Hierarchical Spatial Organization of Geographical Networks

In this work we propose the use of a hirarchical extension of the polygonality index as a means to characterize and model geographical networks: each node is associated with the spatial position of the nodes, while the edges of the network are defined by progressive connectivity adjacencies. Through the analysis of such networks, while relating its topological and geometrical properties, it is possible to obtain important indications about the development dynamics of the networks under analysis. The potential of the methodology is illustrated with respect to synthetic geographical networks.Comment: 3 page, 3 figures. A wokring manuscript: suggestions welcome

Evaluation of sealing between abutment and inner connection of cone morse dental implant: microgaps between implant and abutment

Introdução: Aspectos biomecânicos relacionados à adaptação de próteses fixas sobre implantes estão diretamente asso­ciados ao sucesso do tratamento. Objetivo: Avaliar in vitro a presença de microgaps na união formada pelo pilar e a conexão interna do implante dentário Cone Morse. Materiais e método: Dois grupos de implantes foram analisados. O primeiro grupo (n = 16) utilizou materiais (implantes e pilares) do mesmo fabricante, enquanto o segundo grupo (n = 16) utilizou materiais de diferentes fabricantes. Os conjuntos foram enviados para o microscópio eletrônico de varredura, onde foram tomadas as medidas dos microgaps formados entre a conexão do implante e o pilar. Resultados: Os resultados obtidos foram submetidos à avaliação estatística (Mann-Whitney-U) das medidas de dispersão e à tendência central dos valores (desvio padrão e médio). No grupo 1, a média encontrada foi de 5,69 μm e o desvio padrão (SD) foi de 8,46 μm. O grupo 2 apresentou média de 1,24 μm e SD: 0,44 μm. A diferença encontrada foi estatistica­mente significativa (p = 0,002). Conclusão: Dentro da limitação deste estudo, os resultados indicam que o grupo formado por implante e abutment de diferentes fabricantes oferece menores valores de microgaps e, portanto, uma melhor adaptação in vitro de componentes. DESCRITORES | Implantes Dentários; Dente Suporte; Microscopia Eletrônica de Varredura.Introduction: The adaptation of prostheses fixed over implants involves biomechanical aspects that are directly associated with treatment success. Objective: The aim of this in vitro study was to evaluate the presence of microgaps in the abutment/inner connection interface of cone morse dental implants. Materials and methods: Two groups of implants were analyzed. The first group (n = 16) employed single-manufacturer dental implants and abutments, whereas the second group (n = 16) combined multi-manufacturer materials. The sets were analyzed through scanning electron mi­croscopy, wherein microgaps between the implant connection and the abutment were observed. Results: Group 1 had an average microgap of 5.69 μm (SD ± 8.46 μm). Group 2 had an average microgap of 1.24 μm (SD ± 0.44 μm). A significant difference was found between the two groups (p = 0.002). Conclusion: Within the limitations of this study, results suggest that the group formed by multi-manufacturer implants and abutments (group 2) had smaller microgap values, and, therefore, a higher in vitro adaptation of components. DESCRIPTORS | Dental Implants; Dental Abutments; Scanning Electron Microscopy

Conhecimento dos enfermeiros sobre o novo protocolo de ressuscitação cardiopulmonar

Objetivo: Avaliar o conhecimento de enfermeiros sobre o atendimento à parada cardiorrespiratória (PCR), suporte básico e avançado de vida cardiovascular, tendo como base as novas diretrizes de Ressuscitação Cardiopulmonar (RCP) da American Heart Association (AHA) do ano de 2015. Métodos: Trata-se de um estudo descritivo de abordagem quantitativa, realizado no hospital escola de um município do interior de Minas Gerais, através da aplicação de um questionário fechado, elaborado pelas pesquisadoras. Os dados coletados foram processados pelo Statistical Package for the Social Sciences (SPSS) versão 20. Resultados: Participaram do estudo 19 enfermeiros. O número de acertos dos participantes no questionário oscilou entre 0 a 100%, com média de 4,2 e desvio padrão de 3,2. Foi classificado, como conhecimento satisfatório, o número de acertos superior e/ou igual a 70% e o conhecimento insatisfatório, o número inferior a 70%. Apenas 26,4% dos enfermeiros obtiveram conhecimento satisfatório. Conclusão: Constatou-se que enfermeiros não possuem conhecimento satisfatório sobre as mudanças propostas pelas novas diretrizes de RCP da AHA de 2015

XANTOMA ERUPTIVO – RELATO DE CASO

Introduction: eruptive xanthomas are yellowish erythematous papules due to agglomeration of lipids and foam cells in the dermis associated with metabolic disorders. Objectives: report clinical and diagnostics aspects of a case of eruptive xanthoma, as well as associated metabolic changes. Material and Methods: this is a descriptive observational study, a case report. The information was collected through medical records and interview. Taking into account the ethical issues, a free and informed consent form and authorization for the publication of the photos was obtained. Results: a 32-year-old male patient sought UnirG University Center’s dermatology department, in Gurupi-TO, reporting episodic appearance of yellowish papules disseminated throughout his skin. Pleomorphic skin lesions, papules and nodules measuring from 1 to 4 mm, were found on the torso and elbow extensor regions. Histopathological analysis revealed xanthomatous macrophages in the dermis and extracellular accumulations of lymphocytes and lipids compatible with eruptive xanthoma. Biochemical tests showed fasting glycaemia of 360 mg/dL and triglycerides of 1,370 mg/dL. The patient was referred endocrinology department of the same school. Therapy was based on changes in lifestyle associated with lipid-lowering and hypoglycemic agents. After 4 months of treatment there was regression of the condition, endocrine control, and there were no new lesions. Conclusion: despite the benign nature of dermatological lesions, eruptive xanthoma is associated with a high risk factor for cardiovascular and pancreatic diseases due to associated metabolic alterations. Recognition and early treatment are fundamental for prevention of recurrences and more serious complications.  RESUMO Introdução: xantomas eruptivos são pápulas amareladas de base eritematosa por aglomeração de lipídeos e células espumosas na derme associado a transtornos metabólicos.  Objetivo: relatar os aspectos clínicos e diagnósticos de um caso de xantoma eruptivo, assim como, das alterações metabólicas associadas. Material e Métodos: trata-se de um estudo observacional descritivo, relato de caso. As informações foram colhidas através de prontuários e entrevista. Atendendo as questões éticas foi obtido o termo de consentimento livre e esclarecido e autorização para publicação das fotos. Resultados: paciente, sexo masculino, 32 anos, procurou o serviço de dermatologia do Centro Universitário UnirG, Gurupi-To, relatando surgimento episódicos de pápulas amareladas disseminadas na pele. Foram verificadas lesões cutâneas pleomórficas, pápulonodulares de 1 a 4 mm, localizadas em tronco e regiões extensoras. Na análise histopatológica foram observados macrófagos xantomatosos na derme e acúmulos extracelulares de linfócitos e lipídios compatíveis com xantoma eruptivo. Os exames laboratoriais demonstraram glicemia de jejum de 360 mg/dL e triglicérides de 1.370 mg/dL. O paciente foi encaminhado para o ambulatório de endocrinologia do mesmo centro de ensino. A terapêutica foi baseada em mudanças do estilo de vida associado à hipolipemiantes e hipoglicemiantes. Após 4 meses de tratamento houve regressão do quadro, controle endócrino, não havendo surgimento de novas lesões. Conclusão: apesar da benignidade das lesões dermatológicas, o xantoma eruptivo está associado a elevado fator de risco para doenças cardiovasculares e pancreáticas devido a alterações metabólicas associadas. Seu reconhecimento e tratamento precoce são fundamentais para prevenção de recorrências e de complicações mais graves.   Palavras-chave: Xantomatose. Hipertrigliceridemia. Doenças do Sistema Endócrino. ABSTRACT Introduction: eruptive xanthomas are yellowish erythematous papules due to agglomeration of lipids and foam cells in the dermis associated with metabolic disorders. Objectives: report clinical and diagnostics aspects of a case of eruptive xanthoma, as well as associated metabolic changes. Material and Methods: this is a descriptive observational study, a case report. The information was collected through medical records and interview. Taking into account the ethical issues, a free and informed consent form and authorization for the publication of the photos was obtained. Results: a 32-year-old male patient sought UnirG University Center’s dermatology department, in Gurupi-TO, reporting episodic appearance of yellowish papules disseminated throughout his skin. Pleomorphic skin lesions, papules and nodules measuring from 1 to 4 mm, were found on the torso and elbow extensor regions. Histopathological analysis revealed xanthomatous macrophages in the dermis and extracellular accumulations of lymphocytes and lipids compatible with eruptive xanthoma. Biochemical tests showed fasting glycaemia of 360 mg/dL and triglycerides of 1,370 mg/dL. The patient was referred endocrinology department of the same school. Therapy was based on changes in lifestyle associated with lipid-lowering and hypoglycemic agents. After 4 months of treatment there was regression of the condition, endocrine control, and there were no new lesions. Conclusion: despite the benign nature of dermatological lesions, eruptive xanthoma is associated with a high risk factor for cardiovascular and pancreatic diseases due to associated metabolic alterations. Recognition and early treatment are fundamental for prevention of recurrences and more serious complications. Keywords: Xanthomatosis. Hypertriglyceridemia. Endocrine system diseases

Prevenção e controle da contaminação bacteriana de hemocomponentes

Apesar do advento da gentica molecular, terapia celular e automao de procedimentos, a possibilidade de transmisso de infeces por contaminao bacteriana dos componentes do sangue, cresce em importncia, sendo observada como evento adverso transfuso de sangue conhecido como reao transfusional por contaminao bacteriana. Foi verificado durante as anlises realizadas pelo controle de qualidade do Servio de Hemoterapia, que existe uma incidncia varivel de contaminao bacteriana nas bolsas dos hemocomponentes do sangue. Estes dados demonstraram que parte dos pacientes submetidos a transfuses de sangue poderiam estar expostos aos microrganismos presentes nas bolsas de sangue avaliadas como positivas pelo procedimento de cultura e, desta forma, adquirir algum tipo de infeco devido a esta contaminao. Dentre todas as medidas de preveno e controle da contaminao bacteriana de hemocomponentes, merecem destaque, os procedimentos de assepsia adequados do local da puno do brao do doador, assim como, a assepsia das mos, que devem ser habitualmente incorporados em todos os bancos de sangue, alm do uso de luvas descartveis durante a execuo de todas as atividades. Estas medidas visam, no somente, a proteo de todos os profissionais envolvidos, como tambm, evitar o risco de infeces nosocomiais desencadeadas pela contaminao dos hemocompoentes atravs dos microrganismos presentes na pele do doador e tambm, destes profissionais

Utilization of livers donated after circulatory death for transplantation - An international comparison.

BACKGROUND AND AIM Liver graft utilization rates are a hot topic due to the worldwide organ shortage and an increasing number of transplant candidates on waiting lists. Liver perfusion techniques have been introduced in several countries, and may help to increase the organ supply, as they potentially allow the assessment of livers before use. METHODS Liver offers were counted from donation after circulatory death (DCD) donors (Maastricht-type-III) arising during the past decade in eight countries, including Belgium, France, Italy, the Netherlands, Spain, Switzerland, UK, and US. Initial DCD-type-III liver offers were correlated with accepted, recovered and implanted livers. RESULTS A total number of 34`269 DCD livers were offered, resulting in 9`780 liver transplants (28.5%). The discard rates were highest in UK and US, ranging between 70 and 80%. In contrast, much lower DCD liver discard rates, e.g., between 30-40%, were found in Belgium, France, Italy, Spain and Switzerland. In addition, large differences were recognized in the use of various machine perfusion techniques, and in terms of risk factors in the cohorts of implanted livers. For example, the median donor age and functional donor warm ischemia were highest in Italy, e.g., >40minutes, followed by Switzerland, France, and the Netherlands. Importantly, such varying risk profiles of accepted DCD livers between countries did not translate into large differences in five-year graft survival rates, which ranged between 60-82% in this analysis. CONCLUSIONS We highlight a significant number of discarded and consequently unused DCD liver offers. Countries with more routine use of in- and ex-situ machine perfusion strategies showed better DCD utilization rates without compromised outcome. IMPACT AND IMPLICATIONS A significant number of Maastricht type III DCD livers are discarded across Europe and North America today. The overall utilization rate among eight Western countries is 28.5%, but varies significantly between 18.9% and 74.2%. For example, the median DCD III liver utilization in five countries, e.g., Belgium, France, Italy, Switzerland, and Spain is 65%, in contrast to 24% in the Netherlands, UK and US. Despite this, and despite different rules and strategies for organ acceptance and preservation, the one and five-year graft survival remains currently relatively comparable among all participating countries. Factors which impact on DCD liver acceptance rates include the national pre-selections of donors, before the offer is made, as well as cutoffs for key risk factors, including donor age and donor warm ischemia time. In addition, a highly varying experience with modern machine perfusion technology is noticed. In situ and ex situ liver perfusion concepts, and assessment tools for type III DCD livers before transplantation may be one key part for the observed differences in better DCD III utilization

Scoring System Prognostic of Outcome in Patients Undergoing Allogeneic Hematopoietic Cell Transplantation for Myelodysplastic Syndrome

To develop a system prognostic of outcome in those undergoing allogeneic hematopoietic cell transplantation (allo HCT) for myelodysplastic syndrome (MDS)