Wave uplift pressures on horizontal platforms

The major objective of the study has been to investigate in detail the rapidly-varying peak uplift pressure and the slowly-varying positive and negative uplift pressures that are known to be exerted by waves against the underside of a horizontal pier or platform located above the still water level, but not higher than the crests of the incident waves.

In a "two-dimensional" laboratory study conducted in a 100-ft long by 15-in.-wide by 2-ft-deep wave tank with a horizontal smooth bottom, individually generated solitary waves struck a rigid, fixed, horizontal platform extending the width of the tank. Pressure transducers were mounted flush with the smooth soffit, or underside, of the platform. The location of the transducers could be varied.

The problem of a d equate dynamic and spatial response of the transducers was investigated in detail. It was found that unless the radius of the sensitive area of a pressure transducer is smaller than about one-third of the characteristic width of the pressure distribution, the peak pressure and the rise-time will not be recorded accurately. A procedure was devised to correct peak pressures and rise-times for this transducer defect.

The hydrodynamics of the flow beneath the platform are described qualitatively by a si1nple analysis, which relates peak pressure and positive slowly-varying pressure to the celerity of the wave front propagating beneath the platform, and relates negative slowly-varying pressure to the process by which fluid recedes from the platform after the wave has passed. As the wave front propagates beneath the platform, its celerity increases to a maximum, then decreases. The peak pressure similarly increases with distance from the seaward edge of the platform, then decreases.

Measured peak pressure head, always found to be less than five times the incident wave height above still water level, is an order of magnitude less than reported shock pressures due to waves breaking against vertical walls; the product of peak pressure and rise-time, considered as peak impulse, is of the order of 20% of reported shock impulse due to waves breaking against vertical walls. The maximum measured slowly-varying uplift pressure head is approximately equal to the incident wave height less the soffit clearance above still water level. The normalized magnitude and duration of negative pressure appears to depend principally on the ratio of soffit clearance to still water depth and on the ratio of platform length to still water depth.

Respostas agudas de pressão arterial e variabilidade da frequência cardíaca são dependentes do volume total do exercício aeróbio em adultos saudáveis

A hipotensão pós-exercício (HPE) é um fenômeno de relevância clínica, mas dúvidas persistem no tocante ao efeito do modo e da forma de execução (contínua vs. acumulada) do exercício aeróbio para sua manifestação, bem como o papel do controle autonômico cardíaco como mecanismo fisiológico associado à HPE. Assim, a presente tese objetivou: a) investigar a HPE induzida por sessões aeróbias de exercício isocalórico contínuo e acumulado; b) comparar as respostas de pressão arterial sistólica (PAS) e diastólica (PAD) após teste cardiopulmonar de exercício máximo (TCPE) em três modalidades; c) verificar a influência do modo de exercício e do controle autonômico cardíaco em repouso sobre a reativação vagal após TCPE. No primeiro estudo, 10 homens saudáveis (idade: 27,6 3,5 anos) realizaram TCPEs de corrida e ciclismo para medida do consumo de oxigênio de pico (VO2pico) e sessões contínuas (400 kcal) e acumuladas (2 x 200 kcal) de corrida e ciclismo à 75%VO2reserva. A PAS e PAD reduziram similarmente após exercício contínuo e acumulado (4,6 2,3 vs. 5,2 2,3 mmHg, 2,6 2,5 vs. 3,6 2,5 mmHg, respectivamente, P > 0,05). Porém, a corrida provocou maior declínio na PAS do que o ciclismo (P < 0.05). A atividade simpática (componente de baixa frequência, LF) e parassimpática (componente de alta frequência, HF) aumentou (P < 0,001) e diminuiu (P < 0,001) em relação à sessão controle, elevando o balanço simpato-vagal (razão LF:HF) (P < 0,001) que foi inversamente correlacionado ao ΔPAS e ΔPAD (r = -0,41 a -0,70; P < 0.05). No segundo e terceiro estudos, 20 homens saudáveis (idade: 21.2 3.0 anos) realizaram três TCPEs (ciclismo, caminhada e corrida). No segundo estudo, investigou-se a resposta aguda da PA, débito cardíaco (Q), resistência vascular periférica (RVP), sensibilidade do barorreflexo arterial (SBR), variabilidade da frequência cardíaca (VFC) e dispêndio energético durante 60 min após os TCPEs e sessão controle. Comparado ao controle, somente a corrida modalidade envolvendo maior dispêndio energético total (P < 0,001) - foi capaz de reduzir a PAS no pós-exercício (P < 0,001). Mudanças na RVP, SBR, LF, e razão LF:HF foram negativamente correlacionadas às variações na PAS (-0,69 a -0,91; P < 0,001) e PAD (-0,58 a -0,93; P ≤ 0,002). No terceiro estudo, examinou-se a reativação parassimpática após cada TCPE pela raiz quadrada da média do quadrado das diferenças entre intervalos R-R normais adjacentes em janelas de 30 s (rMSSD30s). Apesar da menor FCpico, VO2pico e dispêndio energético no ciclismo vs. caminhada e corrida (P < 0,001), a reativação parassimpática foi significativamente mais rápida após o ciclismo (P < 0,05). Outrossim, o Δ rMSSD30-180s foi positivamente correlacionado ao HF (rs = 0,90 a 0,93; P < 0,001) e negativamente correlacionado ao LF e a razão LF:HF medidos no repouso (rs = -0,73 a -0,79 e -0,86 a -0,90, respectivamente; P < 0,001). Em conclusão, a forma de execução do exercício aeróbio não interfere na magnitude da HPE, mas a HPE é dependente do modo ou o volume total de exercício. Os resultados também indicam que o padrão de recuperação do controle autonômico cardíaco pela análise espectral da VFC pode ter um papel importante na indução da HPE.

Fracionamento biomonitorado de fração isolada do extrato hexânico de Pterodon polygalaeoflorus

O gênero Pterodon compreende algumas espécies largamente distribuídas sobre a região central do Brasil. Seus frutos são comercialmente disponíveis no mercado da flora medicinal sendo amplamente utilizados pelas suas propriedades farmacológicas como antirreumático, anti-inflamatório e analgésicas. O objetivo deste trabalho foi biomonitorar o fracionamento do extrato hexânico de Pterodon polygalaeflorus Benth. (ExPpg), utilizando modelos de inflamação aguda (edema de pata e bolha de ar). O fracionamento/sub-fracionamento foi realizado por cromatografia em coluna de sílica e as amostras analisadas por cromatografia em camada fina e cromatografia gasosa acoplada a espectrômetro de massas. O edema de pata foi induzido em camundongos SW por injeção (s.c.) de carragenina. Uma hora antes da inoculação de carragenina os animais foram tratados v.o. com veículo (EtOH 15%, 1,25% Tween-20), indometacina (10 mg/kg p.c.) ou ExHPpg/frações/sub-frações de Ppg. No modelo bolha de ar, a cavidade foi desenvolvida em camundongos SW através da injeção de ar estéril (s.c.) no dorso e a inflamação induzida por carragenina. Uma hora antes de inocular a carragenina os animais foram tratados (v.o) com o veículo, indometacina (10 mg/kg) ou ExHPpg/Fr2Ppg/sub-frações. Após 4 h o exsudato da bolha foi coletado para contagem total e diferencial de leucócitos (Panótico rápido) e dosagem de proteínas (biureto), e a pele referente à bolha foi removida para análises macroscópica e histológica (HE). Também foi realizado estudo de migração de neutrófilos pelo ensaio do transwell. Após demonstração do efeito antiedematogênico do ExHPpg, este foi fracionado em quatro frações. A fração Fr2Ppg, mais ativa no modelo de edema de pata, também inibiu os diferentes parâmetros inflamatórios avaliados no modelo de bolha de ar, com a menor dose testada, e foi sub-fracionada em cinco sub-frações. Destas, as SF2.1 e SF2.2 foram as que mostraram melhor efeito anti-inflamatório pelo modelo da bolha de ar. Em relação ao grupo controle com carragenina, o ExHppg, Fr2Ppg, SF 2.1 e SF 2.2, na dose 0,02 mg/kg, exerceram inibições de 70,6%, 62,8%, 54,7% e 79% no número total de células no exsudato, reduções de 76,8%, 76,9%, 71,1% e 73,3% na concentração de proteína, respectivamente. Com a dose de 0,2 mg/kg, foram observadas inibições apenas para ExHPpg e SF 2.1, com intensidades menores, na leucometria total (62,9% e 48,62%, respectivamente), e na concentração de proteína para SF 2.1 e SF 2.2 (reduções de 68,2% e 30,4%, respectivamente). As análises macroscópica e histológica mostraram redução importante da vasodilatação e do infiltrado inflamatório pelo tratamento com o ExHppg, Fr2Ppg, SF 2.1 e SF 2.2. No ensaio de transwell a Fr2Ppg exibiu 31,4% de inibição na migração de neutrófilos. As sub-frações SF2.1 e SF2.2 foram avaliadas por GC-MS, identificando-se de diversos compostos majoritários. Em resumo, este trabalho confirma o potencial anti-inflamatório da espécie Pterodon polygalaeflorus e mostra um fracionamento efetivo do ExHPpg quanto à composição e ação anti-inflamatória.

扬子地区上奥陶－下志留统黑色岩系形成机理

The black rock series of the Upper Ordovician - Lower Silurian in Yangtze area are important source rocks and have exceptional characteristics of sediment, biology, element geochemistry, carbon and oxygen isotope, organic geochemistry and etc. These characteristics are the reflection of important geology events. Due to scarce system research, many problems that relate to the development mechanism of source rocks are not solved. And this restricts the exploration of Oil and gas in South China. In this paper, author studied the palaeo-climate, palaeo-structure and palaeo-environment of the Upper Ordovician - Lower Silurian in Yangtze area by sedimentology, palaeobiology and geochemistry, especially the element geochemistry and isotope geochemistry. The environment model of source rocks is established and some conclusions are drawn. The Upper Ordovician - Lower Silurian sediment types in Yangtze area are mostly black shales, next, mudstone, shell limestone and siltystone. During the Late Ordovician and Earily Silurian periods, a series of big upheaval and depressed are distributed in Yangtze area, and the strata pattern of interphase upheaval and depressed led to Yangtze palaeosea isolated with outside sea. So the stagnant and anoxic environment that are the favorable factor of rich organic black shales sediment is formed in Yangtze area. That Chemical Index of Alteration (CIA) values of the lower Wufeng formation and Longmaxi formation exhibits moderate chemistry weathering suggests they were deposited under the circumstances of the warm and humid climate. However, the large difference of the CIA values of N.extraordinarius-N.ojsuensis biozone suggests that climate is changeful. Therefore, there were two different kinds of climates in the course of the deposition of the Wufeng formation and Longmaxi formation. During the Late Ordovician - Earily Silurian periods, in Yangtze palaeosea, the surface water which is full of rich nutriment and abundant bacterium - algae has high palaeo-productivity that is obvious difference in the different space – time. The content of sulphate changes gradually from the surface water columns to the deep water columns. That is, salinity in the surface water columns is serious low and the salinity in deep water columns is normal. Salinity delamination is favor of the forming of deep anoxic environment. During Wufeng period, the oxidated and low sulfate environment exists in the upper Yangtze palaeosea, while the anoxic and normal salinity environment occurs in the lower Yangtze palaeosea. During the Late Wufeng and Guanyinqiao periods, the steady anoxic environment is replaced by oxidated environment. During the Longmaxi period, layered and anoxic environment recur. In Yangtze area, studies of δ13C of sedimentary organic carbon show a positive δ13C excursion up to 4‰ in the Guanyinqiao stage and then, acute negative excursion in the earily Longmaxi stage. These organic carbon isotopes curve are not only efficient measure of carving up strata borderline, but also reflected the change of originality productivity. These organic carbon isotopes curves showed the process of the enhanced embedding of the global organic carbon. Anoxic event is the main factor of increasing organic carbon embedding speed. And the reduced organic carbon embedding in Hirnantian stage is due to the water column with abundant oxygen. The δ34S values are gradually positive excursion from P.pacificus biozone to N.extraordinarius biozone, and reach the maximum in the Upper Hirnantian stage. Then, the δ34S values are negative excursion. The excursions of δ13C and δ34S reflect the acute change of environment. The formation of source rocks is largely dependent on the nature of organisms from which kerogen is derived and the preservation conditions of organic matter, which are fundamentally dependent on a favourable combination of various elements in which organisms live and are subsequently buried. These elements include palaeoclimate, palaeostructure and palaeoenvironmental conditions. Based on above mentioned circumstance, the coupling connection of source rock and the palaeoclimate, and of palaeostructure and palaeoenvironmental conditions are confirmed, and the “anoxic-marginal depression-photosynthesis” environemental model is established. It is indicated that anoxic played important role in production of organic matter. The produced organic matter was accumulated in marginal depression of the Yangtze area. The photosynthesis is favor of the high productivity. Source rocks have a good perspective, like that of “hot shale” deposited in North Africa.

Gas-liquid two phase flow through a vertical 90deg elbow bend

Pressure drop data are reported for two phase air-water flow through a vertical to horizontal 90° elbow bend set in 0.026 m i.d. pipe. The pressure drop in the vertical inlet tangent showed some significant differences to that found for straight vertical pipe. This was caused by the elbow bend partially choking the inflow resulting in a build-up of pressure and liquid in the vertical inlet riser and differences in the structure of the flow regimes when compared to the straight vertical pipe. The horizontal outlet tangent by contrast gave data in general agreement with literature even to exhibiting a drag reduction region at low liquid rates and gas velocities between 1 and 2 m s -1. The elbow bend pressure drop was best correlated in terms of le/d determined using the actual pressure loss in the inlet vertical riser. The data showed a general increase with fluid rates that tapered off at high fluid rates and exhibited a negative pressure region at low rates. The latter was attributed to the flow being smoothly accommodated by the bend when it passed from slug flow in the riser to smooth stratified flow in the outlet tangent. A general correlation was presented for the elbow bend pressure drop in terms of total Reynolds numbers. A modified Lockhart-Martinelli model gave prediction of the data.

Alpha-1-antitrypsin aerosolized augmentation abrogates neutrophil elastase-induced expression of cathepsin B and matrix metalloprotease 2 in vivo and in vitro

Background: Neutrophil elastase (NE) activity is increased in lung diseases such as a1-antitrypsin (A1AT) deficiency and pneumonia. It has recently been shown to induce expression of cathepsin B and matrix metalloprotease 2 (MMP-2) in vitro and in a mouse model. It is postulated that increased cathepsin B and MMP-2 in acute and chronic lung diseases result from high levels of extracellular NE and that expression of these proteases could be inhibited by A1AT augmentation therapy.

Methods: Cathepsin and MMP activities were assessed in bronchoalveolar lavage (BAL) fluid from patients with A1AT deficiency, pneumonia and control subjects. Macrophages were exposed to BAL fluid rich in free NE from patients with pneumonia following pretreatment with A1AT. MMP-2, cathepsin B, secretory leucoprotease inhibitor (SLPI) and lactoferrin levels were determined in BAL fluid from A1AT-deficient patients before and after aerosolisation of A1AT.

Results: BAL fluid from both patients with pneumonia and those with A1AT deficiency containing free NE had increased cathepsin B and MMP-2 activities compared with BAL fluid from healthy volunteers. The addition of A1AT to BAL fluid from patients with pneumonia greatly reduced NE-induced cathepsin B and MMP-2 expression in macrophages in vitro. A1AT augmentation therapy to A1AT-deficient individuals also reduced cathepsin B and MMP-2 activity in BAL fluid in vivo. Furthermore, A1AT-deficient patients had higher levels of SLPI and lactoferrin after A1AT augmentation therapy.

Conclusion: These findings suggest a novel role for A1AT inhibition of NE-induced upregulation of MMP and cathepsin expression both in vitro and in vivo.

Palaeoglacial and palaeoclimatic conditions in the NW Pacific, as revealed by a morphometric analysis of cirques upon the Kamchatka Peninsula

The distribution of glacial cirques upon the Kamchatka peninsula, Far Eastern Russia, is systematically mapped from satellite images and digital elevation model data. A total of 3,758 cirques are identified, 238 of which are occupied by active glaciers. The morphometry of the remaining 3,520 cirques is analysed. These cirques are found to show a very strong N bias in their azimuth (orientation), likely resulting from aspect-related variations in insolation. The strength of this N bias is considered to indicate that former glaciation upon the peninsula was often ‘marginal’, and mainly of cirque-type, with peaks extending little above regional equilibrium-line altitudes. This is supported by the fact that S and SE-facing cirques are the highest in the dataset, suggesting that glacier-cover was rarely sufficient to allow S and SE-facing glaciers to develop at low altitudes. The strength of these azimuth-related variations in cirque altitude is thought to reflect comparatively cloud-free conditions during former periods of glaciation. It is suggested that these characteristics, of marginal glaciation and comparatively cloud-free conditions, reflect the region’s former aridity, which was likely intensified at the global Last Glacial Maximum, and during earlier periods of ice advance, as a result of the development of negative pressure anomalies over the North Pacific (driven by the growth of the Laurentide Ice Sheet), combined with other factors, including an increase in the extent and duration of sea ice, a reduction in global sea levels, cooler sea surface temperatures, and the localised growth of mountain glaciers. There is published evidence to suggest extensive glaciation of the Kamchatka Peninsula at times during the Late Quaternary, yet the data presented here appears to suggest that such phases were comparatively short-lived, and that smaller cirque-type glaciers were generally more characteristic of the period.

The cardiovascular hemodynamic responses to various levels of orthostatic stress in children

The ability of the cardiovascular system to quickly and efficiently adapt to an orthostatic stress is vital for the human body to function on earth. The way in which the various aspects of the cardiovascular system work together to counteract an orthostatic stress has been previously quantified in the adult population. However, there are still many unknowns surrounding the topic of how the cardiovascular system functions to cope with this same stress in children. The purpose of this study was to describe the cardiovascular hemodynamic adaptations to various levels of orthostatic stress induced using a lower body negative pressure (LBNP) chamber in pre-pubertal boys. A secondary purpose was to determine indices of baroreceptor sensitivity (BRS) at both rest and during low levels of LBNP in this same pediatric sample. Finally, this study aimed to compare the relative responses to LBNP between the children and adults. To complete the study 20 healthy pre-pubertal boys and adult males (9.3 ± 1.1 and 23 ± 1.8 years of age respectively) were recruited and randomly exposed to three levels of LBNP (15, 20 and 25 mmHg). At rest and during the application of the LBNP heart rate (HR), manual and bcat-by-beat systolic (SBP), diastolic (DBP) and mean arterial blood pressure (MAP) were monitored continuously. Aortic diameter was measured at rest and peak aortic blood velocity (PV) was recorded continuously for at least I minute during each baseline and LBNP condition. From the raw data HR, stroke volume (SV), cardiac output (Q), total peripheral resistance (TPR), low frequency baroreceptor sensitivity (LF BRS), high frequency baroreceptor sensitivity (HF BRS) and LFIIIF ratio were calculated. At rest, llR wa'i higher and SBP, SV, Q and LF/HF ratio were lower in the children compared to the adult males (pgJ.05). In response to the increasing LEN!> IIR and TPR increased, and LF BRS. SV and Q decreased in the adult group (pSf).05). while the same levels of LBNP caused an increase in TPR and a decrease in SBP, SV and Q in the children (pSf).05). Although not significant, the LF/HF ratio in the adult group showed an increasing trend in response to increased negative pressure (p=O.088). As for resting BRS, there were no significant differences in LF or HF BRS between the children and the adults despite a tendency for both measures to be 18% lower in the children. Also the LF/HF ratio was almost significantly greater in the adults compared to the children (p=O.057). In addition, a comparison between the relative adult and child responses to LBNP yielded no significant group by level interactions. This result should be taken with caution though, as the low sample size and high measurement variability generated very low statistical power for this analysis. In conclusion, the results of this study suggest that the hemodynamic adaptations to an orthostatic stress were less pronounced in the prepubertal males, most likely due to an underdeveloped autonomic system. These results need to be strengthened by further research before any implications can be derived for health care purposes.

Dynamic modelling of a wind catcher/tower turret for natural ventilation

This paper discusses experimental and theoretical investigations and Computational Fluid Dynamics (CFD) modelling considerations to evaluate the performance of a square section wind catcher system connected to the top of a test room for the purpose of natural ventilation. The magnitude and distribution of pressure coefficients (C-p) around a wind catcher and the air flow into the test room were analysed. The modelling results indicated that air was supplied into the test room through the wind catcher's quadrants with positive external pressure coefficients and extracted out of the test room through quadrants with negative pressure coefficients. The air flow achieved through the wind catcher depends on the speed and direction of the wind. The results obtained using the explicit and AIDA implicit calculation procedures and CFX code correlate relatively well with the experimental results at lower wind speeds and with wind incidents at an angle of 0 degrees. Variation in the C-p and air flow results were observed particularly with a wind direction of 45 degrees. The explicit and implicit calculation procedures were found to be quick and easy to use in obtaining results whereas the wind tunnel tests were more expensive in terms of effort, cost and time. CFD codes are developing rapidly and are widely available especially with the decreasing prices of computer hardware. However, results obtained using CFD codes must be considered with care, particularly in the absence of empirical data.

An accelerating cosmology without dark energy

The negative pressure accompanying gravitationally-induced particle creation can lead to a cold dark matter (CDM) dominated, accelerating Universe (Lima et al. 1996 [1]) without requiring the presence of dark energy or a cosmological constant. In a recent study, Lima et al. 2008 [2] (LSS) demonstrated that particle creation driven cosmological models are capable of accounting for the SNIa observations [3] of the recent transition from a decelerating to an accelerating Universe, without the need for Dark Energy. Here we consider a class of such models where the particle creation rate is assumed to be of the form Gamma = beta H + gamma H(0), where H is the Hubble parameter and H(0) is its present value. The evolution of such models is tested at low redshift by the latest SNe Ia data provided by the Union compilation [4] and at high redshift using the value of z(eq), the redshift of the epoch of matter - radiation equality, inferred from the WMAP constraints on the early Integrated Sachs-Wolfe (ISW) effect [5]. Since the contributions of baryons and radiation were ignored in the work of LSS, we include them in our study of this class of models. The parameters of these more realistic models with continuous creation of CDM are constrained at widely-separated epochs (z(eq) approximate to 3000 and z approximate to 0) in the evolution of the Universe. The comparison of the parameter values, {beta, gamma}, determined at these different epochs reveals a tension between the values favored by the high redshift CMB constraint on z(eq) from the ISW and those which follow from the low redshift SNIa data, posing a potential challenge to this class of models. While for beta = 0 this conflict is only at less than or similar to 2 sigma, it worsens as beta increases from zero.

CDM accelerating cosmology as an alternative to Lambda CDM model

A new accelerating cosmology driven only by baryons plus cold dark matter (CDM) is proposed in the framework of general relativity. In this scenario the present accelerating stage of the Universe is powered by the negative pressure describing the gravitationally-induced particle production of cold dark matter particles. This kind of scenario has only one free parameter and the differential equation governing the evolution of the scale factor is exactly the same of the Lambda CDM model. For a spatially flat Universe, as predicted by inflation (Omega(dm) + Omega(baryon) = 1), it is found that the effectively observed matter density parameter is Omega(meff) = 1 - alpha, where alpha is the constant parameter specifying the CDM particle creation rate. The supernovae test based on the Union data (2008) requires alpha similar to 0.71 so that Omega(meff) similar to 0.29 as independently derived from weak gravitational lensing, the large scale structure and other complementary observations.

Local and remote tissue injury upon intestinal ischemia and reperfusion depends on the TLR/MyD88 signaling pathway

Innate immune responses against microorganisms may be mediated by Toll-like receptors (TLRs). Intestinal ischemia-reperfusion (i-I/R) leads to the translocation of bacteria and/or bacterial products such as endotoxin, which activate TLRs leading to acute intestinal and lung injury and inflammation observed upon gut trauma. Here, we investigated the role of TLR activation by using mice deficient for the common TLR adaptor protein myeloid differentiation factor 88 (MyD88) on local and remote inflammation following intestinal ischemia. Balb/c and MyD88(-/-) mice were subjected to occlusion of the superior mesenteric artery (45 min) followed by intestinal reperfusion (4 h). Acute neutrophil recruitment into the intestinal wall and the lung was significantly diminished in MyD88(-/-) after i-I/R, which was confirmed microscopically. Diminished neutrophil recruitment was accompanied with reduced concentration of TNF-alpha and IL-1 beta level. Furthermore, diminished microvascular leak and bacteremia were associated with enhanced survival of MyD88(-/-) mice. However, neither TNF-alpha nor IL-1 beta neutralization prevented neutrophil recruitment into the lung but attenuated intestinal inflammation upon i-I/R. In conclusion, our data demonstrate that disruption of the TLR/MyD88 pathway in mice attenuates acute intestinal and lung injury, inflammation, and endothelial damage allowing enhanced survival.

Tratamento de fístulas enterocutâneas através de sistema a vácuo com alta pressão e dieta oral normal

Enterocutaneous fistulas are associated with prolonged hospital stay, high morbidity/mortality, and increase in hospital costs. This study aims to describe the use of a vacuum system and normal oral diet in dealing with this problem. Methods: Seventy-four consecutive patients with recent and defined external postoperative fistulas were analyzed. Abdominal imaging was used to exclude abscess and distal obstruction. The fistula tract was sealed with Foley catheter, connected to a negative pressure flask, changed daily for 5, 10 or 15 days, as necessary. Normal oral diet was permitted. Results: No patient died. Serum albumin and transferrin showed significantly higher levels at the end of treatment than at the beginning. The moderate and low-output fistulas had the best results (97% closed). Forty-eight (65%) fistulas closed after five days, 16(22%) after 10 days and 4(5%) after 15 days. Treatment failed in 6(8%) patients, who subsequently underwent surgery. Only one patient with low-output did not close her fistula. The cost of the treatment was US$ 41.75/day and it was considered cost effective. Conclusions: The vacuum system demonstrated good results in the treatment of fistulas. It included simplicity, low cost, short hospital stay, absence of skin breakdown, normal eating, good nutrition and activity patterns

Efficacy of linear and convex transducers for ultrasound-guided transvaginal follicle aspiration

A new device was developed to hold linear transducers for transvaginal follicle aspiration. Efficacy of follicle aspiration was compared using a linear 6 MHz and a convex 5 MHz transducer. Fifty-five cows were submitted to follicle aspiration at random days of the estrous cycle. Aspirations were conducted with linear (n = 28) and convex (n = 38) transducers with 18 G needles at a negative pressure corresponding to 13 ml H2O/min. A greater number of follicles were aspirated using convex than to linear probe (12.4 versus 7.8, respectively, P < 0.05). Mean number of oocytes and recovery rates were similar for convex (5.4 and 48.6%) and linear (4.6 and 59.3%) transducers. Limited space between the linear transducer and needle guide restricted access to some portions of the ovary, reducing the number of follicles aspirated using a linear transducer. The newly developed adaptor allowed greater stability, holding the ovaries firmly against the linear transducer. This diminished mobility permitted a similar number of oocytes to be recovered with both transducers. In conclusion, this new adaptor provided a low cost alternative for routine follicle aspiration and oocyte recovery in cattle. (C) 2002 Elsevier B.V. All rights reserved.

Acurácia dos indicadores clínicos do diagnóstico de enfermagem volume de líquidos excessivo em pacientes submetidos à hemodiálise

Trasnversal study, with the objective of evaluating the accuracy of clinical indicators of nursing diagnosis excessive fluid volume in patients undergoing hemodialysis. The study occurred in two stages, the first consisted of the evaluation of the diagnostic indicators in study; and the second, the diagnostic inference conducted by nurse diagnosticians. The first stage occurred from december 2012 to april 2013, in a University Hospital and a Hemodialysis Clinic in Northeastern of Brazil, with a sample of 100 chronic renal failure patients on hemodialysis. The data were selected through an interview form and a physical examination, organized into spreadsheets and analyzed as to the presence or absence of the indicators of diagnosis excessive fluid volume. In the second step, the spreadsheets were sent to three nurses diagnosticians, who judged the presence or absence of diagnosis in the clientele searched. This step was conducted from july to september 2013. For analysis of the data, we used descriptive and inferential statistics. In the descriptive analysis, we used measures of central tendency and dispersion. In inferential analysis, we used the tests Chi- square, Fisher and prevalence ratios. The accuracy of the clinical indicators pertaining to the diagnosis were measured as to the specificity, sensitivity, predictive values, likelihood ratios and Diagnostic Odds Ratio. Also developed a logistic regression. The results were organized in tables and discussed with literature. This study was approved by the Ethics Committee in Research of the Federal University of Rio Grande do Norte, with Presentation Certificate for Ethics Appreciation nº 08696212.7.0000.5537. The results revealed that the diagnosis studied was present in 82% of patients. The characteristics with prevalence above 50 % that stood out were: azotemia, decreased hematocrit, electrolyte imbalance, intake exceeds output, anxiety, edema, decreased hemoglobin, oliguria and blood pressure changes. Eight defining characteristics were presented statistically significant association with the nursing diagnosis investigated: pulmonary congestion, intake exceeds output, electrolytes imbalance, jugular vein distension, edema, weight gain over short period of time, agitation and adventitious breath sounds. Among these, the 10 characteristics which showed higher prevalence ratios were: edema and weight gain over short period of time. The features with the highest sensitivity were edema, electrolytes imbalance and intake exceeds output and the standing out with greater specificity were: anasarca, weight gain over short period of time, change in respiratory pattern, adventitious breath sounds, pulmonary congestion, agitation and jugular vein distension. The indicators jugular vein distension, electrolytes imbalance, intake exceeds output, increased central venous pressure and edema, together, were identified in the logistic regression model as the most significant predictors. It is concluded that the identification of accurate clinical indicators allow a good prediction of the nursing diagnosis of excessive fluid volume in patients undergoing hemodialysis in order to assist the nurse in the inference process, which will contribute to the success of patient care. In addition, nurses will consider for diagnostic inference not only his clinical experience, but also scientific evidence of the occurrence of excessive fluid volume, contributing to the control of volemia in these patients