Comparación de parámetros de atención en una escala de triage de 5 niveles con los parámetros estándar

Introducción: La escala de severidad en emergencias es una herramienta que ofrece seguridad a pacientes en servicios de urgencias. Este trabajo evalúa la aplicación de la escala ESI 4.0 en términos de oportunidad de atención y consumo de recursos en la Fundación Santa Fé de Bogotá, para comparar los resultados con parámetros estándar. Metodología Estudio observacional analítico de corte transversal. Se incluyeron 385 pacientes aleatorizados por nivel de atención. Se tomaron datos demográficos y variables como consumo de recursos y destino del paciente para su descripción y análisis. Resultados: El promedio de edad fue 44.9 años IC95%42.9–46.9, el 54.5% fueron mujeres. Se encontró un tiempo promedio de espera para nivel 1 de 1.39 min, para el nivel 2 de 22.9 min 2, para el nivel 3 de 41.9 min, para el nivel 4 de 56.9 min y para el nivel 5 de 52.1 min. El tiempo promedio de estancia en urgencias fue 5.9 horas y el 78.9% consumió recursos. Al comparar los tiempos con estándares mundiales en el nivel 1, 2 y 3 son significativamente mayores (P<0,05), en el nivel 4 es similar (p0,51) y en el nivel 5 es significativamente menor (p=0,00) Discusión: La escala ESI 4.0 es una herramienta segura, con un comportamiento similar en oportunidad de atención y consumo de recursos con respecto a los estándares de cuidado en los servicios de urgencias.

Cloud optical depth retrievals from the Aerosol Robotic Network (AERONET) cloud mode observations

Cloud optical depth is one of the most poorly observed climate variables. The new “cloud mode” capability in the Aerosol Robotic Network (AERONET) will inexpensively yet dramatically increase cloud optical depth observations in both number and accuracy. Cloud mode optical depth retrievals from AERONET were evaluated at the Atmospheric Radiation Measurement program’s Oklahoma site in sky conditions ranging from broken clouds to overcast. For overcast cases, the 1.5 min average AERONET cloud mode optical depths agreed to within 15% of those from a standard ground‐based flux method. For broken cloud cases, AERONET retrievals also captured rapid variations detected by the microwave radiometer. For 3 year climatology derived from all nonprecipitating clouds, AERONET monthly mean cloud optical depths are generally larger than cloud radar retrievals because of the current cloud mode observation strategy that is biased toward measurements of optically thick clouds. This study has demonstrated a new way to enhance the existing AERONET infrastructure to observe cloud optical properties on a global scale.

Differential activation of protein kinase C isoforms by endothelin-1 and phenylephrine and subsequent stimulation of p42 and p44 mitogen-activated protein kinases in ventricular myocytes cultured from neonatal rat hearts.

The translocation of protein kinase C (PKC) isoforms PKC-alpha, PKC-delta, PKC-epsilon, and PKC-zeta from soluble to particulate fractions was studied in ventricular cardiomyocytes cultured from neonatal rats. Endothelin-1 (ET-1) caused a rapid ETA receptor-mediated translocation of PKC-delta and PKC-epsilon (complete in 0.5-1 min). By 3-5 min, both isoforms were returning to the soluble fraction, but a greater proportion of PKC-epsilon remained associated with the particulate fraction. The EC50 of translocation for PKC-delta was 11-15 nM ET-1 whereas that for PKC-epsilon was 1.4-1.7 nM. Phenylephrine caused a rapid translocation of PKC-epsilon (EC50 = 0.9 microM) but the proportion lost from the soluble fraction was less than with ET-1. Translocation of PKC-delta was barely detectable with phenylephrine. Neither agonist caused any consistent translocation of PKC-alpha or PKC-zeta. Activation of p42 and p44 mitogen-activated protein kinase (MAPK) by ET-1 or phenylephrine followed more slowly (complete in 3-5 min). Phosphorylation of p42-MAPK occurred simultaneously with its activation. The proportion of the total p42-MAPK pool phosphorylated in response to ET-1 (50%) was greater than with phenylephrine (20%). In addition to activation of MAPK, an unidentified p85 protein kinase was activated by ET-1 in the soluble fraction whereas an unidentified p58 protein kinase was activated in the particulate fraction.

Efeitos da suplementação de L-arginina e do exercício em cicloergômetro sobre a função endotelial e estresse oxidativo em indivíduos com diabetes tipo 1

Introdução e Objetivo: O fluxo sangüíneo gera estresse de cisalhamento sobre a parede dos vasos induzindo a conversão do aminoácido L-arginina em L-citrulina pela ação da eNOs, liberando o vasodilatador óxido nítrico. O exercício aumenta o fluxo sangüíneo e ativa a eNOs, promovendo vasodilatação. Um aumento no diâmetro do vaso diminuiria os níveis de estresse oxidativo pela diminuição do estresse de cisalhamento. O objetivo deste estudo foi verificar os efeitos da suplementação de L-arginina sobre a função endotelial e estresse oxidativo em indivíduos com diabetes tipo 1. Métodos: Foram avaliados 10 indivíduos do sexo masculino com diabetes do tipo 1 e 20 indivíduos saudáveis para controle, que realizaram teste de cargas progressivas em cicloergômetro para a determinação da carga de exercício, que correspondia a 10% abaixo do 2 º limiar ventilatório. Em uma nova data, os voluntários se exercitaram durante 45 minutos em cicloergômetro, onde foram avaliados parâmetros de função endotelial e estresse oxidativo antes e depois do exercício. Os voluntários foram separados aleatoriamente em dois grupos: L-arginina e placebo. A suplementação de L-arginina foi realizada a partir da ingesta de 7g ao dia na forma de cápsulas; o grupo placebo recebeu amido. Após a suplementação, foi repetido o protocolo de exercício. A função endotelial foi avaliada através da avaliação do fluxo sangüíneo e concentração de nitritos plasmáticos; o estresse oxidativo foi avaliado pelas técnicas do TBARS, carbonil, TRAP e ácido úrico plasmáticos Utilizou-se ANOVA Fatorial de duas vias e teste post hoc de Tukey para análise dos resultados, aceitou-se p<0,05 como significativo. Resultados: Os dados estão expressos em média + erro padrão. Os indivíduos com diabetes do tipo 1 não apresentaram disfunção endotelial quando comparados aos controle, entretanto tiveram parâmetros de estresse oxidativo elevados (TBARS de 1,09 + 0,41 e 2,44 + 0,46 nmolMDA.mg PTN-1, p=0,039; carbonil de 0,148 + 0,02 e 1,48 + 0,20 fM.mg PTN-1, p=0,000 e ácido úrico de 44,55 + 2,06 e 28,10 + 1,57 mg/dl, p=0,000, em controles e diabéticos, respectivamente). O exercício aumentou significativamente o fluxo sangüíneo nos controle e diabéticos ( de 3,53 + 0,35 para 5,46 + 0,35 ml.100ml-1.min-1 no controle, p=0,001 e de 2,66 + 0,33 para 3,77 + 0,36 ml.100ml-1.min-1 nos indivíduos com diabetes, p= 0,000), mas não alterou as concentrações plasmáticas de nitritos nem os parâmetros de estresse oxidativo. Os diabéticos que receberam suplementação com L-arginina tiveram seus valores de fluxo sangüíneo em repouso elevados significativamente (de 3,05 + 0,63 para 4,74 + 0,86 ml.100ml-1.min-1 , p=0,036), efeito não encontrado no grupo controle que recebeu a suplementação. Entretanto, este grupo não apresentou aumento do fluxo sangüíneo após o exercício, conforme observado no momento antes da suplementação. Conclusão: O exercício físico em cicloergômetro aumenta o fluxo sangüíneo sem alterar os parâmetros de estresse oxidativo em indivíduos controle e diabéticos tipo 1. A suplementação com L-arginina aumenta a vasodilatação dependente do endotélio em indivíduos com diabetes do tipo 1, e atenua o aumento do fluxo sangüíneo em resposta ao exercício nestes pacientes. Esta resposta demonstrou uma possível melhora na função endotelial na situação de repouso com a suplementação. Entretanto, restam questões obscuras sobre a resposta de fluxo ao exercício sob o efeito da L-arginina nesta população, sendo necessários estudos adicionais para o esclarecimento.

Preparação e caracterização de um material híbrido, à base de vermiculita modificada com quitosana, para a remoção de íons de chumbo presentes em efluentes sintéticos

Actually, surveys have been developed for obtaining new materials and methodologies that aim to minimize environmental problems due to discharges of industrial effluents contaminated with heavy metals. The adsorption has been used as an alternative technology effectively, economically viable and potentially important for the reduction of metals, especially when using natural adsorbents such as certain types of clay. Chitosan, a polymer of natural origin, present in the shells of crustaceans and insects, has also been used for this purpose. Among the clays, vermiculite is distinguished by its good ion exchange capacity and in its expanded form enhances its properties by greatly increasing its specific surface. This study aimed to evaluate the functionality of the hybrid material obtained through the modification of expanded vermiculite with chitosan in the removal of lead ions (II) in aqueous solution. The material was characterized by infrared spectroscopy (IR) in order to evaluate the efficiency of modification of matrix, the vermiculite, the organic material, chitosan. The thermal stability of the material and the ratio clay / polymer was evaluated by thermogravimetry. To evaluate the surface of the material was used in scanning electron microscopy (SEM) and (BET). The BET analysis revealed a significant increase in surface area of vermiculite that after interaction with chitosan, was obtained a value of 21, 6156 m2 / g. Adsorption tests were performed according to the particle size, concentration and time. The results show that the capacity of removal of ions through the vermiculite was on average 88.4% for lead in concentrations ranging from 20-200 mg / L and 64.2% in the concentration range of 1000 mg / L. Regarding the particle size, there was an increase in adsorption with decreasing particle size. In fuction to the time of contact, was observed adsorption equilibrium in 60 minutes with adsorption capacity. The data of the isotherms were fitted to equation Freundlich. The kinetic study of adsorption showed that the pseudo second- order model best describes the adsorption adsorption, having been found following values K2=0,024 g. mg-1 min-1and Qmax=25,75 mg/g, value very close to the calculated Qe = 26.31 mg / g. From the results we can conclude that the material can be used in wastewater treatment systems as a source of metal ions adsorbent due to its high adsorption capacity

Metabolismo de glicose em gêmeos monozigóticos discordantes para aptidão cardiorrespiratória

OBJETIVO: Verificar se as concentrações de glicose e insulina em jejum são reguladas pela aptidão cardiorrespiratória (VO2máx), independentemente dos efeitos genéticos. MÉTODOS: Dados de 38 pares de gêmeos monozigóticos (11 a 18 anos) foram analisados transversalmente. Os participantes foram submetidos a um teste de esforço máximo com ergoespirometria aberta (MedGraphics VO2000® - Medical Graphics Corp., St. Paul, MN) e à coleta de sangue para estimar a concentração de glicose e insulina em jejum. A zigosidade foi determinada por intermédio da investigação de concordância dos gêmeos em relação a 15 marcadores genéticos polimórficos. Nove pares demonstraram diferença média intrapar para o consumo máximo de oxigênio ≥10mL.kg-1.min-1 e foram divididos em dois grupos, de alta e baixa aptidão. Os grupos foram comparados a partir do teste pareado de Wilcoxon, tendo em vista a assimetria dos dados. RESULTADOS: em média, os gêmeos do grupo de alta aptidão apresentaram consumo máximo de oxigênio 17% superior (13,5±3,7mL.kg-1.min-1) a seus irmãos menos aptos. Não houve diferença entre os grupos para as concentrações de insulina (36,5±34,6 versus 25,3±13,7mg/dL; p<0,813), porém, os gêmeos mais aptos demonstraram menor concentração de glicose do que seus contrapares menos aptos (82,9±7,3 versus 86,7±7,6mg/dL; p<0,010). CONCLUSÕES: Neste estudo, caracterizado como caso-controle (gêmeos monozigóticos discordantes), o irmão com menor aptidão cardiorrespiratória apresentou maior concentração de glicose em jejum, sugerindo que a baixa aptidão cardiorrespiratória está associada a distúrbios no metabolismo de glicose.

Structural and surface properties of thermally prepared Ti/RhxTi(1-x)Oy electrodes: I - influence of preparation parameters

Electrodes of RhxTi(1-x) O-y nominal composition were prepared by thermal decomposition of the chloride or nitrate precursor salts dissolved in strongly acidic medium and applied by brush to both sides of a Tidegrees support. A systematic study of the influence of calcination temperature and time as well as oxygen flux was conducted. The coatings were characterised by SEM, EDAX, XRD, open circuit potential measurements and cyclic voltammetry (CV). Visible-ultraviolet spectrophotometry was employed to identify the chemical form of the precursor in solution while thermogravimetric analysis (TGA) was used to assess the decomposition temperature ranges. Optimisation of the coating preparation parameters showed coatings obtained from [Rh(H2O)(6)](NO3)(3) precursor dissolved in HNO3 1:2 (v/v) and fired at 430 degreesC for 2 h in a 5 1 min (-1) oxygen stream-furnished stable electrodes having the highest electrochemically active surface area. (C) 2002 Elsevier B.V. Ltd. All rights reserved.

Postsurgical stability of oropharyngeal airway changes following counter-clockwise maxillo-mandibular advancement surgery

Purpose: This study evaluated oropharyngeal airway changes and stability following surgical counter-clockwise rotation and advancement of the maxillo-mandibular complex.Methods and Patients: Fifty-six adults (48 females, 8 males), between 15 and 51 years of age, were treated with Le Fort I osteotomies and bilateral mandibular ramus sagittal split osteotomies to advance the maxillo-mandibular complex with a counter-clockwise rotation. The average postsurgical follow-up was 34 months. Each patient's lateral cephalograms were traced, digitized twice, and averaged to estimate Surgical changes (T2-T1) and Postsurgical changes (T3-T2).Results: During surgery, the occlusal plane angle decreased significantly (8.6 +/- 5.8 degrees) and the maxillo-mandibular complex advanced and rotated counter-clock-wise. The maxilla moved forward (2.4 +/- 2.7 mm) at ANS and the mandible was advanced 13.1 +/- 5.1 min at menton, 10 +/- 4.4 mm at point B, and 6.9 +/- 3.7 mm at lower incisor edge. Postsurgical hard tissue changes were not statistically significant. While the upper oropharyngeal airway decreased significantly (4.2 +/- 3.4 min) immediately after surgery, the narrowest retropalatal, lowest retropalatal airway, and the narrowest retroglossal airway measurements increased 2.9 +/- 2.7, 3.7 +/- 3.2, and 4.4 +/- 4.4 mm, respectively. Over the average 34 months Postsurgical period, upper retropalatal airway increased 3.9 +/- 3.7 mm, while narrowest retropalatal, lowest retropalatal airway, and narrowest retroglossal airway remained stable. Head posture showed flexure immediately after Surgery (4.8 +/- 5.9 degrees) and extension postsurgically (1.6 +/- 5.6 degrees).Conclusion: Maxillo-mandibular advancement with counter-clockwise rotation produces immediate increases in middle and lower oropharyngeal airway dimensions, which were constrained by changes in head posture but remain stable over the postsurgical period. The upper oropharyngeal airway space increased only on the longest follow-up. (C) 2006 American Association of Oral and Maxillofacial Surgeons.

Dielectric and fatigue properties of Pb(Zr0.53Ti0.47)O-3 thin films prepared from oxide precursors method

Fatigue is an important problem to be considered if a ferroelectric film is used for non-volatile memory devices. In this phenomena, the remanent polarization and coercive field properties degrades in cycles which increase in hysteresis loops. The reasons have been attributed to different mechanisms such as a large voltage applied on ferroelectric film in every reading process in Ferroelectric Random Access Memory (FeRAM) or memories for digital storage in computer, grain size effects and others. The aim of this work is to investigate the influence of the crystallization kinetics on dielectric and ferroelectric properties of the Pb(Zr0.53Ti0.47)O-3 thin films prepared by an alternative chemical method. Films were crystallized in air on Pt/Ti/SiO2/Si substrates at 700 degrees C for 1 hour, in conventional thermal annealing (CTA), and at 700 degrees C for 1 min and 700 degrees C 5 min, using a rapid thermal annealing (RTA) process. Final films were crack free and presented an average of 750 nm in thickness. Dielectric properties were studied in the frequency range of 100 Hz - 1 MHz. All films showed a dielectric dispersion at low frequency. Ferroelectric properties were measured from hysteresis loops at 10 kHz. The obtained remanent polarization (P-r) and coercive field (E-c) were 3.7 mu C/cm(2) and 71.9 kV/cm respectively for film crystallized by CTA while in films crystallized by RTA these parameters were essentially the same. In the fatigue process, the P, value decreased to 14% from the initial value after 1.3 x 10(9) switching cycles, for film by CTA, while for film crystallized by RTA for 5 min, P, decreased to 47% from initial value after 1.7 x 10(9) switching cycles.

Características aeróbias e anaeróbias de mesatenistas brasileiros treinados

O objetivo deste estudo foi determinar, em mesatenistas bem treinados, as aptidões aeróbia e anaeróbia. Participaram do presente estudo oito mesatenistas brasileiros treinados do sexo masculino (18±2 anos). Os sujeitos foram submetidos a um teste incremental específico para determinação do consumo pico de oxigênio (VO2PICO), intensidade associada ao VO2PICO (iVO2PICO) e do ponto de compensação respiratório (PCR) e a dois testes de esforço repetitivo, sendo o teste de RAST e o índice anaeróbio alático (IAA), para determinação dos índices anaeróbios. O VO2PICO correspondeu a 50,5±4,4ml kg-1 min-1 , a iVO2PICO a 52,1±9,6 bolas min-1 e o PCR a 44,9±8,0 bolas min-1. No RAST, a potência pico (PP) e a potência média (PM) relativa corresponderam a 9,0±1,3W kg-1 e 7,0±0,9W kg-1, respectivamente, enquanto que o IAA foi 1,14±0,51 mM/m s-1 . Esses valores de VO2PICO e dos parâmetros anaeróbios quando comparados a valores de outros esportes com raquetes caracterizaram que mesatenistas brasileiros treinados apresentam potência aeróbia moderada e potência anaeróbia é baixa.

Caracterização e comparação entre programas de treinamento para cavalos de enduro

Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)

Caracterização bioquímica de lipase extraída de sementes oleaginosas de Pachira aquatica

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Avaliação de propriedades de superfície da liga Ti-35Nb-7Zr-5Ta submetida à anodização e seus efeitos n adesão bacteriana

Pós-graduação em Odontologia - FOAR

Correlation between Hoff test performance, body composition and aerobic and anaerobic fitness in professional soccer players

Purpose The purpose of the study was to investigate a possible association between the distance covered in the Hoff test with parameters of maximal oxygen uptake (V_O2MAX), anaerobic threshold, anaerobic fitness, and body composition of professional adult soccer players. Methods Twenty-five professional soccer players (20 ± 3 years) participated in the study. On different days the athletes performed: a graded incremental exercise test in a laboratory to measure V_O2MAX; a specific soccer field test called the Hoff test; a running anaerobic sprint test (RAST); an incremental test on an oval circuit to determine the velocity relative to anaerobic threshold (VAnT) and an estimation of body composition. Results The average V_O2MAX corresponded to 4.1 ± 0.1 L min-1 (54.1 ± 1.2 mL kg-1 min-1 ). The average distance covered during the Hoff test was 1,442.4 ± 30.0 m. The distance covered during the Hoff test showed significant correlations with absolute and expressed in an appropriated scale V_O2MAX (r = 0.44, p = 0.02; r = 0.42, p = 0.02, respectively) while no significant differences were found with body composition, VAnT and RAST variables. Conclusions The present study demonstrated that the distance covered during the Hoff test has weak correlation with V_O2MAX determined in treadmill running, and no correlation with VAnT, body composition and RAST outcomes, probably due to the non-specificity of the proposed tests when associated with the Hoff test.

Plasma levels of endothelin-1 after a pulmonary embolism of bone marrow fat

BACKGROUND: During orthopedic surgery, embolization of bone marrow fat can lead to potentially fatal, intra-operative cardiovascular deterioration. Vasoactive mediators may also be released from the bone marrow and contribute to these changes. Increased plasma levels of endothelin-1 (ET-1) have been observed after pulmonary air and thrombo-embolism. The role of ET-1 in the development of acute cardiovascular deterioration as a result of bone marrow fat embolization during vertebroplasty was therefore investigated. METHODS: Bone cement was injected into three lumbar vertebrae of six sheep in order to force bone marrow fat into the circulation. Invasive blood pressures and heart rate were recorded continuously until 60 min after the last injection. Cardiac output, arterial and mixed venous blood gas parameters and plasma ET-1 concentrations were measured at selected time points. Post-mortem, lung biopsies were taken for analysis of intravascular fat. RESULTS: Cement injections resulted in a sudden (within 1 min) and severe increase in pulmonary arterial pressure (>100%). Plasma concentrations of ET-1 started to increase after the second injection, but no significant changes were observed. Intravascular fat and bone marrow cells were present in all lung lobes. CONCLUSION: Cement injections into vertebral bodies elicited fat embolism resulting in subsequent cardiovascular changes that were characterized by an increase in pulmonary arterial pressure. Cardiovascular complications as a result of bone marrow fat embolism should thus be considered in patients undergoing vertebroplasty. No significant changes in ET-1 plasma values were observed. Thus, ET-1 did not contribute to the acute cardiovascular changes after fat embolism.