332 research outputs found
Comparación entre la gravedad del paciente y la carga de trabajo de la enfermería antes y después de la ocurrencia de eventos adversos en ancianos con cuidados críticos
Indexación: Scopus.Objective: to compare the patient severity and the nursing workload before and after the occurrence of moderate and severe adverse events in elderly hospitalized at intensive care units. Method: comparative study developed at nine intensive therapy units of a University Hospital in São Paulo. The events were collected from the patient histories and classified as moderate and severe according to the World Health Organization. For the severity analysis, the Simplified Acute Physiologic Score II was used and, for the workload analysis, the Nursing Activities Score was applied 24 hours before and after the moderate and severe event. The t-test with 5% significance was used to compare the mean clinical severity and workload scores before and after the event. Results: the sample consisted of 315 elderly, 94 (29.8%) of whom were victims of moderate and severe events at the units. Among the 94 events, the clinical process and procedure type was predominant (40.0%). The installation and maintenance of therapeutic artifacts and catheters were the prevalent interventions that resulted in moderate (76.5%) physiopathological damage (66.0%). The mean workload score (75.19%) dropped 24 hours after the occurrence of the event (71.97%, p=0.008), and the severity, represented by the probability of death, increased from 22.0% to 29.0% after the event (p=0.045). Conclusion: in the patient safety context, the identification of the changes in clinical conditions and the nursing workload in elderly victims of events supports the prevention of these occurrences. © 2018, Universidade Federal de Santa Catarina. All rights reserved.Objetivo:
comparar a gravidade do paciente e a carga de trabalho de enfermagem antes e após a ocorrência de evento adverso moderado e grave em idosos internados em unidades de terapia intensiva.
Método:
estudo comparativo, realizado em nove unidades de terapia intensiva de um Hospital Universitário de São Paulo. Os eventos foram coletados dos prontuários dos pacientes e classificados em moderados e graves segundo a Organização Mundial de Saúde. A análise da gravidade foi realizada segundo o Symplified Acute Phsiologic Score II e a carga de trabalho segundo o Nursing Activities Score, 24 horas antes e depois do evento moderado e grave. O teste t, com significância de 5%, foi utilizado para a comparação das médias da gravidade clínica e da carga de trabalho, antes e após o evento.
Resultados:
a amostra foi composta por 315 idosos, sendo que 94 (29,8%) sofreram eventos moderados e graves nas unidades. Dos 94 eventos, predominou o tipo processo clínico e procedimento (40,0%). A instalação e manutenção de artefatos terapêuticos e cateteres foram as intervenções prevalentes que resultaram em danos fisiopatológicos (66,0%), de grau moderado (76,5%). A média de pontuação da carga de trabalho (75,19%) diminuiu 24 horas após a ocorrência do evento (71,97%, p=0,008) e, a gravidade, representada pela probabilidade de morte, aumentou de 22,0% para 29,0% depois do evento (p=0,045).
Conclusão:
no contexto da segurança do paciente, a identificação das alterações nas condições clínicas e na carga de trabalho de enfermagem em idosos que sofrem eventos subsidiam a prevenção dessas ocorrências.Objetivo:
comparar la gravedad del paciente y la carga de trabajo en enfermería antes y después de ocurrir un evento adverso moderado y grave en ancianos internados en unidades de terapia intensiva.
Método:
estudio comparativo realizado en nueve unidades de terapia intensiva de un Hospital Universitario de São Paulo. Los eventos fueron obtenidos a través de los prontuarios de los pacientes y clasificados en moderados y graves según la Organización Mundial de la Salud. El análisis sobre la gravedad fue realizado de acuerdo al Symplified Acute Physiologic Score II y la carga de trabajo se hizo conforme al Nursing Activities Score, 24 horas antes y después del evento moderado y grave. El test t, con una significancia del 5%, fue utilizado para la comparación de los promedios de la gravedad clínica y de la carga de trabajo antes y después del evento.
Resultados:
la muestra incluyó 315 ancianos, siendo que 94 (29,8%) sufrieron eventos moderados y graves en las unidades. De los 94 eventos, predominó el tipo de proceso clínico y el procedimiento (40,0%). La instalación y mantenimiento de artefactos terapéuticos y catéteres fueron las intervenciones prevalentes que resultaron en daños fisiopatológicos (66,0%) y de grado moderado (76,5%). El promedio de puntuación de la carga de trabajo (75,19%) disminuyó 24 horas después de ocurrido el evento (71,97%, p=0,008) y la gravedad, representada por la probabilidad de muerte, aumentó de 22,0% para 29,0% después del evento (p=0,045).
Conclusion:
en el contexto de seguridad del paciente, la identificación de las alteraciones en las condiciones clínicas y en la carga de trabajo de enfermería en los ancianos que sufren eventos subsidia la prevención de tales ocurrencias.http://ref.scielo.org/wcg6x
Gene trio signatures as molecular markers to predict response to doxorubicin cyclophosphamide neoadjuvant chemotherapy in breast cancerpatients
In breast cancer patients submitted to neoadjuvant chemotherapy (4 cycles of doxorubicin and cyclophosphamide, AC), expression of groups of three genes (gene trio signatures) could distinguish responsive from non-responsive tumors, as demonstrated by cDNA microarray profiling in a previous study by our group. In the current study, we determined if the expression of the same genes would retain the predictive strength, when analyzed by a more accessible technique (real-time RT-PCR). We evaluated 28 samples already analyzed by cDNA microarray, as a technical validation procedure, and 14 tumors, as an independent biological validation set. All patients received neoadjuvant chemotherapy (4 AC). Among five trio combinations previously identified, defined by nine genes individually investigated (BZRP, CLPTM1,MTSS1, NOTCH1, NUP210, PRSS11, RPL37A, SMYD2, and XLHSRF-1), the most accurate were established by RPL37A, XLHSRF-1based trios, with NOTCH1 or NUP210. Both trios correctly separated 86% of tumors (87% sensitivity and 80% specificity for predicting response), according to their response to chemotherapy (82% in a leave-one-out cross-validation method). Using the pre-established features obtained by linear discriminant analysis, 71% samples from the biological validation set were also correctly classified by both trios (72% sensitivity; 66% specificity). Furthermore, we explored other gene combinations to achieve a higher accuracy in the technical validation group (as a training set). A new trio, MTSS1, RPL37 and SMYD2, correctly classified 93% of samples from the technical validation group (95% sensitivity and 80% specificity; 86% accuracy by the cross-validation method) and 79% from the biological validation group (72% sensitivity and 100% specificity). Therefore, the combined expression of MTSS1, RPL37 and SMYD2, as evaluated by real-time RT-PCR, is a potential candidate to predict response to neoadjuvant doxorubicin and cyclophosphamide in breast cancer patients
Evaluation of the AR4 CMIP3 and the AR5 CMIP5 model and projections for precipitation in northeast Brazil
This article compares the sensitivity of IPCC CMIP3-AR4 and CMIP5-AR5 models used on the latest reports from the Intergovernmental Panel on Climate Change (IPCC) in representing the annual average variations (austral summer and autumn) on three regions in Northeastern Brazil (NNEB) for the periods 1979–2000 using the CMAP (Climatology Merged Analysis of Precipitation) data as reference. The three areas of NNEB chosen for this analysis were the semiarid, eastern, and southern regions. The EOF analysis was performed to investigate how the coupled models resolve the temporal variability of the spatial modes in the Tropical Atlantic Sea Surface Temperature (SST), which drives the interannual variations of the rainfall in the Northeastern Brazil. CMIP3-AR4 and CMIP5-AR5 models presented a good representation of the annual cycle of precipitation. Results from correlation and mean absolute error analysis indicate that both CMIP3 and CMIP5 models produce large errors and barely capture the interannual rainfall variance during austral summer and autumn in Northeast Brazil, this features is closely related to the poor representation of the modes of SST variability in the Tropical Atlantic Ocean. For the summer and autumn rainfall projections (2040–2070) in the semiarid region, there was no convergence between the CMIP3 and CMIP5 models. During the summer and autumn in the eastern sector, both the CMIP3 and CMIP5 models projected rainfall above the mean for the 2040–2070 period
Induction of a gloverin-like antimicrobial polypeptide in the sugarcane borer Diatraea saccharalis challenged by septic injury
Diatraea saccharalis (Fabricius, 1794) (Lepidoptera: Crambidae) is an important pest for Brazilian sugarcane. In the present study, we detected two distinct spots in hemolymph from septic injured larvae (HDs1 and HDs2), which are separated by 2DE gel electrophoresis. Both spots were subjected to in-gel tryptic digestion and MALDI-TOF/TOF analysis, which revealed the sequence VFGTLGSDDSGLFGK present in both HDs1 and HDs2. This sequence had homology and 80% identity with specific Lepidoptera antimicrobial peptides called gloverins. Analyses using the ImageMaster 2D software showed pI 8.94 of the HDs1 spot, which is similar to that described to Hyalophora gloveri gloverin (pI 8.5). Moreover, the 14-kDa molecular mass of the spot HDs1 is compatible to that of gloverins isolated from the hemolymph of Trichoplusia ni, Helicoverpa armigera and H. gloveri. Antimicrobial assays with partially purified fractions containing the HDs1 and HDs2 polypeptides demonstrated activity against Escherichia coli. This is the first report of antimicrobial polypeptides in D. saccharalis, and the identification of these peptides may help in the generation of new strategies to control this pest
Search for fingerprints of disoriented chiral condensates in cosmic ray showers
Although the generation of disoriented chiral condensates (DCCs), where the
order parameter for chiral symmetry breaking is misaligned with respect to the
vacuum direction in isospin state, is quite natural in the theory of strong
interactions, they have so far eluded experiments in accelerators and cosmic
rays. If DCCs are formed in high-energy nuclear collisions, the relevant
outcome are very large event-by-event fluctuations in the neutral-to-charged
pion fraction. In this note we search for fingerprints of DCC formation in
observables of ultra-high energy cosmic ray showers. We present simulation
results for the depth of the maximum () and number of muons on the
ground, evaluating their sensitivity to the neutral-to-charged pion fraction
asymmetry produced in the primary interaction.Comment: 7 pages, 4 figure
Densidade da madeira de árvores em savanas do norte da Amazônia brasileira
Densidade da madeira (DM) é uma variável importante para estimativas de estoques de carbono arbóreo em ecossistemas terrestres. Este tema é pobremente investigado em áreas de savana da Amazônia brasileira. O objetivo deste estudo foi investigar a DM das oito principais espécies arbóreas que ocorrem na savana aberta de Roraima, a maior área de savana do norte do bioma Amazônia. Foram verificadas as variações na DM em função da espécie e dos diferentes diâmetros observados ao longo da dimensão vertical de 75 indivíduos amostrados em seis sítios de coleta. Foi utilizado o método direto para obtenção de peças de madeira do fuste e da copa. Os resultados indicaram discrepância significativa interespecífica, sendo Roupala montana Aubl. a espécie de maior DM média (0,674 g cm-3). Foi detectado que existe variação significativa da DM entre as peças do fuste e da copa, independente da espécie e do sítio de coleta. A densidade da madeira de peças da copa com diâmetro entre 5 e 10 cm pode ser utilizada como preditora da DM média do indivíduo arbóreo. Nós concluimos que a DM das oito espécies arbóreas investigadas possui variabilidade interespecífica, com discrepâncias entre a DM do fuste e das partes lenhosas da copa. As distinções aqui detectadas devem ser considerados como uma importante ferramenta para melhorar as estimativas de estoque de carbono em áreas de savanas na Amazônia
Gênero, saúde reprodutiva e vida cotidiana em uma experiência de pesquisa-ação com jovens da Maré, Rio de Janeiro
The Fluorescence Detector of the Pierre Auger Observatory
The Pierre Auger Observatory is a hybrid detector for ultra-high energy
cosmic rays. It combines a surface array to measure secondary particles at
ground level together with a fluorescence detector to measure the development
of air showers in the atmosphere above the array. The fluorescence detector
comprises 24 large telescopes specialized for measuring the nitrogen
fluorescence caused by charged particles of cosmic ray air showers. In this
paper we describe the components of the fluorescence detector including its
optical system, the design of the camera, the electronics, and the systems for
relative and absolute calibration. We also discuss the operation and the
monitoring of the detector. Finally, we evaluate the detector performance and
precision of shower reconstructions.Comment: 53 pages. Submitted to Nuclear Instruments and Methods in Physics
Research Section
Anisotropy studies around the galactic centre at EeV energies with the Auger Observatory
Data from the Pierre Auger Observatory are analyzed to search for
anisotropies near the direction of the Galactic Centre at EeV energies. The
exposure of the surface array in this part of the sky is already significantly
larger than that of the fore-runner experiments. Our results do not support
previous findings of localized excesses in the AGASA and SUGAR data. We set an
upper bound on a point-like flux of cosmic rays arriving from the Galactic
Centre which excludes several scenarios predicting sources of EeV neutrons from
Sagittarius . Also the events detected simultaneously by the surface and
fluorescence detectors (the `hybrid' data set), which have better pointing
accuracy but are less numerous than those of the surface array alone, do not
show any significant localized excess from this direction.Comment: Matches published versio
Update on the correlation of the highest energy cosmic rays with nearby extragalactic matter
Data collected by the Pierre Auger Observatory through 31 August 2007 showed
evidence for anisotropy in the arrival directions of cosmic rays above the
Greisen-Zatsepin-Kuz'min energy threshold, \nobreak{eV}. The
anisotropy was measured by the fraction of arrival directions that are less
than from the position of an active galactic nucleus within 75 Mpc
(using the V\'eron-Cetty and V\'eron catalog). An updated
measurement of this fraction is reported here using the arrival directions of
cosmic rays recorded above the same energy threshold through 31 December 2009.
The number of arrival directions has increased from 27 to 69, allowing a more
precise measurement. The correlating fraction is , compared
with expected for isotropic cosmic rays. This is down from the early
estimate of . The enlarged set of arrival directions is
examined also in relation to other populations of nearby extragalactic objects:
galaxies in the 2 Microns All Sky Survey and active galactic nuclei detected in
hard X-rays by the Swift Burst Alert Telescope. A celestial region around the
position of the radiogalaxy Cen A has the largest excess of arrival directions
relative to isotropic expectations. The 2-point autocorrelation function is
shown for the enlarged set of arrival directions and compared to the isotropic
expectation.Comment: Accepted for publication in Astroparticle Physics on 31 August 201
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