Traumatic Brain Injury Treatment Internationally

Surveying Speech Language Pathologist Around the Worl

Valor del diámetro ecográfico de vena porta en la predicción de varices esofágicas en adultos con cirrosis del hospital Belén de Trujillo

Demostrar que el diámetro ecográfico de vena porta tiene valor en la predicción de varices esofágicas en adultos con cirrosis del Hospital Belén de Trujillo. Material y métodos: Estudio de pruebas diagnósticas, retrospectivo, observacional, en 74 pacientes cirróticos. Se calculó la sensibilidad, especificidad, valor predictivo positivo y negativo. Se aplicó el test de chi cuadrado y área bajo la curva. Resultados: El mejor punto de corte del diámetro ecográfico de vena porta fue 11 milímetros correspondiéndole una sensibilidad, especificidad, valor predictivo positivo y negativo de 83%, 73%, 88%, 65%; respectivamente. El área bajo la curva fue de 0.84. Conclusiones: El punto de corte de 11 milímetros del diámetro ecográfico de vena porta ofrece el mejor perfil predictivo con gran significancia estadística para varices esofágicas en cirróticos. El área bajo la curva calculada le confiere exactitud intermedia.Determine the ability of portal vein diameter to predict esophageal varixs in cirrhotic patients at Trujillo Belen Hospital. Material and methods: Retrospective, observational, diagnosis test study to plicate in 74 cirrhotic patients. We calculated the sensitivity, specificity, positive and negative predictive value to mortality in acute coronary syndrome. We calculated the chi square test and the area under the curve. Results: The best cut off value to portal vein diameter was 11 millimeters and sensibility, specificity, positive and negative predictive value was 83%, 73%, 88%, 65% respectively . The under the curve area were 0.84. Conclusions: The best cut off value of portal vein diameter was 11 millimeters and this offers the better predictive value with a great statistical significance to esophageal varixs in cirrhotic patients. The under the curve area offer an intermedium degree of exactitude.Tesi

Recurring pleural effusion secondary to walled-off pancreatic necrosis

Recurring, exudative, lymphocytic-predominant pleural effusions have not been previously reported in association with walled-off pancreatic necrosis. We present a case of chronic pancreatitis complicated by a large pancreatic fluid collection and recurrent pleural effusion. Endoscopic drainage of the walled-off pancreatic necrosis was the definitive treatment for both fluid collections

Background radiation measurements at high power research reactors

Research reactors host a wide range of activities that make use of the intense neutron fluxes generated at these facilities. Recent interest in performing measurements with relatively low event rates, e.g. reactor antineutrino detection, at these facilities necessitates a detailed understanding of background radiation fields. Both reactor-correlated and naturally occurring background sources are potentially important, even at levels well below those of importance for typical activities. Here we describe a comprehensive series of background assessments at three high-power research reactors, including gamma-ray, neutron, and muon measurements. For each facility we describe the characteristics and identify the sources of the background fields encountered. The general understanding gained of background production mechanisms and their relationship to facility features will prove valuable for the planning of any sensitive measurement conducted therein. (C) 2015 Elsevier B.V. All rights reserved

Biophysical interactions in the Cabo Frio upwelling system, southeastern Brazil

The rising of cold water from deeper levels characterizes coastal upwelling systems. This flow makes nutrients available in the euphotic layer, which enhances phytoplankton production and growth. On the Brazilian coast, upwelling is most intense in the Cabo Frio region (RJ). The basic knowledge of this system was reviewed in accordance with concepts of biophysical interactions. The high frequency and amplitude of the prevailing winds are the main factor promoting the rise of South Atlantic Central Water, but meanders and eddies in the Brazil Current as well as local topography and coast line are also important. Upwelling events are common during spring/summer seasons. Primary biomass is exported by virtue of the water circulation and is also controlled by rapid zooplankton predation. Small pelagic fish regulate plankton growth and in their turn are preyed on by predatory fish. Sardine furnishes an important regional fish stock. Shoreline irregularities define the embayment formation of the Marine Extractive Reserve of Arraial do Cabo making it an area with evident different intensities of upwelled water that harbors high species diversity. Consequently, on a small spatial scale there are environments with tropical and subtropical features, a point to be explored as a particularity of this ecosystem

No evidence of selenosis from a selenium-rich diet in the Brazilian Amazon

Selenium (Se) is an essential element and a well-known anti-oxidant. In the Lower Tapajos River region of the Brazilian Amazon, biomarkers of Se range from normal to very high. The local traditional diet includes important Se sources such as Brazil nuts, chicken, game meat and certain fish species. Some studies have reported alterations in keratin structure, gastrointestinal problems and paresthesia in populations with high Se intake. The objective of the present study was to evaluate cutaneous and garlic odor of the breath signs and sentinel symptoms of Se toxicity (selenosis) in relation to Se status in communities along the Tapajos River. Participants (N = 448), aged 15-87 years, were recruited from 12 communities. Se concentrations were measured in blood (B-Se) and plasma (P-Se) by ICP-MS. A nurse performed an examination of the hair, nails, skin and breath for signs of Se toxicity. Interview-administered questionnaires were used to collect information on socio-demographics, medical history and possible symptoms of Se toxicity. In this population, the median levels of B-Se and P-Se were 228.4 mu g/L (range 103.3-1500.2 mu g/L) and 134.8 mu g/L (range 53.6-913.2 mu g/L) respectively. Although B-Se and P-Se surpassed concentrations considered toxic (B-Se: 1000 mu g/L (U.S. EPA, 2002)), no dermal or breath signs or symptoms of Se toxicity were associated with the biomarkers of Se status. In the present study population, where Se intake is mostly from traditional diet, there is no evidence of selenosis. These findings support the need to re-assess Se toxicity considering factors such as the chemical form of Se exposure, route of exposure (inhaled versus ingested), co-exposures to toxic elements such as mercury. Considering the current food transition towards a western diet in the Amazon, further studies should address the possible association between high Se status and cardiometabolic health in this study population. (C) 2011 Elsevier Ltd. All rights reserved.Canadian Institutes of Health ResearchFundacao de Amparo a Pesquisa do Estado de Sao PauloCanadian Natural Sciences and Engineering CouncilInternational Development Research Centr