985 resultados para Sudden stops


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The present work evaluated several aspects of the generalized stress response [endocrine (cortisol), metabolic (glucose), hematologic (hematocrit and hemoglobin) and cellular (HSP70)] in the Amazonian warm-water fish matrinxã (Brycon amazonicus ) subjected to an acute cold shock. This species farming has been done in South America, and growth and feed conversion rates have been interesting. However, in subtropical areas of Brazil, where the water temperature can rapidly change, high rates of matrinxã mortality have been associated with abrupt decrease in the water temperature. Thus, we subjected matrinxã to a sudden cold shock by transferring the fish directly to tanks in which the water temperature was 10oC below the initial conditions (cold shock from 28ºC to 18oC). After 1h the fish were returned to the original tanks (28ºC). The handling associated with tank transfer was also imposed on control groups (not exposed to cold shock). While exposure to cold shock did not alter the measured physiological conditions within 1h, fish returned to the ambient condition (water at 28º C) significantly increased plasma cortisol and glucose levels. Exposure to cold shock and return to the warm water did not affect HSP70 levels. The increased plasma cortisol and glucose levels after returning the fish to warm water suggest that matrinxã requires cortisol and glucose for adaptation to increased temperature.

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Objectives
This paper reports the quantitative findings of the first phase of a larger program of ongoing research: Feedback Incorporating Review and Simulation Techniques to Act on Clinical Trends (FIRST2ACTTM). It specifically aims to identify the characteristics that may predict primary outcome measures of clinical performance, teamwork and situation awareness in the management of deteriorating patients.

Design
Mixed-method multi-centre study.

Setting
High fidelity simulated acute clinical environment in three Australian universities.

Participants
A convenience sample of 97 final year nursing students enrolled in an undergraduate Bachelor of Nursing or combined Bachelor of Nursing degree were included in the study.

Method
In groups of three, participants proceeded through three phases: (i) pre-briefing and completion of a multi-choice question test, (ii) three video-recorded simulated clinical scenarios where actors substituted real patients with deteriorating conditions, and (iii) post-scenario debriefing. Clinical performance, teamwork and situation awareness were evaluated, using a validated standard checklist (OSCE), Team Emergency Assessment Measure (TEAM) score sheet and Situation Awareness Global Assessment Technique (SAGAT). A Modified Angoff technique was used to establish cut points for clinical performance.

Results
Student teams engaged in 97 simulation experiences across the three scenarios and achieved a level of clinical performance consistent with the experts' identified pass level point in only 9 (1%) of the simulation experiences. Knowledge was significantly associated with overall teamwork (p = .034), overall situation awareness (p = .05) and clinical performance in two of the three scenarios (p = .032 cardiac and p = .006 shock). Situation awareness scores of scenario team leaders were low overall, with an average total score of 41%.

Conclusions
Final year undergraduate nursing students may have difficulty recognising and responding appropriately to patient deterioration. Improving pre-requisite knowledge, rehearsal of first response and team management strategies need to be a key component of undergraduate nursing students' education and ought to specifically address clinical performance, teamwork and situation awareness.

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To assess and compare the number and type of outdoor food advertisements at public transit stops within suburbs of varying levels of socioeconomic disadvantage.

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A dissertação investiga a relação entre a abertura comercial e o custo de reversão do saldo da conta corrente em economias que sofrem episódios de contração abrupta do influxo de capital. Nesses episódios, os governos procuram inicialmente equilibrar o balanço de pagamentos recorrendo às reservas internacionais, mas normalmente o fenômeno persiste até que se efetive uma desvalorização real do câmbio. Apresentamos um modelo simples para mostrar que, em economias mais abertas comercialmente, o saldo da balança comercial responde com mais intensidade à desvalorização cambial. Dessa forma, a reversão do saldo de conta corrente em episódios de restrição de liquidez decorrentes da contração dos influxos de capital é alcançada de maneira menos custosa. Confirmamos essa constatação teórica para países emergentes através de um exercício empírico que utiliza dados trimestrais de 42 países entre 1980 e 2003.

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Citrus sudden death (CSD) has greatly affected sweet orange cultivars grafted on Rangpur lime in São Paulo and Minas Gerais States, Brazil. To characterize and quantify CSD damage, fruit yield and quality were assessed in each combination of sweet orange cultivar (Hamlin, Pera, Natal, and Valencia), age class (3 to 5, 6 to 10, and 11 to 15 years old), and CSD severity class (0 = no symptom, 1 = initial symptoms, and 2 = severe symptoms). For each combination, 10 trees were harvested and 20 fruit were taken for quality analysis. Damage was characterized by reduc_ tion of: (i) total weight of fruit/tree (36 and 67% for severity class 1 and 2, respectively), (ii) number of fruit/tree (27 and 55%), (iii) fruit size (13 and 25% in diameter and height [stem to styler distance]), (iv) fruit weight (32 and 56%), (v) total soluble solids (TSS)/fruit (18 and 42%), and increase of (vi) Brix (14 and 34%), (vii) acidity (16 and 41%), and (viii) TSS/90-1b. box (21 and 33%). There was no alteration on Brix/acidity ratio and percentage of juice on fruit of affected trees. Sweet orange cultivars did not differ in percentage of reduction or increase of all yield and quality variables, with the exception of Pera, which expressed increases of Brix and acidity. For more severe affected trees, the youngest plants showed a higher reduction in fruit number/tree, whereas plants 6 to 10 years old showed a higher increase in fruit acidity and TSS/box. However, no differences in percentage of reduction or increase for other variables were observed among different age classes. The damage to the above probably was associated with reduced water absorption capacity of CSD-affected trees.

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

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

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

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We consider a model for rattling in single-stage gearbox systems with some backlash consisting of two wheels with a sinusoidal driving; the equations of motions are analytically integrated between two impacts of the gear teeth. Just after each impact, a mapping is used to obtain the dynamical variables. We have observed a rich dynamical behavior in such system, by varying its control parameters, and we focus on intermittent switching between laminar oscillations and chaotic bursting, as well as crises, which are sudden changes in the chaotic behavior. The corresponding transient basins in phase space are found to be riddled-like, with a highly interwoven fractal structure. (C) 2004 Elsevier Ltd. All rights reserved.

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O Diabetes mellitus é uma enfermidade crônica que leva a alterações sensitivas e motoras. Tais alterações comprometem o equilíbrio e a deambulação, predispondo seus portadores à ocorrência de quedas. Esta revisão teve por objetivo levantar, na literatura recente, estudos que visassem avaliar parâmetros da marcha e aspectos envolvidos com a deambulação. Para isso, foi realizada uma busca nas bases de dados MEDLINE, SciELO, LILACS e PEDro, cruzando as palavras-chave: Neuropatias Diabéticas x Marcha; Diabetes Mellitus x Marcha e Pé Diabético x Marcha. Após passarem pelos critérios de seleção, foram obtidos 15 artigos, os quais foram sintetizados e discutidos, sendo, portanto, incluídos nesta revisão. Ficou claro que a neuropatia diabética leva a déficits na amplitude do passo, velocidade e cadência da marcha em superfícies planas, sem mudanças bruscas de direção ou paradas, e déficits de equilíbrio e coordenação em aclives, declives e terrenos irregulares. Acarreta, também, aumento dos índices de pressão plantar e, devido à alteração de ativação do tríceps sural, dificuldade na fase de apoio terminal e pré-balanço. Assim, o próximo contato inicial ocorrerá de maneira inadequada, com o antepé e sem absorção de choques.

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Background: Air conditioning-induced rhinitis in allergic individuals is a common epidemiologic finding, but its physiopathology,is still controversial. The aim of this study was to describe and compare the effects of experimental air conditioning temperature changes on the nasal mucosa of individuals with persistent allergic rhinitis compared with a control group.Methods: A case-control challenge study was performed in a laboratory of thermal comfort with experimental twin challenge chambers set at a 12 C difference in temperature. A group of 32 patients with persistent allergic rhinitis and a group of 16 control subjects were exposed for 30 minutes, 3 times alternately in each chamber. Nasal symptom scores were recorded and nasal samples collected before, immediately after, and 24 and 48 hours after the challenge.Results: the rhinitis group showed a higher symptom score, epithelial shedding, percentage of eosinophils, total inflammatory cells, leukotriene C-4, eosinophil cationic protein, albumin, and tryptase levels compared with controls. There was also a significant increase in symptom score, total cells recovered, percentage of eosinophils, epithelial shedding, albumin, myeloperoxidase, and soluble intercellular adhesion molecule 1 in both groups compared with baseline levels.Conclusion: Sudden temperature changes led to a more pronounced inflammatory nasal response in the rhinitis group with the recruitment and activation of eosinophils.Clinical implications: Persistent allergic rhinitis is a risk factor for developing sudden temperature change-related rhinitis even in the absence of allergen exposure.

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Sudden-onset bilateral deafness as a clinical manifestation of hyperleukocytosis in chronic myeloid leukemia (CML) is a rare occurrence. We found only 27 clinical descriptions in 16 published papers. In this work, the authors present a review on deafness in CML and describe a new case with prominent hyperleukocytosis, where the neurological findings suggest slowing of the circulation through small blood vessels in the brainstem as the cause of deafness. The evolution was good after treatment. To our knowledge, this is the second case documented with electrical auditory brainstem-evoked potentials and the first with magnetic resonance imaging. Copyright (C) 2000 S. Karger AG, Basel.

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Previous events evidence that sudden cardiac death (SCD) in athletes is still a reality and it keeps challenging cardiologists. Considering the importance of SCD in athletes and the requisite for an update of this matter, we endeavored to describe SCD in athletes. The Medline (via PubMed) and SciELO databases were searched using the subject keywords sudden death, athletes and mortality. The incidence of SCD is expected at one case for each 200,000 young athletes per year. Overall it is resulted of complex dealings of factors such as arrhythmogenic substrate, regulator and triggers factors. In great part of deaths caused by heart disease in athletes younger than 35 years old investigations evidence cardiac congenital abnormalities. Athletes above 35 years old possibly die due to impairments of coronary heart disease, frequently caused by atherosclerosis. Myocardial ischemia and myocardial infarction are responsible for the most cases of SCD above this age (80%). Pre-participatory athletes' evaluation helps to recognize situations that may put the athlete's life in risk including cardiovascular diseases. In summary, cardiologic examinations of athletes' pre-competition routine is an important way to minimize the risk of SCD. © 2010 Ferreira et al; licensee BioMed Central Ltd.