PROTECIONISMO ECONOMICO NOS ESTADOS UNIDOS DA AMÉRICA: BARACK oBAMA VS DONALD TRUMP

O presente trabalho buscou evidenciar as principais diferenças nas políticas econômicas de comércio exterior adotadas pela administração dos presidentes estadunidenses Barack Obama e Donald J. Trump sob ótica do protecionismo econômico. A relevância de tal estudo se justifica pela representatividade que a econômica dos Estados Unidos da América apresentam na economia global. O país possui o maior PIB do mundo de acordo com o FMI. O protecionismo econômico tem origem no século XVII, época em que foi utilizado intensivamente. O conceito criado durante o período absolutista é basicamente o mesmo utilizado nos mercados atuais: são criadas barreiras alfandegárias aos produtos importados, fazendo como que seus preços fiquem elevados, forçando a população à consumir produtos nacionais, mantendo a balança comercial em superávit. Para o levantamento foi realizado uma pesquisa bibliográfica, baseada em dados secundários. As ações de cunho protecionistas de políticas internas de recuperação da economia adotadas durante da gestão de Obama surtiu efeito positivo, fazendo com que a economia estadunidense se recupera-se da crise de 2008 que assolou o país. Desde de 2007 os números da economia sofriam fortes quedas e a taxa de desemprego aumentava. Trump apresenta uma política protecionista muito mais agressiva, entrando em conflito direto com diversos países, até então, parceiros dos EUA. Destaca-se a China em ambos os países protagonizaram uma “guerra fiscal” em que sucessivos aumentos de tributos sobre produtos importados

Comparing four video laryngoscopes and one optical laryngoscope with a standard macintosh blade in a simulated trapped car accident victim

Background. Tracheal intubation still represents the "gold standard" in securing the airway of unconscious patients in the prehospital setting. Especially in cases of restricted access to the patient, video laryngoscopy became more and more relevant. Objectives. The aim of the study was to evaluate the performance and intubation success of four different video laryngoscopes, one optical laryngoscope, and a Macintosh blade while intubating from two different positions in a mannequin trial with difficult access to the patient. Methods. A mannequin with a cervical collar was placed on the driver’s seat. Intubation was performed with six different laryngoscopes either through the driver’s window or from the backseat. Success, C/L score, time to best view (TTBV), time to intubation (TTI), and number of attempts were measured. All participants were asked to rate their favored device. Results. Forty-two physicians participated. 100% of all intubations performed from the backseat were successful. Intubation success through the driver’s window was less successful. Only with the Airtraq® optical laryngoscope, 100% success was achieved. Best visualization (window C/L 2a; backseat C/L 2a) and shortest TTBV (window 4.7 s; backseat 4.1 s) were obtained when using the D-Blade video laryngoscope, but this was not associated with a higher success through the driver’s window. Fastest TTI was achieved through the window (14.2 s) when using the C-MAC video laryngoscope and from the backseat (7.3 s) when using a Macintosh blade. Conclusions. Video laryngoscopy revealed better results in visualization but was not associated with a higher success. Success depended on the approach and familiarity with the device. We believe that video laryngoscopy is suitable for securing airways in trapped accident victims. The decision for an optimal device is complicated and should be based upon experience and regular training with the device

The Effect of Stabilization Procedures on Sports Discipline and Performance Level in Non-Elite Athletes after Acute Syndesmotic Injury: A Prospective Randomized Trial

Colcuc C, Wähnert D, Raimann FJ, et al. The Effect of Stabilization Procedures on Sports Discipline and Performance Level in Non-Elite Athletes after Acute Syndesmotic Injury: A Prospective Randomized Trial. Journal of Clinical Medicine. 2022;11(15): 4609.BACKGROUND: Suture button devices for tibiofibular syndesmosis injuries provide semirigid dynamic stabilization. The effect of stabilization procedures on sports discipline and performance level in non-elite athletes after acute syndesmotic injury has not been clarified in sports medicine research to date.; METHODS: A total of 47 of 56 eligible patients were analyzed and completed the 1-year follow-up. The average age was 35.5 years (range, 18-60 years). The screw fixation and knotless suture button groups comprised 26 and 21 patients, respectively. Nine patients were lost to follow-up. Patients underwent clinical and radiological evaluations preoperatively and twice during the 1-year postoperative follow-up. Function was measured using the FADI sports scale, the FAAM sports module, and a visual analogue scale for pain and function in sports. Questionnaires were completed to assess preoperative and postoperative sports levels and to evaluate the sports discipline.; RESULTS: All scores increased during the follow-up, but no significant differences were found in the FADI score, the FAAM sports module score and or the VAS score for pain and function during sport (p ≤ 0.05). Using Spearman's rank correlation coefficient, we found no significant correlation between the groups for age, injury mechanism, or body mass index. Differences were identified in sports discipline and performance level between the groups during the follow-up period.; CONCLUSION: No statistically significant differences could be demonstrated between the two stabilization methods in terms of return to previous sport level and return to the original sport discipline, so both procedures can be regarded as equivalent at present

Role of POC INR in the early stage of diagnosis of coagulopathy

Background: Acute bleeding requires fast and targeted therapy. Therefore, knowledge of the patient's potential to form a clot is crucial. Point-of-care testing (POCT) provides fast and reliable information on coagulation. Structural circumstances, such as person-bound sample transport, can prolong the reporting of the results. The aim of the present study was to investigate the diagnostic quality and accuracy between POCT INR diagnostics and standard laboratory analysis (SLA) as well as the time advantage between a pneumatic tube and a personal-based transport system. Methods: Two groups of haemorrhagic patients (EG: emergency department; OG: delivery room; each n = 12) were examined in the context of bleeding emergencies using POCT and SLA. Samples were transported via a pneumatic tube system or by a personal transport service. Results: INR results between POCT and SLA showed a high and significant correlation (EG: p < 0.001; OG: p < 0.001). POCT results were reported significantly more quickly (EG: 1.1 vs. 39.6 min; OG: 2.0 vs. 75.0 min; p < 0.001) and required less time for analysis (EG: 0.3 vs. 24.0 min; OG: 0.5 vs. 45.0 min; p < 0.001) compared to SLA. The time for transportation with the pneumatic tube was significantly shorter (8.0 vs. 18.5 min; p < 0.001) than with the personal-based transport system. Conclusion: The results of the present study suggest that POCT may be a suitable method for the emergency diagnosis and may be used as prognostic diagnostic elements in haemotherapy algorithms to initiate targeted haemotherapy at an early point in time

PROTECIONISMO ECONOMICO NOS ESTADOS UNIDOS DA AMÉRICA: BARACK oBAMA VS DONALD TRUMP

O presente trabalho buscou evidenciar as principais diferenças nas políticas econômicas de comércio exterior adotadas pela administração dos presidentes estadunidenses Barack Obama e Donald J. Trump sob ótica do protecionismo econômico. A relevância de tal estudo se justifica pela representatividade que a econômica dos Estados Unidos da América apresentam na economia global. O país possui o maior PIB do mundo de acordo com o FMI. O protecionismo econômico tem origem no século XVII, época em que foi utilizado intensivamente. O conceito criado durante o período absolutista é basicamente o mesmo utilizado nos mercados atuais: são criadas barreiras alfandegárias aos produtos importados, fazendo como que seus preços fiquem elevados, forçando a população à consumir produtos nacionais, mantendo a balança comercial em superávit. Para o levantamento foi realizado uma pesquisa bibliográfica, baseada em dados secundários. As ações de cunho protecionistas de políticas internas de recuperação da economia adotadas durante da gestão de Obama surtiu efeito positivo, fazendo com que a economia estadunidense se recupera-se da crise de 2008 que assolou o país. Desde de 2007 os números da economia sofriam fortes quedas e a taxa de desemprego aumentava. Trump apresenta uma política protecionista muito mais agressiva, entrando em conflito direto com diversos países, até então, parceiros dos EUA. Destaca-se a China em ambos os países protagonizaram uma “guerra fiscal” em que sucessivos aumentos de tributos sobre produtos importados

Prospective Trial to Compare Direct and Indirect Laryngoscopy Using C-MAC PM® with Macintosh Blade and D-Blade® in a Simulated Difficult Airway

Objective. Evaluation of C-MAC PM® in combination with a standard Macintosh blade size 3 in direct and indirect laryngoscopy and D-Blade® in indirect laryngoscopy in a simulated difficult airway. Primary outcome was defined as the best view of the glottic structures. Secondary endpoints were subjective evaluation and assessment of the intubation process. Methods. Prospective monocentric, observational study on 48 adult patients without predictors for difficult laryngoscopy/tracheal intubation undergoing orthopedic surgery. Every participant preoperatively received a cervical collar to simulate a difficult airway. Direct and indirect laryngoscopy w/o the BURP maneuver with a standard Macintosh blade and indirect laryngoscopy w/o the BURP maneuver using D-Blade® were performed to evaluate if blade geometry and the BURP maneuver improve the glottic view as measured by the Cormack-Lehane score. Results. Using a C-MAC PM® laryngoscope, D-Blade® yielded improved glottic views compared with the Macintosh blade used with either the direct or indirect technique. Changing from direct laryngoscopy using a Macintosh blade to indirect videolaryngoscopy using C-MAC PM® with D-Blade® improved the Cormack-Lehane score from IIb, III, or IV to I or II in 31 cases. Conclusion. The combination of C-MAC PM® and D-Blade® significantly enhances the view of the glottis compared to direct laryngoscopy with a Macintosh blade in patients with a simulated difficult airway. Trial Registration Number. This trial is registered under number NCT03403946

Prospective Trial to Compare Direct and Indirect Laryngoscopy Using C-MAC PM® with Macintosh Blade and D-Blade® in a Simulated Difficult Airway

Objective. Evaluation of C-MAC PM® in combination with a standard Macintosh blade size 3 in direct and indirect laryngoscopy and D-Blade® in indirect laryngoscopy in a simulated difficult airway. Primary outcome was defined as the best view of the glottic structures. Secondary endpoints were subjective evaluation and assessment of the intubation process. Methods. Prospective monocentric, observational study on 48 adult patients without predictors for difficult laryngoscopy/tracheal intubation undergoing orthopedic surgery. Every participant preoperatively received a cervical collar to simulate a difficult airway. Direct and indirect laryngoscopy w/o the BURP maneuver with a standard Macintosh blade and indirect laryngoscopy w/o the BURP maneuver using D-Blade® were performed to evaluate if blade geometry and the BURP maneuver improve the glottic view as measured by the Cormack-Lehane score. Results. Using a C-MAC PM® laryngoscope, D-Blade® yielded improved glottic views compared with the Macintosh blade used with either the direct or indirect technique. Changing from direct laryngoscopy using a Macintosh blade to indirect videolaryngoscopy using C-MAC PM® with D-Blade® improved the Cormack-Lehane score from IIb, III, or IV to I or II in 31 cases. Conclusion. The combination of C-MAC PM® and D-Blade® significantly enhances the view of the glottis compared to direct laryngoscopy with a Macintosh blade in patients with a simulated difficult airway. Trial Registration Number. This trial is registered under number NCT03403946