997 resultados para 121-756A
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The mineral component of pelagic sediments recovered from the Indian Ocean provides both a history of eolian deposition related to climatic changes in southern Africa and a record of terrigenous input related to sediment delivery from the Himalayas. A composite Cenozoic dust flux record from four sites in the central Indian Ocean is used to define the evolution of the Kalahari and Namib desert source regions. The overall record of dust input is one of very low flux for much of the Cenozoic indicating a long history of climate stability and regional hyperaridity. The most significant reduction in dust flux occurred near the Paleocene/Eocene boundary and is interpreted as a shift from semiarid climates during the Paleocene to more arid conditions in the early Eocene. Further aridification is recorded as stepwise reductions in the input of dust material which occur from about 35 to 40 Ma, 27 to 32 Ma, and 13 to 15 Ma and correlate to significant enrichments in benthic foraminifer delta18O values. The mineral flux in sediments from the northern Indian Ocean, site 758, records changes in the terrigenous input apparently related to the erosion of the Himalayas and indicates a rapid late Cenozoic uplift history. Three major pulses of increased terrigeneous sediment flux are inferred from the depositional record. The initial increase began at about 9.5 Ma and continued for roughly 1.0 million years. A second pulse with approximately the same magnitude occurred from about 7.0 to 5.6 Ma. The largest pulse of enhanced terrigenous influx occurred during the Pliocene from about 3.9 to 2.0 Ma when average flux values were severalfold greater than at any other time in the Cenozoic.
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Recent investigations have shown the significance of subarachnoid bleeding on computed tomography scans first taken after admission for head injuries. In our study, we describe a prospective follow-up of 121 patients with traumatic subarachnoid hemorrhage (tSAH). From January 2004 to January 2007 we collected data prospectively from 121 patients admitted with diagnosis of tSAH to our trauma intensive care unit, on the basis of admission with a computed tomography scan. The classification of tSAH was performed using the Fisher scale with modification, and the follow-up was performed using the Glasgow Outcome Scale (GOS). The minimum period for a follow-up was established 6 months after the injury. Traffic accident was the main cause of head injuries (72% in total; 48% involving cars and 24% involving motorcycles), followed by falls (23%) and aggression (5%). Twenty-eight percent of patients sustained major multiple injuries, with spinal injury as the main associated trauma. The outcome was favorable (GOS score 4 or 5) in 54 patients (45%) and unfavorable (GOS score 1, 2, or 3) in 67 patients (55%). The mortality rate was proportionally greater in patients who had cisternal clots >1 mm (P < 0.001), assessed by the Fisher scale with modification. When functional recovery was evaluated using the GOS, the recovery rate and the daily life activities were lower in patients with intraventricular bleeding (P = 0.001). Our results showed that patients with severe tSAH had the worst prognosis.
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OBJECTIVES. The purpose of this study was to obtain data on the association of antiphospholipid antibodies with clinical manifestations in childhood and to enable future studies to determine the impact of treatment and long-term outcome of pediatric antiphospholipid syndrome. PATIENTS AND METHODS. A European registry extended internationally of pediatric patients with antiphospholipid syndrome was established as a collaborative project of the European Antiphospholipid Antibodies Forum and Lupus Working Group of the Pediatric Rheumatology European Society. To be eligible for enrollment the patient must meet the preliminary criteria for the classification of pediatric antiphospholipid syndrome and the onset of antiphospholipid syndrome must have occurred before the patient`s 18th birthday. RESULTS. As of December 1, 2007, there were 121 confirmed antiphospholipid syndrome cases registered from 14 countries. Fifty-six patients were male, and 65 were female, with a mean age at the onset of antiphospholipid syndrome of 10.7 years. Sixty (49.5%) patients had underlying autoimmune disease. Venous thrombosis occurred in 72 (60%), arterial thrombosis in 39 (32%), small-vessel thrombosis in 7 (6%), and mixed arterial and venous thrombosis in 3 (2%). Associated nonthrombotic clinical manifestations included hematologic manifestations (38%), skin disorders (18%), and nonthrombotic neurologic manifestations (16%). Laboratory investigations revealed positive anticardiolipin antibodies in 81% of the patients, anti-beta(2)-glycoprotein I antibodies in 67%, and lupus anticoagulant in 72%. Comparisons between different subgroups revealed that patients with primary antiphospholipid syndrome were younger and had a higher frequency of arterial thrombotic events, whereas patients with antiphospholipid syndrome associated with underlying autoimmune disease were older and had a higher frequency of venous thrombotic events associated with hematologic and skin manifestations. CONCLUSIONS. Clinical and laboratory characterization of patients with pediatric antiphospholipid syndrome implies some important differences between antiphospholipid syndrome in pediatric and adult populations. Comparisons between children with primary antiphospholipid syndrome and antiphospholipid syndrome associated with autoimmune disease have revealed certain differences that suggest 2 distinct subgroups. Pediatrics 2008; 122: e1100-e1107
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Health and Social Care: Comparative Data for Northern Ireland and other Countries - May 2004
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Equality Impact Assessments
