Specifična obilježja u pedijatrijskoj traheostomiji - pregledni rad

Surgical tracheostomy is a life-saving procedure performed for emergent or expectant airway compromise. Morbidity in the pediatric population is higher than in adults due to smaller operating field, immaturity of tissues, anatomic specificities of the child’s neck, or the presence of craniofacial dysmorphism. The procedure varies among surgeons regarding the position of the skin incision (vertical or horizontal), resection of the subcutaneous adipose tissue and isthmus of the thyroid gland, use of tracheal flaps, and use of maturation or stay sutures. Both early and late complications can be life-threatening, and include accidental decannulation, stomal plugging, bleeding, and difficult ventilating. Consistent tracheostomal care is crucial in avoiding complications. Primary caregivers must be included and educated about proper stomal care. Decannulation failures are common. Prerequisites for safe decannulation include non-dependence on mechanical ventilation and no recent aspiration events, positive endoscopic airway assessment, and successful daytime capping. The role of polysomnography in decannulation protocols is debated. Although seldom performed, tracheostomy is the procedure of choice in a selected group of pediatric patients. The risks and benefits of the procedure must be weighed for each patient. The education of medical personnel and caregivers is key to reducing serious complications.Kirurška traheotomija je postupak kojim se osigurava dišni put kompromitiran uslijed infektivnih bolesti, traume, tumora ili anomalija dišnih putova. Pobol je veći u pedijatrijskoj populaciji zbog malog operativnog polja, nezrelosti tkiva, anatomskih specifičnosti ili prisutnosti kraniofacijalnih dismorfizama. Procedura varira između kirurga. Ne postoji usuglašeni stav oko pozicije kožne incizije, resekcije supkutanog masnog tkiva i istmusa štitnjače, upotrebe trahealnih režnjeva ili maturacijskih šava. I rane i kasne komplikacije mogu biti životno ugrožavajuće. Najčešće su nenamjerna dekanulacija, začepljenje traheostome sluznim čepovima, krvarenje ili otežana ventilacija. Stalna briga o traheostomi je ključna u sprječavanju komplikacija. Skrbnici moraju biti uključeni i obrazovani o pravilnoj njezi stome. Neuspjele dekanilacije su česte. Preduvjeti za pokušaj dekanilacije su neovisnost o mehaničkoj ventilaciji, endoskopski pregled dišnih putova i toleriranje začepljene kanile tijekom dana. Upotreba polisomnografije u dekanilacijskom protokolu nije ušla u široku primjenu. Iako se rijetko izvodi, traheostomija je postupak izbora za zbrinjavanje dišnog puta u određenim skupinama pedijatrijskih bolesnika. Prednosti i nedostatci moraju se razmotriti za svaki pojedini slučaj. Izobrazba medicinskog osoblja i skrbnika je ključna za smanjenje broja ozbiljnih komplikacija

Diversidade de espécies, variação cariotípica e distribuição dos roedores da Chapada Diamantina, BA

The Chapada Diamantina is a vast mountainous plateau in the interior of Bahia state, with altitudes varying from 400 to 2000m. No systematic mammal survey encompassing the total latitudinal and altitudinal ranges of the Chapada Diamantina was attempted so far. Six expeditions were performed in to a total of 18 different sampling localities, between December/2002 and February/2004. Specimens were captured in Sherman and pit-fall traps, karyotyped and prepared as vouchers deposited in the Museu Nacional, Rio de Janeiro. In addition, specimens previously deposited in mammal's collection in Museu Nacional were also analyzed. A total of 19 species of rodents was registered and 12 of them are new registers for the area. All species were characterized on the basis of cranial morphology and pelage coloration. Karyological studies were performed to 14 species but the diploid and fundamental numbers were given to 18 species recorded. The 19 species can be separated in three main groups. a more widespread one, proper of caatinga and agreste habitats, a second one, composed mainly by forms from more densely forested landscapes, and the third group, which usually occurs in altitudinal fields in the rocky outcrops of higher limits of the Chapada Diamantina. A pattern of latitudinal diversity was also observed. Five of the 19 species registered occurs only above 1000m. The Serra do Sincorá (central region) and Morro do Chapéu (north region) presented the most diverse rodents fauna, considering the specimens collected in our surveys. In addition with the species previously deposited in Museu Nacional, the Serra do Sincorá region is the most diverse. Therefore, three areas were considered as potentially areas for preservation in Chapada Diamantina: Mucugê and Palmeiras located in Serra do Sincorá and Morro do Chapéu.CAPESA Chapada Diamantina é um vasto platô montanhoso localizada no interior do estado da Bahia, com altitudes variando de 400 a 2000m. Nenhum trabalho sistemático sobre a fauna de mamíferos englobando todo o gradiente latitudinal e longitudinal da Chapada Diamantina foi realizado até o momento. Seis coletas foram realizadas em 18 localidades diferentes entre Dezembro/2002 e Fevereiro/2004. Os espécimes foram capturados em armadilhas Sherman e pitfall, cariotipados, preparados e foram depositados no Museu Nacional, Rio de Janeiro. Também foram analisados espécimes anteriormente depositados na Coleção de Mamíferos do Museu Nacional. Um total de 19 espécies foram registradas, sendo que destas, 12 são novos registros para a região. Todas as espécies foram caracterizadas morfologicamente no nível craniano e da morfologia externa. As análises cariotípicas foram realizadas em 14 espécies, sendo que o número diplóide e fundamental foram dados para 18 espécies. As 19 espécies registradas podem ser separadas em três principais grupos em relação ao ambiente. O primeiro, mais amplo, encontrado em habitats de caatinga e agreste, o segundo, composto por espécies que frequentam ambientes mais florestados e o terceiro, característico de altitudes extremas como campos rupestres e formações rochosas. Um padrão de diversidade no gradiente latitudinal também foi observado. Cinco das 19 espécies registradas ocorrem somente em altitudes acima de 1000m. Considerando os roedores coletados neste estudo, a Serra do Sincorá (região central) e Morro do Chapéu (região norte) apresentaram a fauna de roedores mais diversa. Somando com as espécies anteriormente depositadas no Museu Nacional, a Serra do Sincorá passa a ser a mais diversa. Três áreas foram consideradas como potenciais para a preservação, sendo elas localizadas nos municípios de Mucugê e Palmeiras, na Serra do Sincorá e a região de Morro do Chapéu

Sociocultural aspects of political activism: A new model proposal

This paper analyses the correlation between political activism, political participation, and certain value orientations, as crucial parts of modern governance in society today. A sample of the survey were members of the ruling and opposition parties, who were structured by age, place of residence, political affiliation, and role in local parliaments in six cities in Serbia. Results show a mixture of pre-modern (traditional), modern, and postmodern values, with traditional values still being viable, which could be one of the factors that significantly reduces the process of social transition. Socio-demographic variables and value orientations (autocratic-democratic, traditional-modern), along with the aspects of political culture, determine political behaviour to a large extent. The model of political activism, on which the study is based, is the model of socio-economic status. The results of the research suggest that a new, enhanced model should be proposed, entitled socio-cultural model of political activism

Discriminação morfométrica entre Trinomys albispinus (Is. Geoffroy, 1838) e Trinomys minor (Reis & Pessôa, 1995) da Chapada Diamantina, Bahia, Brasil, e o carioótipo de Trinomys albispinus (Rodentia, Echimyidae)

A morphometric discrimination analysis was performed for Trinomys minor (Reis Pessôa, 1995) and Trinomys albispinus (Is. Geoffroy, 1838). The samples used in this study are from localities in the Chapada Diamantina, a vast plateau in central Bahia State, Brazil. A specimen recently obtained near the type-locality of Trinomys minor was allocated to T. albispinus by principal component and discriminant analyses and by qualitative pelage traits. The karyotype of Trinomys albispinus is described on the basis of this specimen as 2n=60, NA=116, with two Nucleolar Organizer Regions (NORs) located in the interstitial region of the long arm of chromosome pair 10. The similarity between this karyotype and that previously published for T. minor is interpreted here as evidence that T. minor and T. albispinus are closely related forms, probably at subspecific level. A pattern of karyological similarity is here documented for other species pairs in the genus in which a close relationship has been revealed by mitochondrial DNA data.Uma análise de discriminação morfométrica foi realizada entre Trinomys albispinus (Is. Geoffroy, 1838) e Trinomys minor (Reis Pessôa, 1995) com base em amostras provenientes da Chapada Diamantina, um vasto platô situado na área central da Bahia. Um espécime recentemente obtido próximo à localidade-tipo de T. minor foi alocado em análises morfométricas multivariadas e em comparações da pelagem à T. albispinus. O cariótipo de Trinomys albispinus é descrito com base neste espécime. Trinomys albispinus apresentou 2n= 60 e NA= 116, e duas regiões organizadoras de nucléolo (RONs) localizadas na região intersticial do braço longo do par cromossômico 10. A similaridade cromossômica entre esse cariótipo e o previamente publicado para T. minor é interpretada aqui como evidência que T. minor e T. albispinus são espécies muito relacionadas, provavelmente em nível subespecífico. Um padrão de similaridade cariotípica é aqui documentado entre outros pares de espécies no gênero onde uma relação filogenética próxima tenha sido revelada por análises de DNA mitocondrial

Mind your Ps: A probabilistic model to aid the interpretation of molecular epidemiology data

Background: Assessing relatedness of pathogen sequences in clinical samples is a core goal in molecular epidemiology. Tools for Bayesian analysis of phylogeny, such as the BEAST software package, have been typically used in the analysis of sequence/time data in public health. However, they are computationally-, time-, and knowledge-intensive, demanding resources that many laboratories do not have available or cannot allocate frequently. Methods: To evaluate a faster and simpler alternative method to support the routine interpretation of sequence data for epidemiology, we obtained sequences for two regions in the measles virus genome, N-450 and MF-NCR, from patient samples of genotypes B3, D4 and D8 taken between 2011 and 2017 in the UK and Romania. A mathematical model incorporating time, possible shared ancestry and the Poisson distribution describing the number of expected substitutions at a given time point was developed to exclude epidemiological relatedness between pairs of sequences. The model was validated against the commonly used Bayesian phylogenetic method using an independent dataset collected in 2017–19. Findings: We demonstrate that our model, using time and sequence information to predict whether two samples may be related within a given time frame, minimises the risk of erroneous exclusion of relatedness. An easy-to-use implementation in the form of a guide and spreadsheet is provided for convenient application. Interpretation: The proposed model only requires a previously calculated substitution rate for the locus and pathogen of interest. It allows for an informed but quick decision on the likelihood of relatedness between two samples within a time frame, without the need for phylogenetic reconstruction, thus facilitating rapid epidemiological interpretation of sequence data.This work was funded by the United Kingdom Health Security Agency (UKHSA). The World Health Orga- nization European Regional Office funded Aurora Fernández-García and Mihaela Lazar training visits to UKHSAS

LEVANTAMENTO DE AGENTES ZOONÓTICOS ENCONTRADOS EM PEQUENOS MARSUPIAIS DA AMÉRICA DO SUL

Zoonoses são doenças que são transmitidas de animais vertebrados para o homem e também do homem para os animais, principalmente quando seu ciclo ecológico é alterado, seja por intervenção natural ou pela intervenção humana. Incluem doenças emergentes e reemergentes distribuí­das mundialmente e de preocupação para a saúde pública, pois causam vários prejuí­zos e mortes na população humana. Estudos revelam que as zoonoses estão ligadas a várias espécies de mamí­feros, incluindo os marsupiais, que atuam como hospedeiros de algumas destas doenças zoonóticas. Apesar da maioria dos estudos se concentrarem em marsupiais didelfí­deos de porte maior, identificamos várias espécies de pequenos marsupiais dos gêneros Monodelphis, Marmosa (Marmosa), Marmosa (Micoureus), Gracilinanus e Thylamys como hospedeiras de agentes zoonóticos causadores de doenças, como toxoplasmose, leishmaniose, tripanossomí­ase, verminoses, coccidiose, arboviroses, microsporidiose, peste negra e fasciolí­ase, na América do Sul, e no Brasil. Algumas destas informações sobre marsupiais como hospedeiros não podem ser recuperadas em função da falta de espécimes testemunhos, aliado  s mudanças taxonômicas ocorridas dentro do grupo

Forensic Fractal Nature Applications

Fractals are fragmented geometric shapes based on each or parts self-similarity. Fractal dimension (FD) is the most important characteristics in fractal nature analysis. There are many fractals applications including the forensic photography. The fractals image reconstruction is very important for modern forensic science. Here we demonstrate the very new original fractal applications in forensic sciences. This is a quite new application in crime investigations specifically in latent fingerprinting within biometric analysis. All of these open a new frontier in falsificates, financial and generally economic crime scene areas

Nanocomposite thin film of Ag nanoparticles embedded in amorphous Al 2 O 3 on optical sensors windows: Synthesis, characterization and targeted application towards transparency and anti-biofouling

Increased motivation for environmental monitoring requires robust and reliable sensors. The present work aims at increasing the service time of optical sensors immersed in riverine waters by decreasing the development of biofouling on their surface. In this aim, nanocomposite coatings composed of metallic silver nanoparticles embedded in an amorphous alumina are co-deposited on sensor glass windows by chemical vapor deposition. Immersion for one week in the Saulx river, France, revealed a threefold decrease of biofouling on their surface compared with untreated glass surfaces while maintaining transparency. Such coatings can be considered as part of integrated tools, including for example mechanical cleaning, to reduce the maintenance of optical sensors immerged in riverine waters