997 resultados para perioperative period
Resumo:
Odontoid fractures are the most common cervical fractures in the adult population. They represent 9 to 18 % of all cervical fractures and the type II is the most common. The incidence of neurologic deficits (ND) in odontoid fractures varies between 3 to 25%. A recent study showed that patients with ND had a mortality rate increased by 4.72 times and a complication rate higher of 1.18 times. The most common complication in patients with ND was respiratory distress8. Surprisingly, although type II odontoid fractures are frequent cervical fractures, their natural history has been poorly described. Surgery for odontoid fractures is well described. However, there are so far guidelines based on class II and class III evidence only regarding indications for surgery and regarding surgical techniques. The class II guidelines recommend to consider surgical stabilization and fusion for type II odontoid in patients over 50 years of age. The class III recommendations are to first manage non-displaced odontoid type II fracture with external immobilization and that translation of 5mm or more is associated with a high rate of non- union with the conservative treatment and should be treated surgically.
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Stable carbon and nitrogen isotopes in skin and bone of South American sea lions from Brazil and Uruguay were analysed to test the hypothesis that trophic overlap between the sexes is lower during the pre-breeding season than throughout the rest of the year. The isotopic values of skin and bone were used to infer the trophic relationships between the sexes during the pre-breeding period and year round, respectively. Prey species were also analysed to establish a baseline necessary for interpreting the stable isotope ratios of skin and bone. Standard ellipse areas, estimated using Bayesian inference in the SIBER routine of the SIAR package in R, suggested that males and females used a wide diversity of foraging strategies throughout the year and that no differences existed between the sexes. However, the diversity of foraging strategies was largely reduced during the pre-breeding period, with all the individuals of each sex adopting similar strategies, but with the two sexes differing considerably in stable isotope values and the ellipse areas of males and females not overlapping at all. Nevertheless, the results revealed a general increase in the consumption of pelagic prey by both sexes during the pre-breeding period. The progressive crowding of individuals in the areas surrounding the breeding rookeries during the pre-breeding period could lead to an increase in the local population density, which could explain the above reported changes.
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We study the lysis timing of a bacteriophage population by means of a continuously infection-age-structured population dynamics model. The features of the model are the infection process of bacteria, the death process, and the lysis process which means the replication of bacteriophage viruses inside bacteria and the destruction of them. The time till lysis (or latent period) is assumed to have an arbitrary distribution. We have carried out an optimization procedure, and we have found that the latent period corresponding to maximal fitness (i.e. maximal growth rate of the bacteriophage population) is of fixed length. We also study the dependence of the optimal latent period on the amount of susceptible bacteria and the number of virions released by a single infection. Finally, the evolutionarily stable strategy of the latent period is also determined as a fixed period taking into account that super-infections are not considered
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We report the use of an optical fiber sensor to measure the soybean oil concentration in samples obtained from the mixture of pure biodiesel and commercial soybean oil. The operation of the device is based on the long-period grating sensitivity to the surrounding medium refractive index, which leads to measurable modifications in the grating transmission spectrum. The proposed analysis method results in errors in the oil concentration of 0.4% and 2.6% for pure biodiesel and commercial soybean oil, respectively. Techniques of total glycerol, dynamic viscosity, density, and hydrogen nuclear magnetic resonance spectroscopy were also employed to validate the proposed method.
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Risk analysis of climate change on plant diseases has great importance for agriculture since it allows the evaluation of management strategies to minimize future damages. This work aimed to simulate future scenarios of coffee rust (Hemileia vastatrix) epidemics by elaborating geographic distribution maps using a model that estimates the pathogen incubation period and the output from three General Circulation Models (CSIRO-Mk3.0, INM-CM3.0, and MIROC3.2.medres). The climatological normal from 1961-1990 was compared with that of the decades 2020s, 2050s and 2080s using scenarios A2 and B1 from the IPCC. Maps were prepared with a spatial resolution of 0.5 × 0.5 degrees of latitude and longitude for ten producing states in Brazil. The climate variables used were maximum and minimum monthly temperatures. The maps obtained in scenario A2 showed a tendency towards a reduction in the incubation period when future scenarios are compared with the climatological normal from 1961-1990. A reduction in the period was also observed in scenario B1, although smaller than that in scenario A2.
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In this study, it was adjusted a mathematical model to measure the effect of electric motor efficiency on pumping system costs for irrigation on the tariff structure of conventional electricity and green horo-seasonal , and also to calculate the recovery period of the invested capital in higher efficiency equipment. Then, it was applied to a center pivot irrigation system in two options of electric motor efficiency, 92,6% (standard line) and 94,3% (high efficiency line), and the acquisition cost of the first corresponded to 70% the of the second. The power of the electric motor was 100hp. The results showed that the model allowed us to evaluate if a high efficiency motor was economically viable compared to the standard motor in each tariff structure. The high efficiency motor was not viable in the two tariff structures. In the green horo-seasonal tariff, would only be viable if its efficiency was 4.46% higher than the standard motor. In the conventional tariff, it would only be viable if the efficiency overcame 2.71%.
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Kirjallisuusarvostelu
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Understanding perioperative pathophysiology and implementing care regimes, through a multimodal approach, to reduce the organic response to stress after surgery and the related postoperative ileus, are major challenges. Multimodal surgical strategies such as pre-operative intake of a carbohydrate drink, instead of the usually recommended 2- to 6-hour period of nothing-bymouth, together with patient's education of the postoperative care plan, plus efficacious analgesia and early postoperative nutrition, among others, have been described to significantly impact on the previous variables. Therefore, these strategies accelerate rehabilitation and, as a consequence, decrease complications and hospital length of stay and, its related costs.
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OBJECTIVE: To assess hematological and biochemical features of splenic effluent blood and their influence on the rise of hematological values after splenectomy.METHODS: we studied 20 patients undergoing surgical treatment for schistosomatic portal hypertension. We collected blood samples for CBC, coagulation, bilirubin and albumin in the splenic vein (perioperative) and peripheral blood (immediately pre and postoperative periods).RESULTS: the splenic blood showed higher values of red blood cells, hemoglobin, hematocrit, platelet count, total leukocytes, neutrophils, lymphocytes, monocytes, eosinophils and basophils, as well as reduction of laboratory coagulation parameters in relation to peripheral blood collected preoperatively. In the postoperative peripheral blood there was an increase in the overall leukocytes and in their neutrophil component, and decreased levels of basophils, eosinophils and lymphocytes. The other postoperative variables of complete blood count and coagulation tests were not different compared with the splenic blood. The albumin values were lower postoperatively when compared to preoperative and splenic blood. There were higher values of direct bilirubin in the postoperative period when compared with the preoperative and splenic blood. Postoperative indirect bilirubin was lower compared to its value in the splenic blood.CONCLUSION: hematological and biochemical values of splenic effluent blood are higher than those found in peripheral blood in the presence of schistosomal splenomegaly. However, the splenic blood effluent is not sufficient to raise the blood levels found after splenectomy.
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Objective: To evaluate perioperative outcomes, safety and feasibility of video-assisted resection for primary and secondary liver lesions. Methods : From a prospective database, we analyzed the perioperative results (up to 90 days) of 25 consecutive patients undergoing video-assisted resections in the period between June 2007 and June 2013. Results : The mean age was 53.4 years (23-73) and 16 (64%) patients were female. Of the total, 84% were suffering from malignant diseases. We performed 33 resections (1 to 4 nodules per patient). The procedures performed were non-anatomical resections (n = 26), segmentectomy (n = 1), 2/3 bisegmentectomy (n = 1), 6/7 bisegmentectomy (n = 1), left hepatectomy (n = 2) and right hepatectomy (n = 2). The procedures contemplated postero-superior segments in 66.7%, requiring multiple or larger resections. The average operating time was 226 minutes (80-420), and anesthesia time, 360 minutes (200-630). The average size of resected nodes was 3.2 cm (0.8 to 10) and the surgical margins were free in all the analyzed specimens. Eight percent of patients needed blood transfusion and no case was converted to open surgery. The length of stay was 6.5 days (3-16). Postoperative complications occurred in 20% of patients, with no perioperative mortality. Conclusion : The video-assisted liver resection is feasible and safe and should be part of the liver surgeon armamentarium for resection of primary and secondary liver lesions.
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The study aimed to evaluate tear production by means of modified Schirmer tear tes-1 (mSTT-1) in neonate cats. Likewise, correlation between mSTT-1 and STT-1 was assessed in vitro. Standard SST strips were cut in half and after eye lid opening, tear production of neonates (n=15) was daily measured in both eyes (mSTT-1), until the 7th day, and at day 14, 21, and 28. Animals were daily weighted until 28 days of age. Results were compared statistically (P<0.05). During the first 7 days, the overall mSTT-1 mean was 0.76 wetting/minute. Significant differences between right and left eyes were not observed at any time point (P=1.00). Tear secretion increased significantly, from the 14th to 28th day, in comparison with 7 first days (P<0.05). Positive correlation between maturity parameters and tear secretion was observed (P<0.0001). Distance between slopes of each strip changed significantly (P<0.0001). It was concluded that tear secretion in the neonatal period of cats is very below the reference values described for young and adults of the same species. It is not possible to extrapolate results obtained with mSTT-1 to standard STT-1.
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Corrective shoeing is a method commonly used to alter the locomotion pattern in animals or as therapy for various disorders of the locomotive system of horses. However, to date, there have been no scientific studies discussing the period during which animals adapt to this type of intervention. The goal of this study was to evaluate the horseshoe adaptation period with the toe or heel elevated by six degrees at 0, 48, and 96 hours after each type of shoeing. For this analysis, the horses were recorded while walking on a treadmill. Stride length and gait qualitative analyzes were performed using Dvideow software. The level of significance adopted was 5%. In the present study, there was no significant difference between the evaluation times; elevating the toe or heel by six degrees do not generates discomfort during locomotion, therefore, horses are able to return to a regular exercise or training routine immediately after shoeing.
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The effects of different weed management periods on potatoes were studied in three areas (Bailundo, Chianga and Calenga) of the central highlands of Angola and in three cropping seasons, from June 2005 to May 2007. Six weed-management treatments were used to identify critical periods of competition and to allow the development of more precise management recommendations. Total potato yield ranged from about 22 t ha-1 in weed-free plots to about 3 t ha-1 with no weed control a yield loss of 86%. Major weed species Galinsoga parviflora, Cyperus esculentus, Bidens biternata, Amaranthus hybridus, Nicandra physaloides, Portulaca oleracea and Datura stramonium differed from area to area. The species G. parviflora dominated the weed flora in all three areas 73, 97 and 72 plants m² 50 days after crop emergence in Bailundo, Chianga and Calenga respectively, in dry season trials; while C. esculentus was also present in Chianga and Calenga, with an average density of ca 30 plants m-2 in dry season trials. Gompertz and logistic equations were fitted to data representing increasing periods of weed-free growth and weed interference, respectively. Critical periods for weed control, with a 95% weed-free total yield, were estimated from 26 to 66 and from 20 to 61 days after emergence for the rainy and dry seasons, respectively. Weed competition before or after these critical periods had negligible effects on crop yield.
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An experiment was laid down in a screen house to determine the distribution of weed seeds at different soil depths and periods of cultivation of sugarcane in Ilorin, Nigeria. Soil samples from different depth levels (0-10 cm, 11-20 cm and 21-30 cm) were collected after harvesting of canes from three different land use fields (continuous sugarcane cultivation for > 20 years, continuous sugarcane cultivation for < 10 years after long fallow period and continuous sugarcane cultivation for < 5 years after long fallow period) in November, 2012. One kilogram of the sieved composite soil samples was arranged in the screen house and watered at alternate days. Germinating weed seedlings were identified, counted and then pulled out for the period of 8 months. Land use and soil depth had a highly significant (p £ 0.05) effect on the total number of weeds that emerged from the soil samples. The 010 cm of the soil depth had the highest weed seedlings that emerged. There was an equal weed seed distribution at the 11-20 cm and 21-30 cm depths of the soil. Sugarcane fields which have been continuously cultivated for a long period of time with highly disturbing soil tillage practices tend to have larger seed banks in deeper soil layers (11-20 cm and 21-30 cm) while recently opened fields had significantly larger seed banks at the 0-10 cm soil sampling depth.
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Recent studies indicate that glyphosate applied in post-emergence in RR soybean can eventually cause phytotoxic effects. However, there are many questions that need to be clarified in the scientific and technical contexts, involving the issue of RR soybeans regarding the use of glyphosate. This study has assessed the impact of the application of different doses and formulations of glyphosate in the reproductive period of RR soybean (R1 stage). For that purpose, an experiment in the field was conducted in two harvests (2011/12 and 2012/13), in which a 2 x 5 factorial design was used (formulations versus doses) totaling 10 treatments. In these two experiments the variables related to agronomic performance were: phytotoxicity (7, 14, 21 and 28 days after application), plant height, number of pods per plant, yield and weight of 100 grains (end of soy cycle). The results obtained allowed characterizing phytotoxicity and damages to the height and yield in RR soybean, with increasing rates of glyphosate applied in the reproductive period.