909 resultados para Survival and emergency equipment.


Relevância:

100.00% 100.00%

Publicador:

Resumo:

This article examines the effect on price of different characteristics of holiday hotels in the sun-and-beach segment, under the hedonic function perspective. Monthly prices of the majority of hotels in the Spanish continental Mediterranean coast are gathered from May to October 1999 from the tour operator catalogues. Hedonic functions are specified as random-effect models and parametrized as structural equation models with two latent variables, a random peak season price and a random width of seasonal fluctuations. Characteristics of the hotel and the region where they are located are used as predictors of both latent variables. Besides hotel category, region, distance to the beach, availability of parking place and room equipment have an effect on peak price and also on seasonality. 3- star hotels have the highest seasonality and hotels located in the southern regions the lowest, which could be explained by a warmer climate in autumn

Relevância:

100.00% 100.00%

Publicador:

Resumo:

Introducción. El ataque cerebrovascular (ACV) ocupa el primer lugar en frecuencia entre todas las enfermedades neurológicas de la vida adulta, y el tercer lugar como causa más frecuente de muerte. Se aprobó para el manejo agudo, la terapia con activador del plasminógeno tisular recombinante (t-PA) en las primeras 4,5 horas después del inicio de los síntomas, demostrando mayor sobrevida y menos niveles de discapacidad. Sin embargo solo el 5-10% de pacientes reciben este manejo. Por estas razones es necesario conocer que factores se asocian con la no intervención terapéutica. Objetivo. Describir los factores asociados con la no trombolisis en pacientes con ataque cerebrovascular en un hospital de IV nivel en Bogotá, Colombia. Métodos. Estudio analítico de corte transversal, en un centro de cuarto nivel en Bogotá entre enero de 2009 y enero de 2011. Resultados. Se encontraron 178 pacientes en un promedio de edad de 65,9 años (DE± 10 años) con una relación hombre-mujer 1:1, la principal causa de no trombolisis fue la ventana mayor a 4.5 horas, 33,7% (n=60), 26,4% por cambios en imágenes diagnosticas, y 14% por puntajes leves o severos en las escala National Institute of Health Stroke Scale (NIHSS), historia quirúrgica 7.3% y laboratorios 4.5%. El tiempo promedio de atención fue 23 minutos (DE ± 21 min) para la activación del código de ACV, 39 minutos para valoración por neurología (DE ± 25 min), 46 minutos (DE ± 19,1 min) para toma de paraclínicos, 66 minutos para toma de imágenes y 97 minutos para trombolisis (DE ± 21min, DE ± 17 min, respectivamente). Se realizó trombolisis en 17 pacientes, 9,6%. No se encontró asociación significativa entre cultura de organización con trombolisis ni de tiempos de atención con trombolisis. Conclusiones. La principal razón de no trombolisis, fue la ventana mayor a 4.5 horas, no se encontró relación entre cultura de organización institucional con trombolisis. El tiempo promedio de trombolisis fue de 90 minutos. Deben instaurarse medidas para reducir el tiempo de llegada al hospital, y los tiempos de atención en urgencias. Deben realizarse nuevas evaluaciones del código ACV posterior a las estrategias de mejoría.

Relevância:

100.00% 100.00%

Publicador:

Resumo:

El marcaje de proteínas con ubiquitina, conocido como ubiquitinación, cumple diferentes funciones que incluyen la regulación de varios procesos celulares, tales como: la degradación de proteínas por medio del proteosoma, la reparación del ADN, la señalización mediada por receptores de membrana, y la endocitosis, entre otras (1). Las moléculas de ubiquitina pueden ser removidas de sus sustratos gracias a la acción de un gran grupo de proteasas, llamadas enzimas deubiquitinizantes (DUBs) (2). Las DUBs son esenciales para la manutención de la homeostasis de la ubiquitina y para la regulación del estado de ubiquitinación de diferentes sustratos. El gran número y la diversidad de DUBs descritas refleja tanto su especificidad como su utilización para regular un amplio espectro de sustratos y vías celulares. Aunque muchas DUBs han sido estudiadas a profundidad, actualmente se desconocen los sustratos y las funciones biológicas de la mayoría de ellas. En este trabajo se investigaron las funciones de las DUBs: USP19, USP4 y UCH-L1. Utilizando varias técnicas de biología molecular y celular se encontró que: i) USP19 es regulada por las ubiquitin ligasas SIAH1 y SIAH2 ii) USP19 es importante para regular HIF-1α, un factor de transcripción clave en la respuesta celular a hipoxia, iii) USP4 interactúa con el proteosoma, iv) La quimera mCherry-UCH-L1 reproduce parcialmente los fenotipos que nuestro grupo ha descrito previamente al usar otros constructos de la misma enzima, y v) UCH-L1 promueve la internalización de la bacteria Yersinia pseudotuberculosis.

Relevância:

100.00% 100.00%

Publicador:

Resumo:

Los defectos herniarios inguinales son una condición con alta prevalencia en nuestra población. En los últimos años la introducción de la cirugía laparoscopia para la corrección de esta patología ha tomado fuerza gradualmente. El propósito del presente trabajo es describir la experiencia en el uso de esta técnica quirúrgica en una institución hospitalaria. Materiales y métodos: estudio descriptivo de corte trasversal en el cual se revisaron las historias clínica de cada uno de los sujetos llevados a herniorrafia inguinal laparoscópica, donde se evaluaron las características pre y postoperatorias de los casos, así como las complicaciones derivadas del procedimiento. Resultados: Se evaluaron un total de 250 pacientes para un total de 334 Herniorrafias. El promedio de edad fue 58,3 años. La relación hombre mujer fue 3,7: 1. Del total de procedimientos 168 correspondieron a defectos bilaterales. 32 pacientes tenían antecedentes de herniorrafia previa. Se presentaron un total de tres complicaciones. El promedio general de tiempo quirúrgico fue de 69,3 minutos. El seguimiento post operatorio evidencio al dolor inguinal agudo como el principal proceso patológico derivado. El promedio de tiempo de incapacidad en total fue 8,3 días. Se encontró reproducción de la hernia comprobado por ecografía en 10 pacientes. No se produjo ninguna mortalidad en los pacientes del estudio. Conclusiones: La corrección laparoscopia se ha convertido en una alternativa segura y eficiente en el tratamiento definitivo de los defectos herniarios inguinales y debe ser tenida en cuenta en el momento de seleccionar la vía de acceso.

Relevância:

100.00% 100.00%

Publicador:

Resumo:

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.

Relevância:

100.00% 100.00%

Publicador:

Resumo:

El presente trabajo es un capítulo de libro titulado “Anestesia Regional y Periférica Guiada por Ultrasonido en el Paciente Crítico” que será incluido en la última edición del libro “Manual de Ultrasonido en Terapia Intensiva y Emergencias” cuyo editor es el Doctor José de Jesús Rincón Salas y que será publicado por la Editorial Prado de México para distribución latinoamericana desde dicho país. Por solicitud del editor y teniendo en cuenta el enfoque del libro, el presente trabajo está dirigido a estudiantes de formación, médicos graduados y especialistas en las áreas de cuidado intensivo, anestesiología, dolor, medicina interna y medicina de urgencias. Tiene como propósito empapar de conocimientos necesarios y prácticos en anestesia regional a personas que usualmente no han tenido contacto con la anestesia regional, pues desafortunadamente sólo en los últimos años ha sido posible que la anestesia regional haya comenzado a salir de las salas de cirugía, ámbito donde ha estado confinada tradicionalmente. El lenguaje utilizado es sencillo y el capítulo ha sido escrito para que sea fácil de leer y consultar, dejando así mensajes muy claros sobre la utilidad, viabilidad e implicaciones que tiene el uso de anestesia regional guiada por ultrasonido en cuidado intensivo. Los autores esperamos que de esta manera, el presente capítulo permita continuar superando los obstáculos que se interponen entre los invaluables beneficios de la anestesia regional y los pacientes de cuidado intensivo que necesitan de ella.

Relevância:

100.00% 100.00%

Publicador:

Resumo:

The European Cancer Registry-based project on hematologic malignancies (HAEMACARE), set up to improve the availability and standardization of data on hematologic malignancies in Europe, used the European Cancer Registry-based project on survival and care of cancer patients (EUROCARE-4) database to produce a new grouping of hematologic neoplasma(defined by the International Classification of Diseases for Oncology, Third Edition and the 2001/2008 World Health Organization classifications) for epidemiological and public health purposes. We analyzed survival for lymphoid neoplasms in Europe by disease group, comparing survival between different European regions by age and sex. Design and Methods Incident neoplasms recorded between 1995 to 2002 in 48 population-based cancer registries in 20 countries participating in EUROCARE-4 were analyzed. The period approach was used to estimate 5-year relative survival rates for patients diagnosed in 2000-2002, who did not have 5 years of follow up. Results: The 5-year relative survival rate was 57% overall but varied markedly between the defined groups. Variation in survival within the groups was relatively limited across European regions and less than in previous years. Survival differences between men and women were small. The relative survival for patients with all lymphoid neoplasms decreased substantially after the age of 50. The proportion of ‘not otherwise specified’ diagnoses increased with advancing age.Conclusions: This is the first study to analyze survival of patients with lymphoid neoplasms, divided into groups characterized by similar epidemiological and clinical characteristics, providing a benchmark for more detailed analyses. This Europe-wide study suggests that previously noted differences in survival between regions have tended to decrease. The survival of patients with all neoplasms decreased markedly with age, while the proportion of ‘not otherwise specified’ diagnoses increased with advancing age. Thus the quality of diagnostic work-up and care decreased with age, suggesting that older patients may not be receiving optimal treatment

Relevância:

100.00% 100.00%

Publicador:

Resumo:

Pseudomonas fluorescens EPS62e es va seleccionar com a agent de biocontrol del foc bacterià per la seva eficàcia en el control de Erwinia amylovora. En aquest treball es van desenvolupar mètodes de traçabilitat que van permetre la seva detecció específica i quantificació. Mitjançant les tècniques RAPD i U-PCR es van obtenir fragments d'amplificació diferencial per EPS62e que es van seqüenciar i caracteritzar com marcadors SCAR per dissenyar una PCR en temps real. La PCR a temps real es va utilitzar simultàniament amb mètodes microbiològics per estudiar l'adaptabilitat epifítica de EPS62e en pomera i perera. L'ús combinat de mètodes microbiològics i moleculars va permetre la identificació de tres estats fisiològics de EPS62e: la colonització activa, l'entrada en un estat de viable però no cultivable, i la mort cel·lular. Aquest treball mostra que EPS62e està ben adaptada a la colonització de flors a camp, encoratjant la seva utilització dins d'una estratègia de control biològic contra el foc bacterià.

Relevância:

100.00% 100.00%

Publicador:

Resumo:

The dynamics of silence and remembrance in Australian writer Lily Brett’s autobiographic fiction Things Could Be Worse reflects the crisis of memory and understanding experienced by both first and second-generation Holocaust survivors within the diasporic space of contemporary Australia. It leads to issues of handling traumatic and transgenerational memory, the latter also known as postmemory (M. Hirsch), in the long aftermath of atrocities, and problematises the role of forgetting in shielding displaced identities against total dissolution of the self. This paper explores the mechanisms of remembrance and forgetting in L. Brett’s narrative by mainly focusing on two female characters, mother and daughter, whose coming to terms with (the necessary) silence, on the one hand, and articulated memories, on the other, reflects different modes of comprehending and eventually coping with individual trauma. By differentiating between several types of silence encountered in Brett’s prose (that of the voiceless victims, of survivors and their offspring, respectively), I argue that silence can equally voice and hush traumatic experience, that it is never empty, but invested with individual and collective meaning. Essentially, I contend that beside the (self-)damaging effects of silence, there are also beneficial consequences of it, in that it plays a crucial role in emplacing the displaced, rebuilding their shattered self, and contributing to their reintegration, survival and even partial healing.

Relevância:

100.00% 100.00%

Publicador:

Resumo:

Populations on the periphery of a species' range may experience more severe environmental conditions relative to populations closer to the core of the range. As a consequence, peripheral populations may have lower reproductive success or survival, which may affect their persistence. In this study, we examined the influence of environmental conditions on breeding biology and nest survival in a threatened population of Loggerhead Shrikes (Lanius ludovicianus) at the northern limit of the range in southeastern Alberta, Canada, and compared our estimates with those from shrike populations elsewhere in the range. Over the 2-year study in 1992–1993, clutch sizes averaged 6.4 eggs, and most nests were initiated between mid-May and mid-June. Rate of renesting following initial nest failure was 19%, and there were no known cases of double-brooding. Compared with southern populations, rate of renesting was lower and clutch sizes tended to be larger, whereas the length of the nestling and hatchling periods appeared to be similar. Most nest failures were directly associated with nest predators, but weather had a greater direct effect in 1993. Nest survival models indicated higher daily nest survival during warmer temperatures and lower precipitation, which may include direct effects of weather on nestlings as well as indirect effects on predator behavior or food abundance. Daily nest survival varied over the nesting cycle in a curvilinear pattern, with a slight increase through laying, approximately constant survival through incubation, and a decline through the nestling period. Partial brood loss during the nestling stage was high, particularly in 1993, when conditions were cool and wet. Overall, the lower likelihood of renesting, lower nest survival, and higher partial brood loss appeared to depress reproductive output in this population relative to those elsewhere in the range, and may have increased susceptibility to population declines.

Relevância:

100.00% 100.00%

Publicador:

Resumo:

Organic materials such as compost are often proposed as suitable materials for the remediation of contaminated brownfield sites intended for soft end-use. In addition to vitalising the soil, they are also believed to immobilise metals thereby breaking contaminant-receptor pathways and reducing the ecotoxicity of the contaminants. However, some research has demonstrated contradictory effects between composts on metal immobilisation. In the present study, four different composts and a liming product containing organic matter (LimeX70) were tested to examine both their metal retention and toxicity reduction capabilities on three different metal contaminated soils. Leaching tests, a plant growth test with Greek cress (Lepidium sativum), an earthworm (Eisenia fetida) survival and condition test and a bacterial toxicity test using Vibrio fischeri were carried out. The leaching test results showed that spent mushroom compost caused an increase in metal concentration in the leachates, while LimeX70 caused a decrease. The variation in behaviour between different amendments for each soil was high, so a generic conclusion could not be drawn. Toxicity tests showed significant reduction of metal bioavailability and toxicity for Greek cress, earthworms and bacteria. The results also suggest that more research should be undertaken to understand the mechanisms involved in metal complexation using different types of organic matter, in order to optimise the use of organic materials like compost for soil remediation. Crown Copyright (C) 2007 Published by Elsevier Ltd. All rights reserved.

Relevância:

100.00% 100.00%

Publicador:

Resumo:

Organic materials such as compost are often proposed as suitable materials for the remediation of contaminated brownfield sites intended for soft end-use. In addition to vitalising the soil, they are also believed to immobilise metals thereby breaking contaminant-receptor pathways and reducing the ecotoxicity of the contaminants. However, some research has demonstrated contradictory effects between composts on metal immobilisation. In the present study, four different composts and a liming product containing organic matter (LimeX70) were tested to examine both their metal retention and toxicity reduction capabilities on three different metal contaminated soils. Leaching tests, a plant growth test with Greek cress (Lepidium sativum), an earthworm (Eisenia fetida) survival and condition test and a bacterial toxicity test using Vibrio fischeri were carried out. The leaching test results showed that spent mushroom compost caused an increase in metal concentration in the leachates, while LimeX70 caused a decrease. The variation in behaviour between different amendments for each soil was high, so a generic conclusion could not be drawn. Toxicity tests showed significant reduction of metal bioavailability and toxicity for Greek cress, earthworms and bacteria. The results also suggest that more research should be undertaken to understand the mechanisms involved in metal complexation using different types of organic matter, in order to optimise the use of organic materials like compost for soil remediation. Crown Copyright (C) 2007 Published by Elsevier Ltd. All rights reserved.

Relevância:

100.00% 100.00%

Publicador:

Resumo:

The effects of metal contamination on natural populations of Collembola in soils from five sites in the Wolverhampton area ( West Midlands, England) were examined. Analysis revealed that metal concentrations were elevated above background levels at all sites. One location in particular (Ladymoor, a former smelting site) was highly contaminated with Cd, Cu, Pb and Zn at more than 20 times background levels. Biodiversity indices ( Shannon - Weiner, Simpson index, Margalef index, alpha index, species richness, Shaneven ( evenness) and Berger - Parker dominance) were calculated. Of these indices, estimates of species richness and evenness were most effective at highlighting the differences between the Collembola communities. Indeed, the highest number of species were found at the most contaminated site, although the Collembola population also had a comparatively low evenness value, with just two species dominating. The number of individuals per species were allocated into geometric classes and plotted against the cumulative number of species as a percentage. At Ladymoor, there were more geometric classes, and the slope of the line was shallower than at the other four sites. This characteristic is a feature of polluted sites, where a few species are dominant and most species are rare. The Ladymoor soil also had a dominance of Isotomurus palustris, and was the only site in which Ceratophysella denticulata was found. Previous studies have shown that these two species are often found in sites subject to high metal contamination. Survival and reproduction of the "standard'' test springtail, Folsomia candida (Willem), were determined in a 4 week exposure test to soils from all five sites. Mortality was significantly increased in adults and reproduction significantly lower in the Ladymoor soil in comparison to the other four sites. This study has shown that severe metal contamination can be related to the population structure of Collembola in the field, and performance of F. candida ( in soils from such sites) in the laboratory.

Relevância:

100.00% 100.00%

Publicador:

Resumo:

We examined the species diversity and abundance of Collembola at 32 sampling points along a gradient of metal contamination in a rough grassland site ( Wolverhampton, England), formerly used for the disposal of metal-rich smelting waste. Differences in the concentrations of Cd, Cu, Pb and Zn between the least and most contaminated part of the 35 metre transect were more than one order of magnitude. A gradient of Zn concentrations from 597 to 9080 mug g(-1) dry soil was found. A comparison between field concentrations of the four metals and previous studies on their relative toxicities to Collembola, suggested that Zn is likely to be responsible for any ecotoxicological effects on springtails at this site. Euedaphic ( soil dwelling) Collembola were extracted by placing soil cores into Tullgren funnels and epedaphic ( surface dwelling) species were sampled using pitfall traps. There was no obvious relationship between the total abundance, or a range of commonly used diversity indices, and Zn levels in soils. However, individual species showed considerable differences in abundance. Metal "tolerant'' (e.g., Ceratophysella denticulata) and metal "sensitive'' (e.g., Cryptopygus thermophilus) species could be identified. Epedaphic species appeared to be influenced less by metal contamination than euedaphic species. This difference is probably due to the higher mobility and lower contact with the soil pore water of epedaphic springtails in comparison to euedaphic Collembola. In an experiment exposing the standard test springtail, Folsomia candida, to soils from all 32 sampling points, adult survival and reproduction showed small but significant negative relationships with total Zn concentrations. Nevertheless, juveniles were still produced from eggs laid by females in the most contaminated soils with 9080 mug g(-1) Zn. Folsomia candida is much more sensitive to equivalent concentrations of Zn in the standard OECD soil. Thus, care should be taken in extrapolating the results of laboratory toxicity tests on metals in OECD soil to field soils, in which, the biological availability of contaminants is likely to be lower. Our studies have shown the importance of ecotoxicological effects at the species level. Although there may be no differences in overall abundance, sensitive species that are numerous in contaminated sites, and which may play important roles in decomposition("keystone species'') can be greatly reduced in numbers by pollution.

Relevância:

100.00% 100.00%

Publicador:

Resumo:

The endemic pink pigeon has recovered from less than 20 birds in the mid-1970s to 355 free-living individuals in 2003. A major concern for the species' recovery has been the potential genetic problem of inbreeding. Captive pink pigeons bred for reintroduction were managed to maximise founder representation and minimise inbreeding. In this paper, we quantify the effect of inbreeding on survival and reproductive parameters in captive and wild populations and quantify DNA sequence variation in the mitochondrial d-loop region for pink pigeon founders. Inbreeding affected egg fertility, squab, juvenile and adult survival, but effects were strongest in highly inbred birds (F≥0.25). Inbreeding depression was more apparent in free-living birds where even moderate levels of inbreeding affected survival, although highly inbred birds were equally compromised in both captive and wild populations. Mitochondrial DNA haplotypic diversity in pink pigeon founders is low, suggesting that background inbreeding is contributing to low fertility and depressed productivity in this species, as well as comparable survival of some groups of non-inbred and nominally inbred birds. Management of wild populations has boosted population growth and may be required long-term to offset the negative effects of inbreeding depression and enhance the species' survival.