306 research outputs found
Management of Bleeding Associated with Malignant Wounds
Abstract Bleeding malignant wounds in palliative care patients can be anxiety-provoking for patients, their caregivers, and healthcare providers, and can be difficult to manage. We present the case of a 60-year-old man with a bleeding neck wound due to squamous cell carcinoma of the hypopharynx admitted to our inpatient palliative care unit. Management of bleeding included local wound care measures and psychosocial support for the patient and his wife. We review therapeutic approaches to managing bleeding malignant wounds with the aim of providing clinically useful information.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/98457/1/jpm%2E2011%2E0286.pd
A Dynamic Approach to the Thermodynamics of Superdiffusion
We address the problem of relating thermodynamics to mechanics in the case of
microscopic dynamics without a finite time scale. The solution is obtained by
expressing the Tsallis entropic index q as a function of the Levy index alpha,
and using dynamical rather than probabilistic arguments.Comment: 4 pages, new revised version resubmitted to Phys. Rev. Let
Modelling the impact of climate change on Tanzanian forests
This research article was published by Wiley Online Library in 2020Aim: Climate change is pressing extra strain on the already degraded forest eco system in Tanzania. However, it is mostly unknown how climate change will affect
the distribution of forests in the future. We aimed to model the impacts of climate
change on natural forests to help inform national-level conservation and mitigation
strategies.
Location: Tanzania.
Methods: We conducted maximum entropy (MaxEnt) modelling to simulate forest
habitat suitability using the Tanzanian national forest inventory survey (1,307 oc currences) and environmental data. Changes in forest habitats were simulated under
two Representative Concentration Pathways (RCPs) emission scenarios RCP 4.5 and
RCP 8.5 for 2055 and 2085.
Results: The results indicate that climate change will threaten forest communities,
especially fragmented strips of montane forests. Even under optimistic emission
scenario, the extent of montane forest is projected to almost halve by 2085, inter secting many biodiversity hotspots across the Eastern Arc Mountains. Similarly, cli mate change is predicted to threaten microhabitat forests (i.e. thickets), with losses
exceeding 70% by 2085 (RCP8.5). Other forest habitats are predicted to decrease
(lowland forest and woodland) representing essential ecological networks, whereas
suitable habitats for carbon-rich mangroves are predicted to expand by more than
40% at both scenarios.
Conclusions: Climate change will impact forests by accelerating habitat loss, and
fragmentation and the remaining land suitable for forests will also be subject to pres sures associated with rising demand for food and biofuels. These changes are likely
to increase the probability of adverse impacts to the country's indigenous flora and
fauna. Our findings, therefore, call for a shift in conservation efforts, focusing on (i)
the enhanced management of existing protected areas that can absorb the impacts
of future climate change, and (ii) expanding conservation efforts into newly suitable
regions through effective land use planning and land reclamation, helping to preserve
and enhance forest connectivity between fragmented patches
Atrofia muscular em pacientes oncológicos internados em unidade de terapia intensiva
Immobilization and prolonged bed rest of patients in the Intensive Care Unit can lead to muscle atrophy and muscular weakness. This study was conducted to quantify the adverse effects of prolonged bed rest. Seven cancer patients in the ICU of the Hospital do Cancer were underwent ultrasound evaluation, which measured the thickness of the gastrocnemius and femoral quadriceps muscles at interval of five days. All patients were under mechanical ventilation and received nutritional support, chestphysiotherapy and passive limb movements performed by a physiotherapist. We found that muscle thickness decreased in all patients studied, the means percent of muscle reduction were 28% (13.1 a 37.5%) and 34.6% (11.2 a 62.7) for gastrocnemius and femoral quadriceps respectively. Complete deambulation recovery occurred between 3 to 7 days after ICU discharge. All cancer patients presented severe muscle atrophy and muscular weakness during ICU treatment. Further studies are necessary to establish the importance of physical therapy to prevent and treat muscle atrophy in patients in the ICU.A imobilização e restrição ao leito de pacientes internados em Unidade de Terapia Intensiva causam, entre outras complicações, diminuição da força e atrofia muscular. Com o objetivo de avaliarmos estes efeitos em sete pacientes oncológicos internados na Unidade de Terapia Intensiva do Hospital do Câncer, mensuramos as espessuras do músculos gastrocnêmio e quadriceps, com intervalo de cinco dias por meio de ultrassonografía transcutânea e a recuperação das atividades motoras após a alta da UTI. Todos os pacientes estiveram sob ventilação mecânica, receberam suporte nutricional e fisioterapia motora e respiratória convencionais. Observou-se diminuição da espessura do músculo gastrocnêmio em média 28,5% (13,1 a 37,5%) e do quadriceps em média 34,6% (11,2 a 62,7%). Nos quatro pacientes onde foi possível o acompanhamento pós alta, a recuperação da deambulação sem auxílioocorreu entre três a sete dias e um paciente não se recuperou. Não foi possível estabelecer a correlação entre o grau de perda de massa muscular e o impacto na recuperação das atividades motoras após a alta da UTI. O real papel da fisioterapia na prevenção ou recuperação destes distúrbios ainda não estão totalmente esclarecidos
TP53 mutation p.R337H in gastric cancer tissues of a 12-year-old male child - evidence for chimerism involving a common mutant founder haplotype: case report
<p>Abstract</p> <p>Background</p> <p>Gastric adenocarcinoma is rare in children and adolescents, with about 17 cases under age 21 in the world's literature. We report a case of invasive well-differentiated metastatic gastric cancer in a Brazilian 12-year-old boy without documented familial history of cancer.</p> <p>Case presentation</p> <p>The patient, diagnosed with metastatic disease, died seven months after surgery. DNA from intra-surgical specimens revealed a <it>TP53 </it>mutation at codon 337 (p.R337H) in samples with neoplastic cells (dysplasia, tumor and metastasis) but not in non-transformed cells (incomplete intestinal metaplasia and non-involved celiac lymph node). In all mutation-positive tissues, p.R337H occurred on the same background, a founder allele identified by a specific haplotype previously described in Brazilian Li-Fraumeni syndrome patients. The same mutant haplotype, corresponding to a founder mutation present in 0.3% of the general population in Southern Brazil, was found in the genome of the father. Presence of this inherited haplotype in the tumor as well as in the father's germline, suggests a rare case of microchimerism in this patient, who may have harbored a small number of mutant cells originating in another individual, perhaps a dizygotic twin that died early in gestation.</p> <p>Conclusion</p> <p>This case represents one of the earliest ages at diagnosis of gastric cancer ever reported. It shows that cancer inheritance can occur in the absence of an obvious germline mutation, calling for caution in assessing early cancers in populations with common founder mutations such as p.R337H in Southern Brazil.</p
Modalidades de ocupación y posibilidades de crecimiento futuro en el área metropolitana de Santa Fe, Sauce Viejo-Arroyo Leyes
El área de estudio de este trabajo se circunscribe al tramo comprendido entre Sauce Viejo y Arroyo Leyes, en la denominada Área Metropolitana Santa Fe (Argentina). Las localidades que la integran se encuentran ubicadas en la planicie de inundación del río Paraná, por lo tanto, en sus procesos de crecimiento ha sido sustancial su relación con diversos cuerpos de agua y otras formaciones propias de esta geografía. En el desarrollo del conocimiento sobre el área se plantea el siguiente interrogante: ¿cómo se relaciona el Área Metropolitana de Santa Fe con los cuerpos de agua que la circundan? Para ello es indispensable construir información cartográfica que habilite el cruce de datos censales, físicos y legales y posibilitar así un abordaje sensible de las problemáticas que lo atraviesan. Este trabajo reconoce y enumera esas problemáticas (entre ellas, el crecimiento poblacional de las ciudades centrales, la absorción de ese crecimiento por parte de las localidades vecinas, la transformación de los usos del suelo, la escasez de información geográfica vinculada al tema), a la vez que avanza sobre la construcción de cartografía a partir de diversas fuentes consultadas.The study area of this work is limited to the section between Sauce Viejo and Arroyo Leyes, in the so-called Santa Fe Metropolitan Area (Argentina). The cities that integrate it are located in the flood plain of the Paraná River, therefore, in its growth processes has been substantial its relationship with various bodies of water and other formations in this geography. In the development of knowledge about the area the following question arises: How does the Metropolitan Area of Santa Fe relate to the bodies of water that surround it? For this it is essential the construction of cartographic information that enables the crossing of census, physical and legal data; and thus enable a sensitive approach to the problems that run through it. This work recognizes and lists these problems (among them, the population growth of the central cities, the absorption of that growth by neighboring cities, the modification of land uses, the scarcity of geographic information linked to the topic). At the same time, it advances on the construction of cartography from different sources consulted.Mesa 2: Gestión de los territorios fluviales en áreas urbanas y periurbanasUniversidad Nacional de La Plata (UNLP) - Facultad de Arquitectura y Urbanismo (FAU
Naturaleza y artefacto: operaciones diversas en la construcción de la ribera del Paraná en el tramo san Javier-Coronda
¿Cómo se construyó la ribera fluvial entre las localidades de San Javier y Coronda en la Provincia de Santa Fe (Argentina)? ¿Tuvo en cuenta su vulnerabilidad hídrica? ¿Es este proceso el resultado de una antropización sustentable? Este territorio es una de las áreas de más antigua ocupación de la provincia de Santa Fe. En el siglo XVI (1573) se establece Santa Fe La Vieja (actual parque arqueológico de Cayastá), la ciudad fundada por Juan de Garay que se trasladó en el siglo XVII a su actual emplazamiento con el nombre de Santa Fe de la Vera Cruz. Esta ciudad fue el epicentro de distintos intentos de domesticación del territorio que incluyen reducciones, fuertes y estancias, situación que terminó confluyendo en el siglo XIX en la creación de colonias agrícolas, o en la conversión de pueblos en colonias. La ciudad de Coronda, por su parte, no fue ajena a este proceso y se definió como un centro poblado, primero vinculado a la pacificación del territorio provincial en el siglo XVIII y, más tarde, a la administración departamental, a la producción frutihortícola y al desarrollo de la cárcel modelo.
En los siglos XX y XXI las ciudades que ocupan esta franja del territorio santafesino han ido cambiando sus dimensiones y actividades productivas pero lo que se ha mantenido inalterado es su alta vulnerabilidad hídrica dado que se desarrollan en la planicie de inundación del río Paraná por lo que, en su concepción, se han reflejado distintos paradigmas de intervención, algunos más respetuosos del paisaje y las dinámicas naturales y otros más agresivos y transformadores. Se recupera aquí la idea del rizoma como estructura resiliente para el tramo La Guardia – San Javier (Bertuzzi, 2015), se sostiene que esa estructura es aplicable para el tramo Santo Tomé – Coronda y se identifican las estrategias de antropización del paisaje, valorizando aquellas que suponen una mayor resiliencia, conservación del mismo y construcción de calidad paisajística.How was the river bank built between the towns of San Javier and Coronda in the Province of Santa Fe (Argentina)? Did it take into account its water vulnerability? Is this process the result of sustainable anthropization? This territory is one of the oldest occupied areas of the province of Santa Fe. In the XVI century (1573) Santa Fe La Vieja (current Cayastá) is established, the city founded by Juan de Garay that moved in the seventeenth century to its current location with the name of Santa Fe de la Vera Cruz.
This city was the epicenter of various attempts to domesticate the territory that include indian reservations, forts and agricultural quarters, situation that ended up coming together in the 19th century in the creation of agricultural colonies, or in the conversion of small villages into colonies.The city of Coronda was not alien to this process and was defined as a populated center, first linked to the pacification of the provincial territory in the 18th century and, later, to the departmental administration, to fruit and vegetable production and to the development of the model prison.
In the 20th and 21st centuries, the cities that occupy this stretch of Santa Fe's territory have been changing their size and productive activities but what has remained unchanged is their high water vulnerability since they develop in the flood plain of the Paraná River. In its conception, different intervention paradigms have been reflected, some more respectful of the landscape and the natural dynamics and others more aggressive and transformative. The idea of the rhizome is recovered as a resilient structure for the section La Guardia - San Javier (Bertuzzi, 2015), it is argued that this structure is applicable for the Santo Tomé - Coronda stretch and the strategies of anthropization of the landscape are identified, valuing those that suppose a greater resilience, conservation and construction of landscape quality.Mesa 1: Historia de las relaciones entre lo urbano y lo fluvialUniversidad Nacional de La Plata (UNLP) - Facultad de Arquitectura y Urbanismo (FAU
Naturaleza y artefacto: operaciones diversas en la construcción de la ribera del Paraná en el tramo san Javier-Coronda
¿Cómo se construyó la ribera fluvial entre las localidades de San Javier y Coronda en la Provincia de Santa Fe (Argentina)? ¿Tuvo en cuenta su vulnerabilidad hídrica? ¿Es este proceso el resultado de una antropización sustentable? Este territorio es una de las áreas de más antigua ocupación de la provincia de Santa Fe. En el siglo XVI (1573) se establece Santa Fe La Vieja (actual parque arqueológico de Cayastá), la ciudad fundada por Juan de Garay que se trasladó en el siglo XVII a su actual emplazamiento con el nombre de Santa Fe de la Vera Cruz. Esta ciudad fue el epicentro de distintos intentos de domesticación del territorio que incluyen reducciones, fuertes y estancias, situación que terminó confluyendo en el siglo XIX en la creación de colonias agrícolas, o en la conversión de pueblos en colonias. La ciudad de Coronda, por su parte, no fue ajena a este proceso y se definió como un centro poblado, primero vinculado a la pacificación del territorio provincial en el siglo XVIII y, más tarde, a la administración departamental, a la producción frutihortícola y al desarrollo de la cárcel modelo.
En los siglos XX y XXI las ciudades que ocupan esta franja del territorio santafesino han ido cambiando sus dimensiones y actividades productivas pero lo que se ha mantenido inalterado es su alta vulnerabilidad hídrica dado que se desarrollan en la planicie de inundación del río Paraná por lo que, en su concepción, se han reflejado distintos paradigmas de intervención, algunos más respetuosos del paisaje y las dinámicas naturales y otros más agresivos y transformadores. Se recupera aquí la idea del rizoma como estructura resiliente para el tramo La Guardia – San Javier (Bertuzzi, 2015), se sostiene que esa estructura es aplicable para el tramo Santo Tomé – Coronda y se identifican las estrategias de antropización del paisaje, valorizando aquellas que suponen una mayor resiliencia, conservación del mismo y construcción de calidad paisajística.How was the river bank built between the towns of San Javier and Coronda in the Province of Santa Fe (Argentina)? Did it take into account its water vulnerability? Is this process the result of sustainable anthropization? This territory is one of the oldest occupied areas of the province of Santa Fe. In the XVI century (1573) Santa Fe La Vieja (current Cayastá) is established, the city founded by Juan de Garay that moved in the seventeenth century to its current location with the name of Santa Fe de la Vera Cruz.
This city was the epicenter of various attempts to domesticate the territory that include indian reservations, forts and agricultural quarters, situation that ended up coming together in the 19th century in the creation of agricultural colonies, or in the conversion of small villages into colonies.The city of Coronda was not alien to this process and was defined as a populated center, first linked to the pacification of the provincial territory in the 18th century and, later, to the departmental administration, to fruit and vegetable production and to the development of the model prison.
In the 20th and 21st centuries, the cities that occupy this stretch of Santa Fe's territory have been changing their size and productive activities but what has remained unchanged is their high water vulnerability since they develop in the flood plain of the Paraná River. In its conception, different intervention paradigms have been reflected, some more respectful of the landscape and the natural dynamics and others more aggressive and transformative. The idea of the rhizome is recovered as a resilient structure for the section La Guardia - San Javier (Bertuzzi, 2015), it is argued that this structure is applicable for the Santo Tomé - Coronda stretch and the strategies of anthropization of the landscape are identified, valuing those that suppose a greater resilience, conservation and construction of landscape quality.Mesa 1: Historia de las relaciones entre lo urbano y lo fluvialUniversidad Nacional de La Plata (UNLP) - Facultad de Arquitectura y Urbanismo (FAU
Naturaleza y artefacto: operaciones diversas en la construcción de la ribera del Paraná en el tramo san Javier-Coronda
¿Cómo se construyó la ribera fluvial entre las localidades de San Javier y Coronda en la Provincia de Santa Fe (Argentina)? ¿Tuvo en cuenta su vulnerabilidad hídrica? ¿Es este proceso el resultado de una antropización sustentable? Este territorio es una de las áreas de más antigua ocupación de la provincia de Santa Fe. En el siglo XVI (1573) se establece Santa Fe La Vieja (actual parque arqueológico de Cayastá), la ciudad fundada por Juan de Garay que se trasladó en el siglo XVII a su actual emplazamiento con el nombre de Santa Fe de la Vera Cruz. Esta ciudad fue el epicentro de distintos intentos de domesticación del territorio que incluyen reducciones, fuertes y estancias, situación que terminó confluyendo en el siglo XIX en la creación de colonias agrícolas, o en la conversión de pueblos en colonias. La ciudad de Coronda, por su parte, no fue ajena a este proceso y se definió como un centro poblado, primero vinculado a la pacificación del territorio provincial en el siglo XVIII y, más tarde, a la administración departamental, a la producción frutihortícola y al desarrollo de la cárcel modelo.
En los siglos XX y XXI las ciudades que ocupan esta franja del territorio santafesino han ido cambiando sus dimensiones y actividades productivas pero lo que se ha mantenido inalterado es su alta vulnerabilidad hídrica dado que se desarrollan en la planicie de inundación del río Paraná por lo que, en su concepción, se han reflejado distintos paradigmas de intervención, algunos más respetuosos del paisaje y las dinámicas naturales y otros más agresivos y transformadores. Se recupera aquí la idea del rizoma como estructura resiliente para el tramo La Guardia – San Javier (Bertuzzi, 2015), se sostiene que esa estructura es aplicable para el tramo Santo Tomé – Coronda y se identifican las estrategias de antropización del paisaje, valorizando aquellas que suponen una mayor resiliencia, conservación del mismo y construcción de calidad paisajística.How was the river bank built between the towns of San Javier and Coronda in the Province of Santa Fe (Argentina)? Did it take into account its water vulnerability? Is this process the result of sustainable anthropization? This territory is one of the oldest occupied areas of the province of Santa Fe. In the XVI century (1573) Santa Fe La Vieja (current Cayastá) is established, the city founded by Juan de Garay that moved in the seventeenth century to its current location with the name of Santa Fe de la Vera Cruz.
This city was the epicenter of various attempts to domesticate the territory that include indian reservations, forts and agricultural quarters, situation that ended up coming together in the 19th century in the creation of agricultural colonies, or in the conversion of small villages into colonies.The city of Coronda was not alien to this process and was defined as a populated center, first linked to the pacification of the provincial territory in the 18th century and, later, to the departmental administration, to fruit and vegetable production and to the development of the model prison.
In the 20th and 21st centuries, the cities that occupy this stretch of Santa Fe's territory have been changing their size and productive activities but what has remained unchanged is their high water vulnerability since they develop in the flood plain of the Paraná River. In its conception, different intervention paradigms have been reflected, some more respectful of the landscape and the natural dynamics and others more aggressive and transformative. The idea of the rhizome is recovered as a resilient structure for the section La Guardia - San Javier (Bertuzzi, 2015), it is argued that this structure is applicable for the Santo Tomé - Coronda stretch and the strategies of anthropization of the landscape are identified, valuing those that suppose a greater resilience, conservation and construction of landscape quality.Mesa 1: Historia de las relaciones entre lo urbano y lo fluvialUniversidad Nacional de La Plata (UNLP) - Facultad de Arquitectura y Urbanismo (FAU
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