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A Miniaturized Radiation Monitor (MIRAM) has been developed for the continuous measurement of the radiation field composition and ionizing dose rates in near earth orbits. Compared to currently used radiation monitors, the presented device has an order of magnitude lower weight while being comparable in power consumption and functionality. MIRAM is capable of on-board real-time self-diagnostic. Furthermore, it supports on-board analysis of the measured data to be able to work autonomously. The dose rate is calculated continuously based on the energy deposition in the Timepix3 detector. For the estimation of the particle species composition of the radiation environment, two methods are applied depending on the current flux. At lower fluxes (

This paper presents the case for how students can be helped to increase their scientific vocation by experimental work and the introduction of particle physics into pre-university studies. These two ideas are the two main lines of work of the ADMIRA initiative, which has been created by individuals belonging to different and complementary educational and research institutions. The initiative consists of a network of schools that share Minipix devices, a readout system for the Timepix detector designed at CERN in the framework of the Medipix2 Collaboration. The schools receive logistical and technical support from the local University (the University of Barcelona) and from CERN. The centres involved and the objectives, as well as the characteristics of the project are presented. The technical and didactic materials available are also shown. Finally, some initiative data has been analysed to show its rapid growth, and some students’ research is presented showing the diversity of tasks that can be done with such detectors.

Position and directional-sensitive spectrometry of energetic charged particles can be performed with high resolution and wide dynamic range (energy, direction) with the hybrid semiconductor pixel detectors Timepix/Timepix3. The choice of semiconductor sensor material, thickness, and properties such as the reverse bias voltage, greatly determine detector sensitivity and resolving power for spectrometry and particle tracking. We investigated and evaluated the spectral tracking resolving power such as deposited energy and linear-energy-transfer (LET) spectra with the Timepix3 detector with different semiconductor sensors, based on GaAs:Cr, CdTe, and Si, using well-defined radiation sources in terms of radiation type (protons), energy, and incident direction to the detector sensor. Measurements of particle incident direction in a wide range were performed with collimated monoenergetic proton beams of various energies in the range 8–31 MeV at the U120-M cyclotron at the NPI CAS Rez near Prague. All detectors were per-pixel calibrated. This work enables to examine and perform a detailed study of charge sharing and charge collection efficiency in semiconductor sensors. The results serve to optimise the detector chip-sensor assembly configuration for measurements especially with high-LET particles in ion radiotherapy and outer space. The work underway includes evaluation of newly refined semi-insulating GaAs sensors and improved radiation hard semiconductor sensors SiC.

The semiconductor pixel detector Timepix2 is operated with highly integrated readout electronics as a miniaturized and portable MiniPIX TPX2 radiation camera for radiation imaging and spectral-sensitive particle tracking in wide field-of-view. The device provides room-temperature operation, ease of use (single USB 2.0 port), online response with single track visualization, fast frame readout (up to 60 fps) and double per-pixel response for detailed measurements with per-pixel energy and counting or energy and timing sensitivity. We evaluate the response and applicability of a MiniPIX TPX2 camera with the Timepix2 ASIC chip equipped with a 300 µm thick silicon sensor for wide-range composition and spectral characterization of mixed-radiation fields. Measurements were performed in high-energy proton radiotherapy environments with protons of selected energies in the range 225–70 MeV and water-equivalent targets of varying configuration (size, dimension, geometry). High-resolution pattern recognition and spectral-tracking analysis of the single particle tracks in the pixelated detector enable to resolve and classify all detected signals according particle species, direction and energy loss. Based on the experimental calibrations performed with well-defined radiation fields together with quantum imaging visualization of single particle tracks, ten broad-range particle-event classes are resolved. Mixed-radiation fields are thus analyzed according particle-event types in wide range of deposited energy, linear-energy-transfer LET, particle fluxes and dose rates. The spatial distribution over the detector sensor matrix of the distinguished groups can be visualized as well as the directional mapping of energetic charged particles.

We evaluate a high-resolution contrast-enhanced method for energy-sensitive radiography of thin samples with low-energy protons at the light-ion Tandetron accelerator of the NPI-CAS in Rez near Prague. We make use of the high-sensitivity of the hybrid semiconductor pixel detectors Timepix enabled by integrated per-pixel signal processing electronics. For this work we use the Timepix3 ASIC chip equipped with a 500 µm Si sensor operated with the fast data rate AdvaPix readout electronics interface. Measurements are performed in air with a 2.9 MeV proton microbeam on thin samples (

The miniaturized radiation camera MiniPIX TPX3 is designed for detailed and wide-range measurements of mixed-radiation fields present in many applications such as radiotherapy and space radiation in outer orbit. The highly integrated instrumentation utilizes a single connector for control and readout for flexible measurements and quick deployment. The device features an option to process the registered data on the same device with limited resolution and basic particle-type resolving power. A novel readout and data processing technique exploits the detector high granularity and double per-pixel signal electronics to measure and characterize radiation fields of high intensity over a wide range with basic particle-type discrimination.

A highly integrated particle telescope is assembled from two MiniPIX Timepix3 detectors in stack configuration to provide time- and spectral-sensitive tracking of energetic charged particles. The telescope architecture, high granularity and per-pixel spectral response of the imaging detectors enable directional mapping of energetic charged particles in wide field-of-view (FoV) with high angular resolution (sub degree) without the need for collimators. The pixel detectors are operated in sync and readout each with separate USB 2.0 cable for integrated control and power supply. Timepix3 two per-pixel signal channels are operated in energy and time mode for detailed spectral- and time-registration of single events in each detector. Events are registered with time stamp resolution at tens of ns level between both detectors. Correlated events between both detector layers are resolved by correlated time stamp with a coincident time window 1 + ΔE2 technique. Data products include detailed angular distributions of energetic charged particles with high angular resolution, time stamp, spectral response (energy loss, LET value) and enhanced particle-type resolving power of over 8 event classes. The directional response and angular resolution depend on the spacing gap between the tracker detectors. The resulting field-of-view, geometric factor and angular resolution are evaluated. Results are presented with proof-of-principle of the technique and evaluation of synchronized operation with 31 MeV protons.

The mass-separator MASHA built to identify Super Heavy Elements by their mass-to-charge ratios is described. The results of the off- and on-line measurements of its separation efficiency are presented. In the former case four calibrated leaks of noble gases were used. In the latter the efficiency was measured via 284 MeV $^{40}$ Ar beam and with using the hot catcher. The ECR ion source was used in both cases. The $\alpha $ -radioactive isotopes of mercury produced in the complete fusion reaction $^{40}$ Ar+ $^{144}$ Sm $\rightarrow ^{184-xn}$ Hg+xn were detected at the mass-separator focal plane. The half-lives and the separation efficiency for the short-lived mercury isotopes were measured. Potentialities of the MEDIPIX detector system have been demonstrated for future use at the mass-separator MASHA.

The VZLUSAT-1 satellite, the first Czech CubeSat, was successfully launched on June 23, 2017, to a 510 km Sun-synchronous low-Earth orbit. It carries several scientific payloads including a Timepix detector as focal plane imager for the X-Ray telescope onboard. The Timepix detector contributes significantly to the satellite data collection, with more than 25 000 sampling acquisitions in the first year of deployment. Despite limitations of the satellite attitude control system, necessary for capturing X-Ray images of the Sun, the Timepix detector allows measuring the space radiation environment along the satellite orbit. As of September 2018, we conducted 33 whole-Earth mappings, recording radiation doses around the planet. Further, we show data from scans of the South Atlantic Anomaly and polar radiation horns, where the location and acquisition time were tailored to minimize event pile-up and particle track overlap. Since October 2017, the optics segment of the onboard X-Ray telescope was deployed, which exposed the Timepix detector unshielded to free open space. This change produced entirely new observations namely of low energy charged particles and a significant increase of measured particle flux. We also registered the effects of exposing the sensor to direct intense sunlight. We will summarize on the actual performance of the custom readout interface, which exceeds expectations in the constrained environment of the low-cost and low-powered CubeSat nanosatellite.

Cinco descritores bioquímicos foram avaliados em algodoeiro infectados com o fungo causador da ramulose visando detectar respostas associadas à infecção. Sementes de quatro cultivares com diferentes níveis de resistência à doença foram semeadas em vasos plásticos, em casa de vegetação. Vinte dias após a emergência, as plântulas foram inoculadas com uma suspensão de 1 x 10(6) conídios/mL de Colletotrichum gossypii var. cephalosporioides. Folhas foram coletadas aos 3, 15 e 30 dias após a inoculação e utilizadas para determinação de prolina livre, catalase, peroxidase, carboidratos solúveis e proteínas totais. Verificou-se que os teores de prolina livre, peroxidase e catalase foram discriminadores na reação de plantas infectadas. Estes descritores apresentaram rápida resposta nos primeiros dias após a infecção das plantas, sendo mais expressivo na cv. resistente BRS Antares. Os descritores prolina livre e catalase podem ser utilizados como ferramentas auxiliares na identificação de cultivares resistentes à ramulose nos programas de melhoramento da cultura do algodão. Five biochemical descriptors were assessed in cotton plants infected with the ramulosis-causing fungus in order to detect differences associated with the infection. Seeds from four cotton cultivars with different levels of resistance were sown in plastic containers in greenhouse conditions. At 20 days after emergence, plants were inoculated with a suspension at 1 x 10(6) conidia/mL of Colletotrichum gossypii var. cephalosporioides. Leaves were collected at 3, 15 and 30 days after inoculation and free proline, catalase, peroxidase, soluble carbohydrates and total proteins were determined. Proline, peroxidase and catalase levels discriminated the reaction of infected plants. These descriptors changed soon after infection and the change was more evident in the resistant BRS Antares variety. Free proline and catalase descriptors can be used in the identification of ramulosis-resistant cultivars in cotton breeding programs.

Resumen pt: Vinte e nove linhagens intra-especificas de amendoim, geradas a partir dos parentais BR 1(Arachis hypogaea subsp. fastigiata, grupo Valencia) e Florunne...

Sugarcane (Saccharum officinarum L.) production is influenced by various abiotic stresses, including salt stress. Salinity can induce oxidative stress, which in turn damages biomolecules and cellular structures. However, such damage can be avoided or minimized by the enzymatic and non-enzymatic defense systems of plants. The aim of the study was to determine the effect of exogenous proline on Na+ and K+ content and on the activity of catalase, ascorbate peroxidase and peroxidase in two sugarcane genotypes (RB931011 and RB872552) grown in vitro under salt stress. The plants were grown for 20 days with or without 100 mM NaCl and exposed to 20 mM proline for varying period of time. The data were subjected to ANOVA factorial (two genotypes and five treatments), and the mean values were compared by Tukey test at a 5 % probability. Under salinity stress, both genotypes exhibited membrane integrity reduction, reduced total soluble protein content and unaltered or increased endogenous proline content. Exogenous proline reduced Na+ accumulation in a manner proportional to the exposition period at the amino acid. In both genotypes, antioxidant enzymes activity increased with the addition of NaCl. In conclusion, RB931011 genotype showed higher proline accumulation and increased in activity of the antioxidant enzymes, indicating better salt stress tolerance than in RB872552 genotype. La producción de caña de azúcar (Saccharum officinarum L.) está influenciada por varios factores abióticos desfavorables, como el estrés salino. La salinidad puede inducir el estrés oxidativo, que causa daño a las biomoléculas y a las estructuras celulares. Sin embargo, estos daños se puede evitar o minimizar por los sistemas de defensa enzimático y no enzimáticos de las plantas. El objetivo del estudio fue determinar el efecto de la prolina exógena en el contenido de Na+ e K+, y la actividad de la catalasa, ascorbato peroxidasa y peroxidasa en dos genotipos de caña de azúcar (RB931011 y RB872552) cultivados in vitro bajo estrés salino. Las plantas se cultivaron durante 20 días en presencia o ausencia de NaCl 100 mM y expuestos a prolina 20 mM durante un periodo de tiempo variable. Los datos fueron sometidos a ANOVA factorial (dos genotipos y cinco tratamientos), y las medias se compararon mediante la prueba de Tukey al 5 % de probabilidad. Bajo estrés salino, ambos genotipos mostraron reducción en la integridad de la membrana, disminución de las proteínas solubles totales y el mantenimiento o incremento en el contenido de prolina endógena. La prolina exógena reduce la acumulación de Na+ en proporción al período de exposición al aminoácido. En ambos genotipos, la actividad de las enzimas antioxidantes se incrementó con la adición de NaCl. En conclusión, el genotipo RB931011 mostró mayor acumulación de prolina y un mayor aumento de la actividad de la catalasa, ascorbato peroxidasa y peroxidasa, lo que indica una mejor tolerancia al estrés salino en comparación con el genotipo RB872552.

Heat shock proteins (Hsp) are moving from the category of basically intracellular chaperone molecules to important proteins in both innate and acquired immune responses, with great potential for clinical application as immunomodulators. Both proinflammatory and regulatory Hsp-reactive T cells have been described in animal models of autoimmune diseases. To investigate the role of autoreactivity to Hsp60 and Hsp70 in human transplantation, we analyzed, sequentially, peripheral blood mononuclear cell proliferation and cytokine production before and at different time points after renal transplantation, as well as the modulation of proliferation to Hsp in the presence of exogenous cytokines. Proliferation to Hsp60 and Hsp70 in the pretransplantation (pre-Tx) period was significantly associated with rejection episodes in the first months post-Tx. In contrast, IL-4 production was significantly associated with absence of rejection. Addition of exogenous IL-4 distinctly modulated the proliferative response to Hsp60; inhibiting proliferation in 83% of patients in the early post-Tx period (0-6 months), in which rejection episodes occurred, and inducing proliferation in 62.5% of patients in the later period (>12-24 months), when no rejection was observed. Characterization of autoreactive anti-Hsp60 regulatory T cells may permit new approaches to control the proinflammatory response to the graft, as well as aggressive autoimmunity.

In a prospective study of indirect alloresponse in renal transplantation, we detected proliferation and cytokine production to donor and third-party HLA-DR peptides unrelated to rejection. Twenty of 28 patients (71%) presented proliferation, 29% before and 71% after transplantation. Half of the patients also presented proliferation to third-party peptides. Indirect alloresponse was also detected in 75% of healthy individuals (HI). Variability of response was observed in patients and HI for both proliferation and cytokine production. IL-10 predominance was observed in indirect alloresponses to donor peptides pre- and post-Tx, in contrast with more IFN-gamma and TGF-beta being detected in HI. IL-10 production was frequently detected without proliferation, in contrast with more frequent proliferation being found with IFN-gamma and TGF-beta production. The lack of association of either cytokine or proliferation with rejection, together with the predominance of IL-10 unrelated to proliferation, suggests that regulatory cells may be part of the T cell repertoire involved in indirect alloreactivity.

Undoped multiple quantum well (MQW) samples grown by the molecular beam epitaxy method were irradiated by 5.15 MeV energy alpha particles. A strong influence of irradiation on the photoluminescence (PL) intensity was observed in these nearly intrinsic samples: the PL intensity at liquid nitrogen and room temperatures decreased by more than two orders of magnitude at alpha particle fluence of 10(exp 11) cm(exp -2). The dependence of the PL intensity on irradiation dose is described by a rate equation model that takes into account the generation of nonradiative point centers in barriers and wells of the MQW structure during irradiation.

The methodology of the coincidence instrumental activation analysis (CIAA) based on the three-parameter gamma–gamma coincidence spectrometer with two high-purity germanium (HPGe) detectors is presented. The flexible coincidence system was built on NIM spectrometric modules connected to VME or CAMAC data acquisition system, respectively. First results of the application of CIAA for the determination of scandium, cobalt, cesium or iridium contents by means of neutron irradiation are presented.

The aim of the present multicentre study is to assess health-related quality of life in patients with community-acquired sepsis, severe sepsis, or septic shock (CAS) 6 months after discharge from the intensive care unit (ICU) and to compare the health-related quality of life of the ICU survivors with CAS with ICU survivors with other ICU diagnoses.Prospective, multicentre study in nine combined medical and surgical ICUs in Portugal. Health-related quality of life was assessed 6 months after ICU stay, using EuroQol-5D (EQ-5D) mailed to patients. ICU-related factors were obtained from the local ICU database and the local database for the SACiUCI follow-up study.A total of 313 (52%) surviving patients answered the questionnaire, and of these 91 (29%) were admitted for CAS. There were no significant differences in health-related quality of life between the two study groups.Patients admitted to ICU for CAS did not perceived different health-related quality of life compared with ICU patients admitted for other diagnoses.

Radiation therapy with ion beams is a highly precise kind of cancer treatment. As ion beams traverse material, the highest ionization density occurs at the end of their path. Due to this Bragg-peak, ion beams enable higher dose conformation to the tumor and increased sparing of the surrounding tissue, in comparison to standard radiation therapy using high energy photons. Ions heavier than protons offer in addition increased biological effectiveness and lower scattering. The Heidelberg Ion Beam Therapy Center (HIT) is a state-of-the-art ion beam therapy facility and the first hospital-based facility in Europe. It provides proton and carbon ion treatments. A synchrotron is used for ion acceleration. For dose delivery to the patient, narrow pencil-like beams are scanned over the target volume.

Problems survivors face after intensive care unit (ICU) discharge begin while they are still in the ward, where many of their specific problems may run unrecognized, but they assume a heavy weight when they arrive at their homes and face several kind of limitations, from being unable to climb stairs because of weight loss, asthenia, dyspnea or joint stiffness to anxiety, depression or post-traumatic stress disorder. Follow-up consultations have given us a better understanding of these specific problems, and the information gained has been used to improve intensive care itself and promote a quality service for patients and relatives. The aim of this article is to provide an overview on adult ICU outcome studies and discuss how they have influenced and improved the delivery of intensive care. We will explain how we went from real patients to outcome studies and what we have learned concerning the consequences of critical illness and critical care. Development of outcome studies, what we have learned through them and our own experience will be outlined focusing mainly in four topics: mortality, physical disability, neuropsychological disability and health-related quality of life. Interventions to improve outcome on these main topics will be presented, and we will explain how we went from outcome studies to clinical interventions, focusing on the most recent proposals of intervention to improve outcome.

BACKGROUND: Delirium (acute brain dysfunction) is a potentially life threatening disturbance in brain function that frequently occurs in critically ill patients. While this area of brain dysfunction in critical care is rapidly advancing, striking limitations in use of terminology related to delirium internationally are hindering cross-talk and collaborative research. In the English literature, synonyms of delirium such as the Intensive Care Unit syndrome, acute brain dysfunction, acute brain failure, psychosis, confusion, and encephalopathy are widely used. This often leads to scientific "confusion" regarding published data and methodology within studies, which is further exacerbated by organizational, cultural and language barriers. OBJECTIVE: We undertook this multinational effort to identify conflicts in terminology and phenomenology of delirium to facilitate communication across medical disciplines and languages. METHODS: The evaluation of the terminology used for acute brain dysfunction was determined conducting communications with 24 authors from academic communities throughout countries/regions that speak the 13 variants of the Romanic languages included into this manuscript. RESULTS: In the 13 languages utilizing Romanic characters, included in this report, we identified the following terms used to define major types of acute brain dysfunction: coma, delirium, delirio, delirium tremens, délire, confusion mentale, delir, delier, Durchgangs-Syndrom, acute verwardheid, intensiv-psykose, IVA-psykos, IVA-syndrom, akutt konfusion/forvirring. Interestingly two terms are very consistent: 100 % of the selected languages use the term coma or koma to describe patients unresponsive to verbal and/or physical stimuli, and 100% use delirium tremens to define delirium due to alcohol withdrawal. Conversely, only 54% use the term delirium to indicate the disorder as defined by the DSM-IV as an acute change in mental status, inattention, disorganized thinking and altered level of consciousness. CONCLUSIONS: Attempts towards standardization in terminology, or at least awareness of differences across languages and specialties, will help cross-talk among clinicians and researchers.

A maternal mortality audit identified 106 cases of maternal death in Maputo (340 per 100 000 live births), caused by haemorrhage (31%), hypertensive diseases of pregnancy (15%), puerperal sepsis (12%) and septic abortion (9%). Puerperal uterine inertia (12%) and malaria (9%), respectively, were the most prevalent causes of direct and indirect maternal death. The maternal mortality audit analyses, indicated that health services research is fruitful in a more detailed, systematic study on maternal deaths at the community level wit ensuing analyses of avoidability aspects. Lack of transport and poor quality of antenatal and intrapartum care in peripheral maternity units implied that women with eclampsia, obstructed labor, post partum atonic haemorrhage and uterine rupture arrived late due to deficient transport.Shortage of blood and delay in access to operating theatre contributed significantly to fatal maternal outcome in several cases. The audit provided evidence that approximately 40% of the deaths would have been avoidable with existing resources. It is particularly significant that the analysis of antenatal cards revealed that only 30% had any high risk factors, implying that more than two thirds of women dying a maternal death are low risk women.

This paper gives a brief and qualitative overview of the principles of nuclear physics in the context of the physical microworld.

Central venous catheterization is commonly used in critically ill patients and may cause different complications, including infection. This type of infection contributes to morbidity, mortality and, as a consequence, to the increase in health care costs.

Cirrhotic patients admitted to the ICU are usually regarded as having a particularly poor prognosis when compared with other groups of critically ill patients. The aim of our study was to evaluate the prevalence, case mix and outcomes of patients with cirrhosis admitted to the general ICU of a nontransplant center.

SUMMARY. One of the most frequently occurring anatomic failures after laparoscopic fundoplication is migration of the wrap into the chest, with or without disruption. This so-called ‘slipped’ Nissen fundoplication may be the result of inadequate closure of the diaphragmatic crura or rupture of the sutures or disruption of the muscle fibers approached. From January 2000 to December 2002, a total of seven patients (four male) with a mean age of 56 years (range 22–72 years), were considered for laparoscopic antireflux procedure using DACRON mash to reinforce the crural hiatal closure. The patients were operated under general anesthesia; laparoscopy was performed by classical approach with five trocars. The mean operative time was 120 minutes (range 40–240 min). There were no deaths. The average of postoperative hospital stay was 3.5 days (range, 3–5). Patients returned to normal activities usually on postoperative day 10 (range, 7–15). The follow-up time was at least 2 years. There was only one late complication related to the use of DACRON mesh at the hiatus, due to migration of the mesh into the esophageal lumen causing disphagia. In conclusion the mesh repair antireflux surgery is a good alternative for closing the diaphragmatic defect in large hiatal hernias or to correct this problem in case of recurrence or Barrett's esophagus.

Summary form only given. Proteomics, focuses on the identification, localization, and functional analysis of the protein make up of the cell. It evolved from genomics, where the focus is on the information of one target molecule DNA. Genomics involves the high throughput sequencing of DNA and the subsequent data storage and annotation; the process is complex but there is only one genome for each organism. In contrast, the proteins present in a cell, together with their function, sub-cellular location, and structure change dramatically with the organ, and the conditions faced by their host cells including: age, checkpoint in the cell cycle, and external or internal signaling events. Thus, there will be many proteomes for each organism and consequently, the quantity and complexity of proteomics data will be orders of magnitude greater genomic data. Acquiring, analyzing, and interpreting these vast data sets requires a robust proteomics pipeline that integrates a series of high-throughput technologies to lead the researcher from experimental design to biological insight. Engineering this proteomics pipeline requires the integrated application of information technology, biomedical engineering, and bioinformatics to implement individual analyses, link the different stages together, maximize throughput, optimize the information extracted from the data, and provide a comprehensive overview of the results. Moreover, since proteomics is inherently collaborative, the proteomics pipeline must provide for the flow of information to and from researchers working at different stages of one project or different projects. The Montreal Proteomics network is undertaking ambitious project which aims to characterize the proteome(s) of the organelles that make up the mammalian cell. This paper will define the functional requirements of the proteomics pipeline required to support this project and describe the hardware/software architecture and implementation strategy adopted. It will then discuss key elements of the current pipeline, document its performance, and describe ongoing research aimed at improving its accuracy and throughput. Finally, it will describe how new technologies can be expected to impact the proteomics pipelines.

To study the development of tracheal stenosis after endotracheal intubation, percutaneous tracheotomy or both; to assess risk factors for tracheal stenosis and the relation of risk to endotracheal cuff pressure.A prospective study enrolling patients sustaining endotracheal intubation longer than 8 hours and/or undergoing percutaneous tracheotomy. Cuff pressure was recorded at the moment of intubation and every 8 hours thereafter; a ceiling of 25 mm Hg was targeted. The patients were examined 6 months after discharge.Sixteen percutaneous tracheotomies were performed in the 95 patients enrolled (58 men, 37 women). The mean age was 54.1 +/- 19.7 years. The mean APACHE II score for all patients was 16.3 +/- 7.7 and the mean intubation time was 7.3 +/- 11 days, whereas the respective means for patients undergoing percutaneous tracheotomy were 18.4 +/- 7.6 and 20.5 +/- 19 days. Six months after discharge, 55 patients were examined for laryngotracheal lesions by fiberoptic endoscopy. Twenty-three of the remaining patients had died, 7 were lost to follow-up and 10 were only interviewed by telephone. Fiberoptic laryngotracheal endoscopy revealed minimal scarring and reduction of the endotracheal lumen. Reduction of the lumen was observed only in patients who had undergone percutaneous tracheotomy.Monitoring cuff pressure three times per day seems to contribute to preventing ischemic lesions and tracheal stenosis.

The authors present their own experience on the installation of an in-hospital resuscitation programme, in a new tertiary hospital with 400 beds, an ICU with 8 beds and an emergency room 24 hours per day. The most important features presented are: the support by the Board of the Hospital, the engagement of all the health professionals, the distribution standardization and maintenance of the resuscitation equipment, the training in basic life-support techniques the doctors and nurses in the hospital, the performance of the cardiac arrest teams, all of which are fundamental to the maintenance of the chain of survival of cardiopulmonary resuscitation.

Evaluation of a hospital-wide resuscitation program at one year.All records of cardiac arrest calls were collected, logged in a database by the same operator, and analyzed. The cardiac arrest teams consist of a physician and a nurse with ALS (Advanced Life Support) training. Each team has a radio that is activated by a single emergency number. Only cardiac arrest calls were analyzed.Between March 1999 and March 2000 there were 173 emergency team calls. Of these, 120 were cardiac arrest calls (90 in-hospital and 30 from the emergency room--out-of-hospital cardiac arrests). Of the 90 in-hospital cardiac arrests, 61% were male, and median age was 73 years. In 90% of the calls, basic life support (BLS) was started before the arrival of the cardiac arrest team. The immediate cause was cardiac in 39% of the patients. Initial rhythm was ventricular fibrillation in 8%, asystole in 60% and other rhythms in 24% of the patients. Thirty percent presented return of spontaneous circulation (ROSC). There were no differences between those in whom BLS was started before the arrival of the cardiac arrest team and those in whom BLS had not been started. Ten patients (11%) were discharged from hospital. Of the 30 out-of-hospital cardiac arrests, 70% were male, and median age was 69 years. In 97% BLS was started before the arrival of the cardiac arrest team. The immediate cause was cardiac in 30% of patients. Initial rhythm was ventricular fibrillation in 10%, asystole in 73% and other rhythms in 17% of the patients. ROSC was achieved in 27% of the patients. Three patients (10%) were discharged from hospital. There were no differences either in ROSC or in survival to hospital discharge between in-hospital and out-of-hospital cardiac arrests. The state of health previous to cardiac arrest was significantly different between in- and out-of-hospital cardiac arrests: 3% versus 32% healthy, with no functional limitation. The authors conclude that: first, the current records do not enable all the desired goals of the "Utstein style" to be achieved and need to be reviewed; second, 90 to 97% of BLS previous to the arrival of the cardiac arrest team is a good indication of the efficiency of the hospital-wide program, which included training in BLS for all the hospital staff; third, the survival rate, although in accordance with much of the literature, could be improved.

Genes linked to the major histocompatibility complex (MHC), have been implicated in atopic asthma. Asthma is highly prevalent in the Venezuelan population (estimated at 20%) and genetic markers are needed to identify populations at risk and plan intervention strategies.To study the influence of the MHC class I and class II genes in the susceptibility to atopic asthma.MHC-class I HLA-A, -C, -B and MHC-class II HLA-DR, -DQ, -DP gene haplotype frequencies were determined in 135 Venezuelan mestizos, 71 belong to 20 atopic asthmatic families and 64 unrelated controls. The index cases were 20 atopic asthmatics with positive skin-prick tests and specific serum immunoglobulin E (IgE) for Dermatophagoides pteronyssinus (Der p) and Dermatophagoides farinae (Der f). To ascertain the genes associated with susceptibility to atopy and/or asthma, two control groups were studied, 41 non-atopic subjects with skin-prick negative test, and undetectable levels of specific IgE and 23 non-asthmatic atopic subjects with detectable specific IgE to Der p and Der f. A linkage analysis was performed in those families with two or more atopic siblings (with or without asthma).MHC-class I genes analysis showed that HLA-Cw7 was absent in the asthmatic patients studied, whereas the frequency of this allele was 14.3% in non-atopic controls (P = 0.0 17, PC = 0.19) and 20.8% in the atopic controls (P = 0.0066, PC = 0.07). MHC-class II gene analysis showed a significant increase of the HLA-DRB1*11 in the asthmatic patients compared with non-atopic controls (allele frequencies of 25.6 vs 4.4% P = 0.0017, PC = 0.02). There were no significant differences among asthmatic and atopic controls in the frequency of HLA-DRB1*11 (25.6 vs 17.4%). In contrast, the HLA-DRB1*1101+ haplotypes were significantly higher in asthmatics compared with atopic and non-atopic controls (19.6% vs 2.2% vs 2.3%, PC0.05). The HLA-DRB1*1101, DQA1*0501, DQB1*0301 haplotype was found significantly increased in the patients vs non-atopic controls (15.4 vs 1.1%, PC0.01). The serum levels of specific IgE were detectable in both atopic asthmatics and atopic controls; however, it was higher in atopic asthmatics vs atopic controls Der p (median, 58.7 vs 2.7 kU/L, P0.001) and Der f (median, 46.9 vs 2.7 kU/L, P0.001). No linkage between MHC genes and mite-atopy could be documented on informative families with two or more atopic siblings.We have identified an association between the haplotype HLA-DRB1*1101, DQA1*0501, DQB1*0301 and atopic asthma that confers susceptibility to develop mite-sensitive asthma to atopics (relative risk, RR 8.2), and to non-atopic controls (RR = 15.8) that carry this haplotype. Conversely, the allele HLA-Cw7 was absent in the asthmatics studied and had higher frequencies in the atopic (RR = 0.05) and non-atopic (RR = 0.08) controls. Thus, it may have a protective role for developing atopic asthma in the population studied.

Analisa a produção científica do curso de pós-graduação do Instituto de Psicologia da Universidade de São Paulo (IPUSP), no período de 1980 a 1989, para identificar aspectos relevantes à sua caracterização e traçar um perfil do trabalho de pesquisa realizado naquele decênio. Utiliza formulário para registro dos dados e aplica a técnica da análise de conteúdo aos resumos dos trabalhos, para obtenção dos dados quanto a: tipologia da pesquisa; características dos sujeitos focalizados nos estudos; delineamento de pesquisa empregado; local de realização da coleta de dados; constructo psicológico focalizado; instrumento de pesquisa utilizado. Apresenta análise descritiva dos dados baseada nas distribuições de freqüência e tabulações cruzadas das variáveis de interesse. Constata que o IPUSP realiza primordialmente pesquisa de campo; utiliza preferencialmente grupos humanos de ambos os sexos, nas faixas etárias de crianças e adultos, das classes econômicas menos favorecidas; a metodologia predominante é o Levantamento, realizado no contexto escolar e utilizando entrevista; o constructo mais freqüente pertence ao grupo de assuntos ligados ao ensino e aprendizagem; os pós-graduandos levam em média 5,5 anos para concluir o mestrado, e outro tanto para chegar ao subseqüente doutorado; quando passam ao doutorado, tendem a manter a mesma área de concentração do mestrado, mas mudam a metodologia. Analyzes theses and dissertations from the Institute of Psychology at the University of São Paulo (IPUSP) from 1980 to 1989 to identify relevant aspects to define its characterization, and to establish a research work profile accomplished in that decade. Uses forms for data registration and applies the content analysis research technique to the abstracts of those studies to obtain data referring to: type of research; characteristics of subject focused in those dissertations; research strategy employed; site of data collection; psychological subject focused; research instruments most used. Presents a descriptive analysis of data based on frequency distributions and crossed tabulations of the variables of interest. Realizes that IPUSP is involved primarily with field research; uses preferably human groups of both sexes, children and adults from less privileged economical classes; the predominant methodology is descriptive research (concentrating on interviews) applied to school environments; most frequently subject is related to teaching and learning; graduate people take about 5,5 years to conclude their masters degree and just as long to accomplish their subsequent doctorate; they usually keep the same subtect area of their masters, but change the methodology.

Respiratory viral infections are usually self-limited in adults but 4 to 30% can be clinically severe and lead to intensive care needs. The aim of this study was to determine the impact of viral respiratory infections in an intensive care setting and the role of systematic viral testing in patients admitted to an ICU.