998 resultados para Fisher scale


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Objetive. To determine if high grades of Fisher scale are useful to predict the development of hydrocephalus in consecutive Colombian patients with spontaneous subarachnoid hemorrhage (SAH) assessed from January 2005 to April 2012 with 12 month follow-up. Methods. 251 patients were included in a restrospective manner. The association between Fisher scale and hydrocephalus was analyzed bivariate and multivariate analysis. In addition, a systematic literature review (SLR) was done. Results. In our cohort of patients, the etiology of SAH was due to aneurysms; 78,5%. The prevalence of hydrocephalus was found to be of 27,1%. Overall survival with a 12 month follow-up was of 65,7%. Average age of included patients was 55,5 ± 15 years, and most of them were women; 65,7%. Having Fisher 4 and Hunt-Hess III are significantly associated with hydrocephalus: adjusted OR: 2.93 95% CI: 1.51-5.65, P <0.001, adjusted OR: 2.83 95% CI: 1.31-6.17 P=0.008 respectively. The SRL showed an overall prevalence of hydrocephalus between 17 and 68% and mortality varied between 3.0% and 33%. 50% of the included studies significantly associated intraventricular hemorrhage ( Fisher 4) with hydrocephalus. Conclusion. Our results confirm current concepts on post-SAH hydrocephalus and the fact that is obstructive and secondary to Fisher 4 and having neurological impairment on admission (Hunt and Hess III).

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Objetivo. Determinar si la cantidad de sangre y su localización es el espacio subaracnoideo, medible con la escala de Fisher en las primeras 24 horas de ocurrido el ictus hemorrágico, es un factor predictor para el desarrollo de hidrocefalia en pacientes con diagnóstico de hemorragia subaracnoidea (HSA) espontánea, vistos en el Hospital Universitario Clínica San Rafael (HUCSR) con seguimiento de 12 meses. Métodos. 251 pacientes fueron incluidos en una cohorte retrospectiva. La asociación entre la escala de Fisher y el desarrollo de hidrocefalia en pacientes con HSA espontánea fue analizada a través de un análisis bivariado y multivariado. Resultados. La edad promedio de los pacientes fue de 55,5 ± 15 años; con predominancia en el sexo femenino 65,7%. La prevalencia de hidrocefalia fue de 27,1% en la cohorte y la etiología de la HSA fue en su mayoría por ruptura de aneurismas de arterias cerebrales; 78,5%. La sobrevida a 12 meses fue de 65,7%. Tanto el grado 4 en la escala de Fisher como Hunt-Hess III se asocian con el desarrollo de hidrocefalia: ORA; 2.93 IC 95%: 1.51-5.65, P <0.001, ORA 2.83 IC 95%: 1.31-6.17 P=0.008 respectivamente. Conclusión. La presencia de sangrado Intraventricular o intraparenquimatoso ( Fisher 4) en las primeras 24 horas, asociado a un deterioro neurológico al ingreso Hunt-Hess III están asociados con el desarrollo de hidrocefalia en los 251 pacientes evaluados con diagnóstico de HSA espontánea; hallazgos consistentes con lo reportado en la literatura mundial.

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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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Trabalho Final do Curso de Mestrado Integrado em Medicina, Faculdade de Medicina, Universidade de Lisboa, 2014

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Universidade Estadual de Campinas. Faculdade de Educação Física

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A socio-economic research is required as an attempt to address the socio-economic issues facing small-scale fisheries. A study of the socio economic conditions of small-scale fishermen is a prerequisite for good design and successful implementation of effective assistance Programmes. It will provide an overall pidure of the structure, activities and standards of living of small-scale fisherfolk The study is confined to the coastal districts of Ernakulam, Thrissur and Malappuram districts. It also gives a picture of socio-economic conditions of the fisher folk in the study area. The variables that may depict the standard of living of the small-scale fisherfolk are occupational structure, family size, age structure, income, expenditure, education, housing and other social amenities. It attempts to see the asset creation of the fisherfolk with the help of government agencies, and the nature of savings and expenditure pattern of the fisherfolk. It also provides a picture of the indebtedness of the fisherfolk in the study area. The study analyses the schemes implemented by the government through its agencies, like Fisheries Department, Matsyaboard, and Matsyafed; and the awareness of fisherfolk regarding these schemes, their attitude and reactions, the extent of accessibility, and the viability of the schemes.

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Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)

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Background and Purpose: Oropharyngeal dysphagia is a common manifestation in acute stroke. Aspiration resulting from difficulties in swallowing is a symptom that should be considered due to the frequent occurrence of aspiration pneumonia that could influence the patient's recovery as it causes clinical complications and could even lead to the patient's death. The early clinical evaluation of swallowing disorders can help define approaches and avoid oral feeding, which may be detrimental to the patient. This study aimed to create an algorithm to identify patients at risk of developing dysphagia following acute ischemic stroke in order to be able to decide on the safest way of feeding and minimize the complications of stroke using the National Institutes of Health Stroke Scale (NHISS). Methods: Clinical assessment of swallowing was performed in 50 patients admitted to the emergency unit of the University Hospital, Faculty of Medicine of Ribeirao Preto, Sao Paulo, Brazil, with a diagnosis of ischemic stroke, within 48 h after the beginning of symptoms. Patients, 25 females and 25 males with a mean age of 64.90 years (range 26-91 years), were evaluated consecutively. An anamnesis was taken before the patient's participation in the study in order to exclude a prior history of deglutition difficulties. For the functional assessment of swallowing, three food consistencies were used, i.e. pasty, liquid and solid. After clinical evaluation, we concluded whether there was dysphagia. For statistical analysis we used the Fisher exact test, verifying the association between the variables. To assess whether the NIHSS score characterizes a risk factor for dysphagia, a receiver operational characteristics curve was constructed to obtain characteristics for sensitivity and specificity. Results: Dysphagia was present in 32% of the patients. The clinical evaluation is a reliable method of detection of swallowing difficulties. However, the predictors of risk for the swallowing function must be balanced, and the level of consciousness and the presence of preexisting comorbidities should be considered. Gender, age and cerebral hemisphere involved were not significantly associated with the presence of dysphagia. NIHSS, Glasgow Coma Scale, and speech and language changes had a statistically significant predictive value for the presence of dysphagia. Conclusions: The NIHSS is highly sensitive (88%) and specific (85%) in detecting dysphagia; a score of 12 may be considered as the cutoff value. The creation of an algorithm to detect dysphagia in acute ischemic stroke appears to be useful in selecting the optimal feeding route while awaiting a specialized evaluation. Copyright (C) 2012 S. Karger AG, Basel

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Starting from the Fisher matrix for counts in cells, we derive the full Fisher matrix for surveys of multiple tracers of large-scale structure. The key step is the classical approximation, which allows us to write the inverse of the covariance of the galaxy counts in terms of the naive matrix inverse of the covariance in a mixed position-space and Fourier-space basis. We then compute the Fisher matrix for the power spectrum in bins of the 3D wavenumber , the Fisher matrix for functions of position (or redshift z) such as the linear bias of the tracers and/or the growth function and the cross-terms of the Fisher matrix that expresses the correlations between estimations of the power spectrum and estimations of the bias. When the bias and growth function are fully specified, and the Fourier-space bins are large enough that the covariance between them can be neglected, the Fisher matrix for the power spectrum reduces to the widely used result that was first derived by Feldman, Kaiser & Peacock. Assuming isotropy, a fully analytical calculation of the Fisher matrix in the classical approximation can be performed in the case of a constant-density, volume-limited survey.

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This research project sought to find out the socio-economic status of the small-scale fishers of the blue swimming crab (Portunuspelagicus) in Samar, considering the diminishing volume of catch of the species in the recent years. Using a blend of quantitative and qualitative methods, the study employed an interview schedule, focus group discussion (FGD) and observation in collecting data not only from the fishers but also from other sectors directly involved in the blue swimming crab industry.

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We measured the distribution in absolute magnitude - circular velocity space for a well-defined sample of 199 rotating galaxies of the Calar Alto Legacy Integral Field Area Survey (CALIFA) using their stellar kinematics. Our aim in this analysis is to avoid subjective selection criteria and to take volume and large-scale structure factors into account. Using stellar velocity fields instead of gas emission line kinematics allows including rapidly rotating early-type galaxies. Our initial sample contains 277 galaxies with available stellar velocity fields and growth curve r-band photometry. After rejecting 51 velocity fields that could not be modelled because of the low number of bins, foreground contamination, or significant interaction, we performed Markov chain Monte Carlo modelling of the velocity fields, from which we obtained the rotation curve and kinematic parameters and their realistic uncertainties. We performed an extinction correction and calculated the circular velocity v_circ accounting for the pressure support of a given galaxy. The resulting galaxy distribution on the M-r - v(circ) plane was then modelled as a mixture of two distinct populations, allowing robust and reproducible rejection of outliers, a significant fraction of which are slow rotators. The selection effects are understood well enough that we were able to correct for the incompleteness of the sample. The 199 galaxies were weighted by volume and large-scale structure factors, which enabled us to fit a volume-corrected Tully-Fisher relation (TFR). More importantly, we also provide the volume-corrected distribution of galaxies in the M_r - v_circ plane, which can be compared with cosmological simulations. The joint distribution of the luminosity and circular velocity space densities, representative over the range of -20 > M_r > -22 mag, can place more stringent constraints on the galaxy formation and evolution scenarios than linear TFR fit parameters or the luminosity function alone.

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Dysphagia is relatively common in individuals with neurological disorders. To describe the swallowing management and investigate associated factors with swallowing in a case series of patients with Parkinson's disease. It is a long-term study with 24 patients. The patients were observed in a five-year period (2006-2011). They underwent Fiberoptic Endoscopic Evaluation of Swallowing, Functional Oral Intake Scale and therapeutic intervention every three months. In the therapeutic intervention they received orientation about exercises to improve swallowing. The Chi-square, Kruskal-Wallis and Fisher's tests were used. The period of time for improvement or worsening of swallowing was described by Kaplan-Meier analysis. During the follow-up, ten patients improved, five stayed the same and nine worsened their swallowing functionality. The median time for improvement was ten months. Prior to the worsening there was a median time of 33 months of follow-up. There was no associated factor with improvement or worsening of swallowing. The maneuvers frequently indicated in therapeutic intervention were: chin-tuck, bolus consistency, bolus effect, strengthening-tongue, multiple swallows and vocal exercises. The swallowing management was characterized by swallowing assessment every three months with indication of compensatory and rehabilitation maneuvers, aiming to maintain the oral feeding without risks. There was no associated factor with swallowing functionality in this case series.

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Universidade Estadual de Campinas . Faculdade de Educação Física