Engorgement

The first milk that your body starts making in late pregnancy is called “colostrum.” When your baby is 1–5 days old (normally, about 3½ days old), your milk supply will increase. This is when your milk “comes in.” As your breasts get full with milk they may get hard, swollen and painful. This is called engorgement. It is best to avoid getting engorged, if possible.

Engorgement des centres d'urgences: une raison légitime de refuser l'accès aux patients non urgents [Emergency department overcrowding: a legitimate reason to refuse access to urgent care for non-urgent patients?].

Non-urgent cases represent 30-40% of all ED consults; they contribute to overcrowding of emergency departments (ED), which could be reduced if they were denied emergency care. However, no triage instrument has demonstrated a high enough degree of accuracy to safely rule out serious medical conditions: patients suffering from life-threatening emergencies have been inappropriately denied care. Insurance companies have instituted financial penalties to discourage the use of ED as a source of non-urgent care, but this practice mainly restricts access for the underprivileged. More recent data suggest that in fact most patients consult for appropriate urgent reasons, or have no alternate access to urgent care. The safe reduction of overcrowding requires a reform of the healthcare system based on patients' needs rather than access barriers.

Efficacy of Rhipicephalus (Boophilus) microplus Bm86 against Hyalomma dromedarii and Amblyomma cajennense tick infestations in camels and cattle

The recombinant Bm86-based tick vaccines have shown their efficacy for the control of cattle ticks, Rhipicephalus (Boophilus) microplus and R. annulatus infestations. However, cattle ticks often co-exist with multi-host ticks such as Hyalomma and Amblyomma species, thus requiring the control of multiple tick infestations for cattle and other hosts. Vaccination trials using a R. microplus recombinant Bm86-based vaccine were conducted in cattle and camels against Hyalomma dromedarii and in cattle against Amblyomma cajennense immature and adult ticks. The results showed an 89% reduction in the number of H. dromedarii nymphs engorging on vaccinated cattle, and a further 32% reduction in the weight of the surviving adult ticks. In vaccinated camels, a reduction of 27% and 31% of tick engorgement and egg mass weight, respectively was shown, while egg hatching was reduced by 39%. However, cattle vaccination with Bm86 did not have an effect on A. cajennense tick infestations. These results showed that Bm86 vaccines are effective against R. microplus and other tick species but improved vaccines containing new antigens are required to control multiple tick infestations. (C) 2012 Elsevier Ltd. All rights reserved.

Un modèle global et intégré de la performance : application à l’urgence d’un hôpital au Mexique

À cause de la nature complexe et non linéaire de leurs opérations, les salles d’urgence (SU) constituent des entités organisationnelles uniques dans le domaine de la santé. Les SU subissent des pressions accrues résultant des dynamiques des sociétés contemporaines et de leurs systèmes de santé, et font face ainsi à des défis uniques comme l’engorgement. Contrairement aux croyances dominantes sur le phénomène, le présent travail de recherche établit que ce problème est en réalité une manifestation de pauvre performance systémique plutôt qu’une faillite opérationnelle. Alors, pour les SU, la performance organisationnelle relève une importance incontestable. En effet, l’étude de la performance organisationnelle est un sujet de recherche qui intéresse de nombreux chercheurs des services de santé. Il s’agit, néanmoins, d’un concept historiquement difficile à définir à cause de son caractère complexe, multidimensionnel et paradoxal. Le modèle EGIPSS, basé sur la théorie de l’action sociale de Parsons, est capable de saisir cette complexité et constitue un cadre conceptuel robuste et exhaustif, pouvant s’adapter à des contextes divers. Ce mémoire adopte le modèle EGIPSS pour présenter un outil global et intégré d’évaluation de la performance organisationnelle de la salle d’urgences de l’Hôpital Général Régional 46 à Guadalajara, au Mexique. Cet instrument est conçu pour prendre en compte spécifiquement les particularités propres des SU, ainsi que les caractéristiques organisationnelles uniques de l'Hôpital Général Régional 46. Enfin, le développement de ce projet de mémoire contribue aux efforts d’amélioration continue de la performance de cet établissement, et enrichit les connaissances sur les urgences en tant qu’unités organisationnelles.

Cutaneous Basophilia in the Resistance of Goats to Amblyomma cajennense Nymphs after Repeated Infestations

Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)

Guinea Pigs Develop Cutaneous Basophilia after Repeated Infestations by Nymphs of the Tick Amblyomma triste

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

Aspectos clínicos, ultra-sonográficos e venográficos da tromboflebite jugular experimental em equinos

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Morphological and enzymatic analysis of the midgut of Anopheles darlingi during blood digestion

The midgut of adult female Anopheles darlingi is comprised of narrow anterior and dilated posterior regions, with a single layered epithelium composed by cuboidal digestive cells. Densely packed apical microvilli and an intricate basal labyrinth characterize each cell pole. Before blood feeding, apical cytoplasm contains numerous round granules and whorled profiles of rough endoplasmic reticulum. Engorgement causes a great distension of midgut. This provokes the flattening of digestive cells and their nuclei. Simultaneously, apical granules disappear, the whorls of endoplasmic reticulum disassemble and 3 h post bloodmeal (PBM), nucleoli enlarge manyfold. An intense absorptive process takes place during the first 24h PBM, with the formation of large glycogen inclusions, which persist after the end of the digestive process. Endoproteases activities are induced after bloodmeal and attain their maximum values between 10 and 36 h PBM. At least two different aminopeptidases seem to participate in the digestive process, with their maximum activity values at 36 and 48 h PBM, respectively. Coarse electrondense aggregates, possibly debris from digested erythrocytes, begin to appear on the luminal face of the peritrophic membrane from 18 h PBM and persist during all the digestive process, and are excreted at its end. We suggest that these aggregates could contain some kind of insoluble form of haem, in order of neutralize its toxicity. (c) 2005 Elsevier Ltd. All rights reserved.

Action of permethrin on Rhipicephalus sanguineus (Latreille, 1806) (Acari: Ixodidae) semi-engorged females: Morpho-physiological evaluation of salivary glands

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

Copulation is necessary for the completion of a gonotrophic cycle in the tick Rhipicephalus sanguineus (Latreille, 1806) (Acari: Ixodidae)

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

Cytotoxic effects of permethrin in salivary glands of Rhipicephalus sanguineus (Latreille, 1806) (Acari: Ixodidae) semi-engorged females

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

Effects of fipronil (active ingredient of Frontline (R)) on salivary gland cells of Rhipicephalus sanguineus females (Latreille, 1806) (Acari: Ixodidae)

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

Cytoplasmic RNA and nuclear changes detected cytochemically during the degeneration of salivary glands of the tick Rhipicephalus sanguineus (Latreille, 1806) (Acari, Ixodidae)

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Death by apoptosis in salivary glands of females of the tick Rhipicephalus sanguineus (Latreille, 1806) (Acari : Ixodidae)

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