Autopsy: quality assurance in the ICU

Objective: To examine the correlation between the clinical diagnosis and autopsy findings in adult patients who died in an intensive care unit (ICU). To determine the rate of agreement of the basic and terminal causes of death and the types of errors in order to improve quality control of future care,Design, Retrospective study.Setting: Adult ICU in a university hospital.Patients: 30 adult patients who died in the ICU. with the exclusion of medicolegal cases.Methods and main results: Anatomo-clinical meetings were held to analyze the pre- and postmortem correlations in 30 consecutive autopsies at the ICU of the University Hospital, School of Medicine of Botucatu/ UNESP, from January 1994 to January 1997. The rate of correct clinical diagnoses of the basic cause was 66.7 %; in 23.3 % of cases, if the correct diagnosis was made, management would have been different, as would have been the evolution of the patient's course (Class I error): in 10 % of the cases the error would not have led to a change in management (Class II error). The rate of correct clinical diagnoses of terminal cause was 80 %.Conclusions: the rate of recognition of the basic cause was 66.7 %, which is consistent with the literature, but the Class I error rate was higher than that reported in the literature.

Apical Sealing Quality of In Vitro Apicectomy Procedures After Using Both Er:YAG and Nd:YAG

The aim of this study was to evaluate the apical sealing of dentinal tubules after root-end surface cutting by using Er:YAG and Nd:YAG lasers. After root-canal instrumentation and filling, apices of 50 extracted maxillary canine human teeth were resected by Er: YAG with 400 mJ, 10 Hz, for 30 sec. The samples were randomly assigned to five groups (n = 10): (GI) treated without root-end cavity, but with Nd: YAG (1.0W, 10 Hz, 20 sec) for dentinal tubules sealing; (GII) treated with root-end cavity without the use of Nd: YAG; (GIII) treated with root-end cavity and Nd: YAG application; (GIV) treated with root-end cavity made by Er: YAG with no focus and without Nd: YAG application; and (GV) treated without root-end cavity and without Nd: YAG application. The root-end cavities were performed by using Er: YAG at 300 mJ, 10 Hz, for 20 sec. Subsequently, all teeth were waterproofed and immersed in 2% methylene blue for 48 h in a vacuum environment. The samples were longitudinally sectioned, and microleakage was measured. ANOVA and the Fisher LSD test showed that GIV was less susceptible to microleakage than were the other groups (p < 0.05). Interestingly, the use of the Er: YAG with no focus showed superior dentinal tubule sealing in comparison with the other groups, even with or without root-end cavity and Nd: YAG application.

Water balance and locomotor performance in three species of neotropical toads that differ in geographical distribution

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

The evolution of jumping performance in anurans: morphological correlates and ecological implications

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

The contribution of air breathing to aerobic scope and exercise performance in the banded knifefish Gymnotus carapo L.

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

Effect of fertilization in water quality and in zooplankton community in open plankton-culture ponds

The effect of swine manure fertilization on the water quality of zooplankton artificial culture in two ponds was measured in diel cycles on different months (October 1999, January and March 2000). Fertilization affected directly water quality; values for total phosphorus were above 1.4 mgL(-1) and maximum rates for ammonia reached 108 mu gL(-1). Zooplankton community comprised four species, namely, Brachionus calyciflorus, B. falcatus, Moina sp. and Thermocyclops sp. B. falcatus (Rotifera) and Moina sp (Cladocera) were dominant respectively in January and in March. There was no difference in abundance of zooplankton between the two ponds (p>0.05), although adult cyclopoid Thermocyclops sp was different between diel cycles (p<0.05). There were significant differences (p<0.05) in dissolved oxygen, ammonia, total phosphorus, orthophosphate, nitrite and nitrate between ponds. In fact, only dissolved oxygen and pH were significantly different (p<0.05) between the ponds' surface and bottom. Organic fertilization also provided greater amount of nutrients and higher pH and conductivity, coupled to greater oscillations in the concentration of dissolved oxygen, directly affecting the zooplanktonic composition.

The effects of anxiety on visual search, movement kinematics, and performance in table tennis: A test of Eysenck and Calvo's processing efficiency theory

Processing efficiency theory predicts that anxiety reduces the processing capacity of working memory and has detrimental effects on performance. When tasks place little demand on working memory, the negative effects of anxiety can be avoided by increasing effort. Although performance efficiency decreases, there is no change in performance effectiveness. When tasks impose a heavy demand on working memory, however, anxiety leads to decrements in efficiency and effectiveness. These presumptions were tested using a modified table tennis task that placed low (LWM) and high (HWM) demands on working memory. Cognitive anxiety was manipulated through a competitive ranking structure and prize money. Participants' accuracy in hitting concentric circle targets in predetermined sequences was taken as a measure of performance effectiveness, while probe reaction time (PRT), perceived mental effort (RSME), visual search data, and arm kinematics were recorded as measures of efficiency. Anxiety had a negative effect on performance effectiveness in both LWM and HWM tasks. There was an increase in frequency of gaze and in PRT and RSME values in both tasks under high vs. low anxiety conditions, implying decrements in performance efficiency. However, participants spent more time tracking the ball in the HWM task and employed a shorter tau margin when anxious. Although anxiety impaired performance effectiveness and efficiency, decrements in efficiency were more pronounced in the HWM task than in the LWM task, providing support for processing efficiency theory.

Effects of isoflurane on Tei-index of myocardial performance in healthy dogs

Recently, the Tei-index, a noninvasive index that combines systolic and diastolic time intervals, has been proposed to assess global cardiac performance. However, the effects of isoflurane on the Tei-index have not been characterized. This study aimed at studying the effects of 1.0 minimal alveolar concentration isoflurane anesthesia on the pre-ejection period (PEP), left ventricular ejection time (LVET), PEP/LVET ratio, isovolumic relaxation time (IVRT), stroke index (SI), cardiac index (CI), heart rate (HR), and the Tei-index in healthy unpremedicated dogs. We observed significant increases in PEP, PEP/LVET ratio, IVRT, and TEI, whose maximal increases obtained throughout the study were 47%, 48%, 78%, and 56%, respectively. The LVET and HR did not change significantly, whereas the SI and CI decreased during anesthesia (29% and 26%, respectively). In conclusion, isoflurane produced direct effects on the Tei-index. The changes in systolic and diastolic parameters were supportive of this finding and were consistent with an overall impairment of left ventricular function during anesthesia.

Comparative sediment quality assessment in different littoral ecosystems from Spain (Gulf of Cadiz) and Brazil (Santos and Sao Vicente estuarine system)

The goal of this work was to establish comparisons among environmental degradation in different areas from Southern Spain (Gulf of Cadiz) and Brazil (Santos and Sao Vicente estuary), by using principal component analyses (PCA) to integrate sediment toxicity (amphipods mortality) and chemical-physical data (Zn, Cd, Pb; Cu, Ni, Co, V, PCBs, PAHs concentrations, OC and fines contents). The results of PCA extraction of Spanish data showed that Bay of Cadiz, CA-1 did not present contamination or degradation; CA-2 exhibited contamination by PCBs, however it was not related to the amphipods mortality. Ria of Huelva was the most impacted site, showing contamination caused principally by hydrocarbons, in HV-1 and HV-2, but heavy metals were also important contaminants at HV-1, HV-2 and HV-3. Algeciras Bay was considered as not degraded in GR-3 and -4, but in GR-3' high contamination by PAHs was found. In the Brazilian area, the most degraded sediments were found in the stations situated at the inner parts of the estuary (SSV-2, SSV-3, and SSV-4), followed by SSV-6, which is close to the Submarine Sewage Outfall of Santos - SSOS. Sediments from SSV-1 and SSV-5 did not present chemical contamination, organic contamination or significant amphipod mortality. The results, of this investigation showed that both countries present environmental degradation related to PAHs: in Spain, at Ria of Huelva and Gudarranque river's estuary areas; and in Brasil, in the internal portion of the Santos and Sao Vicente estuary. The same situation is found for heavy metals, since all of the identified metals are related to toxicity in the studied areas, with few exceptions (V for both Brazil and Spain, and Cd and Co for Brazilian areas). The contamination by PCBs is more serious for Santos and Sao Vicente estuary than for the investigated areas in Gulf of Cadiz, where such compound did not relate to the toxicity. (c) 2006 Elsevier Ltd. All rights reserved.

Validity of the critical speed to determine blood lactate response and aerobic performance in swimmers aged 10-15 years

Introduction - the aim of this study was to analyze the validity of the critical speed (CS) to determine the speed corresponding to 4 mmol 1(-1) of blood lactate (S4) and the speed in a 30 min test (S30min) of swimmers aged 10-15 years.Synthesis of facts - CS, S4 and S30min were determined in 12 swimmers (eight boys and four girls) divided into two groups: 10-12 years and 13-15 years.Conclusion - CS was a good predictor of aerobic performance (S30min) independent of the chronological age, providing practical information about the aerobic performance state of young swimmers. (C) 2002, Editions scientifiques et medicates, Elsevier SAS. All rights reserved.

Effects of recovery type after a judo combat on blood lactate removal and on performance in an intermittent anaerobic task

Aim. The objective of this study was to verify the effects of active (AR) and passive recovery (PR) after a judo match on blood lactate removal and on performance in an anaerobic intermittent task (4 bouts of upper body Wingate tests with 3-min interval between bouts; 4WT).Methods. The sample was constituted by 17 male judo players of different competitive levels: A) National (Brazil) and International medallists (n. 5). B) State (São Paulo) medallists (n. 7). Q City (São Paulo) medallists (n. 5). The subjects were submitted to: 1) a treadmill test for determination of VO2peak and velocity at anaerobic threshold (VAT); 2) body composition; 3) a 5-min judo combat, 15-min of AR or PR followed by 4WT.Results. The groups did not differ with respect to: body weight, VO2peak, VAT, body fat percentage, blood lactate after combats. No difference was observed in performance between AR and PR, despite a lower blood lactate after combat (10 and 15 min) during AR compared to PR. Groups A and B performed better in the high-intensity intermittent exercise compared to athletes with lower competitive level (C).Conclusion. The ability to maintain power output during intermittent anaerobic exercises can discriminate properly judo players of different levels. Lactate removal was improved with AR when compared to PR but AR did not improve performance in a subsequent intermittent anaerobic exercise.

Towards Interoperability in P2P World: an Indexing Middleware for Multi-Protocol Peer-to-Peer Data Sharing

Despite the abundant availability,of protocols and application for peer-to-peer file sharing, several drawbacks are still present in the field. Among most notable drawbacks is the lack of a simple and interoperable way to share information among independent peer-to-peer networks. Another drawback is the requirement that the shared content can be accessed only by a limited number of compatible applications, making impossible their access to others applications and system. In this work we present a new approach for peer-to-peer data indexing, focused on organization and retrieval of metadata which describes the shared content. This approach results in a common and interoperable infrastructure, which provides a transparent access to data shared on multiple data sharing networks via a simple API. The proposed approach is evaluated using a case study, implemented as a cross-platform extension to Mozilla Fir fox browser; and demonstrates the advantages of such interoperability over conventional distributed data access strategies.