Plan integral de enfermería para la atención domiciliaria de pacientes con enfermedad neuromuscular e insuficiencia respiratoria

Las enfermedades neuromuscualres son enfermedades neurológicas, de naturaleza progresiva, normalmente hereditarias cuya principal característica clínica es la debilidad muscular. Dentro de las enfermedades que causan problemas respiratorios, existen una gran variedad de enfermedades neuromusculares que comprometen la función respiratoria, las cuales pueden dividirse en enfermedades neuromusculares neuropaticas y miopáticas, además de poder clasificarlas según la evolución. Las ENM pueden comprometer el sistema respiratorio condicionando morbilidad respiratoria de intensidad y precocidad variable dependiendo del grado de afección de los músculos respiratorios y deglutorios, así como de otros factores como el estado nutricional o la capacidad de deambulación, todos ellos factores que pueden ser incluidos dentro de un programa de enfermería de atención a domicilio.

Sulfonamidas em leite por cromatografia líquida de alta eficiência com derivação pré-coluna e detecção por fluorescência

O objetivo deste trabalho foi avaliar e validar um método para deteminação de resíduos de sulfatiazol (STZ), sulfametazina (SMZ) e sulfadimetoxina (SDM) em leite UHT integral. A extração foi realizada com diclorometano e coluna de extração em fase sólida de sílica. Os resíduos, após derivação com fluorescamina, foram quantificados por cromatografia líquida de alta eficiência com detector de fluorescência. O limite de detecção das três sulfas em amostra de leite integral foi 0,3 µg L-1 e o limite de quantificação foi 1 µg L-1 para STZ e SMZ e 2,5 µg L-1 para SDM, com coeficientes de variação entre 4,4 e 6,6%. Os valores de recuperação para STZ, SMZ e SDM foram 63,2, 91,2 e 63,2%, respectivamente. Considerando o limite máximo de resíduo estabelecido pela legislação brasileira de 100 µg kg-1 para a soma das concentrações totais de STZ, SMZ e SDM, o método descrito permite a determinação simultânea dos três analitos em amostras de leite UTH integral.

Caracterização nutricional de grãos integrais e descascados de cultivares de cevada

O objetivo deste trabalho foi determinar a composição de nutrientes de grãos de diferentes cultivares de cevada, na forma integral e descascada, e classificá-los em grupos com características nutricionais distintas. Foram utilizadas amostras de 17 cultivares, da Embrapa Trigo, Passo Fundo, RS, da safra de 2005. As determinações químicas foram realizadas de acordo com os métodos de análise oficial da AOAC Internacional. Foram observadas diferenças significativas entre grãos integrais de cultivares para proteína bruta, cinzas, extrato etéreo, fibra total e carboidratos não-fibrosos, porém, os teores de fibra insolúvel e fibra solúvel não diferiram. Em grãos descascados, foram observadas diferenças em todos os parâmetros analisados. Com exceção da fração de carboidratos não-fibrosos, o processo de descascamento promoveu redução em todas as frações avaliadas, em especial nos teores de fibra total e fibra insolúvel. Diferenças na composição bromatológica ocorreram devido à variabilidade genética das cultivares e ao descascamento.

Variáveis ruminais avaliadas por meio de funções matemáticas contínuas

O objetivo deste trabalho foi avaliar as variáveis pH e concentração de nitrogênio amoniacal ruminal em bovinos por meio de funções matemáticas contínuas, utilizando-se o polinômio trigonométrico em série de Fourier. Foram utilizados quatro conjuntos de dados simulados referentes à alimentação de vacas em lactação em confinamento e bovinos suplementados em pastejo. Os ajustamentos dos modelos foram realizados por procedimentos iterativos. Os efeitos nutricionais nas diferentes situações de alimentação simuladas foram estimados por operações de cálculo integral. As séries de Fourier apresentam elevada capacidade de ajustamento para descrição do comportamento diário do pH e concentração de nitrogênio amoniacal ruminal. As variáveis geradas por integração das funções ajustadas apresentam elevada capacidade discriminatória, o que permite refinamentos sobre a interpretação dos efeitos nutricionais de diferentes dietas das características físico-químicas do ambiente ruminal.

HIV-1 elite controllers: beware of super-infections.

Super- and co-infection with HIV-1 are generally associated with accelerated disease progression. We report on the outcome of super-infection in two HIV-1 infected individuals previously known as elite controllers. Both presented an acute retroviral syndrome following super-infection and showed an immuno-virological progression thereafter. Host genotyping failed to reveal any of the currently recognized protective factors associated with slow disease progression. This report indicates that elite controllers should be informed of the risk of super-infection, and illustrates the complexity of mounting broad anti-HIV immunity.

Effects of epitope modification on T cell receptor-ligand binding and antigen recognition by seven H-2Kd-restricted cytotoxic T lymphocyte clones specific for a photoreactive peptide derivative.

We tested for antigen recognition and T cell receptor (TCR)-ligand binding 12 peptide derivative variants on seven H-2Kd-restricted cytotoxic T lymphocytes (CTL) clones specific for a bifunctional photoreactive derivative of the Plasmodium berghei circumsporozoite peptide 252-260 (SYIPSAEKI). The derivative contained iodo-4-azidosalicylic acid in place of PbCS S-252 and 4-azidobenzoic acid on PbCS K-259. Selective photoactivation of the N-terminal photoreactive group allowed crosslinking to Kd molecules and photoactivation of the orthogonal group to TCR. TCR photoaffinity labeling with covalent Kd-peptide derivative complexes allowed direct assessment of TCR-ligand binding on living CTL. In most cases (over 80%) cytotoxicity (chromium release) and TCR-ligand binding differed by less than fivefold. The exceptions included (a) partial TCR agonists (8 cases), for which antigen recognition was five-tenfold less efficient than TCR-ligand binding, (b) TCR antagonists (2 cases), which were not recognized and capable of inhibiting recognition of the wild-type conjugate, (c) heteroclitic agonists (2 cases), for which antigen recognition was more efficient than TCR-ligand binding, and (d) one partial TCR agonist, which activated only Fas (C1)95), but not perforin/granzyme-mediated cytotoxicity. There was no correlation between these divergences and the avidity of TCR-ligand binding, indicating that other factors than binding avidity determine the nature of the CTL response. An unexpected and novel finding was that CD8-dependent clones clearly incline more to TCR antagonism than CD8-independent ones. As there was no correlation between CD8 dependence and the avidity of TCR-ligand binding, the possibility is suggested that CD8 plays a critical role in aberrant CTL function.

Influence of biocontrol strain Pseudomonas fluorescens CHA0 and its antibiotic overproducing derivative on the diversity of root colonizing pseudomonads

Non-target effects of biocontrol strains of Pseudomonas on the population of resident pseudomonads should be assessed prior to their large scale application in the environment. The rifampicin resistant bacterium P. fluorescens CHA0-Rif and its antibiotic overproducing derivative CHA0-Rif/pME3424 were introduced into soil microcosms and the population of resident pseudomonads colonizing cucumber roots was investigated after 10 and 52 days. Both CHA0-Rif and CHA0-Rif/pME3424 displaced a part of the resident pseudomonad population after 10 days. To investigate the population structure, utilization of 10 carbon sources and production of two exoenzymes was assessed for 5600 individual pseudomonad isolates and 1700 isolates were subjected to amplified ribosomal DNA restriction analysis of the spacer region (spacer-ARDRA). After 10 days, only the proportion of pseudomonads able to degrade -tryptophan was reduced in treatments inoculated with either biocontrol strain. In parallel the phenotypic diversity was reduced. These effects were only observed 10 days after inoculation, and they were similar for inoculation with CHA0-Rif and CHA0-Rif/pME3424. Changes in the population structure of resident pseudomonads on cucumber roots during plant growth were more pronounced than changes due to the inoculants. The inoculants did not affect the genotypic diversity detected with spacer-ARDRA, but the genotypic fingerprints corresponded only partially to the phenotypic profiles. Overall CHA0-Rif had a small and transient impact on the population of resident pseudomonads and the effect was essentially the same for the genetically engineered derivative CHA0-

Bayes linear spaces

Linear spaces consisting of σ-finite probability measures and infinite measures (improper priors and likelihood functions) are defined. The commutative group operation, called perturbation, is the updating given by Bayes theorem; the inverse operation is the Radon-Nikodym derivative. Bayes spaces of measures are sets of classes of proportional measures. In this framework, basic notions of mathematical statistics get a simple algebraic interpretation. For example, exponential families appear as affine subspaces with their sufficient statistics as a basis. Bayesian statistics, in particular some well-known properties of conjugated priors and likelihood functions, are revisited and slightly extended

Field Testing of Integral Abutments, Interim Report, HR-399, 1998

Integral abutment bridges are constructed without an expansion joint in the superstructure of the bridge; therefore, the bridge girders, deck, abutment diaphragms, and abutments are monolithically constructed. The abutment piles in an integral abutment bridge are vertically orientated, and they are embedded into the pile cap. When this type of a bridge experiences thermal expansion or contraction, horizontal displacements are induced at the top of the abutment piles. The flexibility of the abutment piles eliminates the need to provide an expansion joint at the inside face to the abutments: Integral abutment bridge construction has been used in Iowa and other states for many years. This research is evaluating the performance of integral abutment bridges by investigating thermally induced displacements, strains, and temperatures in two Iowa bridges. Each bridge has a skewed alignment, contains five prestressed concrete girders that support a 30-ft wide roadway for three spans, and involves a water crossing. The bridges will be monitored for about two years. For each bridge, an instrumentation package includes measurement devices and hardware and software support systems. The measurement devices are displacement transducers, strain gages, and thermocouples. The hardware and software systems include a data-logger; multiplexers; directline telephone service and computer terminal modem; direct-line electrical power; lap-top computer; and an assortment of computer programs for monitoring, transmitting, and management of the data. Instrumentation has been installed on a bridge located in Guthrie County, and similar instrumentation is currently being installed on a bridge located in Story County. Preliminary test results for the bridge located in Guthrie County have revealed that temperature changes of the bridge deck and girders induce both longitudinal and transverse displacements of the abutments and significant flexural strains in the abutment piles. For an average temperature range of 73° F for the superstructure concrete in the bridge located in Guthrie County, the change in the bridge length was about 1 118 in. and the maximum, strong-axis, flexural-strain range for one of the abutment piles was about 400 micro-strains, which corresponds to a stress range of about 11,600 psi.

Empirical study of correlated survival times for recurrent events with proportional hazards margins and the effect of correlation and censoring.

Background: In longitudinal studies where subjects experience recurrent incidents over a period of time, such as respiratory infections, fever or diarrhea, statistical methods are required to take into account the within-subject correlation. Methods: For repeated events data with censored failure, the independent increment (AG), marginal (WLW) and conditional (PWP) models are three multiple failure models that generalize Cox"s proportional hazard model. In this paper, we revise the efficiency, accuracy and robustness of all three models under simulated scenarios with varying degrees of within-subject correlation, censoring levels, maximum number of possible recurrences and sample size. We also study the methods performance on a real dataset from a cohort study with bronchial obstruction. Results: We find substantial differences between methods and there is not an optimal method. AG and PWP seem to be preferable to WLW for low correlation levels but the situation reverts for high correlations. Conclusions: All methods are stable in front of censoring, worsen with increasing recurrence levels and share a bias problem which, among other consequences, makes asymptotic normal confidence intervals not fully reliable, although they are well developed theoretically.

Il·lusionisme. Nova Construcció i Rehabilitació Integral de la Vil·la Urània com a complex d'equipaments

Award-winning

Desempenho de bezerros aleitados com soro de queijo em associação ao colostro

O objetivo deste trabalho foi avaliar o desempenho de bezerros mestiços, aleitados com soro de queijo em associação ao colostro. Foram utilizados 24 bezerros Holandês x Zebu, distribuídos em delineamento inteiramente casualizado, com três tratamentos e oito repetições. Os tratamentos consistiram de: leite integral, 50% de leite integral + 50% de soro de queijo, e 30% de colostro + 70% de soro de queijo. O desenvolvimento dos bezerros foi avaliado até os 60 dias de idade, por meio de pesagens semanais e mensurações corporais. Para a estimativa de consumo, foram feitas medições diárias de consumo da dieta sólida, pelo método oferta/sobra. O desempenho econômico foi avaliado pelo cálculo de indicadores de custos e receitas, e de medidas de resultados econômicos. Não houve influência da dieta líquida sobre o consumo de matéria seca e sobre as médias de medidas corporais dos bezerros. Foram observadas diferenças significativas no ganho de peso dos animais na segunda e na quarta semanas de vida. A dieta com colostro apresentou o maior lucro adicional em comparação ao tratamento controle. A associação do soro de queijo ao colostro é a opção mais vantajosa economicamente, já que a substituição de 100% do leite por esses subprodutos não prejudicou o desempenho dos animais.

Evidence of systematic and proportional error in a widely used glucose oxidase analyser: Impact for clinical research?

Real time glycemia is a cornerstone for metabolic research, particularly when performing oral glucose tolerance tests (OGTT) or glucose clamps. From 1965 to 2009, the gold standard device for real time plasma glucose assessment was the Beckman glucose analyzer 2 (Beckman Instruments, Fullerton, CA), which technology couples glucose oxidase enzymatic assay with oxygen sensors. Since its discontinuation in 2009, today's researchers are left with few choices that utilize glucose oxidase technology. The first one is the YSI 2300 (Yellow Springs Instruments Corp., Yellow Springs, OH), known to be as accurate as the Beckman(1). The YSI has been used extensively for clinical research studies and is used to validate other glucose monitoring devices(2). The major drawback of the YSI is that it is relatively slow and requires high maintenance. The Analox GM9 (Analox instruments, London), more recent and faster, is increasingly used in clinical research(3) as well as in basic sciences(4) (e.g. 23 papers in Diabetes or 21 in Diabetologia). This article is protected by copyright. All rights reserved.

T cell recognition of hapten. Anatomy of T cell receptor binding of a H-2kd-associated photoreactive peptide derivative.

To elucidate the structural basis of T cell recognition of hapten-modified antigenic peptides, we studied the interaction of the T1 T cell antigen receptor (TCR) with its ligand, the H-2Kd-bound Plasmodium berghei circumsporozoite peptide 252-260 (SYIPSAEKI) containing photoreactive 4-azidobenzoic acid (ABA) on P. berghei circumsporozoite Lys259. The photoaffinity-labeled TCR residue(s) were mapped as Tyr48 and/or Tyr50 of complementary determining region 2beta (CDR2beta). Other TCR-ligand contacts were identified by mutational analysis. Molecular modeling, based on crystallographic coordinates of closely related TCR and major histocompatibility complex I molecules, indicated that ABA binds strongly and specifically in a cavity between CDR3alpha and CDR2beta. We conclude that TCR expressing selective Vbeta and CDR3alpha sequences form a binding domain between CDR3alpha and CDR2beta that can accommodate nonpeptidic moieties conjugated at the C-terminal portion of peptides binding to major histocompatibility complex (MHC) encoded proteins.

Digestibilidad aparente de ingredientes de origen vegetal y animal en la cachama

El objetivo de esta investigación fue evaluar los coeficientes de digestibilidad aparente de materia seca (MS), proteína y energía de alimentos de origen animal y vegetal, utilizados en raciones para cachama (Piaractus brachypomus). Fueron formuladas 15 dietas experimentales, compuestas por 69,5% de una dieta referencia semipurificada, 0,5% de óxido de cromo y 30% del ingrediente a evaluar. En cada experimento, fueron utilizados 90 peces que se alimentaron durante cinco días con la correspondiente dieta; al quinto día, los animales fueron trasladados a tanques cónicos para recolección de heces. Los coeficientes de digestibilidad aparente (CDA) de proteína variaron de 92,1 a 84,7% entre los ingredientes proteicos de origen vegetal, de 85,0 a 68,5% en los proteicos de origen animal, y de 83,7 a 57,6% entre los de origen vegetal con baja proteína. Los CDA de energía de torta de soya, gluten de maíz, harina de yuca integral y de todos los ingredientes de origen animal arrojaron valores superiores a 76%. Los máximos CDA de MS variaron entre 71 y 78% y fueron observados en gluten, harina de yuca y en los ingredientes de origen animal. La cachama tiene alta capacidad para aprovechar eficientemente ingredientes de origen animal y vegetal.