Measuring functional outcome in paediatric patients with burns: methodological considerations

Methodological criticisms of research undertaken in the area of paediatric burns are widespread. To date, quasi-experimental research designs have most frequently been used to examine the impact of impairments such as scarring and reduced ran e of motion on functional outcomes. Predominantly, these studies have utilised a narrow definition of functioning (e.g. school attendance) to determine a child's level of participation in activities post-burn injury. Until recently, there had been little attempt to develop and/or test a theoretical model of functional outcome with these children. Using a conceptual model of functional outcome based oil the International Classification of Functioning, Disability and Health, this review paper outlines the current state of the research literature and presents explanatory case study methodology as an alternative research design to further advance the Study of functional outcome post-burn injury. (C) 2004 Elsevier Ltd and ISBI. All rights reserved.

Healing effect of Terminalia chebula Retz extract on second-degree burns in rats

Purpose: To investigate the healing effect of Terminalia chebula Retz Extract (TCRE) on seconddegree burns in rats. Methods: Male Sprague Dawley (SD) rats, weighing 200 – 220 g, were subjected to deep seconddegree skin burns by electrical scald instrument. The animals were divided into three groups as follows: (1) second-degree burns model (control) group, (2) burns model treated with 1 % silver sulfadiazine (SSD) group, and (3) burns model treated with 100 mg·mL-1 TCRE group. On days 3, 7 and 14 following the administration of the drug/extract, the wound area and histopathological changes in rat epidermis were evaluated for the various groups. The minimum inhibitory concentration (MIC) of TCRE on Staphyloccocus aureus, Pseudomonas aeruginosa and Escherichia coli were also assessed separately. Results: On day 14, the mean wound area of TCRE treatment group (0.25 ± 0.06 cm2) was significantly smaller than that of the control rats (2.71 ± 0.20 cm2, p < 0.01). The histological results indicate that the inflammatory cells disappeared and were replaced by new granulation tissue in the group treated with 100 mg·mL-1 TCRE by day 14. Compared with SSD group rats, the inflammatory cells and fibroblast and granulation tissues of burnt rats treated with 100 mg·mL-1 TCRE were same as those of rats that had no burns. The antibacterial results revealed that the MIC of TCRE on Staphyloccocus aureus, Pseudomonas aeruginosa and Escherichia coli was 3.13, 12.5 and 6.25 mg·mL-1, respectively. Conclusion: Terminalia chebula Retz. has potentials to be developed as an effective medicinal herb for the treatment of second-degree burns.

Uso de plasma rico em plaquetas em queimaduras Modelo experimental em ratos

As queimaduras são eventos comuns e recorrentes no dia a dia dos atendimentos médicos. Há uma constante busca para entender a sua fisiopatologia, no intuito de minimizar seus resultados devastadores. Plasma rico em plaquetas (PRP) é um concentrado de plaquetas com capacidade de liberação local de múltiplos fatores de crescimento (FC) que aceleram a cicatrização. Este estudo consiste em dois experimentos: o primeiro visa validar um modelo experimental para a criação de queimaduras de tamanho e profundidade padronizados e, o segundo, avalia o uso de PRP em queimaduras. Para o desenvolvimento de queimaduras na validação do modelo experimental, foi idealizado um equipamento que permitisse o controle preciso da temperatura, além da utilização em conjunto de uma técnica inovadora de fixação que garante pressão constante no momento das queimaduras. Para o primeiro experimento, foram utilizados 12 ratos, por grupo, submetidos a queimaduras de 60 oC, 70 oC ou 80 oC por dez segundos, com um equipamento que desenvolvemos. Metade dos animais de cada grupo foi morta no terceiro dia e suas feridas foram analisadas por histologia, e, na outra metade, a ferida foi mensurada e acompanhada até o seu fechamento. No uso de PRP em queimaduras, foram avaliadas queimaduras de segundo grau (SG), segundo grau com diabetes mellitus induzido (SGD) e queimaduras de terceiro grau (TG). Noventa animais foram distribuídos em três grupos (SG, SGD e TG), onde, em cada um, dez animais foram tratados, dez serviram de controle e dez foram utilizados para o preparo do PRP. As áreas das feridas foram acompanhadas até o vigésimo primeiro dia, quando os animais foram mortos e biópsias de pele foram realizadas. Os resultados da validação do modelo mostram que as queimaduras produzidas com 60 oC foram de SG superficial (28% da derme envolvida); com 70 oC foram de SG profundo (72% da derme envolvida); e com 80 oC foram de TG (100% da derme envolvida). Em relação ao uso de PRP em queimaduras, observou-se que nos grupos tratados SG e SGD houve aceleração do fechamento da ferida e redução no número de células CD31, CD163, CD68, MPO e TGF-β positivas, e aumento do número de células MMP2 positivas. A neoepiderme foi mais fina nos controles dos grupos SG e SGD, e o tecido de granulação foi reduzido nos controles SGD e TG. O modelo utilizado é seguro e confiável para produzir queimaduras regulares e uniformes, de diâmetros variados, pela capacidade do controle fino da temperatura e pelo posicionamento do animal, e reprodutíveis. PRP parece acelerar a cicatrização de queimaduras de SG e SGD, mas não de TG.

Ansiedade na performance: causas e possíveis curas

I - Este relatório pretende descrever o estágio especializado em ensino de música realizado no âmbito do mestrado em Ensino de Música na Escola Superior de Música de Lisboa. Este estágio decorreu no Instituto Gregoriano de Lisboa e no Conservatório de Música, de Dança e de Arte Dramática de Lisboa, duas escolas de ensino oficial especializado. Sendo a primeira pública e a segunda privada, estas escolas apresentam realidades muito diferentes do ponto de vista organizacional e de gestão, que resultam em situações heterogéneas e dependentes de vários factores que serão mencionados ao longo deste relatório. A análise SWOT efectuada para cada uma destas organizações descreve mais objectivamente os factores e variáveis que permitiram construir este relatório. Foram caracterizados três alunos, um de cada curso: preparatório, básico e secundário. A Maria M. é a aluna do 2º ano do curso preparatório, o Pedro R. é aluno de 3º grau do curso básico de instrumento e o Diego M. é aluno de 7º grau. Foram aprofundadas as práticas pedagógicas desenvolvidas com cada um dos alunos e os avanços e metas atingidas por cada um destes alunos. Este estágio resulta numa reflexão sobre a prática pedagógica aplicada e as suas motivações.

Os trabalhos para casa no 1.º ciclo do ensino básico – conceções de alunos e professor

Relatório Final apresentado à Escola Superior de Educação de Lisboa para obtenção de grau de mestre em Ensino do 1.º e do 2.º Ciclo do Ensino Básico

Seguimiento de áreas cruentas cubiertas con queratinocitos autólogos cultivados en suero autólogo: Estudio multicéntrico en Bogotá

En 2009 se presento la estandarización de cultivos de queratinocitos autólogos cultivados en suero autólogo. En este estudio los autores describen la efectividad de estos parches de regeneración de piel, para la cobertura de áreas cruentas con indicación de injerto de piel parcial. El porcentaje de epitelización del área cruenta fue el punto principal. Métodos: 47 pacientes fueron incluidos consecutivamente, equivalentes a 78 áreas cruentas. Las áreas fueron estratificadas según la profundidad: grupo 1:IIA (n=8) grupo 2: IIB (n=39); grupo 3,III (n=24) y grupo 4, etiología diferente: Otras (n=7). Todas las áreas fueron tratadas con injertos de queratinocitos autólogos cultivados en suero autólogo y se realizo registro fotográfico y del porcentaje de epitelización al día 5, 7, 15 y 30. Resultados: La efectividad de los injertos de queratinocitos autólogos es de 53.16% ± 46.46%. El porcentaje de epitelización es mayor para el grupo 1 (100%) y grupo 2 (62.79%) que para el grupo 3 (27.57%) y el grupo 4 (33.86%). Se encontró relación entre la interacción de las medianas del porcentaje de epitelización entre área corporal y grado de quemadura (p<0.001 KW) siendo mayor para el grupo 1 en todas las áreas, grupo 2 en cara, grupo 3 en tronco y grupo 4 en cara; y el menor porcentaje de epitelización en el grupo 3 y grupo 4 de las áreas ubicadas tronco. Conclusión: Los injertos de queratinocitos autólogos cultivados en suero autólogo son un método de cobertura eficaz para áreas cruentas producidas por quemaduras IIA y IIB independientemente del tamaño y la localización , y para las áreas cruentas pequeñas (<9cm2) de etiología diferente o grado III de profundidad. Palabras Clave: Cultivo queratinocitos, cobertura áreas cruentas, efectividad.

Mapeamento do contorno estrutural do embasamento da bacia sedimentar de Curitiba - PR

The sedimentary Curitiba basin is located in the Central-Southern part of the first Parananense plateau, and comprises Curitiba (PR), and part of the neighbour Municipalities (fig.1). It is supposed to be of Plio-Pleistocene age. It has a shallow sedimentary fulfillment, represented by the Guabirotuba formation (BIGARELLA and SALAMUNI, 1962) which is dristributed over a large area of about 3.000km2. The internal geometry, not entirely known yet, is actually object of detailed research, that shows its geological evolution to Cenozoic tectonic movements. For the purpose of this study the definition of the structural contour of the basement and their depo-centers is fundamental. This paper presents the results of the integration of surface and subsurface data, processed by statistical methods, which allowed a more precise definition of the morphostructural framework of the basement. For the analysis of the geological spacial data, specific softwares were used for statistical processing for trend surfaces analysis. The data used in this study are of following types: a) drilling logs for ground water; b) description of surface points of geological maps (CRPM, 1977); c) description of points of geotechnical drillings and down geological survey. The data of 223 drilling logs for ground water were selected out of 770 wells. The description files of 700 outcrops, as well as planialtimetric field data, were used for the localization of the basement outcrop. Thus, a matrix with five columns was set up: utm E-W (x) and utm N-S (y); surface altitude (z); altimetric cote of the contact between sedimentary rocks and the basement (k); isopachs (l). For the study of the basement limits, the analysis of surface trends of 2(nd) and 3(rd) degree polinomial for the altimetric data (figs. 2 and 3) were used. For the residuals the method of the inverse of the square of the distance (fig.4) was used. The adjustments and the explanations of the surfaces were made with the aid of multiple linear regressions. The analysis of 3rd degree polinomial trend surface (fig.3) confirmed that the basement tends to be more exposed towards NNW-SSE explaining better the data trend through an ellipse, which striking NE-SW and dipping SW axis coincides with the trough of the basin observed in the trending surface of the basement. The performed analysis and the respective images offer a good degree of certainty of the geometric model of the Curitiba Basin and of the morphostructure of its basement. The surface trend allows to sketch with a greater degree of confidence the structural contour of the topgraphic surface (figs. 5 and 6) and of the basement (figs. 7 and 8), as well as the delimitation of intermediate structural heights, which were responsible for isolated and assymmetric depocenters. These details are shown in the map of figures 9 and 10. Thus, the Curitiba Basin is made up by a structural trough stretching NE-SW, with maximum preserved depths of about 80m, which are separated by heights and depocenters striking NW-SE (fig. 11). These structural features seems to have been controlled by tectonic reactivation during the Tertiary (HASUI, 1990) and which younger dissection was conditioned by neotectonic processes (SALAMUNI and EBERT, 1994).

Teoria da formação das ações mentais por etapas, de P. Galperin, e o processo de humanização

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Perfil epidemiológico dos pacientes internados na unidade de tratamento de queimaduras do Hospital Estadual de Bauru

Burns are frequent accidents, and they are among the major causes of morbidity and mortality in our society. In Brazil, statistical data on such lesions are relatively scarce, and they are concentrated in a few treatment centers. Data on such accidents allow for specific care to be timely and properly taken in order to provide patients with a better prognosis, in addition to enabling the development of prevention programs as well as fire-prevention safety laws. To characterize the epidemiological profile of users at the Burn Treatment Unit of Bauru State Hospital. Collection of epidemiological data through the e-pront system and from charts of burned inpatients from April 2005 to April 2010. During the studied period, 906 hospitalizations of burned patients occurred, with an annual average of 181.2 individuals. Their mean age was 28.4 years, with a predominance of males. The mean hospitalization period was of 27.6 days, with a median of 16 days and a maximum of 216 days; 14.7% developed to death, with the highest mortality rate in the first two weeks of hospitalization. Second-degree burns were the most frequent; 36.8% of the patients burned less than 10% of their body surface, and there was a gradual frequency reduction when a larger burned surface was taken into account; the greater the affected areas, the higher the number of deaths; 91% resulted from thermal agents, 6% from electric and 2% from chemical agents; scalding was the major cause among all agents, followed by alcohol associated with fire and direct flame. The major area affected areas were the upper limbs. The study shows the need for educational and preventive measures, particularly for the young adult population, by means of educational programs and prevention campaigns

Effect of photodynamic therapy on the healing of cutaneous third-degree-burn: histological study in rats

The aim of this study was to conduct a histological assessment of the effect of photodynamic therapy (PDT) on the repairing of third-degree-burn wounds made on the backs of rats with a heated scalpel. Ninety-six rats were divided into groups: G1, control (n = 24), cold scalpel; G2, burned, heated scalpel (n = 24); G3, low-level laser therapy (LLLT) (n = 24), on burns; and G4, photodynamic therapy (PDT) (n = 24), toluidine-O blue (100 A mu g/ml) and LLLT treatment on burns. The laser (685 nm) was applied in continuous mode, 50 mW, 4.5 J/cm(2), contact mode at nine points (9 s/point). Eight animals in each group were killed at 3 days, 7 days or 14 days after surgery, and tissue specimens containing the whole wounded area were removed and processed for histological analysis; the results were statistically analyzed with Kruskal-Wallis and Dunn's tests (P < 0.05). The results demonstrated significant differences between G2 and G3, and between G2 and G4, at both 3 days and 7 days, with regard to acute inflammation scores; G1 and G2 showed significant differences when compared with G4 at 3 days, with regard to neo-angiogenesis scores; G1 and G2 were statistically different from G3 and G4 at both 3 days and 7 days, with regard to re-epithelization scores; G2 showed statistically significant differences when compared with G3 and G4 with regard to collagen fiber scores at 7 days. LLLT and PDT acted as a biostimulating coadjuvant agent, balancing the undesirable effect of the burn on the wound healing process, acting mainly in the early healing stages, hastening inflammation and increasing collagen deposition.

Integrated approach to foreign language in the building engineering degree at the Universidad Politécnica Madrid

The European Union has been promoting linguistic diversity for many years as one of its main educational goals. This is an element that facilitates student mobility and student exchanges between different universities and countries and enriches the education of young undergraduates. In particular,a higher degree of competence in the English language is becoming essential for engineers, architects and researchers in general, as English has become the lingua franca that opens up horizons to internationalisation and the transfer of knowledge in today’s world. Many experts point to the Integrated Approach to Contents and Foreign Languages System as being an option that has certain benefits over the traditional method of teaching a second language that is exclusively based on specific subjects. This system advocates teaching the different subjects in the syllabus in a language other than one’s mother tongue, without prioritising knowledge of the language over the subject. This was the idea that in the 2009/10 academic year gave rise to the Second Language Integration Programme (SLI Programme) at the Escuela Arquitectura Tecnica in the Universidad Politecnica Madrid (EUATM-UPM), just at the beginning of the tuition of the new Building Engineering Degree, which had been adapted to the European Higher Education Area (EHEA) model. This programme is an interdisciplinary initiative for the set of subjects taught during the semester and is coordinated through the Assistant Director Office for Educational Innovation. The SLI Programme has a dual goal; to familiarise students with the specific English terminology of the subject being taught, and at the same time improve their communication skills in English. A total of thirty lecturers are taking part in the teaching of eleven first year subjects and twelve in the second year, with around 120 students who have voluntarily enrolled in a special group in each semester. During the 2010/2011 academic year the degree of acceptance and the results of the SLI Programme are being monitored. Tools have been designed to aid interdisciplinary coordination and to analyse satisfaction, such as coordination records and surveys. The results currently available refer to the first semester of the year and are divided into specific aspects of the different subjects involved and into general aspects of the ongoing experience.

Labor risk prevention culture encouragement among students from building degree in the Technical University of Madrid

The influence of training in labor risk prevention and the development of the resulting pre-emptive culture are analyzed within this paper. In order to achieve this, a quantitative analysis of the students of Building Degree in the Technic University of Madrid has been developed. This study has been made in all grades, valuating the previous knowledge acquired during compulsory education. It must be kept in mind that the students in 3rd and 4th grade have received general and specific compulsory training in prevention and safety in the building sector.

A review of three years experience using email and videoconferencing for the delivery of post-acute burns care to children in Queensland

A virtual outpatient service has been established in Queensland for the delivery of post-acute burns care to children living in rural and remote areas of the state. The integration of telepaediatrics as a routine service has reduced the need for patient travel to the specialist burns unit situated in Brisbane. We have conducted 293 patient consultations over a period of 3 years. A retrospective review of our experience has shown that post-acute burns care can be delivered using videoconferencing, email and the telephone. Telepaediatric bums services have been valuable in two key areas. The first area involves a programme of routine specialist clinics via videoconference. The second area relates to ad-hoc patient consultations for collaborative management during acute presentations and at times of urgent clinical need. The families of patients have expressed a high degree of satisfaction with the service. Telepaediatric services have helped improve access to specialist services for people living in rural and remote communities throughout Queensland. (C) 2003 Elsevier Ltd and ISBI. All rights reserved.