Dinâmica do agronegócio brasileiro da melancia: produção, consumo e comercialização.

bitstream/CNPH-2009/34420/1/ct_42.pd

Fatores de risco para as infecções relacionadas ao caracter venoso central em terapia intensiva pediátrica

OBJECTIVES: To identify risk factors for short-term percutaneously inserted central venous catheter-related infections in children and to evaluate the accuracy of a mortality score in predicting the risk of infection. METHOD: After reviewing the charts of patients who developed catheter-related infection in a university hospital's pediatric intensive care unit, we conducted a case-controlled study with 51 pairs. Variables related to patients and to catheter insertion and use were analyzed. Risk factors were defined by logistic regression analysis. The accuracy of the Pediatric Risk of Mortality score to discriminate the risk for infection was tested using the Receiver Operating Characteristic curve. RESULTS: Infection was associated with respiratory failure, patient's length of stay, duration of tracheal intubation, insertion of catheter in the intensive care unit and parenteral nutrition. Insertion site (femoral or internal jugular) was unimportant. Multivariate logistic regression analysis identified the following variables. Risk factors included more than one catheter placement (p=0.014) and duration of catheter use (p=0.0013), and protective factors included concomitant antibiotic use (p=0.0005) and an intermittent infusion regimen followed by heparin filling compared to continuous infusion without heparin (p=0.0002). Pediatric Risk of Mortality did not discriminate the risk of infection. CONCLUSIONS: Central parenteral nutrition and central venous catheters should be withdrawn as soon as possible. Femoral vein catheterization carries a risk of infection similar to internal jugular catheterization. The Pediatric Risk of Mortality score should not be used to predict the risk of central catheter-related infections.OBJETIVOS: Identificar fatores de risco para as infecções relacionadas a cateter venoso central de curta permanência, inserido por punção, em crianças e avaliar a eficiência de um escore de mortalidade pediátrica em prever o risco de infecção. MÉTODOS: Revisão dos casos de infecção relacionada a cateter ocorridos na unidade de terapia intensiva pediátrica de um hospital universitário seguida de estudo caso-controle com 51 pares. Foram analisadas variáveis relacionadas aos pacientes e à inserção e utilização dos cateteres, sendo definidos fatores de risco por análise de regressão logística. A eficiência de Pediatric Risk of Mortality em discriminar o risco de infecção foi testada pela curva receiver operating characteristic. RESULTADOS: Foram variáveis associadas à infecção: insuficiência respiratória, duração da internação, tempo de intubação, inserção do cateter na unidade de terapia intensiva e nutrição parentérica. O sítio de inserção foi indiferente quando comparadas as veias jugular interna e femoral. Foram fatores de risco: inserção de mais de um cateter (p=0,014) e tempo de permanência do cateter (p=0,0013). Foram fatores de proteção: uso concomitante de antibióticos (p=0,0005) e infusão intermitente seguida de heparinização quando comparada à infusão contínua sem heparinização (p=0,0002). Pediatric Risk of Mortality não discriminou o risco de infecção. CONCLUSÕES: Deve-se suspender a nutrição parentérica e retirar o cateter venoso central assim que possível. A cateterização da veia femoral implica em risco de infecção semelhante ao da veia jugular interna. O escore Pediatric Risk of Mortality não deve ser utilizado para estimar o risco de infecção relacionada ao cateter venoso central

Risk Factors For Central Venous Catheter-related Infections In Pediatric Intensive Care.

To identify risk factors for short-term percutaneously inserted central venous catheter-related infections in children and to evaluate the accuracy of a mortality score in predicting the risk of infection. After reviewing the charts of patients who developed catheter-related infection in a university hospital's pediatric intensive care unit, we conducted a case-controlled study with 51 pairs. Variables related to patients and to catheter insertion and use were analyzed. Risk factors were defined by logistic regression analysis. The accuracy of the Pediatric Risk of Mortality score to discriminate the risk for infection was tested using the Receiver Operating Characteristic curve. Infection was associated with respiratory failure, patient's length of stay, duration of tracheal intubation, insertion of catheter in the intensive care unit and parenteral nutrition. Insertion site (femoral or internal jugular) was unimportant. Multivariate logistic regression analysis identified the following variables. Risk factors included more than one catheter placement (p=0.014) and duration of catheter use (p=0.0013), and protective factors included concomitant antibiotic use (p=0.0005) and an intermittent infusion regimen followed by heparin filling compared to continuous infusion without heparin (p=0.0002). Pediatric Risk of Mortality did not discriminate the risk of infection. Central parenteral nutrition and central venous catheters should be withdrawn as soon as possible. Femoral vein catheterization carries a risk of infection similar to internal jugular catheterization. The Pediatric Risk of Mortality score should not be used to predict the risk of central catheter-related infections.62537-4

Stratification of the orbit space in gauge theories. The role of nongeneric strata

Gauge theory is a theory with constraints and, for that reason, the space of physical states is not a manifold but a stratified space (orbifold) with singularities. The classification of strata for smooth (and generalized) connections is reviewed as well as the formulation of the physical space as the zero set of a momentum map. Several important features of nongeneric strata are discussed and new results are presented suggesting an important role for these strata as concentrators of the measure in ground state functionals and as a source of multiple structures in low-lying excitations.Comment: 22 pages Latex, 1 figur

Experimental polarization encoded quantum key distribution over optical fibres with real-time continuous birefringence compensation

In this paper we demonstrate an active polarization drift compensation scheme for optical fibres employed in a quantum key distribution experiment with polarization encoded qubits. The quantum signals are wavelength multiplexed in one fibre along with two classical optical side channels that provide the control information for the polarization compensation scheme. This set-up allows us to continuously track any polarization change without the need to interrupt the key exchange. The results obtained show that fast polarization rotations of the order of 40*pi rad/s are effectively compensated for. We demonstrate that our set-up allows continuous quantum key distribution even in a fibre stressed by random polarization fluctuations. Our results pave the way for Bell-state measurements using only linear optics with parties separated by long-distance optical fibres

Computability and Adaptivity in CFD

We give a brief introduction to research on adaptive computational methods for laminar compressible and incompressible flow, and then focus on computability and adaptivity for turbulent incompressible flow, where we present a framework for adaptive finite element methods with duality- based a posteriori error control for chosen output quantities of interest. We show in concrete examples that outputs such as mean values in time of drag and lift of a bluff body in a turbulent flow are computable to a tolerance of a few percent, for a simple geometry using some hundred thousand mesh points, and for complex geometries some million mesh points