Caracterización del trauma vascular periférico del hospital de Kennedy

Introducción: El trauma vascular en nuestro país es común, causando mortalidad en la población entre 15-44 años; como causa principal, las heridas por arma corto punzante en los miembros superiores lideran sobre las de arma de fuego y los miembros inferiores. En Colombia se cuenta con algunos registros de trauma vascular secundario a la guerra, por lo que con este trabajo buscamos describir la población afectada de la localidad octava como punto inicial para estudios analíticos. Metodología: revisión de la base de datos de los pacientes llevados a cirugía en el hospital de Kennedy, de los cuales se extrajeron aquellos con trauma vascular, recolección de las variables a estudiar y análisis de las mismas. Resultados: encontramos 1267 pacientes que consultaron por trauma, de ellos 32 cursaron con trauma vascular, llevados a cirugía(0,3%), el promedio de edad fue de 24 años, la mayoría de sexo masculino (84%); el 72% fueron heridas por arma blanca, 56% fueron heridas múltiples, afectando en el 41% a las extremidades superiores; las lesiones en cuello casi igualan a las heridas en miembros inferiores con un 28%, solo se presentó un caso de amputación y no se presentaron mortalidades. Discusión: en Colombia hacen falta estudios acerca de esta patología que aunque común esta subpublicada, este estudio es tan solo un paso que nos introduce en las características demográficas, y algunas característica clínicas interesantes en comparación a la literatura mundial consultada

A atividade física em amputados transtibiais

A atividade física é um bom indicador de saúde para a população em geral. Os amputados abaixo do joelho também beneficiam com o exercício físico regular. Este trabalho pretendeu analisar a atividade física dos amputados transtibais. Para a sua realização executou-se um manuscrito da revisão sistemática da literatura e um manuscrito com base em artigos científicos. A revisão sistemática da literatura teve como objetivo analisar a atividade física, medida por instrumentos próprios, dos amputados transtibais. O outro manuscrito visou verificar quais as diferenças de atividade física em amputados vasculares e traumáticos, expor fatores que possam influenciar a atividade física e determinar um possível tempo de recomendação de exercício físico para esta população. Os resultados indicam que os amputados são menos ativos fisicamente que os indivíduos aparentemente saudáveis. Os amputados traumáticos têm uma atividade física maior que os vasculares, mas a etiologia da amputação não é a principal razão que influencia a atividade física. Esta pode ser influenciada pelo nível de amputação, pelo tempo de uso da prótese, pela funcionalidade do amputado com a prótese e a idade do amputado. A partir dos 100 minutos de atividade moderada a vigorosa já poderá ser recomendável a amputados transtibiais. Será importante a realização de estudos que abordem os amputados, uma vez que em Portugal são raras as investigações que indicam a incidência e prevalência de amputados. Mais estudos que avaliam a atividade física também seriam bem-vindos, para uma maior diversidade de opiniões e conhecimento.

Strategies to prevent falls and fractures in hospitals and care homes and effect of cognitive impairment: systematic review and meta-analyses

OBJECTIVES: To evaluate the evidence for strategies to prevent falls or fractures in residents in care homes and hospital inpatients and to investigate the effect of dementia and cognitive impairment. DESIGN: Systematic review and meta-analyses of studies grouped by intervention and setting (hospital or care home). Meta-regression to investigate the effects of dementia and of study quality and design. DATA SOURCES: Medline, CINAHL, Embase, PsychInfo, Cochrane Database, Clinical Trials Register, and hand searching of references from reviews and guidelines to January 2005. RESULTS: 1207 references were identified, including 115 systematic reviews, expert reviews, or guidelines. Of the 92 full papers inspected, 43 were included. Meta-analysis for multifaceted interventions in hospital (13 studies) showed a rate ratio of 0.82 (95% confidence interval 0.68 to 0.997) for falls but no significant effect on the number of fallers or fractures. For hip protectors in care homes (11 studies) the rate ratio for hip fractures was 0.67 (0.46 to 0.98), but there was no significant effect on falls and not enough studies on fallers. For all other interventions (multifaceted interventions in care homes; removal of physical restraints in either setting; fall alarm devices in either setting; exercise in care homes; calcium/vitamin D in care homes; changes in the physical environment in either setting; medication review in hospital) meta-analysis was either unsuitable because of insufficient studies or showed no significant effect on falls, fallers, or fractures, despite strongly positive results in some individual studies. Meta-regression showed no significant association between effect size and prevalence of dementia or cognitive impairment. CONCLUSION: There is some evidence that multifaceted interventions in hospital reduce the number of falls and that use of hip protectors in care homes prevents hip fractures. There is insufficient evidence, however, for the effectiveness of other single interventions in hospitals or care homes or multifaceted interventions in care homes.

Development and application of in vivo expression technology (IVET) for analysing microbial gene expression in complex environments

Establishing the mechanisms by which microbes interact with their environment, including eukaryotic hosts, is a major challenge that is essential for the economic utilisation of microbes and their products. Techniques for determining global gene expression profiles of microbes, such as microarray analyses, are often hampered by methodological restraints, particularly the recovery of bacterial transcripts (RNA) from complex mixtures and rapid degradation of RNA. A pioneering technology that avoids this problem is In Vivo Expression Technology (IVET). IVET is a 'promoter-trapping' methodology that can be used to capture nearly all bacterial promoters (genes) upregulated during a microbe-environment interaction. IVET is especially useful because there is virtually no limit to the type of environment used (examples to date include soil, oomycete, a host plant or animal) to select for active microbial promoters. Furthermore, IVET provides a powerful method to identify genes that are often overlooked during genomic annotation, and has proven to be a flexible technology that can provide even more information than identification of gene expression profiles. A derivative of IVET, termed resolvase-IVET (RIVET), can be used to provide spatio-temporal information about environment-specific gene expression. More recently, niche-specific genes captured during an IVET screen have been exploited to identify the regulatory mechanisms controlling their expression. Overall, IVET and its various spin-offs have proven to be a valuable and robust set of tools for analysing microbial gene expression in complex environments and providing new targets for biotechnological development.

Molecular structures of benzoic acid and 2-hydroxybenzoic acid, obtained by gas-phase electron diffraction and theoretical calculations

The structures of benzoic acid (C6H5COOH) and 2-hydroxybenzoic acid (C6H4OHCOOH) have been determined in the gas phase by electron diffraction using results from quantum chemical calculations to inform restraints used on the structural parameters. Theoretical methods (HF and MP2/6-311+G(d, p)) predict two conformers for benzoic acid, one which is 25.0 kJ mol(-1) (MP2) lower in energy than the other. In the low-energy form, the carboxyl group is coplanar with the phenyl ring and the O-H group eclipses the C=O bond. Theoretical calculations (HF and MP2/6-311+ G(d, p)) carried out for 2-hydroxybenzoic acid gave evidence for seven stable conformers but one low-energy form (11.7 kJ mol-1 lower in energy (MP2)) which again has the carboxyl group coplanar with the phenyl ring, the O-H of the carboxyl group eclipsing the C=O bond and the C=O of the carboxyl group oriented toward the O-H group of the phenyl ring. The effects of internal hydrogen bonding in 2-hydroxybenzoic acid can be clearly observed by comparison of pertinent structural parameters between the two compounds. These differences for 2-hydroxybenzoic acid include a shorter exocyclic C-C bond, a lengthening of the ring C-C bond between the substituents, and a shortening of the carboxylic single C-O bond.

Molecular structures of 3-hydroxybenzoic acid and 4-hydroxybenzoic acid, obtained by gas-phase electron diffraction and theoretical calculations

The structures of 3-hydroxybenzoic acid and 4-hydroxybenzoic acid have been determined by gas-phase electron diffraction using results from quantum chemical calculations to inform the choice of restraints applied to some of the structural parameters. The results from the study presented here demonstrate that resonance hybrids are not as helpful in rationalizing the structures of 2-, 3-, and 4-hydroxybenzoic acids as are models based upon electrostatic effects.

Hydrogen bonding in the gas-phase: the molecular structures of 2‑hydroxybenzamide (C7H7NO2) and 2‑methoxybenzamide (C8H9NO2), obtained by gas-phase electron diffraction and theoretical calculations

The structures of 2-hydroxybenzamide(C7H7NO2) and 2-methoxybenzamide (C8H9NO2) have been determined in the gas-phase by electron diffraction using results from quantum chemical calculations to inform restraints used on the structural parameters. Theoretical methods (HF and MP2/6-311+G(d,p)) predict four stable conformers for both 2-hydroxybenzamide and 2-methoxybenzamide. For both compounds, evidence for intramolecular hydrogen bonding is presented. In 2-hydroxybenzamide, the observed hydrogen bonded fragment is between the hydroxyl and carbonyl groups, while in 2-methoxybenzamide, the hydrogen bonded fragment is between one of the hydrogen atoms of the amide group and the methoxy oxygen atom.

Regurgitated bodies: presenting and representing trauma in 'The Act of Killing'

Focusing on The Act of Killing, this chapter examines how an “ethics of realism” operates on three key cinematic arenas: genre, authorship and spectatorship. As far as genre is concerned, the film’s realist commitment emerges from where it is least expected, namely from Hollywood genres, such as the musical, the film noir and the western, which are used as documentary, that is to say, as a fantasy realm where perpetrators can confess to their crimes without restraints or fear of punishment, but which nonetheless retains the evidentiary weight of the audiovisual medium. Authorship, in turn, translates as Oppenheimer’s unmistakable auteur signature through his role of self-confessed “infiltrator” who disguises as a sympathiser of the criminals in order to gain first-hand access to the full picture of their acts. One of them, the protagonist Anwar Congo, is clearly affected by post-traumatic stress disorder, and his repetitive reliving of his killings is made to flare up in front of the camera so as to bring back the dead to the present time in their material reality, through his own body, including a harrowing scene of the actor’s unpredictable and uncontrollable retching as he re-enacts the killing of his victims through strangulation. Finally, in the realm of spectatorship, the usual process of illusionistic identification on the part of the spectator is turned onto its head by means of disguising these criminals as amateur filmmakers, led to shoot, act within, and then watch their own film within the film so as to force them to experience beyond any illusion the suffering they had caused.

Objective characterization of the course of the parasellar internal carotid artery using mathematical tools

Background Along the internal carotid artery (ICA), atherosclerotic plaques are often located in its cavernous sinus (parasellar) segments (pICA). Studies indicate that the incidence of pre-atherosclerotic lesions is linked with the complexity of the pICA; however, the pICA shape was never objectively characterized. Our study aims at providing objective mathematical characterizations of the pICA shape. Methods and results Three-dimensional (3D) computer models, reconstructed from contrast enhanced computed tomography (CT) data of 30 randomly selected patients (60 pICAs) were analyzed with modern visualization software and new mathematical algorithms. As objective measures for the pICA shape complexity, we provide calculations of curvature energy, torsion energy, and total complexity of 3D skeletons of the pICA lumen. We further measured the posterior knee of the so-called ""carotid siphon"" with a virtual goniometer and performed correlations between the objective mathematical calculations and the subjective angle measurements. Conclusions Firstly, our study provides mathematical characterizations of the pICA shape, which can serve as objective reference data for analyzing connections between pICA shape complexity and vascular diseases. Secondly, we provide an objective method for creating Such data. Thirdly, we evaluate the usefulness of subjective goniometric measurements of the angle of the posterior knee of the carotid siphon.

Active galactic nuclei: sources for ultra high energy cosmic rays

Ultra high energy cosmic ray events presently show a spectrum, which we interpret here as galactic cosmic rays due to a starburst, in the radio galaxy Cen A which is pushed up in energy by the shock of a relativistic jet. The knee feature and the particles with energy immediately higher in galactic cosmic rays then turn into the bulk of ultra high energy cosmic rays. This entails that all ultra high energy cosmic rays are heavy nuclei. This picture is viable if the majority of the observed ultra high energy events come from the radio galaxy Cen A, and are scattered by intergalactic magnetic fields across much of the sky.

Exercise-associated thermographic changes in young and elderly subjects

This study aimed at evaluating the thermographic changes associated with localized exercise in young and elderly subjects. An exercise protocol using 1 kg load was applied during 3 min to the knee flexors of 14 elderly (67 +/- 5 years) and 15 young (23 +/- 2 years) healthy subjects. The posterior thigh`s skin temperature of the exercised limb and contralateral limb were measured by infrared thermography on pre-exercise, immediately post-exercise, and during the 10-min period post-exercise. Difference (p < 0.01) between elderly and young subjects was observed on pre-exercise temperature. Although differences were not observed between pre-exercise and immediately post-exercise temperature in the exercised limb, thermographic profile displayed heat concentration in exercised areas for both groups. Temperature reduction was only observed for the young group on the 10-min post-exercise (p < 0.05) in the exercised limb (30.7 +/- 1.7 to 30.3 +/- 1.5 degrees C). In contrast, there was a temperature reduction post-exercise (p < 0.01) in the contralateral limb for both groups. These results present new evidences that elderly and young subjects display similar capacity of heat production; however, the elderly subjects presented a lower resting temperature and slower heat dissipation. This work contributes to improve the understanding about temperature changes in elderly subjects and may present implications to the sports and rehabilitation programs.

Physiological demands of competitive elite cross-country skiing

Introduction Researchers have, for decades, contributed to an increased collective understanding of the physiological demands in cross-country skiing; however, almost all of these studies have used either non-elite subjects and/or performances that emulate cross-country skiing. To establish the physiological demands of cross-country skiing, it is important to relate the investigated physiological variables to the competitive performance of elite skiers. The overall aim of this doctoral thesis was, therefore, to investigate the external validity of physiological test variables to determine the physiological demands in competitive elite cross-country skiing. Methods The subjects in Study I – IV were elite male (I – III) and female (III – IV) cross-country skiers. In all studies, the relationship between test variables (general and ski-specific) and competitive performances (i.e. the results from competitions or the overall ski-ranking points of the International Ski Federation (FIS) for sprint (FISsprint) and distance (FISdist) races) were analysed. Test variables reflecting the subject’s general strength, upper-body and whole-body oxygen uptake, oxygen uptake and work intensity at the lactate threshold, mean upper-body power, lean mass, and maximal double-poling speed were investigated. Results The ability to maintain a high work rate without accumulating lactate is an indicator of distance performance, independent of sex (I, IV). Independent of sex, high oxygen uptake in whole-body and upper-body exercise was important for both sprint (II, IV) and distance (I, IV) performance. The maximal double-poling speed and 60-s double-poling mean power output were indicators of sprint (IV) and distance performance (I), respectively. Lean mass was correlated with distance performance for women (III), whereas correlations were found between lean mass and sprint performance among both male and female skiers (III). Moreover, no correlations between distance performance and test variables were derived from tests of knee-extension peak torque, vertical jumps, or double poling on a ski-ergometer with 20-s and 360-s durations (I), whereas gross efficiency while treadmill roller skiing showed no correlation with either distance or sprint performance in cross-country skiing (IV). Conclusion The results in this thesis show that, depending on discipline and sex, maximal and peak oxygen uptake, work intensity at the lactate threshold, lean mass, double-poling mean power output, and double-poling maximal speed are all externally valid physiological test variables for evaluation of performance capability among elite cross-country skiers; however, to optimally indicate performance capability different test-variable expressions should be used; in general, the absolute expression appears to be a better indicator of competitive sprint performance whereas the influence of body mass should be considered when evaluating competitive distance performance capability of elite cross-country skiers.

Soft money : private foundations of party politics

In the area of campaign financing in federal elections, one of the most controversial issues is that of soft money. Soft money refers to those funds raised by the national party organizations for use on various grassroots and party-building activities. but which are not subject to the restraints of federal campaign finance law. Critics contend that these party-building activitie, such as generic television advertising, voter registration and get-out-the vote drives, provide ancillary benefits to federal candidates and should, therefore, be subject to federal contribution and expenditure limits. Critics further argue that because these funds are not subject to federal law and do benefit federal candidates, the national parties raise monies in amounts and from sources, such as corporations and unions, that are prohibited under federal law. Efforts to gain a better understanding of soft money have been hampered by a lack of data, as the national parties were not required to disclose their soft money receipts and transactions until 1991. The purpose of this study is to analyze data recently made available in an attempt to add the import of empirical evidence to the debate over soft money. The nature, size and timing of soft money contributions are investigated and national party soft money disbursements are examined. The findings suggest that any attempts to reform the soft money system must first consider its compensatory benefits. Most prominently, this includes the extent to which soft money has promoted the resurgence of the national party organizations in the context of election politics.

Desenvolvimento do saltar à horizontal : uma análise topológica

O objetivo deste estudo foi investigar a organização espaço-temporal dos segmentos da perna e da coxa no saltar à horizontal, verificando as infiuências do organismo e do ambiente (dois tipos de piso: concreto e areia). Participaram do estudo 21 sujeitos, 3 de cada faixa etária: 4, 5, 7, 9, 11, 13 e adulta (X = 19 anos de idade). Os sujeitos foram filmados realizando o saltar à horizontal com marcas desenhadas no centro das articulações do tornozelo, joelho e quadril. Estes pontos foram digitalizados e processados obtendo a posição e velocidade angular dos segmentos da perna e da coxa. A partir da posição e velocidade angular foi possível delinear os gráficos dos atratores (retratos de fase) e calcular os valores dos ângulos de fase para cada segmento, durante a realização da tarefa. Duas reversões para cada segmento, na posição angular, foram identificadas e nestes momentos os valores dos ângulos de fase foram capturados. Analisando as trajetórias dos retratos de fase verificou-se que os segmentos da perna e da coxa apresentaram um conjunto específico de características topológicas, na realização do saltar à horizontal. A análise dos valores dos ângulos de fase, nas duas reversões, indicou que ao longo das faixas etárias e nos dois tipos de piso os segmentos da perna e da coxa apresentaram organização espaço-temporal semelhante, indicando coordenação invariante.

A trajetória do movimento e da participação: a origem da organização sindical na educação

Resgate histórico do Movimento Organizado dos trabalhadores técnico administrativos da Universidade Federal do Rio de Janeiro - UFRJ. O presente estudo tem como objetivo central, descrever, de que forma a ascensão da ação organizada dos funcionários da UFRJ - traduzida, inicialmente, na figura da Associação - desencadeou na transformação de sua entidade representativa em Sindicato da categoria. Os sujeitos da pesquisa referem-se à dirigentes sindicais, que tiveram uma inserção significativa nesse processo. Os principais protagonistas dessa história, relatam fatos marcantes, os quais, muitos deles, não se encontram registrados nos acervos da organização estudada. A análise de documentos que identificam essa história, também foi utilizada como apoio ao estudo. A ênfase do trabalho está voltada à pesquisa descritiva e analítica. A pesquisa de campo ocorre no Sindicato dos Trabalhadores em Educação da UFRJ, situado na llha do Fundão. A análise do material empírico indica que o processo de transformação - de associativismo para sindicalismo - não se dá na passagem formal, ocorrida em 93. Mas, a partir da década de 80, quando um grupo de servidores pertencentes à Unidades diversas, com posturas ideológicas e políticas semelhantes, se insere, gradativamente, no órgão. Passa a impetrar uma prática político-reivindicatória, diferenciada das atuações recreativa e assistencialista que permearam as gestões anteriores. Contudo, em relação à descrição dessa história, a pretensão não foi a de pontuar uma evolução linear, mas a de também identificar questões que determinaram momentos de instabilidade, bem como de reavaliação, por parte dos sujeitos envolvidos. Constitui, portanto, um válido instrumento para avaliação das práticas, objetivos, políticas e culturas que permearam a atuação desse movimento, elaborando questões que possam contribuir para a superação de eventuais equívocos ou entraves no momento presente.