In der vorliegenden Arbeit wurde das Outcome von 112 Patienten mit intrakranieller Blutung analysiert, um das Blutungsvolumen und die unterschiedliche Dynamik der Blutungen als Einfluss- und prädiktive Faktoren zu korrelieren. 21.4% der 112 eingeschlossenen Patienten hatten ein EDH, 38.4 % ein SDH- bzw. 40.2% ein Intrazerebralhämatom. Die Sub- und Epiduralhämatome waren mehrheitlich traumatische Läsionen, die intrazerebralen Blutungen vorwiegend spontane. Im Gesamtkollektiv hatten 28.6% ein funktionelles, respektive 71.4% ein nicht funktionelles Outcome. Das Ergebnis der 71 traumatischen Blutungen war signifikant besser (38.0% funktionell) als das der 41 spontanen (12.2% funktionell, p=0.004). Bei gleichem Hämatomvolumen haben operativ versorgte spontane Blutungen eine 88% geringere Chance für ein funktionelles Ergebnis als operierte traumatische Blutungen. Im Untersuchungskollektiv wurde der reziproke Zusammenhang von Volumen und GOS sowohl für spontane und traumatische, als auch für akute und subakute Blutungen demonstriert. Nicht signifikant verschieden waren akut und subakut verlaufende Blutungen bezüglich ihres Outcomes (32.8% vs. 23.5% funktionelles Outcome, p= 0.302), und der Volumina (47.5ml vs. 52.8ml, p=0.102)). Der vermutete Zusammenhang zwischen Hämatomgröße und zeitlichem Verlauf konnte damit nicht gezeigt werden. Wir fanden auch keinen signifikanten Unterschied des klinischen Ergebnisses in Bezug auf den chirurgischen Interventionszeitpunkt (< 6h vs. > 6h). Bei den traumatischen Hämorrhagien wurde ein Modell mit 3 unabhängigen Faktoren (Alter, initaler GCS und Volumen) zur Prädiktion des Outcomes entwickelt. Kleine Volumina, ein niedriges Alter und ein initial hoher GCS lassen ein funktionelles Outcome vorhersagen. Weitere Faktoren, die jedoch nicht unabhängig mit dem Outcome assoziiert waren, sind Mittellinienverlagerung, initiale Blutglukose, Vorliegen eines Hirnödems und arterielle Hypertonie. Die initiale Glukosekonzentration kann zur Vorhersage des Outcomes nach traumatischen Blutungen beitragen, Als einziger unabhängiger Prädiktor wurde bei den spontanen Raumforderungen die Mittellinienverlagerung ermittelt. Volumen und initiale GCS waren nicht unabhängige Prädiktoren. Das schlechte Outcome nach spontaner Blutung, unabhängig vom Versorgungszeitpunkt, unterstreicht die kontroverse Datenlage bezüglich operativer Therapie dieser Raumforderungen. Traumatische Hämorrhagien in temporaler Lokalisation zeigen ein besseres Ergebnis als vergleichbare lokalisierte spontane Blutungen.

In der vorliegenden Arbeit wurde das Outcome von 112 Patienten mit intrakranieller Blutung analysiert, um das Blutungsvolumen und die unterschiedliche Dynamik der Blutungen als Einfluss- und prädiktive Faktoren zu korrelieren. 21.4% der 112 eingeschlossenen Patienten hatten ein EDH, 38.4 % ein SDH- bzw. 40.2% ein Intrazerebralhämatom. Die Sub- und Epiduralhämatome waren mehrheitlich traumatische Läsionen, die intrazerebralen Blutungen vorwiegend spontane. Im Gesamtkollektiv hatten 28.6% ein funktionelles, respektive 71.4% ein nicht funktionelles Outcome. Das Ergebnis der 71 traumatischen Blutungen war signifikant besser (38.0% funktionell) als das der 41 spontanen (12.2% funktionell, p=0.004). Bei gleichem Hämatomvolumen haben operativ versorgte spontane Blutungen eine 88% geringere Chance für ein funktionelles Ergebnis als operierte traumatische Blutungen. Im Untersuchungskollektiv wurde der reziproke Zusammenhang von Volumen und GOS sowohl für spontane und traumatische, als auch für akute und subakute Blutungen demonstriert. Nicht signifikant verschieden waren akut und subakut verlaufende Blutungen bezüglich ihres Outcomes (32.8% vs. 23.5% funktionelles Outcome, p= 0.302), und der Volumina (47.5ml vs. 52.8ml, p=0.102)). Der vermutete Zusammenhang zwischen Hämatomgröße und zeitlichem Verlauf konnte damit nicht gezeigt werden. Wir fanden auch keinen signifikanten Unterschied des klinischen Ergebnisses in Bezug auf den chirurgischen Interventionszeitpunkt (< 6h vs. > 6h). Bei den traumatischen Hämorrhagien wurde ein Modell mit 3 unabhängigen Faktoren (Alter, initaler GCS und Volumen) zur Prädiktion des Outcomes entwickelt. Kleine Volumina, ein niedriges Alter und ein initial hoher GCS lassen ein funktionelles Outcome vorhersagen. Weitere Faktoren, die jedoch nicht unabhängig mit dem Outcome assoziiert waren, sind Mittellinienverlagerung, initiale Blutglukose, Vorliegen eines Hirnödems und arterielle Hypertonie. Die initiale Glukosekonzentration kann zur Vorhersage des Outcomes nach traumatischen Blutungen beitragen, Als einziger unabhängiger Prädiktor wurde bei den spontanen Raumforderungen die Mittellinienverlagerung ermittelt. Volumen und initiale GCS waren nicht unabhängige Prädiktoren. Das schlechte Outcome nach spontaner Blutung, unabhängig vom Versorgungszeitpunkt, unterstreicht die kontroverse Datenlage bezüglich operativer Therapie dieser Raumforderungen. Traumatische Hämorrhagien in temporaler Lokalisation zeigen ein besseres Ergebnis als vergleichbare lokalisierte spontane Blutungen.

Bakgrund: Patienter som ventilatorvårdas på intensivvårdsavdelning behöver ofta någon form av lätt sömn (sedering) för att tolerera endotrachealtuben och ventilatorbehandling. De traditionella intravenösa läkemedel som ges har lång halveringstid och det är stor risk för kvardröjande effekter. Syfte: Denna pilotstudie syftar till att studera sederingsdjupet enligt MAAS hos de patienter som blivit sederade med inhalationsgas, kontrollera vakenhetsgraden enligt GCS hos dessa patienter efter avslutad sedering, samt beskriva vilka patientgrupperna är som fått inhalationssedering. Metod: Journalgranskning där resultatet har analyserats och kategoriserats, därefter har en sambandsanalys gjorts. Resultat: I resultatet identifierades 3 patientkategorier som fått isofluransedering: patienter med hotad luftväg som förväntats behöva kort sederingstid och snabb väckning, patienter som var svåra att sedera optimalt med intravenös metod samt patienter med organsvikt där risk för ackumulation och/ eller förlängd elimination av läkemedel förelåg. Något samband mellan MAAS 12 timmar före extubation och GCS- värde efter väckning hos de 14 patienter som ingick i studien har inte kunna styrkas. Konklusion: Inhalationssedering med isofluran förefaller vara en effektiv sederingsmetod när en lättstyrd sederingssituation med möjlighet till snabb väckning prioriteras, samt när man strävar efter att patienten ska uppnå 14-15 i GCS- värde så snart som möjligt efter väckning och extubation. / Background: Patients which are nursed by ventilator at the intensive care unit often need some form of sedative in order to tolerate an endotracheal tube and the ventilator treatment. The traditional intravenous drugs have a long half- life and potential risk for lingering effects. Aim: This pilot study aim to study the depth of sedation according to MAAS with the patients having been sedated with inhalation gas, check alertness according to GCS with these patients after completion of sedation, and describe which group of patients that have received inhalation treatment. Method: Journal Review where the result have been analysed and categorized then a link analysis has been made. Result: In the result three patient categories were identified which had received isoflurane sedation: patients with threatened airway and expected short time of sedation and fast wake- up, patients which were difficult to sedate optimally with intravenous method, and patients with organ failure where risk for accumulation and/ or  extended elimination of drugs were expected. Any relationship between MAAS 12 hour prior to extubation and GCS- score after awakening with the 14 patients included in the study have not been established. Conclusion: Sedation by isoflurane inhalation seems to be an effective sedation method when an easily controlled sedation situation with the possibility of a fast awakening are prioritized as well as when the strive is to achieve a GCS- score of 14-15 as soon as possible after awakening and extubation.

No description available.

Os neutrófilos estão entre as principais células da imunidade inata e são as primeiras células a migrarem para o sítio de infecção. O BAY 41-2272, estimulador de guanilato ciclase solúvel, é capaz de ativar fagócitos mononucleares e em neutrófilos diminuir migração in vivo e in vitro. O presente trabalho teve como objetivo avaliar o potencial do BAY 41-2272, e sua via, como uma ferramenta farmacológica para modulação da função dos neutrófilos. Para isso foi realizado o tratamento in vitro dos PMNs com o BAY 41-2272. A viabilidade celular, quimiotaxia e funções efetoras como burst oxidativo e produção de citocinas foram avaliadas, observando-se que o BAY 41-2272, como ativador direto, não altera estas funções. No entanto, o pré-tratamento com BAY 41-2272 nas doses de 3 M e 30M por uma hora, com subsequente ativação com PMA, mostrou perfil inibitório na quimiotaxia, produção da citocina IL-8 e no burst oxidativo . Foram avaliados também a expressão de moléculas como CD15, CD31, CD35, CD49d, CD63, CD66b, CD162 e a produção de GMPc. As moléculas de superfícies não mostraram alterações após tratamento direto com BAY 41-2272. A produção de GMPc foi induzida na dose de 30 M de BAY 41-2272 e pelo SNAP (doador de NO). Esses dados sugerem um potencial inibitório do BAY 41-2272 sobre a ação dos neutrófilos, e uma possível alternativa a ser explorada em seus aspectos translacionais na busca por novas terapias destinadas ao controle de doenças ligadas a inflamações crônicas e doenças auto-imunes. / Neutrophils are the major cells of innate immunity and are the first cells to migrate to the site of infection. BAY 41-2272, a soluble guanylate cyclase stimulator, is capable of activating mononuclear phagocytes and in neutrophils decreasing migration in vivo and in vitro. The present work aimed to evaluate the potential of BAY 41-2272, and its pathway, as a pharmacological tool for modulating neutrophil function. For this, the in vitro treatment of PMNs with BAY 41-2272 was performed. Cell viability, chemotaxis and effector functions such as oxidative burst and cytokine production were evaluated, observing that BAY 41-2272, as a direct activator, does not alter these functions. However, pretreatment with BAY 41-2272 at the doses of 3 M and 30 M for one hour, with subsequent activation with PMA, showed an inhibitory profile in chemotaxis, IL-8 cytokine production and in the \"oxidative burst\". We also evaluated the expression of molecules such as CD15, CD31, CD35, CD49d, CD63, CD66b, CD162 and cGMP production. Surface molecules did not show changes after direct treatment with BAY 41-2272. The cGMP production was induced at the dose of 30 M BAY 41-2272 and for SNAP (NO donor). These data suggest an inhibitory potential of BAY 41-2272 on the action of neutrophils, and a possible alternative to be explored in its translational aspects in the search for new therapies aimed at the control of diseases linked to chronic inflammation and autoimmune diseases.

OBJECTIVES: The S100B protein subgroup is a thermolabile acidic calcium-binding protein. S100B protein was first described in the central nervous system. Destruction of the nerve tissue results in S100B protein release from astrocytic glial cells and elevation of its levels in the cerebrospinal fluid. If the blood-brain barrier is also damaged, S100B gets into the systemic circulation and elevated blood levels of S100B are detected. Higher S100B serum levels in patients with head injury are predictive of possible development of secondary brain injury and the extent of permanent injury to the CNS. MATHERIAL AND METHODS: The authors present their results obtained in the group of 39 children aged 0 (newborns) to 17 years with isolated craniocerebral injury. RESULTS: Our group included 39 children aged 0-17 years. Excellent results (GOS - Glasgow outcome scale 4-5) were observed in 33 patients already at the time of transfer from our ICU to the neurological department. There was no death and the poor outcome group included only 6 children. Second GOS evaluation was performed 6 months later, when 36 children were in the GOS 4-5 group and only 3 children in the GOS 2-3 group. CONCLUSIONS: Due to high variability in S100B protein serum levels in children depending on age and gender, no correlation between...

The topic of this thesis is ?Nursing care for patients with craniocerebral trauma?. Three goals were set. We tried to find what the specifics of nursing care for patients with craniocerebral trauma are. We also examined whether nurses were aware of the specifics of nursing care for patients with craniocerebral trauma. The last goal was to find out whether nurses used basal stimulation in these patients. The research was based on a non-standardized interview. The interviews were performed with twelve nurses caring about these patients in the České Budějovice Hospital and the Faculty Hospital Královské Vinohrady. Three research questions were set. 1: What are the specifics of nursing care for patients with craniocerebral trauma? The research has shown that elevated head position, monitoring of GCS, pupil state and response, administering of bolus analgosedation doses in some nursing activities, ensuring detention administration and list of valuables are the specifics. We have also included CT examination, pre-operation preparation, care of invasive inputs, drains, operation wounds, careful handling with patients, constipation problems, care of a disturbed or aggressive patient and special approach to communication with these patients. 2: Are nurses aware of the specifics of nursing care for patients with craniocerebral trauma? We found that respondents knew the above mentioned specifics. However we found two drawbacks. The first one was in the unawareness of the possibility to increase ICP during defecation among the respondents, the other one was in communication with disturbed or aggressive patients. 3: Do nurses use basal stimulation in patients with craniocerebral trauma? The research has shown that the respondents do apply the concept of basal stimulation, but they only use some of the stimulation elements. This thesis may serve as study material for new nurses starting at the department, where they will care about these patients. The research results and the Standard nursing procedure of Basal stimulation elaborated by us will be offered to managers of both the hospitals where the interviews with nurses were performed.

This thesis is at the intersection of migration and labour in tourism and the hospitality sector. Empirically, this study explores the experiences of well-trained migrant dishwashing employees (DE) in restaurants in Copenhagen, Denmark and aims to understand their motivation for migration. They, while acquiring hospitality sector experience, struggle beyond the workplace to fulfill their intentions of long term settlement. The study explores how they face resistance to labour market access and participation based on their skills and experience. The focus of this qualitative study is on the highly skilled Green card Holders (GCH) of Denmark, majority of who are stuck as DE in the restaurant industry. This master thesis argues about the challenges of employability, underutilization of foreign education credentials and work-life struggle. A sizable proportion of GCH have managed to find jobs and are working as DE. Qualified professionals like IT specialists, teachers, accountants, and engineers face unanticipated challenges that are explained through open-ended unstructured interviews with GCH. These professionals are still working as DE or have left the Danish labour market. Further, this thesis explores how these DE are struggling to lead the routine life of an expat. I have discussed the significance of job satisfaction as blue- collar employees in the host country and compared it with white-collar job experience from their respective home countries. GCH migrants from Asian countries in Denmark have come under the spotlight during this study. This study provides unique insights from their experience as a DE, exploitation of human capital flight, feelings of humiliation and discrimination of GCH despite being well trained employed back home. Highlighting some of the challenges as a migrant DE, it makes a strong case for reviewing national policy towards them. / <p>2022-01-22</p>

Ground subsidence due to underground coal mining is a complex, narrowly-understood phenomenon. Due to the complicated physical processes involved and the lack of a complete knowledge of the characteristics of overlying strata, the reliability of current prediction techniques varies widely. Furthermore, the accuracy of any given prediction technique is largely dependent upon the accuracy of field measurements and surveys which provide input data for the technique. A valuable resource available for predicting and modeling subsidence is aerial survey technology. This technology produces yearly datasets with a high density of survey points. The following study introduces a method wherein these survey points are converted into elevation plots and subsidence plots using GIS. This study also presents a method, titled the Type-Xi Integration method (TXI method), which improves upon a previous subsidence prediction technique. This method differs from the previous technique in that it incorporates accurate surface topography and considers irregular mine geometry, as well as seam thickness and overburden variations in its predictions. The TXI method also involves comparing predicted subsidence directly to measured subsidence from subsidence plots. In summary, this study illustrates a method of combining data from aerial survey points and mine geometry with subsidence models in order to improve the accuracy of the models.

No description available.