NUTRIÇÃO ARTIFICIAL NO DOENTE CRÍTICO

Introdução: O suporte nutricional tem papel importan- te no tratamento dos doentes internados em Unidades de Cuidados Intensivos (UCI). O objetivo deste trabalho foi avaliar a carga calórica fornecida aos doentes críticos, con- siderando o impacto da carga calórica “secundária” (não nutricional) e a teoria da “Subnutrição permissiva”. Obje- tivos: Avaliar a carga calórica fornecida aos doentes inter- nados em Unidades de Cuidados Intensivos. Material e métodos: Estudo transversal analítico realizado em 6 dife- rentes Unidades de Cuidados Intensivos em doentes inter- nados mais de 5 dias. Resultados: 153 doentes, idade 58,18 ± 18,47 anos, sendo do foro médico (22,88%), cirúrgico (21,56%), neurocirúrgico (28,76%) e trauma (26,80%). Internados durante 14,54 ± 9,05 dias, com SOFA de 6,95 ± 3.23 e IMC de 24,57 ± 3,84. A mortalidade foi de 32,03%. Foram fornecidos 12,3 ± 8,4 kcal/kg/dia, com evolução gradativa nos 10 primeiros dias. A carga calórica secundária decresceu, apresentando impacto no valor calórico global somente até ao 2o dia de internamento. Os doentes do foro médico atingiram mais precocemente os objetivos nutricio- nais. A carga calórica secundária teve maior impacto nos pacientes cirúrgicos. Numa fase imediata e intermediária os doentes receberam um aporte calórico significativamente superior ao modelo de Wilmore, enquanto que na fase final o aporte foi significativamente inferior. Discussão: A sub- nutrição encontrada revelou-se diferente do conceito de subnutrição permissiva de Wilmore, provavelmente devido à desvalorização do peso, do bom estado nutricional na admissão, ou à própria gravidade desses doentes, colocan- do a terapia nutricional em segundo plano. Conclusão: Este estudo vem realçar a dificuldade que existe em fornecer um suporte nutricional adequado aos doentes internados em Unidades de Cuidados Intensivos

Native larval parasitoids (Hymenoptera) of Frugivorous Tephritoidea (Kiptera) in South Pantanal, Brazil.

El objetivo de este estudio es evaluar la incidencia de los parasitoides (Hymenoptera) sobre larvara de tephritidae (moscas de la fruta) y los Lonchacidae frugivoros, en varias especies frutiferas nativas y exoticas en el Pantal sur Mato Grosso do Sul, Brasil. Noventa Y dos especies de frutas de 36 familias y 22 órdenes fueron evaluadas..

Percutaneous retrieval of foreign bodies from the cardiovascular system

We report our experience of seven patients referred to our hospital with foreign bodies embolized in the cardiovascular system, namely fragmented catheters and devices used in interventional techniques, which were retrieved by a percutaneous approach. The patients' ages ranged from 2 to 29 years, with a mean age of 17. The majority (57%) were male. The retrieval equipment used included a pigtail catheter, multipurpose catheter with hand-prepared snare, Amplatz gooseneck snare, nitinol multisnare set and basket catheter. The foreign bodies were successfully removed percutaneously in all cases, with no complications

An analysis of helium primordial nucleosynthesis with a variable cosmological coupling

The synthesis of helium in the early Universe depends on many input parameters, including the value of the gravitational coupling during the period when the nucleosynthesis takes place. We compute the primordial abundance of helium as function of the gravitational coupling, using a semi-analytical method, in order to track the influence of $G$ in the primordial nucleosynthesis. To be specific, we construct a cosmological model with varying $G$, using the Brans-Dicke theory. The greater the value of $G$ at nucleosynthesis period, the greater the abundance of helium predicted. Using the observational data for the abundance of the primordial helium, constraints for the time variation of $G$ are established

Correlation of Helicobacter pylori genotypes with gastric histopathology in the central region of a South-European country

BACKGROUND: Outcome of Helicobacter pylori (H. pylori) infection results from interaction of multiple variables including host, environmental and bacterial-associated virulence factors. AIM: This study aimed to investigate the correlation of cagA, cagE, vacA, iceA and babA2 genotypes with gastric histopathology and disease phenotype in the central region of a South-European country. METHODS: This prospective study involved 148 infected patients (110 female; mean age 43.5 ± 13.4 years) submitted to endoscopy with corpus and antrum biopsies. H. pylori was cultured and DNA extracted from the isolates. Genotypes were determined by PCR. Histopathological features were graded according to the updated Sydney system and OLGA/OLGIM classification. Only patients with single H. pylori genotypes and complete histopathological results were included. RESULTS: Antrum samples presented higher degrees of atrophy, intestinal metaplasia, chronic inflammation and neutrophil activity. Genotype distribution was as follows: cagA-31.8 %; cagE-45.9 %; vacA s1a-24.3 %; vacA s1b-19.6 %; vacA s1c-0.7 %; vacA s2-55.4 %; vacA m1-20.9 %; vacA m2-79.1 %; vacA s1m1-18.9 %; vacA s1m2-25.7 %; vacA s2m1-2 %; vacA s2m2-53.4 %; iceA1-33.8 %; iceA2-66.2 %; babA2-12.2 %. CagA genotype was significantly associated with higher degrees of intestinal metaplasia, neutrophil activity, chronic inflammation and OLGIM stages. BabA2 was linked with higher H. pylori density. Strains with vacA s1m1 or vacA s1m1 + cagA positive genotypes had a significant association with peptic ulcer and vacA s2m2 with iron-deficient anemia. CONCLUSIONS: cagA, vacA s1m1 and babA2 genotypes are relatively rare in the central region of Portugal. cagA-positive strains are correlated with more severe histopathological modifications. This gene is commonly associated with vacA s1m1, and such isolates are frequently found in patients with peptic ulcer.info:eu-repo/semantics/publishedVersio

First fossil of an oestroid fly (Diptera: Calyptratae: Oestroidea) and the dating of oestroid divergences

Calyptrate flies include about 22,000 extant species currently classified into Hippoboscoidea (tsetse, louse, and bat flies), the muscoid grade (house flies and relatives) and the Oestroidea (blow flies, bot flies, flesh flies, and relatives). Calyptrates are abundant in nearly all terrestrial ecosystems, often playing key roles as decomposers, parasites, parasitoids, vectors of pathogens, and pollinators. For oestroids, the most diverse group within calyptrates, definitive fossils have been lacking. The first unambiguous fossil of Oestroidea is described based on a specimen discovered in amber from the Dominican Republic. The specimen was identified through digital dissection by CT scans, which provided morphological data for a cladistic analysis of its phylogenetic position among extant oestroids. The few known calyptrate fossils were used as calibration points for a molecular phylogeny (16S, 28S, CAD) to estimate the timing of major diversification events among the Oestroidea. Results indicate that: (a) the fossil belongs to the family Mesembrinellidae, and it is identified and described as Mesembrinella caenozoica sp. nov.; (b) the mesembrinellids form a sister clade to the Australian endemic Ulurumyia macalpinei (Ulurumyiidae) (McAlpine’s fly), which in turn is sister to all remaining oestroids; (c) the most recent common ancestor of extant Calyptratae lived just before the K–Pg boundary (ca. 70 mya); and (d) the radiation of oestroids began in the Eocene (ca. 50 mya), with the origin of the family Mesembrinellidae dated at ca. 40 mya. These results provide new insight into the timing and rate of oestroid diversification and highlight the rapid radiation of some of the most diverse and ecologically important families of flies. ZooBank accession number–urn:lsid:zoobank.org:pub:0DC5170B-1D16-407A-889E-56EED3FE3627.publishedVersio

On a parabolic strongly nonlinear problem on manifolds

In this work we will prove the existence uniqueness and asymptotic behavior of weak solutions for the system (*) involving the pseudo Laplacian operator and the condition $\displaystyle\frac{\partial u}{\partial t} + \sum_{i=1}^n \big|\frac{\partial u}{\partial x_i}\big|^{p-2}\frac{\partial u}{\partial x_i}\nu_i + |u|^{\rho}u=f$ on $\Sigma_1$, where $\Sigma_1$ is part of the lateral boundary of the cylinder $Q=\Omega \times (0,T)$ and $f$ is a given function defined on $\Sigma_1$