Erythrocyte selenium concentration predicts intensive care unit and hospital mortality in patients with septic shock: a prospective observational study

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Risk factors for the acquisition of imipenem-resistant Acinetobacter baumannii in a burn unit: An appraisal of the effect of colonization pressure

Imipenem-resistant Acinetobacter baumannii (IRAB) is a major threat for critically ill patients, including those admitted to burn units. Recent studies have suggested that colonization pressure (the proportion of patients or patient-days harbouring the pathogen of interest) is an important driver of the risk for acquisition of multidrug-resistant organisms. With that in mind, we conducted a cohort study, enrolling 208 patients admitted to a burn unit from November 2008 through December 2009. The outcome of interest was the acquisition of IRAB. In addition to the usual risk factors, we assessed the impact of colonization pressure. The number of wound excisions (odds ratio (OR) 12.06, 95% confidence interval (CI) 2.82-51.64) and the number of antimicrobials used (OR 22.82, 95% CI 5.15-101.19) were significant risk factors for the outcome of interest. On the other hand, colonization pressure (measured for whole time of exposure or up to the last 14, 7, or 3 days) was not associated with the risk for IRAB acquisition.

Practising Arithmetic Using Educational Video Games with an Interpersonal Computer

Studies show the positive effects that video games can have on student performance and attitude towards learning. In the past few years, strategies have been generated to optimize the use of technological resources with the aim of facilitating widespread adoption of technology in the classroom. Given its low acquisition and maintenance costs, the interpersonal computer allows individual interaction and simultaneous learning with large groups of students. The purpose of this work was to compare arithmetical knowledge acquired by third-grade students through the use of game-based activities and non-game-based activities using an interpersonal computer, with knowledge acquired through the use of traditional paper-and-pencil activities, and to analyze their impact in various socio-cultural contexts. To do this, a quasi-experimental study was conducted with 271 students in three different countries (Brazil, Chile, and Costa Rica), in both rural and urban schools. A set of educational games for practising arithmetic was developed and tested in six schools within these three countries. Results show that there were no significant differences (ANCOVA) in the learning acquired from game-based vs. non-game-based activities. However, both showed a significant difference when compared with the traditional method. Additionally, both groups using the interpersonal computer showed higher levels of student interest than the traditional method group, and these technological methods were seen to be especially effective in increasing learning among weaker students.

Quaternion orders over quadratic integer rings from arithmetic fuchsian groups

In this paper we show that the quaternion orders OZ[ √ 2] ≃ ( √ 2, −1)Z[ √ 2] and OZ[ √ 3] ≃ (3 + 2√ 3, −1)Z[ √ 3], appearing in problems related to the coding theory [4], [3], are not maximal orders in the quaternion algebras AQ( √ 2) ≃ ( √ 2, −1)Q( √ 2) and AQ( √ 3) ≃ (3 + 2√ 3, −1)Q( √ 3), respectively. Furthermore, we identify the maximal orders containing these orders.

Szegö polynomials: quadrature rules on the unit circle and on [-1, 1]

We consider some of the relations that exist between real Szegö polynomials and certain para-orthogonal polynomials defined on the unit circle, which are again related to certain orthogonal polynomials on [-1, 1] through the transformation x = (z1/2+z1/2)/2. Using these relations we study the interpolatory quadrature rule based on the zeros of polynomials which are linear combinations of the orthogonal polynomials on [-1, 1]. In the case of any symmetric quadrature rule on [-1, 1], its associated quadrature rule on the unit circle is also given.

Risk factors for infection with coagulase-negative staphylococci in newborns from the neonatal unit of a brazilian university hospital

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

Care to terminal patients. Perception of nurses from the intensive care unit of a hospital

Objective. To identify the perception of nurses with regard to the process of providing care to patients in the context of hospice care. Method. Qualitative study using the methodological framework Collective Subject Discourse. A total of 18 nursing professionals of the adult intensive care unit of a public hospital in São Paulo, Brazil were interviewed between June and August 2012. Results. The process of providing care to terminal patients is permeated by negative, conflictive and mixed feelings. As regards communication, while the participants acknowledge its importance as a therapeutic resource, they also admit a lack of professional qualification. Conclusion. The interviewees have difficulties to deal with care provided to terminal patients. The qualification of these professionals needs to be improved, starting in the undergraduate program.

Cytogenetic and molecular data demonstrate that the bryconinae (ostariophysi, bryconidae) species from southeastern Brazil form a phylogenetic and phylogeographic unit

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Correlating soil porosity and respective geological unit in Paraíba do sul Valley, Brazil: a geostatistical methodology proposal

This manuscript aims proposing a methodology for correlating soil porosity to the respective geological units using geostatistical analysis techniques, including interpolation data by kriging. The site studied was in Lorena municipality, Paraíba do Sul Valley, southeastern Brazil. Specifically all studies were carried out within an area of 12 km2 located at Santa Edwirges farm. The database comprehended 41 soil samples taken at different geological and geomorphologic units at three different depths: surface, 50 cm and 100 cm depth. The geostatistical analyses results were correlated to a geological mapping specifically elaborated for the site. This mapping accounts for two different geological formations and a geological contact characterized by a shearing zone. The results indicate the existence of a significant relationship between the soil porosity and the respective geological units. The studies revealed that the residual soils from weathered granitic rocks tend to have higher porosities than the residual soils from weathered biotite gneiss rocks, while the soil porosity within the shearing zone is relatively un-sensitive to the respective geological formation. The spatial patterns observed were efficient to evaluate the relationship between the soil porosity, geology unit and the and geomorphology showing a good potential for correlating with others soil properties such as hydraulic conductivity, soil water retention curves and erosion potentials.

Experience of family members as a result of children's hospitalization at the Intensive Care Unit

Objective. To describe the experience of family members as a result of children’s hospitalization at the Intensive Care Unit (ICU). Methodology. Descriptive and cross-sectional study. A structured interview was held with 20 relatives of patients hospitalized at two clinics of the Botucatu Medical School at Universidade Estadual Paulista “Júlio de Mesquita Filho”. Information was collected between July and September 2010. Results. The main characteristics of the participating relatives were: 80% mothers of the children; 70% low education level and 70% married. Sixty percent of the children were hospitalized at the ICU for the first time. Eighty percent of the interviewees believe that the children’s behavior changes inside the unit and 85% consider that visiting hours are sufficient. The predominant negative feelings are fear (50%) and insecurity (20%), while the predominant positive feelings are hope (50%) and the expectation of discharge (25%). The professional who most supported the relatives was the nurse (35%). Conclusion. The family members’ experience as a result of the children’s hospitalization at the ICU involves positive and negative aspects, which also affect the child’s behavior at the unit.

Bacteria on the hands of school-age children at a Pediatric Hospitalization Unit

Objective. To estimate the prevalence of bacteria isolated in samples from the hands of school-age children at a hospitalization unit. Methodology. In 2009, strains were cultured from the hands of 90 school-age children at the pediatric hospitalization unit of Hospital Estadual Bauru (São Paulo, Brazil). After culture of the samples, the isolated bacteria were identified. Results. In 98% of the samples taken from the children, bacteria were isolated. Coagulase-negative Staphilococcus was isolated in 64% of the samples, followed by Staphilococcus aureus (5%) and Pseudomonas aeruginosa (1%). Conclusion. In most of the samples from the children’s hands, bacteria were isolated. Therefore, educative actions about hygiene habits in- and outside the hospital environment should be reinforced, aimed at children and their companions.

Body temperature, Aldrete-Kroulik index, and patient discharge from the Post-Anesthetic Recovery Unit

Patient discharge from post-anesthetic recovery (PAR) depends, among other factors, on normothermia and the patient's score on the Aldrete-Kroulik index. The objective of this study was to verify the relationship between the Aldrete-Kroulik index and body temperature in patients. This study was performed at the University of Sao Paulo University Hospital. Convenience sampling was used, and the sample consisted of 60 patients of ages between 18 and 60 years who underwent general anesthesia. The patients' body temperature was obtained by tympanic measurement, and the Aldrete-Kroulik index was measured on admission and at discharge from post-anesthetic recovery. The data were processed using SPSS, considering a significance level of 5%, and the Spearman and Wilcoxon tests were applied. In conclusion, no significant correlation was found between the two parameters for discharge.

Hydrodynamic evaluation of a mechanical flocculation pilot unit

This work focused on the hydrodynamic research aiming at the short-circuiting evaluation for five different outlet configurations through the compartments of a vertical paddle flocculation pilot unit. The tests were carried out with variable and constant velocity gradients, including alternative rotation direction of the paddles. The research pointed out that the relevance of outlet configuration increases with the reduction of the number of compartments. In opposite, the velocity gradient and the rotation direction of paddles seem less significant features. These results open the perspective of viable increasing of performance, with low financial investments, mainly for flocculation units with three or two compartments installed in overloaded water treatment plants.

Low mechanical ventilation times and reintubation rates associated with a specific weaning protocol in an intensive care unit setting: a retrospective study

OBJECTIVES: A number of complications exist with invasive mechanical ventilation and with the use of and withdrawal from prolonged ventilator support. The use of protocols that enable the systematic identification of patients eligible for an interruption in mechanical ventilation can significantly reduce the number of complications. This study describes the application of a weaning protocol and its results. METHODS: Patients who required invasive mechanical ventilation for more than 24 hours were included and assessed daily to identify individuals who were ready to begin the weaning process. RESULTS: We studied 252 patients with a median mechanical ventilation time of 3.7 days (interquartile range of 1 to 23 days), a rapid shallow breathing index value of 48 (median), a maximum inspiratory pressure of 40 cmH2O, and a maximum expiratory pressure of 40 cm H2O (median). Of these 252 patients, 32 (12.7%) had to be reintubated, which represented weaning failure. Noninvasive ventilation was used postextubation in 170 (73%) patients, and 15% of these patients were reintubated, which also represented weaning failure. The mortality rate of the 252 patients studied was 8.73% (22), and there was no significant difference in the age, gender, mechanical ventilation time, and maximum inspiratory pressure between the survivors and nonsurvivors. CONCLUSIONS: The use of a specific weaning protocol resulted in a lower mechanical ventilation time and an acceptable reintubation rate. This protocol can be used as a comparative index in hospitals to improve the weaning system, its monitoring and the informative reporting of patient outcomes and may represent a future tool and source of quality markers for patient care.