Comparação de traqueotomia percutânea precoce e tardia em unidade de terapia intensiva para adultos

ResumoJustificativa e objetivosA traqueotomia percutânea tornou‐se uma boa alternativa para os pacientes com previsão de intubação prolongada em unidades de terapia intensiva. Os benefícios mais importantes da traqueotomia são alta precoce da unidade de terapia intensiva e menos tempo de permanência no hospital. As complicações da intubação intratraqueal prolongada são: lesão da laringe, paralisia das pregas vocais, estenose glótica e subglótica, infecção e lesão traqueal. O objetivo deste estudo foi avaliar as potenciais vantagens da traqueotomia percutânea precoce versus traqueotomia percutânea tardia em unidade de terapia intensiva.MétodosTraqueotomias percutâneas foram realizadas em 158 pacientes em unidade de terapia intensiva para adultos e analisadas retrospectivamente. Os pacientes foram alocados em dois grupos para traqueotomia precoce e tardia, de acordo com o tempo de intubação intratraqueal antes da traqueotomia percutânea. As traqueotomias consideradas precoces foram realizadas nos dias 0‐7 de intubação intratraqueal e as tardias realizadas após o sétimo dia de intubação intratraqueal. Os pacientes com infecção no local da traqueotomia, intubação difícil ou potencialmente difícil, idade inferior a 18 anos, pressão positiva ao final da expiração acima de 10cmH2O e aqueles com diátese hemorrágica ou contagem de plaquetas em 50.000dL−1 foram excluídos do estudo. Os tempos de ventilação mecânica e internação em UTI foram registrados.ResultadosNão houve diferença estatística entre os dados demográficos dos pacientes. Os tempos de ventilação mecânica e de internação em unidade de terapia intensiva do grupo traqueotomia precoce foram menores e a diferença foi estatisticamente significativa (p<0,05).ConclusãoTraqueotomia precoce reduz o tempo de ventilação mecânica e de internação em unidade de terapia intensiva. Portanto, sugerimos a traqueotomia precoce em pacientes com suspeita de intubação prolongada.AbstractBackground and objectivesPercutaneous tracheotomy has become a good alternative for patients thought to have prolonged intubation in intensive care units. The most important benefits of tracheotomy are early discharge of the patient from the intensive care unit and shortening of the time spent in the hospital. Prolonged endotracheal intubation has complications such as laryngeal damage, vocal cord paralysis, glottic and subglottic stenosis, infection and tracheal damage. The objective of our study was to evaluate potential advantages of early percutaneous tracheotomy over late percutaneous tracheotomy in intensive care unit.MethodsPercutaneous tracheotomies applied to 158 patients in adult intensive care unit have been analyzed retrospectively. Patients were divided into two groups as early and late tracheotomy according to their endotracheal intubation time before percutaneous tracheotomy. Tracheotomies at the 0–7th days of endotracheal intubation were grouped as early and after the 7th day of endotracheal intubation as late tracheotomies. Patients having infection at the site of tracheotomy, patients with difficult or potential difficult intubation, those under 18 years old, patients with positive end‐expiratory pressure above 10cmH2O and those with bleeding diathesis or platelet count under 50,000dL‐1 were not included in the study. Durations of mechanical ventilation and intensive care stay were noted.ResultsThere was no statistical difference among the demographic data of the patients. Mechanical ventilation time and time spent in intensive care unit in the group with early tracheotomy was shorter and the difference was statistically significant (p<0.05).ConclusionEarly tracheotomy shortens mechanical ventilation duration and intensive care unit stay. For that reason we suggest early tracheotomy in patients thought to have prolonged intubation

Strategy planning for collaborative humanoid soccer robots based on principle solution

The final publication is available at Springer via http://dx.doi.org/10.1007/s11740-012-0416-4[EN] Collaborative humanoid soccer robots are currently under the lime light in the rapidly advancing research area of multi-robot systems. With new functionalities of software and hardware, they are becoming more versatile, robust and agile in response to the changes in the environment under dynamic conditions. This work focuses on a new approach for strategy planning of humanoid soccer robot teams as in the RoboCup Standard Platform League. The key element of the approach is a holistic system model of the principle solution encompassing various strategies of a soccer robot team. The benefits of the model-based approach are twofold¿it enables intuitive behavioral specification of the humanoid soccer robots in line with the team strategies envisaged by the system developers, and it systematizes the realization of their collaborative behaviors based on the principle solution. The principle solution is modeled with the newly developed specification technique CONSENS for the conceptual design of mechatronic and self-optimizing systems.The specification technique CONSENS was developed in the course of the Collaborative Research Center 614 ‘‘Self-Optimizing Concepts and Structures in Mechanical Engineering’’ funded by the German Research Foundation (DFG) under grant number SFB 614. The first two authors are funded by the Ministry of Higher Education Malaysia under the grant number 600-RMI/ST/ FRGS 5/3/Fst (256/2010) and 600-RMI/ERGS 5/3 (23/2011).Low, CY.; Aziz, N.; Aldemir, M.; Dumitrescu, R.; Anacker, H.; Mellado Arteche, M. (2013). Strategy planning for collaborative humanoid soccer robots based on principle solution. Production Engineering. 7(1):23-34. https://doi.org/10.1007/s11740-012-0416-4S233471Asada M, Kitano H (1999) The RoboCup challenge. Rob Auton Syst 29:3–12Spaan MTJ, Groen FCA (2002) Team coordination through roles, positioning and coordinated procedures. RoboCupLau N, Lopes LS, Corrente G, Nelson F (2009) Multi-robot team coordination through roles, positionings and coordinated procedures. In: 2009 IEEE/RSJ international conference on intelligent robots and systems, October 11–15, St. Louis, USAIocchi L, Nardi D, Piaggo M, Sgorbissa A (2003) Distributed coordination in heterogeneous multi-robot systems. Auton Robots 15:155–168Almeida F, Lau N, Reis LP (2010) A survey on coordination methodologies for simulated robotic soccer teams, multi-agent logics, languages, and organisations federated workshops (MALLOW 2010). Lyon, FranceLückel J, Hestermeyer T, Liu-Henke X (2001) Generalization of the Cascade principle in view of structured form of mechatronic systems. In: IEEE/ASME international conference on advanced intelligent mechatronics (AIM 2001), Villa Olmo, Como, ItalyInternational Council on Systems Engineering (INCOSE) (2007) Systems engineering vision 2020. Incose-TP-2004-004-02, SeptemberGausemeier J, Frank U, Donoth J, Kahl S (2009) Specification technique for the description of self-optimizing mechatronic systems. Res Eng Des 20(4):201–223Cyberbotics Ltd., Webots overview. 20 September 2012 at http://www.cyberbotics.com/overviewBirkhofer H (1980) Analyse und Synthese der FunktionenTechnischerProdukte. Dissertation, TechnischeUniversitätBraunschweigLanglotz G (2000) Ein Beitrag zur Funktionsstrukturentwicklung Innovativer Produkte. Dissertation, Institut fuerr Rechneranwendung in Planung und Konstruktion, Universitaet Karlsruhe, Shaker-Verlag, Band 2/2000, AachenPostel J (1980) User Datagram Protocol. RFC 760, USC/Information Sciences Institut

Türkiye'deki Vahşi Kuşlarda Neospora caninum DNA'sının Varlığı

OBJECTIVE: Neospora caninum is a protozoon parasite that has a worldwide distribution and mainly causes abortion in cattle and current serological evidence shows that the disease may be also zoonotic. Wild birds play a role as a reservoir of the disease in nature. The study aimed to determine the prensence of N. caninum in wild birds. METHODS: In this study, the presence of neosporosis in wild birds (n=55) including 22 different species found in the western side of Turkey, was investigated by polymerase chain reaction (PCR). In addition, PCR positive samples were confirmed by sequencing, BLAST, and phylogenetic analysis using MEGA7. RESULTS: Obtained results showed that the presence of N. caninum DNA was 5.45% (3/55) in brain-heart homogenates wild birds. The bird species which were found positive for N. caninum were little owl (Athene noctua), common buzzard (Buteo buteo), and little tern (Sternula albifrons). According to phylogenetic analysis and BLAST, all samples were compatible with reference N. caninum isolates. CONCLUSION: To the best of authors' knowledge, this is the first study detecting N. caninum in little tern. In future studies, it may be interesting to investigate the prevalence of N. caninum in other wild animals to elucidate the transmission properties.Amaç: Neospora caninum, dünya çapında dağılım gösteren ve esas olarak sığırlarda düşüklere neden olan protozoon bir parazittir ve güncel serolojik kanıtlar hastalığın zoonotik olabileceğini göstermektedir. Yabani kuşlar, doğada hastalığın rezervuarı olarak rol oynamaktadır. Çalışma, yabani kuşlarda N. caninum varlığının belirlenmesini amaçladı. Yöntemler: Bu çalışmada, Türkiye’nin batısındaki 22 farklı yabani kuşta (n=55) neosporosis varlığı polimeraz zincir reaksiyon (PZR) ile araştırılmıştır. Ek olarak, PZR pozitif örnekler sekanslanarak MEGA7 kullanılarak BLAST ve filogenetik analiz ile doğrulanmıştır. Bulgular: Elde edilen sonuçlara göre, yabani kuşların beyin-kalp homojenatlarının %5,45’inde (3/55) N. caninum DNA’sı saptanmıştır. Kukumav (Athene noctua), bayağı şahin (Buteo buteo) ve küçük sumru (Sternula albifrons) N. caninum pozitif bulunan kuş türleridir. Filogenetik analiz ve BLAST sonuçlarına göre, tüm örnekler referans N. caninum izolatları ile uyumlu olarak tespit edilmiştir. Sonuç: Yazarların bildiği kadarıyla bu çalışma, küçük sumruda N. caninum tespit eden ilk çalışmadır. Gelecekteki çalışmalarda N. caninum bulaşma özelliklerini aydınlatmak amacıyla diğer vahşi hayvanlarda prevalansın araştırılması faydalı olabilir. Anahtar Kelimeler: Küçük sumru, Neospora caninum, PZR, Türkiye, vahşi kuşlar

The impact of vitamin E supplementation on semen parameters and pregnancy rates after varicocelectomy: a randomised controlled study

In this study, we aimed to investigate the impact of vitamin E supplementation on semen parameters and pregnancy after varicocelectomy. Forty-five infertile male patients who were diagnosed with varicocele and underwent subinguinal varicocelectomy were included in the study. After performing subinguinal varicocelectomy, the patients were randomised into two groups: 22 receiving vitamin E for 12 months, and 23 as the control group without receiving any supplementation. The pre-operative parameters of semen analyses and pregnancy rates of both groups were compared with those of post-operative parameters. There were no statistically significant differences between the groups in terms of sperm count and motile sperm percentage, in pre-operative, post-operative 3rd month, post-operative 6th month and post-operative 12th month periods. Repeated-measures anova was performed, and sperm count, percentage of change in sperm count, motile sperm count and percentage of change in motile sperm count of the groups were compared. The administration of vitamin E increased all of these parameters; however, they were not found to be statistically significant. In conclusion, vitamin E supplementation might improve the sperm parameters after varicocelectomy; however, further studies including larger number of samples are needed to make a proper decision on vitamin E supplementation after varicocelectomy

Peningkatan Nilai Kalori pada Batubara Lignit dengan Metode Aglomerasi Air dan Minyak Sawit pada PT. Indonesia Power Ujp Pltu Barru

Penggunaan batubara di PLTU sangat bergantung kepada kualitas batubara yang digunakan, karena semakin tinggi kualitas batubara maka akan memaksimalkan pembakaran dan secara langsung akan berdampak pada produksi listrik yang dihasilkan. Penelitian ini bertujuan untuk mengetahui peningkatan nilai kalori pada batubara lignit. Pada penelitian ini digunakan metode aglomerasi dengan media air dan minyak sawit yang pada setiap sampel diberi perlakukan yang sama namun mengalami peningkatan yang berbeda. Ada tiga sampel yang digunakan pada penelitian ini dimana pada setiap sampel memiliki komposisi batubara lignit seberat 1 gram, minyak sawit sebanyak 10,20,30 ml dan air sebanyak 100 ml. Hasil penelitian ini menunjukkan bahwa semakin banyak konsentrasi minyak maka semakin tinggi kadar karbon yang diikat, sehingga dapat meningkatkan nilai kalori batubara. Dilihat dari konsentrasi 30% pada setiap sampel batubara mengalami peningkatan nilai kalori yang sebelumnya 3.765,23 cal/gr menjadi 5.279,46 cal/gr pada sampel pertama, 3.567,44 cal/gr menjadi 4.989,07 cal/gr pada sampel kedua dan 4.026,07 cal/gr menjadi 5.166,98 cal/gr pada sampel ketiga. Dari hasil penelitian ini dapat disimpulkan bahwa batubara lignit yang digunakan di PLTU dapat ditingkatkan nilai kalorinya menggunakan metode aglomerasi air dan minyak sawit

Saç-iplik turnike sendromu

Saç-iplik turnike sendromu, el veya ayak parmakları, nadiren penis veya klitorise saç veya iplik dolanması sonucunda dolaşım bozukluğuna yol açan, sanıldığından daha sık görülen bir sendromdur. Bu yazıda, sağ ayak parmağında saç kılı dolanması sonucu kızarıklık ve şişlik fark edilerek kliniğimize başvuran, nekroz gelişmeden başarılı bir şekilde tedavi edilmiş dört aylık kız olgu sunmaktayız