11 to 13 years for the flexion of the elbow, the pronation, the flexion of the interphalangeal joint of the thumb, as well as the flexion of the metacarpophalangeal joints of digitus II to V. Furthermore, a significant difference in the same joints except from the elbow flexion could be demonstrated between the genders. Conclusion Our study contributes normative data for upper extremity ROM in the pediatric population and presents a gender-related difference in certain joints. Clinical Relevance Normative data for the ROM of upper extremity joints in children is helpful for the evaluation of pediatric orthopedic patients and provides the framework for therapeutic resolution. Since a great number of traumatic injuries in children affect the upper extremity, this information may help the physician to estimate the impact of the injury and decide on the therapeutic management.
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Over the past several decades a variety of models have been proposed to explain perceived behavioral and cognitive differences between Neanderthals and modern humans. A key element in many of these models and one often used as a proxy for behavioral “modernity” is the frequency and nature of hunting among Palaeolithic populations. Here new archaeological data from Ortvale Klde, a late Middle–early Upper Palaeolithic rockshelter in the Georgian Republic, are considered, and zooarchaeological methods are applied to the study of faunal acquisition patterns to test whether they changed significantly from the Middle to the Upper Palaeolithic. The analyses demonstrate that Neanderthals and modern humans practiced largely identical hunting tactics and that the two populations were equally and independently capable of acquiring and exploiting critical biogeographical information pertaining to resource availability and animal behavior. Like lithic techno-typological traditions, hunting behaviors are poor proxies for major behavioral differences between Neanderthals and modern humans, a conclusion that has important implications for debates surrounding the Middle–Upper Palaeolithic transition and what features constitute “modern” behavior. The proposition is advanced that developments in the social realm of Upper Palaeolithic societies allowed the replacement of Neanderthals in the Caucasus with little temporal or spatial overlap and that this process was widespread beyond traditional topographic and biogeographical barriers to Neanderthal mobility.
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Along three sections in the Kara Sea and Obskaya Guba concentrations of dissolved and particulate organic carbon (DOC and POC, respectively) in waters , as well as of organic carbon in bottom sediments (Corg) in September-October 2007 were determined. DOC varied from 6.3 to 2400 µg/l, POC - from 0.84 to 12.2 mg/l. For all samples the average DOC was 200 µg/l (n = 78; sigma = 368), the average POC - 2.7 mg/l (n = 92; sigma = 2.7). Concentrations of Corg in dried samples of upper layer bottom sediments varied from 0.13 to 2.10% (aver. = 0.9%; n = 21; sigma = 0.49%). It is shown that distribution of different forms of organic matter (OM) is an indicator of supply and scattering of particulate matter in the Kara Sea and that DOC and POC of the Kara Sea are formed under impact of runoff of the Ob and Yenisei Rivers. It is found that distribution of OM in bottom sediments is closely related to their grain size composition and to the structure of currents in the area. Variations in Corg concentration in bottom sediment cores from the zone of riverine and sea water mixing represent variability of OM burial.
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Geochemical behavior of Rb-Sr and K-Ar systems in Upper Vendian clayey rocks of the Russian Platform is under consideredation. The use of additional data on grain size fractions of sedimentary rocks recovered from boreholes drilled in the Gavrilov Yam area made it possible to confirm the previous conclusion on two stages of epigenetic matter transformation (approximately 600 and 400 Ma ago). Distortions are related to transformation of sediments due to interaction in the water-rock system. Interaction degree was more intense in the upper part of the sedimentary section relative to its lower strata. These conclusions are substantiated by materials from boreholes that characterize different types of Vendian sections and different tectonic zones.