Background- Stopping the detrimental effects of the renin- angiotensin systemat the most upstream point of the cascade offers theoretical advantages for cardiovascular protection. This study compares the antihypertens...Background- Stopping the detrimental effects of the renin- angiotensin systemat the most upstream point of the cascade offers theoretical advantages for cardiovascular protection. This study compares the antihypertensive efficacy and safety of the novel oral renin inhibitor aliskiren with placebo and an active comparator. Methods and Results- The study was a randomized, multicenter, double- blind, placebo- controlled, active- comparator 8- week trial in patients with mild- to- moderate hypertension(mean sitting diastolic blood pressure ≥ 95 and< 110mm Hg). After a 2- week, single- blind placebo run- in, 652 patients were randomized to receive double- blind treatment with oncedaily oral doses of aliskiren(150, 300, or 600 mg), irbesartan 150 mg, or placebo. Aliskiren 150, 300, and 600 mg effectively lowered both trough mean sitting DBP and systolic blood pressure(SBP)(P< 0.001 versus placebo for both variables). The least- squares mean reductions in trough DBP were 9.3± 0.8, 11.8± 0.8, and 11.5± 0.8 mm Hg, respectively, versus 6.3± 0.8 mm Hg for placebo, and the least- squares mean reductions in trough SBP were 11.4± 1.3, 15.8± 1.2, and 15.7± 1.2 mm Hg, respectively, versus 5.3± 1.2 mm Hg for placebo. The antihypertensive effect of aliskiren 150 mg was comparable to that of irbesartan 150 mg(8.9± 0.7 and 12.5± 1.2 mmHg, least- squares reduction in mean sitting DBP and SBP, respectively, for irbesartan). Aliskiren 300 and 600 mg lowered mean sitting DBP significantly more than irbesartan 150 mg(P< 0.05). Aliskiren showed safety and tolerability comparable to those of placebo and irbesartan; the incidence of adverse events and number of patients discontinuing therapy were similar in all groups. Conclusions- Once- daily oral treatment with aliskiren lowers blood pressure effectively, with a safety and tolerability profile comparable to that of irbesartan and placebo, in patients with mild- to- moderate hypertension. Aliskiren 150 mg is as effective as irbesartan 150 mg in lowering blood pressure.展开更多
Background: Healthcare-associated infections affect hundreds of millions of patients worldwide. Children have greater susceptibility to healthcare-associated infections due to the immaturity of their immune system. Co...Background: Healthcare-associated infections affect hundreds of millions of patients worldwide. Children have greater susceptibility to healthcare-associated infections due to the immaturity of their immune system. Contact precautions aim to promote safety, protection and prevention of contamination. Thus, the objective of this study was to verify adherence to contact precaution measures, as well as compliance to the use of personal protective equipment. Methods: This cross-sectional observational study was carried out from July to October 2019 using a checklist to evaluate health professionals’ adherence to hand hygiene procedures and the use of gloves and surgical gowns when assisting children on contact precautions. Results: A total of 941 observations were carried out in a total of 300.532 hours. Hand hygiene was performed before and after contact with the patient in 58.84% and 75.09% of the cases, respectively and a surgical gown was used in 86.40% of the cases. The use of gloves was the variable most adhered to by professionals (87.57%). Intensive care unit professionals were the care workers who most complied with the regulation regarding hand hygiene after contact with the patient (p = 0.009) and the use of the surgical gown (p < 0.001). The correct hand hygiene technique was the recommendation with least adherence. Non-compliance to the hand hygiene technique was statistically significant among intensive care unit professionals (p = 0.002). Conclusions: Adherence to hand hygiene before contact with the patient and compliance with the hand hygiene technique were neglected by most professionals. However, there was good adherence to the use of surgical gloves and gowns, as well as high compliance to the techniques of removing these items. .展开更多
Neuroarchitecture is a set of characteristics grouped into principles that seek to generate a certain behavior when applied.These principles will vary according to the type of user for whom the design is intended.In t...Neuroarchitecture is a set of characteristics grouped into principles that seek to generate a certain behavior when applied.These principles will vary according to the type of user for whom the design is intended.In this research,these neuroarchitectural principles are identified in the nursing home Mis Abuelitos in Cochachinche,Huánuco.The home was designed and built with notions of nature and the Andean while emphasizing the occupants are the elderly.With this purpose,qualitative research was carried out using two sequential criteria,the first was to identify what these principles are and the second was to recognize the principles within the area.The principles that are assertively used for the elderly occupants were selected.The study observation was performed with observation and photographic sheets and was analyzed with ATLAS.ti processing software.It was obtained that the three neuroarchitectural principles are present in the nursing home which are 67%of the recommended characteristics for the elderly.展开更多
In the practice of advancing the cause of human rights,China has blazed a path of human rights development that is both consistent with the trend of the times and befits the nation’s conditions.WHEN contemplating hum...In the practice of advancing the cause of human rights,China has blazed a path of human rights development that is both consistent with the trend of the times and befits the nation’s conditions.WHEN contemplating human rights,the principle of individual freedom often comes to the forefront.The Chinese government’s perception,however,consists in the more organic concept of a metaphorical garden,wherein human rights flourish by virtue of China’s unique soil-its rich history,ancient culture,and political system.China,as a seasoned gardener,thus endeavors,under the leadership of President Xi Jinping,to develop human rights based on its national conditions.展开更多
Introduction: Cataract surgery is one of the procedures most performed worldwide. Those are several options for anesthetic management, with many factors that affect the choice of any given technique, depending on pati...Introduction: Cataract surgery is one of the procedures most performed worldwide. Those are several options for anesthetic management, with many factors that affect the choice of any given technique, depending on patients’ needs, surgeons’ preferences and institutional facilities and processes. Although being more invasive than topic anesthesia, and with possible hazardous side effects, peribulbar block is still an effective and successful technique. The utilization of blunt canula and ultrasound guidance might enhance the safety pattern for this technique. Methods: This article presents a revision of 1089 consecutive cases from February 2016 to January 2022, of patients submitted to cataract surgery under peribulbar anesthesia with blunt canula and ultrasound guidance. Results: 1318 surgical records were selected, with 1089 filling the inclusion criteria. There was a higher prevalence of the feminine gender (54%), with a median age of 64.3 (28 - 102) years. Mean IAV was 2.9 mL (sd 0.16 mL, 2.5 - 3.0 mL), with total HOS 91.1%;OR to reach G2 or above for each (ISB/IMB) was 11.0;CA was 47.9%, with mean FAV of 4.29 mL (sd 2.17mL, 2.5 - 15 mL). In 8.9% patients, HOS could not be fully observed. ISB, IMB, CA and FAV were calculated for both groups (non-HOS and HOS-only). OR for CA (non-HOS/HOS-only) was 126.21. The main adverse effects were chemosis (2.9%), hyposphagma (5.7%) and high IOP (7.5%). No procedure was postponed due to anesthesia-associated adverse events. Discussion: This study points towards the feasibility of the described technique in an outpatient fashion, with low, mild and tolerable side effects associated.展开更多
Background: Hard brunescent nuclei are difficult to chop with traditional techniques, because leathery tough strands may connect the posterior surface and span across the fragments, which poses a challenge to complete...Background: Hard brunescent nuclei are difficult to chop with traditional techniques, because leathery tough strands may connect the posterior surface and span across the fragments, which poses a challenge to completely divide the nuclei. The ultra-chopping technique was designed to mitigate this issue. Purpose: To compare the intraoperative parameters between Ultra-Chopper and Divide & Conquer Techniques. Setting: This study was performed at Hospital Oftalmológico de Brasília, Brasília, DF, Brazil. Patients and Methods: A prospective, randomized and comparative study. Patients with the diagnosis of dense cataract and surgical extraction programmed were divided into two groups: Ultra-Chopper and Divide & Conquer. Intraoperative data were collected and submitted for the statistical analysis. Results: 36 eyes were included, 19 eyes with Ultra-Chopper and 17 eyes with Divide & Conquer. Groups were statistically equivalent in age and nucleus density. There were no surgical complications. Torsional time and cumulative dissipated energy were significantly reduced in the ultra-chopper group. The ultra-chopper group had less total case time, fluid usage and aspiration (ASP) time. Conclusion: The ultra-chopper tech- nique can reduce ultrasound energy dissipation during cataract surgery, and decrease case time, fluid usage and ASP time.展开更多
The chronic obstructive pulmonary disease (COPD) and asthma are chronic airway diseases that cause considerable physical, emotional and social restrictions. The life quality of patients who suffer from these diseases,...The chronic obstructive pulmonary disease (COPD) and asthma are chronic airway diseases that cause considerable physical, emotional and social restrictions. The life quality of patients who suffer from these diseases, is more affected by dyspnea then by other symptoms. That way is possible to correlate the impact of dyspnea on their life quality. The Pulmonary Rehabilitation Program (PRP) helps to improve the physical fitness and quality of life. This paper presents a study of the life quality and the dyspnea intensity in chronic lung disease patients. The research has participation of fourteen patients, distributed as seven suffering from COPD and the other seven suffering from asthma, for both gender and with an age average of 74.2 ± 8.9. The patients answer the following questionnaires: Baseline Dyspnea Index (BDI), Medical Research Council (MRC) Dyspnea Scale, Airways Questionnaire 20 (AQ20) and the Brazilian version of the Short-Form (SF-36) life quality questionnaire. From the present study, it was concluded that asthma patients have a less impaired life quality, since the dyspnea intensity is lesser, compared to the one with COPD.展开更多
Objectives: Adequate control of hemodynamic parameters in patients undergoing otolaryngology-head and neck (OLHN) surgeries is one of the objectives of peri-operative anesthesia management. In this context, we seek to...Objectives: Adequate control of hemodynamic parameters in patients undergoing otolaryngology-head and neck (OLHN) surgeries is one of the objectives of peri-operative anesthesia management. In this context, we seek to evaluate the effectiveness of metoprolol compared to clonidine in the post-<span>operative control of systolic (SBP) and diastolic (DBP) blood pressures, and </span><span>heart rate (HR), when these medications are used in the immediate </span><span>pre-operative period. Method: this is a randomized double-blind clinical trial. Patients over 18 years old, according to the American Society of Anesthesiologists Physical Status Classification (ASA) I or II, who would undergo OLHN surgery, presenting with greater than 140 mmHg (SBP) or 90 mmHg (DBP), upon arrival at the surgical ward, were included in the study. 46 patients were randomized into two groups (C or M) who received clonidine (75 or 150 mcg) or metoprolol (5 or 10 mg), respectively. The averages of SBP, DBP and HR were compared between groups upon arrival at the post anesthesia care unit (PACU) and four hours post-surgery. Results: In group C, SBP (127.7 </span><span>±</span><span> 18.8 vs 137.3 </span><span>±</span><span> 14.1 mmHg, p = 0.03) and DBP (73.1 </span><span>±</span><span> 15.46 vs 82.6 </span><span>±</span><span> 7.9 mmHg, p <</span><span> </span><span>0.01) were lower, when compared with group M. No difference was observed in HR immediately upon PACU arrival. In addition, for four hours post-surgery, no change was noted in the SBP, DBP or HR. Conclusion: metoprolol was less effective than clonidine in reducing systolic and diastolic blood pressures in the immediate post-operative period of OLHN surgeries.</span>展开更多
Autonomous Underwater Vehicles (AUVs) are robots able to perform tasks without human intervention (remote operators). Research and development of this class of vehicles has growing, due to the excellent characteristic...Autonomous Underwater Vehicles (AUVs) are robots able to perform tasks without human intervention (remote operators). Research and development of this class of vehicles has growing, due to the excellent characteristics of the AUVs to operate in different situations. Therefore, this study aims to analyze turbulent single fluid flow over different geometric configurations of an AUV hull, in order to obtain test geometry that generates lower drag force, which reduces the energy consumption of the vehicle, thereby increasing their autonomy during operation. In the numerical analysis was used ANSYS-CFX® 11.0 software, which is a powerful tool for solving problems involving fluid mechanics. Results of the velocity (vectors and streamlines), pressure distribution and drag coefficient are showed and analyzed. Optimum hull geometry was found. Lastly, a relationship between the geometric parameters analyzed and the drag coefficient was obtained.展开更多
<strong>Background:</strong> The implantation of the intraocular lens (IOL) is still subject to error and complication, as it can result in traumatic opening of the IOL leading to rupture of the posterior ...<strong>Background:</strong> The implantation of the intraocular lens (IOL) is still subject to error and complication, as it can result in traumatic opening of the IOL leading to rupture of the posterior capsule and zonular dialysis, it takes time to train paramedic teams to assemble such IOLs with the manual injectors. Moreover, there is a potential risk of comtamination and endophthalmitis as there is manipulation of the IOL and cartridge. The preloaded IOLs tend to reduce those unwanted results and may optimize the surgical time. <strong>Purpose:</strong> The aim of this study is to compare the effectiveness and implantation time between three injectors and three intraocular lenses, two pre-loaded and one conventional. <strong>Methodology:</strong> Videos of thirty patients undergoing cataract surgery from December 2019 to December 2020 at the Hospital Oftalmológico de Brasília (HOB), Brasília, Brazil were included in this observational, analytical retrospective study, non randomized. All patients had their surgeries recorded, from which the time of injection and opening of the intraocular lens (IOL) was extracted, 20 eyes were implanted with preloaded intraocular lens, and 10 eyes with conventional IOL implant. The patients were divided into three groups with similar eye characteristics. The first received the AutonoMe<sup>TM</sup> (CE) injector with the Clareon<span style="white-space:nowrap;"><sup>®</sup></span><span style="font-size:10px;"> </span><span style="white-space:nowrap;"><span style="color:#FFFFFF;font-family:Roboto, "white-space:normal;background-color:#D46399;"><span style="white-space:nowrap;"></span></span></span>IOL, the second the Isert<sup>TM</sup> injector (I) with the Hoya<span style="white-space:nowrap;"><sup><span style="white-space:nowrap;">®</span></sup></span> IOL, and the third was injected with Johnson & Johnson Platinum 1 Series injector used to deliver Sensar<span style="white-space:nowrap;"><sup><span style="white-space:nowrap;">®</span></sup></span> One AAB展开更多
<span style="font-family:Verdana;">The objective of this study was to evaluate the effect of blends of different oxygenated additives on gasoline in SI engine Otto cycle. The formulations analyzed were...<span style="font-family:Verdana;">The objective of this study was to evaluate the effect of blends of different oxygenated additives on gasoline in SI engine Otto cycle. The formulations analyzed were: pure gasoline (type A), common gasoline (type C), gasoline type A + 15% (v/v) oxygenated additives (ethanol, ethyl octanoate, ethyl oleate). The experiments were performed using engine Branco 4-stroke and 2-cylinder, electric dynamometer, exhaust system, control unit composed of Multi-K unit, variable selector and load cell, stroboscope tachometer, fuel supply system and stopwatch. The rotation was conserved at 4400 rpm and wheel power varied from 3 kW to 12 kW, with intervals of 3 kW to obtain hourly consumption curves and brake specific fuel consumption. Even esters and ethanol having lower heat of combustion, hourly consumption was similar to pure gasoline (type A). In relation to the brake specific fuel consumption, increasing the wheel power had a better conversion of the mass of fuel burned into energy. Thus, this study showed that the mixture of gasoline and esters (ethyl octanoate and ethyl oleate) presented good efficiency in terms of consumption. This research contributes to the needs and to the current studi</span><span style="font-family:Verdana;">es in which industries started to add renewable products to petroleum-</span><span style="font-family:Verdana;">derived fuels;in order to obtain more sustainable fuels at lower costs.</span>展开更多
Background: Stroke has been considered the major cause of chronic disability in the world and ranks among the leading causes of death. Despite the fact that new vascular events often happen and risk factors are the sa...Background: Stroke has been considered the major cause of chronic disability in the world and ranks among the leading causes of death. Despite the fact that new vascular events often happen and risk factors are the same that Cardiovascular Diseases, secondary prevention through non-pharmacological measures, are not part of the routine physical rehabilitation after stroke. Objective: The aim is to answer the following clinical question: Should aerobic fitness be part of the physical rehabilitation of individuals post-stroke? Methodological Design: The methodology used in the study was an integrative literature review. Inclusion Criteria: Articles in English are published in secondary databases: systematic reviews with or without meta-analysis, which address the question PICO: patient (post-stroke), intervention (aerobic exercise), comparison (with or without aerobic conditioning) the outcome (volume of oxygen consumed peak (VO<sub>2peak</sub>), quality of life (QoL), morbidity and mortality). Outcomes: VO<sub>2peak</sub>, QoL, complications and mortality. Analysis of Studies: The methodological quality of included studies is assessed using the tools: PRISMA and R-AMSTAR. Results: There was “good” evidence for the inclusion of aerobic exercise on physical rehabilitation of post-stroke individuals to improve their physical capacity (VO<sub>2peak</sub>), facilitating the completion of activities of daily living and gait. There was weak evidence on the association of aerobic fitness with positive results on QoL in stroke victims and insufficient results to evaluate the effect of aerobic fitness on the risk of stroke recurrence and mortality. Conclusion: The aerobic conditioning should be included in the rehabilitation of stroke victims.展开更多
Objective: To describe the epidemiological profile of children and adolescents who are victims of domestic violence. Method: This is a cross sectional and descriptive study, following a quantitative approach, conducte...Objective: To describe the epidemiological profile of children and adolescents who are victims of domestic violence. Method: This is a cross sectional and descriptive study, following a quantitative approach, conducted from September to December 2013, at the SOS CHILD service, in the city of Natal, Rio Grande do Norte, Brazil. The research protocol was approved by CEP/UFRN under CAAE 0166.0.051.000-11. Results: In the analysis of 69 children, the results were presented from three points of view: 1) the victim—female (56.5%), aged one to 11 years old (66.7%) and lived with one of the parents (43.5%);2) the abuser—female (60.9%) in the 14 - 23 years old and 34 - 43 years old, with the same percentage (24.6%), history of alcohol use and abuse (42.0%), the mother was the one who attacked the most (34.7%);3) types of violence, among the physical ones, the most frequent were slaps (43.2%) and punches (18.9%);the prevalence, among the psychological violence, were curses (35.4%) and abuse (27.8%);negligence, omission of care (73.5%), deprivation of care for personal appearance (18.4%);among sexual violence: sexual caresses (57.1%) and forced sex (42.9%). Conclusion: Children and adolescents placed in an unfavorable social-economic context, under the care of mothers with a history of use and abuse of alcohol and other drugs, are more vulnerable to intra-domiciliary violence.展开更多
Health Education has shown itself as essential for the understanding of indi</span><span style="font-family:Verdana;">viduals about psychological and physical changes caused by diseases. The chro...Health Education has shown itself as essential for the understanding of indi</span><span style="font-family:Verdana;">viduals about psychological and physical changes caused by diseases. The chron</span><span style="font-family:Verdana;">ic obstructive pulmonary disease (COPD) is a severe public health problem, and it depends on health education measures for its control. A group of patients with COPD, in pneumatological medical treatment, were investigated to find </span><span style="font-family:Verdana;">information about the disease. An observational, descriptive and analytical study </span><span style="font-family:Verdana;">with analysis and application of a semistructured questionnaire to evaluate the </span><span style="font-family:Verdana;">individuals</span><span style="font-family:Verdana;">’</span><span style="font-family:;" "=""><span style="font-family:Verdana;"> knowledge about the COPD. Collected data were registered and </span><span style="font-family:Verdana;">analyzed using Google Docs. The software used for the calculation of statistica</span><span style="font-family:Verdana;">l </span><span style="font-family:Verdana;">measures was Microsoft Excel<span style="white-space:nowrap;"><sup>®</sup></span>. For the research participants’ characterization</span> <span style="font-family:Verdana;">analysis, the use of grouped data for the frequency distribution of Sturges Rule</span> <span style="font-family:Verdana;">was necessary. This study provided knowledge about which information a group</span><span style="font-family:Verdana;"> of bearers of COPD receives at a college hospital providing treatment. </span><span style="font-family:Verdana;">The interviewed have an average age of 70 years old and most are women with </span><span style="font-family:Verdana;">education level between elementary and high school and diagnose time of 6</span></span><span style="font-family:Verdana;">.</span><span style="font-family:;" "=""><span style="font-family:Verdana;">8 years. Most of the sample reported knowled展开更多
Objective:The robotic-assisted approach to simple prostatectomy(RASP)was conceived,essentially reproducing the fundaments of open simple prostatectomy.Since the first report,RASP underwent several technical modificati...Objective:The robotic-assisted approach to simple prostatectomy(RASP)was conceived,essentially reproducing the fundaments of open simple prostatectomy.Since the first report,RASP underwent several technical modifications.The study aims to identify and describe the current robotic surgery techniques to approach benign prostatic hyperplasia(BPH).Methods:The paper performed a non-systematic literature review accessing PubMed and Embase databases for all full-text articles published from 2008 to May 2020,assessing robot-assisted surgical techniques for BPH treatment using the terms“robot-assisted simple prostatectomy”OR“robotic simple prostatectomy”OR“RASP”AND“surgical technique”.Results:After careful review of 180 studies in PubMed and 198 in Embase,16 papers reporting different RASP techniques.After the first procedure described by Sotelo et al.[9],several authors contributed to the development of the RASP technique.John et al.[24]proposed the extraperitoneal access,and Yuh et al.[23]first reported the adenoma transcapsular dissection.Some modifications were proposed by Coelho et al.[31]on trigonization,posterior reconstruction,and urethro-vesical anastomosis.Other groups focused on urethral-preserving procedures.Moschovas et al.[28]and Clavijo et al.[32]recently described an intrafascial RASP with the removal of the entire prostatic tissue.Finally,Kaouk et al.[29]reported the feasibility and safety of the da Vinci Single Port approach.Conclusion:In the last eighteen years,the robotic-assisted approach to BPH disease has been evolved,and different techniques have been described.This review details all the technical developments on RASP that distinctive groups have proposed since the multiport robotic platforms until the new da Vinci Single Port.展开更多
A new experimental approach to assess the impact of soil confinement on the long-term behavior of geosynthetics is presented in this paper.The experimental technique described herein includes a novel laboratory appara...A new experimental approach to assess the impact of soil confinement on the long-term behavior of geosynthetics is presented in this paper.The experimental technique described herein includes a novel laboratory apparatus and the use of different types of tests that allow generation of experimental data suitable for evaluation of the time-dependent behavior of geosynthetics under soil confinement.The soil-geosynthetic interaction equipment involves a rigid box capable of accommodating a cubic soil mass under plane strain conditions.A geosynthetic specimen placed horizontally at the mid-height of the soil mass is subjected to sustained vertical pressures that,in turn,induce reinforcement axial loads applied from the soil to the geosynthetic.Unlike previously reported studies on geosynthetic behavior under soil confinement,the equipment was found to be particularly versatile.With minor setup modifications,not only interaction tests but also in-isolation geosynthetic stress relaxation tests and soil-only tests under a constant strain rate can be conducted using the same device.Also,the time histories of the reinforcement loads and corresponding strains are generated throughout the test.Results from typical tests conducted using sand and a polypropylene woven geotextile are presented to illustrate the proposed experimental approach.The testing procedure was found to provide adequate measurements during tests,including good repeatability of test results.The soilegeosynthetic interaction tests were found to lead to increasing geotextile strains with time and decreasing reinforcement tension with time.The test results highlighted the importance of measuring not only the time history of displacements but also that of reinforcement loads during testing.The approach of using different types of tests to analyze the soilegeosynthetic interaction behavior is an innovation that provides relevant insight into the impact of soil confinement on the time-dependent deformations of geosynthetics.展开更多
The transformation of quantitative variables into categories is a common practice in both experimental and observational studies. The typical procedure is to create groups by splitting the original variable distributi...The transformation of quantitative variables into categories is a common practice in both experimental and observational studies. The typical procedure is to create groups by splitting the original variable distribution at some cut point on the scale of measurement (e.g. mean, median, mode). Allegedly, dichotomization improves causal inference by simplifying statistical analyses. In this article, we address some of the adverse consequences of recoding quantitative variables into categories. In particular, we provide evidence that categorization usually leads to inefficient and biased estimates. We believe that considerable progress in our understanding of data analysis can occur if scholars follow the recommendations presented in this article. The recodification of quantitative variables as categorical is a poor methodological strategy, and scientists must stay away from it.展开更多
The objective of this study was to systematically review the literature about the use of the operating microscope in endodontics. It used sources of bibliographic cataloging electronically identified by MEDLINE via Pu...The objective of this study was to systematically review the literature about the use of the operating microscope in endodontics. It used sources of bibliographic cataloging electronically identified by MEDLINE via PubMed, LILACS, BBO and Scopus, using as descriptors: Endodontics, anatomy and microscopy. The selected articles were identified from the titles and abstracts, taking into consideration the following criteria: publications ranging from January 2001 to November 2012, case reports, published in an indexed journal, and publications in English language. The search showed 167 articles related to this topic, and these 21 articles met the inclusion criteria. These indicated that a higher magnification helps coronary access and the location of channels to identify and interpret the complexities of the anatomy of root canals, the removal of nuclei and intracoronary fractured instruments, to minimize trauma of surgeries in soft and hard tissues, and detect fractures and microfractures. It was found that its use has provided Endodontics with a significant improvement in vision of the operative field, offering better quality jobs and a higher success rate.展开更多
文摘Background- Stopping the detrimental effects of the renin- angiotensin systemat the most upstream point of the cascade offers theoretical advantages for cardiovascular protection. This study compares the antihypertensive efficacy and safety of the novel oral renin inhibitor aliskiren with placebo and an active comparator. Methods and Results- The study was a randomized, multicenter, double- blind, placebo- controlled, active- comparator 8- week trial in patients with mild- to- moderate hypertension(mean sitting diastolic blood pressure ≥ 95 and< 110mm Hg). After a 2- week, single- blind placebo run- in, 652 patients were randomized to receive double- blind treatment with oncedaily oral doses of aliskiren(150, 300, or 600 mg), irbesartan 150 mg, or placebo. Aliskiren 150, 300, and 600 mg effectively lowered both trough mean sitting DBP and systolic blood pressure(SBP)(P< 0.001 versus placebo for both variables). The least- squares mean reductions in trough DBP were 9.3± 0.8, 11.8± 0.8, and 11.5± 0.8 mm Hg, respectively, versus 6.3± 0.8 mm Hg for placebo, and the least- squares mean reductions in trough SBP were 11.4± 1.3, 15.8± 1.2, and 15.7± 1.2 mm Hg, respectively, versus 5.3± 1.2 mm Hg for placebo. The antihypertensive effect of aliskiren 150 mg was comparable to that of irbesartan 150 mg(8.9± 0.7 and 12.5± 1.2 mmHg, least- squares reduction in mean sitting DBP and SBP, respectively, for irbesartan). Aliskiren 300 and 600 mg lowered mean sitting DBP significantly more than irbesartan 150 mg(P< 0.05). Aliskiren showed safety and tolerability comparable to those of placebo and irbesartan; the incidence of adverse events and number of patients discontinuing therapy were similar in all groups. Conclusions- Once- daily oral treatment with aliskiren lowers blood pressure effectively, with a safety and tolerability profile comparable to that of irbesartan and placebo, in patients with mild- to- moderate hypertension. Aliskiren 150 mg is as effective as irbesartan 150 mg in lowering blood pressure.
文摘Background: Healthcare-associated infections affect hundreds of millions of patients worldwide. Children have greater susceptibility to healthcare-associated infections due to the immaturity of their immune system. Contact precautions aim to promote safety, protection and prevention of contamination. Thus, the objective of this study was to verify adherence to contact precaution measures, as well as compliance to the use of personal protective equipment. Methods: This cross-sectional observational study was carried out from July to October 2019 using a checklist to evaluate health professionals’ adherence to hand hygiene procedures and the use of gloves and surgical gowns when assisting children on contact precautions. Results: A total of 941 observations were carried out in a total of 300.532 hours. Hand hygiene was performed before and after contact with the patient in 58.84% and 75.09% of the cases, respectively and a surgical gown was used in 86.40% of the cases. The use of gloves was the variable most adhered to by professionals (87.57%). Intensive care unit professionals were the care workers who most complied with the regulation regarding hand hygiene after contact with the patient (p = 0.009) and the use of the surgical gown (p < 0.001). The correct hand hygiene technique was the recommendation with least adherence. Non-compliance to the hand hygiene technique was statistically significant among intensive care unit professionals (p = 0.002). Conclusions: Adherence to hand hygiene before contact with the patient and compliance with the hand hygiene technique were neglected by most professionals. However, there was good adherence to the use of surgical gloves and gowns, as well as high compliance to the techniques of removing these items. .
文摘Neuroarchitecture is a set of characteristics grouped into principles that seek to generate a certain behavior when applied.These principles will vary according to the type of user for whom the design is intended.In this research,these neuroarchitectural principles are identified in the nursing home Mis Abuelitos in Cochachinche,Huánuco.The home was designed and built with notions of nature and the Andean while emphasizing the occupants are the elderly.With this purpose,qualitative research was carried out using two sequential criteria,the first was to identify what these principles are and the second was to recognize the principles within the area.The principles that are assertively used for the elderly occupants were selected.The study observation was performed with observation and photographic sheets and was analyzed with ATLAS.ti processing software.It was obtained that the three neuroarchitectural principles are present in the nursing home which are 67%of the recommended characteristics for the elderly.
文摘In the practice of advancing the cause of human rights,China has blazed a path of human rights development that is both consistent with the trend of the times and befits the nation’s conditions.WHEN contemplating human rights,the principle of individual freedom often comes to the forefront.The Chinese government’s perception,however,consists in the more organic concept of a metaphorical garden,wherein human rights flourish by virtue of China’s unique soil-its rich history,ancient culture,and political system.China,as a seasoned gardener,thus endeavors,under the leadership of President Xi Jinping,to develop human rights based on its national conditions.
文摘Introduction: Cataract surgery is one of the procedures most performed worldwide. Those are several options for anesthetic management, with many factors that affect the choice of any given technique, depending on patients’ needs, surgeons’ preferences and institutional facilities and processes. Although being more invasive than topic anesthesia, and with possible hazardous side effects, peribulbar block is still an effective and successful technique. The utilization of blunt canula and ultrasound guidance might enhance the safety pattern for this technique. Methods: This article presents a revision of 1089 consecutive cases from February 2016 to January 2022, of patients submitted to cataract surgery under peribulbar anesthesia with blunt canula and ultrasound guidance. Results: 1318 surgical records were selected, with 1089 filling the inclusion criteria. There was a higher prevalence of the feminine gender (54%), with a median age of 64.3 (28 - 102) years. Mean IAV was 2.9 mL (sd 0.16 mL, 2.5 - 3.0 mL), with total HOS 91.1%;OR to reach G2 or above for each (ISB/IMB) was 11.0;CA was 47.9%, with mean FAV of 4.29 mL (sd 2.17mL, 2.5 - 15 mL). In 8.9% patients, HOS could not be fully observed. ISB, IMB, CA and FAV were calculated for both groups (non-HOS and HOS-only). OR for CA (non-HOS/HOS-only) was 126.21. The main adverse effects were chemosis (2.9%), hyposphagma (5.7%) and high IOP (7.5%). No procedure was postponed due to anesthesia-associated adverse events. Discussion: This study points towards the feasibility of the described technique in an outpatient fashion, with low, mild and tolerable side effects associated.
文摘Background: Hard brunescent nuclei are difficult to chop with traditional techniques, because leathery tough strands may connect the posterior surface and span across the fragments, which poses a challenge to completely divide the nuclei. The ultra-chopping technique was designed to mitigate this issue. Purpose: To compare the intraoperative parameters between Ultra-Chopper and Divide & Conquer Techniques. Setting: This study was performed at Hospital Oftalmológico de Brasília, Brasília, DF, Brazil. Patients and Methods: A prospective, randomized and comparative study. Patients with the diagnosis of dense cataract and surgical extraction programmed were divided into two groups: Ultra-Chopper and Divide & Conquer. Intraoperative data were collected and submitted for the statistical analysis. Results: 36 eyes were included, 19 eyes with Ultra-Chopper and 17 eyes with Divide & Conquer. Groups were statistically equivalent in age and nucleus density. There were no surgical complications. Torsional time and cumulative dissipated energy were significantly reduced in the ultra-chopper group. The ultra-chopper group had less total case time, fluid usage and aspiration (ASP) time. Conclusion: The ultra-chopper tech- nique can reduce ultrasound energy dissipation during cataract surgery, and decrease case time, fluid usage and ASP time.
文摘The chronic obstructive pulmonary disease (COPD) and asthma are chronic airway diseases that cause considerable physical, emotional and social restrictions. The life quality of patients who suffer from these diseases, is more affected by dyspnea then by other symptoms. That way is possible to correlate the impact of dyspnea on their life quality. The Pulmonary Rehabilitation Program (PRP) helps to improve the physical fitness and quality of life. This paper presents a study of the life quality and the dyspnea intensity in chronic lung disease patients. The research has participation of fourteen patients, distributed as seven suffering from COPD and the other seven suffering from asthma, for both gender and with an age average of 74.2 ± 8.9. The patients answer the following questionnaires: Baseline Dyspnea Index (BDI), Medical Research Council (MRC) Dyspnea Scale, Airways Questionnaire 20 (AQ20) and the Brazilian version of the Short-Form (SF-36) life quality questionnaire. From the present study, it was concluded that asthma patients have a less impaired life quality, since the dyspnea intensity is lesser, compared to the one with COPD.
文摘Objectives: Adequate control of hemodynamic parameters in patients undergoing otolaryngology-head and neck (OLHN) surgeries is one of the objectives of peri-operative anesthesia management. In this context, we seek to evaluate the effectiveness of metoprolol compared to clonidine in the post-<span>operative control of systolic (SBP) and diastolic (DBP) blood pressures, and </span><span>heart rate (HR), when these medications are used in the immediate </span><span>pre-operative period. Method: this is a randomized double-blind clinical trial. Patients over 18 years old, according to the American Society of Anesthesiologists Physical Status Classification (ASA) I or II, who would undergo OLHN surgery, presenting with greater than 140 mmHg (SBP) or 90 mmHg (DBP), upon arrival at the surgical ward, were included in the study. 46 patients were randomized into two groups (C or M) who received clonidine (75 or 150 mcg) or metoprolol (5 or 10 mg), respectively. The averages of SBP, DBP and HR were compared between groups upon arrival at the post anesthesia care unit (PACU) and four hours post-surgery. Results: In group C, SBP (127.7 </span><span>±</span><span> 18.8 vs 137.3 </span><span>±</span><span> 14.1 mmHg, p = 0.03) and DBP (73.1 </span><span>±</span><span> 15.46 vs 82.6 </span><span>±</span><span> 7.9 mmHg, p <</span><span> </span><span>0.01) were lower, when compared with group M. No difference was observed in HR immediately upon PACU arrival. In addition, for four hours post-surgery, no change was noted in the SBP, DBP or HR. Conclusion: metoprolol was less effective than clonidine in reducing systolic and diastolic blood pressures in the immediate post-operative period of OLHN surgeries.</span>
文摘Autonomous Underwater Vehicles (AUVs) are robots able to perform tasks without human intervention (remote operators). Research and development of this class of vehicles has growing, due to the excellent characteristics of the AUVs to operate in different situations. Therefore, this study aims to analyze turbulent single fluid flow over different geometric configurations of an AUV hull, in order to obtain test geometry that generates lower drag force, which reduces the energy consumption of the vehicle, thereby increasing their autonomy during operation. In the numerical analysis was used ANSYS-CFX® 11.0 software, which is a powerful tool for solving problems involving fluid mechanics. Results of the velocity (vectors and streamlines), pressure distribution and drag coefficient are showed and analyzed. Optimum hull geometry was found. Lastly, a relationship between the geometric parameters analyzed and the drag coefficient was obtained.
文摘<strong>Background:</strong> The implantation of the intraocular lens (IOL) is still subject to error and complication, as it can result in traumatic opening of the IOL leading to rupture of the posterior capsule and zonular dialysis, it takes time to train paramedic teams to assemble such IOLs with the manual injectors. Moreover, there is a potential risk of comtamination and endophthalmitis as there is manipulation of the IOL and cartridge. The preloaded IOLs tend to reduce those unwanted results and may optimize the surgical time. <strong>Purpose:</strong> The aim of this study is to compare the effectiveness and implantation time between three injectors and three intraocular lenses, two pre-loaded and one conventional. <strong>Methodology:</strong> Videos of thirty patients undergoing cataract surgery from December 2019 to December 2020 at the Hospital Oftalmológico de Brasília (HOB), Brasília, Brazil were included in this observational, analytical retrospective study, non randomized. All patients had their surgeries recorded, from which the time of injection and opening of the intraocular lens (IOL) was extracted, 20 eyes were implanted with preloaded intraocular lens, and 10 eyes with conventional IOL implant. The patients were divided into three groups with similar eye characteristics. The first received the AutonoMe<sup>TM</sup> (CE) injector with the Clareon<span style="white-space:nowrap;"><sup>®</sup></span><span style="font-size:10px;"> </span><span style="white-space:nowrap;"><span style="color:#FFFFFF;font-family:Roboto, "white-space:normal;background-color:#D46399;"><span style="white-space:nowrap;"></span></span></span>IOL, the second the Isert<sup>TM</sup> injector (I) with the Hoya<span style="white-space:nowrap;"><sup><span style="white-space:nowrap;">®</span></sup></span> IOL, and the third was injected with Johnson & Johnson Platinum 1 Series injector used to deliver Sensar<span style="white-space:nowrap;"><sup><span style="white-space:nowrap;">®</span></sup></span> One AAB
文摘<span style="font-family:Verdana;">The objective of this study was to evaluate the effect of blends of different oxygenated additives on gasoline in SI engine Otto cycle. The formulations analyzed were: pure gasoline (type A), common gasoline (type C), gasoline type A + 15% (v/v) oxygenated additives (ethanol, ethyl octanoate, ethyl oleate). The experiments were performed using engine Branco 4-stroke and 2-cylinder, electric dynamometer, exhaust system, control unit composed of Multi-K unit, variable selector and load cell, stroboscope tachometer, fuel supply system and stopwatch. The rotation was conserved at 4400 rpm and wheel power varied from 3 kW to 12 kW, with intervals of 3 kW to obtain hourly consumption curves and brake specific fuel consumption. Even esters and ethanol having lower heat of combustion, hourly consumption was similar to pure gasoline (type A). In relation to the brake specific fuel consumption, increasing the wheel power had a better conversion of the mass of fuel burned into energy. Thus, this study showed that the mixture of gasoline and esters (ethyl octanoate and ethyl oleate) presented good efficiency in terms of consumption. This research contributes to the needs and to the current studi</span><span style="font-family:Verdana;">es in which industries started to add renewable products to petroleum-</span><span style="font-family:Verdana;">derived fuels;in order to obtain more sustainable fuels at lower costs.</span>
文摘Background: Stroke has been considered the major cause of chronic disability in the world and ranks among the leading causes of death. Despite the fact that new vascular events often happen and risk factors are the same that Cardiovascular Diseases, secondary prevention through non-pharmacological measures, are not part of the routine physical rehabilitation after stroke. Objective: The aim is to answer the following clinical question: Should aerobic fitness be part of the physical rehabilitation of individuals post-stroke? Methodological Design: The methodology used in the study was an integrative literature review. Inclusion Criteria: Articles in English are published in secondary databases: systematic reviews with or without meta-analysis, which address the question PICO: patient (post-stroke), intervention (aerobic exercise), comparison (with or without aerobic conditioning) the outcome (volume of oxygen consumed peak (VO<sub>2peak</sub>), quality of life (QoL), morbidity and mortality). Outcomes: VO<sub>2peak</sub>, QoL, complications and mortality. Analysis of Studies: The methodological quality of included studies is assessed using the tools: PRISMA and R-AMSTAR. Results: There was “good” evidence for the inclusion of aerobic exercise on physical rehabilitation of post-stroke individuals to improve their physical capacity (VO<sub>2peak</sub>), facilitating the completion of activities of daily living and gait. There was weak evidence on the association of aerobic fitness with positive results on QoL in stroke victims and insufficient results to evaluate the effect of aerobic fitness on the risk of stroke recurrence and mortality. Conclusion: The aerobic conditioning should be included in the rehabilitation of stroke victims.
文摘Objective: To describe the epidemiological profile of children and adolescents who are victims of domestic violence. Method: This is a cross sectional and descriptive study, following a quantitative approach, conducted from September to December 2013, at the SOS CHILD service, in the city of Natal, Rio Grande do Norte, Brazil. The research protocol was approved by CEP/UFRN under CAAE 0166.0.051.000-11. Results: In the analysis of 69 children, the results were presented from three points of view: 1) the victim—female (56.5%), aged one to 11 years old (66.7%) and lived with one of the parents (43.5%);2) the abuser—female (60.9%) in the 14 - 23 years old and 34 - 43 years old, with the same percentage (24.6%), history of alcohol use and abuse (42.0%), the mother was the one who attacked the most (34.7%);3) types of violence, among the physical ones, the most frequent were slaps (43.2%) and punches (18.9%);the prevalence, among the psychological violence, were curses (35.4%) and abuse (27.8%);negligence, omission of care (73.5%), deprivation of care for personal appearance (18.4%);among sexual violence: sexual caresses (57.1%) and forced sex (42.9%). Conclusion: Children and adolescents placed in an unfavorable social-economic context, under the care of mothers with a history of use and abuse of alcohol and other drugs, are more vulnerable to intra-domiciliary violence.
文摘Health Education has shown itself as essential for the understanding of indi</span><span style="font-family:Verdana;">viduals about psychological and physical changes caused by diseases. The chron</span><span style="font-family:Verdana;">ic obstructive pulmonary disease (COPD) is a severe public health problem, and it depends on health education measures for its control. A group of patients with COPD, in pneumatological medical treatment, were investigated to find </span><span style="font-family:Verdana;">information about the disease. An observational, descriptive and analytical study </span><span style="font-family:Verdana;">with analysis and application of a semistructured questionnaire to evaluate the </span><span style="font-family:Verdana;">individuals</span><span style="font-family:Verdana;">’</span><span style="font-family:;" "=""><span style="font-family:Verdana;"> knowledge about the COPD. Collected data were registered and </span><span style="font-family:Verdana;">analyzed using Google Docs. The software used for the calculation of statistica</span><span style="font-family:Verdana;">l </span><span style="font-family:Verdana;">measures was Microsoft Excel<span style="white-space:nowrap;"><sup>®</sup></span>. For the research participants’ characterization</span> <span style="font-family:Verdana;">analysis, the use of grouped data for the frequency distribution of Sturges Rule</span> <span style="font-family:Verdana;">was necessary. This study provided knowledge about which information a group</span><span style="font-family:Verdana;"> of bearers of COPD receives at a college hospital providing treatment. </span><span style="font-family:Verdana;">The interviewed have an average age of 70 years old and most are women with </span><span style="font-family:Verdana;">education level between elementary and high school and diagnose time of 6</span></span><span style="font-family:Verdana;">.</span><span style="font-family:;" "=""><span style="font-family:Verdana;">8 years. Most of the sample reported knowled
文摘Objective:The robotic-assisted approach to simple prostatectomy(RASP)was conceived,essentially reproducing the fundaments of open simple prostatectomy.Since the first report,RASP underwent several technical modifications.The study aims to identify and describe the current robotic surgery techniques to approach benign prostatic hyperplasia(BPH).Methods:The paper performed a non-systematic literature review accessing PubMed and Embase databases for all full-text articles published from 2008 to May 2020,assessing robot-assisted surgical techniques for BPH treatment using the terms“robot-assisted simple prostatectomy”OR“robotic simple prostatectomy”OR“RASP”AND“surgical technique”.Results:After careful review of 180 studies in PubMed and 198 in Embase,16 papers reporting different RASP techniques.After the first procedure described by Sotelo et al.[9],several authors contributed to the development of the RASP technique.John et al.[24]proposed the extraperitoneal access,and Yuh et al.[23]first reported the adenoma transcapsular dissection.Some modifications were proposed by Coelho et al.[31]on trigonization,posterior reconstruction,and urethro-vesical anastomosis.Other groups focused on urethral-preserving procedures.Moschovas et al.[28]and Clavijo et al.[32]recently described an intrafascial RASP with the removal of the entire prostatic tissue.Finally,Kaouk et al.[29]reported the feasibility and safety of the da Vinci Single Port approach.Conclusion:In the last eighteen years,the robotic-assisted approach to BPH disease has been evolved,and different techniques have been described.This review details all the technical developments on RASP that distinctive groups have proposed since the multiport robotic platforms until the new da Vinci Single Port.
基金This paper is dedicated to Benedito Bueno(in memoriam),a brilliant researcher and former professor at University of São Paulo,to whom the authors are indebted for his vision and enormous contribution during the development of this work.This study was financed in part by the Coordenação de Aperfeiçoamento de Pessoal de Nível Superior(CAPES),Brazil(finance code 001).
文摘A new experimental approach to assess the impact of soil confinement on the long-term behavior of geosynthetics is presented in this paper.The experimental technique described herein includes a novel laboratory apparatus and the use of different types of tests that allow generation of experimental data suitable for evaluation of the time-dependent behavior of geosynthetics under soil confinement.The soil-geosynthetic interaction equipment involves a rigid box capable of accommodating a cubic soil mass under plane strain conditions.A geosynthetic specimen placed horizontally at the mid-height of the soil mass is subjected to sustained vertical pressures that,in turn,induce reinforcement axial loads applied from the soil to the geosynthetic.Unlike previously reported studies on geosynthetic behavior under soil confinement,the equipment was found to be particularly versatile.With minor setup modifications,not only interaction tests but also in-isolation geosynthetic stress relaxation tests and soil-only tests under a constant strain rate can be conducted using the same device.Also,the time histories of the reinforcement loads and corresponding strains are generated throughout the test.Results from typical tests conducted using sand and a polypropylene woven geotextile are presented to illustrate the proposed experimental approach.The testing procedure was found to provide adequate measurements during tests,including good repeatability of test results.The soilegeosynthetic interaction tests were found to lead to increasing geotextile strains with time and decreasing reinforcement tension with time.The test results highlighted the importance of measuring not only the time history of displacements but also that of reinforcement loads during testing.The approach of using different types of tests to analyze the soilegeosynthetic interaction behavior is an innovation that provides relevant insight into the impact of soil confinement on the time-dependent deformations of geosynthetics.
文摘The transformation of quantitative variables into categories is a common practice in both experimental and observational studies. The typical procedure is to create groups by splitting the original variable distribution at some cut point on the scale of measurement (e.g. mean, median, mode). Allegedly, dichotomization improves causal inference by simplifying statistical analyses. In this article, we address some of the adverse consequences of recoding quantitative variables into categories. In particular, we provide evidence that categorization usually leads to inefficient and biased estimates. We believe that considerable progress in our understanding of data analysis can occur if scholars follow the recommendations presented in this article. The recodification of quantitative variables as categorical is a poor methodological strategy, and scientists must stay away from it.
文摘The objective of this study was to systematically review the literature about the use of the operating microscope in endodontics. It used sources of bibliographic cataloging electronically identified by MEDLINE via PubMed, LILACS, BBO and Scopus, using as descriptors: Endodontics, anatomy and microscopy. The selected articles were identified from the titles and abstracts, taking into consideration the following criteria: publications ranging from January 2001 to November 2012, case reports, published in an indexed journal, and publications in English language. The search showed 167 articles related to this topic, and these 21 articles met the inclusion criteria. These indicated that a higher magnification helps coronary access and the location of channels to identify and interpret the complexities of the anatomy of root canals, the removal of nuclei and intracoronary fractured instruments, to minimize trauma of surgeries in soft and hard tissues, and detect fractures and microfractures. It was found that its use has provided Endodontics with a significant improvement in vision of the operative field, offering better quality jobs and a higher success rate.
