Mutilation of extremities was very frequent in patients affected by leprosy in the past; although it is now much less common, it is still seen, mainly in patients with long-term disease. In general, ...mutilation of the nose and ears is caused by the bacillus and mutilation of the hands and feet a consequence of chronic trauma. Leprosy must be chronically treated and any decision to interrupt therapy is based on laboratory tests and biopsy. Scintigraphy is a non-invasive procedure which could be of great value in to determining disease activity. We studied eight patients (five males and three females, aged 64-73 years) who presented with mutilation of the nose (2), ear (1), feet (3) or foot and hand (2). Conventional three-phase bone scintigraphy (750 MBq) and X-ray examinations of the affected areas were performed in all patients. Bone scintigraphy was abnormal in four patients (the presence of bacilli was confirmed by biopsy in two of them), and normal in the other four. In all patients except for the one with ear mutilation, radiography only showed the absence of bone. We conclude that bone scintigraphy is very useful to determine disease activity in cases of mutilation caused by leprosy. It seems to be superior to conventional radiography and may enable bone biopsies to be avoided.
Celotno besedilo
Dostopno za:
DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
494.
Conventional nutritional support (CNS) in hospitalized surgical patients Leandro-Merhi, V A; Díez García, R W; Braga de Aquino, J L
Nutrición hospitalaria : organo oficial de la Sociedad Española de Nutrición Parenteral y Enteral,
2007 Jul-Aug, 20070701, Letnik:
22, Številka:
4
Journal Article
To compare nutritional status assessment methods on hospital admission and discharge in surgical patients receiving conventional nutritional support (CNS).
One hundred eighty-three patients ...hospitalized in the surgical ward of the Hospital of PUC-Campinas and aging from 30 to 60 years were assessed; of these, 54.6% were females and 45.4% were males. A nutritional support protocol was used to collect the data with identification and diagnosis data obtained from medical records, antecedents, anthropometry, eating history during hospitalization, total energy intake in the usual diet (UD), energy requirement (ER) and nutritional status. The Wilcoxon test was used for the statistical analysis and the Kappa (k) Coefficient was used to verify the agreement between the nutritional status on hospital admission and discharge. The adopted significance level was 5% (0.05).
The analysis of the values on hospital admission and discharge showed that the nutritional status remained constant on admission and discharge when analyzed by groups of diseases. The relationship between nutritional status on hospital admission and discharge in patients with benign biliary tract diseases and vascular diseases presented an excellent agreement between the two moments (k = 1000). It was verified that, discounting the effect of randomness, the nutritional status on admission and discharge agreed in 71.43% and 50% respectively in these two clinical conditions regarding the nutritional diagnosis of being well nourished. In benign diseases of the digestive tract and neoplasias, a good agreement was also observed (k = 0,887 and k = 0,820 respectively). In the total sample, the agreement analysis was high (k = 0,918) showing that the nutritional status remained constant during hospitalization.
These findings may be attributed to the routine monitoring of nutritional status which allowed an adequate support during hospitalization even when the energy requirement and intake differed.
One of the best examinations used routinely to detect gastro-oesophageal reflux (GOR) is scintigraphy and attempts are continuously being made to improve the performance of the test. We have tested a ...new manoeuvre to improve the results. Three hundred and twenty eight patients (190 males and 138 females, aged 1 month to 84 years, average 4.47 years) were studied after a 12 h fast period with 100 MBq of Tc-phytate, 50 ml volume, directly delivered into the stomach in a mixture of orange juice. All patients were strongly suspected of having GOR. Conventional acquisition was done for 20 min, at a rate of one frame every 20 s. In the middle of the examination, small children were put in the upright position and held there for a few seconds or released in a way that allowed movement; adults were asked to stand up and walk a few metres. The test was then continued for the remaining 10 min. The global index of positivity was 64.6% (76 positive cases in the first half of the examination and 134 positive cases only after the manoeuvre). The mean of GOR episodes observed in the positive cases without the manoeuvre was 0.5 per patient, significantly different from the mean of 1.59 noted after the manoeuvre (P<0.01). In 28 cases the manoeuvre increased either the intensity or the frequency of reflux previously detected without it. We believe that this manoeuvre should be performed in all scintigraphic tests aiming to detect GOR. In the present series, the manoeuvre increased the frequency of GOR episodes.
From 1988 to 1995, our laboratory at the Institute of Chemistry of the Federal University of Rio de Janeiro, in Rio de Janeiro, screened 2650 samples from 2000 high-risk patients (mostly children) ...for Inborn Errors of Metabolism (IEM). Chemical tests, various chromatographic techniques and enzyme assays were performed on urine, plasma and in some cases, cerebrospinal fluid (CSF). A total of 145 cases of IEM (7.2%) was identified. These were related to: the metabolism of amino acids (41) and carbohydrates (17), organic acids (7), lysosomal enzymes (61), membrane transport system (16), metals (2), intestinal disaccharidases (1) and porphyrin metabolism (3). Furthermore, a relevant number of patients with abnormal findings is still under investigation. Biochemical results and clinical symptoms are presented and the importance of reference laboratories for the detection of IEM is stressed.
Let S be a semigroup of homeomorphisms of a compact metric space M and suppose that is a family of subsets of S. This paper gives a characterization of the -chain control sets as intersection of ...control sets for the semigroups generated by the neighborhoods of the subsets in . We also study the behavior of -chain control sets on principal bundles and their associated bundles.
To develop a predictive system for the occurrence of nosocomial pneumonia in patients who had cardiac surgery performed.
Retrospective cohort study.Setting. Two cardiologic tertiary care hospitals in ...Rio de Janeiro, Brazil.
Between June 2000 and August 2002, there were 1,158 consecutive patients who had complex heart surgery performed. Patients older than 18 years who survived the first 48 postoperative hours were included in the study. The occurrence of pneumonia was diagnosed through active surveillance by an infectious diseases specialist according to the following criteria: the presence of new infiltrate on a radiograph in association with purulent sputum and either fever or leukocytosis until day 10 after cardiac surgery. Predictive models were built on the basis of logistic regression analysis and classification and regression tree (CART) analysis. The original data set was divided randomly into 2 parts, one used to construct the models (ie, "test sample") and the other used for validation (ie, "validation sample").
The area under the receiver-operating characteristic (ROC) curve was 69% for the logistic regression model and 76% for the CART model. Considering a probability greater than 7% to be predictive of pneumonia for both models, sensitivity was higher for the logistic regression models, compared with the CART models (64% vs 56%). However, the CART models had a higher specificity (92% vs 70%) and global accuracy (90% vs 70%) than the logistic regression models. Both models showed good performance, based on the 2-graph ROC, considering that 84.6% and 84.3% of the predictions obtained by regression and CART analyses were regarded as valid.
Although our findings are preliminary, the predictive models we created showed fairly good specificity and fair sensitivity.
Concern for environmental issues has become a reality in all sectors of society, mainly among researchers and professionals who work directly with environmental status. In this context, several ...studies have been undertaken on sustainable development of the Brazilian Amazon, generating a large amount of data and information. Environmental area characterization involves the knowledge about their natural, economic and social resources, as well as understanding the interaction and correlation among them. Such interdisciplinary character requires new solutions for knowledge representation. This study proposes to minimize metadata recovery problems in Spatial Data Infrastructures by using Topic Maps and Thesaurus. This approach applied to an interface aims to allow users to visually recover information from metadata catalogs.
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