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Gastric laceration after cardiopulmonary resuscitation:A case report

Case reports in Clinical Medicine 2014年第1期3卷 52-56页

作者： r.ta Simone lopes Moreira Solange Guizilini Natasha Marcondes ramiro Colleoni Isadora S.rocco Iran goncalves ana Christina Velloso Caluza Vinicius Santos Batista Antonio Carlos de Camargo Carvalho Hospital Sao Paulo-University Hospital of Federal University of Sao Paulo Sao PauloBrazil Department of Cardiology Federal University of Sao PauloSao PauloBrazil

The cardiopulmonary resuscitation (CPr) persists as the best practice to maintain cerebral and coronary perfusion after cardiac arrest. Due to the chest compressions and ventilation maneuvers during resuscitation, there are common complications reported. Abdominal organs injuries occur in approximately 30% of patients, although studies show that they are under diagnosticated. The aim of this article is to report a case of massive digestive hemorrhage by gastric laceration after cardiopulmonary resuscitation, due to the event severity and rare clinic diagnostic. A 75-year-old Caucasian man suffered a sudden malaise and cardiac arrest and transferred to an Emergency Unit (EU). The set of measures recommended by Advanced Cardiac Life Support (ACLS) was performed. Despite no resistance to the passage of nasogastric survey and spontaneous healing of fresh blood exteriorization, an endoscopy showed ulcers in gastric notch with clots adhered and active blood. There was no track record of liver or gastrointestinal diseases on this patient, identifying a gastric laceration after cardiopulmonary resuscitation. The mechanism by which the gastric laceration after CPr occurred is uncertain. Nevertheless, some precipitating factors are considered such as positioning of the patient during CPr, ideal point of compressions and ventilation pressure. In conclusion, this event is rare with a hard diagnostic however that could be avoided and minimized with preventive measures.

关键词： Cardiac Arrest Ventilation Emergency Care Complications Gastric Injury Cardiopulmonary resuscitation

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Hospitalizations and in-hospital mortality for inflammatory bowel disease in Brazil

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World Journal of Gastrointestinal Pharmacology and Therapeutics 2022年第1期13卷 1-10页

作者： ana Luiza Vilar Guedes Amanda lopes Lorentz Larissa Fernandes de Almeida rios rios Beatriz Camara Freitas Adriano Gutemberg Neves Dias ana Luísa Eckhard Uhlein Felipe Oliveira Vieira Neto Jobson Felipe Soares Jesus Túlio de SáNovaes Torres raquel rocha Vitor D Andrade Genoile Oliveira Santana Life Sciences Department State University of BahiaSalvador 41150-000BahiaBrazil Sciences of Nutrition Federal University of BahiaSalvador 40110-060BahiaBrazil Medicine Department Universidade Salvador(UNIFACS)Salvador 41820-021BahiaBrazil Medicine and Health Postgraduate Program Federal University of BahiaSalvador 40110-060BahiaBrazil

BACKGrOUND Inflammatory bowel disease(IBD)is associated with complications,frequent hospitalizations,surgery and *** introduction of biologic drugs into the therapeutic arsenal in the last two decades,combined with an expansion of immunosuppressant therapy,has changed IBD management and may have altered the profile of hospitalizations and in-hospital mortality(IHM)due to *** To describe hospitalizations from 2008 to 2018 and to analyze IHM from 1998 to 2017 for IBD in *** This observational,retrospective,ecological study used secondary data on hospitalizations for IBD in Brazil for 2008-2018 to describe hospitalizations and for 1998-2017 to analyze *** data were obtained from the Hospital Information System of the Brazilian Unified Health System and population data from demographic *** following variables were analyzed:Number of deaths and hospitalizations,length of hospital stay,financial costs of hospitalization,sex,age,ethnicity and type of hospital *** There was a reduction in the number of IBD hospitalizations,from 6975 admissions in 1998 to 4113 in 2017(trend:y=-0.1682x+342.8;r^(2)=0.8197;Ptalization rate also decreased,from 3.60/100000 in 2000 to 2.17 in *** rates varied during the 20-year period,between 2.06 in 2017 and 3.64 in 2007,and did not follow a linear trend(y=-0.0005049x+2.617;r^(2)=0,00006;P=0.9741).IHM rates also varied between regions,increasing in all but the southeast,which showed a decreasing trend(y=-0.1122x+4.427;r^(2)=0,728;Pregion accounted for 44.29%of all *** Northeast region had the highest IHM rate(2.86 deaths/100 admissions),with an increasing trend(y=0.1105x+1.110;r^(2)=0.6265;Ptalization rate(1.15).The Midwest and South regions had the highest hospitalization rates(3.27 and 3.17,respectively).A higher IHM rate was observed for nonelective admissions(2.88),which accounted for 81%of IB

关键词： Inflammatory bowel disease Crohn’s disease Ulcerative colitis Hospitalization Hospital mortality Hospital information systems Epidemiology

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Climatic Projections of Lightning in Southeastern Brazil Using CMIP5 Models in rCP’s Scenarios 4.5 and 8.5

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American Journal of Climate Change 2017年第3期6卷 539-553页

作者： ana Paula Paes dos Santos Osmar Pinto Júnior Sérgio rodrigo Quadros dos Santos Francisco José lopes de Lima Everaldo Barreiros de Souza André Arruda rodrigues de Morais Eldo E. ávila analía Pedernera National Institute for Space research (INPE) S&atilde o José dos Campos Brazil Vale Institute of Technology (ITV) Belém Brazil National University of Cordoba (UNC) Córdoba Argentina

Given the high and increasing lightning incidence over the Southeast of Brazil and the various impacts that this phenomenon generates to society, there is a growing need in predicting its occurrence, in order to minimize its consequences. In this context, this work presents the development of a methodology for the projection of lightning in the State of S?o Paulo (Southeastern Brazil), using the HadGEM2-ES and CSIrO-Mk3.6 models in two IPCC climate change scenarios: rCP4.5 and rCP8.5. Since lightning is not an output variable of climate models, tests were carried out to evaluate the relationship between the observed data of oceanic and atmospheric fields, which are known as outputs of the models, and the lightning from the rINDAT and BrasilDAT detection networks. As result, a correlation of 0.84 was obtained. In the projections, it was verified that, while during a large portion of the current climate we observed events of lightning below the average, the future climate reveals the preponderance of anomalously above average events, both in the scenario of intermediate-low emissions (rCP4.5) and in the scenario of high emissions (rCP8.5), suggesting a change in the pattern of the lightning incidence in the State of S?o Paulo.

关键词： Lightning Climatic Projections Southeastern Brazil

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renal Function after Major Uro-Oncologic Surgery and Dexmedetomidine Infusion

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Open Journal of Anesthesiology 2013年第8期3卷 356-362页

作者： Marcus Vinicius M. Novaes Paulo Sergio G. Lavinas Grace Haber D. Pires ana Claudia G. de Carvalho renata M. B. lopes regina El Dib Paulo do Nascimento Jr. Cancer Institute (INCA) Rio de Janeiro Brazil Department of Anesthesiology Univ Estadual Paulista (UNESP) Botucatu Brazil

Objective: Acute kidney injury in major surgery is associated with increased postoperative mortality. This study aimed to evaluate renal function after major urologic surgery and intraoperative dexmedetomidine infusion. Methods: Thirty oncologic patients with normal renal function scheduled for prostatectomy or nephrectomy, anesthetized with combined epidural and general anesthesia, were randomized to receive either intraoperative blind infusion of dexmedetomidine (Dexmedetomidine Group, n = 15, 0.5 μg/kg load dose plus 0.7 μg/kg/h) or 0.9% saline (Control Group, n = 15) until the end of surgery. Intraoperative and cumulative 24-hour diuresis, serum creatinine (SCr), calculated creatinine clearance (ClCr) and serum cystatin C (SCys) at postoperative days 1, 2 and 3 and 2 weeks after surgery were evaluated. results: Mean ± standard deviation values for intraoperative diuresis in Dexmedetomidine and Control Groups were 566 ± 396 mL and 298 ± 153 mL, respectively (p = 0.014). Cumulative 24-hour diuresis in Dexmedetomidine and Control Groups was 1947 ± 266 mL and 1748 ± 237 mL, respectively (p = 0.91). Mean values of SCr, ClCr and SCys were not significantly different from their baseline values in both groups and no significant differences were seen between groups at any moment for two weeks (p > 0.05). Conclusion: According to the doses used in this study, despite an intraoperative increase in diuresis, intraoperative infusion of dexmedetomidine did not influence renal performance up to two weeks after major uro-oncologic surgery, as evaluated by SCr, ClCr and SCys.

关键词： Dexmedetomidine renal Function Nephrectomy Prostatectomy Epidural General Anesthesia

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Pressure Ulcers in Institutionalized Elderly People:Association of Sociodemographic and Clinical Characteristics and risk Factors

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Open Journal of Nursing 2017年第1期7卷 111-122页

作者： Suellen Duarte de Oliveira Matos Iraktania Vitorino Diniz Adriana Lira rufino de Lucena Smalyanna Sgren da Costa Andrade Karen Krystine goncalves de Brito Elizabeth Souza Silva de Aguiar Emanuelle Malzac Freire de Santana Mailson Marques de Sousa ana Paula Marques Andrade de Souza Hemílio Fernandes Campos Coelho Mirian alves da Silva Marta Miriam lopes Costa Maria Julia Guimaraes Oliveira Soares Simone Helena dos Santos Oliveira Graduate Program in Nursing Universidade Federal da ParaíbaJoao PessoaBrazil Departament of Statistics Universidade Federal da ParaíbaParaíbaBrazil

Objective: To evaluate the association of socio-demographic and clinical characteristics, and risk factors with occurrence of pressure ulcers in institutionalized elderly people. Method: This cross-sectional, analytical study, in quantitative approach, performed from the database analysis linked to the project “Pressure Ulcer in institutionalized elderly people: Association of incidence with the risk factors to functional and nutritional assessment” developed in six long-stay institutions for the elderly people in João Pessoa. Data were analyzed using the Statistical Package for Social Sciences (SPSS) version 20.0. Associations were made through chi square test and Odds ratio. results: The clinical conditions of significant associations with the occurrence of pressure ulcers were the variables neurological disorders (p = 0.011) and visual impairment (p = 0.005). As for risk factors, the most important was fecal incontinence (p Conclusion: The analysis of the associations pointed out problems that require intervention in order to prevent health implications of the elderly people and to minimize the risk and occurrence of this injury.

关键词： Elderly People Institutions for the Elderly People Pressure Ulcer Health Profile risk Factors

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锆和钽基氧气还原反应催化剂的简易合成(英文)

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催化学报 2015年第4期36卷 484-489页

作者： David Sebastián Vincenzo Baglio Shuhui Sun ana C.tavares Antonino S.Aricò Istituto di Tecnologie Avanzate per l’Energia "Nicola Giordano" CNR Via Salita Santa Lucia sopra Contesse 5 98126 Messina Italy Institut National de la recherche Scientifique-énergie Matériaux et Télécommunications 1650 Boulevard Lionel-Boulet Varennes QC J3X 1S2 Canada

Cathode catalysts for direct alcohol fuel cells(DAFCs) must have high catalytic activity for the oxy-gen reduction reaction(Orr), low cost, and high tolerance to the presence of methanol or ethanol. Pt is the benchmark catalyst for this application owing to its excellent electrocatalytic activity, but its high cost and low tolerance to the organic fuel permeating through the membrane have hindered the commercialization of DAFCs. Herein we present a facile synthesis route to obtain organic fuel-tolerant Zr- and ta-based catalysts supported on carbon. This method consists of a simple precipitation of metal precursors followed by a heat treatment. X-ray diffraction analyses confirmed that the obtained samples were crystalline ZrO 2-x and Na2ta8O21-x having crystallite sizes of 26 and 32 nm, respectively. The thermal treatment effectively increased the activity of the catalysts to-wards the Orr, although further optimization is necessary. Both catalysts exhibited a high tolerance to the presence of methanol with only a moderate reduction in Orr activity even at high methanol concentration(0.5 mol/L).

关键词：阴极催化剂还原反应简便合成低氧直接醇类燃料电池电催化活性 X射线衍射分析钽基

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Clinical and Spatial Characteristics of Severe Acute respiratory Syndrome by COVID-19 in Indigenous of Brazil

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Advances in Infectious Diseases 2021年第4期11卷 441-454页

作者： Daniele Melo Sardinha Karla Valéria Batista Lima ana Lúcia da Silva Ferreira Juliana Conceição Dias Garcez Thalyta Mariany rêgo lopes Ueno Yan Corrêa rodrigues Anderson Lineu Siqueira dos Santos rosane do Socorro Pompeu de Loiola ricardo José de Paula Souza e Guimarães Luana Nepomuceno gondim Costa Lima Programa de Pós-Graduaç ã o em Epidemiologia e Vigilancia em Saúde Instituto Evandro Chagas (PPGEVS/IEC) Ananindeua Brazil Programa de Pós-Graduaç ã o em Biologia Parasitária na Amazô nia Instituto Evandro Chagas and Universidade do Estado do Pará (PPGBPA/IEC/UEPA) Belém Brazil Programa de Pós-Graduaç ã o em Biologia Parasitária na Amazô nia Instituto Evandro Chagas and Universidade do Estado do Pará (PPGBPA/IEC/UEPA) Belém Brazil Secr.taria de Estado de Saúde Pública do Pará(SESPA) Belém Brazil

The new coronavirus (SArS-CoV-2) broke out in Wuhan in China in December 2019, causing severe pneumonia and deaths, soon in March 2020, it reached pandemic level, affecting several countries including Brazil. The disease was named COVID-19, with characteristics of most infected having mild and moderate symptoms and a part severe symptom. The disease has already reached 158 ethnic groups, which have high vulnerability and limited access to health services. The objective is to investigate the clinical and spatial characteristics of Severe Acute respiratory Syndrome of COVID-19 in the indigenous peoples of Brazil. It is an epidemiological, cross-sectional, analytical ecological study, based on data from the OpenDataSUS platform from 01/01/2020 to 31/08/2020. Profile variables, signs and symptoms and risk factors/comorbidities. The data were analyzed by Bioestat 5.3. There were 1,207 cases and 470 deaths. Profile: male gender (59.48%) means age 53 years. Signs and symptoms: fever (74.23%), cough (77.71%), sore throat (35.62%), dyspnea (69.34%), respiratory discomfort (62.80%), O2 saturation rtality: dyspnea (80.0%) and O2 saturation risk factors and comorbidities (45.89%) were associated with deaths (54.04%). About comorbidities, chronic cardiovascular diseases represented (18.97%) and Diabetes Mellitus (18.97%), and associated with deaths: Chronic Cardiovascular Disease (24.46%). Being admitted to the ICU has a risk of death in (Or-3.96- r-1.85- razil should be directed to control the dissemination of COVID-19 in this population, that COVID-19 evolves in the same intensity, however, the indigenous have vulnerabilities that can increase the impact of the pandemic in this population.

关键词： Severe Acute respiratory Syndrome Indigenous People SArS-CoV-2 COVID-19 Brazil

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克隆测序确认HLA新等位基因B~*3712^(★○)

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中国组织工程研究与临床康复 2007年第50期11卷 10131-10133页

作者：张伯伟邢培清赵磊 ana Lazaro Jennifer Ng 河南省红十字血液中心河南省郑州市450012 美国海军骨髓库洛克维尔马里兰州美国20852

目的:由于技术原理的限制,目前尚不能对所有的HLA等位基因进行严格的区分,特别是以往没有发现的新基因序列只能通过测序的方法解决,然而,当遇到等位基因杂合时,测序给出的结果仍然无法确认新的序列改变发生在等位基因的哪一侧,这时需要... 详细信息

目的:由于技术原理的限制,目前尚不能对所有的HLA等位基因进行严格的区分,特别是以往没有发现的新基因序列只能通过测序的方法解决,然而,当遇到等位基因杂合时,测序给出的结果仍然无法确认新的序列改变发生在等位基因的哪一侧,这时需要用分子生物学方法分离杂合子然后进行测序才能确定新的基因序列。采用基因克隆方法确认HLA新等位基因。方法:实验于2006-01/05在河南省红十字血液中心HLA实验室,美国海军骨髓库HLA实验室完。成造血干细胞血样由中华骨髓库提供。采用荧光微珠HLA分型方法对中华骨髓库捐献者血样进行HLA分型检测,无法给出确切结果的摸棱两可结果标本用基因克隆(TOPO ta Cloning)、DNA测序的方法确认新的HLA基因序列。结果:通过克隆分离杂台等位基因,再进行测序确认发现新的序列与B~*3709相比,出现4个核苷酸改变:1.355nt C>A,2.363nt C>G,3.412ntG>A,4 477nt C>G,而且均发生在HLA-B基因外显子3(exon 3)。4处改变引起氨基酸编码改变:①编码95 CTC>ATC,氨基酸改变L>I(亮氨酸>异亮氨酸)。②97 AGC>AGG,S>r(丝氨酸>精氨酸)。③114 GAC>AAC D>N(天门冬氨酸>天冬酰胺)。④135 GCC>GCG A=A无氨基酸改变。结论:①新的基因序列已经在GenBnak注册,被WHO的HLA因子命名委员会得到正式命名为HLA-B~*3712基因。②基因克隆是确认HLA新基因的根本方法。

关键词： HLA新基因基因克隆 DNA测序

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Association between the CYBA and NOX4 genes of NADPH oxidase and its relationship with metabolic syndrome in non-alcoholic fatty liver disease in Brazilian population

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Hepatobiliary & Pancreatic Diseases International 2018年第4期17卷 330-335页

作者： Fabiola rabelo Jose tadeu Stefano ana Mercedes Cavaleiro rodrigo Vieira Costa Lima Daniel Ferraz de Campos Mazo Flair Jose Carrilho Maria Lúcia Correa-Giannellac Claudia P.Oliveiraa Departamento de Gastroenterologia Faculdade de Medicina FMUSPUniversidade de Sao PauloSao PauloSPBrazil Hospital das Clinicas HCFMUSP Departamento de GastroenterologiaLIM07Faculdade de MedicinaUniversidade de Sao PauloSao PauloSPBrazil Laboratório de Carboidratos e radioimunensaio LIM18Hospital das Clinicas HCFMUSP(LIM07)Faculdade de MedicinaUniversidade de Sao PauloSao PauloBrazil Programa de Pos-Graduacao em Medicina Universidade Nove de Julho(UNINOVE)Sao PauloBrazil

Background: Oxidative stress has been implicated in the progression of severe forms of non-alcoholic fatty liver disease(NAFLD). NADPH oxidase produces reactive oxygen species. In the present study, we investigated for the first time two single nucleotide polymorphisms(SNPs) in the regulatory region of genes encoding NADPH oxidase 4(NOX4) and p22 phox(CYBA) in ***: A total of 207 biopsy-proven NAFLD patients [simple steatosis(n = 27); nonalcoholic steatohepatitis(NASH)(n = 180)] were evaluated. Genomic DNA was extracted from peripheral blood cells, and polymorphisms in CYBA(unregistered) and NOX4(rs3017887) were determined by direct sequencing of ***: Associations of CYBA-675 T/A with high-density lipoprotein(HDL)(TT vs ta vs AA; P riglycerides(TGL)(TT vs XA; P re observed only in NASH patients. For polymorphisms in the NOX4 gene, NOX4(rs3017887) CA + AA genotypes was significant associated with alanine aminotransferase(ALT)(CA + AA vs CC; P = 0.02). However, there was no association of SNPs in the CYBA and NOX4 genes encoding the NADPH oxidase system proteins and the presence of NASH. regarding the clinical results, it was observed that the most advanced degrees of fibrosis occurred in patients diagnosed with type 2 diabetes mellitus(66.9% vs 37.5%, P re more obese(32.2 vs 29.0 kg/m2,P rum glucose and insulin levels increased significantly in the presence of ***: There were associations between the presence of the allele A in the NOX4 SNP and a higher concentration of ALT in the NAFLD population; between the presence of the AA genotype in the polymorphism of the CYBA-675 T/A CYBA gene and a higher level of TGL and lower HDL in NASH patients. The presence of metabolic syndrome was associated with advanced degrees of fibrosis in NAFLD patients.

关键词： Non-alcoholic fatty liver disease Nonalcoholic steatohepatitis Genetic polymorphism Metabolic syndrome

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Successful endoscopic resolution of a large gastric bezoar in a child

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World Journal of Gastrointestinal Endoscopy 2011年第6期3卷 129-132页

作者： Sara Azevedo Joo lopes António Marques Paula Mourato Lucília Freitas ana Isabel lopes Gastrenterology Unit Pediatric DepartmentUniversity Hospital Santa Maria Gastroenterology Department University Hospital Santa Maria Gastrenterology Unit Pediatric Department University Hospital Santa MariaMedical Faculty of Lisbon

Bezoars are masses or concretions of indigestible materials found in the gastrointestinal tract,usually in the *** reports of childhood gastric bezoars(particularly phytobezoars)are *** this age group they represent a therapeutic challenge,because of the combination of hard consistency and great *** present report concerns an 8-year-old boy with a history of high fruit intake,presenting with abdominal complaints due to a large gastric *** endoscopic fragmentation coupled with suction removal was accomplished,using a standard-channel *** laborious,it has been shown to be an efficacious and safe procedure,completed in one *** techniques for pediatric bezoar management may thus be cost effective,taking into account the avoidance ofsurgery,the length of the hospital stay and the number of endoscopic sessions.

关键词： Bezoar Children Endoscopic fragmentation

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