934 resultados para Accidental poisoning


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Mercury is neurotoxic, and numerous studies have confirmed its ototoxic effect. However, the diagnosis and follow-up of mercury exposure require understanding the pathophysiology of the chemical substance. Based on a systematic literature review, this study aimed to demonstrate whether mercury is ototoxic and to analyze its mechanism of action on the peripheral and central auditory system, in order to contribute to the diagnosis and follow-up of exposure. This was a systematic review of studies published on the effects of mercury exposure on the auditory system. The full text of the studies and their methodological quality were analyzed. The review identified 108 studies published on the theme, of which 28 met the inclusion criteria. All the articles in the analysis showed that mercury exposure is ototoxic and produces peripheral and/or central damage. Acute and long-term exposure produces irreversible damage to the central auditory system. Biomarkers were unable to predict the relationship between degree of mercury poisoning and degree of lesion in the auditory system.

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Polythiophene (PTh) phase electropolymerized on the stainless steel wire was evaluated as solid-phase microextraction (SPME), and analysis by liquid chromatography with spectrophotometric detection (LC-UV) for determination of new-generation antidepressants, selective serotonin reuptake inhibitors (SSRIs) (citalopram, paroxetine, fluoxetine and sertraline), in plasma samples. The influence of electropolymerization variables (scan rate, potential range and scan cycles) was evaluated on SPME performance. The SPME variables (extraction time, temperature, matrix pH, ionic strength and desorption procedure), as well as the influence of plasma proteins on sorption mechanisms were also evaluated. The SPME/LC-UV method developed for determination of antidepressants in plasma sample presented a linear range between the limit of quantification (LOQ, 200-250 ng mL-1) to 4000 ng mL-1, and interday precision with coefficient of variation (CV) ranged from 11 to 15%. The proposed method can be a useful tool for the determination of antidepressants in human plasma samples in urgent toxicological analysis after the accidental or suicidal intake of higher doses of medications.

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Clostridium perfringens is an anaerobic Gram-positive bacterium known as common pathogen for humans, for domestic and wildlife animals. Although infections caused by C. perfringens type C and A in swine are well studied, just a few reports describe the genetic relationship among strains in the epidemiological chain of swine clostridioses, as well as the presence of the microorganism in the slaughterhouses. The aim of the present study was to isolate C. perfringens from feces and carcasses from swine slaughterhouses, characterize the strains in relation to the presence of enterotoxin, alpha, beta, epsilon, iota and beta-2 toxins genes, using polymerase chain reaction (PCR) and comparing strains by means of Pulsed field gel electrophoresis (PFGE). Clostridium perfringens isolation frequencies in carcasses and finishing pig intestines were of 58.8% in both types of samples. According to the polymerase chain reaction assay, only alfa toxin was detected, being all isolates also negative to enterotoxin and beta2 toxin. Through PFGE technique, the strains were characterized in 35 pulsotypes. In only one pulsotype, the isolate from carcass sample was grouped with fecal isolate of the same animal, suggesting that the risk of cross-contamination was low. Despite the high prevalence of C. perfringens in swine carcasses from the slaughterhouses assessed, the risk of food poisoning to Brazilian pork consumers is low, since all strains were negative to cpe-gene, codifying enterotoxin.

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Foi realizada uma Revisão Integrativa da Literatura com o objetivo de avaliar o conhecimento científico produzido relacionado à qualidade de vida do idoso que sofreu quedas. Métodos: foram selecionados artigos publicados nas bases de dados Lilacs, CINAHL e Medline, com os seguintes descritores: qualidade de vida, idoso e acidentes por quedas, nos idiomas português, inglês e espanhol, entre 1999 e 2009. Resultados: nove artigos atenderam aos critérios de inclusão. Encontrou-se que as quedas são frequentes nos idosos, sendo que aqueles com mais fatores de risco intrínsecos e que já caíram apresentaram mais medo e possuem mais chance de caírem novamente; e também relataram déficits nas funções física, mental/emocional, dor corporal e relacionados ao meio ambiente e que programas de prevenção de quedas podem melhorar sua qualidade de vida com o tempo. Conclusão: evidenciou-se como lacunas no conhecimento: escassa produção científica nacional, principalmente de autores enfermeiros, e predomínio de estudos descritivos e com nível de evidência considerado fraco. Sugere-se a atuação dos profissionais de saúde em pesquisas de intervenções para prevenção de quedas as quais possam ser aplicadas na prática clínica e que possibilitem melhorar a qualidade de vida dos idosos.

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OBJECTIVE: To evaluate suicide rates and trends in São Paulo by sex, age-strata, and methods. METHODS: Data was collected from State registry from 1996 to 2009. Population was estimated using the National Census. We utilized joinpoint regression analysis to explore temporal trends. We also evaluated marital status, ethnicity, birthplace and methods for suicide. RESULTS: In the period analyzed, 6,002 suicides were accrued with a rate of 4.6 per 100,000 (7.5 in men and 2.0 in women); the male-to-female ratio was around 3.7. Trends for men presented a significant decline of 5.3% per year from 1996 to 2002, and a significant increase of 2.5% from 2002 onwards. Women did not present significant changes. For men, the elderly (> 65 years) had a significant reduction of 2.3% per year, while younger men (25-44 years) presented a significant increase of 8.6% from 2004 onwards. Women did not present significant trend changes according to age. Leading suicide methods were hanging and poisoning for men and women, respectively. Other analyses showed an increased suicide risk ratio for singles and foreigners. CONCLUSIONS: Specific epidemiological trends for suicide in the city of São Paulo that warrant further investigation were identified. High-risk groups - such as immigrants - could benefit from targeted strategies of suicide prevention.

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The objective of this study was to review mortality from external causes (accidental injury) in children and adolescents in systematically selected journals. This was a systematic review of the literature on mortality from accidental injury in children and adolescents. We searched the Pubrvled, Latin-American and Caribbean Health Sciences and Excerpta Medica databases for articles published between July of 2001 and June of 2011. National data from official agencies, retrieved by manual searches, were also reviewed. We reviewed 15 journal articles, the 2011 edition of a National Safety Council publication and 2010 statistical data from the Brazilian National Ministry of Health Mortality Database. Most published data were related to high-income countries. Mortality from accidental injury was highest among children less than 1 year of age. Accidental threats to breathing (non-drowning threats) constituted the leading cause of death among this age group in the published articles. Across the pediatric age group in the surveyed studies, traffic accidents were the leading cause of death, followed by accidental drowning and submersion. Traffic accidents constitute the leading external cause of accidental death among children in the countries understudy. However, infants were vulnerable to external causes, particularly to accidental non-drowning threats to breathing, and this age group had the highest mortality rates for external causes. Actions to reduce such events are suggested. Further studies investigating the occurrence of accidental deaths in low-income countries are needed to improve the understanding of these preventable events.

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Um dos maiores problemas de saúde pública na população idosa são as quedas, agravando-se quando relacionadas à presença de osteoporose. Dentre os vários fatores de risco, destacam-se a diminuição do equilíbrio, controle postural e força muscular. O objetivo deste trabalho foi comparar o equilíbrio, o controle postural e a força muscular em idosas osteoporóticas com e sem quedas referidas no último ano. Foram avaliadas 45 mulheres entre 65 e 85 anos, divididas em dois grupos com base no relato de quedas nos 12 meses anteriores à avaliação: grupo com quedas (GCQ; n=21) e grupo sem quedas (GSQ; n=24). O equilíbrio foi avaliado por meio da escala de equilíbrio de Berg; o controle postural pelo teste clínico modificado de interação sensorial no equilíbrio (mCTSIB), realizado no equipamento Balance Master®; e a força muscular dos flexores e extensores de joelho e dorsiflexores de tornozelo, com dinamômetro EMG System do Brasil®. Foi considerado nível de significância α=0,05. Houve diferença significativa no equilíbrio (p<0,01) e na velocidade de oscilação do Centro de Pressão (CP) durante o teste mCTSIB nas condições olhos fechados superfície estável (p=0,05) e olhos abertos superfície instável (p<0,01), com valores maiores para o GCQ. Os grupos foram semelhantes entre si em relação à força muscular (p>0,05). Nossos resultados indicam que idosas osteoporóticas com histórico de quedas nos últimos 12 meses possuem pior equilíbrio e controle postural em relação às osteoporóticas sem quedas referidas.

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Although several studies on ammonia poisoning have been carried out, there is a lack of information on acid-base balance status in ammonia-poisoned cattle. Twelve crossbred steers received intraruminally 0.5 g of urea per kg of body weight in order to induce a clinical picture of ammonia poisoning. Blood samples were collected throughout the trials in order to determine the blood ammonia, lactate, and perform blood gas analysis. All cattle presented a classical clinical picture of ammonia poisoning, with a blood ammonia concentration rising progressively from the beginning until reaching higher values at 180 min (27 ± 3 to 1719 ± 101 μmol L-1), with a similar pattern occurring with blood L-lactate levels (1.7 ± 0.3 to 26.0 ± 1.7 mmol L-1). The higher the blood ammonia concentration the higher the blood L-lactate levels (r = 0.86). All animals developed metabolic acidosis, as blood pH lowered to 7.24 0.03. The steers tried to compensate the metabolic acidosis mainly through the use of blood buffers and respiratory adjustments by lowering the pCO2 levels in the blood to 32.8 ± 2.0 mm Hg.

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Introduction 1.1 Occurrence of polycyclic aromatic hydrocarbons (PAH) in the environment Worldwide industrial and agricultural developments have released a large number of natural and synthetic hazardous compounds into the environment due to careless waste disposal, illegal waste dumping and accidental spills. As a result, there are numerous sites in the world that require cleanup of soils and groundwater. Polycyclic aromatic hydrocarbons (PAHs) are one of the major groups of these contaminants (Da Silva et al., 2003). PAHs constitute a diverse class of organic compounds consisting of two or more aromatic rings with various structural configurations (Prabhu and Phale, 2003). Being a derivative of benzene, PAHs are thermodynamically stable. In addition, these chemicals tend to adhere to particle surfaces, such as soils, because of their low water solubility and strong hydrophobicity, and this results in greater persistence under natural conditions. This persistence coupled with their potential carcinogenicity makes PAHs problematic environmental contaminants (Cerniglia, 1992; Sutherland, 1992). PAHs are widely found in high concentrations at many industrial sites, particularly those associated with petroleum, gas production and wood preserving industries (Wilson and Jones, 1993). 1.2 Remediation technologies Conventional techniques used for the remediation of soil polluted with organic contaminants include excavation of the contaminated soil and disposal to a landfill or capping - containment - of the contaminated areas of a site. These methods have some drawbacks. The first method simply moves the contamination elsewhere and may create significant risks in the excavation, handling and transport of hazardous material. Additionally, it is very difficult and increasingly expensive to find new landfill sites for the final disposal of the material. The cap and containment method is only an interim solution since the contamination remains on site, requiring monitoring and maintenance of the isolation barriers long into the future, with all the associated costs and potential liability. A better approach than these traditional methods is to completely destroy the pollutants, if possible, or transform them into harmless substances. Some technologies that have been used are high-temperature incineration and various types of chemical decomposition (for example, base-catalyzed dechlorination, UV oxidation). However, these methods have significant disadvantages, principally their technological complexity, high cost , and the lack of public acceptance. Bioremediation, on the contrast, is a promising option for the complete removal and destruction of contaminants. 1.3 Bioremediation of PAH contaminated soil & groundwater Bioremediation is the use of living organisms, primarily microorganisms, to degrade or detoxify hazardous wastes into harmless substances such as carbon dioxide, water and cell biomass Most PAHs are biodegradable unter natural conditions (Da Silva et al., 2003; Meysami and Baheri, 2003) and bioremediation for cleanup of PAH wastes has been extensively studied at both laboratory and commercial levels- It has been implemented at a number of contaminated sites, including the cleanup of the Exxon Valdez oil spill in Prince William Sound, Alaska in 1989, the Mega Borg spill off the Texas coast in 1990 and the Burgan Oil Field, Kuwait in 1994 (Purwaningsih, 2002). Different strategies for PAH bioremediation, such as in situ , ex situ or on site bioremediation were developed in recent years. In situ bioremediation is a technique that is applied to soil and groundwater at the site without removing the contaminated soil or groundwater, based on the provision of optimum conditions for microbiological contaminant breakdown.. Ex situ bioremediation of PAHs, on the other hand, is a technique applied to soil and groundwater which has been removed from the site via excavation (soil) or pumping (water). Hazardous contaminants are converted in controlled bioreactors into harmless compounds in an efficient manner. 1.4 Bioavailability of PAH in the subsurface Frequently, PAH contamination in the environment is occurs as contaminants that are sorbed onto soilparticles rather than in phase (NAPL, non aqueous phase liquids). It is known that the biodegradation rate of most PAHs sorbed onto soil is far lower than rates measured in solution cultures of microorganisms with pure solid pollutants (Alexander and Scow, 1989; Hamaker, 1972). It is generally believed that only that fraction of PAHs dissolved in the solution can be metabolized by microorganisms in soil. The amount of contaminant that can be readily taken up and degraded by microorganisms is defined as bioavailability (Bosma et al., 1997; Maier, 2000). Two phenomena have been suggested to cause the low bioavailability of PAHs in soil (Danielsson, 2000). The first one is strong adsorption of the contaminants to the soil constituents which then leads to very slow release rates of contaminants to the aqueous phase. Sorption is often well correlated with soil organic matter content (Means, 1980) and significantly reduces biodegradation (Manilal and Alexander, 1991). The second phenomenon is slow mass transfer of pollutants, such as pore diffusion in the soil aggregates or diffusion in the organic matter in the soil. The complex set of these physical, chemical and biological processes is schematically illustrated in Figure 1. As shown in Figure 1, biodegradation processes are taking place in the soil solution while diffusion processes occur in the narrow pores in and between soil aggregates (Danielsson, 2000). Seemingly contradictory studies can be found in the literature that indicate the rate and final extent of metabolism may be either lower or higher for sorbed PAHs by soil than those for pure PAHs (Van Loosdrecht et al., 1990). These contrasting results demonstrate that the bioavailability of organic contaminants sorbed onto soil is far from being well understood. Besides bioavailability, there are several other factors influencing the rate and extent of biodegradation of PAHs in soil including microbial population characteristics, physical and chemical properties of PAHs and environmental factors (temperature, moisture, pH, degree of contamination). Figure 1: Schematic diagram showing possible rate-limiting processes during bioremediation of hydrophobic organic contaminants in a contaminated soil-water system (not to scale) (Danielsson, 2000). 1.5 Increasing the bioavailability of PAH in soil Attempts to improve the biodegradation of PAHs in soil by increasing their bioavailability include the use of surfactants , solvents or solubility enhancers.. However, introduction of synthetic surfactant may result in the addition of one more pollutant. (Wang and Brusseau, 1993).A study conducted by Mulder et al. showed that the introduction of hydropropyl-ß-cyclodextrin (HPCD), a well-known PAH solubility enhancer, significantly increased the solubilization of PAHs although it did not improve the biodegradation rate of PAHs (Mulder et al., 1998), indicating that further research is required in order to develop a feasible and efficient remediation method. Enhancing the extent of PAHs mass transfer from the soil phase to the liquid might prove an efficient and environmentally low-risk alternative way of addressing the problem of slow PAH biodegradation in soil.

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Two lectins, called lanceolin and stenodactylin, were purified by affinity chromatography on CL Sepharose 6B from the caudices of the Passifloraceae Adenia lanceolata and Adenia stenodactyla, respectively. They are glycoproteins with Mw of 61,243 (lanceolin) and 63,131 daltons (stenodactylin), consisting of an enzymatic A chain linked to a larger B chain with lectin properties, with N-terminal amino acid sequences similar to that of volkensin, the toxic lectin from Adenia volkensii. These two lectins agglutinate red blood cells, inhibit protein synthesis in a cell-free system as well as in whole cells, and depurinate ribosomes and DNA, but not tRNA or poly(A). They are highly toxic to cells, in which they induce apoptosis and strongly inhibit protein synthesis, and to mice, with LD50s 8.16 mg/kg (lanceolin) and 2.76 mg/kg (stenodactylin) at 48 hours after administration. Thus, lanceolin and stenodactylin have all the properties of the toxic type 2 ribosomeinactivating proteins (RIPs). Further experiments were conducted in order to clarify the effects of these RIPs in cells. We investigated the cronological relationship between cytotoxic activity, indirectly evaluated as inhibition of protein synthesis, and loss of cell viability in NB100 cell line. The induction of apoptosis was assessed by determining caspases 3 and 7 levels, which increase 8-16 hours earlier than the beginning of protein synthesis inhibition. This suggest that the arrest of protein synthesis is not a central event in the pathway of cell poisoning by RIPs. The high toxicity and the induction of cell death only by apoptosis and not by necrosis in two muscular cell lines (TE671 and RD/18) suggest that lanceolin and stenodactylin may be potential candidates for experimental chemoablation in strabism and blepharospasm. These results show that lanceolin and stenodactylin are amongst the most potent toxins of plant origin.

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The Ctr family is an essential part of the copper homeostasis machinery and its members share sequence homology and structural and functional features. Higher eukaryotes express two members of this family Ctr1 and Ctr2. Numerous structural and functional studies are available for Ctr1, the only high affinity Cu(I) transporter thus far identified. Ctr1 holigotrimers mediate cellular copper uptake and this protein was demonstrated to be essential for embryonic development and to play a crucial role in dietary copper acquisition. Instead very little is known about Ctr2, it bears structural homology to the yeast vacuolar copper transporter, which mediates mobilization of vacuolar copper stores. Recent studies using over-expressed epitope-tagged forms of human Ctr2 suggested a function as a low affinity copper transporter that can mediate either copper uptake from the extracellular environment or mobilization of lysosomal copper stores. Using an antibody that recognizes endogenous mouse Ctr2, we studied the expression and localization of endogenous mouse Ctr2 in cell culture and in mouse models to understand its regulation and function in copper homeostasis. By immunoblot we observed a regulation of mCtr2 protein levels in a copper and Ctr1 dependent way. Our observations in cells and transgenic mice suggest that lack of Ctr1 induces a strong downregulation of Ctr2 probably by a post-translational mechanism. By indirect immunofluorescence we observed an exclusive intracellular localization in a perinuclear compartment and no co-localization with lysosomal markers. Immunofluorescence experiments in Ctr1 null cells, supported by sequence analysis, suggest that lysosomes may play a role in mCtr2 biology not as resident compartment, but as a degradation site. In appendix a LC-mass method for analysis of algal biotoxins belonging to the family of PsP (paralytic shellfish poisoning) is described.

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The treatment of the Cerebral Palsy (CP) is considered as the “core problem” for the whole field of the pediatric rehabilitation. The reason why this pathology has such a primary role, can be ascribed to two main aspects. First of all CP is the form of disability most frequent in childhood (one new case per 500 birth alive, (1)), secondarily the functional recovery of the “spastic” child is, historically, the clinical field in which the majority of the therapeutic methods and techniques (physiotherapy, orthotic, pharmacologic, orthopedic-surgical, neurosurgical) were first applied and tested. The currently accepted definition of CP – Group of disorders of the development of movement and posture causing activity limitation (2) – is the result of a recent update by the World Health Organization to the language of the International Classification of Functioning Disability and Health, from the original proposal of Ingram – A persistent but not unchangeable disorder of posture and movement – dated 1955 (3). This definition considers CP as a permanent ailment, i.e. a “fixed” condition, that however can be modified both functionally and structurally by means of child spontaneous evolution and treatments carried out during childhood. The lesion that causes the palsy, happens in a structurally immature brain in the pre-, peri- or post-birth period (but only during the firsts months of life). The most frequent causes of CP are: prematurity, insufficient cerebral perfusion, arterial haemorrhage, venous infarction, hypoxia caused by various origin (for example from the ingestion of amniotic liquid), malnutrition, infection and maternal or fetal poisoning. In addition to these causes, traumas and malformations have to be included. The lesion, whether focused or spread over the nervous system, impairs the whole functioning of the Central Nervous System (CNS). As a consequence, they affect the construction of the adaptive functions (4), first of all posture control, locomotion and manipulation. The palsy itself does not vary over time, however it assumes an unavoidable “evolutionary” feature when during growth the child is requested to meet new and different needs through the construction of new and different functions. It is essential to consider that clinically CP is not only a direct expression of structural impairment, that is of etiology, pathogenesis and lesion timing, but it is mainly the manifestation of the path followed by the CNS to “re”-construct the adaptive functions “despite” the presence of the damage. “Palsy” is “the form of the function that is implemented by an individual whose CNS has been damaged in order to satisfy the demands coming from the environment” (4). Therefore it is only possible to establish general relations between lesion site, nature and size, and palsy and recovery processes. It is quite common to observe that children with very similar neuroimaging can have very different clinical manifestations of CP and, on the other hand, children with very similar motor behaviors can have completely different lesion histories. A very clear example of this is represented by hemiplegic forms, which show bilateral hemispheric lesions in a high percentage of cases. The first section of this thesis is aimed at guiding the interpretation of CP. First of all the issue of the detection of the palsy is treated from historical viewpoint. Consequently, an extended analysis of the current definition of CP, as internationally accepted, is provided. The definition is then outlined in terms of a space dimension and then of a time dimension, hence it is highlighted where this definition is unacceptably lacking. The last part of the first section further stresses the importance of shifting from the traditional concept of CP as a palsy of development (defect analysis) towards the notion of development of palsy, i.e., as the product of the relationship that the individual however tries to dynamically build with the surrounding environment (resource semeiotics) starting and growing from a different availability of resources, needs, dreams, rights and duties (4). In the scientific and clinic community no common classification system of CP has so far been universally accepted. Besides, no standard operative method or technique have been acknowledged to effectively assess the different disabilities and impairments exhibited by children with CP. CP is still “an artificial concept, comprising several causes and clinical syndromes that have been grouped together for a convenience of management” (5). The lack of standard and common protocols able to effectively diagnose the palsy, and as a consequence to establish specific treatments and prognosis, is mainly because of the difficulty to elevate this field to a level based on scientific evidence. A solution aimed at overcoming the current incomplete treatment of CP children is represented by the clinical systematic adoption of objective tools able to measure motor defects and movement impairments. A widespread application of reliable instruments and techniques able to objectively evaluate both the form of the palsy (diagnosis) and the efficacy of the treatments provided (prognosis), constitutes a valuable method able to validate care protocols, establish the efficacy of classification systems and assess the validity of definitions. Since the ‘80s, instruments specifically oriented to the analysis of the human movement have been advantageously designed and applied in the context of CP with the aim of measuring motor deficits and, especially, gait deviations. The gait analysis (GA) technique has been increasingly used over the years to assess, analyze, classify, and support the process of clinical decisions making, allowing for a complete investigation of gait with an increased temporal and spatial resolution. GA has provided a basis for improving the outcome of surgical and nonsurgical treatments and for introducing a new modus operandi in the identification of defects and functional adaptations to the musculoskeletal disorders. Historically, the first laboratories set up for gait analysis developed their own protocol (set of procedures for data collection and for data reduction) independently, according to performances of the technologies available at that time. In particular, the stereophotogrammetric systems mainly based on optoelectronic technology, soon became a gold-standard for motion analysis. They have been successfully applied especially for scientific purposes. Nowadays the optoelectronic systems have significantly improved their performances in term of spatial and temporal resolution, however many laboratories continue to use the protocols designed on the technology available in the ‘70s and now out-of-date. Furthermore, these protocols are not coherent both for the biomechanical models and for the adopted collection procedures. In spite of these differences, GA data are shared, exchanged and interpreted irrespectively to the adopted protocol without a full awareness to what extent these protocols are compatible and comparable with each other. Following the extraordinary advances in computer science and electronics, new systems for GA no longer based on optoelectronic technology, are now becoming available. They are the Inertial and Magnetic Measurement Systems (IMMSs), based on miniature MEMS (Microelectromechanical systems) inertial sensor technology. These systems are cost effective, wearable and fully portable motion analysis systems, these features gives IMMSs the potential to be used both outside specialized laboratories and to consecutive collect series of tens of gait cycles. The recognition and selection of the most representative gait cycle is then easier and more reliable especially in CP children, considering their relevant gait cycle variability. The second section of this thesis is focused on GA. In particular, it is firstly aimed at examining the differences among five most representative GA protocols in order to assess the state of the art with respect to the inter-protocol variability. The design of a new protocol is then proposed and presented with the aim of achieving gait analysis on CP children by means of IMMS. The protocol, named ‘Outwalk’, contains original and innovative solutions oriented at obtaining joint kinematic with calibration procedures extremely comfortable for the patients. The results of a first in-vivo validation of Outwalk on healthy subjects are then provided. In particular, this study was carried out by comparing Outwalk used in combination with an IMMS with respect to a reference protocol and an optoelectronic system. In order to set a more accurate and precise comparison of the systems and the protocols, ad hoc methods were designed and an original formulation of the statistical parameter coefficient of multiple correlation was developed and effectively applied. On the basis of the experimental design proposed for the validation on healthy subjects, a first assessment of Outwalk, together with an IMMS, was also carried out on CP children. The third section of this thesis is dedicated to the treatment of walking in CP children. Commonly prescribed treatments in addressing gait abnormalities in CP children include physical therapy, surgery (orthopedic and rhizotomy), and orthoses. The orthotic approach is conservative, being reversible, and widespread in many therapeutic regimes. Orthoses are used to improve the gait of children with CP, by preventing deformities, controlling joint position, and offering an effective lever for the ankle joint. Orthoses are prescribed for the additional aims of increasing walking speed, improving stability, preventing stumbling, and decreasing muscular fatigue. The ankle-foot orthosis (AFO), with a rigid ankle, are primarily designed to prevent equinus and other foot deformities with a positive effect also on more proximal joints. However, AFOs prevent the natural excursion of the tibio-tarsic joint during the second rocker, hence hampering the natural leaning progression of the whole body under the effect of the inertia (6). A new modular (submalleolar) astragalus-calcanear orthosis, named OMAC, has recently been proposed with the intention of substituting the prescription of AFOs in those CP children exhibiting a flat and valgus-pronated foot. The aim of this section is thus to present the mechanical and technical features of the OMAC by means of an accurate description of the device. In particular, the integral document of the deposited Italian patent, is provided. A preliminary validation of OMAC with respect to AFO is also reported as resulted from an experimental campaign on diplegic CP children, during a three month period, aimed at quantitatively assessing the benefit provided by the two orthoses on walking and at qualitatively evaluating the changes in the quality of life and motor abilities. As already stated, CP is universally considered as a persistent but not unchangeable disorder of posture and movement. Conversely to this definition, some clinicians (4) have recently pointed out that movement disorders may be primarily caused by the presence of perceptive disorders, where perception is not merely the acquisition of sensory information, but an active process aimed at guiding the execution of movements through the integration of sensory information properly representing the state of one’s body and of the environment. Children with perceptive impairments show an overall fear of moving and the onset of strongly unnatural walking schemes directly caused by the presence of perceptive system disorders. The fourth section of the thesis thus deals with accurately defining the perceptive impairment exhibited by diplegic CP children. A detailed description of the clinical signs revealing the presence of the perceptive impairment, and a classification scheme of the clinical aspects of perceptual disorders is provided. In the end, a functional reaching test is proposed as an instrumental test able to disclosure the perceptive impairment. References 1. Prevalence and characteristics of children with cerebral palsy in Europe. Dev Med Child Neurol. 2002 Set;44(9):633-640. 2. Bax M, Goldstein M, Rosenbaum P, Leviton A, Paneth N, Dan B, et al. Proposed definition and classification of cerebral palsy, April 2005. Dev Med Child Neurol. 2005 Ago;47(8):571-576. 3. Ingram TT. A study of cerebral palsy in the childhood population of Edinburgh. Arch. Dis. Child. 1955 Apr;30(150):85-98. 4. Ferrari A, Cioni G. The spastic forms of cerebral palsy : a guide to the assessment of adaptive functions. Milan: Springer; 2009. 5. Olney SJ, Wright MJ. Cerebral Palsy. Campbell S et al. Physical Therapy for Children. 2nd Ed. Philadelphia: Saunders. 2000;:533-570. 6. Desloovere K, Molenaers G, Van Gestel L, Huenaerts C, Van Campenhout A, Callewaert B, et al. How can push-off be preserved during use of an ankle foot orthosis in children with hemiplegia? A prospective controlled study. Gait Posture. 2006 Ott;24(2):142-151.

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Die Elemente Uran und Plutonium besitzen seit Entdeckung der Kernspaltung und der technischen Nutzung der Kernenergie eine globale Bedeutung. So trägt Pu hauptsächlich zur Radiotoxizität von abgebrannten Brennelementen bei und erfordert im Falle einer Endlagerung in einer tiefen geologischen Formation einen sicheren Verschluss für bis zu einer Million Jahre. Das Wissen über die vorliegenden chemischen Spezies ist dabei entscheidend für das Verständnis der chemisch-physikalischen Wechselwirkungen im jeweiligen geochemischen System, insbesondere mit dem Wirtsgestein (hier Ton) und den allgegenwärtigen Huminstoffen (hier Fulvinsäure). Längerfristig sind so Vorhersagen über einen Transport des hochradioaktiven Abfalls nach Auslaugung und Austritt aus einem Endlager bis in die Biosphäre möglich. Gerade der Ultraspurenbereich, im Fernfeld eines Endlagers zu erwarten, ist dabei von besonderem Interesse. Darüber hinaus machen nuklearforensische Untersuchungen – in Hinblick auf illegal benutztes Nuklearmaterial, Schmuggel oder Nuklearterrorismus – zur Bestimmung der Herkunft, des Alters oder der Radiotoxizität isotopenselektive Nachweismethoden im Ultraspurenbereich notwendig. Im Rahmen dieser Arbeit wurden hierfür die Resonanzionisationsmassenspektrometrie (RIMS) zur isotopenselektiven Spuren- und Ultraspurenanalyse von U und Pu sowie die Kapillarelektrophorese (CE) gekoppelt an die induktiv gekoppelte Plasma (ICP)-Massenspektrometrie (CE-ICP-MS) zur Speziation von Pu eingesetzt. Für den isotopenselektiven Nachweis von Ultraspurenmengen von Uran mittels RIMS wurden vorbereitende Studien durchgeführt und mehrere zweifach resonante Anregungsleitern mit nicht-resonanter Ionisation untersucht. Eine Effizienz von ca. 10^-10 bei einer Nachweisgrenze von 10^12 Atomen U-238 konnte erzielt werden. In Zusammenarbeit mit dem Institut für Radiochemie, TU München, wurde mittels RIMS die Isotopenzusammensetzung von Plutonium, abgetrennt aus einem panzerbrechenden Urangeschoss aus dem Kosovokonflikt, bestimmt und dieses als Waffenplutonium mit einem Gehalt von 15 pg Pu-239/g Uran identifiziert. Rückschlüsse über Herkunft und Alter des Plutoniums konnten daraus gewonnen werden. Für Studien zur Umweltüberwachung von Plutonium in Rheinland-Pfalz wurden Grund-, Oberflächen- und Klärwasserproben mittels RIMS untersucht. Oberhalb der Nachweisgrenze von ca. 10^7 Atomen Pu-239/500 mL konnte kein signifikanter Gehalt bestimmt werden. Zusätzlich wurden Klärschlammproben untersucht, wobei in einer Probe 5,1*10^7 Atome Pu-239/g gemessen wurde, was auf eine Anreicherung von Pu im Klärschlamm aus großen Wasservolumina hindeuten könnte. Speziationsuntersuchungen von Plutonium in Kontakt mit Fulvinsäure und dem Tonmineral Kaolinit wurden in Hinblick auf die Wechselwirkungen im Umfeld eines nuklearen Endlagers durchgeführt. Die Redoxkinetik von Pu(VI) in Kontakt mit Gorleben-Fulvinsäure zeigt eine mit steigendem pH zunehmend schnellere und vollständige Reduktion und ein vergleichbares Verhalten zur Huminsäure. Für ein Plutoniumgemisch aus allen vier umweltrelevanten Oxidationsstufen in Kontakt mit Gorleben-Fulvinsäure konnte nach ca. 1 Monat Kontaktzeit eine fasst vollständige Reduktion zum tri- und tetravalenten Pu beobachtet werden. Sorptionsuntersuchungen der stabilsten Oxidationsstufe, Pu(IV), in Kontakt mit Kaolinit bei pH = 0 bis 13 im Konzentrationsbereich 10^-7 bis 10^-9 mol/L verdeutlichen das ausgeprägte Sorptionsverhalten von Pu(IV) (ca. 60% bis 90% Sorption) im umweltrelevanten pH-Bereich bei einem Einsetzen der Sorption bei pH = 0 bis 2. Im Rahmen des "Colloid and Radionuclide Retardation" (CRR) Experiments im Felslabor Grimsel, Schweizer Alpen, wurde in Zusammenarbeit mit dem Institut für Nukleare Entsorgung, Karlsruhe, die kolloidgetragene Migration von Pu(IV) in einem Grundwasserstrom durch Scherzonen im Granitgestein unter umweltrelevanten Bedingungen untersucht. Bei Zugabe von im Grundwasser stabilen Bentonitkolloiden – Bentonit wird als ein geeignetes Verschlussmaterial für nukleare Abfälle erforscht – konnte ein erhöhter Transport des Pu(IV) beobachtet werden, der durch Sorption des Pu an die mobilen Kolloide hervorgerufen wird. Zur Speziation von Plutonium im Ultraspurenbereich wurde im Rahmen dieser Arbeit an der Entwicklung der Kopplung der CE mit der sehr sensitiven RIMS gearbeitet. Das Prinzip der offline-Kopplung basiert auf dem Sammeln der zu unterschiedlichen Zeiten am Ende der Kapillare eluierten Oxidationsstufen in einzelnen Fraktionen. Aus jeder Fraktion wird ein eigenes Filament hergestellt und mit RIMS auf seinen Plutoniumgehalt untersucht. Eine erste Validierung der Methode konnte durch Bestimmung der Oxidationsstufenzusammensetzung eines bekannten Gemischs erfolgreich für einen Gehalt von ca. 6*10^9 Atome Pu-239 durchgeführt werden. Dies stellt einen möglichen Zugang zu dem erwarteten Konzentrationsbereich im Fernfeld eines Endlagers dar.

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La tesi si propone di tracciare un confronto tra due autori molto distanti tra loro sia nel tempo che nello spazio: Nikolaj Gogol’ e Dario Fo; in particolare si analizzano le commedie Il Revisore di Gogol’ (1836) e Morte accidentale di un anarchico di Fo (1970). Il nesso tra le due opere è stato individuato dalla critica italiana (Franco Quadri, Ferdinando Taviani, Paolo Puppa). Tuttavia gli spunti interpretativi e comparativi non sono mai stati sviluppati appieno della critica. Nonostante le grandi distanze temporali e spaziali, l’analisi si propone dunque di evidenziare i numerosi motivi di consonanza tra le due opere e i due autori, che peraltro testimoniano anche della grande fortuna arrisa all’estero all’autore ucraino, attraverso la mediazione del teatro russo-sovietico del XX secolo. L’approccio metodologico adottato si fonda sui testi dei formalisti russi, di Lotman, sulla Stilkritik di Aurbach, sugli studi di Frye sulla Bibbia intesa come “grande canone” della letteratura occidentale, e soprattutto sull’analisi della cultura carnevalesca e popolare condotta da Bachtin. Lo studio è indirizzato su alcuni elementi precisi: la trama, lo scambio della personalità, l’impostura, la paura e il riso. Per ciascun di questi elementi è stata svolta l’analisi comparativa delle due opere, situandole in un contesto letterario e culturale che va all’antichità e al Medio Evo, dal quale entrambi gli autori mutuano molte suggestioni.

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Die Produktion eines spinpolarisierten Strahls mit hohem mittleren Strom ist sowohl für den Betrieb von existierenden polarisierten Quellen als auch in noch stärkerem Maße für geplante zukünftige Projekte wichtig. Die Betriebszeit solcher Quellen wird durch die Abnahme der Quantenausbeute der Photokathode mit der Zeit begrenzt. Die Problematik der Abnahme der Quantenausbeute konnte durch die Reaktion der Kathodenoberfläche mit sauerstoffhaltigen Molekülen sowie durch Ionenbombardement geklärt werden. Im Laufe dieser Arbeit wurden, teilweise zum ersten Mal, Mechanismen untersucht, die zur Entstehung der chemisch aktiven Moleküle und der Ionen beitragen und weitere Effekte, die die Betriebszeit der polarisierten Quellen reduzieren. Die Experimente wurden an einer genauen Kopie der an MAMI vorhandenen polarisierten Quelle durchgeführt. Es wurde demonstriert, dass Erwärmung der Photokathode, Ioneneinfang und Strahlverlust aufgrund der Raumladungskräfte die Kathodenlebensdauer begrenzen können. Der erste Effekt ist Erwärmung der Photokathode. Die Laserleistung wird fast vollständig in Wärmeleistung umgesetzt, was zur Absenkung der Verfügbarkeit der polarisierten Quellen führen kann, und zwar unabhängig davon, ob der Photostrom produziert wird oder nicht. Der zweite Effekt ist Ionenbombardement mit den sowohl in der Beschleunigungsstrecke als auch in der Strahlführung entstehenden Ionen. Es wurde demonstriert, dass der in der Strahlführung entstehende Ionenstrom sogar größer ist als der in der Kanone. Unter bestimmten Bedingungen können die gebildeten Ionen durch das Potenzial des Elektronenstrahls eingefangen werden und die Kanone erreichen und damit zusätzlich zur Zerstörung der negativen Elektronenaffinität beitragen. Der dritte Effekt ist Strahlverlust. Es wurde demonstriert, dass die relativen Strahlverluste kleiner als 1*10-6 sein sollten, um eine Lebensdauer von mehr als 1000 Stunden beim Strom von 100 A zu erreichen, was für die vorhandene Apparatur möglich ist. Zur Erzeugung extrem hoher Ströme wurde zum ersten Mal im Bereich der spinpolarisierten Quellen das Prinzip der „Energierückgewinnung“ eingesetzt. Experimente bei einer mittleren Stromstärke von 11.4 mA und einer Spitzenstromstärke von 57 mA bei 1% Tastverhältnis wurden bereits durchgeführt.