993 resultados para regional leadership


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We investigated the systemic and regional hemodynamic effects of early crystalloid infusion in an experimental model of septic shock induced by intravenous inoculation with live Escherichia coli. Anesthetized dogs received an intravenous infusion of 1.2 x 10(10) cfu/kg live E. coli in 30 min. After 30 min of observation, they were randomized to controls (no fluids; N = 7), or fluid resuscitation with lactated Ringer's solution, 16 ml/kg (N = 7) or 32 ml/kg (N = 7) over 30 min and followed for 120 min. Cardiac index, portal blood flow, mean arterial pressure, systemic and regional oxygen-derived variables, blood lactate, and gastric PCO2 were assessed. Rapid and progressive cardiovascular deterioration with reduction in cardiac output, mean arterial pressure and portal blood flow (~50, ~25 and ~70%, respectively) was induced by the live bacteria challenge. Systemic and regional territories showed significant increases in oxygen extraction and in lactate levels. Significant increases in venous-arterial (~9.6 mmHg), portal-arterial (~12.1 mmHg) and gastric mucosal-arterial (~18.4 mmHg) PCO2 gradients were also observed. Early fluid replacement, especially with 32 ml/kg volumes of crystalloids, promoted only partial and transient benefits such as increases of ~76% in cardiac index, of ~50% in portal vein blood flow and decreases in venous-arterial, portal-arterial, gastric mucosal-arterial PCO2 gradients (7.2 ± 1.0, 7.2 ± 1.3 and 9.7 ± 2.5 mmHg, respectively). The fluid infusion promoted only modest and transient benefits, unable to restore the systemic and regional perfusional and metabolic changes in this hypodynamic septic shock model.

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Angiotensin-converting enzyme inhibitors have been shown to improve splanchnic perfusion in distinct shock states. We hypothesized that enalaprilat potentiates the benefits of early fluid resuscitation in severe experimental sepsis, particularly in the splanchnic region. Anesthetized and mechanically ventilated mongrel dogs received an intravenous infusion of live Escherichia coli over a period of 30 min. Thereafter, two interventions were performed: fluid infusion (normal saline, 32 mL/kg over 30 min) and enalaprilat infusion (0.02 mg kg-1 min-1 for 60 min) in randomized groups. The following groups were studied: controls (fluid infusion, N = 4), E1 (enalaprilat infusion followed by fluid infusion, N = 5) and E2 (fluid infusion followed by enalaprilat infusion, N = 5). All animals were observed for a 120 min after bacterial infusion. Mean arterial pressure, cardiac output (CO), portal vein blood flow (PVBF), systemic and regional oxygen-derived variables, and lactate levels were measured. Rapid and progressive reductions in CO and PVBF were induced by the infusion of live bacteria, while minor changes were observed in mean arterial pressure. Systemic and regional territories showed a significant increase in oxygen extraction and lactate levels. Widening venous-arterial and portal-arterial pCO2 gradients were also detected. Fluid replacement promoted transient benefits in CO and PVBF. Enalaprilat after fluid resuscitation did not affect systemic or regional hemodynamic variables. We conclude that in this model of normotensive sepsis inhibition of angiotensin-converting enzyme did not interfere with the course of systemic or regional hemodynamic and oxygen-derived variables.

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The purpose of this Master’s thesis is to study sponsor satisfaction in charity sport events. Lack of research in regional charity sport events, emergence of corporate social responsibility and increasing popularity of charity sport events have created a research gap to be further explored. Theoretical part of the thesis focuses in development of sponsorships, charity sport event sponsorships and sponsorship as a marketing tool. Concept of satisfaction is discussed by implementing marketing theories to weight options on measuring sponsor satisfaction as a part of sponsorship evaluation process. Empirical analysis of the thesis was conducted in a regional charity sport event – Maailman Pisin Salibandyottelu. Evidences were collected in qualitative research method through semi-structured theme interviews. Altogether 12 major and minor sponsors were selected for the primary source of data. The data was analyzed by comparing sponsors’ expectations and experiences, and by displaying sponsors’ perceived satisfaction. The results indicated that sponsors were involved by partly altruistic and partly selfish motives as suggested by previous research. Respondents expressed very few, mainly non-financial expectations, yet were hoping to gain positive image association via event exposure. Negative experiences appear to have relatively small impact in overall satisfaction. Exceeding or fulfilling expectations appears to increase perceived satisfaction which was mainly driven by contribution towards the goodwill, perceived success of the event (successful record attempt, visibility (on- and off-line) and event execution.

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Sympathetic ganglion block (SGB) or intravenous regional block (IVRB) has been recommended for pain management in patients with complex regional pain syndrome type I (CRPS-I). Forty-five patients were initially selected but only 43 were accepted for the study. The present study evaluated the efficacy of IVRB produced by combining 70 mg lidocaine with 30 µg clonidine (14 patients, 1 male/13 females, age range: 27-50 years) versus SGB produced by the injection of 70 mg lidocaine alone (14 patients, 1 male/13 females, age range: 27-54 years) or combined with 30 µg clonidine (15 patients, 1 male/14 females, age range: 25-50 years) into the stellate ganglion for pain management in patients with upper extremity CRPS-I. Each procedure was repeated five times at 7-day intervals, and pain intensity and duration were measured using a visual analog scale immediately before each procedure. A progressive and significant reduction in pain scores and a significant increase in the duration of analgesia were observed in all groups following the first three blocks, but no further improvement was obtained following the last two blocks. Drowsiness, the most frequent side effect, and dry mouth occurred only in patients submitted to SGB with lidocaine combined with clonidine. The three methods were similar regarding changes in pain intensity and duration of analgesia. However, IVRB seems to be preferable to SGB due to its easier execution and lower risk of undesirable effects.

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O objetivo deste trabalho foi estabelecer uma proposta para o processamento do queijo Coalho regional seguindo-se os procedimentos adequados para a obtenção de um produto final de qualidade. Empregou-se leite de vaca padronizado e pasteurizado e culturas láticas endógenas. Foram isoladas, identificadas e caracterizadas culturas láticas endógenas de leite de vaca cru e de queijos Coalho artesanais. Algumas culturas foram avaliadas para a fabricação do queijo Coalho, seguindo-se o fluxograma de fabricação estabelecido neste estudo. O produto final foi submetido a análises físico-químicas, teste de aceitação e teste de fritura. Os resultados obtidos mostraram que é viável a padronização do produto tradicional, proporcionando redução de custos, qualidade microbiológica e a manutenção das características sensoriais do queijo Coalho regional, com o uso de culturas láticas nacionais.

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