A prática clínica é de extrema importância no manejo dos usuários admitidos em Unidades de Terapia Intensiva (UTI). No entanto, nem sempre isso é suficiente para se compreender a fundo os agravos em ...saúde que acometem determinado cliente, tornando-se indispensável o uso de aparatos tecnológicos para a prestação de uma assistência integral e de qualidade. Este estudo tem como objetivo enfatizar a importância e eficácia do uso de aparatos tecnológicos dentro de uma UTI, na qual a utilização da tecnologia foi essencial para obter sucesso em um procedimento de reanimação cardiorrespiratória. Trata-se de um relato de experiência com abordagem descritiva. O relato traz a eficácia dos aparatos tecnológicos que possibilitaram salvar a vida de uma criança, em estado de parada respiratória, ocasião em que só foi possível verificar o motivo de tal acontecimento através do uso de um broncoscópio, identificando que o corpo estranho presente nos brônquios da criança se tratava da metade de um caroço de feijão. Dessa forma, é necessário estimular a reflexão acerca da união dos aspectos clínicos com as ferramentas tecnológicas disponíveis, que são de extrema relevância, pois esta união proporciona um olhar centrado nas necessidades afetadas dos usuários, colaborando com um cuidado cada vez mais sistematizado, humanizado e holístico.
Thousands of human diseases could be treated by selectively controlling the expression of specific proteins in vivo. A new series of alkenyl amino alcohol (AAA) ionizable lipid nanoparticles (LNPs) ...capable of delivering human mRNA with unprecedented levels of in vivo efficacy is demonstrated. This study highlights the importance of utilizing synthesis tools in tandem with biological inspiration to understand and improve nucleic acid delivery in vivo.
Canine visceral leishmaniasis is a tropical climate disease, commonly found in countries of the Americas. In Brazil, its incidence has been increasing due to the animal migrations within from the ...country itself, which have been rising the rate of animals infected by the protozoan Leishmania chagasi. This report describes a female dog, 2.5 years old, from São Paulo state, which made a trip to Maranhão state and whose tutors came to establish housing in Indaial, SC. Soon after settling in this city, the animal began to show characteristic symptoms of canine visceral leishmaniasis. Biochemical tests and serological diagnoses were requested to confirm the suspected and performed treatment.
A leishmaniose visceral canina é uma doença de clima tropical, sendo comum em países das Américas. No Brasil, sua incidência vem crescendo devido o aumento de migrações de animais dentro do próprio país, o que pode elevar o índice de animais infectados pelo protozoário Leishmania chagasi. Este relato trata de uma cadela, de 2,5 anos de idade, oriunda do estado de São Paulo, que realizou uma viagem ao estado do Maranhão, cujos tutores vieram a fixar moradia em Indaial, SC. Logo após se estabelecerem nesta última cidade, o exemplar começou a apresentar sintomas característicos da leishmaniose visceral canina. Testes bioquímicos e diagnósticos sorológicos foram solicitados para a confirmação da suspeita e realização do tratamento.
To determine prospectively the accuracy of a magnetic resonance (MR) perfusion imaging and MR angiography protocol for differentiation of chronic thromboembolic pulmonary arterial hypertension ...(CTEPH) and primary pulmonary hypertension (PPH) by using parallel acquisition techniques.
The study was approved by the institution's internal review board, and all patients gave written consent prior to participation. A total of 29 patients (16 women; mean age, 54 years +/- 17 +/- standard deviation; 13 men; mean age, 57 years +/- 15) with known pulmonary hypertension were examined with a 1.5-T MR imager. MR perfusion imaging (temporal resolution, 1.1 seconds per phase) and MR angiography (matrix, 512; voxel size, 1.0 x 0.7 x 1.6 mm) were performed with parallel acquisition techniques. Dynamic perfusion images and reformatted three-dimensional MR angiograms were analyzed for occlusive and nonocclusive changes of the pulmonary arteries, including perfusion defects, caliber irregularities, and intravascular thrombi. MR perfusion imaging results were compared with those of radionuclide perfusion scintigraphy, and MR angiography results were compared with those of digital subtraction angiography (DSA) and/or contrast material-enhanced multi-detector row computed tomography (CT). Sensitivity, specificity, and diagnostic accuracy of MR perfusion imaging and MR angiography were calculated. Receiver operator characteristic analyses were performed to compare the diagnostic value of MR angiography, MR perfusion imaging, and both modalities combined. For MR angiography and MR perfusion imaging, kappa values were used to assess interobserver agreement.
A correct diagnosis was made in 26 (90%) of 29 patients by using this comprehensive MR imaging protocol. Results of MR perfusion imaging demonstrated 79% agreement (ie, identical diagnosis on a per-patient basis) with those of perfusion scintigraphy, and results of MR angiography demonstrated 86% agreement with those of DSA and/or CT angiography. Interobserver agreement was good for both MR perfusion imaging and MR angiography (kappa = 0.63 and 0.70, respectively).
The combination of fast MR perfusion imaging and high-spatial-resolution MR angiography with parallel acquisition techniques enables the differentiation of PPH from CTEPH with high accuracy.
Bringing Back the MWSG Rosa, Frank
Marine Corps Gazette,
05/2018, Letnik:
102, Številka:
5
Trade Publication Article
Aviation ground support The Deputy Commandants for Installations & Logistics and Aviation recently teamed to support the reactivation of Marine Wing Support Group (MWSG) Headquarters-27 and -37 in ...fiscal year 2019- Despite recent force reductions and redesign efforts, the requirement to bring back the MWSG to plan, prioritize, and allocate aviation ground support (AGS) across the MAW has remained constant. ...of the 2010 Force Structure Review, the MWSG headquarters were deactivated as a means to meet decreased end strength requirements. The Deputy Commandant for Combat Development & Integration led efforts to develop tables of organization and equipment; assess across the doctrine, organization, training, materiel, leadership, and facilities spectrum; submit for the command selection program; and publish supporting Marine Corps Bulletin 5400s to reactivate MWSG-27 and -37 headquarters.
Evaluation of the role of FDG-PET in comparison to conventional staging methods for detecting extrahepatic tumour deposits prior to resection of liver metastases.
In our prospective study, 58 ...patients (24 women, 34 men; age 33-81 years) with liver metastases of colorectal carcinoma underwent FDG-PET. Images were acquired in 3D-mode including transmission scans and reconstructed iteratively. For conventional staging all patients underwent abdominal ultrasound, helical computed tomography (CT) of the thorax and abdomen, and colonoscopy/rectoscopy. A preliminary therapeutic decision was established without knowledge of the FDG-PET findings. Thereafter, it was revised or confirmed according to the results of FDG-PET.
In 3/58 patients extrahepatic tumour deposits were concordantly identified with both conventional staging methods and FDG-PET. However, in one case, both conventional methods and FDG-PET were false positive regarding pulmonary metastases. In 12/58 patients, nothing but FDG-PET detected extrahepatic tumour masses, which were later confirmed either by histology or follow-up.
Our study suggests that in 21% of patients exclusively FDG-PET is an appropriate diagnostic tool to reveal extrahepatic metastases or local recurrence of colorectal carcinoma. Our results demonstrate that FDG-PET provides relevant additional information for accurate therapeutic planning as compared to the conventional combination of staging methods. Therefore, FDG-PET has to exert a decisive influence on the decision for resection of hepatic metastases.
O objetivo deste artigo é apontar a importância vital do diálogo socrático e, em especial, na figura de Sócrates na construção da tese dos exercícios espirituais de Pierre Hadot e a ...transformação/construção ética do sujeito ante a condição frágil e vulnerável do ser humano. Esse objetivo é aqui pensado a partir da interpretação que Hadot faz da figura de Sócrates e da filosofia antiga. Com efeito, desde o início do pensamento grego, o Sábio aparece como uma norma viva e concreta como nota Hadot: “essas pesquisas, essas reflexões sobre o Sábio como norma se fixaram pouco a pouco, por muitas razões, na figura única de Sócrates”. Sócrates torna-se o mediador entre o ideal transcendente de sabedoria e a realidade ética humana concreta.
The purpose of this program is to address problems of peer aggression and victimization that are so prevalent in schools. A number of factors have been found to contribute to the development of ...aggression in children, such as parental influences, peer networks, and environmental factors. The Linking Everyone in Aggression Prevention in Schools (LEAPS) program was developed to address these problems, using empirically supported behavioral methods. Specifically, the program aims at preventing and reducing reactive and proactive aggressive responses in students. The target population consists of youth aged 11–14 in middle school, school personnel, and the parents of youth referred for individual treatment. The program's behavioral treatment strategies involve a school-wide intervention, group skill training, individual treatment, and parent behavior management training in preventing and reducing student aggressive behavior in school while promoting pro-social interaction in the targeted population.
To evaluate the different tissue reactions at magnetic resonance (MR) imaging after balloon dilation and placement of covered and uncovered stents.
Contrast material-enhanced MR imaging was performed ...in 14 patients with polyester-covered nitinol stents, 10 patients with conventional metallic stents, and 12 patients who underwent peripheral percutaneous transluminal angioplasty. Lesions were located in the subclavian, iliac, femoral, and popliteal arteries.
MR imaging demonstrated perivascular soft-tissue inflammation in 11 of 14 (79%) patients with polyester-covered stents. Eight (57%) of these patients showed clinical symptoms. No reaction was found among the group with uncovered stents and those who underwent peripheral percutaneous transluminal angioplasty.
The polyester-covered nitinol stent can induce systemic and severe local reactions. These reactions seem to be specific to this type of stent. No definite cause has been established, although the phenomenon appears to be self-limiting.
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