Search

O pé diabético é uma complicação major comum da Diabetes mellitus sendo o cirurgião geral o responsável pelo seu diagnóstico e tratamento. A infecção aguda é uma urgência médico-cirúrgica. Este artigo tem como objectivos orientar o cirurgião no diagnóstico e tratamento do pé diabético infectado no serviço de urgência. Antibioterapia de largo espectro, drenagem/ desbridamento cirúrgico no serviço de urgência, internamento, repouso do membro e apósitos adequados são medidas essenciais para o correcto tratamento do pé diabético com infecção moderada-grave. Os desbridamentos devem, sempre que possível, preservar a estrutura e funcionalidade do pé. A intervenção atempada é essencial para reduzir o número de amputações major, a mortalidade e custo social associados. Diabetic foot is a common major complication of Diabetes mellitus. The general surgeon is responsible for its diagnosis and treatment. Acute infection is a medical and surgical emergency. This article aims to guide the surgeon in the diagnosis and treatment of infected diabetic foot in the emergency department. Broad-spectrum antibiotics, surgical drainage/debridement in the emergency department, inpatient, lying of the member and appropriate dressings are essential for the proper treatment of the diabetic foot with moderate-severe infection. The debridement should preserve the structure and function of the foot. Early intervention is essential in order to reduce the number of major amputations and mortality and social cost associated.

Item does not contain fulltext The Movement Disorder Society established a task force to review rating scales for the assessment of tremor. Screening instruments used in identifying patients with tremor were also reviewed. Seven tremor severity scales, six activities of daily living (ADL)/disability scales, four quality-of-life scales, and five screening instruments were identified by searching PubMed.gov. The availability, use, acceptability, reliability, validity, and sensitivity to change were reviewed for each scale; and each scale was classified as recommended, suggested or listed based on whether 3, 2, or 1 of the following criteria were met: (1) used in the assessment of tremor (yes/no), (2) used in published studies by people other than the developers (yes/no), and (3) successful clinimetric testing (yes/no). Five tremor severity scales (the Fahn-Tolosa-Marin Tremor Rating Scale, the Bain and Findley Clinical Tremor Rating Scale, the Bain and Findley Spirography Scale, the Washington Heights-Inwood Genetic Study of Essential Tremor Rating Scale, and the Tremor Research Group Essential Tremor Rating Assessment Scale), one ADL/disability scale (the Bain and Findley Tremor ADL Scale), one quality-of-life scale (the Quality of Life in Essential Tremor Questionnaire), and one screening instrument (the Washington Heights-Inwood Genetic Study of Essential Tremor Rating Scale, version 1) are recommended using these criteria. However, all scales need a more comprehensive analysis of sensitivity to change in order to judge their utility in clinical trials and individual patient assessments. The task force recommends that further work with existing recommended scales be performed as opposed to the development of new tremor scales. (c) 2013 International Parkinson and Movement Disorder Society.

Foram avaliados os efeitos do uso da tecnologia de led na iluminação artificial de codornas japonesas, utilizando-se 176 aves com 35 dias de idade, em delineamento inteiramente casualizado (DIC) com quatro tratamentos (lâmpadas incandescentes 15W, leds: azuis, laranjas e brancos) e quatro repetições de 11 aves cada. A partir da primeira semana de alojamento, estabeleceu-se um programa de luz contínuo, iniciando-se com 13 horas diárias de fotoperíodo, com aumentos sucessivos de 30 minutos por semana até que atingisse 17 horas diárias de fotoperíodo. Semanalmente, os ovos e as sobras de ração de cada parcela foram pesados, para determinação do peso médio dos ovos e do consumo médio diário de ração. Foram realizadas avaliações por etograma simples durante 4 escotofases a fim de avaliar a frequência de acessos aos comedouros por tratamento no momento de acionamento das tecnologias de iluminação. Não foram detectadas diferenças significativas (p>0,05) entre os tratamentos para produção de ovos. Para peso médio do ovo, consumo de ração, peso da casca e espessura de casca não foram observadas diferenças significativas (p>0,05) entre os tratamentos. A Unidade Haugh e a gravidade específica também não apresentaram diferenças estatísticas (p>0,05) entre os tratamentos. The effects of the use of led technology in lighting's program of Japanese quail was evaluated, using 176 birds with 35 days of age, in a completely randomized design with four treatments (15W incandescent lamps, leds: blue, orange and white) and 2 replicates of 22 birds each. Since the first week of housing we established the lighting program, starting with 13 hours of light, with increases of 30 minutes per week until it reached 17 hours of light. Eggs and leftover food from each plot were weighed weekly to determine the average egg weight and feed consumption, expressed as daily basis. Evaluations were performed by ethogram for 4 escotophases to assess the frequency of access to the feeders by treatment in activation of lighting technologies. There were no significant differences (p>0.05) between treatments for egg production. To the parameters of egg weight, feed intake, shell weight and shell thickness were not observed significant differences (p>0.05) between treatments. The Unit Haugh and specific gravity also not showed statistical differences (p>0.05) between treatments.

Drug-induced dyskinesia is a common phenomenon in Parkinson's disease (PD) and is often socially as well as physically disabling for patients. The Movement Disorders Society commissioned a task force to assess available clinical rating scales, critique their clinimetric properties, and make recommendations regarding their clinical utility. A task force composed six clinical researchers who systematically searched the literature for scales measuring dyskinesia in PD, evaluated the scales' previous use, performance parameters, and quality of validation data (if available). A scale was designated "Recommended" if the scale has been used in clinical studies beyond the group that developed it, has been specifically used in PD reports, and if clinimetric studies have established that it is a valid, reliable, and sensitive. "Suggested" scales met two of the above criteria and those meeting one were "Listed." Based on the systematic review, eight rating scales for dyskinesia that have either been validated or used in PD were identified. These were the Abnormal Involuntary Movement Scale (AIMS), The Unified Parkinson's Disease Rating Scale (UPDRS) part IV, the Obeso Dyskinesia Rating Scale, the Rush Dyskinesia Rating Scale, the Clinical Dyskinesia Rating Scale (CDRS), the Lang-Fahn Activities of Daily Living Dyskinesia Scale, the Parkinson Disease Dyskinesia Scale (PDYS-26), and the Unified Dyskinesia Rating Scale (UDysRS). Based on this review, at present two of the reviewed dyskinesia scales (AIMS and the Rush Dyskinesia Rating Scale) fulfill criteria for Recommended for use in PD populations, albeit weakly so; all of the remaining met criteria to be Suggested. However, the two most recent scales (PDYS-26 and UDysRS) have excellent clinimetric properties and appear to provide a reliable and valid assessment tool of dyskinesia in PD. If they are used successfully beyond the groups that developed them, both have the potential to be re-ranked as Recommended. As further testing of these scales in PD is warranted, no new scales are needed until the available scales are fully tested clinimetrically.

Made available in DSpace on 2022-10-25T18:08:36Z (GMT). No. of bitstreams: 1 1-s2.0-S0378112709000334-main.pdf: 355336 bytes, checksum: 252d74f45579dfd3bc6cca255a42ebf9 (MD5) Previous issue date: 2009

Texto completo: acesso restrito. p. 251-256 Submitted by Suelen Reis (suziy.ellen@gmail.com) on 2014-01-07T11:50:03Z No. of bitstreams: 1 174328507X198654.pdf: 262144 bytes, checksum: d57dacc44abcfe50d9b0d9c02be8999f (MD5) Approved for entry into archive by LIVIA FREITAS (livia.freitas@ufba.br) on 2014-01-20T14:23:16Z (GMT) No. of bitstreams: 1 174328507X198654.pdf: 262144 bytes, checksum: d57dacc44abcfe50d9b0d9c02be8999f (MD5) Made available in DSpace on 2014-01-20T14:23:16Z (GMT). No. of bitstreams: 1 174328507X198654.pdf: 262144 bytes, checksum: d57dacc44abcfe50d9b0d9c02be8999f (MD5) Previous issue date: 2007 The present paper presents the results of fluorite flotation carried out on a column cell without wash water addition. Concentrate flow was obtained by making tailing flows smaller than feed flows. Hence, part of the feed water was carried up within bubble wakes. No pulp/froth interface was established. A high recovery was obtained in a 2 m collection zone column. The recovery reached >80% with a grade of ∼90%. It was found that the recovery depended on the value of the difference between the feed flow and tailing flow. In addition, a straight line between the surface velocity of mineral and the recovery was found. It appears that a maximum capacity of solid is ∼10 g min−1 cm−2.

To assess the prevalence, nature, and associated phenotypes of ATP13A2 gene mutations among patients with juvenile parkinsonism (onset21 years) or young onset (between 21 and 40 years) Parkinson disease (YOPD).We studied 46 patients, mostly from Italy or Brazil, including 11 with juvenile parkinsonism and 35 with YOPD. Thirty-three cases were sporadic and 13 had positive family history compatible with autosomal recessive inheritance. Forty-two had only parkinsonian signs, while four (all juvenile-onset) had multisystemic involvement. The whole ATP13A2 coding region (29 exons) and exon-intron boundaries were sequenced from genomic DNA.A novel homozygous missense mutation (Gly504Arg) was identified in one sporadic case from Brazil with juvenile parkinsonism. This patient had symptoms onset at age 12, levodopa-responsive severe akinetic-rigid parkinsonism, levodopa-induced motor fluctuations and dyskinesias, severe visual hallucinations, and supranuclear vertical gaze paresis, but no pyramidal deficit nor dementia. Brain CT scan showed moderate diffuse atrophy. Furthermore, two Italian cases with YOPD without atypical features carried a novel missense mutation (Thr12Met, Gly533Arg) in single heterozygous state.We confirm that ATP13A2 homozygous mutations are associated with human parkinsonism, and expand the associated genotypic and clinical spectrum, by describing a homozygous missense mutation in this gene in a patient with a phenotype milder than that initially associated with ATP13A2 mutations (Kufor-Rakeb syndrome). Our data also suggest that ATP13A2 single heterozygous mutations might be etiologically relevant for patients with YOPD and further studies of this gene in Parkinson disease are warranted.

Dopamine agonists are used as initial treatment in patients with Parkinson's disease (PD) to reduce incidence and severity of motor complcations. This paradigm is based on longterm studies, allowing "rescue" therapy with levodopa. The present strict monotherapy study (PELMOPET, the acronym for the pergolide-versus-L-dopa-monotherapy-and-positron-emission-tomography trial) evaluated the efficacy and safety of pergolide versus levodopa without levodopa "rescue" medication. This multicenter, double-blind, randomized, 3-year trial compared pergolide monotherapy (n = 148) with levodopa monotherapy (n = 146) in dopamine-naive patients with early PD (Hoehn and Yahr stage 1-2.5). Primary efficacy measures were clinical efficacy, severity and time to onset of motor complications, and disease progression. During the 3 years, severity of motor complications was significantly lower and time to onset of dyskinesia was significantly delayed in the group receiving pergolide (3.23 mg/ day) compared with those receiving levodopa (504 mg/day). However, time to onset of motor complications was not longer in patients receiving pergolide after 3 years. Symptomatic relief (assessed by Unified Parkinson's Disease Rating Scale [UPDRS], UPDRS II, and III, Clinical Global Impressions [CGI] severity, and CGI and Patient Global Impressions [PGI] improvement) was significantly greater in patients receiving levodopa. Adverse events led to discontinuation of therapy in 17.6% of pergolide patients and 9.6% of levodopa patients. This is the first study comparing strict monotherapy with a dopamine agonist versus levodopa in previously untreated early PD. In principle, both levodopa and a dopamine agonist such as pergolide seem to be suitable options as initial PD therapy. The choice remains with the treating physician based oil the different efficacy and adverse event profiles. (c) 2005 Movement Disorder Society

RESTRITO Submitted by Santiago Fabio (fabio.ssantiago@hotmail.com) on 2012-07-06T15:01:15Z No. of bitstreams: 1 DD.pdf: 111324 bytes, checksum: 14c8ed618f782a91283abe9b84694f6d (MD5) Made available in DSpace on 2012-07-06T15:01:15Z (GMT). No. of bitstreams: 1 DD.pdf: 111324 bytes, checksum: 14c8ed618f782a91283abe9b84694f6d (MD5) Previous issue date: 2006 This paper presents flotation results carried out on fluorite ore using a relatively short column, operated under negative bias regime and without wash water. The term short column is used from a kinetic point of view from which collection zone comes out to be around 8 m tall (the relation height/diameter appears valid for industrial size columns). Negative bias was achieved making tailing flow smaller than feed flow. Hence, part of the water is carried up within bubbles wakes. No wash water is added. It was found that, heavily loaded bubbles, formed in high-grade fluorite pulps, at negative bias, levitate easier than positive bias. Under such conditions, carrying capacity of columns seems to increase due to a decrease in downward velocity of pulp. Recovery increases considerably, resulting in a sort of rougher flotation. High recovery as well as grades was obtained under negative bias regime.

Tricyclic antidepressant overdose is a frequent diagnosis in the emergency room. It is responsible for a significant percentage of hospital admissions for observation and treatment. This is due to its cardiac (as well as neurologic) toxicity, and the difficulty in predicting its clinical gravity. The authors present this paper with two objectives in mind: 1) information about a common and significant cardiological emergency; 2) presentation of the methodology concerning systematic reviews of the literature. In this second (of four) articles, the clinical presentation and diagnosis of tricyclic antidepressant overdose are presented (in the first article--published in the previous issue of the Journal--we discussed the epidemiological aspects). In the remaining two papers we will present its management, prognosis and prevention. NOTE: This is the second of a series of four articles on the cardiac toxicity of tricyclic antidepressant overdose; the next two articles will be presented in the September and October issues of the Revista.